A TEXT-BOOK OF HYGIENE. 
DOMESTIC HYGIENE 
AND 
SANITARY INFORMATION, 
INCLUDING ARTICLES ON 
THE HUMAN BODY, DIGESTION AND NUTRITION, THE CAUSES OF DIS- 
EASE, THE EFFECTS OF INTEMPERANCE, FOOD AND DIET. CLEAN- 
LINESS AND CLOTHING, EXERCISE, RECREATION AND TRAINING, 
THE HOME AND ITS SURROUNDINGS, THE PREVENTION 
OF INFECTIOUS DISEASES, ETC. 
\/¥ 
GEORGE WILSON, M.A., M.D., 
AUTHOR OF " HANDBOOK OF HYGIENE AND SANITARY SCIENCE." 
EDITED WITH NOTES AND ADDITIONS 
BY 
J. G. RICHARDSON, M. D., 
PROFESSOR OF HYGIENE IN THE UNIVERSITY OF PENNSYLVANIA, 
IN PHILADELPHIA. 
PHILADELPHIA: 
P. BLAKISTON, SON & CO., 
No. 1012 Walnut Street. 
1885. " Hygiene is the art of preserving health ; that is, of obtaining the most perfect 
action of body and of mind during as long a period as is consistent with the laws 
of life. In other words, it aims at rendering growth more perfect, decay less rapid, 
life more vigorous, death more remote."-Parkes. 
"Only in a strong and clean body can the soul do its message fitly."-Fuller. 
" Who would not give a trifle to prevent 
What he would give a thousand worlds to cure?" 
Young. 
" Houses are built to live in, and not to look on; therefore let use be pre- 
ferred before uniformity, except where both may be had."-Lord Bacon. EDITOR'S PREFACE. 
The admirable manner in which Prof. Wilson has 
performed his task leaves little to be done by an Amer- 
ican editor, save the addition of a few notes respecting 
matters wherein variations of climate, habits of life, 
social surroundings, and, above all, sanitary regulations 
in the United States, slightly modify sundry solutions 
to the hygienic problems so ably discussed. 
His hope that the volume will be specially welcomed 
by parents and teachers, is amply justified by its 
thorough adaptation to the wants of the school room, 
and its exact fitness for meeting the requirements of 
instructors, who desire to take part in the prevailing 
new and excellent movement for teaching hygiene and 
physiology in both public and private schools. Since 
all human happiness depends so absolutely upon obedi- 
ence to the laws of Hygiene, no more useful study 
than that of sanitary science can form part of the 
curriculum of any institution of learning, and Dr. 
Wilson's clear, definite, and everywhere reliable state- 
ments, render this work singularly valuable, as a 
Text-book of Hygiene for schools. 
J. G. R. 
Philadelphia, April, 1885. 
III AUTHOR'S PREFACE. 
When I was requested by the Publishers to write a popular 
work on Health and Healthy Homes, I readily consented to 
do so because I believed then, as I do now, that a concise and 
practical treatise on this all-important subject was very much 
required. For although there are many excellent works which 
have been published of late years on health, there are very few 
indeed in which any attempt has been made to treat the whole 
subject, so far as it relates to the domain of Domestic Hygiene, 
in a systematic and comprehensive way. Some of them are 
devoted almost exclusively to a description of the various 
structures and uses of the organs of the human body; others 
to practical details concerning food and diet; others to causes 
of disease, and rules of life and conduct; while only a few 
contain special information concerning the hoyie and. its sur- 
roundings, or the prevention of dangerous infectious disease. 
Now, a glance at the table of contents will, I trust, convince 
the reader that it has been my special aim throughout to ren- 
der the work as complete in these and other respects as its 
prescribed limits would permit, and to present it, in accordance 
with the title, as a trustworthy guide to Domestic Hygiene in 
all its branches. 
In the Introductory Chapter, I have endeavored to prove by 
an appeal to vital statistics, how vast is the amount of pre- 
ventable disease and suffering, which still saps the foundations 
IV PREFACE. 
V 
of national health, and have tried to interest the reader by 
explaining all the more important bearings of so dry a subject 
in as attractive a way as I possibly could. In the Second 
Chapter, I have entered with sufficient fullness into the struc- 
ture of the human body and the physiology and functions of 
its various organs, to supply all the information which need be 
required to understand clearly the nature of those intricate 
processes going on within us which constitute the miracle of 
life, and which are so essential to an intelligent appreciation 
of the laws of health. In the Third Chapter, the numerous 
causes of disease are explained and illustrated-whether in- 
duced by hereditary influence; by personal habits, mode of 
living, or mental worry and overwork; by material agents, 
such as impure air, bad or tainted food, and polluted water; 
by local causes connected with the home and its surroundings; 
or by so-called disease-germs, which are still so recklessly dis- 
seminated among all classes of the community. In the Fourth 
Chapter, the important subject of food and diet is treated, 
giving in detail the nutritive values of different articles of 
food,-including water, beverages, and stimulants,-together 
with a large amount of useful information concerning food 
constituents and the principles of dietetics, the qualities and 
examination of numerous articles of food, the preparation of 
food, and practical hints on diet in respect to age, sex, and 
conditions of life. In the Fifth Chapter will be found instruc- 
tions with regard to cleanliness, bathing, and clothing, in their 
relations to health; while the Sixth is devoted to a considera- 
tion of the hygienic uses and advantages of exercise, recrea- 
tion, and physical training. In the Seventh Chapter, the 
essentials of healthy homes and their surroundings are fully 
detailed; and in the Eighth Chapter, the principal dangerous 
infectious diseases are described, the various modes in which 
they are disseminated explained, and the precautionary meas- 
ures for their prevention indicated. I have only to add that, 
without in any way interfering with the continuity of the work, 
I have so arranged it that each chapter may be read as a sepa- 
rate and distinct essay on the subject of which it treats. 
How far I may have succeeded in carrying out this some- 
what extensive programme with commendable precision and VI 
PREFACE. 
completeness, I leave the reader to judge. I may, however, be 
permitted to say that I have avoided technicalities as much as 
possible, and while I have endeavored to treat every subject 
with all attainable accuracy, I have written avowedly for all 
classes of readers, and, I trust, in such a practical way as to be 
clearly understood without being diffuse or tedious. The book 
in no sense infringes on the art of curing disease, but aims 
solely at its prevention, by affording such information and in- 
culcating such principles as will tend to preserve health and 
prolong life. 
In conclusion, I venture to hope that this little work will be 
specially welcomed by parents and teachers, and that it will 
prove a reliable and readable guide to all, whether old or 
young, who carefully peruse it. 
23, Claremont Road, Leaminston. CONTENTS. 
CHAPTER I. 
Introductory. 
PAGE 
Vision of Mirza 17 
Casualties which befall a Generation in its March through 
Life at different Stages . . . . . . .18 
Natural Duration of Life 22 
Uses of Vital Statistics . . . . . • . .24 
Calculation of Annual Death-rate . . . .25 
Calculation of Zymotic Death-rate ...... 25 
Zymotic Diseases defined 26 
Rate of Infant Mortality . . . . . . . . 26 
Difference between Rates of Mortality in different Districts . 26 
Amount of Preventable Disease ...... 27 
Possibility of lowering General Death-rate . . . .29 
CHAPTER II. 
The Human Body. 
I. Chemical Composition 33 
Vital Force 33 
Protoplasm . . . . '35 
VII VIII 
CONTENTS. 
PAGE 
II. Food Constituents ........ 35 
Functions of Nitrogenous Constituents . ■ . . . .36 
Functions of Fatty Constituents ...... 37 
Functions of Farinaceous Constituents . . . . .37, 
Functions of Water and Saline Constituents . . . .38 
III. The Tissues ......... 40 
The Connective Tissue . . 40 
The Skin 41 
The Muscular Tissue .41 
The Bones 42 
The Nervous System 43 
IV. Digestion and Nutrition ....... 46 
Mastication .......... 46 
Function of Salivary Glands ....... 47 
Swallowing 47 
The Stomach arid the Gastric Juice 47 
Secretion of Liver 48 
Changes which Food undergoes in Intestines . . . .49 
How Food is absorbed into the Circulation and converted into 
Blood . 50 
Assimilation 51 
V. Composition of the Blood 51 
VI. Circulation of the Blood 52 
Structure and Mechanism of the Heart 53 
Structure and Distribution of the Arteries . . . .54 
The Pulse 54 
Capillaries. .......... 54 
Structure and Distribution of the Veins . . . . .55 
Rhythmical Action of the Heart .56 
VII. Respiration, Oxidation, and Excretion . . . .57 
Structure and Action of the Lungs 58 
Functions of.Respiration . 59 
Composition of Air 59 
Difference between Inspired and Expired Air . . .60 
Changes which the Blood undergoes in its Passage through the 
Lungs 61 
Excretion ........... 62 
Relation of the Vital Processes ...... 63 
Interchanges of Dead and Living Matter . . . .64 CONTENTS. 
IX 
CHAPTER III. 
Causes of Disease. 
Advantages of Sound Health 66 
Uncontrollable Causes of Disease ...... 68 
Atmospheric Changes 68' 
Controllable Causes . . . . . . . . .70 
I. Hereditary Influence . . . . . . .■ .70 
Illustrations in Domestication of Lower Animals . . .71 
Family Characteristics . . . 71 
Atavism 72 
Limits of Hereditary Transmission ...... 73 
Hygienic Application of Laws of Heredity . . . . '74 
Ages at which Special Hereditary Tendencies are liable to be 
developed 74 
Course of Hereditary Transmission . . . . .76 
Consequences of Unsuitable Marriages . . . . .77 
Obligations on entering the Married State . . . .78 
II. Self-Induced and Social Causes of Disease . . . .79 
1. Intemperance ......... 80 
Statistical Details 82 
Physiological Action of Alcohol ...... 83 
Diseases induced by Intemperance ...... 85 
Estimate of Annual Mortality from Intemperance . . .88 
How to cope with the National Evil of Intemperance . . 89 
2. Tobacco and Narcotics 90 
Injury of Smoking to Boys * 90 
Precautions 91 
3. Errors in Diet '91 
Excess of Food 91 
Eating at Irregular Hours ....... 92 
Careless Feeding of Infants . ..... 93 
4. Mental Worry and Overwork .93 
Symptoms and Results ........ 94 
Effects of Physical Strain 95 
5. Idleness 96 
6. Immorality .......... 97 
7. Irregular modes of Life 97 
PAGE CONTENTS. 
X 
PAGE 
Late Hours 98 
Amount of Sleep required 99 
Importance of cultivating Habits of Regularity and Punctu- 
ality 99 
8. Errors in Clothing ........ 100 
III. Material, Local, and Communicable Causes of Disease . 100 
1. Impurities in Air . . . . . . . 101 
Evils of Overcrowding . . . . / . . .102 
Consumption . . . . 102 
Typhus Fever 103 
Diseases induced by Sewer Air and Foul Effluvia . . 104 
Diseases induced by particular Trades ..... 105 
Diseases induced by Dampness of the Air .... 106 
2. Impure Water 107 
Impurities in Water . . . . . . . 108 
Diseases induced by Polluted Water 109 
3. Unsound Food 110 
Agehcy of Milk in the Spread of Disease .... 110 
Diseases induced by Unsound Butcher's Meat . . .112 
Diseases induced by Unwholesome Fish . . . .114 
Diseases induced by Unsound Vegetable. Food . . . 115 
Effect of Adulteration Acts 115 
4. Disease-Germs . . . . . . . . .116 
Mode of Propagation of Infectious Diseases . . . .116 
CHAPTER IV. 
•Food and Diet. 
I. Nutritive Values of Foods . . . . . . .119 
Table of Alimentary Equivalents . . . . . . 122 
Amount of Food regulated by Amount of Work . . . 123 
Proportion of Several Food Constituents required in a 
Healthy Diet 124 
Necessity of a Mixed Diet ....... 126 
II. Choice of Food and Drink 126 
1. Vegetable Foods 126 
Flour 127 CONTENTS. 
XI 
PAGE 
Characteristics of Wholesome Bread ..... 127 
Oatmeal 128 
Barley Meal . . . 128. 
Rye Meal 129 
Maize ........... 129 
Rice and other Farinaceous Foods. . . . 129 
Pulses or Legumes, such as Peas, Beans, and Lentils . . 130 
Potato 131 
Turnips, Carrots, Cabbages, etc. . . ... . . 131 
Mushrooms 132 
Pumpkins, Marrows, Cucumbers, etc. ..... 132 
Ripe Fruits 132 
Sea-weed and Lichens 132 
Sugar and Treacle ......... 132 
Pickles and Condiments . . . . . . . 133 
2. Animal Foods . . . . . . . . 133 
Milk . . . . .133 
Condensed Milk 134 
Characteristics of Good Milk 135 
Butter 135 
Cheese ' 136 
Butcher's Meat 136 
Characteristics of Good Butcher's Meat .... 136 
Most Economical Parts for Cooking 138 
Bacon ........ % 139 
Poultry 139 
Game ' . . . 139 
Fish 139 
Turtle 140 
Eggs ' . 140 
Preserved Meat. . . . . . . . . .141 
3. Water, Beverages, and Stimulants ..... 142 
Sources and Qualities of Drinking Water .... 143 
Mineral and Aerated Waters 144 
Non-alcoholic Drinks ........ 145 
Tea 145 
Characteristics of Good Tea 145 
Coffee 146 
Cocoa 146 
Alcoholic Beverages . . . . . . . 147 XII 
CONTENTS. 
PAGE 
Amount of Alcohol which can be consumed daily without 
Detriment to Health 147 
Distilled Spirits . . . . . . . . 147 
Wines 148 
Safest Wines to Drink 149 
Beers, Porters, and Ales . . . . . . .150 
III. Preparation of Food 151 
Faults in Cooking . . . . . . • . . . 152 
Soup Kitchens and Cooking Dep6ts ..... 154 
Formulae for Soup Kitchens 154 
Hints for Economy in the Diet of the Agricultural Laborer . 155 
How to make Broths and Soups 156 
General Details with respect to Boiling, Roasting, Stewing, 
and Braising . . 157 
IV. Hints on Diet .' . . . . . . .159 
Necessity of Variety 159 
Relative Digestibility of different Articles of Diet . . 159 
Hints on the Feeding of Infants ...... 160 
Diet Suitable for Children 163 
Errors in School Diet . . . . . . .164 
Diet during the Period of Youth 165 
Distribution of Meals 166 
General Rules . . . 167 
CHAPTER V. 
Cleanliness and Clothing. 
I. Cleanliness 169 
Necessity of Body Cleanliness . . . . . .170 
Public Baths 171 
Hints with respect to the Uses of the Sponge, Cold, Shower, 
Plunge, and Tepid Baths ...... 172 
Swimming . . . . . . . . . .174 
Instructions of the Royal Humane Society with respect to 
Bathing .......... 175 
Turkish, Vapor, and other Baths 176 
Hints on Cleaning the Teeth 177 CONTENTS; 
XIII 
PAGE 
II. Clothing . . . . . . . . . .178 
Qualities of Different Articles of Clothing in respect to Bodily 
Warmth . . . 179 
Clothing Suitable for Warm Weather ..... 180 
Clothing Suitable for Cold Weather 181 
Hints concerning Bed Clothes ...... 181 
Hints concerning Boots and Shoes 182 
Injurious Effects of Tight Lacing 183 
Necessity of fashioning Dress in conformity with the Natural 
Lines and Proportions of the Body . . . . . 184 
CHAPTER VI. 
I. National Physique . . . ... . . . 187 
Is the British Race deteriorating ? 187 
Average Stature of Adult Englishmen . . . . 188 
Necessity of Recreation ........ 190 
II. Physiological Details 190 
Necessity of Muscular Activity or Exercise .... 191 
Amount of Exercise required for the Maintenance of Health . 193 
Necessity of Variety of Exercise,and Recreation according to 
Individual Peculiarities or Avocations .... 195 
III. National Aspects of the Question . . . . . 196 
Reading Rooms, Public Parks, Museums, National Pastimes, 
etc. ........... 197 
Advantages of joining a Volunteer Corps .... 199 
IV. Exercise during Childhood ...... 200 
School Furniture ......... 201 
School Drill 201 
Play-grounds .......... 202 
V. Exercise for Boys * . . . . . . . . 202 
Dangers to be guarded against 202 
Suitable Kinds of Exercise 203 
Gymnasium .......... 203 
VI. Exercise for Girls ........ 204 
Evil Effects of Neglect of Suitable Exercise and Recreation . 205 
Kinds of Exercise recommended at School .... 206 
Exercise, Recreation, and Training. XIV 
CONTENTS. 
PAGE 
VII. Exercise for Women . . . . . • . . 207 
Neglect of Bodily Exercise a Fruitful Source of Disease . 208 
VIII. Exercise for Men . . . . . . . .210 
Timely Warnings . . . . . . . .211 
IX. Exercise in Old Age ........ . 212 
X. Training ........... 213 
Physiological Details 213 
General Hints on Training . . . . . . .214 
Evil Effects of Over-Training ...... 215 
Athletic Contests . . . . . . .. . . 216 
Hints on Diet during Training ...... 217 
System of Training pursued at the English Universities . 217 
CHAPTER VII. 
The Home and its Surroundings. 
Historical Sketch of English Homes ..... 221 
I. Site 225 
Sites to be avoided . . . . . . . . . 225 
Hints with respect to Choice of Site or Dwelling . . . 226 
II. Structural Details ......... 228 
Foundations .......... 229 
How to prevent Dampness of Walls . . . . 229 
Arrangement of Rooms 230 
Structural Details with Respect to Ventilation and Warming . 232 
Situation and Construction of Closets 233 
III. Drainage .......... 238 
Laying, Ventilation, and Trapping of House Drains . . 238 
Cesspools . . . . . . . . . . 241 
IV. Water Suppig ......... 243 
Constant and Intermittent Systems in Towns. . . . 244 
Structural Details 245 
Dangers to be guarded against ...... 246 
Water Supply in Country Districts ...... 246 
Hints with respect to Wells, etc. 247 
Sources of Supply 248 
Filters . . ... . . . . . . . 249 CONTENTS. 
XV 
PAGE 
V. Ventilation, Warming and Lighting ..... 250 
Amount of Fresh Air required ...... 251 
Amount of Cubic Space required ...... 252 
Various Methods of Ventilation 252 
Ventilation and Warming by Fire-places .... 255 
Ventilating Grates . . 256 
Hints with respect to Lighting ...... 258 
Tests for Ventilation . 259 
VI. Outside Premises . . . .' . . . . 260 
Paths, Yards, Dust-bins 260 
Outside Closets . 261 
Keeping of Animals ........ 261 
VII. Hints about Choosing a House . ... . 261 
VIII. Nuisances and Sanitary Defects removable under the Sani- 
tary Acts 265 
Nuisances removable by Householders 266 
Defects removable by Owners . 267 
Sanitary Authorities . ..... 267 
CHAPTER VIII. 
Infectious Diseases and their Prevention. 
Prevalence of Epidemics during Past Ages and .Recent 
Times 269 
Black Death . . .270 
Sweating Sickness ......... 270 
Scurvy ........... 271 
Jail Fever . . . . . . . 272 
Cholera ■ 273 
I. Principal Zymotic Diseases ....... 274 
Classification and Remarks thereon .• ■ . . . . 274 
1. Small-Pox 2^ 
Prevalence of the Disease during Past Century . . . 276 
Introduction of Inoculation ....... 277 
Discovery of Vaccination . . . . . . 278 
Statistics proving the Value of Vaccination .... 280 
Risks attending Vaccination . . . . . . 283 
Mode of Propagation of Small-pox ..... 284 XVI 
CONTENTS. 
PAGE 
Precautionary Measures 285 
2. Measles 286 
3. Whooping-cough 286 
4. Scarlatina or Scarlet Fever 287 
5. Diphtheria 289 
6. Fever * . 290 
(a) Typhus Fever 290 
(b) Relapsing Fever ........ 292 
(c) Typhoid or Enteric Fever ...... 292 
7. Diarrhoea 294 
Channels of Infection ...... . . 295 
II. Practical Disinfection 297 
III. General Precautionary Measures ..... 300 
Penalties .......... 303 
Concluding Remarks 305 CHAPTER I. 
INTRODUCTORY. 
Many of my readers, I have bo doubt, are well ac- 
quainted with Addison's beautiful allegory, "The Vision 
of Mirza." Looking eastward from the highest pinnacle 
of the rock on which his guide had placed him, Mirza 
beheld a huge valley, and a prodigious tide running 
through it. The valley, he was told, was "the vale of 
misery," and the tide of water which "rose out of a thick 
mist at one end', and lost itself in a thick mist at the 
other," was but part of the great tide of eternity called 
Time. Peering across this shoreless ocean, Mirza then 
discovered a bridge standing in the midst of it, but 
shrouded at either end by a dark cloud, and the bridge, 
he was told, was human life. Being asked to survey it 
more closely, he found that "it consisted of three-score 
and ten entire arches, with several broken arches, which, 
added to those which were entire, made up the number 
about an hundred.-" And over the bridge he beheld 
multitudes passing, and several of the passengers drop- 
ping through into the great tide that flowed underneath, 
for "there were innumerable trap-doors which lay con- 
2 
17 18 
INTRODUCTORY. 
cealed in the bridge, which the passengers no sooner trod 
upon but they fell through them into the tide, and im- 
mediately disappeared." He noticed further that these 
hidden pitfalls were set very thickly at the entrance of 
the bridge, so that throngs, fell through them as soon as 
they broke through the cloud. They became fewer 
towards the middle, but multiplied and lay closer to- 
gether towards the end of the arches that were entire, 
while over the broken arches there were some persons, 
though very few indeed, that "continued a kind of hob- 
bling march, but fell through one after the other, being 
quite tired and spent with so long a walk." 
Such was the opening vista in " The Vision of Mirza," 
and weird and shadowy though its outlines be, it repre- 
sents very vividly what has been called the march of a 
generation through life, and the casualties under which 
so many succumb even in the first few stages. It is true 
that the trap-doors or hidden pitfalls suggest a somewhat 
fatalistic view of the deadly "ills which flesh is heir to," 
but in Addison's days, and indeed until quite recently, 
disease was regarded as inevitable far more than avoid- 
able-curable it might be in some instances, but rarely 
admitting of prevention or control. The very few who 
reached the broken arches were looked upon pretty much 
in the same light as soldiers who had luckily escaped the 
shot and shell of a thickly strewn battle-field. Now, 
however, we are beginning to realize that most of these 
pitfalls may be avoided, and the trap-doors made secure 
and passable, so that' many, instead of the ever-lessening 
few, may travel on towards the broken arches. 
But to leave metaphor aside, and come to the dry 
details of figures, let us glance briefly at the casualties 
which befall an English generation in the various stages 
of its march through life. These have been very care- 
fully and fully worked out by Dr. Farr, in one of his MARCH OF A GENERATION THROUGH LIFE. 
19 
recent masterly reports accompanying the Returns of the 
Registrar-General, and the sum and substance of them 
are as follows:-Out of every 1000 children born, 149 
succumb on the average before the first year of life is 
reached, and before the age of five /ears as many as 263. 
Many die from a diseased heritage, many from starvation 
and neglect, and many more from diseases, such as scarlet 
fever, measles, and whooping-cough, which we shall after- 
wards see are more or less preventable. But the number 
of victims varies largely in different localities. Thus, in 
the so-called healthy districts of the country, out of 1000 
born, the number of children who die in the first five 
years of life is 175 instead of 263; while in Liverpool, 
which represents the most unfavorable sanitary condi- 
tions, the number is 460, or 285 in excess of the deaths 
in healthy districts. Such enormous waste of infant life 
may truly be called appalling. 
Returning now to the 737 survivors, who on the average 
reach the sixth year, we find that most of them have 
been attacked by one disease or another, and diseases of 
a kind which fortunately seldom recur in the same indi- 
vidual. So the total deaths in the following five years 
are comparatively few, and only amount to 35, about a 
fourth of which are due to scarlet fever, which still at- 
tacks some who had previously escaped. From ten to 
fifteen years of age, the deaths are fewer than at any 
other period, and only number 18. But after the age of 
puberty has been passed, the mortality begins to increase, 
especially amongst women, and consumption claims a 
considerable share of the death-roll; indeed, between the 
ages of twenty and twenty-five, nearly one-half the num- 
ber who die succumb to this fatal disorder, and fever is 
associated with it as the great preventable disease. Melan- 
choly suicide begins to contribute its victims, the worries 
and anxieties of life induce fatal brain affections, deaths 20 
INTRODUCTORY. 
by accident among males become more numerous, insanity 
in both sexes looms on the horizon, and childbirth among 
women has its fatalities. 
At twenty-five years of age, we find the number of 
travellers on life's journey reduced from 1000 to 634, 
and 62 drop off before the age of thirty-five is reached. 
This stage embraces the prime of life, the period of manly 
vigor; yet consumption still proves the most fatal disease, 
and more so among women. Two-thirds of these are now 
married, and the deaths from childbirth exceed the deaths 
from accident among the men. Fever, though not so fatal 
as it was in the previous period, causes 4 out of the 62 
deaths, while consumption claims 27. Other diseases of 
the lungs, and diseases of the heart and brain, increase 
in intensity. 
And here, by way of contrast, let us glance at the fate 
of a generation exposed to unfavorable sanitary condi- 
tions, such, for instance, as prevail in large and crowded 
populations like Liverpool. There, out of the 1000 born, 
only 434, or less than one-half, reach the age of twenty- 
five, and only 360 are alive at thirty-five; whereas in 
healthier districts as many as 727 live to the age of 
twenty-five, and 667 survive ten years longer. 
Between the ages of thirty-five and forty-five, the 572 
survivors at the former age are reduced by 62; and now 
we come to the middle arch of life, when the ranks are 
thinned of one-half their number. A few months after 
the age of forty-five is reached the 1000 lives are reduced 
to 500, and when fifty-five is reached the numbers are 
still further reduced to 421. The passing generation has 
now produced the succeeding generation. Many of the 
structures begin rapidly to give way. Consumption still 
holds its fatal prominence, while lung diseases, heart 
diseases, brain diseases, and liver diseases are becoming 
more common and deadly. Fever continues to claim its victims, deaths by accident are not uncommon, suicide is 
slightly on the increase, and cancer (especially amongst 
women) begins to swell the death-roll. 
From the age of fifty-five and onwards, the numbers 
thin with increasing rapidity. Out of the 421 who enter 
this stage of life, only 309 reach the age of sixty-five,' 
and 161 the age of seventy-five. Diseases of the lungs 
destroy the largest number of lives. Many die from 
heart disease, brain disease, and diseases of the liver and 
bowels. Intemperance and disregard of the laws of health 
claim their later and larger harvest. Cancer becomes 
increasingly fatal amongst women, and not a few of both 
sexes die of no well-defined disease, their deaths being 
attributed to debility or old age. The few remaining 
pilgrims have at last reached the broken arches described 
in "The Vision of Mirza." Only 38 out of the 1000 
reach the age of eighty-five, and one by one they continue 
to drop through, "being quite tired and spent with so 
long a. walk." The wheels of life are run down, and the 
greater number sink to rest calmly and placidly "after 
the fashion and semblance of a kindly and pleasant 
sleep." At the age of ninety-five, but 2 survive out of 
the 1000, while only one out of every 4000 born reaches 
the age of one hundred. 
And what, it may be asked, are the inferences to be 
drawn from these figures, and the various casualties 
which they represent? In the first place, it will have 
been noticed that the mortality at different ages is largely 
influenced by the sanitary surroundings and conditions 
of the people. In densely crowded towns, for example, 
the average duration of human life sinks to nearly half 
the standard of healthy districts; and this is the result 
of the enormously increased mortality among children 
under five years of age, and the excessive mortality in 
MARCH OF A GENERATION THROUGH LIFE. 
21 22 
INTRODUCTORY. 
youth and'manhood up to the ultimate term of life, but 
few reaching and few surviving the "three-score years 
and ten." It will be seen also that certain diseases prove 
very fatal in certain epochs, and that others, though com- 
mon to different epochs, are far less destructive at some 
periods of life than at subsequent periods. Thus, measles, 
whooping-cough, and scarlet fever are essentially fatal 
during childhood; while diseases of the lungs, though 
common to this period, become increasingly fatal as old 
age creeps on. But without proceeding further with 
this analysis, and leaving the facts and figures which 
have been given to tell their own*tale, the question arises, 
.what may reasonably be supposed to be the natural term 
of a man's lifetime? Not a few of the alchemists of the 
Middle Ages, and some philosophers of more' recent times, 
such as Descartes and Franklin, believed that human 
life could be prolonged indefinitely, and we read of men 
wasting their years and shortening their lives in trying 
to discover an elixir vitee, which would ensure immortality 
on earth, and a. manhood of perpetual vigor and strength. 
But delusions like these have long since been dispelled 
by the plain teachings of science, and we now know that 
though life may be prolonged by careful regimen and 
obedience to the laws of health, a time comes in the his- 
tory of every individual, however long-lived he may be, 
when vital energy becomes powerless to resist the stealthy 
progress of decay, and the body sinks at last into the cold 
bosom of mother Earth. 
As regards the length of this period which intervenes 
between birth and natural death, statistics help us to 
make only an approximate estimate. Dr. Farr, who is 
perhaps better able than any other authority to give an 
opinion on this point, has estimated the natural lifetime 
of man to be a hundred years; and certainly, when it is VITAL STATISTICS. 
23 
remembered that some few well-authenticated instances 
are recorded in which the lifetime of a cfentury has been 
exceeded, and many are known in which it has been 
approached, this estimate cannot be regarded as excessive. 
Be this as it may, old age may be said to commence at 
about sixty, with some a little earlier, with others a little 
later, and even though there be a continued freedom from 
disease, the bodily powers gradually and imperceptibly 
begin to wane, the step becomes less elastic, the heart 
beats more slowly, the digestion becomes weaker, the 
breathing shallower, until at last, after a varying period, 
the natural life terminates in natural death. Frequently 
the intellectual faculties retain their vigor long after the 
bodily powers begin insensibly to decline, but by-and-by 
they too show signs of decay. Recent events are readily 
forgotten, and passing incidents are strangely linked with 
newly awakened memories of long ago. The inclination 
to sleep becomes stronger and stronger, and the periods 
of wakefulness. shorter and shorter, until at length the 
sleeper has drifted painlessly and peacefully into the sleep 
that knows no awakening. This is the true Euthanasia 
-the natural death, which completes the cycle of natural 
life. 
We now pass on to the consideration of some further 
statistical details which will be of service in enabling the 
reader to appreciate the value and significance of the 
stated returns of the Registrar-General which find a place 
in the leading daily journals, and of the reports of medical 
officers of health throughout the country which appear 
from time to time in local newspapers. 
It will be inferred from the previous remarks that very 
few die from old age; almost all, including even old 
people, succumb to some particular kind of disease. As 
we shall see subsequently, the disease may be inherited, 
or it may be self-inflicted by vicious habits or carelessness. 24 
INTRODUCTORY. 
or it may be produced by local causes, or it may be the 
result of exposure to infection; but whatever the cause, 
the more closely the sequence of events is scrutinized, 
the clearer it becomes that a very large proportion of 
deaths is attributable to influences brought into ope- 
ration by man himself, and therefore more or less under 
his control. 
Now, it is the special province of what are called vital 
statistics to enable us to arrive at reliable conclusions, 
based on numerous well-ascertained facts, concerning 
everything which affects the health and well-being of the 
community. Ever since the days of Queen Elizabeth, 
births, deaths, and marriages have been partially regis- 
tered in the different parishes throughout England; but 
it was not till 1837 that the Legislature passed an Act 
which provided that for the future all these entries should 
find a place in a national register, and that as regards 
deaths, the various causes or diseases should be certified 
by the medical attendant. -That the important office of 
the Registrar-General of England, which was established 
by that Act, has been productive of a vast amount of 
benefit to the health of the nation, and indeed has largely 
stimulated other countries to follow in the wake of sani- 
tary progress, there can be no doubt. By means of the 
statistics which are forwarded regularly to the central 
office from all parts of the country, the mortality in dif- 
ferent localities from various diseases and at different ages 
can be readily compared, and the relationship to sex and 
occupation can also be determined. But in addition to 
the reports of the Registrar-General, which are of national 
interest, the Public Health Act of 1872 inaugurated an- 
other and more intimate kind of sanitary supervision, by 
the appointment of medical officers of health alike in 
towns and country districts, whose reports, bearing on the 
vital statistics of their several districts, are of local inter- VITAL STATISTICS. 
25 
est and concern.* In order that the inferences or deduc- 
tions which are based on these statistics may be fairly 
accurate and reliable, it is of course necessary that the 
number of the population should be known or approxi- 
mately estimated. This is ascertained positively every 
ten years by census, and for the successive intervening 
years it is calculated by adding the known yearly rate 
of increase which has taken place in any town or dis- 
trict, while as regards the estimate of the general popu- 
lation of the kingdom, other corrections have to be made 
in respect to. emigration and immigration. 
Generally speaking, the vital statistics which may be 
taken as an approximately fair index of the -sanitary 
condition of any locality are-the total death-rate, the 
death-rate from so-called zymotic disease, the infant mor- 
tality rate, and the percentage of deaths of children 
under five years of age. Of course, there are many other 
problems which may be worked out, such as the death- 
rate from any particular kind of disease-as, for example, 
cancer, consumption, or heart disease, or the average age 
at death of those employed in different trades and occu- 
pations; but these are the most important. 
What is called the total or gross annual death-rate 
of any locality is calculated on the number of the popu- 
lation living, without distinction of age or sex, and is 
expressed as so many per 1000. The zymotic death-rate 
is based on the number of deaths which are attributed to 
the seven principal zymotic diseases, namely, small-pox, 
measles, scarlatina, diphtheria, whooping-cough, fever, 
and diarrhoea, and is also expressed as so many per 1000 
of .the population. And here it may be explained that 
* This invaluable care of the public health, which constitutes one of the most 
important functions of a wise and enlightened government, has been sadjy neglected 
in .the United States. As yet a few of our commonwealths only have active and 
efficient Boards of Health, but it is to be hoped that legislators throughout the 
country, will soon discern and remedy this lamentable omission.-(R.) 26 
INTRODUCTORY. 
the term "zymotic" is applied to those diseases which 
are believed to be propagated by infective germs which 
develop as ferments in the body of the person infected, 
and give rise to all the symptoms of the special disease. 
The term is derived from a Greek word zume, signifying 
a ferment, and the theory is that these germs or parti- 
cles, although they are too minute to be detected by the 
most powerful microscope, bear a strong analogy to the 
cells of the yeast plant, which are capable of being trans- 
mitted from one tumbler of saccharine substance to 
another, and of growing and multiplying in that sub- 
stance. It is true that all this is mere hypothesis ; but 
we do find practically that many diseases are propagated 
very much in this way. The contagion of small-pox, for 
example, has often been wafted from one side of a street 
to another, and both it and scarlet fever are frequently 
spread by articles of clothing which have been infected 
by tainted air in one house, and conveyed, it may be, long 
distances, to some other, in the ordinary intercourse of 
life.* The infant mortality rate is usually measured by 
the proportion of deaths of infants under one year to 
births registered, and is also expressed as so many per 
1000, or it may be expressed as a percentage of the total 
number of deaths. 
The mean annual death-rate for the whole of England 
and Wales during the ten years 1861-70 was 22.4 per 
1000; but it need hardly be said that it varied very con- 
siderably in different localities. Thus, in fifty-four regis- 
tration districts the mortality was at the rate of only 17 
per 1000, and in a few it was as low as 15. In another 
series of districts it was 19, and gradually increasing 
pretty much according to density of population, to 22 and 
25, it reached in Manchester a rate of 32.5, and in Liver- 
*See editor's lecture on "The Germ Theory of Disease and its present Bearing 
upon Public and Personal Hygiene." Penn Monthly for Nov., 1878.-(K.) VITAL STATISTICS. 
27 
pool it reached the enormous rate of 38.6 per 1000. The 
significance of these figures becomes all the more manifest 
when it is remembered that, had the average death-rate 
of the whole of England and Wales been the same as that 
which prevailed in the healthy districts, namely, 17 per 
1000, there would have been an annual saving of 115,000 
lives. But even in the so-called healthy districts there 
are numerous local causes of disease which still call for 
removal, so that the estimate of 120,000 lives sacrificed 
annually to insanitary conditions and neglect of ordinary 
precautions cannot be considered to be by any means ex- 
cessive. When, moreover, we reflect that many diseases 
which terminate fatally are induced, not by local causes 
or exposure to infection, but by disobeying the ordinary 
laws of health or the rules of domestic hygiene, it will 
become at once apparent that this estimate large, though 
it be-amounting, indeed, to about one-fourth of the 
'average annual death-rate-falls very far short of the 
mark in giving any adequate idea of the vast amount of 
preventable human suffering which is scattered broadcast 
throughout the country. 
Let us now glance at the death-rate from the seven 
principal zymotic diseases which have already been enu- 
merated. During the year 1878, it amounted to 3.3 per 
1000 persons living, and represented a total of over 82,000 
deaths. Now, almost all these deaths were due to local 
conditions of filth and nuisance polluting air and water, 
or to reckless dissemination of contagion by so-called 
disease-germs, and both these wide fields of disease-causa- 
tion can be greatly lessened by carrying out the provisions 
of the Public Health Act in securing healthier homes 
and more cleanly surroundings, and in adopting adequate 
precautionary measures against the spread of infectious 
disease. 
The zymotic death-rate in healthy districts ought not 28 
INTRODUCTORY. 
to exceed 1 per 1000, and in institutions under proper 
sanitary control it is practically nil. 
With regard to the infant mortality rate, it has been 
previously shown that during the ten years 1861-70 the 
average annual number of infants who died under one 
year of age was 149 out of every 1000 births, ranging 
from about 100 in the healthiest rural districts to over 
250 per 1000 births in some of the unhealthiest towns. 
It has also been shown that in the healthiest districts only 
175 children die in the first five years of life out of every 
1000 born, whereas in Liverpool as many as 460, or 
nearly one-half the number born, succumbed before they 
reached the age of five. No doubt many of these deaths 
are due to culpable neglect on the part of unmotherly 
mothers, to ignorance in feeding, to hereditary debility, 
as well as to local causes; but the vast difference in the 
rate of mortality in different localities, proves how enor- 
mous the saving of infant life would be if proper care 
and healthy conditions could alike be secured. Hitherto, 
pnfortunately, a high death-rate among infants has been 
regarded as inevitable among the poorer classes in our 
large towns; but the results of the efforts of building 
societies for improving the dwellings of the laboring classes 
have already proved beyond all doubt that, when properly 
housed, the death-rate among such families can be reduced 
by more than one-half. As an illustration of the effects 
of sanitation in reducing the death-rate among children, 
I may refer to the admirable address delivered by Mr. 
Edwin Chadwick at the Social Science Congress held 
at Aberdeen, in the autumn of 1877, in which he states 
that in several large pauper asylums for children between 
the ages of three and fifteen, the mean death-rate has 
been steadily reduced to 3 per 1000, or to less by two- 
thirds of the death-rate prevalent amongst the general 
population of the same ages. VITAL STATISTICS. 
29 
Without commenting further on the subject of vital 
statistics and the lessons which they teach, I may here 
append a few other examples of the results of sanitation 
deducible from normal instances, which have been summed 
up by Mr. Chadwick in the same address, and they are 
these:-• 
■ 1. That we have gained the power of reducing the sick- 
ness and death-rate in most old cities by at least one-third, 
or to 16 or 17 per 1000 of the population. 
2. That in new localities with healthy dwellings, pro- 
perly constructed drainage, and a pure water supply, we 
may reasonably look forward to ensuring a death-rate of 
only 10 per 1000, or less than one-half of the present 
average death-rate. 
3. That in well-provided and well-regulated institutions 
for children, and in prisons and other places under effec- 
tive sanitary control, the death-rate is not only enormously 
reduced when compared with that of the general popula- 
tion of the same ages, but a practical immunity can be 
secured against zymotic diseases. 
4. That amongst the general population a reduction by 
full one-half of diseases of the lungs may be effected by 
general public sanitation. 
Other examples are given, but these are sufficient to 
show how controllable is the general mortality rate, and 
what a vast amount of disease and suffering may be pre- 
vented by public and private hygienic measures when 
fully and intelligently carried out. But there are some 
people who argue that, because the general death-rate has 
with slight fluctuations remained stationary at a little 
over 22 per 1000 for years back, sanitary improvements 
and sanitary knowledge are alike powerless to combat 
against the death-roll entailed by over-crowding and 
over-population. Concerning over-population theories 
this much may be said-that, thanks to free trade and ex- 30 
INTRODUCTORY. 
tended commerce, the people of this country are no longer 
dependent upon home products for home consumption. 
We largely supplement our own supplies of food from 
other countries, and when the time comes we have still 
many waste lands left which could be made fruitful and 
productive. But with regard to the possibility of lower- 
ing the general death-rate and prolonging the average 
duration of life, there is no doubt. For example, the 
death-rate in London has* been lowered from 80 per 1000 
in the seventeenth century to 50 per 1000 in the past 
century, and to 24 per 1000 at the present day. Then, 
again, we find, during recent years, that improvements in 
drainage and water supply have been followed by a very 
considerable lowering of the death-rate in many other 
towns throughout the country. Thus, from 1841 to 1870, 
the death-rate has been lowered in Salisbury from 28 to 
20 per 1000; in Coventry from 27 to 21 per 1000; in 
Hull from 31 to 26 per 1000; in Macclesfield from 26 to 
23 per 1000; and in Wolverhampton from 27 to 24 per 
1000. It is true that these reductions have been counter- 
balanced by increased death-rates in other towns, mainly 
attributable to the evils attendant on over-crowding, 
against which no legal enactments had been passed until 
within the last few years, but they prove conclusively that 
the argument of the impossibility of lowering the general 
death-rate is untenable. The results of sanitary legisla- 
tion and local administration have not yet had time to 
declare themselves in many of our large towns, because 
the evils to be combated were so enormous. But recent 
statistical returns show that even in Liverpool, Man- 
chester, Sheffield, and other localities where vast popula- 
tions have been huddled together, there are hopeful signs 
of amelioration. At the same time, it must not be for- 
gotten that in over-populated towns, and indeed elsewhere, 
there are other causes of disease not under administrative VITAL STATISTICS. 
31 
control, which contribute largely to the death-roll; but 
these will be more conveniently considered in a separate 
chapter. 
Meanwhile, it is encouraging to note that steady pro- 
gress is being made in establishing and carrying out sound 
principles of sanitation throughout the country generally. 
The period of half-knowledge and painful experimentation 
has gone by, and we can now say we know the nature and 
extent of the work which lies before us; we know every 
day more fully the principles and details which should 
guide us in carrying it out; and, what is more, we can 
rely more safely and surely upon the steady growth of 
intelligent conviction, which, proceeding from the press 
and public platform, is rapidly influencing all classes of 
the community, and enlisting their services in the grand 
policy of prevention. Nor should I omit to refer to the 
benefits which must ultimately accrue from the greater 
attention which the teaching of physiology and the laws 
of health is year by year receiving in our schools. This 
in itself is an influence which is only now beginning to be 
appreciated, but which will doubtless, and at no distant 
date, operate largely in the preservation of health and in 
the prevention of human suffering. For, after all, the 
real groundwork of national health is the knowledge 
which teaches how personal health may be best secured 
and maintained; and this is the aim and scope of domestic 
hygiene. CHAPTER II. 
THE HUMAN BODY. 
In order to acquire a practical knowledge of the laws 
of health, it is very essential that people generally should 
know something of the structure of the human frame, 
and more particularly of the various intricate processes 
going on within us, which constitute the miracle and 
mystery of life. Now, it is apparent at the outset that 
the living body performs a great variety of actions, some 
of which are so obvious that they need barely be alluded 
to, while others require the closest observation and the 
minutest scientific research. Thus the body can perform 
a certain amount of work like a machine; and even when 
we sleep, some parts of it are always in motion, as shown 
by the regular heaving of the chest and the beating.of the 
heart. Then, again, we know that the body is always 
warm and gives off heat; we know, too, by breathing 
against a pane of glass, that it gives off moisture; and if 
we breathe into lime-water, we find that the lime-water 
speedily becomes milky from the precipitation of carbon- 
ate of lime, showing that carbonic acid gas is also given 
off by the breath. If, moreover, we weigh the body of a 
living man very carefully, and set him to do some active 
work for an hour or so, we find, on again weighing him, 
that he has lost weight-provided, of course, that he has 
taken no food dr drink in the interval. Thus, it is made 
clear that an active man exerts mechanical force, gives 
off heat, gives off moisture and carbonic acid, and loses 
substance; and in order to keep this living machine and 
32 CHEMICAL COMPOSITION. 
33 
its various processes going, it is necessary that the body 
should be supplied with three things: fresh air, food, and 
water. Every part of the body is constantly undergoing 
waste, and this waste is being constantly renewed by the 
three essentials just named. Having thus glanced briefly 
at the working of the machine, let us now proceed to 
consider its structure, and its relations to dead and living 
matter. 
I. Chemical Composition. 
In the world around us, matter may be said to exist in 
the four following phases:-(1) The elemental stage, or 
the stage of irreducible matter; (2) the mineral stage, or 
the stage of chemical compounds; (3)'the vegetable stage, 
or the vegetable world; and (4) the animal stage, or the 
animal world. The first two stages are comprised in 
what is called the inorganic world, or world of dead 
matter; and the last two. make up the organic world, or 
world of living matter. The first, or elemental stage, is 
so called because it includes the various substances found 
in the earth or its atmosphere, which cannot be reduced 
into simpler forms, and altogether they amount to over 
sixty in number. A few of them are gaseous, such as 
oxygen, hydrogen, nitrogen, and chlorine; but most of 
them are solid, such as iron, carbon, sulphur, phosphorus, 
calcium, sodium, and magnesium. If we further examine 
into the relationships which subsist between these several 
phases of matter, we find that the first or elemental stage 
is converted into the second by what is called chemical 
force, while the first and second stages are converted into 
the third, and the third into the fourth, by what is called 
vital force. 
But what is vital force ? Is it a separate entity which 
may be regarded as the efficient cause of the production 
and maintenance of every living organism, irrespective 
3 34 
THE HUMAN BODY. 
and totally independent of other forces, such as heat, 
light, and electricity, which operate in the inorganic 
world? We have no reason to believe so. Indeed,.the 
more one studies this mystery, the more is the mind 
driven to the conclusion that vital force, though not 
identical with, is inseparable from, the ceaseless cycle of 
energy which pervades the universe. We find that the 
germ of a plant or animal is a mere microscopic mass 
endowed with a mode of activity, so to speak, which en- 
ables it under suitable conditions to develop into a sem- 
blance of its parent, to produce other germs like itself, 
and to resist external destructive agencies for a certain 
period; and it is this mode of activity which is known as 
vital force. But this is not the real organizing force of 
either the plant or the animal. In both cases the organ- 
izing force is heat, the heat originally derived from the 
sun.' The germ, therefore, may be said to supply direc- 
tive energy, but not constructive force. Just as chemical 
affinity cannot raise matter from the elemental to the 
mineral stage without the aid or development of heat, 
so we find that the mineral stage cannot be raised to the 
vegetable, nor the vegetable to the animal stage, without 
the aid of this constructive agency. But although there 
is this intimate relationship between physical and vital 
force, it scarcely admits of dispute that life, after all, is a 
special endowment which cannot be originated by any 
physical agencies, nor imparted except by inheritance. 
Whether it be plant or animal, there must be parentage, 
and when life becomes extinct, the elements which enter 
into the composition of the body gradually disperse and 
enter into new combinations. 
Altogether about seventeen of these elements have been 
discovered in the human body, but many of them exist 
only in very minute quantities. Those which constitute 
by far the largest proportion are the four gases already FOOD CONSTITUENTS. 
35 
mentioned, namely, oxygen, hydrogen, nitrogen, and 
chlorine; while of the solid elements, calcium, sodium, 
magnesium, carbon, sulphur, and phosphorus are the 
most plentiful. It need hardly be said that they are all 
derived from food and drink, and they are variously com- 
bined to form compounds, of which water is the most 
abundant, for it forms more than two-thirds of the weight 
of the whole body, and water is a compound of oxygen 
and hydrogen. What is called protoplasm, or the formal 
basis of life in plants as in animals, is composed of the 
four elements, oxygen, hydrogen, carbon, and nitrogen, 
and in its simplest form appears as a cell. It is termed 
an albuminous compound, and as it exists in the germ so 
it continues to exist, though variously modified, in every 
part of plant or animal. In plant life, the albuminoids 
are exemplified by the gluten of flour, and in animal life 
by the albumen of white of egg, the fibrin which is con- 
stantly present in the blood, and the gelatin which is 
derived from boiling down bones or tendons. Besides 
the albuminous, or nitrogenous, compounds, the other 
principal organic compounds which are found in the 
human body are the fatty, or oleaginous; and the saccha- 
rine, or farinaceous. Both of them consist of the three 
elements, oxygen, hydrogen, and carbon, but without the 
nitrogen, and hence they are frequently designated non- 
nitrogenous substances. Amongst the inorganic com- 
pounds are water, already referred to, carbonic acid, and 
ammonia, together with the various compounds of the 
alkalies and alkaline earths, such as lime, potash, and 
soda, which are found in bone and other tissues. 
Without entering more minutely into the chemical 
composition of the human body, it will be readily inferred 
II. Food Constituents. 36 
THE HUMAN BODY. 
from these brief remarks that the materials which are 
required by animals for the development and maintenance 
of their fabric are of two kinds, namely, the organic and 
inorganic. The organic alone are generally regarded as 
foods, but the inorganic are none the less necessary for 
bodily sustenance, and fortunately they are found to be 
present in all the ordinary articles of diet, and mostly in 
the requisite proportions, whether these be derived partly 
from the animal and partly from the vegetable world, or 
exclusively from the latter. With the exception of a 
portion of the water and common salt required for the 
system, the other inorganic constituents of food are found 
mixed up with the organic constituents, which have been 
prepared in the first instance in the vast laboratory of 
the vegetable world under the vivifying influence of the 
sun's heat, or have become modified in the tissues of other 
animals before they become the food of man. Whilst 
plants subsist on inorganic, or mineral, compounds, the 
principal of which are water, carbonic acid, and ammonia, 
animals subsist directly or indirectly on the organized 
materials which are formed in the tissues of plants, and 
resolve them again into these simple compounds. In 
other words, the life of the plant ends where that of the 
animal begins, and the life of the plant begins where that 
of the animal ends. Viewed in this light, therefore, the * 
human body is the turning point of a stream of matter 
which flows incessantly from the mineral and vegetable 
worlds, and eddies back into the mineral world again. 
If we further subdivide the constituents of food, we 
find them arranged, as already described, in the following 
groups-namely, the nitrogenous, or albuminous; the 
fatty, or oleaginous; the saccharine, or farinaceous; and, 
finally, water and saline substances. Every article of 
diet which contains nitrogen-and the great majority of, 
articles, as will be seen subsequently, in the chapter on FOOD CONSTITUENTS. 
37 
food, contain it in greater or less abundance-supplies 
some albuminous compound, whether it be fibrin, as in 
animal food; casein, as in milk and cheese; albumen, as 
in eggs; gluten, as in bread; or legumen, as in peas and 
other vegetables. All these albuminous compounds are 
remarkably uniform in composition, and as they each 
seem capable of being reduced by the digestive process to 
a like condition, they can replace each other in nutrition, 
though perhaps not to an equal extent. They are essen- 
tially muscle-forming foods, although they contribute also 
to the construction and repair of other tissues of the body, 
and assist in the maintenance of bodily heat and the dis- 
play of bodily vigor. 
The fatty, or oleaginous, constituents are represented by 
the butter in milk, the fat in butcher's meat, and the 
vegetable oils. They play a very important part in the 
maintenance of animal heat, and by their oxidation in 
the blood, as will be subsequently shown, they generate 
to a large extent the force which is rendered apparent in 
locomotion or manual labor. Moreover, the distribution 
of fat in the tissues gives rotundity to the form, serves to 
retain bodily warmth by its non-conducting properties, 
and greatly facilitates the working of the various parts 
of the living machine by lessening.friction, and prevent- 
ing jarring by its elasticity. 
The saccharine, sugary, or farinaceous constituents com- 
prise starch (which is found in rice, potatoes, and other 
vegetable foods) and sugar. As their chemical composi- 
tion is somewhat similar to that of the fatty constituents, 
they exercise similar functions, and are directly subser- 
vient to the maintenance of animal heat and the produc- 
tion of animal force. But their heat-producing powers 
are much inferior to those of fat, and hence we find that 
while fat is largely consumed by the inhabitants of cold 
countries, rice and other farinaceous foods are sufficient 38 
THE HUMAN BODY. 
for the maintenance of bodily heat in warmer climes. By 
the process of digestion, they can be converted into fat 
in the system, and hence it is that persons who are prone 
to obesity are warned by the physician to indulge sparingly 
in bread, sugar, rice-puddings, and the like. 
The part which water plays in the animal economy is 
one of the highest importance. As already stated, it 
constitutes nearly two-thirds of the weight of the whole 
body, seventy-nine per cent, of the blood, eighty per cent, 
of brain and muscle, and ten per cent, even of bone. Its 
main functions are the solution and conveyance of the 
other food constituents to different parts of the system, 
the removal of effete products, the lubrication of the tissues, 
the equalizing of the body's temperature by evaporation, 
and the regulation of the various chemical changes which 
take place in the processes of nutrition and decay. The 
supply of water for these purposes is derived from what 
we drink as fluid directly, or from what we take in the 
ordinary articles of diet, all of which contain water in 
varying quantities. The amount of water required by 
man, over and above what he obtains in food, need rarely 
exceed forty ounces in the twenty four hours, but a much 
larger quantity is consumed by most people in beverages 
and other drinks, and in proportion to the excess, the 
greater is the strain thrown on the excretory organs, 
especially on the kidneys. But, important though the 
quantity be,'it is of still greater moment that the quality 
should be above suspicion, and unalloyed by any dele- 
terious ingredients. If, for example, it be over-charged 
with saline matters, injurious results will follow sooner 
or later; or should it be polluted with filth or decaying 
animal matter, ailments of the gravest description will in 
all likelihood be induced. The purity of our water sup- 
plies,-therefore, becomes a question of the deepest concern 
in the maintenance of the general health of the community. FOOD CONSTITUENTS. 
39 
With the exception of common salt, the saline con- 
stituents of food, as previously stated, are contained in 
the ordinary articles of diet, and for the most part in the 
requisite proportions. They exercise important functions 
in the digestion and assimilation of the other food consti- 
tuents, and in the removal of effete matters. Some of 
them, such as the earthy phosphates, and especially the 
phosphate of lime, are indispensable to the consolidation 
of tissue; for not only are they present in the bony struc- 
tures of the body, but they also enter into the composition 
of flesh. Common salt plays such an important part in 
the animal economy that, though it does' not enter into 
the composition of any of the tissues, it is a large consti- 
tuent of every one of the secretions, and forms about half 
the total weight of the saline matters contained in the 
blood. Then, again, the oxides of iron ought to be men- 
tioned, inasmuch as they are largely concerned in the 
processes of sanguinification, or blood-making, and oxida- 
tion. They enter into the composition of the blood-cor- 
puscles, and indeed the coloring matter of the blood, as 
■well as that of the muscles, is a compound of iron and 
albumen, which possesses the wonderful property of ab- 
sorbing oxygen when exposed to the air, and giving it out 
again in the presence of reducing agents. In the one case 
it assumes a bright florid hue, as in arterial blood, and in 
the other a dark, muddy-looking tint, as in venous blood. 
With regard to the functions of those accessories of 
food called condiments, such as mustard, pepper, sauces, 
and the like, but little need be said. For the most part 
they are merely stimulants of the 'digestive organs, and 
in this respect aid in the process of digestion, while, by 
giving flavor to the food, they render it more palatable 
and whet the appetite. The functions of alcoholic drinks 
and beverages will be considered further on. 
That all these four classes of food constituents should 40 
THE HUMAN BODY. 
be present in a well-arranged dietary is alike taught by 
experience and proved by experiment. No single class is 
capable of sustaining life by itself, although it has been 
ascertained that health may be maintained for some time 
on a diet containing the albuminous, fatty, and saline 
constituents. The absolute quantity and proportions of 
each which are requisite for healthy bodily sustenance 
varies so much according to age, ^ex, employment, and 
other conditions, that it would be useless to attempt to lay 
down any standard which should apply to every particular 
case; but for an averaged-sized adult, performing a mod- 
erate amount of work, the following quantities of water- 
free food are required during the twenty-four hours:- 
Albuminous substances (albuminates), 4J ounces; fatty 
substances, 3 ounces ; .saccharine, or farinaceous, substan- 
ces (carbo-hydrates), 14 ounces; and saline matters, 1 
ounce. 
III. The Tissues. 
What are called the tissues of the human body are 
those constituent parts which are capable of being separ- 
ated by the hand and skill of the anatomist. Thus, cover- 
ing the whole of the body is the skin, or integumentary 
tissue, and this again is continuous at the various open- 
ings into the body with a more delicate membrane, which 
lines all the internal canals, or cavities, and is called the 
mucous membrane. Both the skin and mucous membrane 
are largely made up of a fibrous substance, named con- 
nective tissue, because it is the great connective medium 
by which the various'parts of the body are held together. 
Passing from the skin it ensheaths all the muscles, covers 
all the bones, cartilages, nerves, and blood-vessels, and 
finally becomes united to the lining membrane of the 
internal cavities. It varies very much in character- 
sometimes soft and elastic, as in blood-vessels and nerves ; THE TISSUES. 
41 
at other times being dense and unelastic, as in the liga- 
ments which bind the joints together, and the tendons 
which join the. muscles to the bones. In its delicate 
meshes fat is deposited in little cells in various parts- of 
the body, and it envelops and interpenetrates all the 
different organs, such as the lungs, liver, and kidneys. 
The skin itself is composed of two layers: the upper, 
named the cuticle, or epidermis, and the lower, the dermis, 
or true skin. The epidermis consists of a mass of flattened 
cells, packed closely together; while the dermis, or true 
skin, consists of fibres of connective tissue, and a mesh- 
work of minute blood-vessels and nerves. These are con- 
voluted in the so-called papillae, or ridges, which are 
observable all over the surface of the skin, but are more 
numerous and marked on the palms of the hands and the 
soles of the feet. Between the papillm there are numerous 
minute canals leading to small glands, called the sweat- 
glands, which are intimately connected • with the con- 
voluted capillaries, while there are numerous other glands, 
named sebaceous glands, which secrete an oily substance 
to keep the skin soft. The numerous nerve-filaments, as 
will afterwards be shown, are subservient to the sense of 
touch, and the meshwork of blood-vessels, glands, and 
ducts play a most important part in secretion. The hair 
and nails are appendages of the skin, and, like the epi- 
dermis, consist only of flattened or elongated cells. 
Immediately beneath the skin and the layer of fat 
which is generally found imbedded in the connective 
tissue, we come upon the muscular tissue, which forms the 
great bulk of the human frame, and is generally recog- 
nized as "flesh.-" It is arranged in large bundles of 
fibres, which are bound together as already described, 
and these again are made up of smaller bundles. These 
bundles are arranged in masses of various sizes and shapes, 
ensheathed in connective tissue, and known as the muscles, 42 
THE HUMAN BODY. 
which are united at either end to the bones by the tendons. 
The muscles, under the influence of nervous stimulus, have 
the power of contracting, or becoming shorter; and it is 
by reason of this property that muscular tissue becomes 
the great motor agent of the body. By means of their 
separate and combined action, the bones, which constitute 
the levers of the body, are moved in various directions, 
giving rise to all the phenomena of locomotion, manipula- 
tion, and the like. Muscular action is well exemplified 
by what takes place when a person bends up his arm. 
By grasping the upper arm it is observed that, as the fore- 
arm is gradually drawn up, a large soft mass, which lies 
at the fore part of the upper arm, hardens and becomes 
prominent. This mass is known as the biceps muscle, 
which at its upper extremity is joined to the bones near 
the shoulder-joint, and at its lower to one of the bones of 
the forearm, near the elbow-joint. When this muscle, 
therefore, is called into action, that is, when it contracts, 
it necessarily pulls the forearm towards the shoulder; and 
when the arm is again extended, after the muscle has 
ceased to act, it is found that the swelling and hardness 
which became apparent during its contraction have dis- 
appeared. 
The bones, which constitute the skeleton or framework 
of the body, are in reality masses of connective tissue 
hardened or petrified by deposits of phosphate and carbon- 
ate of lime. They are traversed by very minute openings, 
through which numerous blood-vessels ramify and nervous 
filaments are spread. In early life they consist largely 
of cartilaginous matter, and consequently are more pliable, 
elastic, and possessed of greater vitality; but in old age 
the earthy matter predominates, there is less vitality, and 
injuries such as fractures become more difficult of repair. 
Some of the bones, such as those of the skull, are specially 
designed for the protection of important organs contained THE TISSUES. 
43 
within them ; but by far the greater proportion of them 
are constructed and arranged with a direct reference to 
motion. When one considers the wonderful variety of 
movements required from man, it will at once be inferred 
that the levers which render these movements possible 
must be very numerous; and, indeed, they amount alto- 
gether to over 200. All these bones are fastened together 
by ligaments, or cartilages, and where they move freely 
on one another, a coat of cartilage furnishes the surfaces 
which come into contact; while the numerous joints which 
are thus formed are lubricated, or moistened, by an oily 
kind of fluid, called the synovial fluid, secreted from the 
delicate synovial membrane which lines the interior sur- 
faces of the joints. 
To initiate, control, and direct all the movements of 
which this complicated machinery is capable is the grand 
function of the nervous tissue. The essential parts of the 
nervous system are certain centres, which generate nerve- 
force, and nerve cords, or nerves, which, like telegraph 
wires, communicate between these centres and every part 
of the body. The two main centres are the brain, encased 
in the skull, and the spinal cord proceeding from it, which 
is encased in the spine or spinal column ; while both are 
frequently described together under the common title of 
the cerebro-spinal axis. The brain, besides being the seat 
of the intellectual faculties and the receptacle, so to speak, 
of all our sensations, is the centre from which all the 
voluntary movements of the body are regulated. The 
spinal cord, on the other hand, is the instrument through 
which the mandates of the will are conveyed to the mus- 
cles, and it also regulates many of the reflex, or uncon- 
scious, movements of the body. On examining a small 
section of a nerve-centre under the microscope, we find 
that it is composed of gray and white substances, the 
former consisting of minute cells, and the latter of very 44 
THE HUMAN BODY. 
fine tubules, or fibres. The function of the gray substance 
is to generate nervous force, while the tubules act as con- 
ductors of that force; but how this force is generated, or 
how mind and matter are linked together, we know not. 
This much, however, we do know, that on the brain 
depends our power to reason and will, our power to act, 
our power to acquire knowledge and store it up as in a 
granary, and that without it there is no conscious exist- 
ence found among men. It becomes, therefore, a matter 
of the most vital importance that the nervous system 
generally should be kept in a high state of efficiency, and 
this can only be secured by the maintenance of sound 
bodily health, for a healthy body is above all things 
essential to a perfectly healthy and untrammelled mind. 
Proceeding directly from the brain and upper part of 
the cerebro-spinal axis are the sensory nerves, such as 
those of sight, hearing, smell, and taste; while attached 
to the spinal cord by two sets of roots are the numerous 
spinal nerves, the one set communicating motor power to 
the muscles, and the other conveying sensation to the 
brain. The fibres in both sets of roots cross over to the 
opposite side of the cord at different parts, and hence it is 
that injury or disease of one side of the brain affects the 
opposite side of the body. These nerves- ramify in all 
directions to the muscles to make them the ready instru- 
ments of the mind, and to every part of the surface of the 
body to receive impressions, and, by the sense of touch, 
to put us into direct relation with the external world. 
But in addition to the cerebro-spinal system of nerves, 
there is another system, commonly called the sympathetic, 
or ganglionic, whose nervous filaments act independently 
of the will, and preside over the organic functions, such 
as the processes of digestion and respiration, and the move- 
ments of the heart. They have no direct connection with 
the brain or spinal cord, but arise from a number of dis- THE TISSUES. 
45 
tinct nervous masses, or ganglia, which are situated in 
the neck, chest, and abdomen, along the front and on 
either side of the spinal column. The action of these 
ganglionic nerves is entirely involuntary, and in this re- 
spect differs from that of the cerebro-spinal nerves.» 
Through the agency of the latter we can at pleasure ex- 
cite, direct, or arrest the motions of the ordinary muscles; 
but we have no such control over the muscles- placed un- 
der the influence of the ganglionic nerves. The heart, 
for example, continues to beat with the same rhythm 
during sleep as when we are wide awake, the chest heaves 
with the same regularity in the act of breathing, and the 
various functions of the stomach and other internal organs 
continue unimpeded. But although the will has no direct 
power over the nerves of organic life, experience shows 
that the mind does exercise a certain amount of influence, 
and, as a matter of fact, there are numerous connections 
between the ganglionic and cerebro-spinal nerves. Hence 
it is that the emotions of joy or fear are followed by the 
quickened action of the heart, and that sickness, loathing, 
or faintness are often a consequence of deep mental dis- 
turbance. 
To sum up this brief sketch, the functions controlled 
by the nerve-centres generally may be comprised under 
the different headings of:-(1) sensation, common and 
specific; (2) muscular motion; (3) the various processes 
associated with the nutrition of the body; and (4) all 
those mysterious phenomena of which the brain is the 
instrument, and known as the operations of the mind. As 
regards the connection which exists between mind and 
matter, science gives no answer. Only this much we know, 
that the human mind does act through the agency of mat- 
ter, and that every thought which flashes thro'ugh the 
brain is associated with a corresponding molecular change 
in the brain-tissue. But this intimate connection between 46 
THE HUMAN BODY. 
the material and immaterial parts of our nature affords 
no argument that thought is merely a secretion of the 
brain. We can only look upon it as a temporary arrange- 
ment or adjustment-as an ultimate fact, which we can 
.neither account for nor understand. 
IV. Digestion and Nutrition. 
By the process of digestion the food is liquefied and 
reduced to a form in which it can be absorbed in the in- 
testines, and afterwards taken up by the blood-vessels,, 
and finally, by the process of nutrition, it passes from the 
blood-vessels to replace the waste material which is being 
constantly removed by the blood-current from every tissue 
and part of the body. In its passage through the alimen- 
tary canal-consisting of the mouth, gullet, stomach, and 
intestines, or bowels-the food is subjected to a series of 
mechanical and chemical actions, which reduce it to a 
homogeneous juice, or " chyme," and the more perfectly 
this process is attained, the more healthy is the digestion. 
The first stage, then, in the process of digestion, is the 
conversion of the more solid articles of food into a pulp 
by mastication, or chewing, in which the jaws, teeth, tongue, 
and the salivary glands play a most important part. By 
the mechanical action of the jaws and teeth the food is 
broken up, and while this is going on the mass is being 
constantly moistened by the saliva, which not only lubri- 
cates it and renders it more easily swallowed, but also 
exerts a powerful chemical action in converting farina- 
ceous ingredients into grape sugar. In flesh-eating animals, 
the teeth are so formed as to enable the animal to seize 
its prey and tear the flesh; whereas in herb-feeding animals, 
large ancl chisel-like front teeth are required to crop their 
food, and strong, rough back teeth are provided for grind- 
ing it. In man, we find an intermediate development DIGESTION AND NUTRITION. 
47 
between the two, indicating that his teeth are evidently 
adapted for a mixed diet. 
In order that mastication may be complete, it is highly 
important that the teeth should be kept in good order, 
and when they decay it is very desirable that they should 
be replaced by false ones. ' Then, again, the process of 
chewing should be deliberate and thorough, in order to 
break up completely the fibres of animal food, and, what 
is perhaps of more importance, to allow free admixture of 
the saliva with the farinaceous ingredients, inasmuch as 
the starch contained in these ingredients cannot be ab- 
sorbed until it has first been converted into sugar. This 
chemical action commences in -the mouth, is carried on 
while the food passes down the gullet, is continued in the 
stomach, and is finally reinforced by the intestinal juice. 
The salivary glands are arranged in three pairs, and 
they pour their secretion by ducts into the mouth. The 
saliva itself is slightly alkaline, and contains little more 
than five per cent, of solid matter, the rest being water. 
When the food has been sufficiently masticated, it is 
thrust backwards by the action of the tongue into the 
upper part of the gullet; and at the same time the open- 
ing into the windpipe is closed, to prevent the entrance of 
any solids or liquids into that channel. The remainder 
of the act of swallowing is effected entirely by involuntary 
muscular action, and the churning process which the food 
subsequently undergoes in the stomach and intestines is 
also involuntary. 
The stomach is a large bag-like cavity, stretching across 
the body, and chiefly under the lower part of the left ribs 
-its left extremity, where the gullet, or oesophagus, ter- 
minates, being much more capacious than the right, which 
is made continuous, by a contractile orifice, with the intes- 
tines. The lining or mucous membrane of the stomach 
is studded all over with the minute orifices of numberless 48 
THE HUMAN BODY. 
tubular glands, which secrete the gastric juice, and in 
such quantity that it is estimated to amount to between 
ten and fifteen pints in twenty-four hours. This fluid, 
like the saliva, consists of ninety-five per cent, of water, 
but, instead of being alkaline, is slightly acid, from the 
presence of hydrochloric acid, and it contains that most 
important solvent, pepsin, which acts especially on the 
nitrogenous constituents. While the food remains in the 
stomach, it is constantly moved to and fro, and as it is 
converted into chyme it passes gradually through the small 
orifice on the left extremity into the small intestine. But 
in the passage of the food thus far, a considerable amount 
of the farinaceous ingredients, which have been converted 
into sugar, together with water and saline substances, is 
absorbed by the lining membrane of the gullet, and further 
absorption takes place in the stomach. Owing to the 
acidity of the gastric juices, the solvent action of the 
saliva on the farinaceous ingredients is retarded, but so 
soon as the chyme passes into the intestines this action is 
supplemented by the juice which is secreted from the 
pancreas. The pancreatic juice acts not only on the starch 
granules in the food, by breaking them up and converting 
them into sugar, but it also converts the fatty constituents 
into a milky emulsion capable of being absorbed by the 
numerous glands which line the intestines. Many of these 
starch granules, especially when the food has been im- 
perfectly cooked, cannot be acted on by the saliva until 
their albuminous envelope has been dissolved by the 
gastric juice, and they are then either'rapidly converted 
into sugar by the saliva which has been swallowed, or, 
more slowly, by the pancreatic and other intestinal secre- 
tions. 
But along with the pancreatic juice there is poured into 
the chyme, as it passes from the stomach into the intes- 
tines, the special secretion of the liver. This organ puri- DIGESTION AND NUTRITION. 
49 
fies the blood of noxious ingredients, and the bile is utilized 
in the process of digestion by arresting decomposition in 
animal substances, and further preparing the liquefied 
food for absorption. During its passage through the 
intestinal canal, which in an average adult is about 
twenty-five feet long, the process of digestion is completed, 
and the nutrient material is absorbed by numberless 
minute vessels, called lacteals. These are convoluted in 
small prominences, or villi, which stud the lining mem- 
brane of the intestines, and they finally converge to a 
common duct, named the thoracic duct, which discharges 
into the left jugular vein, while the undigested, indigesti- 
ble, or effete matter is thrown off by the bowels. 
Briefly, then, a meal as it passes downwards is first 
mixed with the salivary fluid, which converts into sugar, 
or renders fit for absorption, a large portion of its starchy, 
or farinaceous, constituents. It is next irrigated by the 
gastric juice, which dissolves its nitrogenous, or albumin- 
ous, constituents. It is then mixed with the pancreatic 
juice, which emulsifies the fatty constituents, and also acts 
on the farinaceous substances which have escaped the 
action of the saliva. At the same time, the bile is poured 
into it, and renders it more easy of absorption; and finally 
the intestinal juice, oozing out throughout a long canal, 
supplements the deficiencies of any of the previous solvent 
acts. The average total quantity of these various juices 
secreted in the twenty-four hours has been estimated to 
amount to nearly three gallons, and about ninety-six per 
cent, of them consists of water. This large amount of 
water is exuded by the intestinal canal, and is again 
absorbed, so that the stream is constantly going its round 
like an endless chain, taking up from the structures of 
the body what ought to be got rid of and, removed, and 
taking in from the food what the nutrition of the body 
requires. 50 
THE HUMAN BODY. 
Apart from the water, sugar, and saline substances, 
which are absorbed in the gullet, stomach, and intestines 
directly into the minute blood-vessels, the other nutrient 
ingredients, after being dissolved and digested, are more 
slowly taken up by the meshwork of lacteals which line 
the intestinal canal, and finally, as we have seen, discharge 
into the left jugular vein. The fluid conveyed by the 
lacteals is called chyle, and is very like milk in appear- 
ance, and indeed very much resembles it in chemical com- 
position. Before it is discharged into the blood-current, 
it is still further elaborated by passing through a series 
of minute glands, called lymphatic glands, and in the 
thoracic duct it mingles with another fluid, which is 
nearly colorless and of a saltish flavor, called lymph. 
This fluid is collected by a set of vessels which pervade 
the whole frame, named the lymphatics, and is derived 
from the various tissues in which these vessels originate, 
as a constituent part of the waste material which is selected 
as still available for nutrition. Both lacteals and lym- 
phatics are freely provided with valves throughout their 
course, to prevent their contents flowing backwards when 
subjected to pressure. It is thus seen that not only is 
provision made by which the food digested in the alimen- 
tary canal finds its way into the circulation, but also that 
the fluid which is no longer needed for the nutrition of 
various tissues is collected and again returned to the 
blood, showing clearly that there is no unnecessary waste 
in the animal economy. 
But after the nutritious chyle has entered the blood- 
stream, some further changes are required before it can 
build up tissues and fulfil other important purposes of the 
organism. This further elaboration, which need not be 
entered upon here, is carried out in the liver, spleen, and 
other glands; and finally, the various ingredients of the 
food are conveyed by the blood-vessels, not only to every COMPOSITION OF THE BLOOD. 
51 
tissue, but to the minutest parts of every tissue in the 
body. 
The right performance of the process of nutrition de- 
pends, in the first place, then, upon a due supply of pure 
and well-elaborated blood, upon the normal condition of 
the part to be nourished, and above all upon the formative 
capacity of the several parts of the various tissues, by 
virtue of which the newly formed structures are reproduced 
in the place of and exactly like those which have become 
disintegrated and removed. No matter how diverse be 
the character and composition of the various tissues, the 
blood supplies the material which each requires, and 
every tissue has an inherent power of abstracting from 
the blood whatever ingredients are necessary to repair 
waste and maintain it in a condition of healthy efficiency. 
V. Composition of the Blood. 
The blood is a red, viscid fluid, slightly alkaline, and 
consisting of water and of solid and gaseous matters. 
The water amounts to about seventy-nine per cent., and 
the dry solids to twenty-one per cent., while the gaseous 
matter contained in the blood is nearly equal to half its 
whole volume, or, in other words, 100 cubic inches of 
blood will contain rather less than fifty cubic inches of 
gases. The gases consist of carbonic acid, oxygen, and 
nitrogen, in the proportion of nearly two-thirds carbonic 
acid, one-third oxygen, and barely one-tenth nitrogen. 
Compared with the weight of the body, the total volume 
of blood amounts on the average to about one-thirteenth; 
so that a person weighing twelve to fourteen stones* would 
have from fifteen to eighteen pints of blood. 
When fresh-drawn blood is examined under the micro- 
scope, it is seen to consist of a colorless liquid called 
* From 168 to 196 pounds. 52 
THE HUMAN BODY. 
plasma, and of numerous globules, or cells, some of a 
reddish tint and others colorless, which float in it. The 
red corpuscles, or cells, are round flattened discs, slightly 
concave in the centre, and their size varies from 3^^ to 
4o'oo an inch in diameter. They contain the coloring 
matter, and have a marked affinity for oxygen. The 
colorless corpuscles are somewhat larger, but not nearly 
so numerous, as the red corpuscles ; and though the rela- 
tion which they bear to each other has not been clearly 
determined, it is believed that the red corpuscle is simply 
the nucleus of the colorless corpuscle somewhat enlarged. 
It is also highly probable* that the colorless corpuscles are 
in reality constituent cells derived from the various tissues 
of the body which have been detached and carried into 
the blood. The plasma, or liquid in which these cor- 
puscles float, is called the serum, and contains fibrin in 
solution. When fresh-drawn blood is allowed to stand 
in a vessel, it thickens or coagulates, the fibrin enclosing 
the red corpuscles gradually sinking to the bottom, while 
the serum floats on the top. Of the twenty-one parts of 
dry solids, about twelve parts consist of corpuscles, six 
parts of albumen, and three parts of a mixture of fibrin, 
saline, fatty, and saccharine matters, and sundry products 
of body-waste. In short, the blood not only contains all 
the materials necessary for the growth and repair of the 
various tissues, but also the products of their' decay. 
VI. The Circulation of the Blood. 
We now pass on to consider very briefly the circulation, 
or the mechanism by which this liquid nutrimeut is con- 
veyed to all parts of the body, going and returning in a 
never-ceasing stream. First, then, there is the powerful 
muscular heart, which, like a force-pump, drives the 
* Much more evidence is needed, however, to establish this theory.-(R.) CIRCULATION OF THE BLOOD. 
53 
blood by successive strokes through a series of elastic 
tubes, called the arteries. This organ is divided into a 
right and left side, or a right and left heart, each of which 
has two cavities, one of them called an auricle, and the 
other a ventricle. The muscular fibres which make up 
the walls of these cavities are so arranged that when the 
muscles of the heart contract, the cavities become com- 
pressed, and the 'blood which they contain is forced out 
of them. The walls of the auricles are thinner and less 
powerful than those of the ventricles, and the right ven- 
tricle is weaker and smaller than the left. In man and 
the higher animals, the heart is lodged between the lungs, 
a little to the left side, and nearer the front than the back 
walls of the chest, and its pulsations may be distinctly 
heard by placing the ear on that side. 
Commencing, then, with the right side of the heart, the 
circulation of the blood is briefly as follows:-The right 
auricle receives into it the blood which flows along the 
great veins from the upper and lower parts of the body, 
and so soon as it becomes filled, it immediately contracts, 
and forces the blood through a valvular opening into the 
right ventricle. In its turn, the right ventricle becomes 
filled, the valves separating the two cavities are closed, 
the ventricle contracts, and the blood is propelled into 
the pulmonary artery through another opening provided 
with valves to prevent any backward flow. The pul- 
monary artery divides into two main arteries, which con- 
vey the blood into the lungs to be exposed to the action 
of the air, when it becomes changed from a dark to a 
bright red color. After being purified in the lungs, the 
blood is collected by the numerous capillaries, and con- 
veyed by the small veins into four large pulmonary veins, 
and from them it flows directly into the left auricle. The 
left auricle then contracts and forces the blood through 
another valvular opening into the strong muscular left 54 
THE HUMAN BODY. 
ventricle, which contracts in its turn, and, the valves 
closing behind, the blood is pumped through another 
opening into the large blood-vessel called the aorta. This 
opening is also furnished with valves to prevent regurgi- 
tation of the blood; and the stream is thus propelled, by 
successive contractions of the left ventricle, along the 
aorta, which runs first upwards, then curves round and 
runs straight down in front of the spine, giving off in its 
course numerous branches, or arteries, which convey the 
blood to all parts of the body. Some of these large 
arteries branch off to the neck, head, and arms; others 
to the stomach, liver, bowels, kidneys, and other organs in 
the abdomen; while a third set branch off to the legs. The 
arteries, whether large or small, are composed of elastic 
fibrous tissue, which yields to each successive impulse of 
the heart. This impulse is conveyed along the arteries, 
and can be seen in some parts, as in the neck, and dis- 
tinctly felt in other parts, as in the wrist. The pulse, 
which can thus be seen and felt, is the result of the 
contractions of the heart, and therefore equals them in 
number. It varies in frequency according to age, health, 
and other circumstances, but in a healthy man the average 
number of beats amounts to about seventy per minute. 
It is quicker in childhood and becomes slower in old age, 
and is slightly more frequent in women than in men. The 
large arterial blood-vessels which branch off to the neck, 
head, extremities, and all other parts of the body, sub- 
divide into smaller ramifications, and these again into 
vessels of less and less diameter, until at last they termi- 
nate in a mesh work of channels so minute that they can 
only be detected under the microscope. The capacity of 
these capillaries, as they are called, is only large enough 
to allow the blood-corpuscles to pass in single file, as it 
were, and they are so crowded together in every tissue 
that a needle's point cannot be pushed into any part of CIRCULATION OF THE BLOOD. 
55 
the body without wounding some of this meshwork of 
minute vessels. But though the arteries may be said to 
terminate in the capillaries, these vessels have no dead 
ends, so to speak-they open into another set of vessels, 
namely, the veins, which are the return-pipes connected 
with the living machinery. The smaller veins collect 
into larger and yet larger branches, and these again finally 
end in two main trunks, called the vena cava, which, as 
we have seen open into the right auricle of the heart. 
The veins resemble the arteries in structure, but they are 
less elastic, and their walls ave thinner and feebler. They 
differ, too, from the arteries in being provided with valves, 
which are intended to prevent any reflux of blood away 
from the heart, while they offer no obstruction to its on- 
ward flow to the heart. These valves are more numerous 
in the veins of the limbs and other muscular parts, and 
it can thus be readily understood that any muscular 
exercise assists the onward flow of the blood in the veins 
in the right direction, and that in this way it is a healthy 
stimulus to the circulation. 
Such, briefly, is the circulation of the blood; but 
something more has to be added. Among the many 
large arteries given off by the aorta in the abdomen, 
there are two which deserve special notice. One of these 
supplies the stomach, intestines, and other organs, and, 
like other branches of the aorta, divides into small arteries, 
and these into capillaries, which again are gathered up 
into veins converging at last into a large vein, called the 
portal vein. Now, this vein, unlike other veins, does not 
join the current in the vena cava, which flows into the 
right side of the heart, but goes to the liver, where it 
branches into smaller veins, and these into capillaries, 
which form a meshwork in the substance of the liver. 
These capillaries collect into small veins, which are ulti- 
mately gathered up, and form a large vein, called the 56 
THE HUMAN BODY. 
hepatic vein, which opens straight into the vena cava. The 
other branch of the aorta, called the hepatic artery, also 
goes to the liver, and after dividing into capillaries, the 
blood which they convey mingles with that collected by 
the hepatic vein. A portion of the blood, therefore, is 
constantly passing through a double set of capillaries, ex- 
clusive of those in the lungs, to be elaborated in the liver 
for the secretion of bile and other substances which largely 
contribute to the process of digestion. 
A word mus't now be said about the rhythmical action 
of the heart. Both auricles are filled, and contract 
simultaneously, and then immediately follows the filling 
and contraction of the ventricles, the right pumping the 
blood into the lungs,'and the left into the arteries of the 
system generally. But while the ventricles are emptying 
themselves, the auricles are again filling, and this alternate 
dilatation and contraction of both sets of cavities goes on 
with a measured regularity, which is evidenced by the 
beating of the heart and the pulse, and by the sounds 
caused by the alternate closing of the different valves, 
which become audible when we place the ear over the 
left front of the chest. 
Briefly, then, the circulation of'the blood pursues this 
course:-right auricle, right ventricle, pulmonary artery, 
capillaries of the lungs, pulmonary veins, left auricle, left 
ventricle, aorta, arteries, capillaries (sometimes two sets), 
veins, venae cavae, right auricle again. It has been ascer- 
tained by experiment that in the horse this circulation is 
completed in about half a minute; but by far the greater 
portion of this half-minute is taken up by the passage of 
the blood through the capillaries. Owing to their exceed- 
ingly minute calibre there is greater friction, and the sub- 
divided stream moves much more slowly than in the 
arteries ; while their walls are so thin that they readily 
permit those interchanges between the blood and the tis- RESPIRATION, OXIDATION, AND EXCRETION. 
57 
sues which are necessary for the nourishment of the body 
and the removal of its effete materials. The passage of 
the blood-corpuscles through the capillaries may readily 
be seen by placing the web of a frog's foot, or the tail of 
a tadpole, under the object-glass of any good microscope. 
Those, again, who are desirous of making themselves more 
thoroughly acquainted with the structure of the heart, its 
situation and relation to the lungs, the nature and mechan- 
ism of its valves and cavities, and the relative position of 
the large vessels connected with it, cannot do better than 
obtain a sheep's pluck from a butcher's shop, and commence 
to investigate for themselves. They will learn far more by 
practical examinations of this kind than from any number 
of illustrations. 
VII. Respiration, Oxidation, and Excretion. 
The lungs, or organs of respiration, with the heart 
between them, are situated in the thorax, or chest, and are 
separated from the stomach, intestines, and other organs 
of the abdomen by the broad flat muscle extending right 
across the body, called the diaphragm, or midriff. This 
muscle is convex towards the thorax, so that when it con- 
tracts it increases the vertical dimensions of the cavity of 
the chest, while the transverse dimensions are simulta- 
neously increased by the action of the muscles which move 
the ribs. For the function of breathing, therefore, we 
possess a bellows-like arrangement, which alternately con- 
tracts and expands under the control of the nervous system, 
bearing a close analogy, in its mode of action, to the cir- 
culatory apparatus. Each consists essentially of a kind 
of pump, which propels a fluid (in the one case aeriform, 
and the other liquid) through a series of ramified tubes, 
the difference being that in the lungs the inflow and out- 
flow pipes are the same. 58 
THE HUMAN BODY. . 
The two lungs occupy almost the entire cavity of the 
thorax which is not taken up with the heart, and each is 
enclosed in a kind of double bag, called the pleura, which 
enables the chest-movements to take place without friction. 
When' the chest expands by the depression or contrac- 
tion of the diaphragm and the elevation of the ribs in 
consequence of the action of the intercostal muscles, the 
lungs, by virtue of their elasticity and the pressure of the 
external air, expand at the same time, so that no vacuum 
is left between them and the walls of the chest or the 
diaphragm. If,, however, an opening is made, either by 
disease or accident, penetrating between the pleura, the 
external air at once rushes in, and the lung on that side 
collapses. 
Although we can breathe either through the mouth or 
nostrils, the latter are the natural air-passages, inasmuch 
as they are-always open. The opening into the windpipe 
itself is situated in the back part of the throat; and its 
mouth, called the glottis, is protected by a kind of lid, 
called the- epiglottis, which immediately closes, under the 
impulse of reflex nervous action, whenever any article of 
food or drink is about to be swallowed. The glottis opens 
into the box-like larynx, containing the vocal cords, and 
this is made continuous with the trachea, or windpipe 
proper. The walls of the trachea are strengthened by a 
series of cartilaginous hoops, which are incomplete behind, 
where the tube comes in contact with the gullet, so that 
the tube is always kept widely open. After passing into the 
cavity of the chest, the trachea divides into two branches, 
which are termed the bronchi. Each bronchus enters the 
lung on its own side, and divides into a large number of 
small branches, named bronchial tubes. As these dimin- 
ish in size, the cartilaginous rings gradually disappear, 
and the walls of the smallest tubes become entirely mem- 
branous, so that they may be almost closed by the con- RESPIRATION-, OXIDATION, AND EXCRETION. 
59 
traction of their muscular walls. These tubes terminate 
in elongated dilatations, about of an inch in diameter, 
which are made up of a series of minute sacs, which open 
into them ; so that the dilatations, when viewed under the 
microscope, bear some resemblance to bunches of grapes. 
The little sacs are the air-cells, and they are so thickly 
clustered together throughout the lung-tissue, that they 
are only separated from each other by very thin delicate 
walls, which contain the capillaries, into which the pul- 
monary artery ^conveys the blood from the right side of 
the heart. The blood, therefore, as it streams through 
these numberless minute capillaries, is exposed on both sides 
to the air; being separated from the air-cell on either side 
only by the exceedingly delicate pellicle which forms the 
wall of the capillary and the lining of the air-sac. 
What is called the respiratory act consists of two parts, 
namely, inspiration and expiration, the air being first 
breathed in, or inspired, and then breathed out, or expired. 
In an adult man, breathing calmly in a sitting posture, 
this act takes place on the average from thirteen to fifteen 
times a minute, and at each inspiration about thirty-two 
cubic inches of air are inhaled into the lungs. But even 
after the most violent - expiratory effort, there is a con- 
siderable quantity of what is called residual air left in 
the lungs, which amounts on the average to 75 or 100 
cubic inches, while in ordinary breathing, the quantity 
left after expiration amounts to about double this ; so that, 
on the average, the total quantity of air contained in the 
lungs after inspiration amounts to about 230 cubic inches. 
Now, in order that the function of respiration may be 
carried on properly, it need hardly be said that it is of 
the first importance that the air which is taken into the 
lungs should be pure. Pure air consists almost entirely 
of a mixture of the two gases, oxygen and nitrogen, there 
being about four times as much nitrogen as oxygen. In 60 
THE HUMAN BODY. 
addition to these, there is a very small percentage of car- 
bonic acid gas, a varying amount of watery vapor, -and 
traces of ammonia, and ozone. To the reader who is 
interested in figures, the .following table will supply the 
averages of these ingredients in 100 parts of pure air;- 
Oxygen 20.99 
Nitrogen 78.97 
Carbonic acid 04 
Watery vapor 
Ammonia 
Ozone 
traces 
From numerous analyses which have been made in 
various parts of the world, it i§ found that the relative 
quantities of the oxygen and nitrogen remain the same, 
or nearly so. The nitrogen, so far as health is concerned, 
is useful only to dilute and mix the oxygen, and is re- 
markable chiefly for its negative properties. It is the 
oxygen alone which is essential to life, and on that account 
it has often been spoken of as 11 vital air." 
Let us now note the changes which the inspired air un- 
dergoes in the lungs before it is expired. First, then, we 
find that, however dry the external air may be, the ex- 
pired air is saturated with watery vapor, or nearly so; 
second, no matter what is the temperature of the external 
air, the temperature of the expired air is the same as that 
of the blood, or about 98° Fahr.; and, third, we find that 
the oxygen of the inspired air has been reduced from 21 
per cent, to about 15 or 16 per cent., and that the car- 
bonic acid has increased from .04 per cent, to about 4.7 
per cent.; or, in other words, that air which has once been 
breathed has gained 5 per cent, of carbonic acid, and lost 
about 5 per cent, of oxygen. The amount of carbon elimi- 
nated during the twenty-four hours is represented on the 
average by a piece of pure charcoal weighing about eight 
ounces, while the amount of water given off during the RESPIRATION, OXIDATION, AND EXCRETION. 
61 
same period, under ordinary circumstances, is about nine 
ounces, or nearly half a pint. In addition to these sub- 
stances, the expired air contains a considerable amount of 
animal matter, which speedily decomposes, and, when 
allowed to accumulate in a crowded room, becomes very 
offensive and injurious. The amount of nitrogen, with 
very slight variations, remains unaltered. 
Such being the differences between the expired and in- 
spired air, we can now understand the changes which the 
blood undergoes as it courses through the meshwork of 
capillaries in the lung-tissue. The dark, or venous, blood 
pumped from the right side of the heart gets rid of a large 
amount of carbonic acid gas, watery vapor, and effete 
animal matter, and as it is whirled along to the pulmonary 
veins, it absorbs about as much oxygen as replaces the 
carbonic acid. The oxygen, it is believed, is taken up 
mainly by the red corpuscles, and the blood, as it leaves 
the lungs, becomes of a bright red tint. This arterial 
blood, as we have seen, is pumped by the left side of the 
heart into every part of the body, .carrying along with it 
the oxygen^which .unites with the carbon,- hydrogen, and 
nitrogen of the waste material of the tissues to form car- 
bonic acid, water, and ammonia; and these products are 
taken up by the capillaries, and conveyed by the veins to 
be ultimately got rid of by the three excretory organs- 
the lungs, the skin, and the kidneys. The blood, therefore, 
while it is continuously distributing nutritious material 
to the tissues^ is continuously removing waste matters from 
them, and these effete matters are seized upon by the 
oxygen - and burned. It is this chemical action which is 
constantly going on within us which produces animal heat, 
and maintains the body at a temperature of from 98° to 
100° Fahr. For just as the combustion of any substance, 
such as coal, or a candle, or gas, is simply the combination 
of the oxygen in the air with the substance which is being 62 
THE HUMAN 30 DY. 
burned, thereby evolving heat and yielding new products; 
so, in the oxidation of tissue-waste, heat is continuously 
evolved, and new and simpler combinations are formed. 
Hence it is that food is often spoken of as the fuel of the 
body, and the body itself likened to a steam-engine. The 
products of combustion of the coal which is used for the 
steam-engine are mainly carbonic acid and watery vapdr; 
an immense amount of heat is evolved, which converts 
the water in the boiler into steam, and this again is con- 
verted into mechanical force, or power. So, in a somewhat 
similar, though much more complicated way, muscular 
force and all the movements of the body, as well as bodily 
heat, are the direct results of the oxidation of the materials 
which are primarily derived from the food. 
We have already seen that a considerable portion of 
these waste products are got rid of by the lungs, and the 
skin and kidneys get rid of the rest. The functions of 
these three secretory organs are closely allied, and though 
they differ much in appearance, they are constructed on 
the same principle. In ultimate anatomical analysis, each 
is found to consist of a very thin delicate membrane, the 
one surface of which'is free, or communicates with the ex- 
terior of the body, while the other is in contact with the 
blood. The blood, as it passes through the numberless 
capillary channels in these organs, is thus purified, by a 
process of filtration, in which the excreted matters are, as 
it were, strained through this thin delicate tissue, and re- 
moved from the body.- The duty of the lungs, as we have 
seen, is to eliminate carbonic acid, watery vapor, and a 
small portion of effete animal matter; the function of the 
skin is to get rid of a large quantity of water, a small 
amount of carbonic acid, and a certain quantity of saline 
matter; while the kidneys get rid of ammonia (as urea 
and uric acid), a large amount of water, and a considerable 
amount of saline substances. The average quantity of RESPIRATION, OXIDATION, AND EXCRETION. 
63 
water given off by the skin during the twenty'four hours 
is about twice as much as that given off by the lungs, or 
nearly a pint; while the carbonic acid eliminated does not 
exceed of that excreted by the lungs. Although under 
ordinary circumstances no liquid is perceptible on the 
surface of the skin, there is, nevertheless, a certain amount 
of what is called insensible perspiration always going on ; 
on the other hand, during violent exercise and intense heat 
combined, the cutaneous perspiration may become so ex- 
cessive that a man may lose two or three pounds in an 
hour. Besides water and a small amount of carbonic 
acid, the skin also secretes, through the sebaceous glands, 
certain fatty matters, and it is constantly throwing off 
scales from the external layer of the epidermis. The 
kidneys secrete nearly two and a half times as much water 
as the skin; but very much depends on exercise, clothing, 
arid the temperature of the external air. 
We thus see, therefore, that water is the principal ex- 
cretion of all three organs, while most solid matter is 
given off by the kidneys, and most gaseous matter by the 
lungs. In its functions, the skin is more allied to the 
kidneys than to the lungs, so that when the free action of 
the skin is interrupted it is usually thrown upon the kid- 
neys ; and when the skin acts freely there is less stress 
thrown on the kidneys, as during warm weather or violent 
exercise. 
The indigestible portions of the food and those which 
are not assimilated, as has already been pointed out, are 
got rid of by the bowels. 
But these various vital processes, or functions, could 
not be carried on or regulated unless they were kept in 
strict harmony with each other. If, for example, the 
balance of healthy life is to be maintained, the food sup- 
plied must be at least equivalent to the tissue-waste, and 
be of a kind to be properly distributed to supply that 64 
TILE HUMAN BODY. 
waste. Or, again, if the body's temperature is to be main- 
tained at a tolerably constant rate, no matter what be the 
temperature of the external air, both respiratory and cir- 
culatory systems must be carefully regulated and kept 
under control. Hence the necessity of a controlling or 
regulating organ, and this is supplied by the nervous 
system. This it is which enables us "to live, and move, 
and have our being;" to know what is going on around 
us; to stimulate us, by the promptings of hunger and 
thirst, when to take our food, and to feel when we>have 
had enough; it enables us to discriminate between what 
is'suitable and what is unsuitable; it controls the alimen- 
tary apparatus, the respiratory apparatus, the circulatory 
apparatus, and the excretory apparatus, for the most part 
in entire independence of the will; and so long as these 
functions are in operation, the body is said to have life. 
When they cease to act, life becomes extinct, and the 
physical forces'which, during life, were the slaves of the 
bodily organism, now become its masters. The oxygen, 
which was the scavenger of the living frame, now becomes 
its destroyer, and atom by atom reduces the complex 
tissues to simpler compounds, such as carbonic acid, water, 
ammonia, and soluble salts. Even the bones and teeth 
are finally dissolved and decomposed. All these simpler 
compounds, as we have seen, may again furnish nutriment 
to the plant, the plant to the animal, and the plant or 
animal, or both, may once more become part and parcel 
of the living frame of some being yet unborn. 
No better illustration of this ceaseless cycle of matter 
can be given than in tracing the course and transmutation 
of the carbonic acid gas given off by our lungs. Though 
we exhale it as a waste product every time we breathe, 
though it is thrown out in enormous volumes by gas-jets, 
fires, and furnaces, it never accumulates in the free air of 
heaven around us; for the economy of nature tolerates no RESPIRATION, OXIDATION, AND EXCRETION 
65 
waste-no accumulation of effete matters. This gas, which 
is so fatal to animal life, is ordained to be indispensable 
to vegetable life. We exhale it, and plants inhale it, so 
that every tree which is still left room to grow in a 
crowded city, and every plant on a window-sill, transmutes 
it by the heat of the sun into blossom and leaf and stem, 
imprisoning the carbon and setting the oxygen free. The 
coal which we now burn was made up, ages long ago, of 
plants fed by the nourishing heat of the sun from the 
carbonic acid in the air, and both the heat and the car- 
bonic acid are returned to us as we sit by the blazing fire. 
And so, too, although we cannot rebreathe this gas with- 
out injury, we can use it as food in our vegetables, and 
transmute the heat pent up within it in the leaves and 
roots into the warmth of our bodies, the strength and 
activity of our limbs, and even the very thoughts which 
flash from our brains. CHAPTER III. 
CAUSES OF DISEASE. 
An old writer has quaintly asked, "Who is he that 
values health at the rate it is worth? Not he that hath it; 
he reckons it among the common ordinary enjoyments, and 
takes as little notice of it, or less regards it, than his 
long-worn clothes; perhaps more careful of his garments, 
remembering their price; but thinks his health costs him 
nothing, and coming to him at so easy a rate, values it 
accordingly, and hath little regard to keep it; is never 
truly sensible of what he enjoyed until he finds the want 
of it by sickness; then health, above all things, is earnestly- 
desired and wished for." 
Although it is the poor man's stock-in-trade, how often 
is it thoughtlessly and recklessly squandered? How often, 
too, is it sacrificed in the race to be rich? And yet the 
rich man would gladly part with all his wealth to regain 
it. For health is one of the mainsprings of human hap- 
piness, because it not only implies freedom from bodily 
pain or discomfort, but without it there can be no real 
enjoyment of life or of the varied pleasures which surround 
us. It more than compensates for any inequality in social 
position, and may even make a king envious of a beggar. 
And yet, though all this has been accepted as trite and 
true ever since moralists began to sermonize on mankind 
and their follies, there is too much reason to fear that the 
scattered seed still falls on somewhat stony ground. Ill 
health and disease often set in so insidiously, that warnings, 
which in themselves are significant and distinct enough, 
66 UNCONTROLLABLE CAUSES. 
67 
are allowed to pass by unheeded, until at last even the 
man who was originally blessed with a strong constitution 
begins to find that he can no longer take liberties with 
himself, and is fortunate if he can still retain a fair stock 
of health by becoming more careful as to what he eats 
and drinks, or more exemplary in his personal habits and 
mode of living generally. Very frequently it happens 
that he finds out his mistake when it is too late; and he 
may thus be doomed to wander through life a hopelessly 
incurable invalid, or perhaps to sink into an early grave. 
"The excesses of our youth," says Colton, "are drafts upon 
our old age, payable with interest about thirty years after 
datebut too often the drafts have to be met at dates 
much earlier than this. 
If health, then, is rightly regarded as the greatest of 
mortal blessings, it surely becomes a matter of paramount 
concern to be in a position to know how disease, which 
has been designated the greatest of mortal evils, may be 
averted. Now, so long as disease was believed to be a 
separate entity, a something inflicted on the living body 
as a " visitation," its causes were looked upon as inscru- 
table, and consequently no intelligent efforts were made to 
remove or mitigate them. It was not till physicians began 
to discover that the phenomena of disease were in reality 
but derangements of the organization of the body or of 
one or more of its functions, that any actual progress 
became possible in the direction of prevention or control. 
For in order to be able to control disease, it is essential 
that the physician should not only comprehend its nature, 
but should be able to discriminate its various phenomena, 
and such accurate discrimination is only of recent growth. 
Then, too, it has to be pointed out, that underlying the 
whole art of prevention, is this other great truth, estab- 
lished in these latter days by the researches of the physi- 
ologist-that the animal organism is intended by nature 68 
Czl USES OF DISEASE. 
to pass through a prescribed period of existence from 
natural birth to natural death, and that it is incapable in 
itself of originating any of the manifestations of disease. 
We have, therefore, to look Outside the body for influences 
or agents which operate as causes of disease in all its 
multiform phases, and with an ever-widening knowledge 
we find -that though many of these causes are uncontrol- 
lable, many more are controllable, and to an extent which 
we have reason to believe renders them preventable. 
Foremost among the uncontrollable causes of disease, 
are those atmospheric changes depending upon seasonal 
variations, ranging from the extreme cold of winter to 
the summer scorching heat. Even on the healthy body, 
and apart from any manifestations of disease, these 
seasonal changes produce influences of a well-marked 
kind. For example, it was proved by Mr. Milner, late 
surgeon of the Wakefield prison, from a large series of 
observations made during several years, that during the 
winter months the body loses weight, while it gains during 
the summer months; and the changes from loss to gain, 
and from gain to loss, take place respectively about the 
beginning of April and September. 
It is true that these changes may be considerably 
modified by regulating the diet and varying the clothing; 
but they nevertheless show that the seasons and the 
variable climate of this country exert a far more powerful 
influence on the bodily functions than is usually supposed. 
For example, a sudden fall of temperature is sure to be 
followed by a long train of ailments, such as catarrh (or 
common colds), influenza, bronchitis, and other forms of 
lung disease; and when we turn to the tables of the 
Registrar-General, we find that the mortality heals a very 
intimate relation to age. Thus, according to Dr. Farr, 
if the degree of mortality following upon a lowering .of 
the temperature below freezing point be expressed as 1 in UNCONTROLLABLE CAUSES. 
69 
1000 at the age of twenty, it becomes 2 at the age of 
twenty-nine, 4 at the age of thirty-eight, 8 at the age of 
forty-seven, and so'on, doubling with every nine years of 
life. Then, again, if we consider the relationship of 
diseases to meteorological conditions, we find that certain 
diseases, such as bronchitis and pneumonia, or inflam- 
mation of the lungs, have their greatest fatality in the 
first quarter of the year, that it gradually falls during the 
second and third quarters, and again increases during the 
fourth quarter. The fatality consequent upon other 
diseases, such as influenza, pleurisy, and quinsey, is in a 
great measure similarly influenced; and there are many 
other ailments which, though they originate independently 
of weather changes, have nevertheless their intensity 
greatly modified by them. During the first and fourth 
quarters of the year, the low average temperature is 
accompanied by low barometric pressure and increased 
moisture in the air, and as these are conditions unfavorable 
to the equalization of the temperature of the body, they 
readily give rise to febrile disturbance, which is a marked 
symptom of the diseases under consideration. 
If we come now to inquire into the effects of excessive 
heat, we find that, apart from cases of sunstroke, which 
are not numerous in this country, they chiefly act upon 
the digestive organs. Just as extreme cold is a fruitful 
cause of disease of the organs of respiration, so excessive 
heat becomes a source of danger to the organs of digestion, 
and hence it is that the deaths from diarrhoea and 
bronchitis, which may be taken as typical diseases of the 
two conditions, bear a constant relation to the higher and 
lower temperatures of summer and winter. No doubt, a 
considerable amount of the diarrhoea which is prevalent 
during warm weather is due to the fermentive changes 
induced in articles of diet, and to the foul effluvia given 
off by decomposing filth of all kinds; but at the same 70 
CA USES OF DISEASE. 
time, there can be no question that excess of heat is fol- 
lowed by a relaxed state of the system, and a great 
diminution in the vital changes going on within the body 
which operate especially on the organs of digestion. 
But though meteorological conditions are thus shown 
to be prominent uncontrollable causes of disease, their 
direct effects are nevertheless capable of being greatly 
modified by due attention to clothing and house-warmth, 
and by an intelligent regulation of diet and exercise 
according to age, sex, occupation, and bodily constitution. 
The primary care is to endeavor to maintain the body at 
all hours and seasons at an equable temperature, and this 
especially applies to the aged and the very young. All 
these are points, however, which will be more fully noticed 
further on. 
We now proceed to the consideration of causes of disease 
which are more or less controllable, and in briefly dis- 
cussing so wide a subject it will be convenient to do so 
under the following heads:- 
I. Hereditary Influence. 
II. Self-Induced and Social Causes of Disease. 
III. Material, Local, and Communicable Causes of 
Disease. 
Section I. Hereditary Influence. 
To those who have paid any attention to the domesti- 
cation of animals, there is no fact more familiar than the 
wonderful resemblances, extending even to color and 
markings, which can be produced over and over again in 
a well-selected stock. While we see in every direction 
the wide and various transmission of incidental varieties 
in each species, depending originally to a large extent on 
combinations of natural causes, we cannot help being 
struck with the precision with which these varieties can 
be perpetuated by judicious management; and not only HEREDITARY INFLUENCE. 
71 
so, but man has actually the power, by careful selection, 
to produce animals after a few generations presenting 
peculiarities of conformation, color, or size so distinct and 
well defined that they virtually constitute a new variety. 
Look, for example, at the numerous breeds of horses, dogs, 
and cattle, or the different varieties exhibited in a well- 
filled poultry show-yard. In all of them we cannot fail 
to recognize the all-powerful influence of hereditary trans- 
mission; and yet there are few among the general public 
who reflect that the same laws of heredity operate with as 
much force on the human race for good or for evil, as 
they do in raising or deteriorating any particular variety 
of inferior species. In this sense, civilization is to man 
what domestication is to the lower animals. In man, as 
in animals, heredity stamps the physique and moulds the 
form and features; and just as instinct is purely the 
heritage of the animal, so mental and moral proclivities 
become the birthright or birthwrong of the newly-born 
child. 
While the prominent inheritance of the child from its 
parents is its physical type, its external conformation, its 
stature, physiognomy, and the color of its hair and skin, 
it is no less true that temperament, idiosyncrasies, and 
mental endowments are as transmissible as external re- 
semblances. Not that parents repeat themselves exactly 
in their offspring, but they certainly impart to the consti- 
tution, in a very large degree, the special direction which 
life has already taken in them. Hence it may be said 
that every family has its organic patrimony-a statement 
which is popularly illustrated by the expressions " good 
blood" and "bad blood." Some families, as we all know, 
are given to stoutness, while others are very spare; some 
are tall and stalwart, while others are small and wiry; 
some are very dark-complexioned, while others are very 
fair. In like manner, hereditary influence affects the 72 
CA USES OF DISEASE. 
structure of the internal organs, and modifies every phase 
of vital action. Hence it is that some families are long- 
lived and healthy, while others are notably short-lived; 
some are dyspeptic and bilious, while others seldom or 
ever suffer in this way. So, too, as regards mental 
qualities and temperament, we find that some are gifted 
with marked mental endowments, while others are dull, 
stupid, and lethargic; some are arrogant and overbear- 
ing, while others are gentle and unassuming. But 
without multiplying instances of the influence of heredity 
on mental capacity and proclivities, I may refer the 
reader to Mr. Galton's, work on "Hereditary Genius," or, 
as regards a scientific exposition of the whole subject, to 
Mr. Darwin's writings on the domestication of plants and 
animals. 
To put it very briefly, the main doctrine which lies at 
the foundation of hereditary influence appears to be this- 
that the accumulation of individual variations or charac- 
teristics, through recent descent, has a far greater influence 
upon a man's bodily and mental constitution than the un- 
changed gifts of a remote ancestry; so much so, indeed, 
that these latter may be regarded as a vanishing quantity. 
In other words, the progeny is invariably moulded by the 
characteristics of its more recent ancestry, and by those of 
the parents, more than by those of its grand-parents, and 
so on backwards, in a constantly decreasing ratio. 
Not to refer again to the influence of parentage, the 
influence of the other immediate progenitors on the bodily 
constitution of the offspring is manifested by the resem- 
blances which crop up under that singular law of heredity 
known as Atavism, where a bodily peculiarity existing in 
a family is partially or wholly lost in one generation, re- 
appearing in that which follows, or even yet later. The 
influence of race, on the other hand, is manifested by the 
constancy of averages, under tolerably constant conditions, HEREDITARY INFL FENCE. 
73 
from generation, to generation, and this not only as regards 
the whole body and its various component parts, but also 
as regards all the facts which are comprised within the 
range of social and vital statistics. Another law, which 
has a wide bearing on the physical condition of communi- 
ties, is this, that deviations from these averages or from 
the normal type, although they are transmissible, cannot 
go beyond certain limits. Thus, as regards size, the giant 
and dwarf form the extreme limits of the chain; and 
hence, in the procreation of individuals representing these 
deviations, the tendency to revert to the normal type is 
invariably manifested in the offspring. In the same way, 
as all forms of deterioration or disease may be regarded as 
deviations or perverted life-processes, they are likewise 
subject to limitation in transmission, and there is the same 
tendency exhibited to revert to the normal type under 
improved conditions. Thus, though many diseases, such 
as consumption, scrofula, gout, and insanity, are hereditary, 
the special disease may be finally eradicated from the 
family by adopting suitable measures, and the morbid 
tendency be eventually overcome. 
Having said so much generally with regard to the laws 
of heredity, let us now consider their hygienic application. 
And first of all, it has to be noted that acquired charac- 
teristics may become a family heirloom. For example, 
the man who, though originally strong and healthy, gives 
way to vicious habits, runs the risk of branding his off- 
spring with a diseased or enfeebled constitution. If he 
becomes a drunkard, the chances are that some of his 
children will become drunkards too. If he lives too well 
and becomes gouty, the gouty tendency which he has con- 
tracted will, in all likelihood, be inherited by one or other 
of his children or their descendants. If, through occupa- 
tion, or being housed in an unhealthy dwelling, he becomes 
consumptive, his children have to face the dangers of 74 
CA USES OF DISEASE. 
scrofula or lung disease, and should they live under the 
same conditions, this danger becomes greatly increased. 
Or again, if, from worry and overwork, he shatters his 
nervous constitution, he may have an imbecile for his heir, 
or a wild-cap to scatter to the winds his hard-earned wealth. 
Last of all, should he become a reprobate criminal or thief, 
what a terrible legacy other than a felon's name may be 
bequeathed to his offspring! All these are instances of the 
deep significance of the old Bible text, "The sins of the 
fathers shall be visited upon the children, even unto the 
third and fourth generations." 
It is one great characteristic of hereditary taint that it 
takes advantage of its opportunity; in other words, the 
different stages of growth or decay through which the 
body passes favor more or less the manifestation of this or 
that kind of hereditary tendency. Hence it is that some 
few diseases appear to be hereditary from birth, others 
after a long period, while others remain unaroused for an 
indefinite period because they are not influenced by any 
exciting causes from without. This is but too painfully 
illustrated by the hereditary tendency bequeathed by con- 
sumptive parents. In childhood, for example, this ten- 
dency very frequently manifests itself in the disease known 
as tubercular meningitis, or inflammation of the lining 
membranes of the brain; in youth, the glands of the neck 
become attacked; while in early adult life, what is called 
phthisis, or true consumption, breaks out in the lungs. 
Insanity, again, which is to a large extent a hereditary 
malady, if it does not declare itself in the idiocy of the 
child, seldom attacks the offspring until the whirl of the 
passions begin to have full play in early manhood. 
Hereditary gout rarely becomes developed before the age 
of thirty, and the liability to cancer, which is far more 
common among the female than it is among the male sex, 
is seldom manifested before the age of forty. It further HEREDITARY INFLUENCE. 
75 
appears that, if the age is passed at which any particular 
taint is liable to become aroused into activity, the morbid 
hereditary tendency is materially lessened. At thirty-six 
years, the individual born of consumptive parents may 
reasonably look forward to reaching a mature age. 
Another deeply interesting question here crops up for 
consideration in connection with the aptitude, to repeat 
the morbid state which the parents presented, and it is 
this-what are the causes which bring this liability into 
play? Indeed, it is only by virtue of a due appreciation 
of these causes that hygiene becomes powerful to combat 
this hereditary tendency to disease, and to stifle it in its 
first beginnings. It is because hereditary disease does not 
usually burst forth without the influence of exciting causes 
that we can dispute with it incessantly the organ or par- 
ticular part of the body which it threatens. And speaking 
generally, it will be found that we can best subdue any 
particular hereditary tendency by studying the causes 
which produced it in the first instance, and as far as 
possible guarding the offspring, especially at critical ages, 
against the operation of these causes. For example, the 
child of a consumptive parent should be well fed, carefully 
clothed, have plenty of exercise in the open air, should 
not be allowed to sleep in an over-crowded room or live in 
a damp house, and should not be put to any occupation 
which cramps the free play of the lungs, or endangers 
them by the inhalation of foul air. On the other hand, 
the son of a gouty father or grandfather should be par- 
ticularly careful not to live too generously, to avoid 
stimulants, and to take plenty of active exercise. Or 
again, if the taint of insanity lurks in the family, every 
effort should be made to curb the passions, to control the 
temper, and to eschew whatever may lead either directly 
or indirectly to violent mental disturbance. 
If, now, we come to consider the course of hereditary 76 
CA USES OF DISEASE. 
transmission, we find that it is not always an easy matter 
to determine it in many instances; for the morbid ten- 
dency often travels in a capricious way across posterity. 
It can leap over a generation, and reappear in one or 
other of the grandchildren, or attach itself to one of the 
two sexes. There is, however, one law connected with it, 
which asserts itself with terrible severity, and it is this- 
that any particular taint, if common to both parents, is 
liable to be greatly intensified in the offspring. It is on 
this account that marriages between cousins or near blood 
relations, are inadvisable, inasmuch as latent morbid ten- 
dencies, should they form part of the organic patrimony 
of the family, are almost certain to become developed in 
the children. If cousins come of a strong and healthy 
parentage on both sides, there is no physiological objection 
to their marriage-indeed, the chances are that the family 
physique-and mental characteristics will be improved; 
but if there should happen to be a lurking taint common 
to both, it will seldom fail to impair the vitality of the 
offspring. The Nemesis of this law is so tellingly chroni- 
cled in the history of many a family, that the thoughtful 
reader will have little difficulty in discovering instances, 
either among his own relations or in the wider circle of 
his friends and acquaintances; or, if he wishes to search 
further afield, he will find that it is in consequence of 
this law that ancient aristocracies, reduced to repeated 
inter-marriage, have become first degenerated physically, 
and have become finally extinct, sometimes by drifting 
into imbecility, or dementia, or, at all events, by becom- 
ing infertile.* 
* The practical value of that great medicine of the future, Preventive Medicine, 
will, I think, be much enhanced by general recognition of an active elimmative law 
in Nature which' I have formulated as The Extinction or the Unfit. This ordi- 
nance is the direct antithesis of Darwin's survival of the fittest, and one chief 
business of Sanitary science is to counteract its influence by rendering individuals, 
families, or nations, doomed in accordance with its conditions, to speedy death from 
inherited disease, more fitted to survive.-(R.) HEREDITARY INFLUENCE. 
77 
And now, before adverting very briefly to the practical 
bearings of this all-important subject, it is necessary that 
some notice should be taken of other consequences of 
unsuitable or imprudent marriages. Without discussing 
over-population theories, it is evident that when a man 
marries, no matter what his age may be, at a time when 
he can barely earn his own subsistence, and when he has 
no other resources to look forward to, he runs the risk of 
begetting a family which he cannot rear without the aid 
of pauper relief. The consequence is that this unthrifti- 
ness in marriage, prevailing as it does among the ignorant 
and degenerate, leads too often to intentional neglect of 
the children, amounting to culpable homicide. 
Then, again, such of the children as do survive the 
terrible evils attending upon squalor, ignorance, and 
neglect, only serve to swell the dwarfed and sickly look- 
ing crowd which nestle in the rookeries of our large 
towns. Side by side, too, with this unthriftiness of 
marriage, there is another cause of deterioration of the 
offspring, namely, the practice which prevails, more espe- 
cially among the artisan and laboring classes, of marrying 
too young; and the reason is that too early marriages, 
like marriages which take place too late in life, if not 
infertile, result iu the birth of children afflicted with a 
lowered vitality. And not only so, but how often do we 
see the very young mother become a permanent invalid, 
barely able, if able at all, to nurse her children, and 
through the ill health, induced by a too early marriage, 
imparting to her offspring a vitiated heritage 1 Indeed, 
so. numerous are cases of this description, that some phy- 
sicians, who have carefully studied the subject, maintain 
that no woman should marry before she is twenty-one 
years of age, and further, that her own health, and con- 
sequently that of her children, has a much less chance 
of becoming deteriorated if marriage on the average is de- 78 
CA USES OF DISEASE. 
layed to the age of twenty-five. As regards the other sex, 
it may be said generally that no man has a right to marry 
unless he is in a position to provide a comfortable home for 
his wife, and that he should endeavor to delay the period 
of marriage until he is at least twenty-five years of age. 
Reverting, however, to hereditary tendencies, it may be 
readily inferred, from what has previously been said, that 
apart from the question of consanguinity, no weak, scrofu- 
lous, or consumptive men should marry any but strong, 
healthy women, if they marry at all; and this, of course, 
applies equally to the opposite sex. Indeed, if the con- 
sumptive tendency is strong and well-marked, there. can 
be no question that the individual so afflicted should avoid 
marriage altogether, or, at all events, should never dream 
of entering the married state until the critical age has 
been safely passed, and even then not without taking 
medical advice. Then, too, it need hardly be said that it 
is most undesirable that two persons should marry in 
whose brains lurk the seeds of insanity. Such a union 
would be tempting a terrible curse upon any children 
that might be born, and throw an awful responsibility 
upon the parents. 
In entering the married state, health is wealth in the 
real sense of the word-better far than a well-lined purse, 
which is the prize too often run after, even when so-called 
prudential motives come into play, to the utter disregard 
of all other considerations. Not that money need be any 
objection-on the contrary, it is often a great aid to 
comfort and happiness; but money becomes, after,.all, a 
poor solace for the unavailing regret which follows the 
ill-assorted match, when the parents can only hope that 
others will be warned by their example. The thoughtful 
and sensible may become warned thereby; but the 
thoughtless, ignorant, and reckless, it is to be feared, will 
continue to reproduce a diseased, vitiated progeny, with SELF-INDUCED AND SOCIAL CAUSES. 
79 
a blind indifference to all laws, until the time comes when 
knowledge, with its blessings, will reach even them, and 
thus become the means of preventing many a tragedy 
and saving many a life. 
In taking leave of this subject, I cannot do better than 
quote the eloquent words of Dr. Farr:-"The hygienic 
problem is how to free the English people from hereditary 
disease: hereditary consumption, cancer, syphilis, gout; 
hereditary insanity, hereditary vagrancy, hereditary crim- 
inality; and to develop in the mass the athletic, intellec- 
tual, aesthetic, moral, and religious qualities which have 
already distinguished some of the breed. There is a 
divine image in the future, to which the nation must 
aspire. The first step towards it is to improve the health 
of the present generation; and improvement, if as per- 
sistently pursued as it is in the cultivation of inferior 
species, will be felt by their children and their children's 
children. A slight development for the better in each 
generation implies progress in a geometrical progression; 
which yields results in an indefinite time, that, if suddenly 
manifested, would appear miraculous." 
Section II. Self-Induced and Social Causes of 
Disease. 
The sources of disease included in this somewhat in- 
definable group, although numerous and intricate, are 
largely under individual control, and the manifestations 
of disease to which they give rise are, therefore, in the 
strict sense of the word, preventable. They depend 
mainly on a personal disregard of the laws of health, 
often through ignorance, sometimes through indifference, 
and sometimes through reckless neglect. Not a few of 
them are associated with the exactions and usages of so- 
ciety, and some are incidental to the pursuit of certain 
occupations, which are injurious to health and life; but, 80 
CA USES OF DISEASE. 
however classified, the mere enumeration of the more 
prominent among them will suffice to convince the reader 
how wide and varied is the list, and what a fruitful source 
they are of disease and death. Intemperance, errors in 
diet, abuse of the luxuries of life, overwork, idleness, 
want of self-control, irregular modes of life, errors in 
clothing, unhealthy occupations, are all of them causes 
which merit consideration under the above category. 
1. Intemperance.-I prefer to use the word intemper- 
ance rather than alcohol as a cause of deterioration and 
disease, because I am frankly of opinion that the moderate 
use of alcoholic stimulants has not been proved to be 
detrimental to the health of persons who may be said to 
partake of them daily, but who are careful never to ex- 
ceed. To' many people, and especially to the slightly 
dyspeptic, they frequently prove valuable aids to diges- 
tion ; to the thoroughly temperate, they make the wheels 
of life run more smoothly, without in any way injuring 
its machinery; while to the aged, they often prove a boon, 
by imparting warmth as a respiratory food, and by indu- 
cing refreshing sleep, which would otherwise forsake the 
pillow. If, again, we look at the broader aspects of the 
question, we find that civilization itself exhibits a strange 
unison with the consumption of alcohol. Compare, for 
example, the average physique and mental culture of 
beer-drinking Germany and whisky-drinking Scotland, 
with those of moderate Spain and abstemious Turkey, 
and making every allowance for racial differences and 
differences of climate, we can, at all events, discover no 
reliable grounds for the doctrine so persistently advocated 
by many, that alcohol is in itself a poison, or that its use 
need necessarily prove the curse of this or any other 
country. By all means let those abstain who believe 
they can get on very well or better without it; let those 
also abstain who have not sufficient control to prevent SELF-INDUCED AND SOCIAL CAUSES. 
81 
them from indulging occasionally, repeatedly, or habitu- 
ally to excess; but surely this intolerant raid in favor of 
total abstinence, and total abstinence alone, is based on 
arguments which are radically weak, and defeats its own 
ends by arousing opposition which it would be wiser to 
conciliate. The advocates of temperance are quite as 
much alive to the terrible evils of alcoholic excess as are 
the most strenuous advocates of total abstinence; and, 
indeed, it may be fairly said that the cause generally has 
prospered far more vigorously since the former have 
taken to the public platform, than during all the years 
when the latter strove to gain the public ear. Not that 
I wish to disparage in. the least the vast amount of good 
which the advocacy of total abstinence principles has 
been the means of producing, but because no unbiased 
mind can help regretting that self-control, which, after 
all, is exercised by the many, should be supplanted by a 
sacred promise, or oath, which, it is to be feared, is as 
often violated as it is observed. So long as free-will has 
play, it is not a pledge, but conviction, that will gain the 
day. 
At the same time, I am free to admit that the .great 
majority of healthy men and women can get on very well 
without alcohol, and that the amount which can be par- 
taken of habitually, without risk of endangering the 
health, is for most people comparatively small. It is 
well known that it can suddenly be left off by the im- 
moderate drinker without any immediate detriment to 
health, and doubtless with ultimate advantage. Then, as 
regards physical endurance, it has been proved over and 
over again, in fatiguing campaigns and long, weary 
marches, that the soldier who abstains can face danger 
with as stout a heart, and march with as firm a step, as 
the soldier who takes the spirit ration. All this goes to 
prove that alcohol is not absolutely necessary to health, 
6 82 
CA USES OF DISEASE. 
and, indeed, when an appeal is made to the statistics of 
Life Assurance Societies, the argument appears to be 
very much against even what is called moderate drink- 
ing; for, according to a paper which was read by Mr. 
Vivian, the Chairman of the United Kingdom Temper- 
ance and General Provident Institution, before the British 
Association, in 1875, the difference in the mortality of the 
abstainers and moderate drinkers is very remarkable. 
It was found, for example, in nine years (1865-74), that, 
while 1110 deaths were expected among the abstaining 
insurers of the institution, according to the calculations of 
the actuaries, only 801 deaths occurred; whereas, during 
the same period, the number expected to die among the 
non-abstaining or moderate drinkers, who had insured, 
amounted to 2002, and the number of deaths which 
actually occurred was 1977. According to this state- 
ment, and others of a similar nature, whose validity can- 
not be impugned, the prospect of longevity is largely in 
favor of total abstainers, and the only weak point in the 
argument is this, that the majority of the non-abstainers 
insured in the same society were probably not moderate 
drinkers in the strict sense of the word, but persons who, 
on the average, took considerably more than the amount 
of stimulants consistent with the maintenance of sound 
health.* 
But in order that the reader may be able to realize the 
dangers which attend the too free use of stimulants, let 
us now consider very shortly the physiological action of 
alcohol, whether it be imbibed in spirits, wine, beer, or 
* This defense of moderate drinking, " in the strict sense of the word," is, I am 
happy to say, better suited to the social atmosphere of England, than to that of the 
more.enlightened portions of America, An observant traveller soon learns to think 
that the English rear so many drunkards, because they are a nation of moderate 
drinkers. I consider that no man who has formed the habit of drinking, is compe- 
tent to decide for himself when, or how much, spirits is good for him; and my 
advice to every one is never to taste alcohol except on the written prescription of 
a reputable physician.-(R.) SELF-INDUCED AND SOCIAL CAUSES. 
83 
cider. The first symptom which deserves notice is the 
quickened action of the heart, as shown by the increased 
rapidity of the pulse; and along with this there is dila- 
tion of all the small blood-vessels, or capillaries. The 
vessels of the skin become turgid, as shown by the flushed 
face and the warm glow all over the body; the vessels of 
the stomach become likewise full of blood, and hence the 
feeling of "comfort within;" the minute vessels of the 
brain are also overcharged-the brain becomes more 
active, thoughts flow more rapidly, and speech becomes 
more free, and sometimes more eloquent. This may be 
called the stage of exhilaration-a stage which is often 
reached at the convivial dinner-party, but which as often 
carries with it the penalty of what is called "seediness" 
next day; a fact which shows but too clearly that even 
at this stage there is danger, if not actual detriment. 
Whenever the face becomes slightly flushed or the tongue 
begins to wag too freely, the convivial guest or the genial 
host may be quite, sure that he has had enough, and more 
than enough; the danger-signal has been hoisted. 
If the alcoholic dose, so to speak, is still further in- 
creased, the higher, or controlling, part of the brain be- 
comes paralyzed for the time being; reason is off duty, 
and the lower, or animal, impulses begin to manifest 
themselves. Then, too, the motor nerve-centres become 
implicated, as shown by the inarticulate speech and un- 
steady gait. In the last stage of all, there is utter uncon- 
sciousness and helplessness to move; the heart and lungs 
may still act, but the victim is veritably on the brink of 
death, and it only requires an extra dose to kill him out- 
right. Along with these changes, there are others to be 
noted, which seriously affect the temperature of the body. 
During the stage of exhilaration, the temperature exhibits 
a distinct increase, owing mainly to the dilated condition 
of the capillaries under the skinj but in consequence of 84 
CC4 USES OF DISEASE. 
this dilation of the blood-vessels, and the more rapid flow 
of blood through them, there is increased radiation of 
animal heat. In other words, the body is parting more 
quickly than usual with its warmth; very soon the nor- 
mal temperature is regained, and during the third or last 
stage of intoxication it is found that the temperature has 
fallen, very much below the average. It is on this account 
that alcohol, even in moderate doses, cannot be tolerated 
in very cold climates; indeed, the loss of heat which 
ensues is found to be so great, that its use is practically 
abandoned in all Arctic expeditions. On the other hand, 
there can be no question that its use is a fruitful source 
of disease in hot climates. Much of the dysentery and 
allied disorders of the alimentary canal, and notably, 
diseases of the liver, are due to stimulants, probably 
because the oxidation of alcohol is very much retarded 
in warm weather, and because the excessive action on the 
skin has a depressing influence on the nervous system. 
Adverting now to the habitual and excessive use of 
alcoholic liquors amounting to intemperance, it may be 
said at the outset that the general effects are of a cumu- 
lative nature. The strong and active individual blessed 
with a sound constitution may be able to withstand the 
inroads of actual. disease for many years, but long before 
he has passed his manhood's prime he begins to find that 
he is not such a good man as he used to be. After a time, 
he discovers that certain kinds of stimulants disagree 
with him-he is obliged to give up his beer, he is afraid 
of port, and he begins to look askance at champagne. 
After a long series of headachy and depressed mornings, 
which even "pick-me-ups" fail to make enjoyable,he rue- 
fully resolves to be a little more careful, and he forthwith 
begins experimenting how not to rob himself of his allotted 
quantity of alcohol, and yet avoid' the painful conse- 
quences which it is bqt too clear he has brought upon SELF-INDUCED AND SOCIAL CAUSES. 
85 
himself. He has been mixing his liquors too much-some 
of them have been too fruity, and he will try dry sherry, 
and, to make amends for his late-born care with regard to 
wine-drinking at the table, he allows himself an extra 
glass of whiskey-and-water or brandy-and-soda before 
going to bed. But he soon finds, much to his disappoint- 
ment, that all this is of no avail, and if he is a wise man, 
he will either knock off stimulants altogether for a time, 
or restrict himself to an amount which is within the limits 
of strict temperance, although far below that which he 
has been accustomed to take for years. 
Fortunately for the public health in general, and for per- 
sonal health in particular, the great majority of so-called 
moderate drinkers take warning in time, though often, it 
may be, through painful experience; but it is no less true 
that there are thousands in this country who, in spite of 
these warnings, drift heedlessly and recklessly onward to 
certain disease and premature death. Of the minor ail- 
ments which assail the intemperate at the outset of their 
career, I may mention some of the more common-head- 
ache, neuralgia, dyspepsia, gouty and rheumatic symptoms, 
colds, languid circulation, palpitation, mental depression, 
inertia, disturbed rest, twitching of the muscles, and pass- 
ing derangements of the bowels and kidneys. In fact, the 
vital powers generally become seriously deteriorated be- 
fore many years are over, and the transit from functional 
disturbance to acute or chronic disease may be either 
sharp and sudden or slow and insidious, but in either case 
it is inevitable if habits of intemperance are continued. 
The following are some of the more serious effects which 
remain to be considered:- 
The nerve-centres become degenerated, and epilepsy 
may result as a terrible sequence to the involuntary mus- 
cular twitchings which were unheeded as danger-signals, 
or paralysis, either general or local, may supervene. But 86 
CA USES OF DISEASE. 
of far more common occurrence are other morbid states, 
which are more or less mental in their character, for after 
a time over-indulgence steadily weakens the self-control 
of the hapless victim, and ultimately makes him an utter 
slave to his lower and mere animal nature. The craving 
for drink becomes well-nigh irresistible-honor, self-re- 
spect, the tears of affection, the dictates of conscience, 
are alike powerless to effect reform; the victim of intem- 
perance has at last become a veritable dipsomaniac, whose 
only chance of cure is restraint in an asylum or some 
other place of retreat. 
Closely allied to this pitiable condition, there is another 
which is exemplified by intermittent indulgence to mad- 
dening excess. This form of disease is called the mania 
apotu; the victim is not habitually intemperate, but at 
intervals he gives way to indulgence to such an extent as 
to become a terror to his friends on account of his violence 
and brutality. Such cases as these are the despair of 
magistrates; they crowd our gaols for. barbarous and un- 
provoked assaults, especially on helpless wives; but pun- 
ishment and admonition appear to be of little avail in 
preventing frequent relapses. 
The disease known as delirium tremens is another terrible 
instance of the effect which alcoholic excess may exercise 
over the nerve centres. The disease is characterized by 
muscular tremors, a low temperature, with cold and clammy 
skin, persistent wakefulness, then delirium, with all the 
horrors df the most hideous phantasmagoria which the 
imagination can possibly conceive. During the attack 
the patient is literally hovering on the brink of the grave, 
and although recovery under proper care and treatment 
is common, it need hardly be said that the system has re- 
ceived a shock from which it will take long to recover. 
The extreme instances of disorganization of the nervous 
system are found in our lunatic asylums-beings who have SELF-INDUCED AND SOCIAL CAUSES 
87 
lost every attribute of humanity except the name; hope- 
less, helpless, doomed to a living death until they cease to 
live. 
• Among diseases induced by alcoholic excess which attack 
other parts of the body, may be mentioned heart disease, 
and more particularly that form of it which consists in a 
degeneration of the muscular substance itself; disease of 
the larger blood-vessels, represented by aneurism; and 
disease of the small vessels or capillaries, thereby in- 
terfering to a serious extent with the nutrition and healthy 
action of almost every one of the vital organs. Thus, 
while the repeated dilatation of the lung-capillaries renders 
the person addicted to habits of intemperance liable to 
attacks of bronchitis, pleurisy, or pneumonia, the struc- 
tural degeneration of these vessels, which is apt to super- 
vene, leads not unfrequently to a form of consumption, 
consisting in a rapid breaking down of the lung-substance, 
which every kind of treatment is powerless to arrest. 
In the same way, there is first enlargement of the liver 
from the frequent engorgement of the capillaries, and this 
is followed by a shrinking, or shrivelling up, of the sub- 
stance of the organ, together with rough and uneven sur- 
face, when it gets the significant name of hobnail, or 
drunkard's liver. Diseases of the liver are very common 
among hard drinkers, and are especially liable to be in- 
duced in warm climates. In extreme cases, dropsy is a 
usually concurrent symptom, and when that sets in death 
is not far off. 
Another organ which becomes affected in various ways, 
and often to a fatal extent, by alcoholic excess, is the 
kidney. Every one knows how readily the secretion of 
this organ is altered by even a single debauch; yet it is 
not generally realized that the pinkish-looking sediment 
or the iridescent film which floats on the surface of the 
fluid, are both of them conditions which are favorable to 88 
CA USES OF DISEASE. 
the formation of stone or the development of gravel. 
Then the strictional deterioration of the capillaries, in- 
duced by continued excess, leads to that form of disease 
of the kidney known as " Bright's Disease," or the repeated 
dilation of these vessels may be followed by an attack of 
acute inflammation of the organ which, if it does not 
terminate fatally, is almost sure to leave serious compli- 
cations behind. Indeed, so powerful is the influence of 
alcoholic excess on the vital action and structure of the 
kidneys, that physicians who are most competent to form 
an opinion maintain that at least three-fourths of the 
instances of kidney disease which come under their notice 
are due to this cause, and to' this cause alone. 
These, then, are some of the more pronounced effects 
of intemperance; • but, unfortunately, statistics do not 
help us to form any reliable estimate of the vast amount 
of disease and suffering which is actually entailed. When 
it is borne in mind, however, that the intemperate man is 
far less able to resist the influence of weather changes 
than the man who is temperate, that his relaxed vessels 
are liable to give way under light pressure, and that there 
is actual deterioration of the body generally, it will be at 
once conceded how much more liable he is to succumb to 
other causes of disease, and how much less his chances 
are of weathering the storm when disease actually sets in. 
In a paper read by Dr.-Norman Kerr, at the Social 
Science Congress last year, he pointed out that, though 
the deaths attributed to alcoholism in England and Wales 
during 1876, according to the Report of the Registrar- 
General, were only 1120, an analysis of the deaths which 
occurred in his own practice warranted him in saying 
that the actual mortality during the twelve months 
throughout the country could not be estimated at less 
than 128,000. Dr. Richardson's estimate is 40,000, while 
the late Mr. Wakley, coroner for Middlesex, and his SELF-INDUCED AND SOCIAL CAUSES. 
89 
successor, the late Dr. Lankester, both agreed that one- 
tenth of the entire mortality among us resulted from 
alcoholic excess. 
As regards the part which intemperance plays as a 
cause of crime, there can be no dispute. Indeed, so fully 
has this become recognized afnong judges and magistrates, 
that it has been long accepted as a truism that were it not 
for the drink our gaols would be well-nigh tenantless. 
And now a few words in conclusion, So far as scien- 
tific investigation can lead us, we are not warranted in 
saying that the moderate use of alcohol is injurious. So 
far as experience can guide us, we are warranted in saying 
that the limits of strict moderation are so easy of tran- 
sition, that many people who never become intoxicated 
suffer repeatedly, and in the long run permanently, from 
the effects of over-indulgence. Some persons are so con- 
stituted, whether through habit or natural tendencies, 
that they are prone to indulge to excess, it may be occa- 
sionally or continually, when opportunity occurs. The 
only safeguard for such is total abstinence. Whenever a 
man deliberately imbibes stimulants to help him through 
a difficult task or to drown sorrow or remorse, he imposes 
a loan on his system which, if frequently repeated, will be 
sure to land him in physiological bankruptcy. What 
really is wanted to cope with the national evil of intem- 
perance are not so much repressive or prohibitory meas- 
ures as greater inducements and opportunities for the 
practice of temperance; and among these may be 
mentioned-better and more comfortable homes for the 
working-classes; better education in cooking for the 
wives; the establishment of coffee stalls, cheap restau- 
rants, and coffee taverns; the establishment, as on the 
Continent, of well-conducted stalls for the supply of 
refreshing drinks during summer in the thoroughfares of 
our large towns; and, above all, the continuous and per- 90 
CA USES OF DISEASE. 
sistent discussion of the drink question. This alone can 
lead to intelligent conviction, and without intelligent 
conviction there is but little hope of real national reform. 
The safeguards in respect to personal health as regards 
the use of stimulants will be discussed in a future chapter. 
2. Tobacco and Narcotics.-Although the great majority 
of the adult male population of this country are smokers, 
it cannot be said that the use of tobacco is a fruitful 
source of disease. No doubt, when the habit is carried 
to excess, it produces functional derangements of' the 
nervous system, palpitation of the heart, certain forms 
of dyspepsia, and irritation of the throat and lungs; but 
the cases of well-pronounced disease which can be at- 
tributed to its influence are doubtful or rare. Much 
stress has been laid on the fact that the active principle 
of tobacco, namely, nicotine, is a deadly poison, which 
acts powerfully on the heart; but the small quantity 
which does get into the blood of the moderate smoker is 
rapidly eliminated by the kidneys, and does not appear 
to do any harm. Used in moderation and at proper times, 
tobacco produces a certain soothing influence without 
exercising any tangible injurious effect. On the other 
hand, too many pipes or cigars will cause nausea and 
depressing sickness, even in those most habituated to its 
use, while it is well known that a few whiffs will suffice 
to produce the same symptoms in those who try it for the 
first time. It is, therefore, not an agent to be trifled with, 
and without attributing all the dire effects to it which are 
laid to its charge in such a wholesale and indiscriminate 
way by its opponents, there are certain precautions with 
regard to its use which, I think, cannot be too strongly 
insisted on. In the first place, there can be no dispute 
that tobacco-smoking, when contracted as a habit, has a 
most deleterious action on boys and lads who have not 
stopped growing. It arrests their growth, and not only SELF-INDUCED AND SOCIAL CAUSES. 
91 
so, but it produces an enervated state of the system, which 
tends greatly to impair muscular and mental activity. 
No one, therefore, should learn to smoke, or be allowed 
to smoke when it can be prevented, until he has reached 
the age of eighteen years, and even then I would honestly 
say, as a smoker, that it is a habit which, on the whole, 
had better be dispensed with, especially if one is ambi- 
tious and eager to succeed in life. Those who have not 
learned to smoke do not miss it, and if they do not ex- 
perience its soothing effects they at all events escape 
many of the discomforts which are too likely to follow 
an extra pipe or cigar. Unless a person is almost con- 
tinuously in the open air, the pipe or cigar had better be 
dispensed with during the day, or only indulged in after 
a meal. The moderate smoker, as a rule, reserves his 
pipe or cigar for the evening before retiring to rest. Any 
one who indulges to such an extent as to render, the 
tongue coated and dry does himself an injury, and when 
palpitation of the heart or other nervous symptoms are 
induced, he should leave off altogether. 
As regards opium, chloral, or other narcotics, it may 
be said, once and for all, that they should never be taken 
repeatedly or continuously, even in the smallest doses, 
unless under medical advice. Although they are valu- 
able remedies in the treatment of disease, they are danger- 
ous agents at all times, and those who habituate their 
bodies to their use run the inevitable risk of shortening 
their lives. 
3. Errors in Diet.-It is a well-known fact that vast 
numbers among the affluent or well-to-do people in this 
country are in the habit of consuming a much larger 
quantity of food than is actually required for the mainte- 
nance of sound health. The consequence is that there is 
not only frequent derangement of the digestive organs, 
dyspepsia, and the like, but the system generally becomes 92 
CA USES OF DISEASE. 
enfeebled and inactive, the body over-corpulent, the 
stomach -over-distended, the muscles fatty and flabby, the 
heart weak, and the brain sluggish. These are among 
the common results of excess, and the sufferers may be 
said to constitute the great bulk of patients who crowd 
the consulting-room of the fashionable physician and fre- 
quent the numerous hydropathic establishments through- 
out the country. 
Among men who are actively employed in business 
pursuits, on the other hand, there are many who drift 
into ill health because they often eat their meals hurriedly, 
or at irregular hours, or allow too long intervals to elapse 
between the times of taking food. Among the less affluent 
classes, again, dietetic errors are frequently committed 
because they are tempted to secure quantity rather than 
quality in their articles of diet, and the ill effects which 
result are often aggravated by bad cooking. Then, too, 
there are large numbers amongst the working classes who 
subsist almost exclusively on bread, potatoes, and other 
starchy foods, and they are easily recognizable by their 
pale looks, attenuated forms, and weak and flabby mus- 
cles. More especially is this species of chronic starvation 
common among the wives of the poorer classes, and women 
employed as sempstresses, and there can be little doubt it 
is to their insufficient diet that the craving for tea at all 
hours of the day is in great measure due. Much more 
nutriment would be obtained, and much mischief avoided, 
if cocoa were more freely used; for it is well known that 
over-indulgence in tea-drinking induces a long train of 
dyspeptic symptoms, accompanied by great excitability 
of the nervous system, which are as painful as they are 
unfortunately common. 
But errors in diet, though productive of serious illness 
and disease amongst the adult population, are far more 
detrimental to infants and children. Indeed, there are SELF-INDUCED AND SOCIAL CAUSES. 
93 
few people who have any adequate conception of the 
enormous waste of infant life which results from diseases 
induced by the insufficient, improper, and careless feeding 
of infants. In the previous chapter it has been shown 
that out of every 1000 children born, 150 die before they 
reach the age of one year, and I do not think it is making 
too high an estimate, if I say that one-third of these 
deaths are attributed to what may be called starvation- 
induced ailments. Assuming, further, that the number 
of children born annually in the United Kingdom 
amounts to 1,000,000-and that is pretty near the mark 
-there is thus an annual sacrifice of at least 50,000 
infant lives. What are the errors to be avoided, and the 
rules to be adopted with regard to the feeding of infants 
and young children, and in respect to age generally, will 
be considered more fully in the Chapter on Food. 
4. Mental Worry and Overwork.-In these days of fast 
living and "the making haste to be rich," the numbers 
who land themselves in what has been called physiological 
bankruptcy long before they have reached the age of 
sixty, are far greater than is generally supposed. The 
excessive competition commenced at school and college, 
though not without its risks, becomes a fruitful source of 
impaired health and premature death, when it is allowed 
to have its full swing in the struggles,. ambitions, and 
cares of every-day life. And this is more especially 
witnessed among that large class of the community who 
constitute the prop and mainstay of the nation, our 
merchant princes and those engaged in commercial pur- 
suits generally. Whenever a man begins to stick to 
business so closely that he finds no time for healthy 
recreation, no leisure for a holiday, and only hurried 
moments, from morning till the drudgery of the day is 
over, to attend to his bodily wants, he is putting an extra 
strain upon his system, which soon begins to tell with 94 
CA USES OF DISEASE. 
increasing severity, and very frequently culminates in a 
complete breakdown. It matters not whether his motives 
are pure and unselfish, as in his desire to educate and 
rear a young and increasing family, or selfish in the ex- 
treme and begotten of the mere love of money-making for 
the sake of the social advantages which wealth too often 
confers; the results are the same. By-and-by he begins 
to find that his day's work has become a toil, and that the 
last pile of figures to be added up, or the last budget of 
letters to be answered, appears to be a much more harass- 
ing and difficult task than in days of yore. He is more 
liable to make mistakes, more apt to overlook important 
minutiae, and prone to forget still more important engage- 
ments. He becomes miserable and dissatisfied with him- 
self, exhausted and irritable when he goes home, his 
dinner is unrelished, the evening paper ceases to interest, 
nothing seems to please, and when he retires to rest his 
sleep is fitful, unrefreshing, and often broken by hideous 
dreams. 
Now, all these are symptoms so characteristic of mental 
strain and worry that they may be regarded as danger- 
signals, indicating clearly that the speed must be slack- 
ened ; indeed, the best restorative, when it can be taken, 
is a holiday, with change of scene and surroundings, to 
distract the attention, and plenty of outdoor exercise. 
But it often happens that the holiday cannot- be taken, 
and the drudgery has to be gone through day after day, 
until a more convenient season arrives. It is in this 
stage that men frequently have recourse to stimulants to 
spur on their jaded energies, or to narcotics to procure 
sleep; and when it comes to this, the case assumes a very 
serious aspect, for when a man, harassed by overwork and 
mental strain, takes to stimulants, whether to drown care 
or spur him on, physiological bankruptcy, if not absolute 
ruin, stares him in the face. His reserve fund of physical SELF-INDUCED AND SOCIAL CAUSES. 
95 
endurance is speedily dissipated beyond all hope of re- 
covery, his mental powers become permanently impaired, 
he may drift into dementia, sink into paralysis, or become 
a doomed man through nervous failure in some vital 
organ, and dies from disease of the heart, the lungs, the 
liver, or the kidney. 
With regard to physical strain and overwork, only a 
few words need be said, although the subject is a wide 
and interesting one. . Its effects are most pronounced, and 
best seen in the stunted forms of the operatives in all our 
large towns, the great majority of whom had to toil in the 
factory so soon as their young hands could be made to 
assist their needy and thriftless parents. It is true that 
much of the injury hitherto inflicted on children in this 
respect is now prevented or greatly mitigated by the 
operations of the Half-Time and other Factory Acts, 
which prohibit the employment of children under a cer- 
tain age, and limit the hours of labor of those who are 
older; but that this cause has contributed largely to the 
physical deterioration of the working classes in manufac- 
turing and mining districts there can be no question, 
although, as will be seen subsequently, other causes have 
operated powerfully in the same direction. 
The mischief arising from physical overstrain, either in 
youth or adult life, is, I believe, limited to comparatively 
few cases. No doubt there is damage done occasionally 
to the heart and some of the large blood-vessels, but, con- 
sidering the large numbers who indulge in severe exercise 
and athletic contests, the risks to the strong and active 
are trivial compared with the advantages which are 
gained. Even as regards that most severe contest of all, 
the University boat-race, Dr. Morgan, of Manchester, has 
proved, by an appeal to statistics, involving an inquiry 
into the physical history of previous crack oarsmen, that 
the dangers of immediate or future mischief have been 96 
CAUSES OF DISEASE. 
grossly exaggerated. At the same time, I am free to 
confess that excess in this direction, as well as in others, 
is a waste of energy, and courts mishap. 
5. Idleness.-In contrast to that large class of the com- 
munity who suffer from overwork, there are numbers who 
suffer, though, perhaps, not to such a great extent, from 
sheer idleness. Among the poorer classes, they go to 
swell the list of vagrants who fill tramp wards, many of 
them get into prison because they prefer to steal rather 
than work, and mostly all of them end a short and fitful 
existence in the workhouse, the prison, or the lunatic 
asylum. Among the affluent classes, those addicted to 
idleness suffer not only from the miseries incidental to 
ennui, but they are liable to induce one or more of the 
many ailments incidental to over-indulgence, whether in 
eating or drinking, and to degeneration of the tissues 
from want of •sufficient bodily exercise. In addition to 
these, there are many who, after a life of toil, retire to 
enjoy their well-earned savings. The business or profession 
which has occupied their energies during the prime of 
manhood is abruptly thrown aside; they have unfortu- 
nately cultivated no pursuit or pastime which can relieve 
the monotony of their self-enforced leisure, and the con- 
sequence is that they speedily feel out of sorts, frequently 
become hypochondriacal, and are constantly liable to 
succumb under slight attacks of acute disease. Men- who 
are thus circumstanced, and who have cultivated no such 
healthy outdoor sports as shooting, fishing, or hunting, 
should be careful to take plenty of healthy exercise, and 
interest themselves in the management of local affairs, 
by aspiring to a seat on the bench, by becoming town 
councillors, or members of local boards, or by taking an 
active part in furthering any good cause which tends to 
the amelioration of humanity. 
There is no doubt that amongst the well-to-do classes, ladies suffer far more from the effects of idleness than do' 
men. For in the first place, their physical training when 
at school has been, as a rule, sadly neglected; and in the 
second place, the aversion to activity of any kind-except, 
perhaps, it be dancing-which has thus been induced, 
becomes habitual to them, so that in after years they 
become more or less invalidish, and are seldom out of the 
doctor's hands. 
In order to insure health and happiness as well, there 
must be no lolling in the lap of luxury or sitting listlessly 
with folded hands. Constant and healthy exercise of 
body and mind are alike' necessary, otherwise there is 
certain deterioration and untimely decay. 
6. Immorality.-This cause of disease is productive of 
immediate disaster, and of far-reaching ill effects on pos- 
terity, which are only known to the physician and physi- 
ologist. It was the cause of the downfall of ancient 
Greece, and the warnings and denunciations directed 
against it in the Sacred Writings are sufficient to convince 
the reader how powerfully it affects the healthy life of the 
individual and the well-being of society. Self-control is 
the only safeguard against the terrible dangers which 
beset the paths of sexual vice, and those who scout the 
sin are most sure to court the danger. Unfortunately, 
however, neither parents, teachers, nor guardians, seem to 
appreciate the important change in the individual which 
occurs at the age of puberty, or; if they do appreciate it, 
they fail, through a sense of false modesty, to warn or 
guide, and it is because this responsibility is so generally 
neglected, that so many, when reaching maturity, unknow- 
ingly or unwittingly drift into evil courses. 
7. Irregular Modes of Life.-There can be no doubt 
that impaired health is very often induced by late hours 
and irregular curtailments of the natural night's rest. 
The earnest student, the man about town, the leading 
SELF-INDUCED AND SOCIAL CAUSES. 
97 98 
CA USES OF DISEASE. 
ladies in society, and their troops of followers, all err 
grievously in this respect, either occasionally or habitually. 
Look at the fashionable ball, for example; dancing seldom 
or never commences before ten o'clock, more frequently 
much later, and is carried on till three or four in the 
morning. The consequence is that every one feels jaded 
and worn out, even after a few hours' rest, and many 
experience the ill effects for several days afterwards. ' No 
wonder that at the close of the London season there are 
so many wan cheeks and pale faces, hungering for the 
pure air and quietude of life in the country. Dancing in 
itself is one of the healthiest of exercises, but practised as 
it is in crowded ball-rooms, and during such unnatural 
hours, the benefits which would otherwise accrue are more 
than neutralized by the ill effects which follow sooner or 
later. Those who have the seeds of consumption lurking 
in their constitution, are especially liable to suffer, inas- 
much as they run the terrible risk of arousing the disease 
into activity. 
Students, literary men, press men, and reporters are 
among the most common sufferers from the depression 
and lowered vitality begotten of late hours and broken 
rest. No doubt the strong man can often resist sleep for 
long periods, but sooner or later -the time comes when 
nature asserts her violated rights-the demand for sleep 
becomes more urgent, and fortunate is he who can woo 
back the friend he has deserted. The penalty which is 
too often exacted is that distressing sleeplessness, or in- 
somnia, which allows the mind no rest, or at best a rest 
which is broken and disturbed by fitful dreams. When 
the sufferer is reduced to this painful condition, he 
frequently has recourse to opiates or other sedatives, 
which only afford temporary or doubtful relief, and if 
persisted in will infallibly produce serious and permanent 
mischief. A holiday, with change of scene and air, and regular hours, will often do wonders in restoring the 
jaded brain to a healthy condition; but whether a holiday 
can be obtained or not, a steady effort must be made to 
retire to rest at regular hours, and not too late. 
As regards the amount of sleep which a healthy adult 
requires during the twenty-four hours, it may be laid 
down as a rule that on the average it should not be less 
than six hours, and need not exceed eight. There are 
some men, such as the late Count Cavour, and General 
Eliott so well known for his famous defence of Gibraltar, 
who only rested four hours; but these are exceptional 
cases. Children and old people require more than eight 
hours; indeed, infants and the very aged pass a large 
portion of their time in sleep. 
Concerning the hour at which the individual should 
retire to rest, a good deal will depend on the hour at 
which he is expected to get up. No doubt early rising 
is highly conducive to health; but "early to bed and 
early to rise" is one of those golden rules which many 
people find it very difficult to follow'. In the country, if 
one gets up at six o'clock, the hour of retiring to rest 
should be about ten for grown-up people, nine for young 
people, and seven or eight for children. If one does not 
require to get up before seven in summer and eight in 
winter, eleven should be the hour for going to bed; and 
it is only under exceptional circumstances that it should 
be later than twelve. Another good rule is, never to lie 
in bed vffien once quite wide awake in the morning. It is 
much more invigorating to turn out at once, for second 
naps indulged in towards the usual hour of getting up are 
generally followed by dull heavy days. 
Then, too, it has to be said that regularity as regards 
the hours at which meals are taken is of the utmost im- 
portance in the maintenance of health. As has previously 
been pointed out, many of the worst forms of dyspepsia 
SELF-INDUCED AND SOCIAL CAUSES. 
99 100 
GA USES OF DISEASE. 
are induced by inattention to this matter, and when once 
induced, they are often difficult of cure. Every one, there- 
fore, ought to strive from youth upwards to cultivate 
habits of regularity and punctuality, to retire to rest at 
proper hours, and to partake of food at regular intervals; 
for in all the laws of life, habits, whether for good or evil, 
become in a measure " second nature." 
8. Errors in Clothing.-As this subject will be more fitly 
discussed in a subsequent chapter, it will suffice to indicate 
here very briefly some of the more important discomforts 
and ailments which are induced in this way. Thus, as re- 
gards the feet, tight or badly fitting boots or shoes are 
well known to be productive of much mischief; garters, 
again, are apt to give rise to varicose veins; tight stays, 
to ailments of a grave kind connected with the functions 
of respiration and digestion; thick veils, to headaches; 
too light clothing, to colds and congestion of the lungs; 
•and so on. Then, too, there is the connection between 
clothing and body cleanliness, which opens up othei' im- 
portant questions regarding personal health; but this, too, 
will be reserved for consideration further on. 
Section III. Material, Local, and Communicable 
Causes of Disease. 
Almost all these causes of disease are more or-less under 
Legislative control, and belong more especially to the 
domain of public hygiene. But inasmuch as public 
measures, however well-devised for the preservation of 
the health of the community, can never be efficiently 
carried out unless they meet with the intelligent co-opera- 
tion of the people themselves, it is very essential that 
these widespread causes of disease should become generally 
known and duly appreciated. Briefly summarized, they 
consist of impurities in air, whether in connection with MATERIAL, LOCAL, AND COMMUNICABLE. 
101 
dwellings, unhealthy occupations or localities; bad water; 
unsound food; and infective particles or germs, which, 
passing from the sick to the healthy, induce diseases of a 
specific nature. 
1. Impurities in Air.-We have already seen, in the 
previous chapter, that pure air consists of a mixture of 
the two gases oxygen and nitrogen, in the proportion of 
about -21 of the former to 79 of the latter, together with 
a very small percentage of carbonic acid gas, a varying 
amount of watery vapor, and traces of ammonia and ozone. 
It has also been shown that it is the oxygen alone which 
is essential to life, and that the expired air differs very 
much in composition from the pure air which has been 
inspired, inasmuch as about five .per cent, of the oxygen 
has disappeared and been replaced by carbonic acid gas. 
The relative amount of nitrogen remains pretty much the 
same, because it only serves as a convenient medium for 
dilution. The watery vapor, however, is considerably in- 
creased, and along with it there is exhaled a certain amount 
of organic effluvia, or effete matter, which is even more 
injurious under ordinary circumstances than carbonic acid 
gas. 
In its concentrated form, this foul matter is the source 
of that disagreeable, sickly smell so often met with in 
crowded rooms, and, along with the carbonic acid gas, is 
the cause of the drowsiness, headache, and feeling of faint- 
ness, which many people experience when they are huddled 
together in closely confined or badly ventilated places. 
Indeed, air which has once been breathed is no longer fit 
to be breathed again, for not only has it been robbed of a 
large portion of its oxygen, but products which are dan- 
gerous to life have been added to it in considerable quan- 
tities. Hence the necessity for ventilation, that is, by 
providing means for the escape of the foul or vitiated 
air, and for the entrance of fresh air to take its place. 102 
CA USES OF DISEASE. 
As an extreme instance of the terribly fatal effects 
arising from overcrowding and want of fresh air, I need 
only refer to the oft-quoted story of the Black Hole of 
Calcutta-how, out of 146 prisoners who were shut up in 
this dungeon during the night, only twenty-three were 
brought out alive next morning, and most of these subse- 
quently succumbed to putrid fever. Then there are records 
of numerous catastrophies befalling slaves or passengers 
in holds of ships when hatches were battened during a 
storm at sea. These are extreme instances, and attract 
attention because of their appalling severity. But of 
more concern to the public generally are the slow, un- 
suspected, and insidious effects arising from breathing air 
which has already been breathed, and thereby de-vitalized, 
or vitiated, by the products of respiration. 
And prominent among diseases which are induced in 
this way must be placed that terrible disease consumption, 
or pulmonary phthisis, which in round numbers destroys 
50,000 people every year in England and Wales, and 
accounts for nearly one-tenth of the total number of deaths. 
As has already been shown, there can be no doubt that 
the disease is in a large number of instances an inherited 
disease, but at the same time, there is a mass of evidence 
of the most indisputable kind which proves that it is a 
disease which has in thousands of instances been produced 
by breathing the impure air of small, overcrowded, or 
badly ventilated rooms, and is so produced still, in spite 
of the legal enactments against overcrowding. 
But besides consumption, there are other diseases of the 
lungs, such as inflammation of the lung-substance, and 
bronchitis, which are also induced by impure air, and to 
a very large extent. Although there is no doubt that these 
diseases are in a great measure attributable to sudden 
changes of temperature, I cannot help thinking that in 
reality they are very often due to the attempts which are MATERIAL, LOCAL, AND COMMUNICABLE. 
103 
made during severe weather, and in confined sleeping- 
places, to close every opening as far as possible in order to 
keep out the cold air. The consequence is that during the 
long nights of winter, the air in sleeping-rooms becomes 
much more impure than during the warmer months, and 
the results declare themselves in the greatly increased rate 
of mortality from lung diseases, and a far greater amount 
of sickness from chest ailments. Scrofula, too, which is 
so closely allied to consumption, is another disease which is 
largely dependent upon the same cause; but there is no 
need to prolong the list, when we consider that in innu- 
merable instances the breathing of impure air night after 
night, and more particularly in the crowded homes of 
our large towns, entails a burden of ill health and discom- 
fort, which, though it may not lead to actual disease, makes 
childhood joyless, and manhood and womanhood too a 
lifelong misery. And so, very often, is begotten, that 
craving for drink which, when it becomes habitually grati- 
fied, makes the burden still harder to bear. Moralists are 
in the habit of pointing to the miserable overcrowded home 
as one of the consequences of drink, and no doubt it is; but 
for my own part, I am inclined to believe that the home, 
with its vitiated air, is just as often the cause. 
Be.that as it may, there can be no question that it is in 
these overcrowded and badly ventilated homes that dis- 
ease finds its readiest victims. Typhus, for example, is a 
fever which thrives essentially in vitiated air, and it is 
one of the best signs of the improvement which is gradu- 
ally taking place in the homes of the poorer classes, that 
it is a much rarer disease than it was not many years ago. 
Indeed, there are good grounds for hoping that, like the 
gaol fever of John Howard's days, and the Plague and 
Black Death of the Middle Ages, it will at no distant 
date be reckoned among the scourges of the past. 
But in addition to the impurities given off by the lungs 104 
and which accumulate in respired air, the air of the house 
is often rendered still more unhealthy by the filthy dust 
and effluvia which result from the sheer want of cleanli- 
ness, or from hidden dangers connected with drains, cess- 
pools, and the like. Typhoid fever, diphtheria, ulcerated 
sore throat, croup, diarrhoea, erysipelas, pysemia, and I 
have every reason to believe, scarlatina, have over and 
over again been originated by the foul effluvia which 
taint the air in and around our dwellings. In the better 
class houses, where scrupulous cleanliness with regard to 
every other particular is observed, it is found too often 
that, owing to some sanitary defect or neglect, sewer gas 
is finding an entrance into the house through some un- 
ventilated closet-pipe, some sink-pipe, or some over-flow 
pipe from a bath, and typhoid fever or some other filth 
disease, with death ever near, breaks out. Then, again, 
in town and country districts alike, there are the foul 
smells from midden heaps,* cesspits, pigsties, and the 
like, which, tainting the air outside the dwelling, pollute 
the air inside, rendering the enjoyment of sound health 
impossible at the best, and but too frequently inducing 
one or other of the diseases which have already been 
mentioned. It is true this is an unsavory subject, .but no 
one who has not had opportunities of judging for himself 
can form any adequate conception of the widespread suf- 
fering and terrible mortality which result from this be- 
foulment of the air we breathe, whether through ignorance, 
want of proper precautions, or sheer uncleanliness, in 
allowing filthy abominations and garbage of all kinds to 
accumulate around dwellings. 
But great though these evils be, they are, as regards 
masses of the population, immensely aggravated by the 
vitiated air of small and badly ventilated shops, ware- 
CAUSES OF DISEASE. 
* Manure heaps or dunghills. MATERIAL, LOCAL, AND COMMUNICABLE. 
105 
houses, factories, workshops, and mines. For in many of 
these industries the air is not only polluted by the pro- 
ducts of respiration, but it becomes laden with minute 
particles consisting of organic matter or mineral sub- 
stances, varying according to the particular trade or 
employment. As a matter of course, this finely divided 
dust is inhaled into the lungs, and with such terrible 
effect that in some classes of industry, the average dura- 
tion of life is shortened by many years. Thus, the steel- 
grinders of Sheffield suffer from gradual destruction of 
the lung-tissue; coal-miners, from what is called "black 
lung;" the scourers in pottery works, from asthma; 
brass-founders, from bronchitis and .ague; and so on 
through a. long dreary list of trades, which, though they 
make the land hum with labor, have, after all, to be 
carried on under conditions more or less hostile to the 
enjoyment of sound health. 
But, it may be asked, cannot these conditions be im- 
proved and ameliorated? There is no doubt they can; 
and what is more, they have been, and are being improved 
every day. Indeed, there is perhaps no more gratifying 
feature in the Reports of the Registrar-General than the 
statistics which prove that, under the operation of various 
Act§ for the regulation of mines, workshops, and' factories, 
the rate of mortality in many of these employments is 
steadily declining. By prohibiting the employment of 
workers under certain ages, limiting the hours of labor, 
securing better means of ventilation; and introducing 
various appliances to remove the irritating dust or fluff 
given off, the risks to health, which not long ago were 
enormous, are becoming less and less every year. More- 
over, employers of labor are beginning to learn, and 
many of them have learned already, that apart alto- 
gether from philanthropic motives, any judicious ex- 
penditure which ensures better health for their work- 106 
CA USES OF DISEASE. 
people is a wise investment, and saves money in the 
long run. 
Then, too, it should be remembered that there are large 
numbers of work-people, such as tailors, dressmakers, 
shoemakers, and the like, whose workshop is their sleep- 
ing-room as well, with too often no bedstead but the 
floor, and only dirty rags to cover them and the poor 
squalid children who may be penned up with them. In 
large towns, ladies fond of wearing fine dresses, and for 
that matter, gentlemen too, would shudder if they only 
knew in what kind of dens their fashionable garments are 
often stitched together. And, what is more, the foul air 
of the reeking chamber may contain the germs of small- 
pox, scarlet fever, or some other infectious disease, from 
which any of the inmates may be suffering, and, clinging 
to the fine dress of the fashionable wearer, when it is sent 
home, may thus work further mischief. The only real 
safeguard against such dangers, and they are far from 
being mythical ones, would be to prohibit by law master- 
tailors, fashionable milliners, and similar employers of 
labor, from sending out work to be done at the homes of 
their work-people, unless such homes are ascertained to be in 
good sanitary condition, and kept under strict supervision. 
Dampness of the air inside the house, from damp walls, 
damp foundations, or damp surroundings, is also a fruit- 
ful source of disease, giving rise to various forms of neu- 
ralgia, rheumatism, and consumption. As an instance in 
point, it may be mentioned that of late years consumption 
has become much less common in many towns where im- 
portant sanitary improvements have been carried out, and 
careful inquiry has shown that the lowered mortality 
from this disease is due to the drying of the subsoil which 
has been effected by new drainage works. 
In order to keep the air of the house pure and healthy, 
there must be no damp foundations, no damp walls, no MATERIAL, LOCAL, AND COMMUNICABLE. 
107 
dark and dingy cupboards or corners to confine the air 
and devitalize it, no filth in or around the dwelling to 
pollute it, and no over-crowding. There should be clean- 
liness everywhere, adequate means of ventilation, plenty 
of window space to let sufficient light into every room, 
and proper appliances for warming during cold weather. 
All these, however, are points which will be more fully 
discussed in a future chapter. 'Meantime, it may be 
briefly pointed out that, notwithstanding the numberless 
impurities which are being incessantly poured into the 
atmosphere, they are as constantly being utilized or ren- 
dered innocuous. Injurious gases become diffused, diluted, 
or decomposed; suspended matters are washed down by 
the rains or fall by their own weight; animal emanations 
are absorbed in the processes of vegetation; while many 
organic substances are oxidized and thus rendered harm- 
less. 
2. Impure Water.-Almost all waters used for drinking 
purposes, unless it be the rain-water collected from roofs, 
contain a certain amount of mineral matter dissolved 
from the soil or particular formation of rock which re- 
ceives the rainfall and from which the water supply is 
obtained. Hence it is that well-waters are found to vary 
in hardness according to the nature of the subsoil, or 
geological formation, some containing so much mineral 
matter as to render them unfit for use, except perhaps for 
medicinal purposes, as is the case with so-called mineral 
springs. Water derived from streams or rivers is, as a 
rule, much softer than well-water, though that also varies 
very much according to the character of the water-shed. 
The mineral matter consists for the most part of com- 
pounds of lime, soda, and magnesia, and unless these are 
present in quantities to render a water very hard, it cannot 
be condemned as unwholesome. Indeed the ailments 
which have been traced to the presence of these sub- 108 
CA USES' OF DISEASE. 
stances in drinking-water are comparatively few, and by 
no means prevalent. Constipation and other dyspeptic 
symptoms have been attributed to excess of earthy salts, 
but the disease which more than any other appears to be 
intimately connected with these ingredients is goitre, and 
chiefly in districts where the magnesian limestone forma- 
tion prevails. Among other mineral substances found in 
drinking-water, the compounds of lead are the most 
injurious, and these are usually absorbed from leaden 
pipes or cisterns, the danger of lead being dissolved being 
much greater if the water is soft. 
When water contains an excess of vegetable matter, it 
is decidedly unwholesome, and has often been known to 
produce diarrhcea and aguish symptoms, but the ingre- 
dients which are especially dangerous are of animal origin. 
The least trace of filth from a cesspool, drain; or manure- 
heap may convert drinking-water into an insidious poison 
fraught with disease and death. Very frequently the 
water may be clear and sparkling, and not unpleasant to 
the taste, so that its polluted condition is not suspected 
until serious illness has broken out in the household, and 
illness of a kind which points to filth as the originating 
cause. A sample is then submitted for chemical analysis, 
when it is pronounced to be highly polluted, and alto- 
gether unfit for use. The investigations into the later 
outbreaks of cholera in this country proved clearly that 
the disease was, if not wholly, at least to a very large 
extent, propagated in this way; but the disease of all 
others which owes its origin and spread to polluted water 
is typhoid fever. In country districts, and in small towns 
or villages, where pump-wells or shallow dip-wells con- 
stitute the source of supply, this disease is produced far 
more frequently by polluted water than by any other 
cause; and even in towns provided with a public water 
supply, many of the most alarming outbreaks of the MATERIAL, LOCAL, AND COMMUNICABLE. 
109 
disease have been traced to contamination of the supply 
either at its source or in the course of its distribution 
through pipes and mains, or by the entrance of foul air 
from closets into periodically empty pipes when the water 
supply is intermittent. Thus at Guildford, in 1867, there 
was a severe outbreak of typhoid fever in a particular 
part of the town which was supplied for a short time with 
water from a certain high-standing reservoir, and this 
reservoir had been previously filled from a new well. 
This well was sunk through the porous chalk formation, 
and in close proximity to it were some sewers, one of 
which was found to be leaking in several places, and 
permitting the sewage to ooze into the well, the water of 
which was found on analysis to be contaminated and unfit 
for use, and was doubtless the cause of the outbreak. 
At Over Darwen, again, in Lancashire, there occurred 
another severe outbreak of the disease towards the close 
of 1874, which was traced to the leakage of a stopped-up 
closet-drain into the principal water main of the.town, 
which it crossed; while at Lewes, during the same year, 
a similar outbreak was traced in the first instance to 
pollution of the town water supply, by water drawn from 
the Ouse, which receives the town sewage, but mainly 
spread by suction of polluting matter into the water-pipes 
of an intermittent water supply. 
But as I have already said, it is in villages and country 
districts where the dangers of water pollution are rifest. 
The well is often in such close proximity to leaky drains 
or cesspools, that the wonder is that the amount of disease 
which is produced in this way, large though that be, is 
not much greater than it actually is. Nor is typhoid 
fever the only disease which owes its origin to polluted 
water. I have very often traced outbreaks of diphtheria 
to the same cause, as well as numerous cases of common 
ulcerated sore throats. To polluted water have also been 110 
CAUSES OF DISEASE. 
traced repeated outbreaks of .what is called low fever, 
diarrhoea, and dysentery, while in districts where shallow 
dip-wells are common, it is very often found that children 
suffer from worms. 
3. Unsound Food.-Perhaps of all articles of food, by 
far the largest amount of disease is produced by the 
agency of milk, and though it is only of recent years 
that the attention of the medical profession has been 
directed to this hitherto unsuspected source of mischief, 
there is a constantly accumulating amount of evidence 
which goes to prove that milk which has been tainted by 
polluted water has over and over again been the cause 
of well-defined outbreaks of typhoid fever; and among 
others may be mentioned the following:-A limited out- 
break described by Dr. Taylor, of Penrith, which occurred 
in that town in 1870; an outbreak of a more extended 
nature which occurred in Islington, in the same year, 
and which was minutely investigated and described by 
Dr. Ballard; an outbreak at Armley, near Leeds, and 
one at Moseley, near Birmingham, both of which were 
investigated by Dr. Ballard, in 1872 and 1873; and lastly, 
several outbreaks which have recently occurred in Glas- 
gow and its neighborhood, which have been minutely 
traced and fully described by Dr. Russell, medical officer 
of health for that city. In many of these outbreaks, the 
origin of the disease has been traced, not only to polluted 
water at the dairyman's house, but to water which further 
investigation has proved to have been specifically tainted 
by the germs of typhoid fever. • In other words, it has 
frequently been found that the disease had broken out in 
the first instance in the dairyman's house, and that the 
cesspool or drain which received whatever came from the 
patient leaked into the well. But judging from my own 
experience, I am fully convinced that milk which has 
been tainted by polluted water, even though there be no MATERIAL, LOCAL, AND COMMUNICABLE. 
111 
case of illness at the.dairymen's house, is quite sufficient 
to produce typhoid fever, low fever, diarrhoea, or dysentery, 
and I have as little doubt that diphtheria and ulcerated 
sore throat can also be produced in the same way. Of 
course, the dairyman will as a rule only admit that the 
milk-cans have been merely washed out with the water; 
but there is always strong presumptive evidence that in 
all these instances the milk itself has been diluted to a 
greater or less extent with the same water. 
Then, too, with regard to the infantile diarrhoea, which 
proves especially fatal during the summer and autumn 
months, it is now generally admitted, and, on my own 
part, I have no doubt of it whatever, that a large pro- 
portion of the deaths are due to milk which has either 
become tainted in this way, or becomes tainted by putting 
it into feeding-bottles which are seldom or never kept 
properly clean. 
Another great danger attaching to milk as a carrier of 
disease depends upon the remarkable powers which it 
possesses of absorbing any effluvia contained in the sur- 
rounding air. If milk, for example, be kept in a badly 
ventilated place, where foul odors are perceptible, it will 
very soon become tainted and unfit for use, and on this 
account it ought never to be stored in sculleries or larders, 
nor should it be stored in vessels made of lead or zinc, be- 
cause in the latter case it is liable to absorb such a quantity 
of lead as to render it poisonous. It is owing to this power 
of absorbing particles floating in the air that milk has 
frequently been the means of producing widespread out- 
breaks of scarlatina. If the disease exists in the dairy- 
man's house, it is sure to be conveyed in this way to some 
if not all of his customers, and very often it would appear 
as if the infectiveness of fhe scales or other particles 
absorbed by the milk had become increased by this mode 
of conveyance. 112 
CA USES OF DISEASE. 
When foot-and-mouth disease is prevalent, all milk 
should be boiled before being used, because it has been 
clearly proved that the milk of cows suffering from this 
disease, though frequently taken with impunity, is very 
apt to produce ulceration of the mouth with swelling of 
the tongue. It need hardly be said that the milk of any 
animals suffering from any acute disease or from inflam- 
mation of any part.of the udder, is decidedly unwholesome 
and altogether unfit for use. 
Such, then, are some of the more prominent dangers 
.attaching to our milk supply, and the recent Order in 
Council with reference to the systematic inspection and 
sanitary condition of cowsheds and dairies, cannot fail to 
be productive of a vast amount of benefit to the public, 
and especially to children, if fairly and honestly carried 
out.* 
Passing on now to the'consideration of ailments induced 
by other articles of food, we have to note in • the first 
instance that the evidence with regard to the effects of 
eating diseased butcher's meat is of a somewhat conflict- 
ing nature. Thus, in Scotland, it- is common for shep- 
herds and farmers and their families to eat what is known 
as braxy, or diseased mutton, with immunity; while it has 
been computed that as much as one-fifth of the butcher's 
meat sent into the Metropolis is diseased meat. While, 
therefore, there can be no doubt that the risk of eating 
diseased meat, especially if properly cooked, is not nearly 
so great as might be expected, there are numerous well- 
authenticated instances which clearly prove that there 
always is a certain amount of risk, and that the symptoms 
induced in this way are chiefly those of vomiting, diar- 
* These atteinptsof our English cousins to discover hy experiment the most prac- 
tical methods for preventing injury to the public health from adulterated food, con- 
tagious diseases, &c., will, I hope, speedily instruct us how to most effectually pro- 
vide by lew against similar frauds and dangers in the United States.-(R.) MATERIAL, LOCAL, AND COMMUNICABLE. 
113 
rhcea, and a low kind of fever. The worst of it is th'at 
dishonest butchers make it theii' constant aim to palm off 
the carcasses of animals, as sound meat, which they have 
bought for a mere nominal sum to be slaughtered because 
they are suffering from an incurable disease, such as in- 
flammation of the lungs, pleuro-pneumonia, and the like. 
In all such cases, I conceive it to be the duty of the medi- 
cal officer of health to condemn such meat as unfit for 
human food, for the general protection of the public, even 
though the risk to health be small or doubtful. 
With regard to animal food which has become more or 
less putrid, there is a similar amount of conflicting evi- 
dence. We all know that game is not considered fit for 
the .epicure's table until it is in an advanced stage of de- 
composition, and beef and mutton are relished all the 
more if they have been allowed to hang until decomposi- 
tion is slowly commencing, No doubt, thorough cooking 
is the main preventive of any mischief which would other- 
wise arise from decomposing animal food; but, in spite of 
this, instances are by no means rare in which symptoms, 
similar to those just enum erated, have been produced by 
food of this description. If, moreover, a person happens 
to have an ulcerated mouth or tongue, he runs the risk of 
suffering from actual blood-poisoning by the putrid food 
coming in contact with the ulcerated parts. Putrid or 
badly smelling sausages are especially dangerous, no 
matter how thoroughly they may be cooked. 
The most distinctive diseases, however, induced by dis- 
eased butcher's meat, are those of a parasitic nature. 
The disease so common in Germany, known as trichiniasis, 
is caused by eating the flesh of animals, and chiefly the 
pig, infested with the larvse of the trichina. When taken 
into the stomach in articles of food, such as bacon or 
sausages, which have not been properly cooked, it speedily 
develops into maturity, new embryos are produced in 114 
CA USES OF DISEASE. 
enormous numbers, which make their way through the 
cellular tissue pervading all parts of the body. The dis- 
ease, when thoroughly established, is incurable, and after 
death, the parasite is found twisted up in spiral form 
(hence the name, trichina spiralis), in numberless minute 
cysts, in almost every muscle of the body. Fever, rheu- 
matic pains, and gradual emaciation, are the prominent 
symptoms, but they are often so vague and ill-defined, that 
the disease has not been suspected until after death. The dis- 
ease is comparatively rare in this country, but on the Conti- 
nent severe outbreaks have been by no means uncommon. 
Of other diseases of a parasitic nature connected with 
food,'may be mentioned tapeworm, which is induced by 
eating what is called measly pork, and hydatid disease of 
the liver and other organs. 
Putrid fish will produce symptoms similar to those 
caused by putrid meat, and many people dare not eat 
shell-fish, because, though fish may not be suspected as 
unwholesome, they seldom fail to induce an eruptive dis- 
ease of the skin, somewhat akin to nettle-rash, and accom- 
panied by a slight amount of fever. 
The disease known as scurvy is induced by the want of 
fresh vegetables, or vegetable juices, and a too exclusive 
use of salted meat. Before the days of Captain Cook-• 
who was the first to demonstrate the real cause of the dis- 
ease-scurvy decimated our crews alike in the navy and 
merchant service, and in recent years more than one 
serious outbreak on board ship has testified to the neglect 
of proper precautions. The great preventive against 
scurvy during long voyages is lime-juice, and all ship- 
owners are bound by law to supply their crews with a 
liberal allowance of this substance, properly prepared, 
and in such condition as to satisfy the officers of the 
Board of Trade. Preserved vegetables of various kinds 
are also very valuable preventives, so that with the aid of MATERIAL, LOCAL, AND COMMUNICABLE. 
these and tinned meats, with occasional doses of lime- 
juice, the longest voyages may nowadays be undertaken 
without any fear of the disease breaking out. 
As regards vegetable food, it need only be pointed out 
that all food of this description which has become fusty or 
mouldy is unwholesome. Mouldy flour or bread has been 
frequently known to produce distressing symptoms; while 
on the Continent, what is known as ergot, or spurred rye, 
when ground up with the rye, and made into bread, has 
been productive of serious epidemics. Owing to the 
operation of the Adulteration Acts, the adulteration of 
articles of food or condiments does not in the present day 
exercise such a deleterious influence on public health 
generally as it doubtless did a few years ago. There still, 
however, remains much to be done to carry out the provi- 
sions of the Act at present in force to any degree approach- 
ing efficiency. Public analysts have been appointed all 
over the country, but the public authorities appear to be 
sadly remiss in collecting samples to be submitted for 
analysis. Milk is still watered to a large extent, butter 
mixed with lard, vinegar fortified with sulphuric acid, 
pickles made attractive-looking and green by the addition 
of sulphate of copper, bread made white by the addition 
of alum, flour mixed with all sorts of mill-sweepings, beers 
fortified with salt and other ingredients, and spirits largely 
diluted with water. The chemist can nowadays detect all 
these and other fraudulent sophistications, and the public 
have themselves to blame if they do not insist that the 
machinery which the Legislature has provided to put a 
stop to them, shall not be allowed to remain any longer at 
a standstill.* 
115 
* Massachusetts has the honor of being first among the United States to provide 
public analysts for the purpose of checking the sophistication of milk, flour, etc., 
and'the present rapid spread of enlightened public opinion in favor of sanitary re- 
form will, we trust, lead to her excellent example being generally followed in every 
part of our Union.-(R.) 116 
CA USES OF DISEASE. 
4. Disease-Germs.-It has already been pointed out, in 
the introductory chapter, that there are certain diseases 
known as zymotic, which, however they may have originated, 
are propagated by infection or contagion, and it is believed 
that the real agents are infective particles, or so-called 
disease-germs, given off by the skin, the lungs, or the 
bowels, as the case may be. It is likewise characteristic 
of these infectious diseases, that they generally breed true, 
and run' a more or less definite course. Thus, the germs 
of small-pox can only induce small-pox, those of scarla- 
tina can only induce scarlatina, and so on. In some the 
infective particles are given off by the skin and lungs, and 
as they are conveyed by the air, they adhere to articles of 
clothing, furniture, and the walls of the sick-room. Small- 
pox, scarlatina, measles, typhus fever, are all propagated 
in this way. In diphtheria and whooping-cough, the in- 
fective particles are conveyed by the breath, while in cholera 
and typhoid fever they are contained in the bowel dis- 
charges. Some of these diseases, such as measles, whoop- 
ing-cough, and scarlatina, are especially fatal to young 
children, and one attack, as a rule, protects from any future 
attack. Old and young, when not sufficiently protected 
by vaccination, are alike liable to small-pox, if exposed 
to infection, while diphtheria, though it is more common 
among children, also attacks people in adult life. Typhoid 
fever and other kinds of fever, on the other hand, are more 
generally fatal to grown-up persons or to those who have 
passed the period of childhood. 
It is further characteristic of almost all these diseases, 
that after the organic poison, or germs, have entered the 
body, whether through the air, by being inhaled into the 
throat and lungs, or through our food or drink, when con- 
taminated, a certain period of incubation elapses before 
any special symptoms begin to manifest themselves. This 
period, though tolerably constant in some of the diseases, MATERIAL, LOCAL, AND COMMUNICABLE. 
117 
such as small-pox, in which it generally runs to about 
twelve or fourteen days, varies from a few hours to several 
days; but, be the time long or short, the infective material 
is supposed to be multiplying in the system, and carried 
to all parts by the circulation of the blood, and thereby 
induces the. particular symptoms by which the disease is 
recognized. If the system can eliminate the poison faster 
than it is reproduced, recovery generally ensues; but if, 
on the other hand, it continues to be reproduced faster 
than it can be got rid of, death is the inevitable result. 
Beyond the brief explanation given in Chapter I. of 
the germ theory, I have purposely avoided all discussion 
concerning this or any other theory which tries to account 
for the origin or mode of propagation of these infectious 
diseases. Indeed, so conflicting are the views entertained 
by various writers concerning their nature, that " disease- 
germs," " infective particles," " organic poisons," are all of 
them terms which are used to indicate the infective or con- 
tagious material which, passing from the sick to the healthy, 
induce the special symptoms of the diseases in question. 
Then, again, "infection" and "contagion" are now used as 
synonymous terms, or, at all events, are used indiscrimin- 
ately, and are intended to convey the same meaning. Of 
far greater importance is it to know that, whatever be the 
origin or mode of propagation of these diseases, they are 
to a very large extent controllable, and many writers even 
go so far as maintaining that,- in the strict 'Sense of the 
word, they are altogether preventable. Thus no one who 
has studied the subject fully and fairly can doubt that 
small-pox could be completely eradicated from our midst 
if every one were thoroughly protected by vaccination; 
and even apart from the protective influence of vaccina- 
tion, it has been proved over and over again that if the 
first case or cases of an outbreak be at once removed to 
a hospital, where they can be properly isolated, there is 118 
no difficulty experienced in stamping out the disease, 
because no fresh case can arise without the contagion 
being conveyed from a previously existing case. This is 
also true with regard to that other very fatal disease, scar- 
latina, though perhaps not to such an exclusive extent, 
inasmuch as there is reason to believe that scarlatina is 
sometimes originated de novo from bad water or foul 
effluvia, but, when once originated, becomes highly in- 
fectious. In all diseases of this class, therefore, isolation 
is one of the most important aids to prevention, and hence 
it is that sanitary authorities throughout the country are 
empowered to build hospitals for infectious diseases, and 
provide them with all the necessary appliances out of the 
public rates. The misfortune is, that except it be in large 
towns, there are few authorities who will provide hospital 
accommodation until some serious epidemic breaks out, 
when it simply becomes a case of " locking the stable-door 
after the steed has been stolen." But in addition to isola- 
tion, disinfection, and other precautionary measures, which 
will be more fully detailed further on, it cannot be too 
widely known that improvement of local surroundings is 
essential to the diminution or complete banishment of so- 
called zymotic or infectious diseases, not only because they 
are all largely fostered by insanitary conditions, but because 
there is an ever-increasing amount of evidence already 
referred to, which goes to prove that many of them have 
a birthplace*exterior to man, but a birthplace in the fester- 
ing filth which he allows to befoul the air which he breathes 
or pollute the water which he drinks. 
For further details respecting infectious diseases and 
their prevention, the reader is referred to Chapter VIII. 
GA USES OF DISEASE. CHAPTER IV. 
FOOD AND DIET. 
I. Nutritive Values of Foods. 
We have already discussed, in Chapter II., the different 
'chemical constituents of food, and the different purposes 
which separately and collectively they subserve in the 
animal economy. We have seen, for example, that the 
nitrogenous, or albuminous, constituents are mainly in- 
tended for the construction and repair of the tissues ; that 
the fatty and farinaceous constituents are largely con- 
cerned in the maintenance of bodily heat and the produc- 
tion of animal force; that the saline constituents, besides 
aiding in the process of nutrition, are concerned in the 
consolidation of the tissues; and that water is the great 
solvent for the conveyance of the nutritive material and 
the removal of waste products. All these constituents, or 
bases, must be present in the food supplied, otherwise 
health cannot be maintained, or, indeed, life supported; 
and all of them are found in the vegetable kingdom, so 
that man, if he chooses, can supply his bodily wants by 
feeding on vegetable food alone. But in the flesh of ani- 
mals which we consume as food, we have these bases 
further elaborated, and we find the materials of flesh, and 
119 120 
FOOD AND DIET. 
sinews, and bone, ready prepared for our purpose. In 
eating meat, therefore, we are utilizing the digestive 
powers of other animals, and are, in fact, economizing 
force in a certain sense, by employing their digestive 
apparatus to do for us what we could not do for ourselves 
without a greater expenditure of vital energy. In other 
words, the meat-eater's digestion is not taxed to the same 
extent as that of the vegetarian pure and simple, although 
it is quite true that the latter is often long-lived, strong, 
and healthy. In this, as in other questions affecting' the 
well-being of the individual, personal peculiarities and 
requirements must be taken into account, although there 
are certain cardinal principles which apply to all alike. 
Now it has long been taught by experience, and abun- 
dantly proved by experiment, that a health-sustaining 
diet should not only contain the several food constituents 
which have been named, but that the amounts and propor- 
tions of them cannot be widely departed from under cer- 
tain uniform conditions without incurring injurious results. 
But as different articles of food vary greatly as regards 
their nutritive qualities, it is further evident that the 
quantity which is requisite for healthy sustenance must 
vary considerably too. Thus the Irishman, who subsists 
almost entirely on potatoes, which chiefly contain starch, 
very little nitrogen, and scarcely any fat, has to consume 
10 lbs. to 11 lbs. daily, and to supplement his diet with a 
little buttermilk or bacon; while the Scotch laborer, who 
subsists mainly oh oatmeal, requires a much smaller 
weight, since this grain not only contains a considerable 
amount of nitrogen, but also a fair amount of fat, as well 
as starch. On the other hand, the man who lives largely 
on flesh and bread, obtains the same food constituents, but 
in a much more concentrated form, and a weight of about 
2 2 lbs. of such food is equivalent, in nutritive value, to the 
Irishman's 10 lbs. of potatoes and extras. NUTRITIVE VALUES OF FOOD. 
121 
Then it has to be considered that climate and the re- 
sources of a country determine to a very large extent the 
nature of the dietary. In tropical countries, for example, 
where less physical activity and heat-production are re- 
quired, the inhabitants subsist mainly on farinaceous foods, 
such as rice, millet, and maize, with only a moderate 
quantity of fat, in the form of butter and vegetable oils. 
In Southern Europe, again, the staple food of the Italians 
consists chiefly of macaroni, legumes, rice, fruits, and 
salads, to which are added oil, cheese, and fish, but very 
little meat; while in Spain, the diet is soriiewhat similar. 
Proceeding northwards, we find that animal food is more 
extensively used, although in France and Germany vege- 
tables constitute a much larger part of the national dietary 
than among ourselves. In the north of Russia, rye and 
oats form the staple food from the vegetable kingdoffi, 
combined with an increased quantity of meat; while in 
the Arctic regions, the inhabitants consume large quanti- 
ties of blubber, in order to generate animal heat abun- 
dantly, and are compelled to live on animal food almost 
exclusively, because in so cold a climate vegetables can- 
not be cultivated. Thus man is clearly omnivorous, and 
it largely depends upon climate whether he should subsist 
mainly on vegetable or animal food, or on a mixed diet. 
In this country a mixed diet is preferable, though it is 
generally admitted that Englishmen err in consuming too 
much animal food. 
The following table of what are called alimentary 
equivalents, which is copied frqm the late Dr. Letheby's 
work on " Food," will enable the reader to appreciate the 
wide divergence which exists between the nutritive values 
of the various articles of diet in common use. These 
equivalents have been calculated on the amount of nitro- 
gen and carbon in the different articles which are avail- 
able for nutrition, and as they have been deduced from a 122 
FOOD AND DIET. 
large number of experiments and observations, they may 
be accepted as approximately accurate:- 
Split peas 
Indian meal 
GRS. PER POUND. 
Carbon. 
2699 
3016 
Nitrogen. 
248 
120 
Barley meal 
2563 
68 
Rye meal 
2693 
86 
Seconds flour 
2700 
116 
Oat meal 
2831 
136 
Baker's bread 
1975 
88 
Pearl barley 
2660 
91 
Rice 
2732 
68 
Potatoes.. 
769 
22 
Turnips 
263 
•13 
Green vegetables 
420 
14 
Carrots 
508 
14 
Parsnips 
554 
12 
Sugar 
2955 
- 
Treacle 
2395 
- 
Butter-milk 
387 
44 
Whey 
154 
13 
Skimmed milk 
438 
43 
New milk 
599 
44 
Skim cheese 
1947 
483 
Cheddar cheese 
3344 
306 
Bullock's liver 
934 
204 
Mutton 
1900 
189 
Beef 
1854 
184 
Fat pork 
4113 
106 
Dry bacon 
5987 
95 
Green bacon 
5426 
76 
White fish 
871 
195 
Red herrings 
1435 
217 
Dripping 
5456 
- 
Suet 
4710 
- 
Lard.. 
4819 
- 
Salt butter 
4585 
- 
Fresh butter 
6456 
- 
Cocoa 
3934 
140 
Beer and porter 
274 
1 
It should be explained here that the above list of NUTRITIVE VALUES OF FOOD. 
123 
equivalents applies to articles in their uncooked state, 
and that as regards the different kinds of animal food, 
the meat has been boned. As this table contains almost 
everything which is met with in a common dietary, it 
becomes no very difficult matter to calculate the total 
amount of carbon and nitrogen which any such dietary 
yields, and to compare the results with other dietaries 
which have been calculated in the same way. 
But as we know that in addition to maintaining the 
body in a healthy state, food is the sole source of the 
active energy displayed in work, exercise, and locomo- 
tion, it becomes at once apparent that the diet must be 
increased as the work increases, and hence the question 
arises-What is the minimum amount of food on which 
an average adult can subsist without detriment to health ? 
This question has been satisfactorily solved after a large 
number of experiments made by the late Dr. Edward 
Smith, Dr. Lyon Playfair, and others, and .taking the 
mean of all the researches, Dr. Letheby has given the 
following as the amounts required daily by an adult man 
for idleness, for ordinary labor, and for active labor:- 
Daily diets for 
Nitrogenous. 
Ozs. 
Carbonaceous. 
Ozs. 
Carbon. 
Grs. 
Nitrogen. 
Grs. 
Idleness . . 
. . 2.67 
19.61) 
I 3816 
180 
Ordinary labor 
. . 4.56 
29.24 I = 
J 5688 
307 
Active labor . 
. . 5.81 
34.97 J 
( 6823 
391 
And here I may state that the general correctness of 
these averages is fully borne out by a series of observa- 
tions which were carried out by myself when officially 
connected with convict prisons, and they have also been 
confirmed by numerous experiments which have been 
made by various physiologists, to determine the daily 
amount of .carbon and nitrogen excreted by adult men 
under different conditions of diet and exercise. 
As regards the proportionate amount of separate food 
constituents, we have already seen (Chapter II.) that the 124 
FOOD AND DIET. 
following quantities of water-free food are required by a 
healthy adult daily:-Albuminous substances (albumi- 
nates), 4J ounces; fatty substances, 3 ounces; saccharine, 
or farinaceous, substances (carbo-hydrates), 14 ounces; 
and saline matters, 1 ounce. These quantities apply to 
food deprived of all water, but as so-called solid food con- 
tains on the average about fifty to sixty per cent, of water, 
the total daily amount, exclusive of liquids, would be 
about 40 ounces. 
In the subjoined table, abridged from Dr. Parke's work, 
are given the analyses of different articles of diet in com- 
mon use, by various analysts, to show the relative propor- 
tion of the several constituents:- 
ARTICLES. 
In 100 parts. 
Water. 
Albu- 
minates. 
Fats. 
Carbo- 
hydrates. 
Salts. 
Butcher's meatof bestquality, 
with little fat 
74.4 
20.5 
3.5 
1.6 
Beef and mutton, as ordi- 
narily supplied 
75 
15 
8.4 
- 
1.6 
Bacon 
15 
8.8 
73.3 
- 
2.9 
Salt beef 
49.1 
29.6 
.2 
- 
21.1 
White fish 
78 
18.1 
2.9 
- 
1 
Poultry 
74 
21 
3.8 
- 
1.2 
Flour 
15 
11 
2 
70.3 
1.7 
Wheaten bread of average 
quality 
40 
• 8 
1.5 
49.2 
1.3 
Rice 
10 
5 
.8 
83.2 
.5 
Oatmeal 
15 
12.6 
5.6 
63 
3 
Peas (dry) 
15 
22 
2 
53 
2.4 
Potatoes 
74 
1.5 
.1 
23.4 
1 
Cabbage 
91 
.2 
.5 
5.8 
.7 
Eggs 
73.5 
13.5 
11.6 
- 
1 
Cheese • 
36.8 
33.5 
24.3 
- 
5.4 
Milk 
86.7 
4 
3.7 
5 
.6 
Butter 
6 
.3 
91 
- 
2.7 
Sugar 
3 
- . 
- 
96.5 
.5 
Speaking in general terms, an adult may be considered 
to be taking sufficient for the ordinary requirements of 
healthy activity if he consumes in twenty-four hours the NUTRITIVE VALUES OF FOOD. 
125 
equivalents of 1 lb. of meat, and 2 lbs. of bread. The 
English soldier on home service receives t lb. of meat and 1 
lb. of bread daily, and he buys about J lb. additional bread, 
and 1 lb. of other vegetable food. Such a diet is amply 
sufficient for any adult under ordinary circumstances of 
light employment; but should extra demands be made 
upon the physical powers, the diet must be increased or 
the health will suffer. Active laborers, such as artisans 
or agricultural laborers, consume about a fifth more nitro- 
genous food and twice as much fat as those engaged in 
light employment, while the farinaceous constituents are 
not increased. Navvies, on the other hand, and those who 
are employed at hard work, while they require more food, 
generally err in taking too much animal food, and ne- 
glecting vegetable food. With a fair allowance of milk, 
plenty of oatmeal porridge and oatmeal cakes, a little 
butter and cheese, potatoes, and other vegetables, a Scotch 
laborer will do as hard a day's work as any English navvy, 
and yet take very little butcher's meat from one year's 
end to the other. Such a diet is as nutritious, and much 
cheaper in country districts, than a diet in which butcher's 
meat is partaken of twice and often thrice daily. 
In a standard or well-arranged diet, the proportion of 
the different constituents should be as follows:-Albumi- 
nates, 1; fats, .6; and carbo-hydrates, 3; and experience 
also shows that these are the proportions which man's 
unaided instinct has all along striven to rtiaintain, so that 
when any particular food is deficient in any single con- 
stituent, it is generally associated with another which con- 
tains an excess of it. Thus, certain kinds of animal food 
which are deficient in fat, such as veal, fowl, and liver, 
are invariably associated with ham or bacon. So, too, we 
use melted butter with certain varieties of fish, or fry them 
in oil; while salmon, eel, and herring possess fat enough 
in themselves, and are eaten alone. Then, again, in making 126 
FOOD AND DIET. 
puddings we mix butter, milk, or eggs with sago, rice, or 
tapioca; salad is dressed with oil; rice boiled in milk; 
cheese or butter is taken with bread; bacon is used with 
cabbage and beans; and so on. These combinations are 
alike indicated by science and experience, and if the just 
proportions are departed from, sound health cannot be 
maintained. If, for example, albuminates be continuously 
taken in excessive quantities, as is often the case with 
large meat-eaters, either a considerable proportion of the 
food is eliminated undigested, or congestions and enlarge- 
ments of the liver are produced, and a general condition 
of plethora ensues. It is generally believed, too, that 
gouty affections are frequently induced in this way, and 
especially if active outdoor exercise is neglected. A large 
excess of albuminates, without other food, produces diar- 
rhoea, general discomfort, and febrile symptoms; while ex- 
cess of fatty and farinaceous substances leads to corpulence 
and fatty degeneration of the tissues. A considerable 
deficiency of albuminates, on the other hand, induces great 
muscular prostration, and feverish dyspeptic symptoms; 
whereas the deprivation of farinaceous substances can, be 
borne for a long time if an abundance of fat is supplied. 
Hence it is that men can be fed on fresh butcher's 
meat for a considerable period without detriment; but, as 
already stated, health can be best sustained in this country, 
and the process of digestion is least interfered with, when 
the diet is mixed and properly proportioned as regards its 
constituents. 
1. Vegetable Foods.-It will be interesting now to sur- 
vey very briefly the vast range of materials which civilized 
man has at his command for purposes of food; and first 
we will commence with those derived -from the vegetable 
kingdom. -The most important of this group are the 
II. Choice of Food and Drink. CHOICE OF FOOD AND DRINK. 
127 
cereals, or cultivated grasses, such as wheat, oats, barley, 
rye, maize or Indian corn, rice, and millet. Wheat, in 
the form of bread, has long been distinguished as " the 
staff of life." The structure of the grain, like that of all 
the other cereals, consists of a gritty and woody outer 
covering, which is indigestible, and which is got rid of 
after the grain has been ground, by sifting. In what is 
called "whole meal," or brown bread, the bran and pol- 
lards derived from this outer covering are retained, and 
though this kind of bread contains more nitrogen than 
white bread, it is seldom used except medicinally, on 
account of its slightly irritant effect on the intestinal 
canal. For general domestic use, seconds flour is practi- 
cally the best, inasmuch as it is the most nutritious, but 
white bread is generally chosen in preference, because it 
is less likely to be tough or sodden, and is more palatable. 
Bread should be evenly porous, and the texture should 
be firm, so that it can be easily cut into thin slices. N.ew 
bread is tough and not so digestible as when the loaf has 
been allowed to cool and dry. The crust should be well 
baked and not burnt, and the crumb should neither be 
flaky nor sodden. The taste and smell should both be 
free from sourness or acidity, and unless there be a con- 
siderable quantity of bran in the flour, the color should 
be white and not dark-looking. Sometimes the dishonest 
tradesman mixes ground rice, glue, or alum with the 
flour, in order to make the bread more retentive of mois- 
ture, and when this is the case, the loaf becomes sodden 
and doughy at the base after standing for some time. 
The best bread is the slowest in growing stale, and the 
aerated bread, in which the dough is raised by forcing 
pure carbonic acid into it, keeps better than any. For 
those who bake at home, brewer's barm is the best yeast, 
when it can be procured fresh, or that known as German 
yeast; but several of the baking-powders answer very 128 
FOOD AND DIET. 
well. Of biscuits there is an endless variety, but those 
made from flour and water only, as "captains" and "ship 
biscuits," are most suitable for travellers, because they 
keep the longest. Lastly, as derived from wheat, should 
be mentioned macaroni and other valuable Italian pastes. 
They are very nutritive, and not by any means dear, and 
when well-cooked, with milk or with cheese, make very 
palatable dishes. 
Oatmeal is richer than flour in nitrogen and fat, and 
is therefore more nutritious. In the form of cakes, and 
cooked as porridge, it constitutes the staple diet of the 
Scotch laborer, and with milk, potatoes, and other vege- 
tables, he need require little else for his sustenance from 
year's end to year's end. The coarsely ground Scotch 
meal is the most suitable and palatable. When cooked 
as porridge, the meal should be well boiled and flavored 
with salt. With good milk, it makes a most nutritious 
dish for children as well as adults, either for breakfast or 
supper, and it is to be regretted that it is not more generally 
used in the nursery and the homes of the poorer classes 
than it is. The grain, deprived of its husk, constitutes 
grits or groats, and when these are crushed they are known 
as Emden groats, and are used for making gruel, a drink 
which was at one time a favorite with our forefathers. 
Barley meal is largely used in the north of Europe, 
and was the common food of poor people in England 
about the time of the Commonwealth. The grain is 
almost always ground whole, and the bread made from it 
is compact and heavy. It is generally mixed with equal 
parts of wheaten flour, or with oatmeal, to make it more 
palatable. Pearl barley consists of the grain deprived of 
its husk, and is much used for making broth. From 
barley, too, is derived malt saccharine, from which our 
famous English beer is brewed; and it is also largely used 
for the distillation of whiskey. CHOICE OF FOOD AND DRINK. 
129 
Rye meal, once a common article of diet among our- 
selves, is still largely used throughout Germany and 
Holland, and is well known to travellers as forming the 
dark, sour bread which is at first so distasteful to many. 
As regards nutritive quality, it is slightly less than that 
of flour. 
Maize in various forms is often recommended as a valu- 
able food, and is one of the most extensively used grains 
in the world. It is largely consumed by the inhabitants 
of South Africa, America, Danubian Principalities, Italy, 
Spain, south of France, and Mexico. The ration for a 
Kafir servant is three pints of Indian corn daily, and 
though he seldom gets anything else, he manages to thrive 
well on it. The grain contains a good deal of oily matter, 
and is rich is nitrogen, but the flavor is somewhat harsh. 
The meal does not make good bread, but it can be cooked 
in the form of cakes, or by stirring it in boiling water or 
milk, as in the case of porridge. There is a tender variety 
of Indian corn, called sugar corn, the head or ear of which 
is cooked whole and in the green state, and makes a very 
succulent dish, much lauded in America. Taking into 
consideration the price of maize, and its high nutritive 
qualities, it is certainly one of the cheapest, if not the 
cheapest, article of food for the poor. 
Rice, though rich in carbon, is one of the least nitro- 
genous of all the cereals, and is not so nutritious as flour. 
In this country it is used only as an adjunct to other 
foods in the form of curry and pudding; but it constitutes 
the principal food of Eastern and Southern nations. 
Millet, like rice, is much used in Egypt, India, and the 
interior of Africa. It is slightly more nutritious than 
rice, but is hardly known in this country. 
Amongst other kinds of farinaceous food sold as dietetic 
adjuncts, may be mentioned arrowroot, sago, and tapioca; 
but as they each consist almost entirely of starch, the 
9 130 
FOOD AND DIET. 
only preference which can be given to any one of them 
depends upon price and flavor. They are best cooked by 
mixing them in boiling water or boiling milk, and then 
allowing them to simmer for a minute or two. 
The next group of vegetable foods which we have to 
consider are the pulses, or legumes, such as peas, beans, 
and lentils. The nutritive value of all of them is very 
high-the highest of all vegetable foods, since they con- 
tain more nitrogen than any of the cereals, and are as 
rich in carbon as wheaten flour. They are cultivated and 
eaten in all parts of the world, and are generally cooked 
with fat. In India, the Hindoo adds lentils to his rice 
and glue, and in this country we associate beans with 
bacon, and peas with butter. Peas and broad beans, 
when cooked whole, should be eaten young, and their 
skins should be tender enough to crack on boiling. When 
they are more matured, the skins become very tough and 
leathery, and the longer they are boiled the harder they 
get. Split or dried peas are deprived of their skins 
already, and if well boiled, as in soup or pudding, they 
make a very nutritious dish. The French, or haricot, 
bean, the fruit of the scarlet runner, which is such a 
favorite in this country in its green state, ought to be 
much more popular than it is in the dried state. When 
properly cooked, and flavored, haricot beaus make a very 
nutritious and a very cheap dish; indeed, there are some 
varieties which can be obtained in this country at about 
two-pence per dish. Then, again, lentils deserve to be 
much more generally used than they are. They make a 
very palatable and nourishing soup when flavored with a 
few pieces of celery or asparagus, and properly seasoned. 
As an illustration of the nutritive value of legumes, it 
may be remembered that during the Franco-Prussian 
war the German soldiers were supplied with a sausage 
named the erbswurst, which was made of peasmeal or pea- CHOICE OF FOOD AND DRINK. 
131 
soup mixed with a certain proportion of lard or bacon, 
onions, etc., and dried so as to be portable. Each sausage 
was a pound in weight, and one constituted the daily 
ration of the soldier. It was easily cooked by boiling in 
water, or it could be eaten cold. What is known as 
Revalentica Arabica consists of ground lentils and cocoa. 
Among what may be called the succulent vegetable 
foods, the potato is by far the most important. It was 
introduced into this country by Sir Walter Raleigh on 
his return from Virginia towards the close of the six- 
teenth century, but did not come into general use for 
more than a century later. Its nutritive value is not 
great, containing as it does only twenty-five per cent, of 
solid matter, of which only about two per cent, is nitro- 
genous; but it possesses the great advantages of being 
easily cultivated, easily kept, easily cooked, and easily 
digested, and, considering its cheapness, it possesses the 
further advantage of being a very economical food. 
Potatoes are best cooked in their skins, and should be 
mealy and powdery. When they are close and waxy, as 
when very young, or when they begin to sprout, they are 
somewhat indigestible. 
The Jerusalem artichoke, though a favorite with people 
who have gardens, has never become very popular in 
England, and indeed, it is not so nutritious as the potato. 
Turnips, carrots, parsnips, beets, onions, cabbages, leeks, 
asparagus, kail, cauliflower, are all pretty much alike in 
nutritive qualities, being made up of a large percentage 
of water, and containing only a small amount of nitrogen. 
They are all, however, very valuable as antiscorbutics, or 
blood-purifiers, and for their qualities of flavoring insipid 
foods and mixing up with strong ones. Salads, which 
should always be made from fresh green vegetables, may 
be so varied in respect to ingredients as to constitute an 
infinite variety of dishes. When fresh vegetables cannot 132 
FOOD AND DIET. 
be obtained, preserved vegetables make very good substi- 
tutes in cooking. 
Mushrooms are always best when grown in open 
meadows. They should peel easily, be of a pink color 
inside, and have a frill or curtain attached to the stalk. 
Fried with butter or fat, and properly seasoned, they 
make an excellent dish, and they also constitute a very 
palatable adjunct to stews. The large puff-ball makes 
very good ketchup, and may be cooked as fritters; while 
there are many other varieties of the Agarici, or mush- 
room-group, which are edible, and which would be used 
if they were more generally known. Allied to the mush- 
room may be mentioned the truffle, but this is only used 
as an expensive luxury. 
Pumpkins, marrows, cucumbers, and various kinds of 
nuts help largely to support life in some countries. The 
banana and bread-fruit are also valuable esculents, the 
former containing about twenty-seven per cent, solid 
matter of about the same nutritive value as rice. The 
bread-fruit contains about twenty per cent, solid matter, 
and in its fresh state is cooked by first peeling it, then 
wrapping it in leaves, and afterwards baking it between 
hot stones. 
Ripe fruits, such as apples, pears, oranges, strawberries, 
etc., though not of much nutritive value, are prized on 
account of their agreeable flavors. Dried fruits, such as 
grapes, figs, etc., which contain much sugar, are very nu- 
tritious, and in tropical climates are largely used for food. 
Among other vegetable foods may be mentioned several 
varieties of sea-weed and lichens, but except it be in 
Arctic regions, they are very little used. Icelandic moss, 
when mixed with rye meal, makes a wholesome and nu- 
tritious bread. 
Sugar and treacle are both extensively used on account 
of their flavoring qualities. They are heat-producing and CHOICE OF FOOD AND DRINK. 
133 
fattening agents, and their nutritive value in these- re- 
spects is about the same as that of starch. Tea, coffee, 
and cocoa will be best considered subsequently as bever- 
ages. 
With regard to pickles and numerous other condiments, 
little need be said. Their dietetic value depends not so 
much on their nutritiousness as on their flavoring qualities, 
by which they whet the appetite and act as aids to di- 
gestion. Pickles were at one time largely contaminated 
with sulphuric acid and sulphate of copper, but those 
which are now obtained from well-known manufacturers 
are generally pure and wholesome. 
2. Animal Foods.-The foremost place among these must 
be given to milk, inasmuch as it is a complete food, con- 
taining all the constituents necessary for nutrition and 
growth. An infant requires nothing except the mother's 
milk for its sustenance during at least the first six months 
of its existence, or, failing that, cow's milk mixed with 
about a third of warm water and a little sugar. After 
this, when teething has commenced, farinaceous food may 
be given in small quantities, but during early childhood, 
milk should continue to be the staple article of diet. 
Human milk and cow's milk differ but little in composi- 
tion, except that cow's milk contains more casein, and 
woman's milk more sugar. They each contain about 
eighty-seven per cent, of water, and the solids consist of 
casein, butter, sugar of milk, and various salts. In Switzer- 
land, goat's milk is used; in Sweden, sheep's milk; in 
Lapland, reindeer's milk; and in Turkey, mare's milk. 
The quality of cow's milk varies according to the 
breed of the animal, the nature of the food, and the time 
of milking-the evening milk being always richer than 
that milked in the morning. When milk is allowed to 
stand for some time, the cream, which contains most of 
the fat, or butter, rises to the top, and when this is re- 134 
FOOD AND DIET. 
moved, the milk is called skim-milk. Butter-milk, on the 
other hand, is the residue of the milk or cream after the 
butter has been removed by churning. It is much poorer 
in fat than skim-milk, but it is nevertheless very whole- 
some and nutritious, and in summer makes a very refresh- 
ing drink. To have it thrown away as food to the pigs, 
instead of being sold or given away to poor people in the 
neighborhood, is, to say the least, a very regretable waste. 
By adding rennet or acid, milk coagulates, and the curd 
is used for making cheese. The liquor which is left after 
the curd has been removed is called whey, and though not 
so nutritious as butter-milk, it still holds a small amount 
of casein in solution, as well as sugar and salts, and makes 
a very refreshing drink; easily digested and rapidly ab- 
sorbed. In composition it very much resembles the serum 
of the blood, and a grate of nutmeg makes it very pala- 
table. In some parts of Switzerland, it is administered 
medicinally at certain establishments largely advertised 
for the " whey-cure." 
. In condensed milk, about sixth-tenths of the water is 
evaporated, and sugar is added as a preservative. It is 
very valuable as a food for infants when good cow's milk 
cannot be obtained, but should be diluted with three times 
its volume of water before it is used. 
Milk is very often adulterated with water, and if the 
water is pure and wholesome, little harm is done, except 
that the mixture is less nutritious; but when the water is 
contaminated, as too often happens, typhoid fever, diar- 
rhoea, and other serious disorders, as has previously been 
shown, are frequently induced. Another great danger 
attaching to milk as a carrier of disease depends upon its 
remarkable powers of absorption, whether it be of foul 
effluvia or disease-germs. Outbreaks of scarlatina have 
been repeatedly traced to the agency of milk, and there 
can be no doubt that much of the infantile diarrhoea, CHOICE OF FOOD AND DRINK. 
135 
■which proves specially fatal during the summer and 
autumn months, is due to milk which has become tainted 
by being kept in close and foul-smelling places,.in insuffi- 
ciently cleansed vessels, or in feeding-bottles which are 
seldom properly washed. The disease called thrush is 
often caused by the neglect to keep feeding-bottles clean. 
Indeed, there are so many hidden dangers in the use of 
milk, especially among careless and filthy people, that to 
ensure safety it should always be boiled in warm weather, 
and in districts where foot-and-mouth disease is prevalent. 
Milk should never be stored in sculleries or larders, or in 
vessels made of zinc or lead; in the latter case, it speedily 
absorbs salts of the metal, and becomes poisonous. It 
need hardly be said that the milk from diseased animals 
is decidedly unwholesome. . 
The purity of our milk supply is a question of such ex- 
treme importance that the Legislature has wisely insisted 
on the inspection and wholesome condition of dairies, and, 
like other articles of food, provision is made to submit 
samples to public analysts for examination when adultera- 
tion is suspected. 
Pure cow's milk, when placed in a tall narrow glass 
vessel, should be perfectly opaque, of a full white color, 
free from deposit, and should yield from six to twelve per 
cent, of ci^eam by volume. It should have a pleasant 
taste, be free from acidity, and have no disagreeable smell. 
By using a graduated glass vessel and the lactometer, one 
can judge with tolerable accuracy whether the milk is 
genuine or not. 
Butter, like milk, is often adulterated with water, which 
may be detected by boiling-the oily matter floating on 
the top, leaving the water underneath. It is also adulte- 
rated with lard and other animal fats, in which case it 
will be found that it does not melt evenly. Good butter 
should give no unpleasant or rancid taste, and when 136 
FOOD AND DIET. 
melted should yield a clear-looking oil, with little deposit 
of water or other substance.. 
Cheese is used for two purposes-one for giving a fillip 
to the palate, in which case it is preferable if rich and 
decayed; and the other, that it may serve as a substantial 
food. In nutritive power, and especially in nitrogenous 
matter, it ranks high as an article of diet, but considering 
its price, it is hardly so economical as many other kinds 
of food. Skim-milk cheese, when it can be obtained 
cheap, makes, however, a very good adjunct to the 
laborer's loaf of bread. 
We now pass on to the consideration of butcher's meat. 
Perhaps of all European nations, the English people are 
the largest consumers of animal food, nor can there be 
the slightest doubt that the well-to-do classes consume 
much more meat than they actually require. Indeed, 
the sole idea which the working classes possess with 
respect to improvement of diet following upon increase of 
wages, is the inordinate use of butcher's meat, and when 
they can afford it, they make this the principal element 
of at least three meals daily. 
As regards nutritive value, butcher's meat varies very 
much according to the proportions of fat and lean; but it 
matters very little whether the meat be beef or mutton. 
In store animals the proportion of the lean is always 
greater than the fat, while in fat animals the fat is always 
very considerably in excess of the lean. Indeed, the main 
result of the fattening process is to substitute fat for water 
in the carcase; and the quality of the meat depends upon 
the free intermixture of streaks of fat with muscular 
fibre. 
The following are the principal characteristics of good 
butcher's meat:-:The lean on the cut surface should show 
a deep purplish red tint, and in beef should be marbled 
with fat, which shows that the animal has been well fed. CHOICE OF FOOD AND DRINK. 
137 
In mutton the cut surface should have the same purplish 
tint, but should be quite even in hue throughout. 
The color of the muscle should neither be too pale nor 
too dark. If pale and moist, it indicates that the animal 
was young or diseased; and if dark or livid, it shows 
that in all probability the animal was not slaughtered, but 
died with the blood in it. Both muscle and fat.should be 
elastic, yet firm to the touch, not moist or sodden, and the 
fat should be free from blood-specks. The raw fat of beef 
should be of a light yellow color, like that of butter, while 
the fat of mutton should be very white. The muscular 
fibres should not be large and coarse, nor should there be 
any gummy or purulent-looking fluid in the cellular tis- 
sue. The surface of good meat should be perfectly dry, 
and even the cut surface should scarcely wet the finger. 
The muscular fibre of a beast in poor condition or 
wasting from disease is pale in color,, and a quantity of 
watery fat of bad color is mixed up with the fasciculi. 
The meat itself is wet, flabby, and inelastic, and pits when 
the point of the finger is pressed against it. Such meat, 
it need hardly be said, is unfit for human food. 
The odor of good meat should be slight and not by any 
means disagreeable. An unpleasant odor indicates com- 
mencing putrefactive change or that the meat is diseased. 
A very good plan to detect any unpleasantness of odor is 
to thrust a long clean knife into the flesh, and smell it 
after withdrawal. 
In lamb and veal, the lean should be pale, but evenly 
tinted and free from mottling, while the fat in both should 
be very white and translucent. 
The internal parts, such as the heart, liver, kidneys, 
lungs, sweetbread, should have no unpleasant smell, and 
be free from spots of congestion or bruises. As they de- 
compose much more rapidly than the flesh of the car- 
cases, they should not be kept long before being cooked, 138 
FOOD AND DIET. 
and when cooked should not be subjected to a very strong 
oi' prolonged heat, because it makes them hard and indi- 
gestible. 
The amount of bone in meat varies very considerably, 
but on the average it is not less than eight per cent. In 
shins and legs of beef it amounts to one-third, and some- 
times to one-half the total weight, while in the neck and 
brisket it amounts to about ten per cent. The most 
economical parts are said to be the round and thick flank, 
then the sticking-piece and brisket, and lastly the leg, 
while in the case of mutton and pork the leg is most 
profitable, and then the shoulder. Sheep's head makes 
excellent broth, and ox-head very good soup; but both re- 
quire long boiling to extract the whole of the nutriment. 
If boiled for eight hours, ox-head will yield about one- 
fourth of its weight in gelatine, and the cheek will furnish 
nearly four pounds of good meat. Shins of beef also 
make excellent soup, but, like ox-head, require long boil- 
ing. Even bones when stript of the meat contain a con- 
siderable amount of fat and nitrogenous matter, so that 
six pounds of bones, when broken up and boiled for nine 
hours, will yield an amount of nitrogen equal to that con- 
tained in a pound of meat and twice as much fat. 
In some parts of the Continent, horse-flesh is regularly 
sold in the open markets, and by many is considered to 
be superior to beef. American beef and mutton are now 
largely imported into this country, and are quite as pala- 
table and nutritious as the average of joints to be obtained 
from English butchers. Indeed, English mutton is too 
frequently over-fat and over-grown; good mutton, like 
Welsh or Scotch mutton, is generally small. Venison 
and the flesh of other wild animals differ very little in 
nutritive quality from butcher's meat, except that they 
are leaner, and contain more blood; as a rule, they are 
more digestible. CHOICE OF FOOD AND DRINK. 
139 
Bacon differs from meat in the relatively large propor- 
tion of fat and small proportion of water. It is a great 
favorite with all classes, on account of its flavor, its facili- 
ties for cooking, and because it is easily kept and is 
always handy. As it is rich in carbonaceous food, it 
forms a suitable adjunct to substances which are rich in 
nitrogen, such as veal, poultry, rabbits, eggs, beans, peas, 
and lentils; its flavoring qualities can make many a dish 
of homely vegetables palatable as well as nutritious. 
Although American bacon is coarser and not so much 
relished as English bacon, it nevertheless deserves a ready 
sale on account of its cheapness. 
As regards poultry, the chief virtue is tenderness. A 
young and tender bird may be known before plucking by 
the largeness of the feet and the leg-joints. When, on 
the other hand, a fowl appears on the table with a thin 
neck and violet thighs, it is wise to decline being helped 
to the leg, because these are sure signs that the fowl is 
old and tough. The same violet tinge may be observed 
in the thighs of old turkeys, which are also characterized 
by their hairiness. The age of geese and ducks may be 
best tested by their beaks, the lower part of which can 
easily be broken away when the birds are young. Apart 
from special points known to the sportsman, game may 
be roughly selected according to the same rules as poultry. 
Neither should be too fat, because in cooking the oil of 
the fat is apt to become rank and indigestible. 
In purchasing fish, care should be taken that it is 
always fresh, and the best points to look to are the fulness 
of the eyes and the pinkness of the gills. There should 
be no offensive smell, which it must be remembered is fre- 
quently masked by the use of ice. 
The different varieties of white fish, such as cod, whit- 
ing, haddock, turbot, plaice, and sole, contain only about 
twenty-two per cent, of solid matter, eighteen of which is 140 
FOOD AND DIET. 
nitrogenous, and in order to increase their nutritive value 
they require to be supplemented with butter. Salmon, 
mackerel, eels, herring, and trout, however, are richer in 
fat, and are therefore more nutritious. Shell-fish only 
contain about thirteen per cent, of solid matter, and pro- 
portionately as little fat as white fish. Some varieties, 
such as whelks, mussels, and limpets, are rather difficult 
of digestion; but lobsters, crabs, periwinkles, and cockles 
are more easily digested, and oysters more so still. Caviare, 
the roe of the sturgeon, is best when obtained in the fresh 
state. The black, hard-looking fish jam, which is sold in 
pots, may be reckoned a great delicacy, but it is scarcely 
fit for human consumption. 
The only variety of reptile of dietetic importance is the 
turtle, and although it is generally regarded as a mere 
luxury, it is in reality very digestible and nutritious, and 
makes excellent soup. Owing to the limited demand for 
it in the market, it is very dear, but nature supplies it in 
immense quantities, and the creature is so tenacious of 
life that it could be readily imported at a trifling cost. 
Dried turtle fins, which are not very expensive, make a 
good, nutritious soup, but they require to be soaked at 
least twenty-four hours before they are cooked. 
Eggs contain about twenty-six per cent, solid matter, 
fourteen of which are nitrogenous.- The yolk is the part 
which contains the fat, the white consisting of albumen 
and water. Owing to their deficiency in carbonaceous 
matter, eggs consort well with oil in salad, fried bacon or 
ham, and farinaceous, puddings. In order to test whether 
eggs are good or not, a good plan is to make a solution 
of common salt and water (one ounce of salt to half a pint 
of water),- when it will be found that in brine of this 
strength, a fresh egg will sink and a bad one float. If 
held up to a candle, a fresh egg will also be found to be 
more transparent than a stale one. Eggs may be pre- CHOICE OF FOOD AND DRINK. 
141 
served for some considerable time by rubbing them well 
with fresh grease or lard when taken from the fowl-house; 
or by plunging them into boiling water, so as to coagulate 
a thin layer of the albumen underneath the shell; or by 
putting them, when quite fresh, into milk of lime. 
Both meat and fish of various kinds are now largely 
preserved in tins, and though they can hardly be con- 
sidered to be as digestible and nutritious as when obtained 
fresh, they make very good substitutes, and possess the 
advantages of being readily cooked, and cheaper in price. 
Among these preserved foods may be mentioned " Liebig's 
extract of meat," which is especially valuable to invalids 
and travellers. Its nutritive qualities are inferior to those 
of good beef-tea, but it can often. be taken by an invalid 
when beef-tea is rejected, and to any one suffering from 
fatigue it is very restorative. 
Tinned meats, as a rule, are somewhat over-cooked, but 
they are so much cheaper than fresh meat that, on the 
score of economy alone, they deserve to be extensively 
used. They are best used cold, or warmed and mixed 
with vegetables, to form a stew, or they may be minced, 
and, when warmed and if well-seasoned, may be rendered 
very palatable. 
The special diseases which are apt to be induced by 
unsound food have already been discussed in the previous 
chapter, and it only remains to refer, before concluding 
this part of the subject, to the saline constituents. As 
previously stated, these consist chiefly of phosphates and 
sulphates of potash, lime, magnesia, small traces of iron, 
and common salt. With the exception of the last, the 
other saline matters are contained in sufficient quantity in 
the ordinary articles of diet, but common salt is not 
present to any large extent, and has, therefore, to be 
added. Its dietetic value has been recognized from the 
earliest times, it exists in all the excretions, and it forms 142 
FOOD AND DIET. 
about one-half the total weight of the saline matters con- 
tained in the blood. 
3. Water, Beverages, and Stimulants.-It has already 
been pointed out that, exclusive of the water contained in 
the ordinary articles of diet, the amount of water required 
by an adult daily, taken pure, or mixed with other liquids, 
need not exceed thirty ounces or at the most a couple of 
pints. But as a rule, this quantity is greatly exceeded, 
by even the majority of so-called temperate persons. 
Thus, it is no unusual occurrence for a man to drink a 
pint of tea or coffee at breakfast; a pint of ale in the fore- 
noon; a couple of glasses of. sherry or half a pint of clarct- 
and-water at luncheon; a pint or more of wine and other 
drinks at dinner; half a pint of tea or coffee afterwards; 
and at least another half-pint of some aerated water, with 
a little spirit, as a "nightcap," before going to bed. 
Altogether, therefore, it would appear that the quantity 
of liquid imbibed by most persons during the twenty-four 
hours, amounts at the very least to about five pints, or 
three times as much as is needful for health; 'and as a 
consequence, the excreting organs become overtaxed, the 
blood becomes thin, and the general tone of the system 
deteriorates much more rapidly than it otherwise would. 
But apart from the quantity, it is of still greater impor- 
tance that the quality of the water consumed should be 
free from excess of saline substances, and otherwise un- 
contaminated. We have already considered, in the pre- 
vious chapter, some of the more fatal of the many dis- 
orders wThich are developed in this way, and hence it is 
unnecessary to again refer to them here. Unfortunately, 
it only occasionally happens that people have a chance 
of choosing the kind of water with which they are sup- 
plied, and even then they are often ignorant of the dangers 
of pollution to which it is exposed. In towns, the water 
supply is public, and though it may be of good quality WATER, BEVERAGES, AND STIMULANTS. 
143 
when it enters the mains, it often becomes contaminated 
in cisterns or in the mains before it is used in the house- 
hold. In country districts, again, well-water or water from 
small streams is chiefly relied on, and the risk of pollution 
becomes greater still. 
Of course, the purest water is that condensed from 
steam, as sometimes manufactured on board ship, but it 
tastes flat and metallic, and, like roof-water, is apt to 
become impregnated with lead, if stored in leaden cisterns; 
Roof or rain water, too, is liable to contain an excess of 
solid particles washed off from the surfaces where it is 
collected, and hence it should always be filtered. In other 
respects it is wholesome, though not so palatable or refresh- 
ing as good well or spring water, but it is excellently 
adapted for cooking and washing purposes. Spring and 
well waters are often very hard, but become softer on 
being boiled, owing to the lime contained in them being 
thrown down as a deposit. Very hard waters are unsuited 
for cooking and washing, and have a tendency to render 
the skin harsh, arrest digestion, and induce gravel or 
stone. River and shallow well waters are liable to become 
polluted with sewage or other organic matter, but spring 
and deep-well waters, though generally harder, are as a 
rule much safer, because not so much exposed to these 
dangers. 
The qualities which should most commend a water, in- 
dependently of its source, are the following:-It should 
be soft, clean, clear, inodorous, sparkling, and sufficiently 
impregnated with saline substances to be tasteless. When 
there is reason to suspect a water which is used for dietetic 
purposes to be impure, it should either be sent to an 
analyst at once, or complaint should be made to the sani- 
tary inspector of the district in order to have it examined. 
Mineral waters, which are used for drinking purposes, 
and not medicinally, should also possess the same virtues. 144 
FOOD AND DIET. 
In this country, all the best manufacturers of aerated 
waters have their own deep wells, and the waters which 
they produce are pure and of excellent quality; but at 
the same time, it cannot be too widely known that there 
are large quantities of cheap ginger-beer, lemonade, soda- 
water, and other drinks, which are made from water of 
doubtful quality, by persons who pay no attention to clean- 
liness, and who employ chemicals and flavoring materials, 
which arc positively injurious. When, therefore, these 
aerated waters are used for dietetic purposes, they should 
always be obtained from well-known manufacturers, or 
the ordinary household water, if of good quality, may be 
aerated by using one or other of the many gazogenes 
which are now in the market. 
When people are travelling, the only safe water to drink 
is a natural mineral water, because there can be little 
doubt that the attacks of fever from which travellers 
abroad are so liable to suffer, are more frequently induced 
by drinking bad water than by any other cause. In Ger- 
many, Apollinaris and Seltzers can generally be obtained; 
in France, St. Galmier; in Austria and Bohemia, Gies- 
hiibel; and in most Italian hotels, either St. Galmier or a 
natural Seltzer. The foreign manufactured aerated waters, 
and particularly those contained in the Siphon, are of 
doubtful quality, and should be avoided. Potash and 
lithia waters should only be used by invalids or those 
with a gouty tendency; indeed, any mineral water, 
whether natural or not, which is vaunted as possessing 
medicinal properties, should never be used for dietetic 
purposes. 
It should always be remembered, too, that if a water 
is contaminated, neither admixture of wine or spirit, nor 
filtration, will make it safe to drink; but it may be ren- 
dered harmless by boiling for half an hour or so, and this 
result is readily attained in any place by making weak WATER, BEVERAGES, AND STIMULANTS. 
145 
tea, toast-and-water, barley-water, gingerade, or lemonade, 
and drinking the beverage cold. 
An excellent drink for laborers, especially when em- 
ployed at very active work, may be made from oatmeal 
and water, with a little salt to flavor. It is nourishing 
as well as refreshing, and is infinitely to be preferred to 
common beer to allay thirst. Toast or barley-water makes 
a good substitute, and many prefer treacle-water, but it 
should not be made too sweet. 
With regard to other beverages, a few words must now 
be said concerning those very important dietetic adjuncts, 
tea, coffee, and cocoa. Although tea is very refreshing 
and largely used as a diluent at meals, as well as a drink, 
there can be little doubt, judging from the shameful way 
in which the trade is at present carried on by offering 
prizes and premiums to purchasers, that large quantities 
are adulterated or of very'inferior quality. The best tea 
is that which possesses the best aroma and is pleasantest 
to the taste of the educated customer. The sedative, or 
soothing, qualities for which tea is prized are contained 
in the leaf, and consist of an essential oil, which may be 
smelt strongest in the best, and weakest in the inferior 
sorts. Indeed, good tea should yield a pleasant aroma 
alike in the dry state and when infused in boiling water, 
and the flavor of the infusion should be agreeable. Very 
often the bloom or glaze of green and black tea is pro- 
duced artificially. In the case of black tea, it sometimes 
consists of a coating of black lead ; and in that of green 
tea, it is not unusually a mixture of Prussian blue, tur- 
meric, and China clay. Moreover, inferior mixtures, such 
as Moning Congou, Maloo mixture, Pekoe siftings, and 
the like, are largely imported into this country, and con- 
sist chiefly of exhausted tea leaves, leaves of other plants, 
iron filings, and the dust and sweepings of the warehouses. 
If strong "black tea" has an inky taste, a magnet will 
10 146 
FOOD AND DIET. 
detect any adulteration with iron filings. The purest teas 
color the water least; indeed, the best yellow tea, which 
comes overland through Russia, imparts only a very slight 
tinge to the infusion. 
Excessive tea-drinking, especially during the afternoon 
and late in the evening, is very liable to induce dyspeptic 
ailments and very depressing nervous symptoms. Par- 
taken as it often is, at all hours of the day, by the wives 
of the laboring classes and needlewomen, it becomes a 
fruitful cause of many of the disorders from which they 
suffer. When strong tea is indulged in late at night, it 
induces sleeplessness and disturbed rest. When taken as 
a drink, it ought always to be weak and allowed to cool. 
Coffee is not so astringent as tea, and with some persons 
it is not so liable to affect the nervous system injuriously. 
In order to obtain it of good quality, it is advisable to 
purchase the beans fresh-roasted and grind them at home, 
or, better still, to purchase the raw beans and roast them 
over a charcoal fire immediately before they are ground. 
The ground coffee sold by grocers is very often mixed with 
chicory, and though this mixture is not unwholesome, the 
beverage is weaker in quality, and does not possess the 
agreeable aroma of really good coffee. The presence of 
chicory may be detected by sprinkling a portion of the 
suspected sample on the surface of water, when the coffee 
will float and the chicory sink. The presence of chicory is 
also indicated, if, on opening a packet of coffee, the con- 
tents are found to be caked or show any signs of caking. 
As regards cocoa, the nibs are the most eligible form in 
which the plant may be used as a beverage; but when it 
is required as a supporting food, it is preferable to use the 
preparations of cocoa or chocolate sold by well-known 
manufacturers. These are much- more nutritious than 
either tea or coffee, and are not so enervating. Indeed, 
there are few foods so nutritious as cocoa and milk, and WATER, BEVERAGES, AND STIMULANTS. 
147 
it is to be regretted they do not meet with more favor 
among the poorer classes. 
We now pass on to consider very briefly the dietetic 
position which should be accorded to stimulants, or alco- 
holic beverages. The physiological effects of alcohol, and 
its terrible potency as a cause of disease, have already 
been fully discussed in a previous chapter; but, admitting 
that alcohol may be taken in small quantities without 
injury, and often with benefit, it remains to be considered 
in what form it should be taken, whether as wine, beer, or 
spirits, and under what limitations. 
And first, it has to be pointed out that, no matter under 
what guise alcohol may be taken, it has been tolerably 
well established, by the experiments of the late Dr. 
Austie, Dr. Parkes, and others, that Jhe quantity which 
may be consumed daily without any appreciable detri- 
ment, ought not to exceed ounces of pure, or absolute, 
alcohol. This is equivalent to 2| pints of weak table 
beer, containing only 3 per cent, alcohol; or lj pints of 
stronger ale or cider, containing about 5 per cent, alcohol; 
or about I pint of light claret, Burgundy, or hock, con- 
taining about 10 per cent, alcohol; or about 6 or 7 fluid 
ounces of port or sherry, containing from 20 to 25 per 
cent, alcohol; or about 3 fluid ounces of spirits, contain- 
ing on the average 50 per cent, alcohol. A good-sized 
sherry glass, therefore, which holds about three ounces, 
will contain as much spirits as may be consumed habitu- 
ally and with safety during the twenty-four hours. No 
doubt there are vast numbers of people^ who constantly 
exceed these amounts, and without apparently suffering in 
health; but on. questioning them closely, it will often be 
found that headaches, general malaise, mental depression, 
and other uncomfortable symptoms are frequently endured 
as a matter of course, and without eliciting any complaint. 
Distilled spirits are in every respect the worst form in 148 
FOOD AND DIET. 
which alcohol can be habitually consumed, and if par; 
taken of freely, the strength or frequency of the dose has 
to be gradually increased to produce the desired effect of 
comfort or exhilaration. Their use, therefore, ought to 
be carefully restricted, and the safest plan is to limit it to 
the "night-cap," when that is required; but most people 
would sleep more soundly if even that were dispensed 
with. Unfortunately, the great bulk of the spirits which 
are consumed contains a considerable amount of fusel oil, 
not to speak of raw spirit, which makes them injurious 
even when taken in the smallest doses. Those who take 
spirits, therefore, should be careful to obtain them good 
and well matured. It will be found, too, that spirits are 
better tolerated in the winter than during summer, and in 
bracing and colder climes than in warm or relaxing 
places. A great deal also depends on the amount of exer- 
cise taken ; but even the sportsman on the moors will find 
that he will shoot more steadily and stand a much better 
chance of making a good bag if he "fights shy" of the 
whiskey-flask during the day. 
As regards wines, much will depend upon whether the 
consumer intends to use them as a regular beverage or a 
luxury, and whether he has any gouty or dyspeptic ten- 
dencies. Beyond all question, the cheapest and best wine 
for daily consumption as a beverage is good sound claret. 
No wine can be more perfect than the greater part of the 
low-priced bourgeois wine from Bordeaux, which is now 
so common in the English market; and it is often far 
more wholesome than some of the wines which are sold at 
much higher prices under fanciful names. 
Strong, full-bodied wines, such as port, sherry, Madeira, 
should rarely be used habitually, not only on account of 
the amount of alcohol which- they contain, but because 
they are apt to derange digestion, produce acidity of the 
stomach, and, in the long run, generate gout. Sweet WATER, BEVERAGES, AND STIMULANTS. 
149 
wines are still more to be guarded against; they are only 
fit to be drunk occasionally, and in small quantities. 
The choicer Rhine wines do not bear carriage well, and 
though wholesome enough where they are produced, are 
too often deteriorated by being brandied in this country. 
Among sparkling wines, good champagne, when well 
matured, and with a minimum amount of alcohol, is the 
wholesomest; while, owing to the rapid absorption of its 
vinous ether, diffused by the carbonic acid, it possesses 
remarkable exhilarating properties. But for gouty per- 
sons, champagne and other sparkling wines are far from 
suitable; indeed, I am strongly of opinion that cham- 
pagne, even of good quality, is as gouty a wine as port, 
Madeira, or rich brown sherry. 
When it is desired to obtain fine wines of good vintages 
and unexceptional character, the purchaser, if not a con- 
noisseur, must either depend upon a wine merchant of 
established reputation to supply them, in which case he 
has to pay a high price, or he has to look out for vintages 
of good repute, select his samples when they are just fit to 
bottle, and then lay them down, and keep them until they 
become matured and fit for use. By making constant 
and well-selected additions, year after year, a man's cellar 
after a time becomes a valuable and interesting part of 
his establishment, adding not only to his own enjoyment, 
but what to a genial host is more pleasurable still, grati- 
fying appreciative friends at his well-selected dinner- 
parties. But no matter how good the wine, it ought to 
be taken sparingly, and not glass after glass for the mere 
sake of drinking it. In this, as in all other questions of 
luxury rather than requirement, every man ought to deal 
honestly and fairly with himself, watching the effects on 
body or mind of any tendency to excess, and rigidly deny- 
ing himself if he is satisfied that he suffers in consequence 
of indulgence, however moderate that may be. Indeed, 150 
FOOD AND DIET. 
it is a wise experiment, and one which does not entail any 
great amount of hardship or discomfort for most people, 
to try total abstinence for a period of two or three months. 
They would then learn more of the practical bearings of 
these agents in their relation to health, than any amount 
of mere book information which can be laid before them. 
Of all alcoholic drinks, good light beer is perhaps the 
safest and wholesomest beverage for those who can take 
it. To men, however, who have reached middle life, and 
whose occupation is mostly indoor and sedentary, it is un- 
suited, because it is apt to derange the digestion and 
induce gouty symptoms. Those who lead active outdoor 
lives can generally take it with impunity, provided they 
do so in moderation, Until long past middle life; but the 
great majority of professional and business men find they 
have to give it up altogether, or take it very sparingly 
when they have reached the age of thirty-five or forty. 
In Germany it is consumed freely at all ages, but German 
beer is usually much lighter than English beer, and con- 
tains less alcohol. Gouty persons, and those who suffer 
from rheumatism, should give it up altogether. 
The great thing to be guarded against in malt liquors is 
hardness, or acidity. Unfortunately, however, a very 
large amount of the beer which is consumed by the work- 
ing classes contains a considerable amount of acetic acid, 
even when it is brewed, and of course becomes more acid 
the longer it is kept. With respect to this point, a physi- 
cian of large experience has remarked that " there is no 
more fruitful source of gout, rheumatism, diseased heart, 
dropsy, and the consequent early death of the robust 
working man, than this beer just on the turn and ready 
to become thick vinegar in the stomach." The enormous 
quantities, sometimes as much as two gallons a day, which 
agricultural laborers consume at bay-time and harvest, 
are productive of much evil, physically as well as morally; PREPARATION OF FOOD. 
151 
and it is a good sign of the times that many farmers are 
now refusing to give beer as part payment. As already 
pointed out, oatmeal-water would be more refreshing and 
sustaining, or even cold weak tea or coffee. As the beer 
which is supplied often contains an excess of salt, instead 
of allaying thirst it increases it, so that the larger the 
quantity drunk the greater becomes the thirst. There is 
no doubt that beer and ale, like most wines, are to a cer- 
tain extent nutritive, and often act as aids to digestion. 
They contain sugar and extractive matters which are 
utilized as carbo-hydrates, and have therefore a tendency to 
fatten; as well as a considerable amount of saline matter. 
Spirits, on the other hand, are for the most part merely 
flavored alcohol, and as they do not contain the ingredients 
which give dietetic value to wines or beer, their habitual 
use should be discouraged, and even their occasional use 
largely restricted. 
It is to be hoped that the introduction of cookery as a 
subject of instruction in some of our public elementary 
schools will speedily be followed by a widespread reform 
in the art of preparing food so as best to sustain the wants 
of the body without excess on the one hand or deficiency 
on the other. For, at present, it must be confessed, the 
errors lie on every side. Not only is there general igno- 
rance with regard to the nutritive qualities of different 
articles of diet and their relative market price, but the 
food which is eaten often loses half its value by the faults 
displayed in its preparation. Hence amongst all classes 
there is constant and deplorable waste. Among the rich 
the sole aim of what is called good cookery appears to be 
to tempt the eater, by a succession of savory and highly 
seasoned dishes, to consume a huge excess of food; while 
among the middle and poorer classes, living and cooking 
III. Preparation of Food. 152 
FOOD AND DIET. 
alike go "by rule of thumb," with but little variety in 
the diet, day after day, and the food too often cooked in 
such a way that ready digestion becomes an utter impossi- 
bility, and a large portion of the nutriment is wasted. 
Every one will acknowledge that in large kitchens the 
amount of broken victuals, crusts, bones, scraps, and so 
forth, which are literally flung away, much of it thrown 
into the dust-bin, would be sufficient to feed many a poor 
family; and among the middle classes there is the same 
want of economy displayed, though not to such a large 
extent. Of course, there is the usual outcry about ser- 
vants, but the fault lies more at the door of the masters 
and mistresses. As a rule, the cook can defy her mistress, 
or, at least, have her own way in everything, because, igno- 
rant as she herself is about the principles of diet, she is 
perfectly well aware that her mistress is more ignorant 
still, and knows absolutely nothing about how to cook 
even the simplest dish. And the only remedy for this 
state of things, so far as one can judge, is for the ladies 
of the present day to endeavor to do as their grandtnothers 
did, and make themselves thoroughly acquainted with the 
details of cookery and household management. 
But not only is there this needless waste of food every- 
where, there is also constant waste of fuel. Although 
there are now numerous excellent, kitchen-ranges in the 
market, and other apparatus for cooking, which would 
more than save their prime cost in the first year of use, 
many householders prefer to cling to the old kitchen-range, 
with its dust and soot and roaring fire. During the sum- 
mer, especially, the economy in fuel would be very con- 
siderable if gas cooking-ranges, or ranges heated by burn- 
ing oil, came into more general use. They are made of 
all sorts and sizes, and are much more cleanly than the 
ordinary kitchen-range. Then there are other apparatus, 
such as Warren's cooking-pot, which ensure less loss of PREPARATION OF FOOD. 
153 
weight in cooking, and, by preventing dispersion of heat, 
effect at the same time a very considerable saving in 
fuel. 
Of course, it need hardly be said that, no matter what 
the apparatus, scrupulous cleanliness should always be 
attended to in the kitchen, as well as in other parts of 
the house. A dirty, greasy-looking cook generally im- 
plies a dirty and untidy kitchen, and if the wife is untidy 
too, it is no wonder that the husband prefers to have his 
meals and spend his evenings from home. 
In the homes of the poor, the cooking appliances are 
generally of the most imperfect kind, so that their meals 
are not only scanty, but wretchedly cooked. They have, 
therefore, to resort to the cook-shops of their neighborhood, 
which are as dirty as their homes, and the fare meagre 
and unsavory. In order to supply the crying wants of 
the poor in this respect, a movement has of late years 
been set on foot in most of our large towns, to establish 
restaurants, where meals may be obtained at the very 
lowest prices consistent with ensuring a small profit after 
paying costs; and certainly the bill of fare provided at 
many of these establishments is not only very reasonable, 
but very wholesome and palatable. The usual practice 
at these places is to supply daily a variety of dishes, both 
hot and cold, at the fixed charge of a penny a ration, and 
these rations, or dishes, consist of soup, broth, potatoes, 
greens, bread, cold pressed beef, ham, butter, coffee, tea, 
pudding, and cheese. A ration of meat generally costs 
a half-penny extra; and in order to get rid of the whole 
of the soup, which is made daily, it is the custom to sell 
the surplus stock at half-price after six o'clock in the 
evening. At many large manufactories and workshops, 
similar arrangements are provided for the work-people, and 
it is to be hoped that those who have been so instrumental 
lately in establishing coffee taverns for the purpose of 154 
FOOD AND DIET. 
supplanting gin-palaces, will see the expediency of sup- 
plementing the taverns with cooking-depdts. 
In the poorer localities of most large towns, soup-kitchens 
have been started for the really destitute. They are not 
intended to be self-supporting, like cooking-depdts, and 
the food is either distributed gratuitously by tickets, or at 
rates of charges much below prime cost. If only one 
kind of food is provided, such as soup, it should be varied 
from day to day, and differently flavored by using different 
kinds of vegetables. Flour or ground peas or lentils 
should be used for thickening, and add very considerably 
to the nutritive qualities of the soup. If meat is also 
given with the soup, it should be cut into small pieces before 
being cooked, and the soup should be constantly stirred 
while it is being served. It should always be served as 
hot as possible, because it is then warm enough to be 
eaten by the family when it is taken home. Any surplus 
stock should never be mixed with the next day's supply, 
but should be warmed aud served separately. 
The following formulae, from the late Dr. E. Smith's 
work on "Practical Dietary," may prove useful to those 
who take an active interest in the management of soup- 
kitchens :- 
Broth to make a hundred rations:-Meat liquor from 
7 lbs. beef and 1 lb. of well-broken bones; split peas, 2f 
lbs.; Scotch barley, 3f lbs.; carrots, 3 J lbs.; turnips, 3| 
lbs.; cabbage and other green vegetables, 71 lbs.; salt, 
pepper, aud dried herbs. (Carbon 300 grains, nitrogen 
12 grains, per ration.) 
Soup to make a hundred rations:-Meat liquor from 7 
lbs. of beef and 1 lb. bones; split peas, 13 lbs.; carrots 
and Swede turnips, each 61 lbs.; onions, 5jibs.; leeks, i 
lb.; salt, pepper, and dried herbs. (Carbon 490 grains, 
nitrogen 36 grains, per ration.) 
Potato-pie, to make a hundred rations:-Potatoes, 431 PREPARATION OF FOOD. 
155 
lbs.; meat (mutton usually), 10| lbs.; bones, li lbs.; 
dripping, H lbs.; flour, 5£ lbs.; onions, 3 lbs.; seasoning. 
(Carbon 878 grains, nitrogen 33 grains, per ration.) 
The following nutritious soup was supplied at Mrs. 
Gladstone's soup-kitchen in Blackburn, during the Cotton 
Famine:-Pea-soup for a hundred rations:-Beef (meat 
only), 4| lbs.; bones, f lb.; ham, 5 lbs.; salted pig's 
cheek, 4| lbs.; white peas, 20 lbs.; pea meal, 2 lbs.; 
Swede turnips, 61 lbs.; onions, I lb.; seasoning with 
pepper, curry, and salt. (Carbon 1048 grains, nitrogen 
75 grains; cost, 0.94d. per ration.) 
The shins of beef, necks, and heads, are the best parts 
for making cheap and nutritious soups, and with a proper 
admixture of the ingredients mentioned in the above 
formulae, the soups may be varied from day to day, at a cost 
not exceeding one penny (about two U. S. cents) per pint. 
But in purely agricultural districts, the same facilities 
cannot be provided for supplying large numbers; so that 
the laborer has generally to depend upon home resources, 
and these, it need hardly be said, are of a very limited 
description. In many parts, fuel is dear and scarce, 
while the cooking utensils are not only of a very primi- 
tive kind, but are so inadequate as to render good and 
varied cooking well-nigh impossible. Hitherto, the chief 
sustenance of the English agricultural laborer has been 
bread and cheese, with a little bacon, and if he has occa- 
sionally a small allowance of butcher's meat it is gener- 
ally frizzled so hard as to be anything but palatable or 
digestible. First, then, he should be induced, or assisted, 
to provide his home with the few necessary cooking uten- 
sils, which, after all, are not dear; and he ought to be 
assisted in the matter of fuel. Then, his bread ought to 
be baked of seconds flour, or whole meal mixed with a 
fourth part of fine flour. If the bread is baked at home, 
with baking-powder, the addition of a little butter and 156 
FOOD AND DIEV 
milk will make it all the more palatable and nutritious, 
and it should be kneaded into Hat cakes, somewhat re- 
sembling tea-cakes. Fresh butcher's meat should be 
cooked chiefly in making soup or stews, and by ringing 
the changes on haricot beans, peas, lentils, barley, and 
maize, with potatoes and fresh vegetables, he could always 
have nourishing and palatable dishes for himself and 
family at a very cheap rate, and with but very little 
expenditure on animal food. Even a piece of bone, or a 
small slice of pork or bacon, will be quite sufficient to 
flavor a large dish of vegetable, pea, or lentil soup. The 
best way to cook dried haricots is to soak them first for 
twelve hours in cold water, then place them in a sauce- 
pan, with a little salt and water (a quart of water to half 
a quart of haricots), on the fire, and after boiling has 
commenced, to allow them to simmer until the beans are 
quite soft and tender, the time usually required being 
from two to three hours. A quart of haricots cooked in 
this way will make a large dish, and butter, pepper, and 
salt, are added"; or, if the beans are afterwards fried 
slightly with a small slice of bacon, or a little lard and 
some fried onions, the dish will not only be as nutritious 
as meat, which will cost four times as much money, but it 
will be very palatable and fit for any table. As already 
pointed out, milk (whether skimmed or butter-milk) and 
good oatmeal, ought to form staple articles in the poor 
man's dietary. When the laborer has to eat his dinner 
away from home, he ought, two or three days a week at 
least, to take with him some soup, and warm it in the 
dish in which it is parried. As a rule, he will have no 
difficulty, if he is not near a house, in kindling a few 
twigs or dry pieces of turf in the fields to make a fire. 
When he can afford to buy sufficient butcher's meat, he 
might vary his dinner by using one or other of the different 
kinds of tinned meat. PREPARATION OF FOOD. 
157 
But not only are soups of various kinds too much 
neglected in the homes of the poor, they are far too little 
appreciated at the tables of the middle and upper classes. 
By the latter they are generally regarded as a mere pre- 
lude to the feast, and are too often hastily swallowed 
merely for the sake of the glass of wine which follows; 
while amongst the former, as we have just seen, they are 
but little known. With plenty of vegetables, and a little 
stock, however, purees of various kinds might be made 
palatable and valuable dishes in every household, and be- 
come as much a feature in the national dietary of this 
country as they have long been in France. 
In making nutritious broths and soups with a fail' 
allowance of butcher's meat, it is advisable, when possible, 
to cook the vegetables separately, and the meat, if intended 
to be eaten with the soup, should be cut up into small 
pieces. In any case, the meat should be put into cold 
water, but should not be boiled, except when the vegeta- 
bles are cooked in the same utensil, a temperature of 
about 150° Fahr, being quite sufficient. If the meat is 
plunged into hot or boiling water at the outset, the ex- 
ternal layer of albumen is coagulated, and the juices are 
prevented from exuding. 
In boiling meat, on the other hand, when the object is 
to retain as much as possible of the soluble juices in the 
meat, the piece ought to be of good size, and it should at 
once be plunged into boiling water to coagulate the out- 
side albumen. After being kept boiling for about five 
minutes, the saucepan should be placed on the hob, and 
the temperature allowed to lower gradually; or it may be 
lowered by the addition of three pints of cold water to 
each gallon of boiling water. In boiling fish, the addi- 
tion of salt makes the flesh firmer and more retentive of 
the flavor. In cooking green vegetables, they should 
first be carefully washed in cold water, but not allowed to 158 
FOOD AND DIET. 
remain in it; then plunged into boiling water and cooked 
rapidly. Potatoes should be boiled in their skins, and 
after boiling for about five minutes, most of the water- 
should be poured off, and then the potatoes should be 
steamed on the hob. 
In roasting meat, the joint should be placed at first be- 
fore a brisk, hot fire, with a view, as in boiling, to coagu- 
late the outside albumen, and then the roasting may be 
conducted more slowly. In roasting, there is greater loss 
in weight than in boiling; and although the latter process 
may be considered slightly more economical, the flavors 
which give' such a pleasant relish to the meat are not so 
freely developed. In baking meat, the loss is also greater 
than in boiling, and if the temperature is high and the 
oven close, the meat too often becomes ill-flavored and 
indigestible. Indeed, roasting is always to be preferred 
to baking, unless the meat is covered, as in a pie, and 
then the baking should take place slowly. Baked vege- 
tables and fruits demand the same slow treatment. 
Stewing has this advantage over dry baking, that there 
is no risk of charring, and the meat is rendered juicy and 
tender. Tough and strong-flavored meats are, perhaps, 
best cooked in this way, because 'they can be rendered 
very palatable and digestible by the addition of vegeta- 
bles and seasoning. Frying is even worse than baking, 
unless very carefully done; but grilling on the gridiron 
is an excellent way of cooking chops, steaks, kidneys, 
and small dishes of fish or fowl. 
Braising is a mode of cooking meat which is too much 
neglected. By this process the meat is just covered, and 
no more, with a strong liquor made from vegetable and 
animal juices or stock. The covered utensil, with close- 
fitting lid, is then exposed, with its contents, to a sur- 
rounding heat short of boiling point, and the cooking is 
allowed to proceed slowly. By this process, tough meats HINTS ON DIET. 
159 
are rendered juicy, tender, and very agreeable to the 
palate. 
In boiling, baking, and roasting, the average losses of 
weight of different kinds of butcher's meat are about 23, 
31, and 34 per cent, respectively. 
In the cooking of salt meat, the heat should be very 
slowly applied and long continued. 
IV. Hints on Diet. 
According to the highest authorities on diet, it is not 
only necessary that the several food constituents should be 
supplied in proper amounts, but it is also requisite for 
healthy sustenance that certain articles belonging to the 
same class should be varied from day to day, otherwise 
the appetite cloys.- Beef should alternate with mutton, 
for example; or variety may be secured by different 
modes of cooking the same article, and by a judicious 
use of the numerous accessories of food, such as sauces, 
condiments, and the like. Apart, too, from the effect 
which good cooking produces, it has to be pointed out 
that various articles .differ very considerably as regards 
digestibility. Most people are made aware of this by 
painful experience; but it was also proved by the experi- 
ments of Dr. Beaumont on a patient who, as a result of 
a gunshot wound, had an external opening into the 
stomach, through which pieces of food could be intro- 
duced, and after a time withdrawn for examination. Ac- 
cording to Dr. Beaumont's experiments, vegetable food, as 
a rule, requires longer time for digestion than animal 
food, the time varying from four hours required by boiled 
cabbage, to one hour required by boiled rice. Boiled 
potatoes and bread require three hours and a half, and 
boiled beans two hours and a half. As regards animal 
food, the order of digestibility was found to be as fol- 
lows:-Tripe and pig's feet, one hour; whipped eggs, 160 
FOOD AND DIET. 
salmon, trout, and venison steak, one hour and a half; 
ox liver and cod fish, two hours; boiled lamb, roast goose, 
and roast pig, two hours and a half; roast beef and 
boiled mutton, three hours; roast duck and fowl, four 
hours; and roast pork, five hours and a quarter. 
Digestibility is materially assisted by the admixture of 
different articles of diet, as fat with lean meat, and butter 
with bread; and it is also influenced by the degree of 
fineness and division of the food, the amount of tritura- 
tion it receives from the teeth, and the quantity which is 
taken at each mouthful. 
Having thus far dealt with general principles, it now 
remains to submit a few hints of a practical nature in 
respect to diet, as influenced by age and employment, 
together with some remarks on the proper distribution of 
meals. And first as regards age. 
Only those who have had practical experience in dis- 
pensary work, have any adequate conception of 'the enor- 
mous waste of infant life which results from diseases 
induced by the insufficient, improper, and careless feeding 
of infants. We have already seen, in a previous chapter, 
that out of every 1000 children born, 150 die before they 
reach the age of one year; and it is no exaggeration to 
say that one-third of these deaths are attributable to 
starvation-induced ailments; so that, in round numbers, 
there is an annual sacrifice of at least 50,000 infant lives. 
Leaving these figures to speak for themselves, there are 
few who would be prepared to dispute that the proper 
food for a new-born infant is the mother's milk; and in 
order that this may be sufficiently nutritious, it is neces- 
sary that the mother herself should be in fairly good 
health, and be very careful as regards her diet. Cow's 
milk, fresh and unskimmed, should if possible be partaken 
of freely every day; and in respect to solid food there 
should be a liberal allowance of animal food, with plenty HINTS ON DIET. 
161 
of farinaceous food and vegetables. With the exception 
of a little light wine, beer, or stout-and even these might 
be advantageously dispensed with in many cases-the less 
a nursing mother takes of stimulants the better, and she 
should especially avoid over-indulgence in the use of tea. 
As regards the infant after the first few days, it should 
be suckled from six to nine times daily, and, as far as 
possible, at regular intervals, after which a gradual re- 
duction may be commenced, until, at weaning, the number 
of meals should not exceed four. The time for weaning- 
generally about the age of nine months-should be deter- 
mined partly by the growth of the teeth, presuming, of 
course, that the mother's health is not suffering in the 
meanwhile. Whenever the first group of teeth appears, 
which usually happens about the sixth or seventh month, 
the mother may begin to diminish the number of times 
for suckling; and when the second group appears in the 
upper front gums, the supply may be cut off altogether. 
If the state of the mother's health prevents her from 
nursing her child, it may be reared on fresh cow's milk, or 
goat's milk, or condensed milk. When cow's milk is 
used, it should at first be mixed with half its bulk of 
pure, soft, tepid water, and sweetened with a little sugar, 
and a grain or two of phosphate of lime should also be 
supplied with it daily for the nourishment of the bony 
structures. Condensed milk will not require sweetening, 
but it should be sufficiently diluted to resemble milk-and- 
water. Although it is not liable to undergo the rapid 
changes to which cow's milk is exposed in warm weather, 
it is not so suitable as fresh, unskimmed milk for constant 
use, but it may very often be advantageously used during 
the summer and autumn months. I say nothing regard- 
ing wet-nursing, because physicians generally recommend 
that, should the mother be unfit to nurse her child herself, 
a trial ought first to be made, under the supervision of 
11 162 
FOOD AND DIET. 
the medical attendant, of artificial feeding; and the num- 
bers of healthy infants who are reared in this way prove 
that, with proper care, a wet-nurse need only be employed 
in very exceptional instances. But great care must be 
exercised, especially as regards the quality of the milk, 
its quantity, the times of feeding, its proper preparation, and 
the observance of the most rigorous cleanliness. Indeed, 
one of the chief objections to the use of the feeding-bottle 
depends upon the fact that the bottle and flexible tube 
are not kept sufficiently clean, so that fermentive changes 
are set up in the milk, and the infant sickens, and very 
often succumbs to diarrhoea. It frequently happens, too, 
that the water which is used to dilute the milk is not 
sufficiently pure, and it is a wise precaution always to boil 
the water if it be derived from a surface well. 
Up to six months old, then, the food of the infant should 
consist of milk, and, if possible, it should not be supple- 
mented by, or mixed with, farinaceous foods, such as arrow- 
root, sago-flour, and the like. The quantity required, 
whether it be from the breast or consist of cow's milk, has 
been ascertained to be a quarter of a pint on the second 
day, two-thirds of a pint on the third day, about a whole 
pint on the fourth day, and this quantity is gradually in- 
creased, until, when the child is six months old, not less 
than two pints are wanted. Unfortunately, however, 
when the mother herself is under-fed, or when amongst 
the poorer classes the child is artificially reared, nothing 
like this quantity is obtained, and the feeding-bottle is 
charged with all sorts of messes which do not in them- 
selves contain sufficient nutriment, and which the child 
cannot digest. The consequence is that the child begins 
to waste away, and whether diarrhoea or other form of 
disease sets in, the actual cause of death is gradual starva- 
tion. The reason why farinaceous foods are unsuited to 
a young infant is simply this, that an abundant secretion HINTS ON DIET. 
163 
from the salivary glands is essential to the proper digestion 
of foods of this description, and these glands do not'begia 
to secrete freely until the child is about six months old. 
After this period, the diet may be supplemented, but at 
first only in a tentative way, by various articles, such as a 
little broth or beef-tea, tapioca, arrowroot, corn-flour, baked 
flour, and the like. All these and others should have their 
turn; but, meanwhile, the child should be carefully watched, 
so that any article which is found to disagree should be 
discontinued. And here it is necessary to allude to the 
dangers of weaning the child too early, not the least among 
which is the liability to suffer from rickets. The child 
may look thriving enough, but the bones are not sufficiently 
nourished, and the mischief is not suspected until the limbs 
become distorted when it begins to move about. It is in 
order to prevent this mischief that physicians recommend 
the addition of a little sugar of milk, and a grain or two 
of phosphate of lime, daily, to be mixed with the milk 
when the child is artificially fed; so long as it is well 
nursed at the breast, the mother's milk supplies (up to 
the time indicated on page 161) a sufficiency of the saline 
as well as the other constituents of food. 
After the child is weaned, and up to the eighteenth or 
twentieth month, when the eye-teeth are cut, milk should 
still continue to form a considerable portion of the diet; 
and indeed, during childhood, it may be laid down as a 
rule that it cannot wholly be dispensed with without detri- 
ment to health. Dr. Ferguson, a factory surgeon, who 
has devoted a large share of attention to this subject, has 
ascertained, from careful measurements of numerous fac- 
tory children, that, between thirteen and fourteen years, 
they grow nearly four times as fast on milk for breakfast 
and supper as on tea and coffee-a fact which proves in- 
contestably that milk is essential to the healthy nutrition 
of the young. If tea or coffee is given, they should be 164 
FOOD AND DIET. 
given sparingly and largely diluted with milk, and stimu- 
lants, except for medicinal purposes, should be prohibited 
altogether. For breakfast and supper, no more wholesome 
and nutritious dish can be given than well-cooked oat- 
meal porridge or gruel, with milk, and bread and butter. 
Animal food should only be given at the midday meal, 
but at first only in small quantities, and served in soups, 
broths, or stews, together with mashed potatoes and other 
vegetables, and followed by a liberal allowance of farina- 
ceous pudding. Good cooking will make up largely for 
variety in diet; at the same time, it should be remembered 
that variety can always be secured without increase of cost, 
at the most homely nursery tables. Above all, there 
should be no stinting, because, with very rare exceptions 
indeed, the natural instinct of a healthy child is a safe- 
guard against gluttony. It is only when the period of 
puberty is approached, or between that and the period of 
full growth, that over-eating is likely to be indulged in; 
and, as any tendencies in this direction can be readily de- 
tected, they should be as rigidly checked. 
But, it may be asked, what about the crowds of very 
young children who have to be left behind in the im- 
poverished home when the mothers go to work? Many, 
no doubt, will languish and die, but many might be saved 
by philanthropic effort, in the establishment of creches, or 
nurseries, where they could be fed and tended during the 
day at a trifling cost. This, however, is a phase of the 
subject which need not be discussed, for, when sufficiency 
of food cannot be provided, it is mockery to talk of dietetic 
rules or errors. Let me rather allude to instances, com- 
mon enough, in which, though sufficiency is guaranteed 
and expected, it is scandalously denied; and in doing so 
I need only refer to numbers of private boarding schools, 
mostly of a cheap kind, where the dietary may be charac- 
terized as a bare subsistence dietary. Although one can HINTS ON DIET. 
165 
appreciate the desire of parents of limited means to obtain 
a good education for their children at a moderate cost, 
they should make it a rule, before sending a child to any 
boarding school, to visit the school and see the pupils, and 
then they could readily judge by their appearance as to 
whether they were well fed or not. There is no doubt 
whatever that numbers of pupils have to suffer in after 
life from weakened constitutions, not to speak of more 
immediate ailments, induced by the scantiness of food 
supplied at the schools to which they have been sent; 
while on the other hand, there are many pupils who, though 
well-fed at school, ruin their digestion and become the 
victims of over-indulgence in after life, by gorging them- 
selves with sweet-stuffs so long as they have pocket-money 
to spend. It need hardly be said that excesses in this 
direction should invariably be discountenanced, and treated 
as habits which have a low and vitiating tendency, and 
that undue greediness should be met with censure and 
reproach. 
During the period of youth the diet should be as liberal 
as for adult age and active employment, inasmuch as 
bodily growth and the activity of youth have both to be 
provided for. It is at this stage that lads sent out into 
the world are apt to suffer from the neglect of a midday 
meal. Owing to the exigencies of business, they take 
little or nothing during the day, and gorge themselves 
when the day's work is over, so that, by-and-by, the diges- 
tion becomes spoiled for the breakfast next ♦morning. 
Indeed, this is a dietetic error which prevails largely in 
the commercial community. Breakfast and dinner are 
rightly regarded as the principal meals, the one before, 
and the other after, the business of the day is over, but 
between the two luncheon should never be neglected or 
partaken of in a haphazard sort of way, but the lighter it 
is the better. If animal food is partaken of at breakfast 166 
FOOD AND DIET. 
and dinner, it may be dispensed with at luncheon, and 
farinaceous foods, vegetables, and fruits should form the 
staple of the midday meal. 
But in all walks of life, one great essential in healthy 
diet is regularity of meals. Among the ancients, and in- 
deed until comparatively recent times, there were only 
twb meals a day. This is the system which still prevails 
on the Continent, and with the light refreshment which 
is served in the morning in the form of cafe-au-lait, cocoa, 
or chocolate, appears to answer very well. Both dejeuner 
and dinner are substantial meals, the one being served 
about noon, and the other about six o'clock in the even- 
ing. In this country, however, most people indulge in 
three or four meals a day. For the active outdoor laborer 
and artisan, an early breakfast before work, a midday 
dinner with an interval of rest, and supper after the day's 
work is over, has long been proved by experience to be 
the most conducive to health. For the business man, a 
later breakfast, a midday luncheon, and a late dinner 
after the day's work is over, is the best arrangement. 
For literary men, who write more in the evening than 
during the day, an early dinner and a light supper will be 
found to be the most advantageous for steady work. Idlers, 
to enjoy life, if they possibly can, should dine early if they 
intend to spend the evening at theatres and the like; but 
if they accept dinner invitations freely, they should be 
very careful not to eat too much at the midday meal. 
The breakfast hour should be determined, in great 
measure, by the hour of rising, but, in any case, food 
should be partaken of before the material business of the 
day is commenced. Those who like to take a constitu- 
tional before breakfast, would find their appetite whetted, 
and their walk made all the more enjoyable, if they took 
a little milk, or cafe-au-lait, with bread or-biscuit, before 
starting. Work done before breakfast is always irksome HINTS ON DIET. 
167 
and fatiguing, and, on that account, is very likely to be 
badly done; and hence, teachers or parents should never 
exact lessons before the first meal of the day. The hast 
meal, whether dinner or supper, should be sufficiently 
late for the whole not to be absorbed before retiring to 
rest. If dinner is the last meal, a cup of tea or coffee, 
with a thin slice of bread and butter, during the course 
of the evening, will be found to be very refreshing; but 
for those who dine early, either what is known as a high 
tea, or a plain but substantial supper, becomes necessary. 
To a person in health, three meals a day ought to be quite 
sufficient, and the stomach ought to be educated to take 
enough at them to supply his bodily wants. The practice 
of constantly taking "something" is sure to bring on in- 
digestion, and especially the habit, which of late years 
has become so fashionable, of indulging freely in the 
afternoon tea. If too long a period intervenes between 
dinner and luncheon, the latter should be moved onwards; 
at any rate, it is much safer to be satisfied with some fruit, 
an ice, or a biscuit, than that ladies should continue to 
"imitate their washerwomen" in lavish afternoon tea- 
drinking. 
And now as to general rules. The three daily meals 
should be taken at regular hours, and these should be 
determined mainly by the nature of one's business or 
occupation. While the appetite should be satisfied, the 
stomach should never be filled so as to induce the feeling 
of uneasy repletion. The food itself should never be 
hastily swallowed, and solid food should be carefully 
masticated. No active bodily or mental exercise should 
be indulged in immediately after a meal. The diet best 
suited for the great majority of people in this country is 
a mixed diet, but persons leading an idle life or pursuing 
a sedentary occupation, should be careful not to eat too 
much animal food. Those who are inclined to become 168 
FOOD AND DIET. 
too stout should take plenty of exercise, and should only 
partake very sparingly of potatoes, fat, sugar, and farina- 
ceous foods generally. 
As regards stimulants,' they should never be given to 
children, and young people would be much better if they 
were to avoid them altogether. People who suffer from 
rheumatism should not drink beer, and those who have 
a gouty tendency should also avoid beer, rich wines, such 
as port or Madeira, and champagne. Finally, it may be 
laid down as a rule that, if health is to be enjoyed to the 
full, stimulants, if used at all, should be used but spar- 
ingly, and with the greatest caution. CHAPTER V. 
CLEANLINESS AND CLOTHING. 
I. Cleanliness? 
The important functions which are discharged by the 
skin ought to convince every one who knows anything 
about the structure of the human body, that personal 
cleanliness cannot be systematically neglected without 
risk to health. We have already seen, in a previous 
chapter (see Chapter II.), that the quantity of water 
excreted by the skin is on the average about double that 
given off by the lungs during the same period; and dur- 
ing violent exercise, for example, and in warm weather, a 
man may lose as much as two or three pounds in weight 
by means of the cutaneous perspiration alone. But in 
addition to water, we have carbonic acid gas and other 
used-up products constantly thrown off by the skin; so 
that it becomes a matter of the utmost importance that 
the eliminating functions of this organ should continue 
unimpaired and unimpeded. The flattened cells, or 
scales, of the scarf-skin are being constantly cast off, but 
are retained on the surface bycontact with the clothing, 
and mingling, as they do, with the oily products of the 
sebaceous glands, they become glutinized as it were into a 
thin crust, which covers the whole of the body. This, if 
not periodically removed, attracts the floating dirt or dust, 
which is ever present in the atmosphere, and the conse- 
quence is that the balance of healthy life is disturbed by 
obstruction of the pores of the skin, a larger share of 
169 170 
CLEANLINESS AND CLOTHING. 
work is thrown on other eliminating organs, the blood is 
liable to be imperfectly purified, and disorders, more 
especially of the skin itself, are apt to be induced. 
General body cleanliness, therefore, is conducive to 
health, no matter what be the occupation, and the whole 
surface should be washed at least once a day from head 
to foot. Those parts of the body which are more exposed, 
such as the hands and face, require to be cleansed more 
frequently; indeed, it is a wise rule, and one that should 
be enforced with regard to children, that hands and face 
should always be washed before sitting down to a meal. 
But it is astonishing what a very strong objection many 
of the poorer classes have to the use of clean water. 
Their skins are filthy, their clothes are filthy, and it is 
needless to say they have an utter disregard for cleanli- 
ness of the dwelling and its surroundings. Hence it is 
that those who have made themselves acquainted with the 
habits and home-life of the "great unwashed," cannot 
help associating foul skins with moral degradation, as 
well as bodily ill health; and, after a little experience, 
are forced to the conclusion that mendicant filth and 
moral depravity generally go hand-in-hand. 
Of course, the plea is constantly urged by this class of 
people that they have neither the means nor the oppor- 
tunities afforded them to practise personal cleanliness- 
and no doubt there are difficulties in securing that degree 
of cleanliness which is here recommended; but the most 
disappointing feature in their case is that, though there 
may be abundance of water close at hand, they seem to 
have the greatest reluctance to make anything like a free 
use of it. They appear to love filth for filth's sake, and 
will contentedly submit to all the discomforts arising from 
plagues of parasites and other irritations of the skin 
rather than take the slightest trouble to rid themselves 
of the dirt which engenders them. Then, too, there can CLEANLINESS. 
171 
be little doubt that personal uncleanliness is not only a 
means of engendering disease, but it becomes a breeding- 
ground for the propagation of those diseases which are 
infectious; and hence it is that elementary schools, where 
compulsory attendance is enforced, assist so largely in the 
spread of scarlatina, measles, whooping-cough, and diph- 
theria. The filthy condition of many of the children not 
only makes ready victims of themselves, but, by polluting 
the air and by personal contact, they impart infective 
particles to those who are better cared for and come from 
cleanly homes. All' schools, therefore, should be provided 
with lavatories, supplied with hot and cold water, and 
teachers and school attendance officers ought to exert 
their influence in promoting body cleanliness among the 
pupils. 
Another direction in which cleanliness could be largely 
promoted would be the enforcement of provisions for 
cleansing at all workshops and factories where offensive 
or dirty trades are carried on. The waste steam, or waste 
warm water of the factory engines could be readily 
utilized for properly constructed warm baths, and if the 
work-people were obliged to bathe and put on a change 
of clothes before going home, the advantages to health 
and comfort would soon become apparent in many ways. 
Many large manufacturers throughout the country have 
already shown an excellent example in this respect; but 
hitherto they have only had a tardy following. 
Although public authorities have no power to enforce 
such provisions or regulations as have thus been briefly 
indicated, they can at all events insist on cleanliness of 
premises, and, by efficient scavengering and enforcing the 
removal of local nuisances, they may assist very materi- 
ally in freeing the crowded populations of our large towns 
from the thraldom of filth. By the erection of public 
baths and wash-houses they may also afford facilities 172 
CLEANLINESS AND CLOTHING. 
which cannot otherwise be secured, and the rest must be 
left to the steady influence of a wider appreciation of the 
time-worn text, that " cleanliness is next to godliness." 
But unfortunately, neglect of personal cleanliness is not 
confined to the poorer classes. There are numbers of 
well-to-do people who seldom or ever wash, and to whom 
the "morning tub" is an unknown auxiliary to health and 
comfort. And yet it takes very little time, expense, or 
trouble to secure daily ablution of the body of some sort. 
A hand-basin, a sponge, a shallow bath or flat tub, a piece 
of good white soap with no excess of alkali, a couple of 
gallons of water, and a towel, are all that are required; 
and the whole process need not occupy more than five 
minutes. Even rubbing the body first with a wet towel 
and afterwards very briskly with a dry one will, in most 
cases, keep the skin sufficiently clean during the week, and 
promote healthy reaction, provided a warm bath, with a 
good soaping, is taken at the close of the week. If such 
a bath cannot be procured or improvised at home, there 
are many places in most towns where it can be procured 
at very reasonable charges. Those, again, who do not 
use soap with the morning tub should also take a warm 
or Turkish bath occasionally, to preserve thorough clean- 
liness of the skin. To persons in health, the morning 
bath should be taken cold, summer and winter; but if 
shivering be experienced after the bath, instead of a warm 
comfortable glow, the temperature should be slightly 
raised. 
Infants should always be bathed in warm water, and 
the transition to the use of cold should be gradual, and 
only tried in the summer-time. Indeed, there is no doubt 
that a great many children contract a strong aversion to 
cold water, because they have injudiciously and thought- 
lessly been subjected to the cold bath at periods when 
they were unable to bear it. Cold is always more or less CLEANLINESS. 
173 
painful, and' the cleansing rites repulsive to persons of 
feeble circulation; and hence it is that women and.young 
girls, unless they are strong and robust, are unable to 
indulge in the cold bath, even in the summer-season. The 
test should be, if the cold bath produces a warm glow 
afterwards, and no numbness of feet and hands, nor 
shivering, it should be persevered in, even during cold 
weather; if, however, the surface of the body feels chilly, 
and there is a tendency to shiver, the temperature ought 
always to be slightly raised. At the same time, it should 
be remembered that, by judicious training the nervous 
system which at first shuddered at the application of the 
sponge charged with moderately tepid water, will often, 
after a time, bear without discomfort a charge of cold 
water, and experience the healthy glow which follows the 
smart friction of a rough towel. 
The best and most convenient time for taking the bath, 
it need hardly be said, is just after getting out of bed in 
the morning. A bath, too, is often found to be very 
refreshing after severe or prolonged exercise of any kind. 
In drying the skin, various kinds of towels may be used, 
but the effects produced by friction will be all the more 
beneficial if the skin can tolerate a rough towel. Many 
persons use flesh-gloves or hair-gloves for rubbing, and no 
doubt with great benefit. 
Persons who are very liable to catch colds, and who are 
unable to indulge in the cold bath, will often find that 
bathing the head, neck, face, and chest with cold water 
will act as a very efficient means of protection. Bald- 
headed people especially, who have a constant dread of 
catching colds, should try douching the head every 
morning from a sponge dipped in cold water or from a 
small basin, as preventive. Indeed, there can be little 
doubt that colds would be far less prevalent than they 
are, if cold water was used much more freely in the 174 
CLEANLINESS AND CLOTHING. 
wash-hand-basin when the cold bath itself is dispensed 
with. 
Owing to the greater shock to the system, the cold 
shower bath and the cold plunge bath can only be in- 
dulged in by the strong and healthy; but those who can 
take them, and have the opportunities of doing so, gener- 
ally prefer them to the sponge bath. With warm water, 
either the shower or plunge bath can be rendered as suit- 
able to the delicate as to the robust; but in all such 
cases, the sensations of the bather must be carefully con- 
sidered. A certain amount of training is as much required 
to enjoy the full benefits derivable from the practice of 
ablution, as it is to enjoy those to be gained by healthy 
exercise. 
As regards the time which should be spent in bathing, 
much will depend upon the particular kind of bath and 
the physical constitution of the bather. When the cold 
sponge bath or the cold plunge bath are used, two or 
three minutes at the outside will be found to be quite 
sufficient; but with the tepid or warm bath, the period 
may be prolonged to ten minutes or a quarter of an hour. 
The cold bath acts as a tonic, and should be taken in the 
morning, while the warm bath acts as a sedative, and on 
that account is preferable to the cold bath after excessive 
fatigue or exercise. 
When bathing is practised in public swimming baths, 
in open fresh water, or in the sea, the period to be spent 
in the water should be regulated by the sensations of the 
bather, and whether he can swim or not. Injurious 
effects are often induced by remaining too long in the 
water, and by bathing at injudicious times. As swimming 
is one of the healthiest exercises, and is, besides, a great 
aid to cleanliness, to say nothing of its advantages in 
saving life, the young of both sexes should be taught to 
practise it wherever facilities are afforded. Public swim- CLEANLINESS. 
175 
ming baths in large towns are already doing good work 
in this direction, and it is to be hoped that their numbers 
will steadily increase, and that year by year they will be 
more generally frequented. 
With a view of diminishing the number of fatal acci- 
dents which annually occur during the bathing season, 
the Secretary to the Royal Humane Society has issued 
the following important instructions:-"Avoid bathing 
within two hours after a meal. Avoid bathing when 
exhausted by fatigue or from any other cause. Avoid 
bathing when the body is cooling after perspiration. 
Avoid bathing altogether in the open air if, after having 
been a short time in the water, there is a sense of chilli- 
ness, with numbness of the hands and feet; but bathe 
when the body is warm, provided no time is lost in getting 
into the water. Avoid chilling the body by sitting or 
standing undressed on the banks or in boats after having 
been in the water. Avoid remaining too long in the 
water, but leave the water immediately there is the 
slightest feeling of chilliness. The vigorous and strong 
may bathe early in the morning on an empty stomach. 
The young and those who are weak had better bathe two 
or three hours after a meal; the best time for such is from 
two to three hours after breakfast. Those who are sub- 
ject to attacks of giddiness or faintness, and those who 
suffer from palpitation or other sense of discomfort at the 
heart, should not bathe without first consulting their 
medical adviser." 
Bathing in the open sea is more bracing than in fresh 
water, and as a rule, bathers can remain longer in salt 
water, whether they are swimmers or not. By using such 
preparations as Tidman's Sea Salt, the common sponge or 
plunge bath may be made more invigorating; but in 
order to ensure thorough cleanliness of the skin, a soft 
water bath and soap must also be occasionally used. 176 
CLEANLINESS AND CLOTHING. 
Persons liable to fits of giddiness, or who have disturbed 
action of the heart, should avoid using a plunge bath, 
whether hot or cold. The other kinds of baths which are 
provided in bathing or hydropathic establishments, such 
as the douche, the needle, the spray, the electric bath, 
have all of them their uses, but they need not be entered 
upon here, because they should not be indulged in, as a 
rule, without medical advice. The Turkish bath often 
proves beneficial to those suffering from colds, rheuma- 
tism, sciatica, or gouty symptoms, and may be advantage- 
ously used by healthy persons for promoting vigorous 
action of the skin and ensuring thorough cleanliness. 
The vapor bath is also beneficial, but to most people not 
so enjoyable. When free action of the skin is desired, a 
modified vapor bath can readily be obtained in the bed- 
room, by placing a pail or tub containing boiling water be- 
neath a cane-bottomed chair, and then plunging a red-hot 
brick into the water to keep up the generation of steam 
for some time. After sitting down on the chair, the body, 
chair and all, should be covered over with a thick blanket 
fastened round the neck, and the bath be continued until 
free action of the skin has set in. The surface of the 
body should then be well rubbed and dried, or first 
douched with tepid water, and the bather should then 
retire to rest. It may here be noted that a comparatively 
cheap apparatus is now manufactured to supply this sort 
of bath, and it is often found to prove very serviceable in 
the household, especially when colds are prevalent, or 
where there is a tendency to irritation of the skin. 
In thus insisting on cleanliness of the skin as contribu- 
ting largely to bodily health and comfort, it need hardly 
be said that cleanliness of the hair must also be carefully 
attended to. It should be kept clean by being regularly 
washed, combed, and brushed, and occasionally sham- 
pooed. The false hair and pads so often worn by women CLEANLINESS. 
177 
become perfect receptacles for dirt and grease, and the 
less they are worn the better, but when they are worn 
they should be kept scrupulously clean. 
In connection, too, with this important question of 
cleanliness, some few remarks ought to be made concern- 
ing the teeth. The pre-eminent part which they play in 
mastication, and the serious injuries to digestion which 
are so frequently induced by their decay, prove clearly 
that every care should be taken to preserve them in good 
working order; and yet they are perhaps as much 
neglected as the skin or hair. For want of rinsing out 
the mouth and brushing, particles of food are allowed to 
lodge in the small crevices between the teeth and in the 
inequalities between the teeth and gums, and as these 
speedily decompose and become acrid, they often render 
the breath offensive, and after a time injure the enamel, 
or external bony layer of the teeth. Again, the secretions 
of the glands of the mouth mix with these particles of 
food to form layers of tartar, which also aid very materi- 
ally in carrying on the process of decay. The best pre- 
servative for • the teeth, therefore, is cleanliness. The 
mouth ought to be rinsed out after every meal, and if 
there is any tendency to foetor of the breath, a little 
Condy's Fluid in the water, or a few drops of the fluid 
called Sanitas, will be found to be very efficacious.* The 
teeth should also be well brushed once or twice daily, 
with water and a good tooth-powder, and the inner sur- 
faces should receive as much attention as the outer. 
Care should also be taken not to take articles of food or 
drink into the mouth which are too hot, because there is 
reason to believe that they injure the enamel. There can 
be no doubt, too, that certain kinds of confectionery, such as 
acidulated drops, have an injurious effect in this respect. 
* A solution of carbolic acid (5-10 drops) to the ounce of water, or a weak carbo- 
late of soda solution may be used with advantage.-(R.) 
12 178 
CLEANLINESS AND CLOTHING. 
II. Clothing. 
We now pass on to the consideration of a subject which 
is closely allied to personal cleanliness, but which has 
important bearings in other respects, namely, clothing. 
Cleanliness of the person, as has already been pointed out, 
cannot be maintained without due attention to cleanliness 
of clothing, and this, of course, not only applies to the 
garments-which are used for daily wear, but to bed-clothes 
and night-dresses. In order to insure thorough cleanli- 
ness, persons should avoid sleeping in any garment worn 
during the day, and bedding and bed-clothes should be 
thoroughly aired every morning. All clothes, after being 
washed, should also be dried in the open air when possible, 
and otherwise well aired before they are put on; indeed, 
clothing of every description should be frequently moved 
about, and should never be kept shut up in close boxes or 
drawers. It is almost needless to add that under-gar- 
ments should be regularly changed, and outer garments, no 
matter of what color or texture, should always be kept 
clean and well brushed. 
The principal use of clothing, however, is to assist in 
the maintenance of animal heat, by affording protection 
against the changes and inclemencies of the weather, and 
generally to add to bodily comfort. The warmth of the 
body is of course solely derived from food, but clothing, 
inasmuch as it prevents the too rapid escape of animal 
heat, really acts as an adjunct to food, so that in cold 
climates the warmer a person is clad, so much the less fuel 
will be required. Now, it is a natural law that when any 
warm substance is placed in contact with a colder one, 
the former parts with a portion of its heat to the. latter, 
and this mode of transferring heat is called conduction. 
Any substance, too, which is warmer than the surrounding 
air is constantly giving off some of its heat by what is CLOTHING. 
179 
called radiation; in other words, the heat passes off from 
it in all directions through the air or into space. Some 
substances absorb heat very readily, and part with it very 
slowly, and are therefore called non-conductors, while 
others are better adapted for reflecting than for absorbing 
heat. Hence clothing can be made suitable either for cold 
or warm climates, or for seasonal changes, by a judicious 
selection of materials depending partly upon texture and 
partly on color. Thus, in very warm weather or in hot 
climates, the surface of the body is best protected by a 
material which will readily reflect the sun's rays, and 
during cold weather or in a cold climate, by garments 
which are bad conductors. But clothing has also to be 
regulated according to its power of absorbing moisture, 
and to its non-interference with the healthy action of the 
skin and the free movements of all parts of the body. 
Its further subsidiary uses, such as the protection of certain' 
parts from pressure, as in the wearing of boots and shoes, 
and its adaptability to keep out wet, are all of them points 
which likewise merit consideration. 
Of the materials which are used, those of animal origin, 
such as wool, silk, hair, furs, and skins, are all of them 
worse conductors of heat, and therefore warmer, than 
materials derived from vegetable sources, such as cotton, 
linen, hemp, and flax. Garihents worn next the skin are 
preferably made of wool or silk, because they absorb the 
moisture readily, are bad conductors of heat owing to the 
layers of air which they retain in their interstices, and 
they can be made very light and durable. Fabrics made 
of silk and wool are also very well adapted for under- 
clothing; and next in order come those made from silk 
and cotton or wool and cotton, then calico, and then linen. 
Delicate people, and those who are past the prime of life, 
should always wear flannel or silk next the skin, summer 
and winter. Those, again, who are in sound health, and 180 
CLEANLINESS AND CLOTHING. 
who prefer leaving off flannel under-garments during the 
summer, should be very careful, not to leave them off too 
soon. Many people contract severe colds through neglect 
of this precaution, and women, owing to their preference 
for calico or linen, are much more liable to suffer in this 
respect than men. People who suffer from rheumatism 
should always wear flannel next the skin, and should 
sleep in flannel night-dresses, and between blankets. To 
workmen who are employed in hot workshops or factories, 
and to persons residing in warm climates, belts made 
of flannel are of great service, provided they are not 
made too thick and heavy. Indeed, thick flannels and 
heavy garments are always objectionable. The clothing 
should be as light as is compatible with warmth, other- 
wise it encases the body too closely, checks evaporation, 
and is neither cleanly nor comfortable. 
As regards protection from direct solar heat, white is 
the most suitable color, and then gray. To wear black or 
dark clothing during hot summer weather is, therefore, a 
mistake, and persons who are in deep mourning, especially 
those who wear heavy folds of crape, often suffer serious 
depression and constant discomfort. The fashion which 
has lately been introduced of wearing a strip of crape on 
the sleeve of the coat or dress usually worn is, therefore, 
to be commended as much on the score of health as 
economy. For those who cannot afford a great variety 
of dresses, fabrics of a light gray color are the most 
suitable to wear all the year round. In warm climates, 
linen is specially suitable as the coolest and smoothest of 
all materials used for clothing, but vests of silk, or of silk 
and wool, should always be worn next the skin. Linen and 
cotton materials possess the further advantages of greater 
cleanliness and of imparting a cleanly appearance; and 
here it may be said that the wearing of dark clothes has all 
along been so general, just because their color conceals dirt. CLOTHING. 
181 
During cold weather, overcoats, shawls, plaids, or cloaks 
should be worn out-of-doors, but they should never be 
thick or heavy when it is intended to take active exercise. 
Furs, as very bad conductors of heat, are very useful and 
highly prized in cold climates and for winter wear in this 
country. In order to keep out wet, waterproof garments 
of various kinds have become exceedingly popular, but as 
they prevent the escape of perspiration, they should always 
be worn loose, either as capes or cloaks. When worn as 
overcoats, they should be made wide and provided with 
ventilating gussets. Wet clothes or wet stockings should 
be changed whenever the house is reached; neglect of 
this precaution being a fruitful cause of rheumatism and 
chest ailments. 
Bed-clothes should never be too heavy or too warm, 
otherwise the respiration is interfered with, the skin is 
made sensitive, and the body generally becomes relaxed; 
the night's proper rest is disturbed, and the sleeper awakes 
unrefreshed. Heavy cotton counterpanes are objectionable, 
because they weigh down the body without adding much 
to warmth. All coverings of the bed, except the sheets 
and counterpane, should be of wool. Amongst poor people, 
paper, whether white or brown, or even old newspapers, 
might be made to do excellent service in imparting addi- 
tional warmth to bed-clothes, by being stitched on to a 
blanket or quilt. Paper is warm and light, and on that 
account might also be readily utilized as lining, to coats 
or petticoats. It is needless to add that the number of 
blankets to be used must be varied according to the 
weather and season, and that spring and horse-hair mat- 
tresses are preferable in every respect to stuffy feather 
beds. 
Great care should be taken as regards the clothing of 
infants and young children, because the constitution is 
less able to resist cold and weather changes. The absurd 182 
CLEANLINESS AND CLOTHING. 
delusion, which suggests that to harden children it is essen- 
tial to expose their legs and chests to the piercing blasts 
of winter and the cold east winds of spring, leads to 
many an illness which terminates fatally. Indeed, there 
is no doubt that a large proportion of the deaths from 
lung diseases, which are so very common among young 
children, are due to needless exposure to cold, and to the 
ignorance or neglect which so generally prevails with re- 
spect to this matter. Very young children ought not to 
be taken out in extremely cold weather unless they are 
able to walk and run about, and then they should be com- 
fortably clad. Flannel should be worn next the skin, and 
neither chest, arms, nor legs should be exposed. Veils 
are sometimes useful when the child is carried, either in 
the arms or in a perambulator, but they should never be 
too thick or warm. 
Old people, as well as young children and persons who 
are delicate and liable to suffer from cold feet, should wear 
woollen stockings, summer and winter.' Boots and shoes 
should be made to fit the feet easily, with low heels and 
fairly broad toes. High-heeled boots are the source of 
great discomfort, and interfere seriously with the free and 
healthy action of the muscles of the leg, while tight-fitting 
boots or shoes induce corns and bunions. Shoemakers, as 
a rule, pay far too little attention to the shape and action 
of the foot, and few of them know how to take the proper 
measurements. For example, the dimensions are generally 
taken when the foot is raised; whereas most of them 
should be taken when the foot is firmly planted on the 
floor, because in the act of walking it is found that the 
foot expands to about one-twelfth of its length, and its 
lateral expansion is even, greater.. Then, again, it is very 
seldom that the shape of the sole is taken, and hence it is 
that new boots are such a source of pain and discomfort 
until the elasticity of the leather permits the boot to CLOTHING. 
183 
become moulded to the shape of the foot. For walking 
and in wet weather, thick-soled boots or shoes should be 
always worn. Goloshes are no doubt very useful, but they 
should be worn as little as possible, because they impede 
evaporation, and when worn they should cover very little 
of the upper part of the foot. Greasing the leather with 
tallow, butter, or fat, is a very effectual plan for keeping 
out wet. Those who suffer from tender feet should avoid 
wearing patent leather boots or shoes, and should fre- 
quently change their socks or stockings. Those, again, 
who have weak ankles, and persons who are accustomed 
to walk a good deal, should wear laced boots, and it need 
hardly be said that for a long walk or a walking tour, new 
boots should never be worn. At first they should be worn 
indoors, or during short walks out-of-doors. Lasts made 
of the exact shape of the foot are exceedingly useful 
in preventing the many discomforts and various .distor- 
tions which are too often induced by badly made boots or 
shoes. 
Making every allowance for the changes of fashion, 
there can be no doubt that male attire is much more 
natural and healthy than the clothing worn by the other 
sex. The tall, stiff hat, is no doubt, a mistake, because it is 
too heavy and impedes evaporation, and it is also a mistake 
to wear a belt instead of braces; but in other respects, 
male attire, as a rule, is easy and comfortable. But what 
shall we say of the tortures, discomforts, and even loss of 
health and impairment of physique, to which the vagaries 
of fashion subject the female sex? From childhood on- 
wards perfect freedom of bodily movement is more or less 
interfered with. The waist is too often pinched with 
corsets which impede respiration, disturb the heart's action, 
and in extreme cases, eventually displace the more im- 
portant organs of digestion. Many ladies are somehow 
taught to believe, or at all events act as if they believed, 184 
CLEANLINESS AND CLOTHING. 
that a small round waist is beautiful and attractive. But 
the natural waist of a handsome woman is not round, and 
a small waist can only be admired when it forms part of 
a lithe and slender figure. Indeed, a waspish waist, as it 
is cynically termed, may betoken a good deal of physical 
endurance and much personal vanity, but it says very little 
either for the common sense or the aesthetic sense of the 
lady who has thus sacrificed herself to the Moloch of a 
spurious fashion. The natural curve from armpit to hip 
of a handsome woman is rounded and graceful, but tight 
lacing destroys the law of balance and proportion, and 
makes the body as ungainly-looking as an old-fashioned 
hour-glass. This distortion, however,-for distortion it is, 
-not only offends the artistic eye, because it is ugly and 
unnatural, but the physician knows only too well that 
healthy, active life has been heedlessly sacrificed, and if 
he were allowed a voice in the matter he would frankly 
and honestly advise any one who consulted him with a 
view to matrimony, to beware of paying his addresses 
to a lady with an artificially deformed waist. The chances 
are that she will always be more or less invalidish, and an 
invalid wife cannot be expected, to become the mother of 
healthy children, or, if they should be born healthy, she 
has incapacitated herself to rear them as they ought to 
be reared. 
Ladies have only to recognize and appreciate the real 
beauty of the natural lines of the body, and they will soon 
learn to regulate their own dress and the dress of growing 
girls, so as to give sufficient support without causing un- 
due constriction. The well-made corset is no doubt an 
improvement to the figure, but it should never be fashioned 
or worn so as to interfere with freedom of motion or easy 
carriage. Fortunately, the practice of tight-lacing is not 
so general now as formerly, but it is still common enough 
to justify a persistent protest against the folly and its CLOTHING. 
185 
dangers. There is no doubt, too, that many would gladly 
leave off the practice altogether if they only could; but 
after a time the muscles become wasted by constriction 
and through want of use, so that the hugging embrace of 
the tight-laced corset comes to be regarded as absolutely 
necessary for the comfort and support of the upper part 
of the body. 
On physiological grounds, the classic mode was incom- 
parably superior to the modern style of dress, because the 
whole weight of the garments was borne by the shoulders, 
and not from a waist constricted by strings and bands, if 
not by tight-laced stays. It may be true that the style of 
garments worn by Greek and Roman women is not suited 
to our colder climate, but the closer the adaptation of 
modern apparel is to that style, so much the more artistic 
taste will be displayed, and the better will be the health 
enjoyed. 
Dress should always be fashioned so as to obey the pro- 
portions of the body, and never to contradict the natural 
lines of the figure. Any dress or article of dress, there- 
fore, which interferes with free movement and easy and 
graceful carriage, is objectionable. Tight dresses are ob- 
jectionable, because they cramp the movement of the 
lower limbs; long walking dresses are objectionable, because 
they drag by their weight, and because the skirts often 
become wet and dirty; garters worn below the knee are 
objectionable, because they impede the free circulation of 
the blood, and are apt to induce varicose veins; low 
bodices are objectionable artistically, because they detract 
from the height, and from a health point of view they are 
still more objectionable, because many suffer seriously 
from such exposure during cold weather. All these are 
points which should be considered, no matter what be the 
prevailing fashion. The present close-fitting dresses, pro- 
vided they are not made too tight, are to be commended, 186 
CLEANLINESS AND CLOTHING. 
because they are strictly in accordance with the natural 
lines of the body, and they are certainly calculated to 
display the beautiful, proportions of a well-made figure. 
But they tempt those who are inclined to be a little too 
stout, to brace themselves in every way too tightly, and 
those who are somewhat thin and angular, to resort to 
padding and other strange devices. By all means let 
every one dress according to the fashion of the day, so far 
as her means or her position in life will fairly warrant her; 
but let her be careful never to sacrifice health and comfort 
to a slavish submission to any style, however fashionable 
that style may be. With regard to other articles of dress, 
such as bonnets, I will venture to say nothing, because 
somehow they are considered to be too sacred for criticism. 
Meanwhile, let me refer my lady readers to the excellent 
little work on the "Art of Dress," by Mrs. Haweis, where 
they will find the requirements of health are as fully 
treated as the rules of good taste are clearly indicated. CHAPTER VI. 
EXERCISE, RECREATION, AND TRAINING. 
I. National Physique. 
The question is often asked in all seriousness-whether 
the British race is or is not deteriorating? and certainly, 
when we reflect on the many complex causes, social as 
well as material, which constantly and almost everywhere 
militate against healthy, active life, it must be confessed 
that, as a nation, we are exposed to this danger. At no 
period in the previous history of this country has the 
struggle for existence been more keen, nor competition in 
the race for wealth and position more fierce and unscru- 
pulous. Men " make haste to be rich," and become physio- 
logical bankrupts often before they reach the age of forty- 
five or fifty, and so retire from business with worn-out 
brains and shattered constitutions. At our schools and 
universities, again, there is still too much of the tendency 
to push the head at the expense of the muscles and sinews 
-to make boys and lads smart and clever, rather than 
healthy, strong, and reliant. The fact is, that in these 
days, and amongst all classes, except it be among those 
employed in active manual labor, the wear and tear of 
busy life tell with the greatest severity on the nervous 
system; while the muscular system, and with it the evenly 
balanced condition of heart and lungs, gets no fair play. 
For example, the facilities for travelling by rail and 
omnibus are now so general, that walking, which in itself 
is one of the healthiest of exercises, is much less frequently 
187 188 
EXERCISE, RECREATION, AND TRAINING. 
indulged in than it used to be. Then, again, it must he 
remembered, that in almost every branch of industry 
steam-power has taken the place of muscular energy, and 
lissom fingers have supplanted brawny arms. Even in the 
purely agricultural districts, we plough, and sow, and 
reap, and thresh, by steam; in short, we have so trained 
the physical forces of nature, and made them subservient 
to our will, that we have only to guide and regulate, and 
let them do the actual drudgery. 
No doubt, all this outcome of scientific discovery has 
immensely increased the prosperity of the nation as re- 
gards the accumulation of wealth and all that wealth can 
command; but the question arises-Has it also improved 
the physical condition of the people? I, for one, doubt 
it very much ; indeed, we have only to bear in mind this 
well-ascertained fact-that the average physique of the 
town population is considerably below that of the rural 
population, and this other fact, that during the last half- 
century the increase in the population of our large towns 
has far exceeded that which has taken place in rural and 
small urban districts, to feel assured that of late years 
the average national physique has become gradually 
lowered. And this is a view which is fully borne out by 
statistics; for, according to the extensive researches of 
Dr. Beddoe, the average stature of adult Englishmen of 
all classes in the present day is only about 5 feet 6.6 
inches, and although there are no data to enable us to 
compare this average with the average of fifty or a hun- 
dred years ago, we can at least draw tolerably reliable 
inferences from the statistics obtained from the existing 
town and country population. Thus, to take the returns 
of Cumberland and Westmoreland, exclusive of Carlisle, 
given in Dr. Beddoe's statistics, as representative of a 
country population, it appears that the average height is 
5 feet 8.1 inches; whereas, in the neighboring county of NATIONAL PHYSIQUE. 
189 
Lancashire, where the native breeds used also to be un- 
deniably tall, the average is as low, or lower, than that 
of England generally. But while the evidence of physi- 
cal deterioration is manifest in the town-bred population, 
it becomes still more pronounced in the degenerate classes 
of the community. Thus I ascertained, when officially 
connected with convict prisons, that the average height 
of the 316 convicts received into the hard-labor prison at 
Portsmouth during the year 1871, was only 5 feet 5 
inches; and Dr. Beddoe's statistics of the lunatics in 
London, Birmingham, and Nottingham, yield an average 
somewhat below this. In saying this much, however, I 
by no means would have it inferred that specimens of the 
strong-limbed and stout-hearted Briton are becoming 
rarer, but only wish to lay stress upon the fact that, in 
the enormous increase of population, and the rapid growth 
of large towns, with all their deteriorating influences at 
work, the weakly and under-sized have become propor- 
tionately much more numerous than they ever were be- 
fore. 
If, therefore, there is reason to fear that the average 
physique of the English race has become gradually low- 
ered during the last half-century, there'are good grounds 
for believing that the deterioration has reached its culmi- 
nating point. Already the results of sanitary improve- 
ments in many parts of the country are beginning to 
declare themselves, not only in a lessened sick-rate and 
death-rate, but in an apparently healthier tone of public 
opinion. Then, too, the baneful conditions which sur- 
round many branches of industrial labor are year by year 
becoming less hurtful. But side by side with this im- 
provement the need for muscular effort is also becoming 
less and less, so that among all classes the work and worry 
of life, as already stated, tell with special severity on the 
nervous system. Even those who are well off, and who 190 
EXERCISE, RECREATION, AND TRAINING. 
therefore ought to be free from the cares of this work-a- 
day world, run great risk of drifting into that lap-dog 
condition in which comfort merges into want of energy, 
and security into sloth. Indeed, there is scarcely a being 
to be less envied than the gentleman at large who has no 
occupation, or the lady who lolls in her carriage, and 
whose only aim in life is to receive visitors,-return calls, 
and end the tedious day in the festivities of the night. 
For every one, rich or poor, nature imposes certain laws 
which cannot be transgressed with impunity, and for our 
present purpose, these may be summed up in the old 
adage that out of the twenty-four hours of each day, 
eight should be devoted to work, eight be passed in sleep, 
and eight given up to recreation of some sort. All must 
work, all must rest, and work and rest must be supple- 
mented by healthy recreation. For recreation is the 
great relief from the wear and tear of life-the oil, as it 
were, which lubricates the machinery, prevents friction, 
and makes the wheels run more smoothly. And not only 
so, but it renovates the exhausted energies, and fits them 
to resume their work in the most appropriate way, and 
with the least expenditure of time. It may either consist 
in variety of employment, amusement, sports, pastimes, 
and the like, but of whatever description, its essential 
function, so to speak, is to provide a frequent and appro- 
priate change of organic activity. 
II. Physiological Details. 
First of all, then, in order to keep the body in health it 
is absolutely necessary that a certain amount of exercise 
or muscular activity should be undergone daily. This has 
already been made clear in a previous chapter; but it 
may assist the reader to an intelligent understanding of 
the principles and practical application of the subject if I PHYSIOLOGICAL DETAILS. 
191 
briefly summarize some of the physiological details which 
were there more fully explained:-The body, it was stated, 
is composed" of certain tissues, such as bone, muscle, and 
nerve; and ramifying throughout all these are the chan- 
nels for conveying the blood. These tissues, again, consist 
of innumerable minute cells, or atoms, every one of which 
has its birth, lives its little day, and finally becomes 
broken up or disintegrated and removed as effete or dead 
matter by the organs of excretion-the skin, the lungs, 
the kidneys, and so forth. Thus there is a constant pro- 
cess of decay and removal going on in every tissue, and 
the loss of the body, and every part of the body, is in 
direct relation to its activity. But in order to repair this 
constant waste, there must also be constant renewal. 
This is supplied by the food in the first instance, which 
by the various processes of digestion becomes in part con- 
verted into blood, and from this ever-circulating, ever- 
changing stream, with tributaries flowing to and from 
every part of the body, the several tissues select or assimi- 
late the nutriment specially suited for them, while into it 
they return whatever of their structure has become used 
up or effete. 
Now, in every tissue, and especially in the muscular 
tissue, the disintegrating process, or process of decay, is 
hastened by activity, and, at the same time, by another 
physiological law, there is an increased flow of blood to 
supply the renovating material. During the period of 
growth, the new material is always in excess of the waste, 
so that there is an increase in the bulk or strength; but 
at whatever stage of the life of the individual, his working 
power, within certain limits, is in direct relation to the 
frequency with which the cells, or atoms composing the 
various tissues, are changed. Muscular activity, then, 
whether it be in the form of active outdoor labor or exer- 
cise, is the chief agent in promoting these wholesome 192 
EXERCISE, RECREATION, AND TRAINING. 
tissue-changes. For not only are the muscles themselves 
benefited, because they, are brought into action, but by 
their action they increase the rapidity of the onward flow 
of the blood to the heart, the heart itself beats more 
vigorously, a larger quantity of blood is sent through the 
lungs, more oxygen is absorbed, a greater quantity of 
heat is engendered by the combination of the oxygen 
with the tissue-waste, and the skin and the other organs 
of secretion are brought into action to get rid of the 
superfluous heat and the products of combustion. Thus 
the heart, lungs, skin, and other organs of the body are 
brought into more active play by muscular activity; the 
brain and the nervous system are invigorated; the diges- 
tion is improved; and the whole machinery of the body 
is kept in efficient working order. On the other hand, 
through want of sufficient bodily exercise, the constitu- 
ents of the food which pass into the -blood are not 
sufficiently oxidized, effete products accumulate; the mus- 
cles become flabby or fat; the digestion is disordered ; the 
nervous system becomes enfeebled; the function of secre- 
tion is impaired; and ill health or disease ensues. Indeed, 
it may be laid down as a rule that, other things being 
equal, those who take a sufficient amount of exercise in 
the open air or are employed in active outdoor labor, will 
enjoy the best health and live the longest; and this is 
borne out by the statistics of the Registrar-General, which 
clearly prove that gamekeepers, farmers, and agricultural 
laborers are among the healthiest classes of the com- 
munity. 
Seeing, then, that general muscular exercise is not only 
conducive but essential to the maintenance of sound 
health, it becomes a very important question to determine 
what amount is necessary to keep the intricate machinery 
of the body in good working order. 
It would take up too much space to enter here into the PHYSIOLOGICAL DETAILS. 
193 
physics or physiology of this question, but it will suffice 
to say that extended experience and numerous experi- 
ments both agree in laying it down as a rule that the 
amount of exercise required by a man of average height 
and weight is equivalent to a daily walk of eight or nine 
miles along a level road. This rule, of course, only 
applies to a man in the prime of life-for growing lads 
or women, who, by the way, are rated as physically equal 
to lads of sixteen, the amount of exercise required would 
be somewhat less. But while growing lads, when under 
favorable circumstances, as a rule, take more than their 
allotted amount of exercise, it is notorious that the 
majority of men, if we exclude those employed at active 
outdoor labor, take nothing like that amount, and women 
take less still; and this neglect of exercise is a most 
fruitful source of ill health among both sexes, but espe- 
cially among the latter. • Of course, the ordinary avoca- 
tions of life may reduce the eig'ht or nine miles' walk 
very considerably, or, in respect to some outdoor employ- 
ments, it may be dispensed with altogether; but to those 
whose employment is mainly sedentary, or inactive, this 
amount of exercise, in some shape or form, is indispen- 
sably necessary. It may be varied in many ways, and, 
as we shall presently see, the more ways the better; but 
for the most part it should always be taken in the open 
air. 
We now pass on to the consideration of another very 
important question, which shows further that healthy 
recreation or exercise depends on the fact that a frequent 
change of organic activity is actually necessary. We 
have already seen that when a tissue or organ is doing 
its work, it is expending energy which it has previously 
obtained from the food which it has assimilated. Now, 
if the supply of energy due to nutrition is equal to the 
outlay expended in work, the working capacity of the 
13 194 
EXERCISE, RECREATION, AND TRAINING. 
organ or tissue will remain stationary; but if the work 
done is in excess of the nutrition supplied, the tissue or 
organ will speedily become exhausted and unfitted for 
further work until it has again assimilated its proper 
amount of nutriment. We thus see that every organ and 
tissue of the body requires periods of rest to alternate 
with periods of activity; indeed, as Dr. Poore has well 
put it, " Our whole life consists in a series of vibrations, 
periods of tension alternating with periods of relaxation; 
and though the rapidity of these vibrations varies im- 
mensely, they are recognizable in all our acts, be they 
voluntary or involuntary." Even .the heart, which is 
ceaselessly beating without our control, has its period of 
absolute repose, and its period of functional exercise, to 
alternate with its period of active labor-in this respect 
teaching us a lesson which we should apply to the habits 
of our daily life. But in the case of the heart and other 
organs depending upon 'involuntary nervous stimulus, the 
activity is tolerably constant, because the outlay of energy 
is kept constantly balanced by the income. In the case, 
however, of the voluntary nerves and muscles, the ex- 
penditure of energy far exceeds their income during the 
period of activity, and hence they have to draw upon the 
stores of energy which they have accumulated during 
their previous periods of repose. So far as .certain groups 
of muscles, nerves, or even parts of the brain are con- 
cerned, these periods of repose may consist either of 
periods of local sleep, or they may take place during 
general sleep. Thus a part of the body may become 
exhausted, and require repose, or local sleep, when the 
whole body is not sufficiently exhausted to require gen- 
eral sleep; and the value of suitable recreation and 
exercise depends upon the fact that this local exhaustion 
can be restored by allowing that part to rest while the 
sphere of activity is transferred to some other part. PHYSIOLOGICAL DETAILS. 
195 
Having so far entered into physiological details, let us 
now proceed to consider some of the bearings of their 
application. It has already been made evident that 
activity is necessary for every part of the body, and that 
the period of activity must be followed by a period of 
repose, or local sleep, and what is true of every part is 
true of the whole system-sleep being only a period of 
general repose, during which the muscles and nerves 
under our control are refreshed and built up by the pro- 
cess of nutrition. But inasmuch as work, which is neces- 
sary for all, is infinitely varied, and taxes some parts of 
the nervous and muscular systems without calling other 
parts into action, it becomes clear that recreation or 
exercise must be infinitely varied too. Hence it is that 
a student who has wearied his brain over a mathematical 
problem, finds a relaxation, and becomes refreshed, by 
devoting his attention to the study of a classical author; 
that the historian finds recreation in the pursuit of sci- 
ence; that the hard thinker finds relief in the fields of 
light literature; and so on. These are examples of men- 
tal work and mental recreation, but work of whatever 
description which tells almost exclusively on the nervous 
system must be relieved, as has already been shown, by 
due attention to the exercise of the muscular system. 
Indeed, to professional men, men of business, and all 
those whose pursuits in life are more or less sedentary, 
plenty of outdoor exercise is almost a sine qua non of 
sound and vigorous health. 
On the other hand, the kind of recreation to be recom- 
mended as necessary for those who are engaged in active 
outdoor employment should obviously not be of the ath- 
letic kind, although sports and pastimes may be freely 
indulged in by all. Naturally, the kind of physical 
recreation which will be of value to the workman will 
depend in great measure upon his occupation. If, for 196 
EXERCISE, RECREATION, AND TRAINING. 
example, the muscles of the arm are mostly brought into 
play, as in the case of the bricklayer, carpenter, and 
blacksmith, the exercise to be indulged in should be such 
as will sustain the healthy activity of the muscles of the 
lower limbs. As a rule,'however, this is sufficiently pro- 
vided for by the walking to and fro incidental to the 
employment, so that it may be said that the kind of re- 
creation most suitable for all who earn their living by 
"the sweat of the brow" should be mental and emotional 
rather than muscular. So far as the physiology of recrea- 
tion is concerned, the points to be borne in mind with 
respect to each individual are these:-(1) That general 
muscular activity is necessary for all; (2) that if any sets 
of muscles are kept vigorous by specialty of labor, the 
others should be kept in healthy activity by suitable exer- 
cise ; and (3) that those whose work is chiefly mental may 
obtain healthy recreation by directing the mind into other 
channels. For just as certain muscles are almost exclu- 
sively employed in certain kinds of bodily labor, so cer- 
tain parts of the brain are more severely taxed than 
others in certain kinds of mental work, and it is by reason 
of this localization of brain-function, so to speak, that we 
can understand how the man of science and the historian 
may find recreation from each other's pursuits, and how 
the hard-working student feels his jaded mind refreshed 
by varying his subject of study. 
III. National Aspects of the Question. 
But whatever be the kind of recreation indulged in, it 
is of the highest importance that the feelings should in- 
variably be pleasurable. There is an old saying that a 
hearty laugh does one good, and there cah be little doubt 
that the ancient custom of exciting laughter at table by 
jesters, or buffoons, was an excellent aid to the digestion 
of the heavy meals of by-gone days. Be this as it may, NATIONAL ASPECTS OF THE QUESTION. 
197 
there can be no question that a prolonged flow of happy 
feelings does more to brace up the system for work and 
recreate the mental energies than any other influence 
operating for the same length of time. Hence the recrea- 
tive value .of pleasant society, whether obtained in -a 
cheerful home, in a club, at the theatre, or any other 
innocent place of amusement. We have been accused, as 
a nation, of amusing ourselves sadly; and there is perhaps 
some foundation for the accusation, inasmuch as the hu- 
mane tendencies of the age have banished all the rougher 
sports of our ancestors, without supplying us with appro- 
priate outlets for the hereditary instincts of action, frolic, 
and passion, which, for good or evil, still linger in most 
of us. Reading-rooms, mechanics' institutes, and museums 
no doubt contribute largely as aids to recreation, but we 
want all these and something more. For the masses in 
our large towns we want places of resort and amusement, 
which will supplant to a large extent the public-house 
and the licensed music-hall; and it is an augury of happier 
times that men of eminence and large philanthropic views 
are exerting themselves in establishing coffee-houses and 
temperance music-halls, which will afford opportunities of 
social intercourse and amusement, and avoid the dangers 
of drink. The vast benefits to be derived from public 
parks are so obvious that they require no comment, except 
that they should be always utilized as free open breathing 
spaces, where lungs and limbs can be exercised without 
stinting or restraint. Let them be adorned with trees and 
decorated with flower-beds by all means, but not to such 
an extent as will curtail the necessary space for cricket, 
foot-ball, and other healthy sports. And here it may be 
noted that there is a steadily growing conviction afnong 
many of the leading men of the day, who cannot be 
accused of irreligion, that the intolerance to .innocent 
Sunday recreation, which has hitherto prevailed, has 198 
EXERCISE, RECREATION, AND TRAINING. 
without doubt a deteriorating influence on national 
health, and therefore exerts a vitiating influence on 
national morals. They argue that working men who go 
to church will continue to go to church, and that if the 
clergy would only consent to the opening of museums, art 
galleries, and to the playing of bands in the public parks 
on the Sunday afternoon, they would wean over large 
numbers to attend church in the forenoon.or evening, who 
at present never go to church at all. To the teeming 
multitudes in our large towns, Sunday is the only day in 
which they are freed from the turmoil of stifling work, 
and, apart from religious observances, the question is 
whether it would not be better to help them to healthier 
life by enticing them to public parks, museums, art gal- 
leries, and the like, than to leave them to drift to public- 
houses whenever the doors are open. 
This, however, is a phase of the subject which it would 
be out of place to discuss here. The great problem is how 
to multiply the means of healthy recreation, and make 
them more accessible to the great masses of the people. 
It is not enough to lessen the hours of labor, and make 
statutory holidays, unless at the same time efforts are 
earnestly and persistently made to ensure that the holi- 
days of the many are not spent in lawless drinking bouts, 
and that the spare hours are not worse than wasted. 
Workingmen's institutes, clubs, reading rooms, cafes, are 
all of them destined to contribute largely to prevent the 
misuse of leisure hours; but we want gymnasia as well as 
reading-rooms, playgrounds everywhere for the children, 
people's parks in plenty for our large towns, and village 
greens for our villagers; and along with all these, we 
want some revival of those active outdoor amusements 
and games which made, our forefathers such an active and 
sturdy race. It is true that modern civilization has not 
banished these altogether, but it has done much to dis- EXERCISE DURING CHILDHOOD. 
199 
courage them, and has in this way contributed, and in no 
small degree, to that downward tendency of the national 
physique which has already been referred to. 
There is, however, one movement which is steadily 
gaining in popularity, and which has already done so 
much good service in the cause of physical recreation that 
it claims especial notice, and that is, volunteering. Only 
those who have been volunteers themselves can appreciate 
the great and lasting benefit which the drill and exercise 
incidental to the service confer, and, speaking as a volun- 
teer, I would strongly advise every able-bodied youth to 
enroll himself in some volunteer corps, for the sake of the 
advantages to be gained from the discipline and training, 
if for no other reason. We have only to take a glance at 
the national life of those grand old Greeks to be convinced 
of the vast importance of physical education when pro- 
perly understood and carried out. All their national 
games-Olympic, Pythian, Numaean, and Isthmian-were 
specially directed to develop the highest possible attain- 
ments in individual culture, courage, and skill; and they 
succeeded so well that in no race, and at no period of the 
world's history, has there ever been witnessed so marvel- 
lous a development of physical perfection amongst men, 
nor have there ever been such glorious legacies bequeathed 
to futurity in the domains of philosophy, literature, and 
art. 
Having said so much with respect to the national 
aspects of the question, let us now proceed to consider the 
kind of recreation and exercise suitable for different 
periods of life and for each sex. 
IV. Exercise during Childhood. 
"A child in health," says Sir W. Jenner, "delights in 
movements of every kind. It joys to exercise every 
muscle. Strip a child of a few months old, and see how 200 
EXERCISE, RECREATION, AND TRAINING. 
it throws its limbs in every direction; it will raise its 
head from the place in which it lies, coil itself round, and, 
grasping a foot with both hands, thrust it into its mouth 
as far as possible, as though the great object of its exist- 
ence at that moment was to turn itself inside out." Now, 
these grotesque movements constitute the natural exercise 
of the child, and parents and nurses should be particu- 
larly careful not to impede the free motion of the limbs, 
either by tight clothing, or by strapping the child in a 
narrow cradle or crib, in which it can scarcely turn. A 
fixed cot is always preferable to a bassinet with a rocking 
or swinging motion, because a child, when once habituated 
to the rocking motion, will seldom fall asleep or remain 
quiet unless the rocking is continued. So soon as the 
child begins to crawl on all fours, it should be allowed to 
do so freely; - but when it commences to walk, it should 
be carefully watched, and not encouraged to stand too 
much on its legs, because at this period the weight of the 
upper half of the body is proportionately much greater 
than it afterwards becomes, and the strain thrown on the 
lower limbs is at first excessive. It is owing to careless- 
ness in this respect that many children become bandy- 
legged and crippled for life, whereas a little more watchful 
care would have prevented all the mischief. When a 
child reaches the age of three years, exercise of a more 
or less systematic kind may be commenced. The peram- 
bulator should now be dispensed with, and the child en- 
couraged to run about after a ball, and the like, and, 
later on, to trundle a hoop. Indeed, it should always be 
remembered that most children will play as they ought 
to play if they are left untrammelled by artificial re- 
straints. Indoors, a rocking-horse, without stirrups, and 
not too broad a saddle, will afford ample scope for the 
exercise of the muscles generally, and especially those of 
the back. The nursery itself should be as light and airy EXERCISE DURING CHILDHOOD. 
201 
as possible, and the floor uncarpeted. In the case of the 
lower classes, the establishment of creches, or public nur- 
series, deserves every encouragement. 
And now we come to consider the physical education 
of school life. It need hardly be said that as every school 
ought to be a nursery of health as well as of intelligence, 
it is highly essential that the sanitary condition of the 
school and its surroundings should, in all respects, be 
satisfactory. The desks and benches should be con- 
structed and arranged with a view to remove discomfort, 
support the back and feet, prevent any straining of the 
eyes when the pupil is writing or drawing, and do away 
with the risks of weakening and distorting the spines of 
pupils, especially in girls' schools. In the new Board 
Schools, desks and benches of this description are now in 
general use, and it is to be hoped that the old-fashioned 
long forms, without backs or foot-boards, will soon be 
banished from every school throughout the country. In 
infant schools, again, there should always be plenty of 
floor space, so that the children can march, sit, or be 
exercised without restraint. 
With respect to that most indispensable adjunct of 
every school, the playground, it may be said generally 
that it is often most limited where it is most required. 
In large towns land is so dear, that in London, for exam- 
ple, buildings of two or three stories have become essen- 
tial, with, in some cases, playgrounds on the roof, or under 
arches, although in every instance some provision has 
been made for the recreation and drill of the children. 
But breathing space and room for play are of such vital 
importance to the healthy growth of young children, that 
any conditions which tend to cramp them into too limited 
dimensions must be regarded as crippling very much the 
influences for good which public elementary schools pos- 
sess in other respects. When ample space for real play 202 
EXERCISE, RECREATION, AND TRAINING. 
cannot be obtained, much benefit may be derived from 
adopting other forms of active exercise, which need not 
require more space than the floor of the school-room 
affords. The simplest forms of drill training, if well 
conducted, so as to procure precision and thereby give 
zest to the various movements and evolutions which may 
be carried out, will do wonders in helping to strengthen 
and straighten the weak limbs of growing children. A 
kind of rhythmic chant introduced now and then, as an 
accompaniment, will also help to expand the lungs, and 
at the same time relieve monotony, by creating a certain 
amount of pleasurable excitement. All this, of course, 
applies more especially to infant schools; but even for 
boys, and for that matter, girls too, in the more advanced 
classes, drill training is equally essential, and should form 
a part of regular instruction and school discipline. 
V. Exercise for Boys. 
At our large public schools and good private schools, 
the playground bec'onies as important a feature as the 
class-room, because schoolmasters, of all men, know best 
that, unless boys have ample time and space for play, the 
energy of body and mind fails, and the school work 
suffers. For the most part the exercises indulged in are 
purely recreative, and are left pretty much to the inclina- 
tions and regulations of the boys themselves. The great 
danger to be guarded against is, allowing the weak and 
delicate to engage indiscriminately in games for which 
they are altogether unequal. Thus, while cricket may be 
freely indulged in by almost every boy so soon as he is 
able to wield a bat, he ought not to be permitted to take 
part in foot-ball matches with lads much older than 
himself, nor unless he is physically strong. There can be 
little doubt, too, that a good many lads suffer. from the 
excessive strain thrown upon them by indulging too freely EXERCISE FOR BOYS. 
203 
ill athletic sports, such as running and jumping. Up to 
the age of seventeen, activity of growth proceeds so 
rapidly in most lads that severe competitive sports of 
any kind should be discouraged, not only on account of 
the risks attending the struggle of the day, but also on 
account of the strain thrown upon them by the necessary 
training. Till then, the ordinary school games will afford 
sufficient healthy recreation, and it is only when a lad 
leaves school for the university, or to start in life, that he 
should think of taking part in any of those contests 
which tax physical strength and endurance to the utmost. 
But in addition to the recreation afforded by cricket, 
swimming, foot-ball, tennis, hockey, fives, rackets, and so 
on, there ought to be a regular system of educational 
exercise carried out under proper supervision, and care- 
fully regulated to suit the requirements and capacities of 
the various groups of pupils. It is on this account that 
drill exercise of even the most rudimentary kind is of 
such value in developing and strengthening the weak 
frames of city children; but at all schools, even where 
there is plenty of playground space for the usual games, 
the advantages to be gained from a regular and progres- 
sive course of bodily training cannot be over-estimated. 
Nor need the requisite apparatus be of a complicated or 
expensive kind. If, for example, a corner of the play- 
ground were covered over, and had fixed in it two or three 
sets of what are called the horizontal bar, the parallel 
bars, and the wooden horse, any well-attended school would 
be provided with a gymnasium, which, under proper tuition, 
would supply all the means requisite for healthy bodily 
training. Of course, for our large public schools, a gymna- 
sium, properly fitted up with every appliance, is a great 
desideratum, and, indeed, is usually provided; but for the 
great majority of schools, public or private, the limited 
amount of apparatus which I have just mentioned, sup- 204 
EXERCISE, RECREATION, AND TRAINING. 
plemented, it may be, by the swing and trapeze, would 
be amply sufficient. But to be of real value, all exercises 
of the kind, as already stated, should form part of the 
regular course of instruction, and ought to be carried out 
either under the supervision of a drill-master or of the 
teacher himself, provided, of course, that he takes the 
trouble to master the subject. 
And here it may be remarked in passing that it would 
be greatly to the advantage of the pupil, and to the dis- 
cipline of the school generally, if punishment drill of 
some sort were substituted for the cruel impositions which 
have become so generally resorted to of recent years, and 
which very often result in a distaste for reading or study 
of any kind. Few boys would care to lose play-hours or 
half-holidays in this fashion; so that, while there can be 
no doubt that punishment drill could be made sufficiently 
repugnant, it would possess the advantage of affording 
plenty of exercise in the open air or under cover. In 
writing an imposition, the nervous energies are not only 
dissipated in a wholly useless manner, but in imprisoning 
the culprit in a dull room at the same time, his bodily 
energies become exhausted too, and he is thus doubly un- 
fitted for work. Indeed, there can be no question that 
corporal punishment, when not unfairly administered, is 
in every respect preferable to the tedious, fatiguing, and 
unhealthy systems which the vapid sentimentalism of the 
day has brought into such general use. 
VI. Exercise for Girls. 
Having said so much with respect to the physical re- 
creation of boys, let us now consider the subject very 
briefly as applied to girls. Up to the age of eight or ten 
years, I do not see that there need be any very material 
difference in the training of both sexes. Plenty of play- 
ground space, simple drill exercise, rope-skipping, swings, EXERCISE FOR GIRLS. 
205 
and so on, should be provided and encouraged as much as 
possible. It is after this period that the great mistakes 
■which are made in the physical education of girls are 
likely to occur, and do still occur, notwithstanding all 
which has been said and written on the subject. At most 
ladies' schools, the humdrum daily walk, and that only 
when the weather is fine, is almost the sole form of ex- 
ercise in which the girls are allowed to indulge. It is 
quite true that nowadays we hear a good deal about calisthe- 
nics; but it is very much to be feared that, like a good 
many other items in the showy prospectuses of ladies' 
schools, they do not amount to very much in the long 
run. Unfortunately, too, the tyranny of dress and fashion 
interferes to a very serious extent with many forms of 
active exercise, which, while they are seemly enough in 
themselves, would make growing girls more graceful, and 
certainly much more vigorous and healthy than many of 
them are. 
It should always be remembered, in the case of girls as 
well as boys, that school life is the time when the organism 
most requires the strengthening and purifying influences 
of bodily recreation, and hence every reasonable scope 
should be given for the healthy flow of natural joyous- 
ness. But as a matter of fact, the school-girl of the 
present day is taught to curb her natural spirits, to regard 
innocent amusements and any kind of romping as unlady- 
like, to indulge in no exercise except that which is allowed 
by a prison-like routine, and to accept the dull monotony 
of her school life as an absolutely essential training for 
the part which by-and-by she will be expected to play in 
the conventionalities of every-day life. All her physical 
energies are sacrificed to the bondage of a genteel deport- 
ment, and is it to be wondered at that, whatever may be 
the long list of her showy accomplishments when she 
leaves school, she returns home with an enervated con- EXERCISE, RECREATION, AND TRAINING. 
206 
stitution, which makes her a ready victim to all sorts of 
nervous disorders? In order to become healthy women, 
and, above all, healthy wives and mothers, it cannot be 
too strongly insisted on that girls' schools should be utilized 
as places intended for healthy recreation and bodily cul- 
ture, as well as for sound education and mental culture; 
and surely there might be large concessions made in this 
respect, without any risk of sacrificing either to refinement 
or good breeding. No one would care to see young ladies 
emulate their brothers in the cricket-field; but there are 
many games in which they could indulge, and which would 
prove equally beneficial, such as lawn-tennis, Badminton, 
fives, rackets, battledore and shuttlecock, and other games 
of the playground. The misfortune is, however, that in 
large towns the playground space either does not exist at 
all, or is so largely curtailed that it is practically useless, 
and to meet this difficulty, it has been suggested that 
schools.might club together to provide a joint playground 
-care, of course, being taken that the social position of 
the pupils is duly considered. The same joint efforts 
might also be made, under a responsible committee, to 
provide a suitable establishment where swimming, rowing, 
and . a few special gymnastic exercises might be taught. 
Swimming and rowing are both of them excellent exer- 
cises for girls, and so is riding, when the family resources 
are sufficient to afford it. If parents and guardians made it 
a duty to inquire personally into the opportunities afforded 
for healthy recreation, and indeed into the general sanitary 
condition of schools, before sending their charges to them, 
there would no doubt be a speedy and general improve- 
ment in this direction; but at present the teachers exert all 
their efforts in taxing their pupils' brains with a medley of 
subjects which they soon forget, and often with accomplish- 
ments, as they-are called, for which they have neither capa- 
city nor liking, while physical recreation isgrossly neglected. EXERCISE FOR WOMEN. 
207 
But apart from outdoor games, active indoor amuse- 
ments ought to be encouraged, and one of the healthiest 
of these is dancing. To quote the eloquent words of the 
late Canon Kingsley, who wrote so much and spoke so 
well on this subject of physical education:-"If the pro- 
moters of higher education for women will compel girls 
to any training analogous to our public school games; if, 
for instance, they will insist on that most natural and 
wholesome of all exercises, dancing, in order to develop 
the lower half of the body; on singing, to expand the lungs 
and regulate the breath ; and on some games-ball or what 
not-which will ensure that raised chest, upright carriage, 
and general strength of the upper torso, without which 
full oxygenation of the blood, and therefore general health, 
is impossible; if they will steadily forbid tight stays, high 
heels, and all which interferes with free growth and free 
motion; if they will consider carefully all which has been 
written by Mr. Chadwick and others, and accept the cer- 
tain physical law that, in order to renovate the brain day 
by day, the growing creature must have plenty of 'fresh 
air and play, and that the child who learns for four' hours 
will learn more, and learn it more easily, than the child 
who learns for the whole eight hours; if, in short, they 
will teach girls not merely to understand the Greek 
tongue, but to copy somewhat of the Greek physical 
training, of that 'music and gymnastic' which helped to 
make the cleverest of the Old World the ablest race 
likewise; then they will earn the gratitude of the patriot 
and the physiologist, by doing their best to stay the 
downward tendencies of the physique, and therefore ulti- 
mately of the morale, in the coming generation of English 
women." 
As already stated, then, there is not the smallest room 
for doubt that the delicate health from which numbers 
VII. Exercise for Women. 208 
of grown-up girls suffer is, in large measure, owing to the 
utter want of any adequate amount of exercise during the 
period of theii' school life; and the aversion to activity of 
any kind-except perhaps it be dancing-which is thus 
engendered, becomes habitual to them, so that in after 
years they become more or less invalidish, and are seldom 
out of the doctor's hands. Look, for example, at the lazy, 
listless existence which the fashionable lady in town leads, 
and contrast it with the active, vigorous life which brings 
roses to the cheeks, roundness to the limbs, and' graceful- 
ness of carriage to the country girl, who feels that plenty 
of outdoor exercise is a sine qua non of her existence. Is 
it to be wondered at that the former, addicted to late 
hours in crowded rooms, and who takes no outdoor exer- 
cise, save what she obtains by lolling in her carriage, 
should look languid and delicate, and soon begin to com- 
plain of headaches, lassitude, feeble circulation, and often 
of ailments worse than these? This habitual violation of 
one of the best known of the laws of health, the neglect 
of taking a sufficient amount of bodily exercise, is one of 
the most fruitful sources of disease and early death, and 
no class suffers more than the ladies of the upper and 
middle ranks of society. Hence their eagerness for the 
close of the season, so that they may rush to the fresh air 
of the country, forgetting all the while that, by living a 
little more in accordance with the laws of health, even 
town life may be made enjoyable apart from its gaieties 
and distractions. If ladies cannot ride, or have not the 
opportunity of riding, they can at least take a daily walk, 
with some pleasant companion, either in the park or when 
shopping. Then there are lawn-tennis, as already said, 
skating, boating, and the like, for the young and active, 
and, above all, there is plenty of dancing; but, unfor- 
tunately, the late hours more than counterbalance the 
good which this would otherwise confer. All these re- 
EXERCISE, RECREATION, AND TRAINING. EXERCISE FOR WOMEN. 
209 
commendations apply more especially to the young or 
middle-aged, but even ladies who are beginning to advance 
in years cannot afford to neglect the few miles' daily walk 
if they wish to keep in good health. I know adady, close 
on sixty, who on the average walks six miles daily for the 
sake of her health, and as a consequence she seldom suf- 
fers from an ache or pain of any kind, and is one of the 
healthiest of her sex. Of course, a great many urge that 
it is physically impossible for them to take anything like 
that amount of exercise; but if they would only make a 
beginning and persevere, it is astonishing how compara- 
tively easy it would afterwards become, and what a sur- 
prising amount of benefit it would confer. 
Among the working-classes, the labor entailed in man- 
aging household work, or different kinds of employment, 
assists greatly in preventing much of the illness which is 
brought on by the inactivity of the lives led by those in 
better circumstances. Household servants in our large 
towns should not be grudged their "Sunday out," on 
account of the benefits which the fresh air and a walk in 
the park confers, not to speak of other opportunities for 
other kinds of healthy recreation. Indeed, what has been 
already said with respect to the recreation of the working- 
classes generally, applies in great measure to the other 
sex, inasmuch as they share to a large extent in the 
recreation of their male friends and relatives. Public 
parks, innocent places of amusement, penny readings, 
window gardening, mothers' meetings, book clubs, all con- 
tribute to relieve. the pressure of the work and worry of 
every-day life. Then, too, it should be noted that in the 
interests of the numbers of friendless shop-girls and dress- 
makers who are to be met with in all our large towns, the 
movement which is now on foot of establishing friendly 
lodges, or clubs, under proper management, is one deser- 
ving of every encouragement and support. 
14 210 
EXERCISE, RECREATION, AND TRAINING. 
Reverting now to the recreation suitable for male adult 
life, it has already been pointed out that those whose 
occupation is for the most part indoors and sedentary, 
ought to take an amount of outdoor exercise equivalent 
at least to a daily walk of eight or nine miles. The clerk 
who has to sit for so many hours daily at his desk, should 
start early enough to enable him to take a brisk walk 
before he enters the office, and should take another after 
the work of the day is over. Of course, if he is fond of 
bicycling, cricket, foot-ball, and the like, so much the 
better. Let him indulge in these active pursuits as much 
as he can, and he will be able to dispense with long walks, 
which are apt to prove somewhat dull and monotonous. 
But when a man approaches the period of middle age, he 
becomes, incapacitated for any active sports which are apt 
to throw a sudden or severe strain upon the heart and 
large arteries, and he ought therefore to take to exercises 
of a less violent description, such as riding, hunting, 
fishing, shooting, golf, bowls, and the like; or, if he cannot 
afford, or has not the opportunity to indulge in these, he 
must apply himself all the more assiduously to the daily 
walk. For it cannot be too strongly insisted on that at 
no period of life is outdoor exercise more essential than it 
is between the ages of forty and fifty, because it is gen- 
erally at this period that the worry and work of life begin 
to tell on the vital organs. Dyspeptic symptoms begin to 
assert themselves; derangements of the liver, weariness, 
headache, uneasy and disturbed sleep, palpitation, floating 
specks on the field of vision, are all of them clear indica- 
tions that the health is failing-it may be from worry and 
overwork, or it may be from eating and drinking more 
than can be assimilated by the system, but in the great 
majority of cases it is because physical exercise has for 
VIII. Exercise for Men. EXERCISE FOR MEN. 
211 
some considerable time been grossly neglected as well. 
Look how even an occasional day's hunting or shooting 
serves to drive away the cobwebs from the brain, and 
remove some of the uncomfortable symptoms just alluded 
to, in the case of many a man who has been sticking too 
closely to business, and there will be no disputing the 
curative as well as preventive value of active exercise in 
the open air. 
But it is urged by many that it is all very well to 
recommend exercise:-what if they have not the time to 
spare? The answer to this is plain;-find the time. It 
is no great hardship to get up a little earlier in the morn- 
ing, and in the evening a portion of the leisure which is 
spent at the club, or is devoted to whist, would be much 
more advantageously expended in taking some kind of out- 
door exercise. But, whatever the form of exercise, there 
should be no lack of heartiness and zest; a profound belief 
that it is essential to sound health will make it all the more 
enjoyable in the long run. The sense of weariness and 
fatigue, which is so often complained of after the labors 
of the day as a bar to exercise, will be found to be dis- 
pelled by it, because in most cases it is purely subjective, 
and has been induced through sheer neglect of muscular 
activity. Then, too, it should be borne in mind that if 
the premonitory symptoms already referred to are dis- 
regarded, the chances are that serious disease will sooner 
or later set in, either in the form of gout, fatty heart, or 
grave disorders of other organs. 
Unfortunately, however, there are numbers who pay no 
heed to these warnings, so that long before the annual 
holiday comes round, they are utterly jaded and worn out, 
and when they do get their holiday, they are apt to rush 
from one extreme to the other. They take either to walk- 
ing tours or long tramps on the moors, when a moderate 
walk is as much as they can accomplish without subjecting 212 
EXERCISE, RECREATION, AND TRAINING. 
themselves to extra fatigue, and the consequence is that 
they run the risk of becoming completely knocked up at 
the very outset. Having neglected to take a sufficient 
amount of exercise for some time back, there is not only a 
want of concordant action between the heart and blood- 
vessels when an extra strain is thrown upon them, but the 
muscles are likewise out of condition, and therefore easily 
fatigued. Men, too, become crippled for a time from blis- 
ters or abrasions on the feet, because walking had not been 
sufficiently practised beforehand to harden them, or be- 
cause the holiday is commenced with thin-soled or badly 
fitting boots. A reasonable amount of preliminary train- 
ing, and better attention to details of the outfit, would 
prevent all this disappointment and mischief, and the 
holiday which is wisely and judiciously utilized will be 
found to confer more benefit from the exercise which is 
taken than from the change of air, which is usually 
credited with almost all the advantages gained. On the 
other hand, it should be remembered that the man who 
keeps up his quantum of exercise daily, keeps himself in 
sound health and fair training as well, and hence he can 
undertake tourist feats or face the moors, not only without 
undue fatigue, but with enjoyment; whereas the one who 
takes his exercise by annual instalments, as it were, be- 
comes easily overmatched, and cannot understand why, 
with his years still light upon him, he is not so good a 
man as he used to be. 
IX. Exercise in Old Age. 
When old age creeps on, the limbs become stiff, and 
certain changes are slowly taking place in the heart and 
blood-vessels, which render vigorous exercise inadvisable 
even when it can be undertaken. The waning energies of 
the body have to be carefully husbanded, and exercise 
should never be indulged in to such an extent as to induce TRAINING. 
213 
extra fatigue. But though both the necessity and desire 
for physical exercise are on the wane, it should still be 
practised as regularly as individual conditions and circum- 
stances will permit. So long as walking can be indulged 
in, it is wise to keep it up, and if horse exercise can be 
taken, an occasional ride will be of the greatest benefit. 
As regards other suitable kinds of exercise, there are few 
to select from, but many can enjoy a game at bowls, golf, 
or a day's fishing, even when verging on the " three-score 
years and ten." After the period of decrepitude has set 
in, every endeavor should be made .not to keep too much 
indoors. When the weather is fine, a drive in the car- 
riage, or a turn in a bath-chair, will help to refresh the 
failing energies, and even the change from one room to 
another will often prevent the patient from becoming bed- 
ridden as soon as he otherwise would. 
X. Training. 
The object of training, in its narrowest sense, is to get 
the body into such a condition and maintain it in that 
condition, that its average working powers can be called 
into action at any time without incurring risk or detri- 
ment to health. But in order to be able to exhibit the 
maximum amount of physical power and endurance of 
which the body is capable, a man must submit to a cer- 
tain regime more or less complicated. His diet must be 
liberal, carefully regulated, and contain little or no alco- 
hol ; his daily exercise must be systematic and progressive, 
his hours must be regular, and he must avoid all excess. 
The results are-that the breathing power is gradually 
increased, a concordant action is established between the 
heart and blood-vessels, so that there is no blockage when 
the rapidity of the heart's action is accelerated during 
exercise; the blood passes more freely through the lungs, 
and is more freely oxygenated; the organs of secretion get  EXERCISE, RECREATION, AND TRAINING. 
214 
rid of the waste material more quickly and efficiently; and 
the vigor and power of the muscular and nervous systems 
attain their maximum development. These are the re- 
sults which ought to be aimed at, but unfortunately, the 
tendency to specialization in athletics tempts many men 
to devote too much attention to one kind of exercise, and 
so to develop some particular parts of the system to the 
neglect of others. No doubt this evil is to some extent 
unavoidable, but for sound training the exercise should 
be as varied as possible. This will at once become clear 
when it is remembered what parts of the body are brouglft 
more prominently into action by particular kinds of exer- 
cise. For example, in walking, running, leaping, and 
riding,, the muscles of the legs and trunk are chiefly exer- 
cised; at tennis, rackets, cricket, fives, and rowing, the 
muscles of the legs and arms are chiefly employed; while 
in swimming, fencing, boxing, and climbing, all the mus- 
cles of the body are brought into nearly equal action. 
But in addition to muscular strength or endurance, the 
other great object aimed at in training is breathing power. 
This is best acquired by running, or it may be acquired in 
rowing with a quick stroke, but for the sake of variety of 
exercise it is always recommended that those who intend 
to compete in boat-races should indulge in occasional runs 
during the morning walk, which may be lengthened as 
the breathing power increases. Men who are inclined to 
be a little too stout, very often take to running in flannels, 
in order to get rid of the superfluous fat; but this plan 
cannot be recommended on physiological grounds, because 
the breathing power is embarrassed by too thick flannels, 
and consequently the carbonic acid is not so freely given 
off as the waste of tissue during and after severe exercise 
requires. If the action of the skin is sluggish, it is a much 
better plan to take a Turkish bath to begin with, and 
afterwards, when the morning tub is taken, to rub well TRAINING. 
215 
with a rough towel. During training, the morning tub 
is generally regarded as indispensable, and should be 
taken immediately after getting out of bed. In very cold 
weather, and in the case of those who do not experience 
the healthy glow of the skin afterwards, it should be taken 
tepid or with the chill off. As a rule, the cold bath 
should be dispensed with at any other time of the day, 
because after severe exercise the bodily powers are de- 
pressed, and the body warmth ought not to be largely 
drawn upon; a rub down with a wet sponge, or a cold 
douche, when it can be conveniently obtained, will be 
quite sufficient, and this should be followed by a vigorous 
towelling. Very often a warm bath before going to bed 
will be found to be very soothing, especially if there are 
symptoms of cramp or muscular tremor; and if soap is 
freely used at the same time, it keeps the pores open and 
aids the healthy action of the skin. 
It need hardly be said that one of the common results 
of training is excessive muscular fatigue, or local exhaus- 
tion, and this is generally accompanied by twitching of 
the muscles or cramp. Men in training should therefore 
be very careful to avoid persevering to such an extent as 
to induce these symptoms, otherwise they are likely to suc- 
cumb from over-training, or "training off," as it is called. 
Whenever a man becomes "stale," that is, when he begins 
to lose flesh when in good condition, dislikes his food, has 
no zest for exercise, and suffers from disturbed sleep,'he 
ought at once to consult a physician, because these symp- 
toms may be due to causes independent of the training 
itself, and which mere rest for a day or two may therefore 
fail to remove. Then, too, it is always wise to take medical 
advice when boils appear, as frequently happens, or any 
other derangement of the system which incapacitates for 
severe exercise. 
Another condition which should be carefully watched 216 
EXERCISE, RECREATION, AND TRAINING. 
during training is the action of the lungs and heart. If 
the pulse rises too high or becomes irregular, or if pal- 
pitation, breathlessness, or deep sighing is induced, the 
training should at once be left off, otherwise there is risk 
of a serious breakdown. And here it may not be con- 
sidered out .of place to allude to the charge which is con- 
stantly being advanced by physicians of eminence and 
large experience that training and athletics are pushed to 
a dangerous and unwarrantable, extent at our public schools 
and universities. Now, with regard to growing lads, it 
has already been pointed out that all severe athletic con- 
tests ought to be avoided on physiological grounds, but in 
the case of young men, the danger is very materially 
lessened. No doubt, there is always a certain amount of 
risk, but the cases of permanent injury, or of "overstrain 
of the heart," are much rarer than is generally supposed, 
for even with regard to the University boat-race, which 
is one of the severest athletic contests of the day, Dr. 
Morgan, of Manchester, who was a crack oarsman him- 
self, has clearly proved, by inquiring into the history of 
all those who have taken part in the race for years back, 
that the instances of actual mischief were rare or doubtful, 
and that, as a rule, the men have all along led vigorous, 
healthy, and active lives. At the same time, there can be 
no question that long running matches, or even the insane 
walking matches, which are now so much in vogue, are 
often productive of serious mischief, and ought to be dis- 
couraged in every way. 
It now remains to say a few words with respect to diet 
during training. At one time, it used to be the practice 
to diet all pretty much alike, and to give far more animal 
food than could be properly assimilated. Nowadays there 
is more latitude allowed by trainers, but individual pecu- 
liarities are not yet so much taken into consideration as 
they ought to be. So long as the diet is plain, nutritious, TRAINING. 
217 
well-cooked, and sufficient for bodily requirements and the 
extra amount of exercise indulged in, it may be varied 
very considerably to suit individual tastes; but the meals 
should be taken at regular hours. Alcoholic liquors, if 
not dispensed with altogether, should be taken very 
sparingly, and in the form of beer or claret at dinner. 
Strong tea should be avoided, and smoking, if it cannot 
be given up entirely, should be indulged in as little as 
possible. A glass of milk or milk-and-water, with or 
without a dry biscuit, should be taken before the morn- 
ing's run or walk which precedes breakfast, while soda- 
water-and-milk will be found to be a very safe and refresh- 
ing drink to allay thirst during the day. No more fluid 
should be taken than is actually required to allay thirst, 
or for the solution of food at meals, and it need hardly be 
said that a large draught should never be taken imme- 
diately before severe exercise is taken, because it impedes 
the full action of the lungs. For severe training, a diet 
which contains about 450 grains of nitrogen and 5000 
grains of carbon will be found to be quite sufficient, while 
for moderate training, the quantities need not exceed 375 
grains and 4600 grains respectively. Butcher's meat, 
bread, butter, vegetables, fruit, oatmeal, and milk may all 
be taken, and an approximate estimate of the relative 
amounts required daily may be obtained by consulting the 
tables which are given in the chapter on Food and Diet. 
Generally, the tendency is rather to over-feed, but if the 
diet is simple and wholesome, there is not much danger 
of erring in this respect. 
As a guide to those who are desirous of putting them- 
selves in training, the following hints, gathered from various 
sources, indicate the system which is pursued at the English 
Universities:- 
Rise at 7 a.m. in winter and 6.30 a.m. in summer. Have 
a cold, tepid, sponge, or douche bath, according to indi- 218 
EXERCISE, RECREATION, AND TRAINING. 
vidual circumstances or season of the year, but in any 
case, have a good towelling afterwards. Then take half 
a tumblerful of milk or milk-and-water, with a dry biscuit 
or bit of toast. Afterwards take a brisk walk of two or 
three miles, with occasional runs, which may be gradually 
lengthened. Breakfast at 8 or 8.30, on steak, chop, or 
fowl, the amount not to exceed half a pound, with one 
boiled egg, stale bread or toast, with butter, and two cups 
of weak tea, or a cup or two of coffee or cocoa, with plenty 
of milk. Fish may be taken occasionally by way of 
change, but ham or bacon should be avoided, because they 
are apt to create too much thirst. 
From 9 o'clock to midday, men are usually engaged in 
their ordinary pursuits, but after 12 they are generally 
free to take exercise, and this may be varied at rackets, 
fives, tennis, boxing, fencing, or in the gymnasium. 
Lunch should not be later than 1 or 1.30, and should 
be as light as possible. A small basin of mutton broth 
or nutritious soup in winter, or a slice or two of cold meat 
in summer, with bread and butter, ought to suffice; while 
as regards drink, a glass of beer or a little claret-and- 
water may be taken, but water alone is preferable. 
At 2.15 or 2.30 the real active exercise of the day is 
commenced. The rowing should be slow and steady for 
the first half-hour. Then varied afterwards to full or half 
speed, or from half-speed to full, steady or continuous, as 
the case may be, care being taken to train gradually, and 
to note any symptoms of distress amongst the members of 
the crew. After the row, the ihen should rub down with 
a wet sponge, followed by a good towelling, and then walk 
quietly back to their rooms, and rest till dinner. When 
the course is rowed, the time on the river should not ex- 
ceed one hour and twenty minutes, and in any case the 
time should not exceed two hours and a half. 
Dinner at 5.30 or 6. A little soup or broth in winter, TRAINING. 
219 
followed by roast mutton, roast beef, roast fowl, chop, steak, 
or dry mutton cutlets. Or, instead of soup, a little fish 
may be taken, and as adjuncts to the more substantial 
part of the meal, potatoes, vegetables, condiments, and 
bread. Those who like puddings may indulge in light, 
farinaceous puddings or cooked fruits; but in any case, 
the after-dinner morsel of cheese need not be dispensed 
with. The great thing to be guarded against is over- 
repletion, and if the meal is plain and substantial, it may 
be varied to any extent. As regards alcoholic liquors, 
they should be taken sparingly, if at all; not more than 
a couple of glasses of bitter ale, or two glasses of claret, 
or one glass of sherry, ought to be indulged in. 
During the evening, a cup of tea may be allowed, and 
at 10 o'clock, a pint of gruel, or a supper somewhat similar 
to the breakfast, but lighter, may be taken, if the appetite 
is keen. 
The time to retire to rest should not be later than 10.30 
or 11; but before retiring, there should be some dumb-bell 
or club exercise, followed by a warm bath, or tepid spong- 
ing, especially if there is much muscular fatigue. 
Such, briefly, is a sketch of the system generally pur- 
sued by university men who are ambitious to excel as 
rowing men, and it can hardly be said that the training, 
when judiciously carried out, is of a kind to over-tax the 
strength of any one of average physique. At the same 
time, there can be little doubt that many men devote too 
much attention to athletics, and too little to study or class- 
work, and this is an error in the opposite direction. 
From childhood onwards, physical and mental culture 
should go hand-in-hand, and varied recreation is as neces- 
sary for the one as the other. But in either case, recreation 
should never be pursued to such an extent as to render it 
laborious or debilitating, nor should it be allowed to en- 
croach upon the hours of natural rest, as it too often does 220 
EXERCISE, RECREATION, AND TRAINING. 
in the ball-room or at cards and billiards. Let there be 
less cramming, and more genuine education, in the real 
sense of the word, at our schools and universities; less 
forced work everywhere, and more recreative freedom; 
and withal, let parents and teachers alike keep constantly 
in view the supreme duty of inculcating those principles 
of morality, without which learning will fail to ennoble, 
and mere physical health fail to secure happiness. CHAPTER VII. 
THE HOME AND ITS SURROUNDINGS. 
Those who are acquainted with the social history of 
England, and the home habits of the .people during the 
dark or Middle Ages and even up to more recent times, 
will have no difficulty in accounting for the terrible epi- 
demics which frequently devastated the country, and the 
excessive mortality from all causes which prevented any 
material increase of the population for centuries. The 
cities and towns were for the most part walled-iu for- 
tresses, and were therefore highly favorable to over- 
crowding and stagnant air. Cleanliness of person and 
home were alike utterly neglected, so that filth accumu- 
lated everywhere. With the exception of the castle, 
which was built more for defence than comfort, the homes 
of the people consisted almost entirely of hovels, with 
mud walls and thatched roofs, while the floors, which 
were generally made of loam, were covered with layers of 
rushes, and these being seldom removed, harbored all sorts 
of abominations. The streets were dark,'narrow, and tor- 
tuous, unpaved, and without sewers or drains. The rural 
population, on the other hand, were scattered in slight 
hovels over dreary wastes and undrained marshes, so that 
rheumatism, ague, and other diseases were constantly rife 
among them. Among all classes, the clothing worn was 
immoderately thick and warm, and was seldom changed 
night or day. Add to all this that gluttony and intem- 
perance were prominent characteristics of the sturdy 
fighting Briton of mediseval times, and it will be readily 
221 222 
THE HOME AND ITS SURROUNDINGS. 
conceded that the habits and habitations of onr forefathers 
were alike inimical to health, and could not fail to foster 
epidemic diseases and preventable disorders of every de- 
scription. 
As time rolled on, improvements of an incidental kind 
were gradually introduced; but sanitary progress and the 
emancipation from the thraldom of filth were slow, tenta- 
tive, and tedious. Indeed, it was not till the Great Fire 
in London occurred in 1666, and consumed everything 
from the Tower to Temple Bar, that people began to 
realize, though in a faint and glimmering way, the sani- 
tary defences afforded by better-constructed homes, wider 
streets, and greater general cleanliness; nor was it until 
a century later that the labors of John Howard imparted 
an impetus in this direction which has proved of lasting 
national benefit. His name, as every one knows, is asso- 
ciated with the suppression of a fatal disease, called jail 
fever, which was constantly breaking out in prisons all 
over the country, and was continually spreading, by means 
of infection through the agency of discharged prisoners, 
amongst all classes of the community. The disease has 
long since been recognized to be the same as typhus fever, 
and John Howard the philanthropist was the first to 
prove beyond all dispute that it is a disease essentially 
engendered by filth and overcrowding. It would be out 
of place to enlarge on the incidents of his self-sacrificing 
labors here; but the outcome of them is simply this-that 
for years back the prisons of this country have been 
proved, by the most rigid statistics, to be far healthier 
than even the better class houses of the present day. 
Coming now to the present century, we find that the pro- 
gress made in the prevention of disease was very consider- 
able. Thus, it is ascertained from the bills of mortality, 
that the death-rate of the city of London, which during 
the seventeenth century had averaged 80 per 1000 of the HISTORICAL SKETCH. 
223 
inhabitants, had been reduced to 50 per 1000 during the 
eighteenth century, and since the Registration Act of 
1836 was passed, it has averaged only 24 per 1000. But 
outside London, at the commencement of the present cen- 
tury, there were no large towns teeming with overgrown 
populations, none contained so many as 100,000 inhabi- 
tants, and only five exceeded 50,000. The population of 
England and Wales, which, in round numbers, was only 
10,000,000 in 1810, had increased to over 15,000,000 in 
1840, and at the present day, it nearly amounts to 25,- 
000,000. And this rapid increase of population, owing to 
the opening up of new sources of industry, and the com- 
mercial prosperity which encourages early marriages, has 
taken place, for the most part, in already populous towns, 
or at centres of industry which speedily became populous. 
Old houses were overcrowded from cellar to attic, and the 
new houses which were run up, though improvements on 
the hovels already described, were built without the 
slightest regard to the veriest rudiments of sanitation. 
The drains were leaky, the sewers were badly constructed, 
cesspits multiplied, wells were polluted, and scavenging 
was everywhere neglected. At last, after many inquiries 
which revealed the terrible evils which were fast accumu- 
lating, the Legislature interfered, and by numerous Acts 
passed year after year, has of late endeavored to enforce 
better construction of houses, provide proper drainage 
and water supply, and to remove such other sanitary de- 
fects connected with existing premises as can be obviated. 
But only those who are acquainted with the rookeries 
of our large towns, and the rickety cottages of our rural 
villages, can form any adequate conception of the gigantic 
nature of the task which has to be accomplished. A 
minimum of at least one-third of the village homes of 
England require to' be pulled down stick and stone, and 
rebuilt, and that has been estimated to represent a mini- 224 
THE HOME AND ITS SURROUNDINGS. 
mum outlay of seventy millions of money; while as re- 
gards the replacement of the reeking abodes and tenements 
of our large towns, more than double that amount will not 
solve the difficulty. 
It sounds like a grim satire on the boasted civilization 
of the present day, but it is no less true, that the modern 
prison is in all sanitary essentials the best existing type 
of what a healthy dwelling ought to be, and even on that 
model there is considerable room for improvement. The 
real sanitary work of the architect and builder, therefore, 
lies entirely in the future, and though a long period may 
elapse before the same metamorphosis will be effected in 
the home and its surroundings as has been effected in the 
jail, we can at least say that the days of ignorance and of 
half-knowledge have gone by, and that the broad princi- 
ples of sound sanitation are now so clearly defined, that it 
only requires time, money, and an ever-widening appreci- 
ation of the advantages to be gained, to have them fully 
and fairly carried out. 
And here I may be permitted to observe that there is 
no writer of modern times who has done so much and 
striven so earnestly to instill these principles into the 
public mind as Dr. Richardson, true though it be that all 
the details so forcibly set forth in his " Hygeia" are never 
likely to be realized, nor, indeed, are they absolutely re- 
quired. Still, it is well to insist upon high ideals, because 
they are the best encouragement to steady onward pro- 
gress. So far as health is concerned, a kitchen on the 
third floor is greatly to be preferred to a kitchen on the 
basement and directly under the living rooms, but it 
would be quite as healthy to have it built in a separate 
back wing, as is done in many of the middle class houses 
which have recently been erected. 
In house construction there is ample scope for architec- 
tural variety without adhering too closely to any model, SITE. 
225 
and in the following remarks it will be my endeavor to 
set forth such sound principles of sanitation, as have 
received general authoritative acceptance, and to point 
out at the same time how they may be applied to remove 
existing defects. 
I. Site. 
Unfortunately it is only the privileged few who have 
the advantage of selecting a site for a new ho*use, but 
most people have the opportunity of choosing a locality 
or situation, where they intend to live; and in either case, 
there are certain important points which ought always to 
receive due consideration. In the first place, the soil 
should be dry, and if not perfectly dry it should be well 
drained. The healthiest soils are gravel, chalk, marl, and 
the looser limestone formations; but even the best soils 
may very soon be rendered unwholesome by imperfect or 
defective house drainage. Dampness of soil induces rheu- 
matism, bronchitis, colds, and it is largely associated with 
that fatal disease, consumption. There is no.doubt, too, 
that before the land was so well drained as it is now, it 
was the principal cause of ague, which was once so com- 
mon and now so rare. In country districts many of the 
cottages are built against sloping banks, with mud or 
brick floors resting directly on the damp soil;-as far as 
possible these ought always to be avoided, because they 
are very unhealthy. 
In the neighborhood of large towns, there is another 
serious evil which has to be guarded against, and that is, 
building houses on what is called made-up ground. There 
are whole streets of houses in Liverpool, London, and 
many other cities and towns, which have been erected on 
vast accumulations of rubbish which has been used to fill 
up the excavations made in brick-making; and the un- 
wholesomeness of such sites may well be imagined, when 
it is explained that this rubbish consists for the most part 
15 226 
THE HOME AND ITS SURROUNDINGS. 
of ashes containing decaying animal and vegetable matter, 
street-sweepings, road-scrapings, and refuse of every de- 
scription. It is not considered safe to build on such 
made-up ground until after a lapse of at least two or 
three years, and not even then unless it has been well 
drained and covered with an impermeable layer of con- 
crete. 
Then, again, it need hardly be pointed out that all 
hollows or low-lying localities, where water is likely to 
lodge, are objectionable, and so is the immediate neigh- 
borhood of sluggish streams and marshy estuaries, because 
in all such localities, not only is the subsoil damp, but the 
air itself is moist, and there is frequent liability to fogs. 
For these and other reasons, the best situation for a house 
is on rising ground or the slope of a hill, with trees in the 
immediate neighborhood, but not so close as to interfere 
with the free movement of the surrounding air. The 
aspect will very likely be influenced in great measure by 
the view to be obtained from the front windows, but it is 
preferable that the house should face east or south-east, 
because the morning rays of the sun penetrate to the front 
rooms, and in the afternoon they cheer those at the back. 
When, on the other hand, the house faces south, the front 
rooms are overheated in summer by the rays of the noon- 
tide sun, while those at the back are deprived altogether 
of direct sunlight. Many people have an objection to 
direct sunlight in rooms, because of its fading effect on 
the colors of carpets and curtains, but that may be guarded 
against by proper selection of blinds, and in any case, the 
gain to health should overrule any possible damage to 
furniture. 
As regards other considerations, it may be said gener- 
ally that the country is healthier than the town, and the 
suburbs, especially those situated on rising ground, are 
more suitable as places of residence than the interior of SITE. 
227 
the town. People, however, should hesitate before they 
choose a site or dwelling in an unfinished suburb, where 
there is no proper scheme of drainage or water supply. 
It is also obvious that squares, terraces, and avenues are 
preferable to streets, and wide streets to narrow streets, or 
close alleys and lanes. Other things being equal, a de- 
tached house is to be preferred to one semi-detached, and 
both to one in a street or row; but, in any case, there 
should always, where possible, be a certain amount of 
open, or garden, space behind, if not in front of the 
house. Houses which are built back to back should 
always be avoided, because any approach to proper ven- 
tilation is impossible; and for the same reason, houses 
which have no back doors are also objectionable. When 
it comes to be a question of living in tenements or 
lodgings, it need hardly be said that cleanliness and or- 
derly neighbors should largely influence the selection of 
dwelling, in addition to considerations of rental and situ- 
ation. Those who wish to maintain a clean and healthy 
home, should keep an eye on the sanitary condition of 
adjacent premises, and should avoid the close proximity 
of factories or other places where offensive trades are 
carried on. 
In localities which are not provided with a public water 
supply, no site should be selected, unless it is quite certain 
that a sufficient supply of pure water can be obtained; 
and, indeed, by virtue of an Act passed last session, which 
applies more particularly to rural districts, no new house 
can be occupied, nor any house which has been rebuilt, 
unless a certificate is first obtained from the Sanitary 
Authority as regards the sufficiency and wholesomeness 
of this necessary of life. All persons, therefore, who 
intend to build in the country should first make sure of 
their water supply, either by sinking a well or otherwise, 
before they commence building operations. And here it 228 
THE HOME AND ITS SURROUNDINGS. 
may be serviceable to point out that in all urban districts, 
or in rural districts which have been granted urban 
powers by the Local Government Board, all plans for new 
houses, or houses which have to be remodeled or rebuilt, 
have to be submitted for approval to the Sanitary Au- 
thority of the district, who are empowered to enforce 
certain conditions in respect to site, open space, structural 
details, ventilation, drainage, and the like. This is a very 
wise provision, and it is much to be regretted that it does 
not apply to every rural as well as to every urban district. 
As regards other special sanitary conditions which 
ought to be carefully kept in view in the selection of a 
house, these will be more conveniently considered further 
on. 
II. Structural Details. 
In building a house, the work ought not to be com- 
menced until all the details of drainage, water supply, 
ventilation, heating, lighting, and warming are clearly 
indicated in the plans and specifications of the architect ; 
because it too often happens that, from inattention to these 
important details, and especially as regards drainage and 
ventilation, the house, after it has been finished, cannot 
be inhabited with safety until many and costly alterations 
have been made, which ought never to have been required. 
I am afraid that it still remains true that architects are 
too apt to sacrifice sanitary requirements to the exigencies 
of style, and over and over again I have been called upon 
to inspect new houses, in whose erection no money was 
spared or grudged, but in which illness had cropped up, 
or foul smells had been complained of, not long after they 
had been occupied, and generally through some glaring 
mistake connected with drainage. 
Having selected a healthy situation, and taken care 
that dryness of the subsoil has been secured by proper 
drainage if there is any tendency to dampness, the next 229 
important point, after laying the foundations, is to lay a 
bed of concrete over the whole site, in order to prevent 
any exhalations of the air which is contained in the inter- 
stices of the soil. Gases of all kinds will find their way 
through the soil into houses, and especially if the soil is 
porous. Even as regards cottages, a bed of concrete will 
greatly modify the effects of positions which in some re- 
spects may be objectionable, and prevent much of the 
dampness and malarial mischief to which the inmates of 
cottages are too frequently exposed. Unless it is abso- 
lutely necessary, no drain should ever traverse the base- 
ment of a house; but when it cannot well be avoided, as 
when houses are joined together in streets and squares, 
every such drain should be made absolutely air and water 
tight. It should be constructed of glazed earthenware 
pipes, laid on a bed of concrete, securely jointed, covered 
with concrete, and provided with full means of ventilation 
and inspection at either side of the basement. When 
such drains have to pass through foundation walls, arches 
should be thrown over them to prevent any breakage 
should there be any subsequent settlement. 
In order to prevent damp from rising into the walls- 
and there is great risk of this when the bricks are porous 
-a damp-proof course should be laid over the whole of 
the foundations about a foot or so above the level of the 
ground. Two or three courses of slate laid in cement will 
answer the purpose, or a course or two of enamelled 
bricks; but the best articles for the purpose are vitrified 
stoneware tiles about one inch and a half thick, and per- 
forated in order to secure free ventilation beneath the 
joists of the floor. When these tiles are not used, it is 
essential to insert perforated bricks at proper intervals for 
ventilation, otherwise the timbers will become liable to 
dry rot. In houses where no damp-proof course has been 
provided, it not unfrequently happens that the ground 
STRUCTURAL DETAILS. 230 
THE HOME AND ITS SURROUNDINGS. 
wet will rise through the bricks to a height of ten or 
twenty feet, and sometimes higher. The entrance of 
underground damp may also be prevented by constructing 
what are called dry areas-that is, by leaving a space be- 
tween the main wall and a thin outer wall, the two being 
joined together by stretching bricks. The great majority 
of old houses and many new ones have foundation or 
basement walls without dry areas of any kind, and the 
consequence is that the water from the saturated earth 
which abuts against them, is constantly trickling through 
them. The bottom of the dry area should be concreted 
over and drained, and means should be provided for ven- 
tilation, otherwise foul air will very likely accumulate in 
the open space between the walls. 
The ground floor of a house should not be below the 
level of the road, street, or ground outside. Kitchens in 
the basement story are always inconvenient and dingy, 
generally more or less unhealthy, and, owing to their situ- 
ation, permit the smells of cooking to ascend all through 
the house. Bedrooms for servants in the basement are 
still more objectionable. They are always dark, badly 
ventilated, stuffy, and close, and though they are to be 
found in this situation in many of the best class houses in 
London and other large towns, there can be little doubt 
that they are detrimental to health. Indeed, it cannot be 
too strongly insisted on, that free ventilation and suffi- 
ciency of light are impossible in underground basement 
stories, and they should only be used for wine-cellars, 
coal-cellars, and lumber-rooms. 
Without relegating the kitchen and servants' rooms to 
the upper story, as proposed by Dr. Richardson, a more 
convenient and equally healthy plan, as already pointed 
out, is to build the kitchen, larder, scullery, and other 
offices, in a distinct offshoot, or wing, behind the house, 
and on the ground floor. STRUCTURAL DETAILS. 
231 
The bedrooms for servants may then be built over the 
kitchen, and can be approached by a separate staircase. 
Kitchen wings of this description are found in many of 
the best class houses in the suburbs of Leamington and 
elsewhere, and possess the special advantages of conveni- 
ence in administration without any of the disadvantages 
attaching to underground kitchens. 
Reverting now to the structure of the walls and other 
details, it has to be pointed out that as much of the damp- 
ness of brick walls depends upon driving wet, the walls 
of a well-planned house ought to be built hollow, with 
binding bricks laid in at regular intervals to render the 
strength and stability of the twin walls equivalent to 
strong single walls. Many kinds of bricks are so soft and 
porous that a single brick will absorb nearly a pound of 
water, and when single walls are built of such materials, 
it is impossible to keep out driving wet, unless they are 
slated or tiled over, or coated on the outside with one or 
other of the several waterproof silicate compositions which 
are well recommended. Sometimes glazed bricks are used 
for outside walls, but all materials which prevent the 
entrance of driving wet likewise prevent the exudation of 
any moisture which is sure to collect in the inner portions 
of the walls, and this moisture will make itself apparent 
on the internal surfaces. As Professor Pettenkofer of 
Munich has pointed out, impervious walls resemble india- 
rubber textures in this respect, that while they protect 
from wet without, they generate dampness in the interior 
by impeding the exchange of inside and outside air, and 
thereby preventing evaporation. The healthiest kind of 
walls, therefore, are hollow walls constructed as described. 
They render a house cool in summer and warm in winter, 
and, owing to their porosity, are readily cleared of mois- 
ture. For the reasons just stated, it is also obvious that 
interior walls should not be painted or varnished over. 232 
THE HOME AND ITS SURROUNDINGS. 
It is much preferable that they should be merely dis- 
tempered, and by means of stencilling or water-color 
painting as much flat ornamentation can be obtained as 
need be desired. Ordinary plastering will not render the 
walls impermeable, but when they are painted, or covered 
over with thick papers, or varnished, they should be 
specially well ventilated. 
It is needless to say that the rooms of a well-planned, 
healthy house, should be lofty, airy, and light. The win- 
dows should reach to near the ceiling, and should be made 
to open at top and bottom. If it be desired to secure 
extr^a warmth, plate glass should be preferred. No single 
bedroom should contain less than 1000 cubic feet, nor 
should any bedstead be fixed in a recess. Indeed, there 
should be as few recesses and dark corners as possible, 
and far more consideration ought to be paid to the bed- 
room accommodation of servants than hitherto has been 
the custom. As already stated, they have often either to 
sleep in dark, stifling, underground catacombs, or they 
have to huddle in attics, frequently under the bare rafters, 
where they are perished in winter and suffocated in 
summer. Bedrooms in attics should always be ceiled and 
plastered, have an average height of not less than eight 
feet, and if no fireplace is provided, they should have a 
special ventilating shaft and be well lighted. 
In order to economize heat and secure warmth, it is a 
good plan to arrange the chimney-stacks or flues as near 
the centre of the house as practicable, and for purposes 
of ventilation it is very desirable that alongside the 
chimney-flues, there should be built in the chimney-stacks 
a separate flue opening near the ceiling into every room. 
These flues act as very efficient extraction shafts, because, 
being warmed by contiguous chimney-flues, a constant 
upward current of air from the different rooms is induced. 
As a further assistance to efficient ventilation hall space STRUCTURAL DETAILS. 
233 
is very valuable, and the hall should have a back as well 
as a front entrance. If the hall is also warmed by a ven- 
tilating stove or grate, or hot water pipes, and the rooms 
ventilated as described, it may be made to form the base 
of a large ventilating shaft, which may be louvred or ven- 
tilated by a skylight in the roof, and in which the stair- 
case and separate landings are placed. And here it may 
be pointed out that among stoves which are well adapted 
for warming and ventilating halls, may be mentioned 
Pierce's Pyro-pneumatic Stove, Musgrave's Slow Combus- 
tion Stove, Bond's Euthermic Stove, and George's Calorigen 
Stove. When these arrangements with regard to ventila- 
tion of rooms, and the warming of the hall itself are not 
adopted, this plan, though affording an efficient upcast 
shaft, is apt. to convey vitiated air from the rooms below 
to the bedrooms above, and to create unpleasant draughts 
on the staircase and landings. 
Another very important detail in the construction of 
new houses is the situation of water-closets. In large 
numbers of old houses, and even in many which have 
recently been built, the closet is placed somewhere in the 
interior of the house, where it cannot be properly lighted, 
and where adequate ventilation is next to impossible. It 
is here that sewer gas finds a ready entrance, in spite of 
trapping and so-called attempts at drain ventilation, and 
the amount of preventable disease and death which has 
been traced to this cause in all parts of the country is so 
enormous that it could hardly be credited, even if exact 
statistics could be placed before the reader. 
The best of all positions for water-closets is to erect 
them in an isolated block, built tower fashion, and abut- 
ting against an outer back wall of the house, with a closet 
on e'ach floor if deemed necessary, and the supply cistern 
on the top. There should be a small ante-room or passage 
between each closet and the house, but large enough to 234 
TIIE HOME AND ITS SURROUNDINGS. 
admit of sufficient cross-ventilation by means of open 
windows, windows with ventilating panes, or special ven- 
tilators. A double set of doors would be required-one 
leading into the house, which might be a swing door, and 
the other cutting off the passage from the closet. The 
closet itself should be well lighted by a window having 
double sashes, and extending up to the ceiling; and in 
order to ensure that it shall always be well ventilated, it 
is a very good plan to keep the top half of the window 
permanently nailed open for some distance. This is espe- 
cially necessary when the closet is not cut off from the rest 
of the house as here recommended, because any foul 
effluvia are much more likely to be drawn into the house 
on account of the inequality of the inside and outside 
temperature, and particularly during cold weather. Addi- 
tional ventilation may be secured by inserting perforated 
air-bricks in the outer walls, and close to the ceiling. In 
smaller-sized houses the closet may be simply projected 
from the building, with the seat facing the door, and with 
two opposite windows reaching to the ceiling, and situated 
between the seat and the door, both of which ought also 
to be kept fastened down for some distance. Cross-ven- 
tilation and sufficient light would thus be obtained without 
the interposition of an ante-room. When either of these 
precautions with regard to the situation of the closet is 
not adopted, it should be situated against an outside wall 
so that the soil-pipe can always be carried outside, and 
ventilated by a special pipe reaching above the eaves, and 
of the same calibre as the soil-pipe. Most of the ventila- 
ting pipes which plumbers attach to soil-pipes are far too 
small, and in consequence of their size, and the acute 
angles at which they are often bent, they are practically 
useless. They ought, at least, to be three or even four 
inches in diameter, and should be carried straight above 
the eaves, or with as few bendings as possible. The soil- STRUCTURAL DETAILS. 
235 
pipe itself should never be plastered or built into the wall, 
but should be left free for inspection throughout its whole 
length. Of course, it may be boarded in, but the boards 
should only be screwed on, so that they could at any time 
be readily removed. Moreover, the soil-pipe should not be 
made of lead, because the lead is apt to become corroded 
by sewer gas, but it should be made of iron or earthen- 
ware, and should not exceed four inches in diameter. 
As regards the closet apparatus, there are now so many 
patents so well arranged in all their details, that it is 
difficult to say which of them are most deserving of re- 
commendation. There are others, again, such as the round 
hopper closet-pan fixed into an ordinary sigmoidal bend, 
or the ordinary closet-pan with foul D-trap, which cannot 
be sufficiently condemned. Generally speaking, those 
closets are the best which provide for efficient and rapid 
flushing without permitting reflux of foul air, and which 
contain a sufficiency of water at all times. Every de- 
tached closet should be provided with a cistern, preferably 
of the waste-preventing class, because it is of the utmost 
importance that there should be no direct connection 
between the closet-pan and the water-main-an arrange- 
ment, however, which is still allowed to prevail in many 
towns. In localities where there is no public water supply, 
the closet is sometimes flushed by a bucket or pail, but in 
these cases it is preferable to provide a large cistern for 
the collection of roof-water, otherwise the flushing is apt 
to be imperfect, and at times neglected altogether. Of 
course, the cistern can also be supplied by-a force-pump; 
but whenever there is any difficulty about water, some form 
of dry closet ought to be adopted instead. But whether 
the water be derived from a public supply or from a well, 
it should always be borne in mind that the same cistern 
which supplies the closet ought on no account to supply 
the drinking water, otherwise the sewer gases from the 236 
THE HOME AND ITS SURROUNDINGS. 
closet are liable to become absorbed by the water in the 
cistern to such an extent as to render it highly polluted, 
and altogether unfit for use. 
Without entering with undue minuteness into.these 
somewhat unsavory details, it may be said generally that 
the closet-pan should be roomy, and be made of white 
glazed earthenware; and the seat should be so framed as 
to come asunder readily to permit of inspection. Among 
closets which have been found to work very well may be 
mentioned the "Excelsior Water-Closet," manufactured by 
Mr. Bostel, Brighton, which has gained the medal of the 
Sanitary Institute of Great Britain; several kinds of 
closets patented by Mr. Jennings; Banner's Closet; Minn's 
Closet; and Dodd's Closet, of Liverpool.* The flush-pipes 
leading from the cistern ought to be, at least, one inch 
and a half in diameter, to ensure a good rush of water. 
The only kind of closet which can be tolerated inside a 
house is a water-closet, for even a dry-earth closet indoors 
is objectionable, on account of the scavenging which it 
entails, unless it is placed against an outside wall on the 
ground floor, and an opening is provided with a door 
through which the pail or pan can be readily removed. 
Outside closets, other than water-closets, should be so 
situated and constructed as to not be productive of offen- 
sive nuisance of any kind. The old-fashioned kind of 
closet, with its foetid cess-pit behind, is always more or less 
of a nuisance, no matter where it is situated, and should 
be done away with altogether. It is especially objection- 
able in connection with schools in rural districts, and I 
have often traced. serious outbreaks of disease among the 
children to the foul effluvia which it generates. Very 
* Of the varieties here spoken of, Jenning's Water-Closets are used to some extent 
in the United States, and can be readily procured in all our large cities. Several 
other patterns are, however, more highly esteemed, and among these may be men- 
tioned Hellyer's, and also Rhoads' Cistern, water-closets. The latter form seems to 
combine all the chief desiderata of a perfect water-closet to an unusual extent.-(.R.) STRUCTURAL DETAILS. 
237 
frequently there is an ash-pit built in connection with the 
closet, but as a rule, this is always too large and too deep, 
permitting of unwholesome accumulations and the en- 
trance of surface-water. If an ash-closet is to be tolerated 
at all, it should be made small, shallow, and should have 
a covering over it to keep out the wet, and sifted ashes or 
dry earth should be used in sufficient quantities to prevent 
any smell. But by far the best kind of outdoor closet is 
one in which a galvanized iron pail or box is used, and 
either dry earth or ashes\dded by special apparatus, such 
as in Moule's Closet, Parker's Closet, or Moser's Closet,* or 
the apparatus may be dispensed with, and the dry earth 
or sifted ashes be supplied from an ordinary receptacle 
placed in the closet. The advantages of using a pail or 
box are twofold, because, in the first place, all soaking 
into the surrounding §oil is obviated, and in the second 
place, frequent and regular scavenging becomes necessary, 
thereby preventing any undue accumulation of foul mat- 
ters near the dwelling. These matters can either be at 
once dug into the garden, disposed of as manure, or they 
can be stored in a remote corner of the garden by digging 
a hole and covering them over with a layer of garden 
mould. 
Bath-rooms and lavatories can be placed where most 
convenient, but it is desirable that they should not be in 
too close proximity to water-closets, and that they should 
be situated on the bedroom floors. The waste-pipes from 
them should never be made to discharge directly into the 
soil-pipe or drain, but should always be carried outside 
and disconnected. 
* Moule's Closets were patented some years since, in the United States, and have 
been largely manufactured by the Hartford (Conn.) Earth Closet Company. Prac- 
tical difficulties, however, in regard to the procuring and subsequent disposal of the 
great amount of dry earth required, seem to have seriously interfered with the suc- 
cess of the enterprise in this country.-(K.) 238 
THE HOME AND ITS SURROUNDINGS. 
III. Drainage. 
It has already been pointed out that, unless when abso- 
lutely necessary, no drain should traverse the basement 
of the house, and when it does become necessary, special 
precautions which have previously been described should 
be adopted. But unfortunately in almost all towns the 
main sewer into which contiguous houses drain is laid 
under the street, and consequently the house-drains have 
to be carried under the houses to discharge into the sewer. 
A much better plan is to construct the main sewer along 
the backs of houses, because by this arrangement the 
house-drains can be laid directly away from the houses, 
and the pipes from sinks, sculleries, bath-rooms, and 
closets, can all be made to discharge without difficulty in 
the rear. If the public sewer is not behind the house it 
is advisable, if possible, to carry the house-drains round 
the house rather than under the basement; but in any 
case the house-drains should be laid at a sufficient depth 
below the basement to carry off all refuse-water and drain 
the cellars. It need hardly be said that they should be 
made of glazed earthenware socket-pipes, well laid, se- 
curely jointed, and with a proper fall. The main drain 
into which the soil-pipe discharges should be trapped and 
disconnected from the main sewer at some point outside 
the outer wall, and it is highly desirable that it should 
also be ventilated at this point by a special pipe, or by 
some contrivance such as Pott's Trap, Banner's Trap, 
Buchan's Trap, or Ayeaver's Ventilated Syphon Trap.* All 
other pipes, such as sink-pipes, scullery-pipes, pipes from 
lavatory or baths, and rain-water-pipes, should be carried 
outside the walls of the house, and be made to discharge 
* With us Dubois' Drawn Lead Trap, and Low's Cast Trap (both ventilating traps,) 
and Bower's Ball Trap (which should only be resorted to when due ventilation is 
impossible) are more frequently employed.-(R.) DRAINAGE. 
239 
in the open air on to trapped gratings communicating 
with the house-drains. By adopting these precautions 
any ingress of foul air through these channels is obviated; 
and if the house-drains themselves are efficiently discon- 
nected, trapped, and ventilated as indicated, the risks from 
the contamination of the air of the house by sewer gas 
are reduced to a minimum. There is, however, another 
important precaution which has to be pointed out. In 
houses with underground cellars, there are generally to 
be found one or more trapped openings communicating 
directly with the house-drains, and it too frequently hap- 
pens that the traps become practically useless, because 
the water in them speedily evaporates and is not replen- 
ished. Every cellar-drain, therefore, should be discon- 
nected outside the wall of the house by constructing a 
special dry area, if there is no open area round the house, 
and ventilating the house-drain by a special pipe at the 
point of disconnection. 
As already indicated, all ventilating pipes should be at 
least three inches in diameter, and should be carried 
above the eaves. It has been urged, by way of objection 
to this plan, that where houses are closely packed together, 
and are of different elevations, the sewer gases discharged 
from the ventilating pipes of the lower houses weuld find 
their way into the higher, and thus become not only a 
nuisance, but a source of danger. With ample sewer 
ventilation, however, the objection does not hold good, 
because, when public sewers are well ventilated and kept 
properly flushed, the sewer air is so diluted as to be inof- 
fensive and comparatively pure; besides, in. cases where 
it is proved to be offensive-and, so far as my own ex- 
perience goes, these are very rare-some such mutual 
arrangements as are adopted with regard to offensive 
chimneys, would meet the difficulty. Hitherto the rain- 
water-pipes have been largely used as ventilating shafts, 240 
THE HOME AND ITS SURROUNDINGS. 
and for that purpose, or for convenience, have been laid 
directly into the house-drains; but the plan is highly 
objectionable, because in most cases their upper ends open 
very near to windows, and also because they are least 
efficient as ventilators when they are most required-that 
is, when there is a heavy fall of rain. The rush of water 
down them, while it displaces the air in the house-drains 
and sewers, prevents the air from ascending through these 
channels so long as the rain continues. 
And now a word or two with regard to traps. That 
too much reliance has been placed by architects and 
builders on the efficacy of these contrivances for the 
exclusion of sewer air from houses, is becoming every 
day more and more evident. Up till quite recently, no 
adequate provision was made for drain or sewer ventila- 
tion, and the consequence was that mechanical ingenuity 
has been taxed to the uttermost to prevent the pent-up 
sewer gases from forcing their way through the terminals 
of drains, which, for the most part, were situated inside 
houses. When hot water is poured down a drain, or when 
a sewer becomes suddenly charged with a large volume 
of water, as after a heavy fall of rain, the forces which 
are brought to bear within the sewer are far greater than 
the resisting power of any trap, and consequently the 
displaced gases often make their escape at points where 
they are the most dangerous. There are few traps whose 
resisting power exceeds that of a column of water an 
inch and a half in depth; indeed, the greater number of 
them, as, for example, common bell-traps, have only a 
resisting pow.er of about one quarter of an inch. Besides, 
it should be remembered that the water in an otherwise 
very efficient trap will absorb sewer gas on the one side, 
and discharge it but little changed on the other. All 
traps, therefore, should be regarded as at the best auxili- 
aries only; for in no case will they afford protection D RAINA GE. 
241 
against the ingress of foul air, if proper ventilation be ne- 
glected between the trap and the sewer. Some traps, 
again, such as the common bell-trap, are worse than use- 
less, because they are readily removed, often forgotten to 
be replaced, and are easily broken. The most useful are 
either of what is called the mid-feather description, with 
one or more partitions dipping into the water, or con- 
structed on the syphon principle; but in any case, their 
efficiency depends entirely on the continuous presence of 
water in the trap. They should be so situated and so 
constructed as to admit of ready inspection, and they 
should be examined and cleaned out at regular intervals. 
Sink-pipes, even when disconnected outside and made to 
discharge on to an open grating, should be provided with 
article-intercepting traps, and all bath and lavatory pipes, 
although disconnected in the same way, should be syphon- 
trapped to prevent the entrance of cold air. 
In addition to* sound construction, efficient ventilation 
and trapping, it need hardly be added that the drains 
themselves should always be kept well flushed. The 
special points with regard to drainage which should be 
inquired into before occupying a house which has already 
been tenanted, although generally indicated by the details 
which have just been submitted, will be more particularly 
alluded to in a subsequent page. 
The next important question for consideration is the 
disposal of the sewage. In towns and suburban districts 
where public sewers have been constructed, all that is re- 
quired is to lay the house-drains into them; but as regards 
scattered houses provided with water-closets, or houses 
situated in villages where there is no proper system of 
drainage, a cesspool is required to receive the sewage. 
This should be situated at a considerable distance from 
the building, and at a safe distance from the well. It 
should be made perfectly water-tight, by constructing the 
16 242 
THE HOME AND ITS SURROUNDINGS. 
walls of cement, or brick-work set in cement and sur- 
rounded with clay puddle. Both roof and bottom should 
be arched, the roof provided with a man-hole and properly 
ventilated, and the bottom built with a fall towards one 
end, where a chain-pump could be fixed. The depth 
should not exceed six or seven feet, otherwise the increased 
hydrostatic pressure would necessitate expensive walling. 
To separate the solids from the liquids, a galvanized iron 
wire diaphragm or grating, should divide the tank into 
two parts. All cesspools should be regularly and fre- 
quently cleaned out, and it is of the utmost importance, 
as already pointed out, that the house-drains leading into 
them should be efficiently trapped and ventilated. If the 
cesspool is situated in a field or orchard some distance 
from the house, the liquid contents can frequently be 
satisfactorily disposed of by' constructing an overflow-pipe 
leading into sub-irrigation drains, either with or without 
a flush-tank. These subirrigation drains are made of 
loose tiles, laid about a foot beneath the surface, so as to 
permit of the sewage oozing into the soil, while the flush- 
tank devised by Mr. Roger Field, C. E., acting by means 
of a syphon, empties itself whenever it becomes full. 
When the sewage has to be pumped out, either a hose or 
a small tank on wheels will be required, and it can then 
be utilized in any part of the orchard or garden. No 
rain-water or subsoil drainage should be allowed to enter 
the cesspool, otherwise the difficulty of dealing with the 
sewage will be greatly increased. Although cesspools 
constructed on these principles may be rendered entirely 
free from danger, they should only be adopted for isolated 
houses, and wherever there is a public sewer within easy 
distance, they should be abolished altogether; 
With regard to the disposal of mere slop-water from 
isolated houses not provided with water-closets, the diffi- 
culties are materially lessened. In villages, the slops are WATER SUPPLY. 
243 
generally made to discharge, by very imperfect drains, 
into the old road-drains; but as it is very seldom that any 
of these drains enter houses, the principal danger is soakage 
into neighboring wells. Where there is sufficient garden 
space, and the ground slopes away from the house, they 
can be got rid of without much trouble, and in many cases 
they can be made to discharge into some neighboring 
ditch without creating nuisance; but in every instance 
where there is danger to a well, the drains should be care- 
fully laid, properly jointed, and always kept well flushed. 
IV. Water Supply. 
It has already been shown in Chapter III. what a large 
amount of preventable disease depends upon impure water, 
and especially when the impurity is of animal origin. 
Outbreaks of cholera, typhoid or low fever, diarrhoea, 
dysentery, diphtheria, ulcerated sore throat, and minor 
ailments, have over and over again been traced to this 
source, and it therefore behoves every householder to 
assure himself that his water supply is uncontaminated 
and otherwise fit for use, and that the quantity is sufficient 
for every purpose of health and cleanliness. 
In towns provided with a public water supply, the 
amount consumed, including the quantity required for 
trade and municipal purposes, is estimated at about 
twenty gallons for every inhabitant daily, when there is 
no undue waste; but in many towns the actual amount 
varies between thirty and forty gallons. On the other 
hand, in villages and outlying districts, where water is by 
no means plentiful, the amount very often does not ex- 
ceed three gallons per head daily; but this is not sufficient, 
and cleanliness of person and home cannot be maintained. 
Public water supplies are regulated either on the con- 
stant, or what is called the intermittent, system, the former 
implying that the public mains are always kept fully 244 
THE HOME AND ITS SURROUNDINGS. 
charged, and the latter that they are only charged during 
a certain number of hours out of the twenty-four.* The 
intermittent system, therefore, necessitates storage in 
house-cisterns, and is otherwise attended by so many dis- 
advantages that the constant system should always be 
adopted wherever it can be carried out. The use of cis- 
terns, except on a small scale for water-closets and boilers, 
is open to the great objection of the risk of contamination 
of the water; for not only are they liable to become fouled 
if not sufficiently protected against the entrance of aerial 
impurities, but the water is apt to become tainted with 
sewer gases if the • same cistern is used to supply the 
drinking-water which supplies the closet, or if care is not 
taken that the overflow-pipe does not discharge directly 
into the soil-pipe or house-drain. Moreover, in poorer 
districts, the cisterns are often of a very inferior descrip- 
tion, are badly situated, and are rarely inspected or cleaned 
out; or it frequently happens that there are no cisterns at 
all, and the water has to be stored in buckets and other 
open vessels which are not always clean and do not keep 
out dust. It is further urged against the intermittent 
system, that the distribution pipes and public mains being 
alternately charged and empty, are liable to become cor- 
roded, collect dirt, and permit the entrance of gases from 
sewers, drains, or neighboring gas-mains. In every respect, 
therefore, the constant system is to be preferred to the 
intermittent system, and provided there are proper fittings, 
strict regulations, and efficient supervision, a constant 
supply requires a less amount of water than an uncon- 
trolled intermittent supply, so that on the score of economy 
alone it should always be adopted by public authorities. 
In many towns, however, the. house-fittings are so im- 
perfect that the intermittent system is still carried on, 
* This intermittent plan of water supply, with its imminent risk of water contami- 
nation, both direct and indirect, is fortunately almost unknown in America.-(B.) WATER SUPPLY. 
245 
because the waste from leaky taps would be enormous, and 
thus a certain amount of storage in every house becomes 
necessary. In other words, one or more cisterns must be 
provided, and with regard to these, special precautions are 
essential. In the first place, it is of the utmost importance, 
as already stated, that the cistern which supplies the closet 
should not supply the drinking-water, otherwise there is 
the constant risk of contamination of the water by foul 
air; in the second place, the overflow-pipe from the cistern 
which supplies the drinking-water should be carried out- 
side and made to discharge in the open, either on to a 
trapped grating or on to some rain-gutter under the eaves; 
and, in the third place, the cistern should be properly 
constructed, conveniently situated for inspection, and 
thoroughly cleaned out at least once in three months. 
The best materials for construction are slate-slabs well set 
in cement, or galvanized iron. Leaden cisterns are always 
objectionable, and especially if the water is soft. All 
cisterns should be covered in, and protected from heat and 
frost. The inlet to every cistern ought to have a- valve- 
cock, with a float to rise and stop the supply when the 
cistern is full; and the overflow should be so exposed as 
to be at once detected, to prevent waste. When the sup- 
ply is intermittent, well-arranged houses ought to be pro- 
vided with at least three. cisterns-one to be exclusively 
used for drinking-water and cooking purposes, one for 
general household purposes, and one or more for closets. 
All water-pipes leading from mains should be so ar- 
ranged that they can be readily examined, whether inside 
or outside the house; and it is very desirable too that 
there should be a stop-cock on the private main leading 
to the house, by means of which the water can be cut off 
when any of the pipes burst or become leaky. The pipes 
themselves should be tinned, if not made of iron through- 
out their whole lengths, and they should be protected 246 
THE HOME AND ITS SURROUNDINGS. 
from frost and direct heat of the sun when carried up out- 
side the walls. 
In towns supplied on the constant system, storage to any 
extent is not required, but cisterns are necessary for 
closets, and these should be of small dimensions, and of 
what is called the waste-preventing kind. The water used 
for drinking and other purposes should be drawn directly 
from the main, and the taps should have screw-down cocks 
to prevent leakage. 
Coming now to the consideration of the water supply 
available in rural districts, it may be said at the outset 
that this is often scanty, and, where plentiful, it is much 
more liable to pollution than when obtained from public 
sources. It is derived either from wells, springs, streams, 
ponds, or collected as rain-water from the roofs. Where 
the level of the underground water is within easy reach 
of the surface, pump-wells or shallow dip-wells constitute 
the usual source of supply, and these, unfortunately, are 
liable to become polluted in many ways. Shallow dip- 
wells are always objectionable because dirty vessels are 
often plunged into them, and they admit surface impurities 
far more readily than pump-wells; but wells of any kind, 
when sunk close to the houses, are often in dangerous 
proximity to leaky drains or cess-pits. Another source of 
danger is that the upper part of the well is seldom clay- 
puddled to a sufficient depth, nor is the covering so evenly 
and imperviously laid as to keep out slop-water. Fre- 
quently, too, a well, in other respects good, becomes ulti- 
mately polluted because it is never cleaned out; and I 
regard this periodic cleansing of wells so essential that I 
think every pump-well should be provided with a properly 
constructed man-hole for purposes of inspection and cleans- 
ing, and that the well should be cleansed at stated times. 
Any deep ash-pit, cess-pit, or other filth accumulation in 
the neighborhood of a well should be regarded as a dan- WATER SUPPLY. 
247 
gerous nuisance and at once removed, and special care 
should be taken that neighboring drains are properly con- 
structed and not leaky. Wells which are close to farm- 
yards often become polluted, and should always be re- 
garded with suspicion.* 
Specially fitted for use in rural districts are the-wells 
known as Norton's Abyssinian Tube-wells. They consist 
of narrow iron tubes driven or screwed into the ground 
in lengths, and with the lowest length perforated and 
pointed at the end. As no well is dug, the dangers arising 
from the entrance of surface impurities are entirely ob- 
viated, and they possess the further advantages of being 
driven into any good water-bearing seam which may be 
selected, of securing a sufficient yield in dry seasons, and 
of entailing comparatively little outlay either in their 
first cost or in sinking. The bore of the small tubes has 
a diameter of one inch and a quarter, and frequently a 
well sixty feet deep can be sunk in two days, which will 
yield an abundant supply of pure water within a few 
hours after completion.. For great depths, and through 
strata which cannot be pierced by percussion or displace- 
ment, boring would, of course, be necessary; but it may 
be said generally that wherever pump-wells are in use 
these tube-wells can be sunk. If the water-bearing seam 
consist of running or loose sand, the water will require 
filtering for some time after the well has been sunk, but 
in most cases the yield becomes quite clear after a very 
short period, so soon as a cavity of some size has been 
formed round the perforated point by suction of the sand. 
But there are many parts of the country where the 
geological formation is such that wells of any description 
* In many parts of our country privy-wells and cess-pits (the contents of which 
will sometimes soak diagonally through the earth for 80 or 100 feet, carrying the 
germs, perhaps, of cholera or typhoid fever) feed the drinking-water wells, and 
these latter in their turn feed the grave-yards of the villages and rural districts 
where such criminal poisoning of the water supply is allowed to occur.-(R.) 248 
THE HOME AND ITS SURROUNDINGS. 
are out of the question, and in these cases the supply must 
either depend on storage of the rainfall, neighboring 
streams, springs, ponds, or land-drains. The water from 
small streams and land-drains is generally more or less 
impure, and should always be carefully filtered, even when 
there is no suspicion of sewage pollution. Pond-water is 
also objectionable for drinking or cooking purposes. Rain- 
water, when properly stored,.though somewhat flat, is pure 
and wholesome, but as dust or other impurities are liable 
to collect on roofs, it should likewise be filtered before 
being used. If it is stored in an underground tank, the 
tank should be made water-tight by cement, ventilated, 
and any overflow-pipe should be carefully disconnected 
so as not to discharge directly into a drain. Very fre- 
quently the water in soft-water tanks becomes so horribly 
polluted in this way, that the water actually stinks when 
it is pumped out, and is utterly unfit even for washing 
purposes. Whenever it is used for drinking or cooking, 
the receptacle in which it is stored, whether tank, cask, or 
tub, should be kept scrupulously clean, and should be 
covered over, to prevent the entrance of aerial impurities. 
Villages in which the water supply is scanty should be 
provided, like towns, with a public supply, and Sanitary 
Authorities are empowered by the Legislature to carry 
out the necessary works; In accordance with the provi- 
sions of the Public Health (Water) Act, 1878, they can 
also compel the owner of any single house to furnish a 
proper supply, provided the cost does not exceed a certain 
amount, or they can give notice to owners of neighboring 
houses to join together to furnish a supply sufficient for 
those houses, if it can be done within certain limits of 
expenditure. Another very important clause of the same 
Act, as already pointed out, prohibits the occupation of 
any new house, or any house which has been rebuilt, un- 
less the Sanitary Authority of the district is first satisfied WATER SUPPLY. 
249 
that the water supply is sufficient in quantity and of good 
quality. 
And now a few words with regard to filters. The best 
filtering media are spongy iron and animal charcoal; 
and amongst filters to be commended may be mentioned, 
Bischoff's Spongy Iron Filters, Bond's Filters, Spencer's 
Carbide of Iron Filters, Atkin's Filters, and Lipscombe's 
Filters. All of these do their work very well, but they all 
require to be regularly cleaned, and if the filtering medium 
is charcoal, it should not only be carefully washed, but 
should occasionally be subjected to a red heat on a shovel 
or in a stove. To those who cannot afford to buy very 
expensive filters, the cheap charcoal bltjck filters may be 
recommended, or the small floating syphon filters devised 
by Dr. Bond. The latter are very portable and conve- 
nient, and are admirably suited for those who intend 
travelling abroad. The filter itself consists of a hollow 
metallic vessel, which may be placed in a pail, jar, or 
other convenient vessel, and from which it will filter the 
water at the rate of from one to several gallons a day. 
It can be readily regulated and cleaned; and as any sus- 
pended impurities are kept outside the filter and allowed 
to gravitate towards the bottom of the containing vessel, 
it is not liable to become clogged up. Another very 
cheap filter, as suggested by the late Dr. Parkes, may be 
improvised as follows:-Get a good-sized earthenware 
flower-pot; cover the hole with a small piece of zinc 
gauze, flannel, or perfectly clean sponge; then get some 
fine gravel, wash it well, and put it into the pot to a depth 
of about three inches; then procure white sand, wash it 
well, and add a layer of about the same depth; then buy 
some 2 lbs. of animal charcoal, wash it well in boiling 
water, lay it over the sand to a depth of about four inches, 
and press the whole well down. The filter is now ready 
for use, and all that is required is to place it over some 250 
vessel to catch the filtered water as it runs through. 
When the charcoal becomes clogged, it should be well 
washed in boiling water, and heated over the fire or in the 
oven; while the other layers can be renewed as required. 
But no matter how efficient a filter may be, it should 
always be remembered that mere filtering can never be 
depended on to purify a water which is contaminated 
with sewage or contains the germs of infectious disease. 
Such a water is altogether unfit for use, and should be 
avoided as poison. Whenever, therefore, there is any 
reason to suspect that a water is polluted in any way, it 
should either not be used at all, or, if used when no other 
water can be procured, it should always be boiled as well 
as filtered; and a sample should be at once submitted for 
analysis, or the case reported to the sanitary inspector of 
the district, in order that some definite action may be taken 
without delay. 
Although it is difficult to lay down any directions which 
may conveniently indicate the quality of water, the follow- 
ing hints may be useful:-A good water should be clear, 
colorless, tasteless, without any odor or dirty deposit, and 
free from floating filaments or particles. Any water which 
tastes bad, or has a disagreeable odor, or contains a dirty 
sediment, or floating particles, or becomes muddy after 
rain, is a suspicious water, and should always be boiled 
before being used. 
THE HOME AND ITS SURROUNDINGS. 
V. Ventilation, Warming, and Lighting. 
I place these three important essentials of a healthy- 
house in the same category, because their action and influ- 
ence are so interdependent-if I may use the phrase-that 
they cannot well be treated separately. I shall also avoid 
as far as possible dealing with doubtful theories or details 
by endeavoring to lay before the reader well-ascertained 
facts and principles, and explaining such expedients VENTILATION, WARMING, AND LIGHTING. 
251 
or contrivances as have been proved to work satisfac- 
torily. 
It has already been shown in Chapter III. that the air 
of a room may be vitiated in many ways-by the carbonic 
acid and effete matter given off by the lungs, by excessive 
moisture or excessive dryness, by foul effluvia, or by infec- 
tive germs or particles; but whatever the cause of dete- 
rioration, the cheapest and most effectual remedy is good 
ventilation-in other words, the foul air must be continu- 
ously removed and continuously replaced by fresh air. 
But in a climate so variable as ours, it likewise becomes 
evident that this interchange of air should take place 
without creating unpleasant draughts or discomfort of any 
kind. We have, therefore, to ascertain first-how much 
fresh air is required to keep the air in an inhabited room 
from becoming too close? and, secondly-at what rate can 
it enter without creating unpleasant draughts? and both 
these are problems in the solution of which the number 
of occupants and the size of the room must be taken into 
account. 
Now, without going into details, I may say at once that 
the broad results which have been arrived at by those who 
have experimented most largely on this subject, are these, 
and they apply specially to bedrooms:-(1) The .cubic 
space per head for every individual should be 1000 cubic 
feet-in other words, a bedroom ten feet square and ten 
feet high, ought only to contain one person; and (2) the 
amount of fresh air entering the room should be 3000 
cubic feet per hour for every occupant in order to prevent 
undue accumulation of the impurities of respiration, and 
avoid disagreeable draughts. 
These are the standards to be aimed at to secure com- 
fortable and well-ventilated bedrooms; but except it be 
in the better class of houses, I need hardly say that 
they are seldom or ever attained. And, indeed, even in THE HOME AND ITS SURROUNDINGS. 
252 
the best houses, as has already been pointed out, the kind 
of bedroom accommodation allotted to servants is too 
often a scandal and a shame. Their beds are too fre- 
quently placed in low attics, out-of-the-way corners, oi' 
basement dungeons, where the breathing space, and the 
most ordinary means of ventilation, are alike grossly in- 
sufficient. But in the homes of the poorer classes, .the 
cubic space for each individual, instead of approaching to 
1000 feet, in numbers of cases does not amount to 200 
feet. In common lodging-houses, the minimum is fixed 
at 300 feet, not because this space is sufficient to meet the 
requirements of sound health, but because a larger space 
cannot be fairly insisted on when the house-accommoda- 
tion of the general population is taken into account. The 
rule should be-try and get 1000 cubic feet of sleeping 
space for each person if it can be obtained, and do not 
keep a spare bedroom in the house unoccupied if the ave- 
rage space without this room is reduced to below 600 
cubic feet. 
And now a few words with regard to the ventilation of 
bedrooms. I need not say that every bedroom window 
should be made to open. If there is no fireplace, there 
should always, if possible, be some other opening: and in 
the majority of cases, it will be found that such an open- 
ing could be readily made into the chimney flue proceed- 
ing from the room beneath, by inserting what is called an 
Arnott's Ventilator or Crossley's Valve near the ceiling. 
Both of these ventilators are so arranged that they per- 
mit the escape of foul air up the chimney, but at once 
close if there is any down draught, and thus prevent the 
entrance of smoke. In all new houses, the by-laws ap- 
plying to urban districts insist that, in the absence of a 
fireplace, some special ventilating shaft shall be provided. 
If, however, there is a fireplace in the bedroom, care 
should be taken to have the flue always open, and not VENTILATION, WARMING, AND LIGHTING. 
253 
stopped up or obstructed by furniture, because it acts as 
a very efficient extraction flue. Then, too, it is very de- 
sirable that the window, especially if there is any tendency 
to overcrowding, should always be kept a little open at 
the top. Another very good plan is to raise the window 
at the bottom two or three inches, and insert a piece of 
wood the whole length, so as to support the sash, and 
close the opening; the air then enters between the sashes, 
because the lower sash is raised above the lower part of 
the upper, and in this way it passes up towards the ceiling 
without creating unpleasant draughts. Amongst other 
contrivances for window ventilation may be mentioned 
the following:-(1) By substituting a glass louvre for the 
top centre pane; (2) by having some of the panes doubled, 
the outer with an open space at the lower edges, and the 
inner with an open space of the same size at their upper 
edges; (3) by having some of the panes made of perfo- 
rated glass, as in Pott's plan; (4) by having a pane, or 
part of a pane, to open or shut by a spring arrangement, 
as in Boyle's Ventilator; (5) by fixing a fine wire screen 
to the top of the window, which unfolds when the window 
is pulled down, and folds up when the window is shut. 
Additional ventilation can be further secured by hav- 
ing an opening over the door, into which a wire gauze 
screen could be fixed; or by having an opening in the 
outside wall near the ceiling, which could be provided 
with what is called a Sherringham Valve; oi' some other 
simple contrivance, so as to direct the entering current of 
air towards the ceiling. This upward direction of the 
entering current can also be secured by inserting one or 
more tubes, as in the system of ventilation introduced by 
•Mr. Tobin, of Leeds, and Messrs. Shillito and Shorland, 
of Manchester. But where cheapness is a desideratum, 
the ventilation of any room in a poor man's house may 
be greatly improved when required by making a slanting 254 
opening in the wall, at a point as far as possible from the 
fireplace, and about two feet from the ceiling-the open- 
ing, of course, to slope inwards and upwards, and to be 
about twenty-four inches in transverse area. Perforated 
bricks or wire-gauze might be used to divide the current, 
and a slide should be provided to close the opening, partly 
or wholly, when the wind blows directly against it. 
But, unfortunately, all these, and other expedients 
which could be as readily adopted, are either neglected 
because the necessity for ventilation is not appreciated, 
or because warmth in many of the houses of the poor can 
only be secured by excluding the fresh outside air as 
much as possible. Another important condition for good 
bedroom ventilation is tb keep the windows widely open 
during the early part of the day, and well air the bedding 
and bed-clothes. No matter how capacious and clean a 
bedroom may be, this important duty should never be 
neglected, and cleanliness and freedom from stuffiness will 
be all the more readily secured, if, instead of carpeting 
over the whole floor, only loose pieces be laid down, which 
can be easily lifted and shaken, and which permit of the 
floor being kept well scrubbed and dried, or bees-waxed 
and dry-rubbed. 
With regard to the ventilation of the other rooms in 
a house, it is very essential that, by means of doors and 
windows on both sides of the house, there should be full 
facility given for what is called through or cross ventila- 
tion. The great evil of back-to-back houses depends upon 
the fact that this cross-ventilation becomes impossible, and 
the air of .the house can never be thoroughly swept out; 
whereas, if there are openings on both sides, and the 
rooms freely communicate with each other by doors and 
passages, the natural movement of the outer air will act 
as a powerful means of ventilation, by sweeping out the 
foul air along with it as it passes through the house. At 
THE HOME AND ITS SURROUNDINGS. VENTILATION, WARMING, AND LIGHTING. 
255 
the same time, it is necessary to guard against unpleasant 
draughts, and these may be prevented by adopting one or 
other of the various expedients which have already been 
mentioned, and more particularly the ventilating tubes of 
Tobin, or Shillito and Shorland. These tubes ought to be 
situated away from the fireplace, and should be made to 
pierce the wall horizontally about two or three feet from 
the floor. They are then diverted upwards along the 
inner surface of the wall, to within about the same dis- 
tance from the ceiling, so that the entering air is made to 
impinge against the ceiling, and is thus distributed gently 
throughout the room without creating unpleasant draughts. 
The tubes themselves may be concealed by various devices, 
or, if desired, they can be ornamented in such a way as 
will, at least, not detract from the elegant appearance of 
a room. This system is well adapted for schools, churches, 
and public buildings. 
When, however, a system of ventilation is adopted for 
the hall as already recommended in the section on struc- 
tural details, the difficulties of ventilating all the rooms 
in the house which open on the staircase and landings are 
greatly lessened. A good ventilating stove, or hot water 
pipes, will supply the staircase and passages with pure 
warm air, which can easily be let into the several rooms 
by openings in doors or walls concealed by pictures or 
other devices. 
In living rooms the chief outlet or extraction flue for 
the foul air is the chimney, and when a fire is kept burn- 
ing, the volume of air constantly passing through the 
room and up the chimney would be amply sufficient in 
the great majority of instances for the purposes of health, 
if the air in the room were only kept properly mixed. 
But usually a large portion of the air enters beneath the 
door when the door is closed, and is drawn along the floor 
towards the fireplace, so that a great portion of it rushes 256 
THE HOME AND ITS SURROUNDINGS. 
up the chimney without mixing with the contained air at 
all. It has also to be pointed out that with no outlets 
near the ceiling the air warmed by the radiation of the 
fire, by respiration, and by gas-lights, and which is full 
of impurities, is kept moving sluggishly about the top of 
the. room furthest from the fireplace, until it becomes 
cooler and gradually sinks and mingles with a portion of 
the air entering beneath the door or through chinks and 
crannies in window-frames. Thus, in most rooms it is 
found that the upper layers of air are disagreeably warm 
and surcharged with the impurities of respiration and 
combustion, while the lower currents rushing towards the 
fireplace, are often extremely cold, and chill the feet and 
legs. On the other hand, if doors and windows are made 
to fit too tightly, and there are no other special inlets for 
fresh air, the chimney is certain to be a smoky chimney 
because of the down draughts which are produced to feed 
the fire. Much of all this can be prevented by providing 
special inlets near the ceiling, as already indicated, but 
away from the fireplace, and by inserting either an Ar- 
nott's or Crossley's Ventilator into the breast of the chim- 
ney and close to the ceiling, if no special extraction flue 
was constructed when the house was first built. 
But to prevent discomfort arising from draughts of 
cold air, the greatest improvement which has been made 
in the warming and ventilation of rooms of late years, is 
the introduction of what are called ventilating grates. 
These are so constructed that a great portion of the fresh 
air entering a room is first warmed in a chamber behind 
the grate, which communicates by a special tube or chan- 
nel with the air outside. They are not much more expen- 
sive than ordinary grates, and apart from their advantages 
from a sanitary point of view, they will I have no doubt 
come into general use at no distant date, on account of 
the great saving in fuel which they ensure. These grates VENTILATION, WARMING, AND LIGHTING. 
257 
were first devised by Captain Douglas Galton, more espe- 
cially for the warming and ventilation of military bar- 
racks; but they are now manufactured by different makers 
and of various patterns to suit every kind of room. Be- 
sides the Galton Grate, the ventilating grates of Shorland, 
Boyle, and Whitwell are all worthy of commendation, 
and the best argument in their favor is that, unless provi- 
sion is made for warming the fresh air, the inmates of 
houses with limited cubic space will seldom permit effec- 
tive ventilation, but will rather be inclined for the sake of 
personal comfort to stop up inlets. 
The great majority of ordinary grates do not project 
far enough into the room, are placed a little too high, and 
having an open grating at the bottom, they consume large 
quantities of fuel without imparting anything like a pro- 
portionate amount of heat. Polished metal or ornamental 
glazed tiles make good radiating surfaces, but the lining 
in immediate contact with the fuel should be made of fire- 
brick because it ensures more perfect combustion, and the 
fire itself should rest on a slab of the same material. The 
grate known as the " Country Parson Grate," manufac- 
tured at Norwich, and the "Abbotsford Grate," are good 
examples of grates of this description. On the same 
principle, a considerable saving of fuel may be effected by 
placing a fire-clay brick of proper size in the bottom of 
any ordinary grate. 
A very cheap and improved- fresh-air cottage grate has 
been devised by Mr. Penfold, of London. It is made of 
well-burnt fire-clay with a chamber at the'back as in 
Galton's grate, in which the fresh air can be heated, 
and arrangements can also be made for supplying the 
warmed air to the bedrooms above. Indeed, by adopt- 
ing ventilating grates in the first construction of a 
house, and providing the necessary flues and openings, 
there would be no difficulty in warming all the rooms 
17 258 
THE HOME AND ITS SURROUNDINGS. 
in the upper stories by means of the grates in the rooms 
beneath. 
Another plan for warming bedrooms which has lately 
come into more general use, is to lay a sufficient quantity 
of asbestos in the grate, and render it incandescent by two 
or three gas-flames arranged underneath. This plan 
possesses the advantages of cleanliness, freedom from 
trouble, and adaptability. It need hardly be said, how- 
ever, that gas-warming, as usually carried out in shops by 
stoves without chimneys, is very unhealthy. 
We now pass on to consider very briefly the subject of 
lighting. And first, it should be said that every room in 
a house should be illuminated from the external air, and 
not by means of light borrowed from another apartment; 
and, further, that all windows should be sufficiently large, 
and, of course, made to open. As regards artificial light, 
gas, though it generates more heat and uses up more oxy- 
gen than any variety of lamps or candles, is cheapest and 
most convenient, and is therefore generally consumed 
where it can be obtained. But, inasmuch as all ordinary 
gas-burners consume from three to four cubic feet of gas 
per hour, and as one cubic foot destroys the oxygen of 
eight cubic feet'of air in combustion, and produces about 
two cubic feet of carbonic acid and other impurities, it is 
evident that the impurity of the contained air will be 
greatly increased, unless some special means are provided 
to carry off the products of combustion. In theatres and 
other large public buildings, extraction shafts above the 
chandeliers are generally provided to remove the vitiated 
air, and what is known as the "sun-burner" acts very 
efficiently in this way. Ricket's Ventilating Globe- 
lights, and those made by Benham, and Strode & Co., 
are also constructed on this principle. They are so 
arranged that so soon as the gas is lighted, an upwafd 
current is produced in the main tube, and as this becomes VENTILATION, WARMING, AND LIGHTING. 
259 
heated, the air in the surrounding tube becomes rarefied 
and set in motion. In this way the heated air in both 
tubes is carried to a special shaft of to the chimney, 
thereby securing the removal of the products of combus- 
tion and a steady current outwards of the vitiated air in 
the room. Tubes of zinc or tin placed over common 
burners, and communicating with the external air or lead- 
ing into the chimney, would answer the same purpose 
where ornamentation can be dispensed with. In the new 
infirmary at Edinburgh, every gas-jet is armed with an 
inverted funnel terminating in a pipe, which passes to foul 
air flues, in the walls. In the great majority of houses, 
however, no special arrangements of this description are 
provided, but much might be done to improve the venti- 
lation and remove impurities by inserting, as already 
recommended, an Arnott's or Crossley's Ventilator into 
the chimney-flue near the ceiling, or by inserting what is 
called a ventilating ceiling flower over the gaselier, to 
communicate with a pipe or extraction flue. But without 
entering into further details, it may be said generally that 
the principles of ventilation by gas-lights are for the most 
part so easy of application, and the advantages to be 
gained are so manifest as regards health, that it is sur- 
prising they should still be so greatly neglected. 
The introduction of the electric light into large public 
buildings, manufactories, workshops, and the like, will no 
doubt obviate many of the disadvantages attending gas 
combustion; but it is very doubtful whether it will 
speedily come into general use for the lighting of private 
houses. 
To determine whether the air in a room is sufficiently 
pure or not, enter it after befog in the open air for some 
time. If the room smells fusty or close, it is either 
overcrowded, badly ventilated, or there is some dirty con- 
dition of the walls or floors, some escape of sewer air, or 260 
THE HOME AND ITS SURROUNDINGS. 
some smell from dry rot or a dead rat under the boards 
or behind the skirting. In any case, the cause ought to 
be discovered and removed or remedied. 
As regards impurities from overcrowding or defective 
ventilation, Dr. Angus Smith has proposed a very con- 
venient test which is as follows:-Take an eight-ounce 
glass-stoppered bottle filled with the air of the room and 
put into it half an ounce of lime-water:-if the lime-water 
shows no milkiness or precipitate after shaking, there is 
no detrimental excess of lung impurities; but if the 
lime-water becomes milky, then either the ventilation is 
defective or there is overcrowding. 
After the details which have already been given in re- 
spect to drajnage, water supply, and closet accommoda- 
tion, but little need be added concerning the surroundings 
of the dwelling, except that tidiness and cleanliness should, 
as far as possible, be maintained everywhere. Paths should 
be well laid or paved, and all yards should be evenly laid 
with some non-absorbent material, such as blue brick, 
cement, or asphalt. Paths or yards with an uneven and 
loose surface are always dusty in dry weather, and become 
so muddy when it is wet that it is next to impossible to 
keep floors clean. A dust-bin, ash-pit, or some other re- 
ceptacle is required for the storage of ashes and dry house 
refuse, and precautions should be taken to prevent it from 
becoming a source of nuisance. In crowded localities it 
is preferable to use a small receptacle which can be placed 
outside the door of each house, and emptied regularly by 
the dustman each morning, but in most cases a dust-bin 
has been constructed. This should be situated at some 
little distance from the house and not under any window. 
It should not be below the level of the ground or basement, 
should be covered in to keep out wet, no slops of any kind 
VI. Outside Premises. HINTS ABOUT CHOOSING A HOUSE. 
261 
should be thrown into it, and it should be emptied regularly 
and at frequent intervals. Deep ash-pits are'always more 
or less a source of nuisance because they not only permit 
of large accumulations, but in most cases the water in the 
surrounding soil drains into them. They should, therefore, 
be filled up to the level of the ground and have a paved 
or cemented bottom. No ash-pit should be connected with 
a drain, because the dust will speedily choke it up. Every 
outside closet, as already explained, unless it be a properly 
constructed water-closet, should either be a dry or ash 
closet provided with a box or pail to prevent nuisance, 
and necessitate frequent scavenging. 
With regard to the keeping of animals, it may be laid 
down as a rule that pig-styes, fowl-pens, or cow-sheds should 
be absolutely prohibited in crowded localities; and even as 
regards isolated houses, the pig-stye should be at a safe 
distance from the house, and be well kept and properly 
drained. Heaps of manure of any kind should not be 
allowed to accumulate near dwellings, nor any collection 
of matter, solid or liquid, which is likely to taint the sur- 
rounding air. 
VII. Hints about Choosing a House. 
In choosing a dwelling, it very often happens that 
questions of convenience and other considerations which 
need not be discussed here, receive far more attention than, 
questions of health. Indeed, the great majority of house- 
holders, whether through ignorance or indifference, trouble 
themselves very little concerning sanitary details, provided 
the homes which they are about to enter suit them in other 
respects; and it is not surprising, therefore, that many of 
them have to pay a heavy penalty in family sickness, 
which a little forethought and inquiry might have pre- 
vented. Of course, it is very difficult to lay down rules 
which would apply to all alike, but there are certain de- 262 
THE HOME AND ITS SURROUNDINGS. 
tails which are of such general application that a few 
hints concerning them may, it is hoped, prove serviceable 
to most people. And, first, I would strongly recommend 
all those who can afford it to avail themselves of the aid 
of skilled advice to help them in the choice of a dwelling, 
or, if they have purchased or taken a house, to have it 
thoroughly examined before they enter it. There are so 
many defects which can be easily remedied beforehand, 
and often at little cost, but which if overlooked in the first 
instance, always entail discomfort in subsequent alterations, 
to say nothing of the risks to health which are sure to he 
incurred. 
But even without the aid of skilled advice, an intelligent 
householder may satisfy himself concerning the sanitary 
arrangements of his intended home, if he has made him- 
self acquainted with such details and requirements as have 
already been submitted in previous parts of this chapter. 
And the main questions which he should ask himself are 
these:-Is the situation suitable and airy? Is the subsoil 
dry ? Are the walls dry ? Are the rooms sufficiently 
commodious and well ventilated ? Are the premises gen- 
erally clean and in good repair? Is the drainage satisfac- 
tory ? Is the water supply sufficient and good ? There 
are vast numbers, of course, who cannot secure these con- 
ditions, even though they may fully appreciate their value, 
but they ought always to influence them as much as pos- 
sible, and, where necessity rather than choice has deter- 
mined the dwelling, an appeal should be made to the 
sanitary inspector of the district, if the landlord turns a 
deaf ear to the plea for necessary alterations and the re- 
moval of serious defects. 
If possible, a house should always be chosen which has 
plenty of free space round it; and if, for other reasons, the 
dwelling must be selected in a crowded locality, preference 
should always be given to one with increased indoor space, HINTS ABOUT CHOOSING A HOUSE. 
263 
which is well lighted, welk ventilated, and otherwise clean 
and in good repair. 
In country districts, the laborer should avoid a cottage 
which is built against a slope, or one which has clay or 
brick floors. In the former case, the walls are almost 
certain to be moist; and in the latter, the flooring is always 
more or less damp-so that in either case there is serious 
risk of rheumatism, lung disease, or some other disorder. 
Floors, even in cottages, should always be laid with wood, 
with a free ventilated space under the boards, and the 
foundations, as already pointed out, ought to be covered 
over with concrete or asphalt. Moreover, the subsoil 
should be drained, and there should always be a dry area, 
either open or filled with rubble, between the walls and 
sloping ground. Then see that the roof does not let in 
the wet; that the walls are dry and clean, and not covered 
with layers of paper; that doors and windows are in good 
repair; that every window is made to open; and that the 
floors are in good order. 
If the water supply is derived from a well, see that there 
is no deep cess-pit, ash-pit, pig-wash cistern, or manure- 
heap near it, and that any passing drain runs freely. 
Should the well not have been used for some time, it should 
always be pumped out before the water is used, and if pos- 
sible, the well itself should be opened, examined, and 
cleaned out; and if there is still reason to suspect the 
water, a sample should be submitted for analysis. 
In towns where the water supply is public, examine the 
cisterns and have them cleansed. See that the same cis- 
tern which supplies the closet does not supply the drinking- 
water, and that the overflow-pipe from the drinking-water 
cistern is disconnected, and does not enter directly into 
any soil-pipe or drain. 
With regard to drainage, unfortunately, there is not 
the same possibility of examining with such a degree of 264 
THE HOME AND ITS SURROUNDINGS. 
minuteness, because the drains are all concealed, and very 
often are laid in unsuspected quarters. Whenever it can 
be obtained, the intending tenant ought to insist on being 
supplied with a plan of the drainage; and if the house is 
old, he should not rest satisfied unless the ground is broken 
up, the drains opened, and any defects as regards construc- 
tion, ventilation, disconnection, and trapping, made good. 
Rats in a house are almost a certain indication that the 
drainage is defective, and that there are free openings 
somewhere. Make special search after any hidden cess- 
pool about the foundations, and if the house is an old 
country house, look out for huge brick culverts and sewage 
catch-pits under the walls. In new houses, see that water- 
closets, if not situated as previously recommended, abut 
against outside walls, that soil-pipes are exposed, in good 
order, and properly ventilated; that the closets themselves 
are well flushed; that the drains are also ventilated and 
trapped; and that all sink-pipes, and overflow-pipes from 
cisterns, baths, and lavatories, are carried outside and dis- 
connected. 
A very good plan to discover, or at least assist in dis- 
covering, whether the air of the house is pure and uncon- 
taminated by sewage or other effluvia, and that the rooms, 
and especially those on the basement or ground floor, are 
well ventilated, is to have good fires lighted in all the 
rooms, and at the same time to have all doors and win- 
dows closed. After a sufficient interval when the fires 
begin to die out, the rooms should be entered one by one- 
first those on the basement or ground floor, and afterwards 
those in the upper stories. If there is any escape of 
sewage gas from drains, or any foul smell from dry rot or 
dead rats, the disagreeable odour will in all likelihood be 
detected, and steps should at once be taken to discover 
the cause. Examine and see whether the free space under 
the ground flooring is adequately ventilated by perforated NUISANCES AND SANITARY DEFECTS. 
265 
bricks or otherwise, and do not overlook the cellar-drains. 
These should always be properly trapped and ventilated 
outside, or disconnected, as already recommended. By 
having fires lighted in all the rooms, it will further be 
made tolerably evident whether the chimney-flues are all 
clear, and whether any of them are smoky or not. 
To enter into further details would be merely a repeti- 
tion of what has already been said, and indeed most of 
the hints which have been here summarized have pre- 
viously been more or less fully treated; but as so much 
depends upon healthiness of the home, there can hardly 
be too much insistence on sanitary essentials. Although 
it is. quite true that the business of life and other con- 
siderations compel most people to live in a particular 
locality, and to take things pretty much as they find them, 
still there can be as little doubt that every householder, in 
his private and public capacity, can do a great deal to 
influence his own health and that of his neighbors in 
endeavoring to improve and maintain the sanitary con- 
dition of his home and its surroundings. 
VIII. Nuisances and Sanitary Defects Removable 
UNDER THE SANITARY ACTS. 
It is an old saying that an Englishman's home is his 
castle; and, accordingly, there are many people who 
foolishly resent the visits of sanitary officials as unwar- 
ranted intrusions into the sanctity of their domains. 
Those, however, who resent such visits are generally not 
tenants, or, if they are tenants, they are conscious that 
they are fostering some nuisance on the premises which is 
contrary to the provisions of the Public Health Act, and 
which the law can compel them to remove. Generally 
speaking, those who are most indignant at such visits are 
owners of the houses in which they live, and who natu- 
rally believe that, if they themselves are satisfied with the 266 
THE HOME AND ITS SURROUNDINGS. 
sanitary conditions, no one else has any right to interfere. 
But the law pays no respect to persons, and it matters not 
whether the tenant is owner or not, the sanitary inspector, 
or inspector of nuisances as he is called, can give notice 
to remove any nuisance on the premises, or to remedy any 
defect which is injurious to health, and, failing compli- 
ance, the owner, agent, or tenant, as the case may be, can 
be summoned before a bench of magistrates, and an order 
obtained to have the nuisance removed, or the defect 
remedied, on penalty of a fine and payment of costs. 
The nature of the nuisance or defect is described on the 
printed form of notice which is served by the inspector, 
and the requisite steps to be taken to remove the same are 
generally indicated, as well as a certain time stipulated in 
which the notice shall be complied with. In the case of 
nuisances or defects which require structural alterations, 
the law holds the owner or his agent responsible, no matter 
what private agreement may have been entered into 
between the owner and tenant; but where no structural 
alterations are required, the notice is generally served on 
the occupier. There is, however, one important exception, 
and it is this:-In the crowded localities of our large 
towns, and in country districts, the tenants of small houses, 
tenements, or lodgings, are usually weekly tenants, and it 
is impossible to keep the houses clean and properly lime- 
washed unless the responsibility of this important require- 
ment devolves upon the landlord or his agent. The law, 
therefore, gives power to every Sanitary Authority to 
compel the owners or agents of such premises to cleanse 
and whitewash whenever it is certified, by the medical 
officer of health or two properly qualified medical prac- 
titioners, that the premises, for want of proper cleanliness, 
are a nuisance injurious to health. In other cases, the 
notice to cleanse and whitewash may be served on the 
occupier, and this should be done in all cases when the NUISANCES AND SANITARY DEFECTS. 
267 
occupier can reasonably be held responsible to attend to 
this duty. Among other nuisances for which the occupier 
is responsible are the following:-The keeping of pigs or 
other animals in any place or in such a way as to be 
injurious to health; accumulations of manure; foul cess- 
pits, ash-pits, or closets; the storage of any liquid filth; 
and overcrowding. 
On the other hand, the defects or nuisances for which 
landlords or their agents are held responsible may be 
summarized as follows:-Damp foundations; damp walls; 
roofs which let in the wet; uneven or broken floors; win- 
.dows not made to open; walk in bad repair; insufficient 
or defective closet-accommodation; defective or badly 
ventilated drains; cesspools or cess-pits improperly situa- 
ted or constructed; deep ash-pits; defects with regard to 
water-pipes or cisterns; insufficient water supply; and 
polluted wells. If premises are situated within a distance 
of a hundred feet from any public sewer or any public 
water-main, the Sanitary Authority can compel the owner 
to drain into the sewer, remove any cesspool, lay on water 
to closets, and lay on water generally to the house. Any 
house so unwholesome or in such a dilapidated condition 
as to be unfit for human habitation, can be closed by the 
Sanitary Authority of the district, on a certificate from 
the medical officer of health. It has only to be added 
that the Sanitary Authorities are-in the Metropolis, the 
Corporation of the City of London, and the Vestries; in 
provincial towns, the Corporations or Local Boards; and 
in rural districts, the Boards of Guardians, or Sanitary 
Committees appointed by them.* 
It will be seen from these brief hints, that full power is 
given to insist on healthy dwellings and wholesome sur- 
* This long list of unwholesome conditions which the English sanitary authorities 
have power to modify and abate, shows how thoroughly the riper civilization of 
Great Britain realizes that "Public Health is Public Wealth."-(R.) 268 
THE HOME AND ITS SURROUNDINGS. 
roundings; and though it is far from my intention to 
encourage any feeling of hostility between tenant and 
landlord, I would again point out that the tenant, who 
finds his landlord deaf to any request made in respect to 
necessary repairs or alterations which he himself is not 
bound to attend to, can always appeal to the Sanitary 
Authority of the district or their inspector. It need 
hardly be said, too, that when repairs and alterations are 
carried • out, especially in connection with the drainage, 
the workmen should be carefully looked after in order to 
ensure that the work is properly executed in all its de- 
tails. 
No doubt the difficulties of providing healthy homes, 
especially for the artisan and the laboring classes, are 
enormous, but earnest strivings are now being made in 
many directions, and, with the intelligent co-operation of 
the people themselves, we can hopefully look forward to 
a steady reduction of the death-rate, a gradual abatement 
of preventable suffering, and a progressive development 
of the national physique, and of every influence which 
tends to improve the public health, and promote human 
happiness. CHAPTER VIII. 
INFECTIOUS DISEASES AND THEIR PREVENTION. 
In the brief historical sketch of the homes and habits 
of our forefathers, which, has been given in the previous 
chapter, it was made sufficiently clear that conditions 
inimical to health were abundant everywhere. The 
wretched huts huddled together in walled-in cities were 
highly favorable to overcrowding and stagnant air; the 
scattered hovels on wild marshy wastes fostered ague and 
other malarial disorders; while the filth, which was 
everywhere allowed to accumulate in and around dwell- 
ings, polluted air and -water alike, and was thus a con- 
stant source of pestilential diseases of the most virulent 
kind. Add to all this that the large armies, which were 
continually marching from place to place, conduced 
greatly to the spread of the infectious diseases thus bred 
and reared in filth, and it need cause no matter for sur- 
prise that fevers and devastating epidemics prevailed to a 
terrible extent for centuries. Thus, according to Dr. Guy, 
there were fifteen widespread epidemics and many famines 
during the twelfth century; twenty epidemics and nine- 
teen famines during the thirteenth century; and eight 
epidemics and more famines during the early part of the 
fourteenth century. And these epidemics, it should be 
remembered, were not mere local outbreaks appearing 
only here and there with terrible severity, but they 
spread so far and wide, and entailed such a frightful 
mortality, that each and all of them were regarded as 
visitations of national disaster. 
269 270 
INFECTIO US DISEASES. 
But the first most notable epidemic in our mediaeval 
history was the Black Death, or Great Mortality, as it 
was called, which appeared in England in the year 1348. 
It was no doubt an aggravated form of the Oriental 
Plague, which was then devastating Europe as it had de- 
vastated the East. It was an eminently infectious disease, 
imported, in all likelihood, in the first instance, but when 
once it gained a footing on our shores, it spread with such 
terrible rapidity that within a few months almost every 
town and village throughout the country had been 
attacked, and in some places only a fourth part of the 
inhabitants were left alive. Imagination fails to realize 
the misery and horrors of the time; the sick died un- 
tended, corpses lay unburied or were flung in heaps into 
yawning trenches-everywhere there was terror and black 
despair. In London alone 100,000 fell victims to the dis- 
ease, while throughout Europe it has been estimated that 
25,000,000, or a fourth part of the entire population, were 
swept away. 
Not to notice other epidemics which followed the epoch 
of the Black Death, the next great pestilence which rav- 
aged the country broke out in 1485, and was known as 
the Sweating Disease. Unlike the Black Death and 
the Oriental Plague, which reappeared in the sixteenth 
and seventeenth centuries, it did not originate in a foreign 
country, to be conveyed by infection to our own shores, 
but it sprang into existence in this, and was no doubt 
generated and propagated by the foul insanitary conditions 
of dwellings and towns, and the filthy and intemperate 
habits of the people. During the latter part of the fif- 
teenth century and the first half of the sixteenth, this 
pestilence reappeared no less than five times, its last visi- 
tation having occurred in 1551. But during all these 
centuries, sanitary progress was slow, tentative, and 
tedious.. Indeed, it may be said that it was not until the HISTORICAL SKETCH. 
271 
Plague, which was the next great pestilence after the 
Sweating Sickness, had repeatedly devastated the country, 
and the Great Fire, which swept away the crowded and 
filthy houses of London in 1666, occurred, that people be-, 
gan to appreciate, though in a faint and glimmering way, 
the principles of prevention. The Plague died out with 
the Fire; but small-pox, typhus or jail fever, malignant 
sore throat, ague, scurvy, and other controllable diseases 
still continued to contribute to the excessive mortality of 
the seventeenth century. 
By-and-by, however, there appeared tangible signs of 
improvement. Food was becoming more plentiful, the 
diet less coarse, and the comforts of life began steadily to 
increase. The people themselves were beginning to 
appreciate more fully the advantages of cleanliness of 
person and of home; in short, the gradual emancipation 
from the thraldom of filth had commenced, and precau- 
tionary measures of a rough-and-ready kind were here 
and there attempted. Hence we find that at the begin- 
ning of the eighteenth century, three terrible scourges, 
namely, the Black Death, the Sweating Sickness, and the 
Plague, had finally disappeared from the bills of mortal- 
ity, but it was not till towards the close of that century, 
that the physical causes of disease began to receive fuller 
investigation, and that consequently any conscious or well- 
sustained efforts were exercised in the way of prevention. 
And foremost amongst these pioneers of sanitary science 
must be mentioned the honored names of Captain Cook, 
John Howard, and the immortal Dr. Jenner. Captain 
Cook's name was associated writh the suppression of that 
terrible disease, scurvy, which before his time had deci- 
mated our armies and fleets, and had.often proved terribly 
fatal among the civil population.. It is a disease which, 
no doubt, was fostered, as many other diseases are, by in- 
sanitary conditions; but its real cause is a diet from which 272 
INFECTIOUS DISEASES. 
vegetables and fruits have been excluded, and therefore its 
prevention or cure depends upon a proper supply of vege- 
table food oi' vegetable juices. It is true that all this had 
been surmised long before the period in question, but it 
was reserved for Captain Cook, in his first voyage of dis- 
covery round the world, from 1772 to 1775, to prove beyond 
all dispute that the disease could be banished from every 
ship's crew, and that it could be entirely eradicated on sea 
and land. But the nation took years to learn the lesson 
which he was the first to illustrate and enforce, and many 
thousands more lives had to be sacrificed before it was 
rendered compulsory by law that lime-juice should form 
a part of the commissariat of every sea-going vessel. 
Scurvy, too, may now be reckoned among the diseases of 
the past, and if it occasionally reappears, it is solely 
through blamable neglect or some other mishap. 
Passing over the self-sacrificing labors of the "great 
and good John Howard," which have already been alluded 
to in the previous chapter, it will suffice to say that the 
outcome of them all is simply this-that epidemic disease 
of any kind has long since been practically banished from 
within prison walls, and that such an improvement was 
commenced in the homes and habits of the people by John 
Howard's influence, that typhus, or jail fever, which was 
once so rife among us, soon began to decline, and is now 
only to be found in the dirty, impoverished slums of our 
large towns. 
Before alluding to the next great sanitary triumph of 
the latter part of the eighteenth century, let us glance 
briefly at the progress made in the actual prevention of 
disease. We have just seen that the Black Death, the 
Sweating Sickness, and the Plague had finally disappeared 
towards the close of the seventeenth century; that the 
causes of scurvy and typhus fever had not only been fully 
investigated, but their prevalence had been largely lessened HISTORICAL SKETCH 
273 
even before the beginning of the present century; and that 
ague, which was once so common, especially in marshy 
districts, has practically been stamped out, owing mainly 
to improvements in drainage and drying of the subsoil. 
Diseases among infants and young children were much 
less fatal towards the close, than they were at the begin- 
ning, of the last century; the health of our soldiers and 
sailors was much better cared for, though up to the date 
of the Crimean war with its terrible lessons, it was still 
scandalously neglected; while, owing to improvements in 
house construction and ventilation, and greater general 
cleanliness, fevers of all kinds were becoming less plentiful. 
Altogether, therefore, the progress made in the actual pre- 
vention of disease was very considerable, and accordingly 
we find, as previously stated, that the annual mortality 
in the city of London, which amounted in round numbers 
to 80 per 1000 of the population during the seventeenth 
century, had been reduced to 50 per 1000 during the last 
century, and for years back it has averaged only 24 per 
1000. ' 
But infectious diseases still continued to contribute 
largely to the death-roll of the nation, and in 1833, 1848, 
and 1853, the country was visited by severe epidemics of 
cholera. These visitations, and the terrible evils which 
were fast accumulating from the rapid increase in the 
population, at last aroused Parliament to commence, a 
long series of legislative enactments, which, though mostly 
of a permissive nature, were intended for the preservation 
of the public health and the prevention of disease. The 
first important Sanitary Act was the Public Health Act 
of 1848; but it was not till the Public Health Act of 1872 
was passed that any approach to a system of sanitary 
supervision throughout the country generally was intro- 
duced ; and this unfortunately still continues to be of a 
very imperfect kind in the great majority of sanitary dis- 
18 274 
INFECTIOUS DISEASES. 
tricts. Meanwhile the causes of preventable disease began 
to be investigated by inspectors appointed by the Govern- 
ment, with a precision and minuteness which have clearly 
and fully established not only the causes themselves, but 
the various intricate ways in which diseases of an infectious 
nature may be propagated, as well as the measures which 
are best calculated to suppress them. 
I. Principal, Zymotic Diseases. 
The reader has already been supplied, in Chapter I., 
with statistics which illustrate the prevalence of these so- 
called zymotic diseases, and in Chapter III. their causes 
have been more or less fully explained; but in order that 
he may be the better enabled to assist in their prevention 
whenever he possibly can, it will be necessary to discuss 
each of the more important of them in detail. The dis- 
eases, then, which we have now to consider separately, and 
known as the seven principal zymotic diseases, are:-small- 
pox, measles, whooping-cough, scarlatina, diphtheria, fever 
(including typhus, typhoid, and relapsing fever), and 
diarrhoea. There are several other diseases of the zymotic 
class which are more or less infectious, such as cholera, 
erysipelas, pyaemia or blood poisoning, and puerperal fever 
which sometimes proves so terribly fatal at childbirth; but 
these are fortunately not so prevalent, and need not there- 
fore require special notice. There has been no epidemic 
of cholera in this country since 1866, and there are strong 
grounds for believing that it has finally disappeared from 
amongst us. It was proved to he mainly propagated by 
impure water, and especially by water which became speci- 
fically tainted by the discharges of patients suffering from 
the disease. The ' precautionary measures which are in- 
dicated are, therefore, these-that in every case the dis- 
charges and any bedding or clothing imbued with them, 
should be carefully disinfected, and that special care should PRINCIPAL ZYMOTIC DISEASES. 
275 
be taken to prevent pollution of the water supply. The 
disease still prevails to a large extent in Eastern countries, 
and though there are widely divergent views to account for 
its dissemination, there is a constantly increasing amount 
of evidence which goes to prove that impure water and 
filth are the main elements in its propagation. 
With regard to erysipelas and pysemia, it may be said 
that they are essentially filth diseases, and they have often 
been known to spread with terrible fatality in the surgical 
wards of hospitals into which sewer air from.defective 
drainage had found an entrance. When either disease 
occurs in isolated houses, it will generally be found to be 
due to similar insanitary conditions, or want of cleanliness 
of some kind. Puerperal fever, again, has often been 
communicated by the medical, attendant or midwife from 
one-patient to another ; indeed, the risk of communicating 
the disease is so great that it is maintained by many in 
the profession that no medical practitioner should attend 
any cases of childbirth for three or four weeks after he 
has attended a case of the kind, and then only after taking 
the minutest precautions with regard to personal disin- 
fection. 
We now pass on to consider the mode of propagation 
of the principal zymotic diseases already named, and the 
precautionary measures which are indicated in respect to 
each. For practical purposes it is not essential that we 
should enter into any speculations with regard to their 
Origin, except in so far as they can be traced to removable, 
local, or material causes. Some of them,- such as small- 
pox, are only known to us as affections of the human body 
which, in case after case, multiply their respective types 
with a definiteness as precise as we see manifested in the 
highest orders of animal or vegetable life; in other words, 
the disease breeds so true that no fresh'case is known to 
arise except by contagion or infection from some previ- 276 
INFECTIOUS DISEASES. 
ously existing case. There are others, again, such as ty- 
phoid fever and diphtheria, which may be originated by 
filth in water, food, or air, but when so originated, propa- 
gate their kind with more or less definiteness from person 
to person, whenever local circumstances and other condi- 
tions favor their spread. But .whatever their origin, or 
however much they may vary in infective power, they all 
thrive most vigorously in localities where overcrowding 
and want of cleanliness abound, and where ignorance, 
indifference, or culpable neglect permit their reckless dis- 
semination. 
1. Small-pox.-The third great sanitary triumph of the 
eighteenth century, already referred to, was, without 
doubt, the discovery of vaccination by Dr. Edward 
Jenner. That most hideous and loathsome disease, 
small-pox, had for centuries back been a terror and 
scourge to all classes of the community here and abroad, 
and, after the disappearance of the Plague, became the 
severest epidemic of the country. At what period it was 
first introduced into England history does not inform us, 
but, according to authentic records, it certainly existed 
both here and on the Continent prior to the ninth cen- 
tury, and there are. notices of severe epidemics in this 
country from the twelfth century onwards. Dr. Guy, in 
his excellent work oh "Public Health," states that it was 
entered on the London bills of mortality from 1629 to 
1831, and that in the year 1796, when vaccination was 
first introduced, the deaths by small-pox alone exceeded 18 
per cent, of the total number of deaths. To -give some 
idea of its relative mortality, he further adds that during 
the last ten years of the past century, it was more than a 
hundred times as fatal as diarrhoea and allied diseases; 
seven times as fatal as measles; and six times as fatal as 
apoplexy, palsy, and sudden death taken together. It 
spared neither age, sex, nor position in life; every fifth SMALL-POX. 
277 
person attacked died; and many of those who survived 
were disfigured or maimed; indeed, it is estimated that 
nearly two-thirds of our blind population formerly owed 
the deprivation of their sight to this fell disease. As a 
rule, the disease, though never entirely absent, broke out 
in the epidemic form every third year, showing that it 
proved specially fatal among young children, and having 
sacrificed or attacked all those who were most susceptible, 
waited for a fresh crop of victims. 
Now, against this loathsome and terribly fatal disease, 
there were discovered in course of time two protective pro- 
cesses or operations, namely, Inoculation and Vaccination. 
The method of inoculation was first introduced into this 
country at the instance of Lady Mary Wortley Montague, 
wife of the English Ambassador at Constantinople, some- 
where about the year 1720. It was largely practised in 
the East during the residence of the ambassador and his 
sprightly wife at Constantinople, and in the year 1717 
their son was inoculated there. But after it was intro- 
duced into England, it took many years before the prac- 
tice became popular, and though there was no doubt that 
the mortality among persons who were inoculated was 
enormously lessened when compared with the mortality 
among those who had the natural form of the disease, 
there were some who believed that it greatly favored the 
spread of the disease itself. 
In spite of this palliative, therefore-and no doubt it 
was a palliative-small-pox still continued to add largely 
to the death-rate up to the close of the century, so that 
any means which would act as a preventive would be 
longed for and welcomed by the profession and the public. 
Now, it so happened that Dr. Jenner, who was born in the 
year 1749, was apprenticed to a surgeon at Sodbury, near 
Bristol, and during his apprenticeship, as the story goes, 
a young woman came into the surgery, and chancing to 278 
INF ECT IO US DISEASES. 
speak about small-pox and its dangers, said, "I cannot 
take the disease for I have had the cow-pox." This 
remark so coincided with the popular belief at the time, 
that it made a strong impression on the mind of the young 
student.- He talked about it to his teacher, the celebrated 
John Hunter, and indeed, became so persistent in giving 
vent to the idea which was now beginning to take posses- 
sion of his whole mind, that many of his friends voted 
him to be a bore. But Jenner stuck to his opinions, and 
after he settled in practice at the village of Berkeley, in 
Gloucestershire, he resolved to put them to the test. He. 
had already stored his mind with all available informa- 
tion concerning the cow-pox and its protective influence 
on the milkers, and he forthwith commenced a long series 
of earnest and painstaking investigations. He first demon- 
strated the complete success of his discovery in 1796, and 
two years later published his researches in the form of a 
thin quarto of scarcely more than seventy pages. But in 
clinging to his first strong impressions, and in putting 
them to the test of experiment, he had to encounter an 
amount of bitter opposition and obloquy that might have 
well disheartened any one whose courage was not sus- 
tained by a holy reliance in the truth of his great dis- 
covery, and it redounds to his credit that he bore these 
trials with becoming equanimity. The honors and re- 
wards came in slowly, but when they did come, and when 
the success of the operation had triumphed over all oppo- 
sition, it was equally to his credit that his natural modesty 
remained unimpaired, and he continued unremitting in 
the discharge of his duties, and kind and attentive to the 
poor. In 1802 and 1807 he received grants from Parlia- 
ment amounting to £30,000, and after living to see the 
triumph of his discovery, he died in the year 1823, at the 
age of seventy-four. 
And now a few words with regard to vaccination itself. SMALL-POX. 
279 
The operation is simply the introduction into the human 
body, by a puncture or punctures in the skin, of that same 
matter which forms on the udder, or teat, of the cow, and 
which was long known to be transferred to the hands of 
the milkers. When Dr. Jenner began his investigations, 
cow-pox was more or less prevalent in Gloucestershire and 
other counties in the south of England, and he himself 
was led to believe that small-pox and cow-pox were in 
reality identical, but with this enormous difference as re- 
gards effects, that those who contracted the disease from the 
cow suffered but very little from constitutional disturbance, 
and had only slight local symptoms. Dr. Jenner's first 
inference, therefore, was this-that inasmuch as cow-pox 
was protective against small-pox, the disease could be 
produced by inserting the point of a lancet, charged with 
lymph from the vesicle on the teat of the cow, as readily 
and surely as when rubbed into the skin by the hand; 
and his second inference was-that if this operation was 
followed by certain local effects consisting of vesicles, the 
lymph from these vesicles would give rise to the same 
series of symptoms and local results, and so on, indefi- 
nitely, from person to person'. " In a word," as Dr. Guy 
has forcibly put it, "it was assumed, and happily demon- 
strated, that just as small-pox had been made to pass 
from person to person by the inoculation of the matter 
from a small-pox vesicle or pustule, so cow-pox might be 
communicated from person to person by the same mode 
of procedure." 
Such, in substance, was Dr. Jenner's great discovery, 
and such the method which he introduced, and though 
variously modified'in minor details, it is the same method 
which still continues to be practised at the present day. 
It may further be of interest to the reader to note, in 
passing, that small-pox may be communicated to the cow, 
to the horse, to sheep, monkeys, and other animals, and 280 
INFECTIOUS DISEASES. 
numerous interesting experiments of inoculating from one 
to the other have long since substantiated Dr. Jenner's 
views with regard to the identity of the infective material 
in all its manifestations. The great value of vaccination, 
then, is briefly this, that it gives rise only to local effects, 
with very slight constitutional disturbance, and if it does 
not afford absolute protection against small-pox, it greatly 
modifies the severity of the attack. 
Let us now glance briefly at the results as borne out by 
statistics. But before doing so, it has to be pointed out 
that although vaccination was introduced in 1796, it made 
but very slow progress during several years; indeed, it is 
believed that in 1801 the total number of persons vacci- 
nated did not exceed 6000; moreover, it did not become 
general till about the year 1819, nor can it be said to have 
entirely superseded the practice of inoculation till 1849. 
Now, according to Dr. Guy, the deaths from small-pox 
which occurred in London during the ten years ending 
1799, amounted to 22,863 per 1,000,000 of inhabitants; 
during the ten years ending 1819, the number was reduced 
to 8045 per 1,000,000; and during the ten years ending 
1849 the number was still "further reduced to 4798. It 
therefore appears that, in round numbers, the death-rate 
had been lowered from nearly 23,000 per 1,000,000 in- 
habitants to a little over 8000 in twenty years, and to less 
than 5000 in thirty years more. But it has also to be 
borne in mind that there were no vaccination laws prior 
to 1840, in which year it was enacted that it should be 
gratuitously provided to the poor; and that compulsory 
vaccination was not enforced prior to 1853. Hence it is 
reasonable to infer that up to 1853 there were crowds of 
children who were not vaccinated at all, and it is \vell 
known too that of those who were vaccinated before and 
long after that date there were numbers on whom the 
operation was very imperfectly performed. Indeed, it is SMALL-POX. 
281 
only within the last fifteen years or so that the system of 
compulsory vaccination has been perfected, and all along 
it has met with no small amount of opposition from a very 
persistent minority. In spite of all these drawbacks, 
however, the death-rate from small-pox has, with slight 
variations, manifested a remarkable and progressive de- 
cline. Thus, if we return to the period when natural 
small-pox prevailed, we find that during the ten years 
ending 1770, the ratio of deaths from the disease com- 
pared with deaths from all causes was 108 pei' 1000 deaths, 
and that during the three subsequent decades of the last 
century, when inoculation became more general, the re- 
spective ratios were 98, 87, and 88 per 1000 deaths. 
During the first seven decades of the present century, 
that is, up to 1870, we find, on the other hand, that the 
ratios of deaths from small-pox to every 1000 deaths from 
all causes, Were successively as follows:-64, 42, 32, 23, 
16, 11, 11. These remarkable figures are alone sufficient 
to attest the protective value of vaccination ; and if there 
are still recurrent outbreaks of the disease here and there 
throughout the country, it is because there are many now 
living who were never vaccinated at all, and many more 
who have been very imperfectly vaccinated. Then, too, 
it has to be conceded that though vaccination, when suc- 
cessfully performed, confers a practical immunity from 
small-pox on the great majority of people, it should be 
supplemented by re-vaccination about the age of twelve 
or fifteen to ensure complete protection. Nurses in small- 
pox hospitals, who have been re-vaccinated, are .never 
known to contract the disease, and it is because medical 
men place such implicit reliance on vaccination and re- 
vaccination, that it is one of the rarest occurrences for 
any member of the profession to become infected, no 
matter how severe or numerous the cases which he may 
have to attend. 282 
' INFECTIOUS DISEASES. 
But even when vaccination does not afford complete 
protection, it so modifies the attack in the great majority 
of cases, that the disease runs a mild course, and there is 
no subsequent disfigurement. If well and thoroughly 
done, its influence extends throughout life, with but little 
loss of protective power; while, if imperfectly done, its 
protective power is nevei' so efficient, and becomes less 
and less as life advances. On the other hand, the unvac- 
cinated person is not only almost certain to contract 
the disease when exposed to infection, but statistics also 
prove that he is likely to take it in its most malignant 
form. 
And now let us consider for a moment the principal 
preventive measures which are indicated by these well- 
established facts. The first, of course, is to ensure that 
the entire population are well and thoroughly vaccinated 
in infancy, and if it be asked, How do we know that a 
person has been well vaccinated ? the answer is, By the size 
and character of the vaccination mark. It has happened 
over and over again in my own experience, when examin- 
ing a patient suffering from small-pox, that no distinct 
mark of any kind was visible on the arm, even though 
assured that the operation had been performed during 
youth. In all probability, the operation bad been per- 
formed, but in a very imperfect fashion. The aim of the 
operator should be to produce, either by separate punctures 
or otherwise, a mark on the child's arm at least the size 
of a shilling piece, and when done skilfully and rapidly, 
the operation cannot be said to be very painful. The 
second practical inference is this-that when small-pox 
appears in the household, or indeed in the neighborhood, 
every infant that has not yet been vaccinated should be 
vaccinated immediately, and every adult, and every child 
who does not possess a good vaccination mark, should be 
re-vaccinated. If these precautions are not taken, other SMALL-POX. 
283 
preventive measures will in all likelihood fail to prevent 
the spread of the disease. 
I have dwelt at some considerable length on this subject, 
because there is no disguising the fact that there is a small 
band of well-meaning, and no doubt conscientious, men 
who are persistently agitating for the repeal of the com- 
pulsory Acts, and for the abolition of vaccination itself- 
their main arguments being that the operation is ineffectual, 
and that it is sometimes the means of imparting odious 
diseases and often impairs health. It is true the former 
of these objections must be admitted to a limited extent, 
but in face of the facts and figures already submitted, it 
is not an objection which can reasonably carry any weight. 
With regard to the latter objection, however, it cannot be 
denied that there have been instances, comparatively few 
though they are, in which vaccination has been followed 
by unfortunate results, not so much of a constitutional as 
of a local nature. ■ Erysipelas is, no doubt, occasionally 
induced, very probably owing to want of proper care in 
keeping the lymph or lancet perfectly clean; but among 
the millions who have been vaccinated, the instances are 
so rare as to afford no well-grounded argument against 
the actual saving of life, and the protection from suffering 
and disfigurement which this inestimable boon has con- 
ferred on mankind. In all measures which concern the 
nation's health, it should not be forgotten that the Legis- 
lature has to consult the public good, even though cases 
of accidental hardship do occur. Meanwhile, it is worthy 
of notice that there is a movement now on foot which, it 
is to be hoped, will ultimately put an end to this disquiet- 
ing agitation. It has been proposed by a few of the 
leading men in the profession that those who object to 
have their children vaccinated with human lymph, should 
be allowed to have the operation performed with lymph 
from the cow, and that the Government Department en- 284 
INFECTIO US DISEASES. 
trusted with the enforcement of the Vaccination Acts 
should afford facilities for the supply of such lymph. 
For my own part, I am inclined to think that this would 
be a judicious concession, for the simple reason that it 
would tend to allay fears which no doubt exist, and court 
acquiescence amongst those whose opposition has hitherto 
been most uncompromising, misleading, and mischievous. 
We now pass on to consider very briefly the mode of 
propagation of the disease itself, and the precautionary 
measures which are indicated for its prevention. And 
first, it may be said that there is no infective poison or 
contagion which is so powerful and certain as that of 
small-pox, nor perhaps any which can operate for so long 
a distance. The infective particles may be wafted from 
house to house on opposite sides of the street, and no 
susceptible person can enter a house in which the disease 
exists, without running immense risk of being attacked. 
The poisonous material is thrown off from the skin, by 
the breath, and with the excretions, and is contained in 
the vesicles, pustules, and scabs which appear on the skin. 
It pervades the air of the sick-room, and attaches itself 
to all articles of bedding, clothing, drapery, or furniture 
contained in the room, while it is possessed of so much 
vitality that if protected from air, it may remain active 
for an unknown number of years. Generally, the period 
of incubation-that is, the period which intervenes be- 
tween the date of infection and the appearance of the 
rash-varies from twelve to fourteen days; but no one 
coming from an infected district can be pronounced safe 
until about eighteen days have elapsed. The first symp- 
toms are those of high fever, followed in three or four 
days by an eruption of pimples, which gradually become 
larger, and assume a peculiar oval shape, with a central 
depression. The eruption is generally at its height on the 
eighth day, when the vesicles, as they are called, begin to SMALL-POX. 
285 
suppurate, and after a time scabs are formed which begin 
to fall off about the fourteenth day. If the pimples, or 
vesicles, are solitary, with free untouched spaces round 
them, the disease is called discrete, or modified; but if 
they run into each other, it is called confluent. In some 
of the malignant forms of the disease, scarcely any erup- 
tion becomes apparent, the patient dying before it has 
had sufficient time,to break out. 
The course of the disease, whether the form be discrete 
or confluent, is divided into four periods, viz., the period 
of incubation, the feverish stage, the eruptive stage, and 
the suppurative stage. In all probability, the first and 
second periods are not (or but slightly) infectious, but the 
third and fourth are markedly so; indeed, a patient can- 
not be pronounced free from infection until all the crusts 
have fallen off, and the whole surface of the body has been 
well sponged with water and some disinfectant soap. 
As regards the speedy suppression of this disease, it 
sometimes unfortunately happens that the first few cases, 
if of a mild nature, are mistaken for chicken-pox or 
measles by the medical attendant, because it is not always 
an easy matter to differentiate between the symptoms of 
these respective diseases. It is a wise rule, therefore, to 
take every precaution, even though the disease is not well 
pronounced; but when the case becomes clear, the best 
known means of prevention should at once be adopted. 
If the patient is not forthwith removed to a hospital, he 
should be carefully isolated; the person in attendance on 
him should, if possible, be one protected by a previous 
attack of small-pox or by re-vaccination; the other mem- 
bers of the household should be re-vaccinated in every 
instance in which the operation is indicated; and the 
same precautions ought to be adopted with regard to 
immediate neighbors. The other details concerning the 
management of the sick-room, disinfection, and .the like, 286 
INFECTIOUS DISEASES. 
will be more fully detailed in the rules which will be 
given further on to prevent the spread of infectious dis- 
eases generally. 
2. Measles.-This disease is eminently communicable, 
and though essentially a disease of childhood, it often 
attacks persons of all ages. The period of incubation 
after infection varies generally from ten to fourteen days; 
then feverish symptoms set in, with running at the eyes 
and nose, and cough. The eruption appears in crops of 
a crimson rash, consisting of slightly elevated small dots, 
scarcely perceptible to the touch, and disposed very often 
in patches of a crescentic form. The febrile and catar- 
rhal symptoms last about four days, the eruption six or 
seven days, and the whole duration of the disease is com- 
pleted in nine or twelve days. So common is the disease 
in this country, that it is considered by many parents to 
be a natural and inevitable disorder of childhood; and 
at what they consider to be a favorable time of the year, 
they deliberately expose their children to infection, in order 
that they may take the disease and have done with it. It 
need hardly be said that so long as such a pernicious and 
fatalistic belief remains unrooted, precautionary measures 
will be of very little avail, and indeed, as regards this and 
the following disease, whooping-cough, the most culpable 
neglect and indifference still prevail even among people 
of whom better things might be expected, with regard to 
the expediency of adopting preventive steps of any kind. 
The poison, as in small-pox, adheres to clothing, bedding, 
and the walls and furniture of the sick-room, and infects 
the air, so that by that medium alone it can travel some 
distance. Isolation, disinfection, and prohibiting any 
children belonging to an infected house from attending 
school, are the precautionary measures indicated, but these 
will be more fully explained further on. 
3. W\ooping-cougli.-The characteristic symptom of SCARLET FEVER. 
287 
this disease is a convulsive cough, followed by a long 
sonorous inspiration which is called the "whoop," or 
"kink." The period of incubation is doubtful, but it is 
believed that it averages five or six days. The premoni- 
tory symptoms are slight feverishness and catarrh, very 
much resembling those of a common cold, and, after the 
disease has fairly set in, it lasts from two to four weeks. 
The cough comes on in convulsive paroxysms, but during 
the intervals the patient is often comfortable, and looks as 
if nothing much were amiss. Like measles, the disease 
especially attacks young children, and it is so prevalent 
that very few escape. The infective material, which is 
believed to be of a volatile nature, is conveyed by the 
breath, and there can be no doubt that it adheres to arti- 
cles of clothing. As regards prevention, strict isolation 
is the only measure of any value', and even this frequently 
fails to check the spread of the disease; while disinfec- 
tants of any kind are not known to be of much service. 
4. Scarlatina, or Scarlet Fever, as it is often called, is a 
highly infectious disease, which specially attacks children 
between the third and fourth years, but after the fifth year 
the chances of attack decline rapidly. It is characterized 
by a scarlet efflorescence, or rash, which appears on the 
back of the throat and tonsils on the second day of the 
attack, then on the neck and face, and afterwards spreads 
over the whole body. The rash on the skin begins to de- 
cline from the fifth to the seventh day, and finally termi- 
nates in desquamation, or peeling off of the upper scales 
or layers of the skin. As a rule, the period which elapses 
between infection and the appearance of the eruption 
varies from four to six days, but in severe cases it may be 
much shorter. The infective material, like that of small- 
pox, is exceedingly powerful and volatile, so that no sus- 
ceptible person can remain in the same room for any 
length of time, or even in the same house, unless the pa- 288 
INFECTIOUS DISEASES. 
tient is carefully isolated, without running great risk of 
contracting the disease. Moreover, the infective material 
is contained in everything which proceeds from the pa- 
tient, but more particularly in the cuticular scales given 
off in peeling. These scales, laden with the specific poison, 
are conveyed by the currents of air to every part of the 
room, and may settle on clothing, bedding, furniture, and 
the walls of the room. They preserve their infecting 
power for an unknown period of time, and may be con- 
veyed long distances by articles of clothing and the like. 
There is reason to believe that the disease is infectious 
through the agency of the breath, even before the erup- 
tion appears; but, according to my own experience, it is 
seldom that other cases break out in the same family if 
the first case is promptly removed to a hospital and thor- 
ough measures of disinfection are carried out. The pa- 
tient ought not to be pronounced free from infection until 
peeling has ceased, and the surface of the body has been 
well bathed. 
There are three varieties of the disorder:-one in which 
the skin only is affected; one in which both skin and 
throat are affected; and one-known as malignant scar- 
latina-in which all the force of the disease seems to be 
expended on the throat. This last form of the disease is 
especially fatal; but, apart from these varieties, there are 
numerous cases to be met with in every outbreak, in 
which the only marked symptom is a slight sore throat, 
with no perceptible eruption on the skin. In the more 
severe forms, the tonsils inflame and become ulcerated, 
the glands of the neck become painful and enlarged, and 
in almost all there is congestion or acute inflammation of 
the kidneys which often induces dropsy. 
There is reason to believe that the disease may be origi- 
nated by sewer gases', foul effluvia from cesspools, and the 
effluvia given off by the decomposing blood from slaughter- DIPHTHERIA. 
289 
houses. But, however originated, or wherever a case 
appears, there is the greatest possible risk of the disease 
spreading if proper precautions are not immediately taken. 
As already pointed out in Chapter III., many severe out- 
breaks have been traced to the agency of milk when the 
disease has been found to exist in the dairyman's house. 
There is no doubt too that it is often spread by washer- 
women who have children ill with the disease, and by 
sempstresses and tailors who are allowed to take their 
work to their own homes. 
While general precautionary measures will be more 
fully detailed further on, I wish to point out here very 
forcibly that if the throat of the patient is carefully 
mopped out by some disinfectant, and the whole of the 
body anointed from day to day with carbolized or cam- 
phorated oil, alternating with baths when admissible until 
desquamation has ceased, the risk of other members of the 
household being attacked would be greatly diminished. 
Indeed, the late Dr. Budd, of Bristol, whose researches 
as regards this disease and ■ typhoid fever are so well 
known, has put it on record that, by isolating the patient 
and carefully carrying out the above precautions, he 
always succeeded in preventing any spread of the disease 
in the same house. But these measures, of course, cannot 
be carried out except under the advice or sanction of the 
medical attendant. 
5. Diphtheria.-Although it is sometimes very difficult 
to trace the precise origin and mode of propagation of 
this disease, there can be no doubt that it is intimately 
associated with sanitary defects, and it is not surprising, 
therefore, that it was numbered among fatal epidemics as 
far back as the sixteenth century. In the present day it 
is much rarer in this country than in former times, owing, 
no doubt, to steady sanitary progress; but there are still 
localized outbreaks, and these are of more frequent occur- 
19 290 
INFECTIOUS DISEASES. 
rence in rural than in urban districts. The disease is 
characterized by fever, often of a low type, and throat 
symptoms. The tonsils and back of the throat become 
inflamed, and after a day or two a gray patch of false 
membrane, as it is called, appears on one oi' both tonsils, 
and may extend over the whole back of the throat and 
down into the larynx, or windpipe. When the membrane 
especially exudes in the windpipe, the disease is often 
called croup, or diphtheritic croup. There can be no 
doubt, too, that where the disease is prevalent there are 
many cases to be met with which present the symptoms 
of simple sore throat. In severe cases, the disease often 
proves rapidly fatal, and in many recovery is slow at the 
best, the glands of the neck and the kidneys being often 
affected as in scarlatina. 
As already pointed out in Chapter III., scattered cases 
can often be traced to polluted water, to sewer air, or to 
milk which has been contaminated with polluted water or 
tainted air. If a milkman has diphtheria in his house, 
or if any of the milkers happen to suffer from the disease, 
there are strong grounds for believing that the milk may 
become infected by the breath, and that the infection may 
readily be spread in this way. Although the disease is 
not so much confined to children as scarlatina, it is often 
propagated by the agency of schools, and in households 
by kissing. The infective particles given off* by the breath 
are exceedingly powerful, and no one should on that ac- 
count bend over or kiss the patient, while all expectorated 
matters, and rags used to wipe the nose and mouth, should 
be carefully disinfected or burned. Strict isolation is of 
course indicated, and, with the exception of the oil inunc- 
tion, the same precautionary measures should be adopted 
as apply to scarlatina. 
6. Fever. («.) Typhus Fever.-This form of fever has 
been more or -less epidemic from the earliest ages. Over TYPHUS FEVER. 
291 
and over again it has decimated insanitary armies, invaded 
jails as in John Howard's days, and its ravages have 
always been greatest where overcrowding and famine have 
prevailed. Owing mainly to improved house accommo- 
dation and greater cleanliness, it rarely appears in this 
country in the present day, except in the dirty over- 
crowded parts of our large towns. It attacks persons of 
all ages and both sexes, and its onset is generally some- 
what sudden, for the exact period of incubation is unknown. 
The disease is characterized by a mottled dusky eruption, 
which appears in the skin, generally from the third to the 
eighth day, and usually remains visible for eleven or 
twelve days. The febrile symptoms are mostly of a low 
type-languor and weariness are prominent from the first, 
often passing into sluggishness of intellect, muttering deli- 
rium, and complete prostration. In cases of recovery, 
the average duration of the disease is about twenty-one 
days, but in mild cases convalescence may be favorably 
advanced from the thirteenth to the seventeenth day. 
When the disease proves fatal, death takes place gener- 
ally between the twelfth and twentieth day. 
The conditions favorable to the propagation of typhus 
fever are mainly these:-overcrowding and deficient ven- 
tilation, want of personal cleanliness, squalor and want, 
a deteriorated state of the constitution from whatever 
causes, and a moderate temperature. The disease, once 
generated, is highly infectious, the poison being thrown 
off by the exhalations from the lungs and skin. But the 
infective material does not travel far through the air, for 
it appears that if the patient is isolated in a well-ventilated 
room, the attendants incur little risk, and the other mem- 
bers of the household none whatever, so long as they avoid 
close contact with the patient or his infected belongings. 
The vast majority of cases of this and other infectious 
diseases, however, occur in houses where strict isolation is 292 
INFECTIOUS DISEASES. 
impossible unless the patient is at once removed to a 
hospital. In addition to isolation, the other general pre- 
cautionary measures which should be adopted are similar 
to those which apply to small-pox and scarlet fever. 
(b.) Relapsing Fever.-This fever has become much less 
frequent during recent years than even typhus, and, though 
infectious in the same way, is not infectious to the same 
extent. It selects its victims from the poor and ill fed, 
who are huddled, together in crowded and badly ventilated 
dwellings, and it is liable to become epidemic in times of 
scarcity or famine. It is characterized by a very abrupt 
onset and short duration; but while the feverish attack 
lasts it is almost always severe, with a bounding pulse, 
headache, vomiting, and sometimes delirium. These 
symptoms generally terminate by free perspiration, between 
the fifth and eighth day, and after an interval during 
which the patient appears to be rapidly recovering, he 
sickens with a second attack, in all respects similar to the 
first, except that it is milder and shorter in duration. This 
relapse, as it is called, usually supervenes on the fourteenth 
day after the commencement of the attack, and it may be 
followed by a third or fourth relapse. There is no special 
rash, or skin eruption, to characterize the disease as in 
typhus fever.* 
(c.) Typhoid Fever.-This fever is known under several 
names, such as enteric fever, gastric fever, low fever, and 
there is no doubt too that it is often registered as simple 
continued fever. Some writers maintain that genuine 
typhoid fever can only be propagated from a previously 
existing case or cases; but there is a constantly increasing 
amount of evidence which goes to prove that it is often 
* The cause of Relapsing Fever is now almost positively proved to be a microscopic 
vegetable organism, which develops by millions in the blood of persons sick with 
the disease; and this fact, of course, encourages us to believe that similar causes of 
other contagious maladies may soon be discovered, and our means of avoiding or 
controlling their spread rendered thereby far more efficacious than heretofore.-(R.) TYPHOID FEVER. 
293 
induced by sewer air, foul effluvia from cesspools, or pol- 
luted water, independently of any previous case. As it 
occurs in rural and small urban districts, my own expe- 
rience leads me to believe that the great majority of scat- 
tered cases are originated apart altogether from the in- 
fluence of specific germs; but, however induced or however 
propagated, it is essentially a filth disease, and when once 
developed, the bowel discharges, where local conditions 
assist, can operate with terrible force, and often at long 
distances from the sick. The outbreaks already referred 
to in Chapter III. show how readily the disease may be 
spread by milk which has become contaminated by pol- 
luted water, or how, if typhoid germs once find an en- 
trance into a sewer or a public water-main, it may attack 
large numbers of people living in the same locality. The 
great preventives against typhoid fever, therefore, are 
these:-properly constructed, ventilated, and flushed sewers 
in towns; properly constructed, ventilated, and discon- 
nected house-drains; a good public water supply, protected 
in all its details against the. entrance of impurities; and 
thorough cleanliness everywhere. In country districts, 
again, the wells must be guarded against pollutions, leaky 
cess-pits or filthy closets abolished, and leaky drains re- 
paired and kept clean. As regards other precautionary 
measures, it is of the utmost importance that all soiled 
clothing and discharges from the typhoid fever patient 
should be thoroughly disinfected,, and that in country dis- 
tricts the excreta should always be buried in the garden, if 
possible, and not thrown into the outside closet. 
The disease itself presents many and varied features, 
but it is mainly characterized by an eruption of rose- 
colored spots on the abdomen, which make their appear- 
ance from the fourth to the twelfth day after the feverish 
symptoms set in. These spots generally occur in crops, 
each spot remaining visible for-about three days. In 294 
INFECTIOUS DISEASES. 
many cases, however, the spots are ill defined or absent 
altogether, but in most there is tenderness over the abdo- 
men, and after a time diarrhoea sets in, and the glands of 
the intestines become inflamed and in severe cases ulcerated. 
The average duration of the illness is about three weeks, 
and when it terminates fatally, death usually occurs towards 
the close of the third week. The period of incubation varies 
greatly, and sometimes may be protracted so long as twenty 
days; indeed, the fever sets in so insidiously that it is often 
difficult to fix the commencement of the attack, the patient 
suffering for days previously from languor, depression, loss 
of appetite, and general bodily discomfort. 
7. Diarrhoea.-It is very doubtful whether this ailment 
ought to be fairly classed among zymotic diseases, inas- 
much as among infants especially, it often results from 
bad feeding, and among grown-up persons, it is not un- 
commonly induced by errors of diet. There can be no 
question, however, that as previously stated, it is frequently 
originated by filth, whether from foul surroundings,sewer 
gas, or polluted water, and it no doubt prevails largely 
among the infant population, because the milk upon 
which they are fed is often diluted with impure water, and 
because feeding-bottles are not kept properly clean. 
Having thus far considered in detail the principal 
zymotic diseases, a few words may now be added concern- 
ing channels of infection which are very liable to be over- 
looked or concealed. And first, it has to be pointed out 
that diseases such as scarlet fever, measles, and diphtheria, 
which especially attack young children, are almost in- 
variably spread through the agency of schools. Not only 
are children from infected houses allowed by their parents 
to attend school so long as they are not prohibited by 
public officials or the medical attendant, but it often 
happens that children who are only affected to a slight 
extent with one or other of these diseases are permitted CHANNELS OF INFECTION. 
295 
to go to school as usual, and thus become certain and 
dangerous centres of infection. But apart from the disas- 
trous results which depend upon the ignorance or reck- 
less indifference of parents in this respect, there can be no 
doubt too that the agency of schools in the propagation 
of infectious diseases is becoming all the more potent as 
attendance becomes better enforced. Under the Education 
Act, teachers in elementary schools are paid by results 
and according to the average attendance, and as closing a 
school therefore entails a certain pecuniary loss, the teacher 
is naturally averse to report cases to the sanitary officials 
because he is afraid that it might be deemed necessary to 
close the school. He forgets the fact that if the first cases 
in an outbreak are isolated, and proper precautionary 
measures are adopted, the further spread of the disease 
may be checked; but these first cases are often concealed, 
or at all events not reported, and consequently the out- 
break may assume serious dimensions before it is known 
to the Sanitary Authority or their officials. 
I have often heard it urged by teachers and school 
managers, that it is of no use closing schools to check the 
further spread of infectious disease, because the children 
are sure to mingle and play together in the streets. But 
the conditions are altogether different. In the open 
streets there is far more free space, and there is little 
comparative risk of inhaling infection from the breath or 
clothes; whereas at schools the children's caps, bonnets, 
and overcoats are hung up together; the children them- 
selves are packed so closely while in school that they must 
inhale each other's breaths, and have to run all the risks 
from personal contact; while the dangers are greatly 
increased by the condition of the outside offices, which, in 
country districts especially, are often of the foulest de- 
scription and notoriously neglected. 
Among other channels by which infectious disease is 296 
INFECTIOUS DISEASES. 
frequently spread may be mentioned the occurrence of 
cases in small shops, or other places of business. Under 
such circumstances, an attempt is generally made to con- 
ceal any cases of the kind as long as possible, because the 
shopkeeper is afraid of losing his business and frightening 
his customers. Then, too, as already pointed out, there 
can be little doubt that infectious disease is often spread 
by tailors and sempstresses, who are allowed to stitch the 
garment of the fashionable wearer in their own miserable 
homes, with, perhaps, a sick child suffering from scarlet 
fever, small-pox, measles, or diphtheria, lying covered 
with rags in a corner of the same room. Indeed, in Lon- 
don and other large towns, there is very little of the actual 
work of fashionable tailoring or millinery establishments 
done on the premises; the large bulk of it is taken hoine 
by the work-people and finished there. But there are 
other channels of infectious communication which operate 
perhaps even more disastrously than these; and amongst 
them I may mention the following:-Pawn-shops, where 
articles of clothing from all parts are huddled and stored 
together; small laundries, which are scattered round the 
outskirts of towns; dairymen's premises, when they are 
not properly supervised and kept in good order; and 
lodging-houses in fashionable watering-places. Nor 
should I omit to refer to the terrible risks attending the 
custom of holding wakes, which still prevails to a large 
extent among the.Irish poor. It matters not whether the 
patient may have died from small-pox, typhus fever, or 
some other dangerous infectious disease, the custom is still 
observed in spite of all remonstrance, and with a reckless 
indifference to danger which can only be accounted for 
by ignorance and superstition. But I have already said 
enough, and more than enough, to convince the reader 
how varied and intricate are the channels of infection, 
and how incomplete and imperfect are our sanitary de- PRACTICAL DISINFECTION. 
297 
fences against them. People who live in clean and 
elegant homes away from the foul breeding-places of infec- 
tious diseases are too apt to forget how closely the dangers 
press upon themselves. Not only may their clothes be 
made in these pestiferous localities, but the message-boys, 
charwomen, postmen, servants, " the hewers of wood and 
drawers of water," who attend to their wants, either live 
in the overcrowded slums of our large towns, or have 
friends or relations whom they visit there. It thus 
appears that infectious diseases take advantage of almost 
every relationship of life. The infective material may be 
left in a cab, communicated in a railway carriage, or be 
actually inhaled from the breath or infected clothing of 
the person sitting next you in an omnibus or tramway 
car. Hence it follows that the prevention of infectious 
disease is a matter of public and national concern, irre- 
spective altogether of private interests or personal con- 
siderations. But public measures, however well devised, 
can never prove effectual unless backed by earnest and 
intelligent private efforts; and we will now proceed to 
indicate how these may best- be carried out. 
II. Practical Disinfection. 
Disinfectants may be described as agents which are in- 
tended to destroy the infective power of so-called disease- 
germs, or indeed of any decomposing matter, whether 
existing in air, water, or other substances, which tend to 
produce disease. Some of them act as deodorants by de- 
stroying offensive effluvia, or as antiseptics by arresting 
decomposition, or as destructives by their direct chemical 
action; and the most efficient amongst them are endowed 
with all these properties, though in varying degrees. It 
would be out of place here to weary the reader with a 
long list of the numerous substances which are recom- 
mended for purposes of disinfection, and I shall therefore 298 
INFECTIOUS DISEASES. 
only mention a few of the agents which have been proved 
to be of undoubted value in this respect. These are- 
fire, or dry heat, sulphurous acid gas, sanitas, Condy's 
Fluid, chloralum, carbolic acid, feralum, and chloride of 
lime. 
While extreme cold prevents putrefactive change, and 
therefore acts as an antiseptic, extreme heat is destructive 
of all organic matter, and is therefore the most efficacious, 
as it is the most ancient, of all disinfectants. But even a 
temperature much below that of actual combustion is 
found to be sufficiently powerful, if continued for any 
length of time, to kill animal or vegetable germs, and to 
render inert any infectious matter. But the temperature 
ought not to be below 240° Fahr., and care must be taken 
that this temperature is actually reached by every parti- 
cle of matter included in the heated space. What are 
called disinfecting chambers are now provided in most 
large towns, and they are so arranged that this tempera- 
ture can be maintained for any desired length of time, so 
that articles of clothing and bedding can be thoroughly 
disinfected in them and without injuring the material. 
In all localities, therefore, where such chambers have 
been provided, the householder should apply to the sani- 
tary officials to have any articles disinfected which can- 
not be so efficiently purified by other means. In cases 
of malignant infectious disease, such as confluent small- 
pox, it is sometimes necessary to have the clothing or bed- 
ding destroyed by fire or disinfected and buried, but that 
is generally done by order of the medical officer of 
health.* 
Sulphurous acid gas is the most convenient and efficient 
agent for disinfecting empty rooms after cases of infec- 
*The thorough disinfection of contaminated clothing, bedding, &c., by hot air is 
performed under the authority of Boards of Health in some of our large cities, and 
we hope will soon become general in America.-(R.) PRACTICAL DISINFECTION. 
299 
tious disease. The plan of procedure is as follows:- 
After recovery or death, the sick-room and its contents 
should be thoroughly fumigated by burning about a 
pound of lumps of sulphur in an iron or earthenware dish 
(or the lid of an iron saucepan), supported on a pair of 
tongs over a bucket of water. Before setting fire to the 
sulphur, the windows should be closed, and the fireplace 
or other crevices pasted over with thick paper, or other- 
wise made air-tight. The door should then be shut, and 
the room be kept closed for five or six hours. After 
which it should be freely ventilated, the paper, if any, 
removed, the walls and ceiling lime-washed, and the 
floor and furniture washed with disinfectant soap and 
water. 
Disinfectants are not of much value to purify the air of 
the sick-room, but they are useful in Removing unpleasant 
odors, provided they do not irritate the patient or dis- 
guise the signs of deficient ventilation. Chloride of lime 
or carbolic acid are not suitable for sprinkling about the 
room, because the odors given off by them are unpleasant ; 
but sanitas or chloralum, or Condy's Fluid,* may be used 
with advantage. The discharges from the patient should 
be received in vessels containing either of these disinfec- 
tants or carbolic acid, and all bed or body linen should 
be received into a vessel containing water charged with 
sanitas, chloralum, or carbolic acid (about half a pint to 
two gallons of water), before removal from the room, and 
afterwards boiled. Condy's Fluid and chloride of lime 
are both unsuitable for this purpose, because the former 
stains, and the latter injures, articles of clothing. The 
medical attendant or sanitary official will generally give 
instructions as to what particular disinfectant to use, and 
* Instead of purchasing this disinfectant in solution, it is better to prepare it when 
wanted, by dissolving one ounce of crystallized Permanganate of Potassa in a gallon 
of water.-(R.) 298 
only mention a few of the agents which have been proved 
to be of undoubted value in this respect. These are- 
fire, or dry heat, sulphurous acid gas, sanitas, Condy's 
Fluid, chloralum, carbolic acid, feralum, and chloride of 
lime. 
While extreme cold prevents putrefactive change, and 
therefore acts as an antiseptic, extreme heat is destructive 
of all organic matter, and is therefore the most efficacious, 
as it is the most ancient, of all disinfectants. But even a 
temperature much below that of actual combustion is 
found to be sufficiently powerful, if continued for any 
length of time, to kill animal or vegetable germs, and to 
render inert any infectious matter. But the temperature 
ought not to be below 240° Fahr., and care must be taken 
that this temperature is actually reached by every parti- 
cle of matter included in the heated space. What are 
called disinfecting chambers are now provided in most 
large towns, and they are so arranged that this tempera- 
ture can be maintained for any desired length of time, so 
that articles of clothing and bedding can be thoroughly 
disinfected in them and without injuring the material. 
In all localities, therefore, where such chambers have 
been provided, the householder should apply to the sani- 
tary officials to have any articles disinfected which can- 
not be so efficiently purified by other means. In cases 
of malignant infectious disease, such as confluent small- 
pox, it is sometimes necessary to have the clothing or bed- 
ding destroyed by fire or disinfected and buried, but that 
is generally done by order of the medical officer of 
health.* 
Sulphurous acid gas is the most convenient and efficient 
agent for disinfecting empty rooms after cases of infec- 
INFECTIOUS DISEASES. 
* The thorough disinfection of contaminated clothing, bedding, &c., by hot air is 
performed under the authority of Boards of Health in some of our large cities, and 
we hope will soon become general in America.-(R.) tious disease. The plan of procedure is as follows:- 
After recovery or death, the sick-room and its contents 
should be thoroughly fumigated by burning about a 
pound of lumps of sulphur in an iron or earthenware dish 
(or the lid of an iron saucepan), supported on a pair of 
tongs over a bucket of water. Before setting fire to the 
sulphur, the windows should be closed, and the fireplace 
or other crevices pasted over with thick paper, or other- 
wise made air-tight. The door should then be shut, and 
the room be kept closed for five or six hours. After 
which it should be freely ventilated, the paper, if any, 
removed, the walls and ceiling lime-washed, and the 
floor and furniture washed with disinfectant soap and 
water. 
Disinfectants are not of much value to purify the air of 
the sick-room, but they are useful in Removing unpleasant 
odors, provided they do not irritate the patient or dis- 
guise the signs of deficient ventilation. Chloride of lime 
or carbolic acid are not suitable for sprinkling about the 
room, because the odors given off by them are unpleasant; 
but sanitas or chloralum, or Condy's Fluid,* may be used 
with advantage. The discharges from the patient should 
be received in vessels containing either of these disinfec- 
tants or carbolic acid, and all bed or body linen should 
be received into a vessel containing water charged with 
sanitas, chloralum, or carbolic acid (about half a pint to 
two gallons of water), before removal from the room, and 
afterwards boiled. Condy's Fluid and chloride of lime 
are both unsuitable for this purpose, because the former 
stains, and the latter injures, articles of clothing. The 
medical attendant or sanitary official will generally give 
instructions as to what particular disinfectant to use, and 
PRACTICAL DISINFECTION. 
299 
* Instead of purchasing this disinfectant in solution, it is better to prepare it when 
wanted, by dissolving one ounce of crystallized Permanganate of Potassa in a gallon 
of water.-(RJ 300 
INFECTIOUS DISEASES. 
it is always advisable to employ one only, such as sanitas,* 
which can be used for all purposes. 
III. General Precautionary Measures. 
When a case of dangerous infectious disease occurs or 
is suspected, a medical practitioner should be immediately 
sent for. No suspected case should be taken to a dispen- 
sary or hospital for advice from any house where dangerous 
infectious disease exists. 
If the patient is not removed without delay to a hospital 
for infectious disease, by advice of the medical attendant, 
he should, if possible, be separated from the rest of the 
family. 
No householder or employer of labor can send servants 
suffering from dangerous infectious diseases to their own 
homes, without rendering themselves liable to be prose- 
cuted by the Sanitary Authority of the district. 
If the disease happens to be small-pox, any unvaccinated 
infant in the house should at once be vaccinated; and all 
adults or children with indistinct vaccine marks should 
be re-vaccinated.f 
As a rule, a room at the top of the house makes the 
best sick-room, and this should at once be stripped of all 
carpets, curtains, or other needless draperies. 
Persons in attendance on the sick should by preference 
wear cotton dresses, maintain scrupulous cleanliness, and 
should avoid, as far as possible, associating with others. 
Disinfectants which have no unpleasant odor may be 
sprinkled about the room; but the best of all disinfectants 
for the air is free ventilation by open windows, and a fire 
if necessary. 
* The carbolic acid solution above-mentioned is probably quite as efficient, and in 
some respects to be preferred.-(R.) 
f It is safer to re-vaccinate every person living in a house where small-pox exists, 
or exposed to the disease, even those who have distinct vaccine marks.-(R.) GENERAL PRECAUTIONARY MEASURES. 
301 
All discharges from the patient, especially if the disease 
is typhoid fever, small-pox, or scarlatina, should be re- 
ceived into vessels containing some suitable disinfectant, 
as recommended, and should be removed from the sick- 
room without delay. In country districts, it is advisable 
that they should be buried in a hole dug in the garden.* 
Soft pieces of rag should be used for wiping the mouth 
and nose of the patient when deemed necessary, and these 
should either be burned, or plunged into some vessel con- 
taining a disinfectant, and removed without delay. 
All bed or body linen which has been in contact with 
the person of the patient should be received into a vessel 
containing water charged with a disinfectant, before re- 
moval from the room, and afterwards boiled. 
All glasses, cups, or other vessels used in the sick-room 
should be scrupulously cleaned before being used by 
others. 
If the disease is scarlet fever, the body of the patient 
should be rubbed all over with camphorated oil daily, so 
soon as approved by the medical attendant, and when the 
patient is able to take a warm bath, the whole of the body 
should be well bathed with water and some disinfectant 
soap. With the approval of the medical attendant, these 
baths should be continued every alternate day until such 
time as he may consider the patient entirely free from 
the disease, after which, and in clean clothes, he may be 
allowed to rejoin the family and go out of doors, but not 
till then.f 
If the disease happens to be small-pox, the patient can- 
not be pronounced free from the disease until all crusts or 
scabs have been removed and the whole body has been 
* At least two hundred feet from any drinking-water well.-(R.) 
f Washing with carbolic-acid soap (or other disinfectant) should be particularly 
thorough among the hair of the head, eyebrows, etc., where flakes of epithelial 
cells, in the form of dandruff, freighted with germs of contagious disease, are espe- 
cially apt to linger.-(R.) 302 
INFECTIOUS DISEASES. 
well bathed. Indeed, the patient should always be well 
bathed before putting on clean clothes, and especially if 
the disease is characterized by any eruption on the skin. 
In case of death, the body should be enveloped in a 
sheet steeped and wrung out of some powerful disinfectant, 
such as carbolic acid, and buried without delay. 
After recovery or death, the sick-room and its contents 
should be fumigated and disinfected, as previously di- 
rected. 
Blankets, bedding, and woollen materials should either 
be sent to a public disinfectant chamber for disinfection, 
or they should be steeped in water charged with a disin- 
fectant, and boiled, and afterwards kept exposed to the 
outside air for some considerable time. The hair of in- 
jected mattresses should be teased out, fumigated in the 
sick-room with sulphurous acid gas, and afterwards ex- 
posed to the air, if the mattresses cannot be disinfected in 
a hot air chamber. 
All articles that cannot be properly disinfected should 
be burned, or buried in a hole dug in the ground, with 
disinfectants thrown over them. 
No clothes should be sent from any house where there 
is fever or infectious disease, to be washed elsewhere; nor 
if clothes are received to wash, should they be received if 
a case of illness of the kind exists in the house. 
The greatest care should be taken not to allow any 
children belonging to a house where there is fever or in- 
fectious disease to mix with other children, and the rest 
of the family should, as far as possible, avoid associating 
with others. 
On no account should any child be sent to school from 
a house or family where fever or infectious disease exists. 
The greatest care should be taken to remove all nui- 
sances from the premises. No filth accumulations of any 
kind should be tolerated, and disinfectants should be freely PENALTIES. 
303 
used for closets, whether inside or outside. Drains should 
be kept well flushed and disinfected. Above all, the water 
supply should be looked to if obtained from a private 
well. 
Early information of every case of fever or infectious 
disease should be forwarded to the sanitary inspector of 
the district, who is generally authorized to order the sup- 
ply of disinfectants to all who are too poor to buy them. 
Although it may not be possible to carry out these pre- 
cautions in all cases, it ought to be the duty of every re- 
sponsible person to strive to do so. 
Penalties. 
By provisions of the Public Health Act, 1875, it is 
enacted as follows:-Any person suffering from any dan- 
gerous infectious disease, who willfully exposes himself in 
any public place or public conveyance, and any one in 
charge of such person, and any owner or driver of a 
public conveyance who does not immediately disinfect his 
conveyance after conveying an infected person; or any 
one who, without previous disinfection, gives, lends, sells, 
or transmits (to the wash or otherwise) any bedding, 
clothing, linen, or rags, which have been exposed to in- 
fection, or who lets any infected house or room, or who 
neglects to disinfect premises after due notice has been 
given, can be prosecuted by the Sanitary Authority, and 
is liable to heavy penalties. 
Concluding Remarks. 
Although it would be out of place to discuss here the 
public measures which are still required for the systematic 
control of preventable disease, it must be apparent to the 
reader that such control cannot be exercised with any 
approach to efficiency until the law makes it compulsory 
to register or report every case of dangerous infectious 304 
INFECTIO US DISEASES. 
disease to the local Sanitary Authority so soon as the na- 
ture of the case is determined. A few towns, such as 
Bolton, Dundee, Jarrow, and Nottingham, have already 
obtained local Acts, containing a clause or clauses com- 
pelling the householder to give such information on the 
certificate of the medical attendant; and it is to be hoped 
that at no distant date an Act will be passed to apply in 
this respect to all parts of the country. No doubt the 
passing of such an Act would be very distasteful to several 
classes of tradespeople, who believe that their interests 
would be seriously jeopardized; but it is often through the 
selfishness of these people and want of regard for the 
public safety that infectious disease is spread. I yefer 
more particularly to that numerous class of small shop- 
keepers whose living-rooms are in direct communication 
with the shop, to lodging-house-keepers, hotel-keepers, 
dairymen, and 'washerwomen. Amongst all these and 
other classes who have intimate relations with the public, 
there is a conspicuous want of conscience in their dealings 
with respect to infectious disease. Concealment is their 
first resort, and this is generally backed by artifice and 
deceit so long as concealment is possible. Nor is this lack 
of conscientious fair dealing confined to tradespeople; 
there is an incredible amount of indifference apparent 
among all classes, and even among those from whom 
better things might be expected. For example, how often 
does it not happen that a domestic servant, who is believed 
to be suffering from fever or infectious disease, is at once 
sent off in the most secret way to her own home, where in 
all probability she cannot be properly nursed, and where 
she is almost sure to be the means of conveying infection 
not only to her relations but to next-door neighbors? 
Every case of dangerous infectious disease, therefore, 
ought to be regarded as a public danger, against which 
the public, as represented by local Sanitary Authorities, CONCLUDING REMARKS. 
305 
are entitled to be warned by timely information; nor can 
there be any doubt that the proper person who ought to 
be made responsible for supplying such information is the 
householder, and that the medical attendant should be 
paid by the Sanitary Authority for the requisite certificate. 
It is for lack of such early information that outbreaks often 
assume serious dimensions before they become ascertained 
facts, and preventive measures become practically power- 
less to arrest their spread because the centres of infection 
have become so numerous and scattered. 
But in addition to compulsory and early information 
of all cases of dangerous infectious disease, it is also requi- 
site that adequate means for isolation should be provided 
for all cases which 'cannot be properly isolated and 
treated at their own homes. It is true that Sanitary 
Authorities are empowered by'the Public Health Act to 
provide hospital accommodation, and to pay for the 
maintenance of poor patients out of the rates, but unless 
it be in large towns, the instances are as yet comparatively 
rare in which these powers have been exercised. But 
even in small villages or places where hospital accommo- 
dation may not be required, much good may be effected 
by adopting, as far as possible, a system of quarantine; 
by supplying skilled nurses when necessary; and by 
taking care that disinfection and other precautionary 
measures are duly carried out. In saying all this, how- 
ever, it must not be forgotten that in arresting the spread 
of infectious disease, we must still rely in great measure on 
the active and intelligent co-operation of the people them-, 
selves, not only in improving and maintaining the sani- 
tary condition of the home and its surroundings, but by 
endeavoring to the best of their ability to prevent others 
from suffering when their own family circle is attacked. 
There are many, too, who look hopefully forward to the 
vast benefits which would ultimately result if the relations 
20 306 
INFECTIO US DISEA SES. 
between the public and the medical profession were very 
much altered. Hitherto the prevailing practice has been 
not to apply for medical advice until after sickness has 
actually set in, but it is maintained by many, and with 
reason, that it would be a far wiser policy to pay the medi- 
cal attendant a fixed sum quarterly or annually to look 
after the health of-the household. This plan is adopted 
to a certain extent in club practice, dispensary work, and 
poor-law work; but as a rule all these appointments are, 
very much underpaid because they are regarded as step- 
ping-stones, so to speak, to general practice. But the 
practice of medicine is very different now to what it was 
in days gone by, for in its modern sense and work it is 
preventive as well as healing. Still, however, it must be 
said that the credulity of the public in the power of cure 
still reigns paramount, while their faith in prevention lies 
practically dormant, and hence it is that quackery of 
every description continues to thrive, and the pills and 
potions which are so largely advertised find a ready sale. 
Then, too, it has to be pointed out that so long as medical 
practitioners are paid solely for their services in attending 
on cases of illness, it is manifestly not to their interests, 
from a purely monetary point of view, to assist in the pre- 
vention of disease, because if prevention means anything 
at all, it certainly implies that the more effectually the 
causes of disease are removed and precautionary measures 
arg carried out, the less numerous ought patients to be- 
come, and the sick-rate and death-rate will both be low- 
ered. It is true that medical men, with the noble disin- 
terestedness which characterizes the profession, are seldom 
lax in doing all they can to prevent the spread of disease; 
but there is no disguising the fact that in many quarters 
there is appearing on the surface a growing antagonism 
between medical practitioners and Sanitary Authorities, 
which is very much to be regretted. All this might be CONCLUDING REMARKS. 
307 
obviated if the public could only be persuaded that it 
would be to their ultimate advantage to pay the medical 
attendant a liberal allowance to conserve the health of 
the household. He would then be in a position to Warn 
them against many unsuspected causes of disease, whether 
personal, material, or local, and thus prevent many an 
illness, and at the same time foster the general health in 
many ways. This, however, is a question which the 
public must settle for themselves; and I have ventured 
to allude to it, by way of conclusion, to show how essen- 
tial it is that, in addition to improved and extended sani- 
tary legislation, aided and sustained by enlightened 
public opinion, the services of the profession generally 
should be enlisted in the grand policy of prevention. INDEX. 
Ash-pits, situation and construc- 
tion of, 260. 
Atavism, 72. 
Atmospheric changes, effects of, 
on health, 68. 
A. 
Aerated waters, 144. 
Air, amount of, to be supplied in 
ventilation, 251. 
- causes of impure, in houses, 
106. 
- changes in, effected during 
respiration, 60. 
- composition of, 59. 
- diseases induced by impure, 
102. 
- examination of, 259. 
- impurities in, 101. 
Air-cells, 59. 
Air-flues in houses, 232. 
Albumen 37. 
Alcohol, abstinence from use of, 
when indicated, 82.- 
-amount of, which can be con- 
sumed without apparent 
detriment to health, 147. 
- diseases induced by abuse of, 
•87. 
- physiological effects of, 83. 
Alcoholic beverages, 148. 
Alimentary canal, 46. 
- equivalents, 121. 
Animal foods, choice of, 133. 
- heat, production of, 61. 
Arteries, distribution and func- 
tions of, 54. 
B. 
Bacon, 139. 
Barley meal, 128. 
Bathing, rules respecting, 175. 
Baths, different kinds of, with 
directions, 172. 
Beating of the heart, 56. 
Bed-clothes, hints respecting, 
181. 
Bedding, disinfection of, 302. 
Bedrooms, ventilation of, 252. 
Beer, 150. 
Beverages, alcoholic, 147. 
- non-alcoholic, 145. 
Bile, 49. 
Blood, changes in, induced, by 
respiration, 60. 
- circulation of, 52. 
- composition of, 51. 
Body, physiology and structure 
of, 32. 
Bones, structure and functions 
of, 42. 
Boots and shoes, hints respect- 
ing, 182, 
309 310 
INDEX. 
Brain, structure and functions 
of, 43. 
Bread, characteristics of whole- 
some, 127. 
Bronchial tubes, 58. 
Butcher's meat, examination of, 
136. 
Butter, characteristics of good, 
135. 
D. 
Dampness, injurious effects of, 
106. 
Death, natural, 23. 
Death-rate, general, how to cal- 
culate, 25. 
- infant, 26. 
- possibility of lowering, 28. 
- zymotic, 27. 
Diarrhoea, causes of, 294. 
Diet,.hints on, 159. 
Dietaries, construction of, 123. 
Digestibility of various articles 
of food, 159. 
Digestion, process of, 46. 
Diphtheria, mode of propagation 
and prevention of) 290. 
Disease, nature of, 67. 
Diseases, classification of causes 
of, 70. 
- infectious, their mode of 
propagation and preven- 
tion, 269. 
Disinfection and disinfectants, 
297. 
Drains, situation and construc- 
tion of, 238. 
Dress, hints respecting, 183. 
Drinks, stimulants, and bever- 
ages, 142. 
Dust-bins, situation and con- 
struction of2 260. 
C. 
Capillaries, structure and func- 
tions of, 54. 
Carbonic acid gas, amount of, 
given off by lungs, 60. 
- in air, 60. 
Causes of disease, 66. 
Cesspools, situation and con- 
struction of, 241. 
- dangers attending, 109. 
Channels of infection, 294. 
Cheese, 136. 
Cholera, mode of propagation 
and prevention of, 274. 
Chyme, 48. 
Cisterns, situation, construction, 
and cleansing of, 245. 
Cleanliness, necessity of per- 
sonal, 169. 
Clothing, directions respecting, 
178.. 
- disinfection of, 298. 
Cocoa, 146. 
Coffee, 146. 
Connective tissue, structure and 
functions of, 40. 
Consanguinity, risks attending 
marriages of, 76. 
Consumption, pulmonary, how 
induced, 74, 102, 225. 
Contagion and infection used as 
synonymous terms, 117. 
Controllable causes of disease, 79. 
Cooking, hints with respect to, 
152. 
Corsets, inj urious effects of tight, 
184. 
Cubic space, necessary amount 
of, for health, 251. 
E. 
Eggs, how to test good, and how 
to preserve, 140. 
Epidemics of Middle Ages and 
during recent times, 269. 
Exercise, amount of, required for 
health, 190. 
- during childhood, 199. 
- for boys, 202. 
- for girls, 204. 
- for men, 210. 
- for women, 207. 
- in old age, 212. 
- physiology of, 190. 
Excretion, organs of, 61. 
Extinction of the Unfit, (note,) 
76. INDEX. 
311 
F. 
Family characteristics, 73. 
Farinaceous constituents of food, 
36. 
Fatty constituents of food, 36. 
Filters, 249. 
Fireplaces, 255. 
Fish, 139. 
Food, different articles of, 125. 
- diseases connected with un- 
sound, 110. 
- functions and constituents of, 
35. 
- in relation to work, 123. 
- nutritive equivalents of, 122. 
Formulae for soup-kitchens and 
cooking-depots, 154. 
Impurities in air, as causes of 
disease, 101. 
- in water, 107. 
Inlets for fresh air, situation and 
construction of, 256. 
Inspiration and respiration, 59. 
Intemperance as a cause of dis- 
ease, 84. 
Interchanges of dead and living 
matter, 64. 
Irregular modes of life as causes 
of disease, 97. 
J. 
Jail fever, its prevalence during 
last century, 222. 
G. 
Game, 139. 
Gas-lights, 258. 
Gastric juice, 48. 
Germ theory of disease, 26, 117. 
Grates, 256. 
K. 
Kidneys, functions of, 63. 
L. 
Lacteals, functions of, 50. 
Late hours, ill effects of, 98 
Lead, how acted on by water, 108. 
Legumes, as articles of food, 130. 
Life, duration of, 21. 
Lighting, 258. 
Liver, functions of, 48. 
Lungs, structure and functions 
of, 58. 
Lymphatic system, 50. 
H. 
Heart, its structure and func- 
tions, 52. 
Heat, generation of animal, 61. 
- as a disinfectant, 298. 
Hereditary influence as a cause 
of disease, 71. 
Houses, drainage of, 238. 
- hints in respect to choice of, 
261. 
- historical sketch of, 221. 
-- outside premises of, 260. 
- site of, 225. 
- structural details of, 228. 
- ventilation, lighting, and 
warming of, 250. 
- water supply of, 243. 
M. 
Maize, 129. 
March of a generation through 
. life, 18. 
Marriages, evil effects of, between 
persons hereditarily dis- 
eased, 78. 
- of consanguinity, dangers at- 
tending, 76. 
Measles, mode of propagation 
and prevention of, 286. 
I. 
Idleness, injurious effects of, 96. 
Immorality as a cause of deterio- 
ration and disease, 97. 312 
INDEX. 
Meat, characteristics of good, 
136. 
- diseases produced by un- 
sound, 112. 
Mental worry and overwork as a 
cause of disease, 93. 
Meteorological changes, influ- 
ence of, on health, 68. 
Milk, amount to be given to 
infants, 162. 
- characteristics of good, 135. 
- propagation of disease by 
means of tainted, 110. 
Mind in relation to matter, 45. 
Muscles, structure and functions 
of, 41. 
Phthisis, by impure air, 102. 
- by hereditary influence, 74. 
Physiology of body, 32. 
- of exercise, 190. 
- of recreation, 196. 
- of training, 213. 
Physique, national, 187. 
Pork, measly, 114. 
Plague, 270. 
Preventable disease, amount of, 
27. 
Preventive or precautionary 
measures, 300. 
Protoplasm, nature of, 35. 
R. 
Recreation, necessity of, 191. 
- physiology of, 193. 
Reflex action, 43. 
Registrar - General's returns, 
value and uses of, 24. 
Relapsing fever, propagation and 
prevention of, 292. 
Relation of vital processes, 63. 
Respiration, physiology ofj 57. 
Rest, necessity of, 194. 
Revaccination, value of, 281. 
Rice, 129. 
Rye meal, 129. 
N. 
Narcotics as causes of disease, 
90. 
Nervous system, physiology of, 
43. 
Nitrogen, amount of, in air, 59. 
Nitrogenous constituents of food, 
36. 
Nuisances removable under Sani- 
tary Acts, 265. 
Nutrition, 46. 
O. 
Oatmeal, 128. 
Overcrowding as a cause of dis- 
ease, 102. 
Overwork as a cause of disease, 
93. 
Oxygen, amount of, in air, 59. 
- chemical action of, in body, 
61. 
- chemical action of, in nature, 
64. 
s. 
Saccharine constituents of food, 
37. 
Saline constituents of food, 38. 
Saliva and salivary glands, 47. 
Scarlatina, or scarlet fever, its 
mode of propagation and 
prevention, 287. 
School diet. 164. 
- drill, 201. 
- hygiene, 201. 
Scurvy, how induced and pre- 
vented, 271. 
Seasons, effects of, on life, 68. 
Sensation, physiology of, 43. 
Sensory nerves, 44. 
Site, choice of, for dwellings, 225. 
P. 
Perspiration, 62. 
Phthisis, pulmonary, production 
of, by dampness of soil, 
225. INDEX. 
313 
Skin, structure and functions of, 
41. 
- lungs, and kidneys com- 
pared, 63. 
Sleep, amount of, necessary for 
health, 99. 
Slops, disposal of, 242. 
Small-pox, history, mode of pro- 
pagation, and prevention 
of, 276. 
Smoking, injurious effects of, on 
boys, 90. 
- precautions with respect to, 
91. 
Sounds of the heart, how pro- 
duced, 56. 
Soup-kitchens and cooking-de- 
pots, 154. 
-- formulae for, 154. 
Statistics, vital, explanation and 
uses of, 24. 
Stays, tight, injurious effects of, 
184. 
Stomach, structure and functions 
of, 47. . • 
Stoves, ventilating, 233. 
Sub-irrigation, 242. 
Sugar, 132. 
Sympathetic system of nerves, 
physiology of, 44. 
Training, physiology of, 213. 
- system of pursued at the 
universities, 217. 
Traps, uses and description of, 
240. 
Trichina spiralis, 113. 
Typhoid fever, mode of propaga- 
tion and prevention of, 
108, 109, 292. 
Typhus fever, mode of propaga- 
tion and prevention of, 
290. 
U. 
Uncleanliness, injurious effects 
of, 169. 
Uncontrollable causes of disease, 
68. 
V. 
Vaccination, history and value 
of, 277. 
Valves of the heart, 53. 
- of the lymphatics, 50. 
- of the veins, 55. 
Vegetable foods, choice of, 126. 
Ventilation of drains, 239. 
- of houses, 252. 
- of water-closets, 234. 
Vital force, 33. 
- statistics, explanation and 
uses of, 24. 
Volunteering, hygienic effects of, 
199. 
T. 
Tea, characteristics of good, 145. 
Tea-drinking, excessive, injuri- 
ous effects of, 92. 
Teeth, cleanliness and preserva- 
tion of, 177. 
Temperature, effects of, on 
health, 68. 
- of body, 60. 
Thoracic duct, 50. 
Thorax, 57. 
Tissues, the, physiology of, 40. 
Tobacco, injurious effects of ex- 
cessive use of, 90. 
Trades, unwholesome, 105. 
Training, diet during, 216. 
w. 
Waste-preventing cisterns, 245. 
Water, amount of, in body, 38. 314 
INDEX. 
Water, distribution of, to houses, 
243. 
- effects of impure, 109. 
- qualities of, according to 
source, 143. 
- quantity of, required for 
health, 142. 
- sources of, 143. 
- uses of, in the animal econo- 
my, 38. 
Water-closets, situation and con- 
struction of, 233. 
Wells, Abyssinian tube-wells, 
247. 
- hints respecting, 246. 
Whooping-cough, mode of pro- 
pagation and prevention 
of, 286. . 
Windows, ventilation by means 
of, 252. 
Worry and overwork, injurious 
effects of, 93. 
z. 
Zymotic diseases, definition of, 
26. 
- mode of propagation and pre* 
vention of, 274. 
THE END. 
ELECTROTYPED BY MACKELLAR, SMITHS 4 JORDAN, PHILADELPHIA. Catalogue No. 5. 
A CATALOGUE 
OF 
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PAGE 
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PHARMACY AND BOTANY, 6 
MEDICAL LEXICONS, 9 
THE MICROSCOPE, 10 
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INDEX OF SUBJECTS. 
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BENTLEY AND TRIMEN'S MEDICINAL PLANTS. 
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BIDDLE'S MATERIA MEDICA. Ninth Edition. 
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P. BL ANISTON, SON A CO'S 
PROCTER'S LECTURES ON PRACTICAL PHARMACY. 
By Prof. Bernard S. Procter. Second Edition, with addi- 
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ROBERTS' MATERIA MEDICA AND PHARMACY. 
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MERRELL'S DIGEST OF MATERIA MEDICA AND PHAR- 
MACY. 
Forming a complete Pharmacopoeia for the Use of Physicians, 
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PEREIRA'S PHYSICIANS' PRESCRIPTION BOOK. 16th Edition. 
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Canada Medical and Surgical Journal. 
A PHARMACOPCEIA OF SELECTED REMEDIES, with Thera- 
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BY THE SAME AUTHOR 
ON THE VALUE OF PHOSPHORUS AS A REMEDY FOR LOSS 
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LONGLEY. POCKET MEDICAL LEXICON. 
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THE MICROSCOPE. 
BEALE'S HOW TO WORK WITH THE MICROSCOPE. 5th Ed. 
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BEALE'S USE OF THE MICROSCOPE IN PRACTICAL MEDI- 
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15 
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WILSON, ON DRAINAGE. 
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