CHAPTER VI. INFECTIOUS DISEASES AND THEIR (Part 6)

kidneys and lU'inary canals are the most important functions of the body. The efficiency of these excretory organs is ab.solutely necessary to health and life. Disturbances of these organs lead to ill-health, disease and i)remature mor- tality. Intestinal elimination is another of the most impor- tant functions of the body. Intestinal stasis and habit- ual eonstipatif)n are foes of health and life. The in- gestion of foods containing a large percentage of cellulose, the eating of vegetables, bran constitutents of cereals, and other bulky foods are necessary for the proi)er intestinal digestion and elimination. Bodily activity and e.xerci.se are also conducive to the same result. Personal Hygiene of the Child. — This difTers in its I)ractical a|)plication according to age. There is neces- sarily a dilVerence in the rules and regulations for the care and i)roinotion of health of infants, of children under school age, of school children, and of athtlescents. The general j)riticiples, howe\er, are identical with 250 PERSONAL HYGIENE those which have Ijeen descril)e(l as rehiting to all persons, whether children or adults. The rules of health are essentially those of proper feeding, clothing, exercise, bathing, and physical and mental training. Infants and young children demand more attention and closer supervision than do the older children. Milk and milk foods are almost the exclusive articles of food for infants under one year. There is at present a tendency to regard the digestion of raw cows' milk as difficult in view of its immediate curdling wnthin the stomach. The objections against pasteurization and sterilization of milk for infants' foods are not considered serious. The modification of milk by chang- ing the percentage of the proteid and fat constitutents has become a regular practice in infant feeding. As to clothing of infants, the opinion seems to prevail that woollen garments have the advantage over cotton and linen. The exposure of the legs or other parts of the body is to be avoided. Bathing in tepid water, 100° to 110° F., is best done before the last feeding in the evening. Regularity in the discharge of the bowels should be encouraged. Sponging with water, 70° to 90° F., is a good routine practice in the morning. As the child grows older, cereals, fruits, vegetables, and bread products may be added to the diet. The feedings should be at regular periods. Evening bathing in tepid water and morning sponging with cool water should be continued, and physical exercise and play should be encouraged. Young infants as well as older children should be kept in the fresh air as much and as long as possible. I'!-:h'S<>.\M. IIYCIF.SK OF TUK (Ull.l) L'.'.l (hitilnor l>l;iy ninl cNcrcisc for older cliildrcii --iKiuld Kc ciicdurau'fd. Siiirar ;iiid coiilcctiitiicry scciii tn lir urll Ixn'iu" and diiii'stctl hy cliildrcii. Tlicy slioiild not l)c used ill excess, however, or in the intervals hetween f"ee(linji;s. l)Ut should he udvcn (hiring each t'ecdiii<:. A slight rise of teniporaturc in children is no indi- cation of pathological conditions, as it may he cansed hy overfeeding, constijiation, diarrhea, excitement, etc. The care of infants and chiidi-cii during sickness cannot he discussed here. The hygiene of the school child has heeii discussed in Chapter 1. hut nieiitioii must he made here of the eare of school children in their homes. The gain is slight if hygienic conditions surroimd the child in the school, hut are neglected in the home. Instruc- tions should he given to mothers in the care, feeding, etc., of the school child while it is in the home, so as not to coimteraet the heneficial iniluences of school life. The most important rule for the care of the school child while in its home is the proper provisi(ni of suhstantial and digestihle hreakfasts so that the child does not leave the house fasting or hungry, .\fter the child is confined within the school for a niiinher of hours it is the duty of its parents to keep it in the fresh air and to allow it to i)lay and exercise outdoors during the part of the da>' when it is out of sdiool. Too niaiiN children are given home tasks and too many children are unfortunately comi)elled to do some home work during the afternoons and e('nings after school hours. Huring adolescence the ucr\ous cJiuilihrium is easily (listuri)e(l and much intelligent care is ncce.s.sary to i^revent ner"ous l)reak-<|own. Intelligent instruc- 252 PERSONAL HYGIENE tiun in the elements of physiology and in sexnal hygiene is necessary for the ])roinotion of the health of the child and for the prevention of varions indiscretions and abnses. Personal Hygiene of the Aged. — The personal hygiene of the aged differs greatly from the hygiene of younger persons. There is considerable difference in the exact age when a person seems or becomes old. Some are old at thirty, while others are young at seventy; nor does old age come on suddenly without previous due notice. Rather it creeps on gradually and slowly. A person is said to be as old as his heart and his arteries. The main indications, therefore, for the care of the aged is in the care of the circulatory system and the prevention of overstrain and fatigue. Indiscretions, overindulgence, exposure, and irregular life are more dangerous in the old than in the young, for the recuperative powers are much lessened in the aged. IVIuch less sleep is needed by the aged, although more prolonged periods of rest are necessary. Too strenuous exercise must be avoided. There is need of much less food and there is greater danger from overfeeding. Bathing with cold water must be done with care, and perhaps avoided, unless the body is accustomed to the effects of cold water. The effects of certain shocks are dangerous. Warm woollen clothing should be worn in moderate as well as in cold weather. The best exercise for the aged is walking outdoors. Golfing is considered a good exercise for the aged who can afford it. There are very few hard-and-fast rules for the aged as well as for the young. Constitutional differences and environmental I'I-:RS<)..\I. IIYdlF.SF. OF THE SICK 2.'):') (•(iiidit itttis iii\ ,ili(l;itf iiiii\ ('r>;il ;iiiil iiiiit'in'iii l.iws ol" licaltli. Personal Hygiene of the Sick. Tlu' rulos miidiii^; tlif iiiir^c ill the rare ol' tlic ill. the coiivjilcsccnt, and tlif di^ca^rd iim>t necessarily diU'er aecdrdinL,^ tdtlie auf ami conditiiin of the sick person, and especially a<(«)rdiiii: to tlie character, degree, and severity of the di.sease fn )ni which the ])ers()n sutt'ers. Here, again, (•(ininioii sense and intelliu'eiice are ])erhaps more important than set rules and regulations. The feeding of sick persons must he done with care and according to the instructions of the physician, who alone is competent to judge of the necessary amounts of food retjuired as well as of the kinds of food needed. As a rule, sick i)ers(»ns need more digestihle and hettcr prepared foods, at more fre- fpicnt intcrxals, than do well ])ersons. The nurse should learn the art of ])rci)aring certain foods and articles of diet which are ai)propriate for the sick. The hathing of sick ])er.sons is a procedure which should he done only according to the directions of a l)hysician. Cold water must he u.sed judiciously and with great care. IJed-ridden patients need special care to i)revent hed-sores. This can he accomplished hy proi)er care of the hed and hcdding. hy smoothing out all wrinkles in the hcdding, l)- approi)riate suj)- port under the sacnun and heels, which arc the places principally ail'ectcd hy hed-sores, and hy massage of the hody and s])ccial parts of the hody as well as l)y alcohol nitis, inunctions, etc. INDEX. Al'CIDKNTS ill ocelli i;i I inns, ISt'i provtMitiiiii tif, 1st) Aci'tylciu" )ian. 2S Adultn-atidii of foods, '.)',) of moat, 100 of milk, 12S Aped, personal hygiene of, '2.V_' Afients of transiiiissi<in of in- fect iniis diseases, I'.IS Air, caihonic acid in, 30 increase and decrease of, :i3 changes due to coinlmstion anil illumination, 31 in houses, 31 composition of, 30 coiilined, '.V2 character and elTects of, 32 ditTusion of, 30 ill etTects caused hy imi)ure,33 im]nirities in, 31 influence of, upon health, :52 moisture in, 30 sewer, (il Alliuminoids in milk, 1 17 Animals, 7'.t ilomestic, T'.t .(iue(luets, 4S Arsenic poisoning, 179 Artificial light, 27 B Back jiressure traps, tio Bacteria, infection of meat hv, 102 in milk, 112, 132 Bacterial di.seases, 1115 Bacteriology, 10 i^.ith tiil.s, 70 Berkefeld filler, ry.i Blended nulk, 123 Brass pijie in plumhing, oU Buililing, school, 153 Butter, 124 Buttermilk, 12-4 (\LORir value of foods, 245 Carbohydrates in foods, 01 Langworthy on, 03 Huliner on, 03 ('art)oii dioxide, 74 monoxide, 74 Carbonic acid in air, 30 Ca.sein in milk, 117 Cellulose in foods, 02 Central heating, 30 ( 'esspools, 57 Chadwick on .sanitarv science, 10 Ch(>ese, 125 Chemical cleansing of water, 51 comiiosition of foods, 00 Chihl labor, 1S2 personal hygiene of, 240 sch«)ol, 14s Chimneys, role of, in ventila- tion, 35 Cholera, milk and, 1 14 Cleaning of house, SI of school building, I5ti Coal gas, 2S Colostnnn in milk, 120 Composition of water, 42 256 INDEX Condensed milk, 124 Conservation of human re- sources, 20 Construction of school building, 153 Contagious diseases of school child, 161 Cost of foods, 94 Cow's milk, 116 Cream, 122 gauge in milk testing, 143 production of, 122 Cresols, disinfection by, 213 Dangers in occupations, 177 prevention of, 185 Definition of disinfection, 209 of foods, 89 of hygiene, 18 of milk, 127 of sanitary art, IS law, 18 science, 18 of sanitation, 18 of traps, 63 of ventiktion, 34 Deterioration of milk, 131 Dietetics, 93, 244 Diphtheria, milk and, 114 nurse in, 231 Disease, insects in, 81 main causes of, 22 relation of, to housing, 24 water and, 43 Diseases associated with hous- ing conditions, 24 due to milk, 113 infants', milk and, 113 of occupations, 169 parasitic, due to meat, 101 possible prevention of, 22 water-borne, 44 Disinfection, 208 chemical, 212 cresols in, 213 definition of, 209 difficulties of, 208 formaldehyde gas in, 215 hme in, 215 Disinfection, physical, 210 practice of New York City Health Dejiartment in, 218 of rooms, 216 of soiled wash, 218 sulphur dioxide in, 215 of walls, 216 Distillation, water, 50 District nurses, 227 general duties of, 228 outfit of, 228 Dust, dangers of, in house, 78 and dirt, 76 dangers of, 77 Prudden, Dr., on removal of, 77 in occupations, 185 prevention of, 185 Dj'sentery, milk and, 114 E Effect of occupation on health, 170 Electricity, heating by, 39 Emergency and first-aid treat- ment in schools liy nurse, 162 Endemic diseases, 194 Epidemic diseases, 194 Erysipelas, nurse in, 239 Estimate of food values, 92 Expectation of life, 20 Exposure in infectious diseases, 193 Factories, functions and duties of nurse in, 189 Factory inspection, 186 Farr on sanitary science, 19 Fats in foods, 91 in milk, 117 P^erments in milk, 118 Feser's lactoscope, 144 Filters, Berkefeld, 53 Filtration of water, 50, 51 Fire escapes, 26 exits in case of* ^6 protection, 25 in housing, 25 Fish foods, 109 INDEX Fisher, Professor I., on proloii- pation of life, '22 First-aid kits. 1S<) Kixturt's, plmnliiiit:. tUi, 70 Komitcs. •_'()() Foods, S9 adulteration of, 09 l>akinti of, 9o hoilinn of, 05 calorir value of, 245 canning of, OS carliohydratcs in, 01 care, storage ami jireservation of, 00 cellulose in, 02 chemical comjMisition of, 00 cooked, 05 cost of, 04 definition of, SO dietetics and, 244 ilrying of, 07 estimate of values of, 02 fats in, 01 frying of, 96 game, lOS high temperatures of, 08 milk as, 110 mineral matters in, 01 poultry, 108 ])reparation of, 03, 05 jirepared, 95 preservation of, 06 protein in, 00 raw, 95 roasting of, 06 salting and pickling of, 98 smoking of. OS steaming of, 06 stewing of, 05 storage of, 0(> temperature influence on, 97 vitamins in, 02 water in, 01 Fore-milk, 121 Formalilehvde gas, disinfection hy, 215 ■ Fumes in occupations, 180 (;.\MK, lOS Gas, acetylene, 28 17 Gas, coal, 28 fixtures, 20 heating hy, 39 service, 29 sewer, non-existent, 61, 62 shades, 20 Gases, carbon dioxide, 71 carbon monoxide, 71 fumes and vapors in occu|)a- tions, ISO house, 74 in occupations, 180 poisons and, 74 smoke and coal-gas, 75 water, 20 Glass, milk, 27 plate, 27 prism, 27 in windows, 27 Habitations, hygiene of, 24 Health Department, New York City, practice in regard to disinfection after infectious diseases, 218 insurance, 187 lactometer for milk testing, 146 occuixitions and, 16() water and, 42 Heating, 37 central, 39 electricity in, 39 gas in, 39 grates in, 38 hot-water, 40 local, 38 means and methods of, 38 regulation of, 41 school, 155 steam in, 41 advantages of, 41 stoves in, 30 Heeren pioscope, 144 Home work, 174, 184 Hot-water heating, 40 supply of, 40 House cleaning, 81 means and methods of, 86 258 INDEX House drain, 60 drainage, 54 insects in, 80 poisons, 75 sewer, 60 waste matters of, 73 water supply of, 48 Housing conditions, 24 lire protection in, 25 important factors in, 25 safety, 25 Humidity, 31 absolute, 31 relative, 31 Hygiene, 17 definitions of, 17 function of, 20 of habitation^, 24 of meat, 101 of occupations, 166 personal, 18, 241 public, 18 Ice, 53 boxes, 54 Illumination, light and, 26 Immunity in infectious diseases, 204 Impurities, water, 42 Incubation in infectious dis- eases, 193 Industrial bettemient, 181 factors, 171 age and, 172 personal, 171 poisons, 179 • Infant diseases, milk and, 113 mortality, milk and, 113 Infectious diseases, KO bacterial, 195 disinfection in, 208 endemic, 194 epidemic, 194 exposure to, 193 fomites in, 200 incubation in, 193 immunity in, 204 artificial, 205 natural, 204 Infectious diseases, immunity in, passive, 207 inoculation in, 206 modes, vehicles and agents of transmission in, 198 morbific agents, 194 nurse in, in diphtheria, 231 district, 227 general duties of, 228 outfit of, 228 in erysipelas, 239 in measles, 231 in pneumonia, 236 in scarlet fever, 231 in tuberculosis, 230 in typhoid fever, 237 period of invasion of, 193 portals of entry of, 196 principles and practice of prevention of, 201 prophylaxis in, methods of, 203 social, 223 role and function of nurse in prevention of, 226 sanitary measures in, 225 Inoculation in infectious dis- eases, 206 Iron pipes in plumbing, 59 Insects, 80 in disease, 81 in house, 80 Inspection of milk, 141 Intensity of light, 27 Joints of pipes in plumljing, 59 Kefir milk, 128 Koumiss milk, 128 Lactometer, 145 of Health Department of New York City, 146 /.\i)i-:' 12.".', I Liictomctcr, Qut'voiiiic's, II") Lactnscoiit", I'Vsrr's, III L:iii)i\vorthv on jJi-otcin siiid car- holiydnitCs, !);{ Lca<l pipfs in pluinl)ing, T)*.) ])(iis()iiiiiv;, 17'.> Li'i>p;th of lili\ iiuToaso of, 21 Life, Iciintli of, increase of, "Ji i,ijrl>t, artilieial, 27 ilhunination and, 2(1 intensity of, 27 natural, 26 amount of, 20 sunliiiht, 2() Li^litin^ of school huildint;:, 1.").") Lime, disinfection 1)V, 214 M Machinkry in oooupations safejiuaniing of, 17r) Mea.sles, milk and, 111 mu'se in, 231 Meat anil me;it supi)ly, 100 adulteration of, 101 characteristics of nood, 104 cold st()rafi;e of, 105 hyuiene of, 101 infection of, hy bacteria, 102 parasitic diseases due to, 101 preservation of, 10.") chemical. 100 heat, 107 sanitary supervision of, 107 tai)o\vorms in, lUl toxins anil ptoinains in, 102 trichina in, 101 unfit ncs,s of, 10.3 causes of, 10.3 diseases of animals, HY.i infection hy pei-sons, 101 Mechanical ventilation, 'M't Medical inspectors in schools, l.V.) Mercurv in occui)ations, 179 Milk, ai. normal, 121 adulteration of, 12.S hy addition of chemicals, 130 of rolorinK matter, '-'A) of skim milk, 130 Milk, adulteration of, l>y addi- I ion of water, 12S hy extraction of cream, I2'.t hy skimming, I2'.l hy waterinji, I2'.> all)ifminoids in, I 17 apjM'arance of, 1 IS l,acteriain, 112, 132 lilended, 123 hutter in, 124 l.uttermilk, 121 cas(Mn in, 1 17 cholera and, 1 II color of, ll'.» colostrum in, 120 (composition of, 1 It) conilensed, 124 cow's, 11(5 definition of, 116 ofhcial, 127 deterioration of, 131 causes of, 131 diphtheria and, 114 diseased hacteria in, 113 disea.ses due to, 1 13 dvsentery and, 114 fat in, 117 ferments and ga.ses in, 118 fore, 121 imi)ortance of, as food, 110 impurities of, 11 1 infant diseases, relation to, 113 mortality due to, 113 inspection of, 141 kefir, 12S koumy.ss, 128 measles and, 114 mineral matter in, 1 IS preservation of, 131 chemical, 136, 139 ohjections to, 140 cold, 136 dryness, 134 high temperature, 13.') low temperature, 134 mean temperature, 13.5 pasteurization, 13.S Rosenjiu on, 13,S sterilization, 137 products, 122 proteids, 117 260 INDEX Milk, reaction of, 119 scarlet fever and, 114 skim, 123 solids in, 117 specific gravity of, 119 standards, official, 126 strippings, 121 sugar in, 117 testing of, 141 by chemical examination, 147 by cream gauge, 143 by Health Department of New York, lactometer in, 146 by lactometer, 145 by lactoscope (Feser), 144 methods of, 141 chemical, 141 physical, 141 by physical examination, 143 by pioscope (Heeren), 144 precautions in, 142 Quevenne lactometer in, 145 specific gravity in, 145 tuberculosis and, 115 typhoid and, 114 variations in, 119 whey, 128 Mineral matter in foods, 91 in milk, 118 in water, 42 Modes of transmission of infec- tious diseases, 198 Momentum traps, 64 Morbidity in occupations, 168 Morbific agents, 194 Mortality rate, 21 decrease in, 21 from various diseases, 21 in occupations, 167 Myopia in school children, 150 N Natural light, amount of, 26 ventilation, 34 Nightingale, Florence, 23 Nurses, district, 227 Nurses, district, general duties of, 228 outfit of, 228 factory, duties of, 189 functions of, 188 increase in number of, 23 in infectious diseases, 226 in diphtheria, 231 in erysipelas, 239 in measles, 231 in pneumonia, 236 role and functions in pre- vention of, 226 in prophylaxis, 23 in scarlet fever, 231 in tuberculosis, 230 in typhoid, 237 school, 158 advice as to physical de- fects in children, 162 emergency and first-aid treatment in, 162 functions and duties of, 158 home visits to children by, 159 treatment of certain dis- eases by, 163 Occupations, accidents of, pre- vention of, 186 child labor in, 182