Popular Science Monthly/Volume 10/December 1876/The Laws of Health

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ON an average, one-half of the number of out-patients treated by a hospital-surgeon suffer from diseases due primarily to a want of knowledge of the laws of health and cleanliness. 1. The ignorance of hygienic laws, which affects so disastrously the health of the rich as well as the poor, exists chiefly in regard to dress, ablution, and ventilation. This statement may, at first, appear startling, but an enumeration of the diseases that, can be constantly traced to the above causes will show upon how sound a basis the statement rests. The following are examples: Varicose ulcers from dress; skin-diseases from want of cleanliness; chest-diseases and fevers from defective ventilation. The vast number of ulcerated legs treated in the outpatient department of hospitals, in workhouse infirmaries, and in private practice, arise from varicose veins. Now, a varicose ulcer is caused by a distended condition of the veins of the leg, which have to sustain the pressure of the blood caused by gravitation. In varicose veins, the valves which help to support the column of blood are to a great extent destroyed, through the veins having been distended by mechanical obstruction to the free return of the blood from the extremities, thereby distending the lower 'veins and separating the edges of the valves. Thus, the weight of an uninterrupted column has to be borne by the veins. This, of course, causes further distention, giving rise to congestion of the capillaries of the skin, and causing swelling, eczema, and ultimately ulceration. This is the varicose ulcer so common in the laboring-classes. It is always difficult to heal, and often impossible, except by prolonged rest in bed. Hence it is the dread of the surgeon, and the cause of misery to thousands. Varicose ulcers are seldom admitted into general hospitals, so that hundreds of poor families are driven to the workhouse, and such cases form a majority in the workhouse infirmary. The most frequent and flagrant cause of obstruction is the ordinary elastic garter. Children should never wear them at all, as the stockings can be perfectly well kept up by attachment of elastic straps to the waistband. If garters are worn, it is important to know how to apply them with the least risk of harm; at the bend of the knee the superficial veins of the leg unite, and go deeply into the under part of the thigh beneath the ham-string tendons. Thus a ligature below the knee obstructs all the superficial veins, but if the constriction is above, the ham-string tendons keep the pressure off the veins which return the blood from the legs; unfortunately, most people, in ignorance of the above facts, apply the garter below the knee. Again, in nine out of ten laboring-men, we find a piece of cord or a buckled strap tightly applied below the knee, for what reason I could never learn. Elastic bands are the most injurious. They follow the movements of the muscles, and never relax their pressure on the veins. Non-elastic bands during muscular exertion become considerably relaxed at intervals, and allow a freer circulation of the blood.

2. The habit of tight lacing again predisposes to varicose veins, in consequence of the abdominal viscera being pushed downward into the pelvis, causing undue pressure on the veins of the lower extremities when they enter the pelvis. Physicians also have reported numerous cases of heart and lung disease caused by this pernicious habit.

3. The use of dress is often misunderstood. Most persons evidently study and practise it with regard to appearance, or only to keep out wet and cold. The hygienic use of clothes, however, is not so much to keep cold out as to keep heat in. The mistake is often made, of taking great care to put on extra wraps and coats when preparing for out-door exercise. This is not at all necessary in robust persons. Sufficient heat to prevent all risk of chill is generated in the body by exercise. The care should be taken to retain sufficient clothing after exercise, and when at rest, to prevent the heat passing out of the body. Indeed, persons very often catch chills from throwing off extra clothing after exercise, or from sitting about in garments, the material of which is not adapted to prevent the radiation of heat from the body. Linen and cotton under-clothing, when moistened by perspiration, parts with heat very rapidly, whereas flannel and silk, being non-conductors, prevent the rapid loss of heat.

4. The most recent offense against the laws of health is the habit of wearing false hair. The perspiration of the scalp is prevented, by the thick covering, from evaporating, thereby causing a sodden and weakened condition of the skin, which predisposes to baldness and other diseases of the scalp. Again, it produces headache and confusion of the intellectual faculties. We all know what a relief it is, during hard mental work, simply to raise one's hair by running the fingers through it. I should think literary ladies either do not wear false hair, or take it off when at work.

5. Ablution is another subject of paramount importance to health. Mr. Urquhart, the introducer of the Turkish bath into this country, is one of the benefactors of the age, and it is to be hoped some day there will be a bath in every town and village in England. Doctors are very much to be blamed for allowing themselves to be prejudiced against it. The usual opinion given by medical men to their patients is, that it is debilitating, and only to be borne by the robust. The reverse is really the case: it is stimulating and strengthening, it is a preventive as well as curative in disease. The effect of the Turkish bath on the skin is to cause an active condition of its functions of elimination, by removing the hardened epithelial scales, by removing the fat from the pores, and by causing the sweat-glands to maintain the activity of their functions, giving a general stimulus to the vital power of the skin. Again, it keeps the body in a state of perfect cleanliness, which is so essential to robust health; but these are not its only virtues—it promotes purity of mind and morals. The man who is accustomed to be physically clean shrinks instinctively from all contact with uncleanliness.

6. There are, however, certain precautions to be observed in the use of the baths. Persons who are apoplectic, or suffering from fatty degeneration of heart, should not venture to disturb the circulation by the excitement of baths. The first effect of Turkish baths is to stimulate the circulation, the second to cause active congestion of the skin, the third to produce profuse perspiration, the fourth to keep down the temperature of the body by rapid evaporation. On leaving the Turkish bath the body should be douched with cold water; the capillaries are thus emptied of their blood by contraction, but immediately after the stimulation causes them to resume a state of activity, and produces vigorous circulation through the skin.

7. In taking a cold bath in the morning the same conditions should be present. The surface of the body should be warm and moist; therefore, the bath should be taken immediately on rising from the bed, and before the surface of the body has had time to cool or the capillaries to contract. The shock of the cold water should cause them suddenly to contract; then quick reaction will take place in the same way as after a Turkish bath. Unless this reaction occurs after the bath, there is great danger of getting a chill; at any rate, the full benefit of the bath is not obtained. Persons with weak circulation, who cannot take an ordinary morning bath, often derive great benefit from the Turkish bath. It opens the pores and improves the circulation of the skin, so that the shock of cold water can afterward be borne. The same persons can generally bear a cold bath if they get for a few minutes into a warm bath first, and then immediately plunge into cold water. By these means an active reaction is brought about. Warm baths should, in my opinion, never be taken on rising except under the above conditions, but warm baths at night are often desirable. They should be taken just before going to bed, when they have the effect of relaxing the muscular system and of promoting sleep by soothing the activity of the brain by the withdrawal of blood from it. I do not think warm baths at night are weakening, as the depression of vital energy which may occur is recovered during sleep. In river and sea bathing, persons should be careful not to remain in the water too long, nor should they exert themselves sufficiently to cause exhaustion, as the power of reaction is much impaired thereby; neither should persons get into cold water when cooling. The old-fashioned idea that persons should wait to cool before plunging into the water is a fallacy. There is no danger in plunging into the coldest water in a state of profuse perspiration, if the heart and arteries are in a healthy state. Of course, it would be unwise to do so immediately after a full meal, as the action of the heart might be impeded by the distended stomach.

8. Many persons complain of always getting up tired in the morning. This is very often due to defective ventilation of the bedroom, or from using an undue amount of bedclothes and bedding. Feather beds are too soft and yielding, and partially envelop the sleeper, thus producing profuse perspirations. The habit of lying too much under blankets is also very pernicious, by reason of the carbonic acid exhaled by the sleeper being respired. Again, it is a common error to suppose that, by simply opening a window a little at the top, a room can be ventilated. People forget that for proper ventilation there must be an inlet and outlet for the air. In bedrooms there is often neither, and if there is a fireplace it is generally closed up. Again, it is a mistake to suppose that foul air goes to the top of a room. Certainly the heated air goes to the top, but the chief impurity, the carbonic acid, falls to the bottom. There is nothing so efficacious in removing the lower strata of air as the ordinary open fireplace, especially if there is a fire burning. The usual defect in ventilation is the want of a proper inlet for the air. If the window be open, the cold air, being heavier, pours down into the room, causing draughts; if the door be open or ajar, the same thing occurs. The perfection of ventilation may be obtained in any room with a fireplace by simply providing proper inlets for the air, and nothing answers so well for the purpose as the upright tubes invented by Mr. Tobin. By this means the heavier external atmosphere ascends vertically through the tubes like the jet of a fountain, displacing the warmer and lighter atmosphere of the room, which finds its exit up the chimney. The tubes should communicate with the outer air on a level with the floor, and should be carried vertically upward in the room for about four or five feet. A constant supply of fresh air is thus insured without the slightest liability to draught, as the current goes directly upward until it strikes the ceiling. It is then diffused downward, mixed with the heated air of the ceiling. The same principle can be carried out in any room with a sash-window, by cutting out two or three holes an inch wide and three inches long in the wood-work of the upper sash where it joins the lower one. The columns of air ascend directly upward, just inside the window, and mix with the heated air in the upper part of the room. If this system were universally carried out, we should hear less of rheumatism and chills caught by sitting in draughts.

9. Persons should cultivate the faculty of detecting sewer-gas in houses. Typhoid fever is often caused by the escape of this gas into the house through defect of the traps and drains. However bad the drains may be outside of the house, there is little to fear, provided the gas can escape externally. The following two very simple precautions would naturally diminish the cases of typhoid fever: First, every main drain should have a ventilating-pipe carried from it, directly outside of the house, to the top of the highest chimney; secondly, the soil-pipe inside the house should be carried up through the roof, and be open at the top.—English Mechanic.