THE COMMONSENSE 
OF HEALTH 
STANLEY M. RINEHART, M.D. The Commonsense 
of Health 
by / 
STANLEY M. RINEHART, M.D. 
GEORGE H. DORAN COMPANY 
ON MURRAY HILL : : NEW YORK Copyright, 1924, 
By George H. Doran Company 
Copyright, 1919, 1920, 1921, 
By The Curtis Publishing Company 
Copyright, 1919, 1920, 
By The Crowell Publishing Company 
THE COMMONSENSE OF HEALTH 
- A - 
PRINTED IN THE UNITED STATES OF AMERICA CONTENTS 
CHAPTMt PAGB 
One: ON CATCHING COLD 9 
Two: CONCERNING COUGHS AND COUGHERS . 24 
Three: PNEUMONIA, THE APACHE 39 
Four: T. B., THE CRIMINAL 53 
Five: THE GREATEST PUMP IN THE WORLD . 67 
Six: WHY THIS HEADACHE? 79 
Seven: SYMPTOMS AND SYMPTOM HUNTING . . 96 
Eight: ONE THOUSAND DIAMETERS 114 
Nine: THE ETERNAL WARFARE 136 
Ten: EATING TO LIVE 152 
Eleven: EXERCISE 172 
Twelve: HOW OLD ARE YOU? 191 
Thirteen: HOW HARD SHOULD WE WORK? .... 208 
Fourteen: YOUR NERVES AND YOUR JOB 227 
Fifteen: WHAT ARE YOU AFRAID OF? 248 
Sixteen: THE BIRTHRIGHT 266 
Seventeen: WHAT IS WRONG WITH OUR YOUNG MEN? 287 THE COMMONSENSE 
OF HEALTH THE COMMONSENSE OF 
HEALTH 
ONE 
ON CATCHING COLD 
TO speak of catching cold is misleading. The 
fact is, one cannot catch cold if he tries. A cold 
is the most elusive thing in the world. One may expose 
himself to all kinds of weather-dry, rainy, freezing, 
hot-and to several different varieties on the same day, 
without catching cold. 
And then some day when he is totally unaware, when 
conditions are perhaps not more unfavorable than 
usual, a cold catches him. Then if he tries to overtake 
it he will realize how difficult it is to catch. An ex- 
press train after it has left the station is not harder to 
overtake than a cold. 
Everyone treats a cold with levity-that is, every- 
one but the victim. He is such a sorry figure that he 
is an object for the shafts of wit of all his acquaint- 
ances. His eyes are watery, his nose is red, he sneezes 
and blows incessantly and he talks through his nose. 
But however humorous his condition may seem to 
others, the victim is miserable. He has a stuffy, 
smothered sensation, extreme dryness of the mouth 
and throat, and extreme moisture of the eyes and nose, 
which are a complete reversal from the normal condi- 
9 10 
THE COMMONSENSE OF HEALTH 
tions. And he has lost his taste for food, his taste 
for tobacco, even his taste for his friends. 
And everyone he meets offers a suggestion as to a 
cure. If one were to go home at noon and follow all 
the directions that he has received in a single morning 
he would be cured-that is, he would never have an- 
other cold; nor anything else. But of course he does 
nothing of the kind. He doesn't even listen to the 
importunities of officious acquaintances. Indeed he is 
too miserable to do anything but weep and sneeze and 
hack and blow; and shiver with the little chills that 
creep up and down his back; and wonder why he has 
been so attacked by Fate. 
Because everybody, sometime or another, has the 
same experience, and especially because everybody 
wonders how it all came about, this is written. 
It may be of some use to inquire how a cold happens, 
what it is, and what may be done to avoid it. But of 
course there is no hope, implied or expressed, that 
after this article is published people will stop having 
colds. That would be impossible. If by following 
the precepts here set down one cold can be made to 
grow where two grew before, the article's mission will 
have been fulfilled. 
Galen, whose writings were an authority on medicine 
for many centuries, said that coryza, or the nasal fluid 
that always accompanies a cold in the head, was a 
secretion from the brain. This unique theory was 
exploded long ago. But the fact is that until a com- 
paratively short time ago, when certain microorgan- 
isms that frequent the nose were discovered, very 
little was known of the causes of the common cold. 
Not that bacteria are the only cause. There are 
other causes, as we shall see, and over some of these ON CATCHING COLD 
11 
we have control. Which, as has been intimated, is the 
reason for this article. 
The nose has three essential functions, which are in 
brief: Olfactory, respiratory and vocal. It is used to 
smell with, to breathe through, and, with certain acces- 
sory chambers, as a sounding box in speaking or 
singing. 
To begin with the function which is of least impor- 
tance to our present purpose, if it were not for the 
nose and the accessory chambers the human voice 
would be lifeless, dull, without overtones, those vibrant 
qualities so pleasing to the listening ear-that is, in 
some voices. 
When one has a cold or, rather, when a cold has one, 
the mucous membrane which lines the nose and the 
accessory sinuses, as they are called, becomes swollen 
and the overtones cease. The sound waves, shut off 
from the sounding boxes, have their exit through the 
mouth only. Then one talks through his nose, which 
is exactly what he does not do. One talks without 
the help of his nose. 
A cold, then, changes the quality of the voice. If 
that were all one could stand it. But another function 
of the nose is more essential to enjoyment of life. The 
nose contains the terminal filaments of the olfactory 
nerve, the nerve of smell. All odors, good or bad, are 
detected there. This nerve enables us to discriminate 
not only between that which is pleasing and that which 
is unpleasant, but it guards us against dangers lurk- 
ing in the air. 
What concerns us most at present is that the sense 
of smell has a great deal to do with taste. All savors 
are perceived through the nose. The nerve of taste, 
distributed over the base of the tongue, enables us to 12 
THE COMMONSENSE OF HEALTH 
distinguish sweet from sour or bitter, but all the finer 
shades of flavor are dependent upon smell. 
When the mucous membrane lining the nose 
is swollen the olfactory filaments are pinched and 
deadened. Then if we shut our eyes we cannot tell 
soup from soap, which is a great loss and adds tremen- 
dously to the discomfort. 
But the most important function of the nose is that 
of respiration. Man was not intended to breathe 
through his mouth. The nose is the front door of the 
lungs. And the air stream does not pursue a straight 
course, but winds deviously through passages, over pro- 
jecting shelves, and when it reaches the lungs it has 
changed considerably. 
To begin with, atmospheric air is usually too dry. 
It must be moistened in its passage. Whatever the 
humidity of the respired air the nose either adds to or 
substracts from it moisture, so as to make it right for 
the lungs. The mucous membrane of the nose sup- 
plies to inspired air about a quart of water a day. 
And the temperature must be raised. Cold air is 
injurious to the lungs. In its passage through the nose 
the temperature must be raised approximately to that 
of the blood. 
Also the air must be filtered, freed from irritating 
particles of dust and from germs. Very little dirt 
gets into the lungs of a nose breather; and almost no 
germs. At the openings, the nostrils, there are hairs 
to catch the grosser particles of dirt. And farther 
within the mucous membrane has an outer coat of what 
is called ciliated epithelium, whose minute cilia wave 
constantly toward the front door, catching the 
minutest foreign matter in the air streams and waving 
it gently but insistently back toward the door through ON CATCHING COLD 
13 
which it entered. Then the mucous membrane itself 
has what is called an inhibitory action upon inimical 
germs, rendering them harmless. And so, though 
innumerable germs get into the nose they do not get 
very far. They crowd in great numbers in the vesti- 
bule. And those that push onward any distance are 
returned, harmless, to the port of entry. 
This is why the nose breather has so much better 
chance, so much greater expectancy of life and hap- 
piness, than the mouth breather. One can realize the 
tremendous task the nose has to perform if one remem- 
bers that about twenty-five hundred gallons of air pass 
through it-or should pass through it-in twenty-four 
hours. And it has been estimated that at least four- 
teen thousand organisms enter the front door during 
an hour's quiet respiration. 
When one takes cold congestion is the first result. 
That is, the smallest blood vessels, the capillaries in 
the mucous membrane, become dilated. There is an 
unnatural dryness and a feeling of heat. About this 
time the victim begins to sneeze, because the nerves 
of sensation are being squeezed. Sneezing is an invol- 
untary expulsive effort, just like coughing, intended to 
free the air passages of a foreign substance. But when 
the nerves of sensation are pinched they cannot tell 
the difference. 
The same lack of discrimination is shown by the 
nerves of the eye. Weeping, except from emotion, is 
merely a flooding for the purpose of washing out irri- 
tating matter. And yet when the mucous membrane 
lining the eyeball or the lids is congested we cry. As 
a cold so often affects the eyes as well as the nose, the 
sufferer will soon begin to weep as well as to blow. 
Usually the dry stage does not last very long. 14 
THE COMMONSENSE OF HEALTH 
Through the capillary walls exude the serum, or 
watery part of the blood, and white corpuscles, or 
lymphocytes. This discharge is often acrid and irrita- 
ting, reddening the nostrils as well as the upper lip. 
But why enter into harrowing details? Everyone who 
reads this will become reminiscent and supply the sen- 
sations to suit himself. 
The nasal passages being naturally narrow and con- 
fined-more so in some people than in others-the 
swollen membranes more or less occlude them if the 
congestion is great. And this occlusion is completed by 
the secretions, which become thicker as the cold ripens. 
The victim by this time has lost his sense of taste, 
because he has lost his power to smell. And he prob- 
ably has a frontal headache, because there are two 
accessory chambers or sinuses in his forehead which 
are connected with the nose. The lining of these 
chambers is likely to become much thickened and to 
press, one surface upon the other, causing great dis- 
comfort. 
Also the process may extend in other directions. It 
may affect the middle ears through the Eustachian 
tubes, which connect them with the throat. Or it may 
go down into the larynx and bronchial tubes. In this 
direction there is no limit until it reaches the air cells 
of the lungs. 
But this hypothetical cold affects, we'll say, only the 
hypothetical eyes and nose. Just an ordinary cold, 
without extraordinarily vicious tendencies. Gradually, 
if let alone-that is, if nothing is done to aggravate it 
-the symptoms will subside, the nose resume business, 
and the temper diminish in violence. 
Before inquiring into the causes of colds and what 
may be done to prevent them it might be well to start ON CATCHING COLD 
15 
right by puncturing a few popular delusions concern- 
ing causes. 
"Be careful not to get wet!" How often that has 
been said by solicitious wives and mothers. Clouds 
and rain and fog have little to do with it; or those 
who live among the clouds, in mountain observatories, 
would not be almost entirely free from colds. 
"Don't get chilled!" One could nearly freeze to 
death a hundred times and not get a cold. Arctic 
explorers never do-until they come home. 
Exposure to sudden changes of weather has no effect 
in itself. Those who live outdoors and are subject 
to rapid changes of temperature and humidity almost 
never catch cold. 
Patients in tuberculosis sanitaria rarely do. But 
damp houses predispose to colds. 
"Getting overheated opens the pores. Don't go out- 
doors with your pores open!" If one's pores were not 
open-wide open-one would not live long. The 
more they are clogged the more likely one is to take 
cold, and other things. 
The truth is that heat, moist or dry, causes hyper- 
sernia-that is, more blood in the capillaries of the sur- 
face of the body. This causes the sweat glands to 
work extra time, and the consequent sweat pours out 
of the pores. From perspiration-the invisible, in- 
tangible breathing through of the moisture-it be- 
comes fluid, or sweat. A sudden chilling, especially if 
prolonged, will drive the blood inward and it may 
congest elsewhere. 
And now for the conditions which actually cause 
colds. First, there are germs. Many are so imbued 
with the idea of the germ theory that they forget that 
it takes two to make a bargain. Most germs, all but 16 
THE COMMONSENSE OF HEALTH 
the most virulent, cannot harm us unless conditions are 
just right. And for conditions to be right for germs, 
they must be wrong for us. They require contributory 
negligence on our part. 
Many germs have their habitat in the nose and 
throat. All of them have long names, but we shall 
mention only two kinds, the Micrococcus Catarrhalis 
and the Diplococcus Coryza. There are many other 
varieties, but they need not concern us here. No 
matter which particular germ or combination of germs, 
the symptoms are the same, and the inflammatory 
changes; and their presence accounts for the infectious 
character of colds. 
If one member of a family has a cold the others may 
be affected subsequently. This is partly at least be- 
cause the germs are present in great numbers in an 
active cold. But it may be due also to other conditions 
in the home, such as dampness, or overheating, or lack 
of fresh air, to which all the family are subject. But 
the germs are the irritating cause. 
Speaking generically then, and not of any particular 
germ, the germs have been circulating, now in the 
microcosmic dust of the atmosphere, then entering a 
human nose with the respired air. Anon, overcome by 
the inhospitable host, gently waved back and coughed 
or sneezed into the circumambient air, they float in the 
impalpable dust again, suspended 'twixt heaven and 
earth, like Mohammed's coffin. 
One day in this constantly repeated cycle their host 
is more hospitable. Conditions are not so unfavorable 
for them and they begin at once to raise the myriads 
of their kind. Being minute vegetables they multiply 
by segmentation, flourishing in the favorable soil. 
Then follow the numerous conditions within that ON CATCHING COLD 
17 
nose and throat; and to the eyes, the ears, and perhaps 
the accessory sinuses, which as a group we call a cold. 
In the beginning of this article the statement was 
made that one cannot catch a cold if he tries. That is 
nearly if not quite true. However, if anyone doubts 
it he may be able to prove his point if he tries any com- 
bination of the following directions for catching cold. 
They are meant only for those who have good prac- 
tical noses through which they ordinarily breathe. Of 
course one who has anything wrong with his nose to 
start with, such as obstructions or chronic catarrh or 
sinus disease, has an advantage. He is likely to catch 
cold on the slightest provocation. 
First, choose as a habitation a house that is contin- 
uously damp. If that is impracticable work every day 
in such a building. Keep all the windows shut, espe- 
cially at night. Remember that night air is bad for 
one, and as night air is the only kind one can get at 
night, keep it out. Use the good day air, or, better, 
day before yesterday's air. 
Breathe in lots of dust. Have the floors swept 
vigorously and often while you are present. Do not 
use a vacuum cleaner or any moist method of removing 
dust. Chase it as you would pigeons, which rise and 
circle, and light again. 
Keep the house hot; plenty of good dry heat. And 
wear heavy underclothing, which, unlike outer gar- 
ments, cannot be removed when you get indoors. 
Do not bathe frequently; keep the mouths of the 
pores clogged with unremoved waste material. 
Eat more than you need. If your appetite fails 
don't weaken. Try rich sauces and pastries and condi- 
ments. And if necessary, or possible these days, take 
a cocktail or two to stimulate the appetite. 18 
THE COMMONSENSE OF HEALTH 
Lose plenty of sleep. Worry will help also; and 
fatigue, and overwork. Try to do all the unnecessary 
thinks you can think of. That may cause mental 
depression. 
Having followed all or part of these directions con- 
scientiously for some time, get your feet soaking wet 
and do not remove your shoes. Then sit next to the 
only open window. But open it only a very little, so 
that there will be a nice strong draft of cold air, pre- 
ferably on the back of your neck. 
You will probably win. In a few minutes or hours 
you may have a nice cold in the head with all the 
trimmings. 
Sitting in a draft does not always give one a cold 
by any means, but it may, if one is in the proper 
condition. 
Why are not sudden and extreme changes of tem- 
perature necessarily harmful? Because the human 
body possesses the most wonderful automatic heating 
apparatus in the world. Men have tried to imitate 
it in the modern dwelling, but they never have ap- 
proached and never will approach its perfection. No 
matter how cold the weather, no matter how great the 
heat, in which one can live, this self-acting apparatus 
self-acts, and the bodily temperature does not appre- 
ciably change. Cold will chill the surface by contract- 
ing the capillaries of the skin, but very soon they will 
dilate and the surface will be warmed by the increased 
supply of blood. Heat will cause greater activity of 
the sweat glands, and evaporating sweat will cool the 
body. 
How then do we circumvent Nature when we sit in 
a draft? A part of the body, usually a small part, is 
chilled while the other is not. We give the heating ON CATCHING COLD 
19 
apparatus an almost impossible task-that of keeping 
a large section of the body under normal conditions 
and at the same time protecting a small surface against 
the cold. Even its marvelous mechanism sometimes 
fails in such circumstances. 
But these conditions do not alone produce a cold. 
There must be something else, a certain lowering of 
resisting power. Not long ago two people sat and 
watched a football game through an hour and a half 
of cold pouring rain. They were soaked to the skin. 
The next day one of the two had a cold, and of course 
it was an interesting topic of discussion. 
That one said: "You can't tell be that getting wet 
dod't give you a cold. I certaidly got bide at the 
gabe 1" 
The other replied tolerantly: "Yes, my dear, but 
why didn't I catch cold?" 
There you are! There is no argument. Many 
thousands were soaked and chilled that same after- 
noon, and it is hardly likely that ten per cent caught 
cold. First, there are the germs, then the exciting 
cause, and third the lowered resistance. 
Constant conflict with bacteria develops an immunity 
in the individual. This immunity must be destroyed if 
the germs are to be victorious, unless they overwhelm 
their victim by force of numbers. This latter is some- 
times the case when one comes in hourly contact with 
them at home, and partly explains the spread of an 
infectious cold among various members of a family. 
If fighting germs increases immunity, so continuous 
absence from contact with them lessens it. Explorers 
returning to civilization after prolonged absence are 
more susceptible than those who have remained at 
home. Among those who dwell in isolated places an 20 
THE COMMONSENSE OF HEALTH 
infectious disease introduced from without will spread 
quickly. 
All this is very well and may be of passing interest, 
but what we want to know is-and this is the meat of 
this cocoanut: How can colds be prevented? A large 
part of the answer is contained in the directions for 
catching a cold, if they are read with reverse English. 
If the nose is not normal it should be put into proper 
condition. Obstructions should be removed. Opera- 
tions for removal of obstructions are usually quite 
simple. Perhaps, when you were young, a playful tap 
on the nose by a companion threw it off center, and it 
never returned. Possibly when too young to recognize 
the proprieties you were given to sucking your thumb 
and pressing at the same time with the forefinger of 
the hand upon that tender nascent organ, the nose,, 
causing a permanent deviation. In other words, the 
septum, or partition between the nostrils, may lean 
too much toward one side, obstructing the passage of 
air. There are many other causes of obstruction than 
a deviated septum, but this will do as an example. 
Chronic catarrhal conditions predispose to colds, 
and to many other things. Germ growth is favored 
by poor soil and chronic inflammation makes poor soil. 
But given a perfectly good practical nose, how can 
one keep it, and himself, from the incidence of such 
accidents as colds? 
Fresh air, for one thing. As was said before, 
patients in tuberculosis sanatoria, who are outdoors 
practically all the time, are seldom affected. And if 
the attending physician comes upon one with a cold he 
says to the patient, "Ah I You've not been getting 
enough fresh air!" and at once consigns him to a bed 
in the open. ON CATCHING COLD 
21 
Open-air games are more healthful than indoor 
sports or exercise. If one must exercise indoors all 
the windows should be wide open. 
Many use the calendar instead of the thermometer 
as a guide to clothing. It is as senseless as discarding 
one's straw hat on September fifteenth, no matter how 
hot the weather; and far more harmful. Both in the 
fall and in the spring we wear too much on the warm 
days, and stew and fret and catch cold without 
realizing why. 
Most of our warm clothing should be removable- 
that is, removable in the presence of company. Homes 
and offices and factories are usually up to summer heat 
in the coldest weather, and yet many people who spend 
nearly all of the twenty-four hours indoors wear heavy 
winter underclothing. This superheating of the body 
lessens the resisting power. Remember, it does not 
open the pores. One should do that daily by a good 
bath with soap and warm water, and follow it with a 
dash of cold water. 
The ordinary tubbing which is supposed to be a daily 
rite of our English cousins is much advocated as a 
means of hardening oneself. It usually consists of a 
dash into a tub of ice-cold water, a dash for the towel, 
and a dash into one's clothes. It is not cleansing and 
will not open the pores. Take the cold water for 
dessert, using soap and water as the piece de resistance. 
And do not rub all the outer layers of the skin off 
with brushes, "loofas" and extraordinarily coarse 
towels. In some countries they wear those outer layers 
of the skin for clothes, and they do not catch cold. 
Nature intended that the outmost layer, only, should be 
rubbed off by gentle friction. 
It may not be necessary, now, to mention alcoholic 22 
THE COMMONSENSE OF HEALTH 
beverages. But if any one should have a little left over 
in this period of drought, here is a recipe for taking a 
cocktail: Spill a little on the tablecloth or doily, then 
glance around to see that no one is looking, and throw 
the rest over the left shoulder, for luck. 
Remedies are of some use, but they should be pre- 
scribed by a physician for the particular cold they are 
intended to banish. As a rule, however, modern medi- 
cine has little to offer, and with two exceptions the 
granny remedies are best. The first exception is the 
hoary axiom: "Feed a cold and starve a fever." A 
cold is not, dietetically speaking, voracious. Feed it 
very little and it will be much kinder to you. And take 
a laxative, or two, as atonement for past indiscretions. 
The other exception is the hot stuffy room as a 
means to a cure. Plenty of warm bed clothing, the 
body entirely immersed in coverings if thought neces- 
sary, head and all-all except the nose. Keep it out 
and take in through it all the outdoors you can get. 
Fresh air is the one essential medicine. 
Having eliminated these two exceptions, bring on 
your granny remedies-the hot milk or hot lemonade; 
the hot salt gargles or spray; the quinine, if you like it; 
and the hot mustard footbath. All of these are a kind 
of bloodletting. They dilate the capillaries at the 
extremities and upon the surface of the body else- 
where, and they cause sweating, which is another form 
of relief. 
By dilatation of the myriads of capillaries in the 
skin they draw away the blood from the congested area 
in the nose and throat, thereby lessening the inflamma- 
tory process. 
One who has a severe cold should be put to bed-for ON CATCHING COLD 
23 
his own good and that of others. Colds are catching 
if one's condition invites them. 
Applications to the nose and throat are helpful if 
made by one who knows what is needed and how to 
apply it. If there are complications-that is, if the 
ears or sinuses are affected-competent advice should 
be sought to prevent serious trouble. 
But whatever you do for a cold do not take promis- 
cuous advice. Do not follow all the precepts of kind 
friends. Or you may never have another cold. TWO 
CONCERNING COUGHS AND COUGHERS 
COUGHS should be an interesting topic because 
so many people are subject to them, especially 
during the winter months. And yet a cough is not 
a condition, it is merely indicative of a condition; 
in fact it may be indicative of many and diverse con- 
ditions, among which may be mentioned: Colds, influ- 
enza, cigarettes, peanuts, pneumonia, shoe buttons, 
germs, tacks, mouth breathing, over-eating, safety pins 
and a weak heart. That will do for the present, but 
the list could be made much longer. 
A cough is Nature's method of expelling something 
from the air passages that should not be there. But 
Nature cannot always discriminate between that which 
can be expelled and that which cannot, between a real 
object and merely a sensation. For this reason we 
cough when we have inhaled something irritating, and 
also when there is inflammation from disease. 
Speaking of inhaling something irritating, no one 
would believe, unless he has looked into the matter, 
how many objects get into the air passages by mistake, 
objects not intended to be inhaled or even swallowed. 
Many persons-not all of them children by any means 
-use their mouths as temporary pockets for things not 
meant to be swallowed; and occasionally something 
slips down with a sudden inhalation. Then there is an 
explosive paroxysm of coughing, a surprised and indig- 
24 CONCERNING COUGHS AND COUGHERS 
25 
^nant attempt by Nature at forcible expulsion of the 
intruder. The effort is not always successful, however, 
and the object remains, to cause an infinite amount of 
trouble. 
The discovery of the X-ray has helped to locate 
foreign bodies in the air passages, because mostly they 
cast a denser shadow than the surrounding tissues, but 
until very recently their removal required long, tedious 
and dangerous operations. Lately an instrument has 
been devised for looking directly down the throat. It 
is called the bronchoscope. It is a straight tube with 
an electric light at one end, and one has to do a sword- 
swallowing feat to get it down, but with considerable 
dexterity on the part of the operator and a throat ren- 
dered insensitive by a local anesthetic it can be done. 
There are medical men whose specialty is to locate and 
remove foreign bodies that have been inhaled. 
A curious fact has recently been discovered: It is 
that the innocent, common garden variety of peanut- 
not one with the shell on but the smooth kernel- 
causes more trouble, greater destruction than a bean or 
a screw or a pipe stem. But they are all destructive 
and none was intended to enter the breathing ap- 
paratus. 
This article, however, is not especially concerned 
with extraordinary and unusual coughs. It will deal 
rather with the more frequent and ordinary causes of 
coughs, and how to avoid them. But first something 
should be said about the breathing apparatus, its 
mechanism and its function. 
You may remember the time when you stood by a 
bowl of goldfish and watched them swallowing. Per- 
haps you were fascinated and wondered how soon they 
were going to burst with high water pressure from 26 
THE COMMONSENSE OF HEALTH 
within, and possibly you may recall that you were 
relieved-or disappointed-when you learned that 
they were not swallowing the water at all but passing 
it out at once over their gills. And later still you were 
told that they were not breathing the water but the air 
which is held in solution in the water. 
A fish uses air very much as we do, but it must have 
the air mixed with water. The gills are the fishes' 
lungs. They are crowded with minute blood vessels 
and when the air in solution passes over them it is 
extracted. After you had learned all this-which is 
really more marvelous than what you thought was 
going on-you probably lost some of your interest in 
goldfish. 
Before a child is born it breathes like a fish-that is, 
it gets its oxygen from the stream of the mother's 
blood, through an apparatus very similar to gills. The 
child's lungs are not yet in use; they are totally empty 
and collapsed. But with the first gasping cry they are 
expanded, and from that moment they are never 
entirely empty of air. The tide of air alternately 
rising and falling leaves always a residual reservoir. 
The lungs are a chemical laboratory, extracting 
oxygen, transferring it to the blood through the capil- 
laries which line the walls of the air cells, and taking 
in exchange the products of combustion, which are cast 
off in each succeeding exhalation. And if the inhala- 
tions and exhalations did not succeed each other with 
considerable regularity, at the average rate of about 
eighteen times a minute, or twenty-six thousand times 
a day, or five-sixths of a billion times in the three-score 
years and ten, the owner of the lungs would depart 
before his allotted time. 
So it behooves us who are the beneficiaries of this CONCERNING COUGHS AND COUGHERS 
27 
important breathing apparatus to know something 
about it and what may be done to keep it fit for its 
duties. 
Imagine a hollow tree upside down, its bulbous, 
hollow roots at the top, then the trunk, then two large 
limbs. Farther down, smaller and smaller branches, 
the minutest twigs ending in groups of hollow leaves. 
Bind this tree's branches and leaves together with a 
soft, delicate, elastic, but firm substance that holds all 
the parts together as a whole. Throw over it all a 
covering of smooth satiny texture. Then place it in a 
box lined on all sides with the same covering. The box 
must have sides and bottom that are movable, to give 
it the power of expansion and contraction. As our tree 
is hollow and as the roots have openings, expansion of 
the box will cause air to rush into this tree, through 
the trunk, thence through the smallest branches, into 
the groups of hollow leaves; and contraction will expel 
a part of the air, not all but a large part, to be replaced 
again by more air with the succeeding expansion. 
It is really not a far-fetched simile to liken the lungs 
to a hollow tree. If it were possible to get a mold of 
the breathing apparatus which would include every- 
thing from the nose and mouth to the remotest air 
cells, the resemblance to a small tree would be remark- 
able. But as this cannot be done because of the 
extreme minuteness and delicacy of the terminal struc- 
tures, we shall have to stimulate our imagination by 
further description. 
First, the roots of our tree: Let them be the mouth 
and nose, because they are directly connected with the 
tree trunk. But just below the back of the mouth two 
tubes lead downward, one collapsible and the other 
always standing open. The latter is the trunk of our 28 
THE COMMONSENSE OF HEALTH 
air tree. Down through the collapsible tube pass 
solids and liquids, into the stomach. But once in a 
while when eating, and always when we least expect it, 
we choke and cough and strangle. After the explosion 
is over somebody may say something about Sunday 
throat. The Sunday throat was not intended for the 
passage of food or drink; its function is to receive air 
only-on Sundays as well as on weekdays. 
For the purpose of guiding food in the way it should 
go, at this parting of the ways is placed a valvelike 
covering which fits down over the air tube when one 
swallows, but at all other times is lifted. Sometimes 
we are careless and breathe when we should swallow. 
Then the valve, the epiglottis, does not cover the 
opening and the particle of solid or liquid goes the 
wrong way. 
Just below this opening, at the inverted base of the 
trunk, is the voice box, or larynx, a projecting part of 
which, the Adam's apple, can be seen rising and falling 
when one swallows. Across the middle of the open 
space in the larynx stretch two bands which are wide 
apart except when one wishes to produce sound. Then 
they become tense and their edges come together to 
make a slit of varying width, through which the air 
rushes, causing them to vibrate, to produce sound. 
The trunk proper of our tree begins at the lower 
margin of the larynx. It passes on down about four 
and one-half inches before dividing into the two main 
branches, or bronchi, one of which leads to the right 
lung and the other to the left. Each bronchus begins 
to branch after entering the lung, and the branches 
subdivide, until finally the smallest tubes are not more 
than one-fiftieth of an inch in diameter. Then they 
lose their cylindrical shape and branch off as irregular CONCERNING COUGHS AND COUGHERS 
29 
channels among the groups of air cells. These air 
cells, like the gills of the fish, contain the small vessels 
through which courses the blood that has come from 
all parts of the body, bearing the products of combus- 
tion to exchange for oxygen, with which it returns to 
the tissues, to carry on more combustion. 
The whole of the air apparatus, from the throat to 
the remotest air tubes, is supplied with nerves of sensa- 
tion. This is unlike the heart, which being entirely 
inclosed and protected has no sensation at all. But 
Nature very prudently provides the lungs and tubes 
with sensation to enable one to cough, in the effort to 
expel whatever is injurious, whether it comes from 
without or is manufactured as a product of disease. 
And very wisely too she places more nerves of sen- 
sation in the upper air passages, which are nearer the 
source of external dangers. For this reason, and be- 
cause the nerves cannot judge between a foreign body 
and the irritation produced by swollen tissues, inflam- 
mation of the throat causes more continuous and more 
violent coughing than many more serious conditions in 
the lungs themselves. 
The most frequent abnormal condition of the upper 
air passages is a cold, which may or may not have 
started in the head and gone down. In susceptible 
people, however, the congestion may begin in the 
trachea or the bronchi. This is especially the case with 
those who have obstructions in the nose, with those 
who are frequently in a very dusty atmosphere, and 
those who inhale much smoke. The last does not set 
apart cigarette smokers, because inhalation of any kind 
of smoke will do it; they are in a class by themselves 
only because they are more frequent inhalers of smoke. 
In order to have a cold in the throat or chest two 30 
THE COMMONSENSE OF HEALTH 
conditions must always be present. They are: First, 
bacteria; second, a lessened resisting power. Indeed 
the same causes are essential to the acquiring of almost 
any acute disease anywhere in the body. 
Nature has placed in the air passages every possible 
safeguard against disease germs. The nose filters 
them and its mucous membrane not only renders them 
harmless but the cilia, or hairlike projections on the 
surface, constantly wave them out by the way they 
came in. And the secretions of mucus catch them and 
they are washed away. But no one breathes entirely 
through his nose and some of the germs get farther 
down. There the same processes are carried on, be- 
cause the lining membrane is of the same kind. This 
membrane has four duties to perform: It covers itself 
with a secretion for its own protection against cold air; 
it helps to warm the air before it gets to the delicate 
air cells; it gathers up bacteria and impurities; it 
destroys bacteria. So under ordinary conditions we 
are fairly free from harm. But suppose the conditions 
are not ordinary, and that a cold has already begun in 
the head. Perhaps it has been ignored and neglected. 
It goes down-that is, by extension it affects the 
throat, the larynx, and then the trunk of the breathing 
apparatus, the trachea. 
First there is congestion of the small blood vessels, 
a dryness and heat of the surface, with hoarseness and 
a dry cough. Very soon the surface becomes moist 
and the cough loose. The oversecretion of mucus, 
which is Nature's attempt at self-cleansing, is coughed 
up and expelled. 
Nature never gives up a fight unless the odds are 
overwhelmingly against her. Conflict arouses her an- 
tagonism and all her fighting forces are called into CONCERNING COUGHS AND COUGHERS 
31 
action. If they were not, even the germs which most 
frequently cause catarrhal colds would be victorious, 
and they are not especially virulent. 
But from the beginning of the attack there have 
been disagreeable sensations. There was probably a 
chill and now there is some fever, also aching and sore- 
ness of the muscles and a general tired feeling. All 
of these are due directly to the germs against which 
the body is fighting. They produce certain poisons 
which are absorbed into the blood, causing much dis- 
turbance and discomfort. 
However, washing out the germs by an excessive 
secretion of mucus and a cough is merely a defensive 
process. Nature has offensive forces also. With the 
first congestion the blood streams have brought up the 
army of white corpuscles. These troops hastily 
mobilized storm enemy trench after enemy trench until 
finally they have regained all the home territory. And 
the casualties are thrown out with the expectoration. 
Then the home troops withdraw into the blood 
streams, which once more resume their normal size, 
repairs to the battlefield are under way and peace 
supervenes. Peace, not armistice, for there can be no 
cessation of hostilities until Victory alights upon one 
banner or the other. There are no drawn battles in 
the fight against disease. 
But at times the issue may be long drawn out. 
It may be that the particular strain of germs is 
more virulent and that its invasion finds the defenses 
weakened. Then the destructive warfare continues 
and more territory is invaded. By this extension the 
inflammation may progress downward, through the 
smaller bronchi-the branchlets of the respiratory 
tree-until it reaches the terminal leaves, the air cells. 32 
THE COMMONSENSE OF HEALTH 
When this occurs the sufferer no longer has bron- 
chitis only; he has broncho-pneumonia, a much more 
serious disease, to which the very young and the aged 
are more prone than those of middle years. 
Most of the germs that ordinarily obtain entrance, 
into the respiratory tract have no harmful effect unless 
its lining surface has been injured. The same is true 
of the skin. The hands come into daily contact with 
hosts of bacteria, especially the pus germs; but the 
outer layers of the skin are protective. If, however, 
the skin is broken or the tissues bruised the germs set 
up their destructive processes. 
Within the air passages a sudden chilling of the sur- 
face, by breathing intensely cold air, and the reaction- 
ary congestion, will destroy the integrity of the lining. 
But the most frequent cause is dust. Irritating parti- 
cles inhaled have an erosive effect upon the membranes. 
Then the germs enter through the broken surface. 
Living in a dusty atmosphere will cause chronic bron- 
chitis. The membranes become thickened and there is 
a more or less constant secretion of mucus, with a 
chronic cough. This thickening of the lining, when it 
reaches the smallest tubes, makes respiration difficult. 
But, curiously, outbreathing is impeded more than 
inbreathing, because expiration is ordinarily a passive 
act while inspiration is the result of muscular effort. 
The chest wall is raised by forcible muscular contrac- 
tion, which causes the inrush of air, but when the chest 
muscles and the diaphragm relax the boundaries of the 
lungs come closer together, narrowing the space be- 
tween. We can breathe out forcibly when we choose, 
but in unconscious respiration expiration is entirely 
passive. 
When there is a chronic thickening of the lining of CONCERNING COUGHS AND COUGHERS 
33 
tne small air tubes one can get air into the cells through 
the narrowed passages, but it is difficult to get it out 
again. And so taking in a little more air than can be 
gotten out easily the air cells become permanently 
dilated. This produces the barrel chest so common 
among coal miners and those who work in a dusty 
atmosphere. These persons have a chronic cough, a 
shallow sometimes gasping respiration, and a wheeze. 
A cough may be useless and harmful or it may be 
beneficial. If there is a foreign substance in the air 
passages or an accumulation of secretion coughing is 
the only method of expulsion. The use of a sedative in 
such a case would be wrong. Taking medicines to 
deaden one's sensibility to the presence of anything 
that should be gotten rid of would defeat the purpose 
of the cough. 
But frequently coughs are due merely to irritation 
of the nerve ends, caused by their being caught and 
pinched in congested swollen tissues. This kind of 
cough is rasping, exasperating and futile. It should be 
quieted because it accomplishes nothing. 
Coughing will cause a cough. Persistent hacking 
will in itself produce congestion of the throat sufficient 
to continue the cough indefinitely. Here is an instance 
of a cough that was started by the imagination: A 
nervous, hysterical patient had been afflicted for years 
with imaginary ills. But her troubles, though various, 
had always been elsewhere than in the throat or lungs. 
One day her mother caught cold and developed a dry 
cough with hoarseness. The next day the girl was 
coughing continuously. Examination of the throat and 
chest discovered nothing wrong. She merely imagined 
it all. But with the persistence of the hysterical she 
kept up the coughing for days, and finally she lost her 34 
THE COMMONSENSE OF HEALTH 
voice completely, being unable to talk above a whisper. 
Later examinations disclosed a deeply congested throat 
with great redness and thickening of the vocal 
bands. She had kept at it until she had produced a 
real condition. 
This is related to illustrate the kind of coughs that 
is harmful. Coughs that do not get anywhere should 
be suppressed, if possible, or soothed by medicines if 
they cannot be controlled. The purely nervous cough 
can be stopped by an effort of the will. But it would 
be folly to use opiates for a cough that gets results. 
In the later stages of pneumonia or of tuberculosis one 
who cannot cough is in a very serious condition. He is 
in imminent danger of drowning in his own secretions. 
The causes of coughs being so numerous and so 
various, to speak of prevention one must necessarily 
include the conditions which produce them. First, 
then, the nose. To have a normal throat and healthy 
lungs there should be free, unobstructed nose breath- 
ing. Air which is taken in through the mouth is germ 
laden, dust laden; it may be too moist or too dry or 
too cold. The nose should cleanse it, warm it, moisten 
it; or the air passages will suffer. 
Children with adenoids are especially subject to 
coughs because they cannot breathe through the nose. 
The adenoid child has a peculiar facial expression-a 
flattened, pinched appearance about the nose, which 
from lack of use is almost invariably smaller and nar- 
rower than it should be. And the adenoid child nearly 
always has large tonsils. 
Mouth breathing leads to disease of the tonsils. 
They are placed in the throat partly as a filter for use 
in such emergencies as occasional mouth breathing. 
But to ignore the nose altogether and take in air con- CONCERNING COUGHS AND COUGHERS 
35 
tinuously through the mouth is to place too much 
burden on the filters. They become diseased as a con- 
sequence, and in turn they are a cause of coughs. 
Adenoids should be removed, and the channels 
through the nose otherwise made clear if there is any 
other obstruction. If this is done in time it is prob- 
able that the tonsils will be saved from chronic inflam- 
mation and from the necessity of removal. 
There is a class of ailments called "occupational dis- 
eases," because they have their origin in certain occupa- 
tions. Among these are the chronic bronchitis of coal 
miners and stonecutters' consumption. A curious fact 
has been noticed about coal miners, especially those 
who mine bituminous coal: They are easy victims of 
chronic bronchitis, of asthma and of emphysema, or 
permanent dilatation of the air cells; but they are com- 
paratively free from tuberculosis of the lungs. No one 
has been able to explain this phenomenon satisfac- 
torily, though several theories have been advanced. 
And yet physicians who practice in the bituminous-coal 
regions are convinced that there are fewer cases of 
consumption among the miners than among men in 
other occupations. 
On the other hand stonecutters and men who work 
at emery wheels are particularly prone to tuberculosis. 
The irritating particles cut their way into the delicate 
structure of the lungs, making a fertile soil for the 
growth of the bacteria. 
There are many other occupational consumptions 
also, as for instance that of those who work with cot- 
ton fiber, with tobacco and with flour-all of them 
dusty jobs. Which merely substantiates what has been 
said about dust being a potent cause of troubles in the 36 
THE COMMONSENSE OF HEALTH 
throat and lungs, and emphasizes the warning that it 
should be avoided as far as possible. 
Colds are infectious, there is no doubt about it. No 
argument will be required here to prove it, because 
everyone has noticed that they spread from one to an- 
other in home or shop or office. A cold hits one in the 
weakest place. One who has a weak throat usually gets 
his cold there, either at first or very soon after it has 
begun in the nose. Now a weak throat is almost in- 
variably the result of some long-continued indiscretion 
that can be avoided. The inveterate cigarette smoker 
is liable to coughs at all times, because he inhales the 
smoke, and to an acute inflammation of the throat with 
every cold. As to prevention in his case the answer is 
obvious. In the case of those who work at dangerous 
occupations-dangerous because of the peculiarly irri- 
tating quality of the dust created-the mouth and nose 
should be covered with a moistened cloth of fine mesh 
to strain the respired air. 
But whether one has a susceptible throat or not, 
intimate contact with the victim of a cold should be 
avoided, because one may come in contact so continu- 
ously with the various bacteria by continuous associa- 
tion with the victim of a cold that their very numbers 
and assiduous attacks will overcome his resistance. 
As with other infectious diseases, one's susceptibility 
to colds depends very much upon one's physical condi- 
tion. The instructions given in the previous chapter on 
how to catch a cold and how to avoid it apply here as 
well as to cold in the head. In general they imply only 
good commonsense in the care of the body. A great 
deal of fresh air; enough rest and sleep; plenty of 
food, but not too much nor too rich food, eating only 
as much as is required by an appetite not stimulated by CONCERNING COUGHS AND COUGHERS 
37 
alcohol or condiments; frequent bathing without exces- 
sive rubbing; warm water and soap, followed by 
enough cold water to cause a reactionary glow. 
Sudden chilling of the body may or may not induce 
a cold, depending on one's general condition; a cold is 
especially likely to result if one has to remain long in 
wet clothes on a cold day. 
A very cold dry wind will sometimes cause conges- 
tion, but this is usually only if one breathes through 
the mouth. Such a congestion is a reaction. The cold 
air causes the small blood vessels lining the throat and 
bronchial tubes to contract, and afterward they dilate. 
This is the same process that may be observed in the 
flushed face or the tingling reddened hands after 
exposure to cold. 
Chronic coughs may be due to other causes than dust 
and mouth breathing. A weak heart will cause a slug- 
gish blood current and the blood will stagnate in the 
lungs. Then there will be a constant soaking of the 
tissues. In chronic kidney disease frequently there is 
the same result. In such cases the avoidance or cure 
lies in correcting the primary troubles. 
A chronic or frequently recurring cough should 
awaken the suspicion of tuberculosis. This disease, 
however, is often masked and there may be no cough 
or at least so little cough for a long time that though 
there may be great weakness and other profound 
symptoms the lungs may not be suspected. But where 
the cough is obstinate the lungs should be thoroughly 
examined. 
Coughs that occur in the course of other diseases 
need attention, especially if they are of the dry, 
harassing kind, because they cause loss of sleep, mental 38 
THE COMMONSENSE OF HEALTH 
unrest and add to the general distress. Such coughs 
call for a sedative. 
Except in acute inflammatory conditions much of our 
coughing is unnecessary and can be controlled. You 
don't believe it? Have you ever been at the theater 
watching a thrilling play? Have you sat, looking, 
listening, almost breathless in the tense palpitating 
silence? Have you seen the interest suddenly die, 
killed by the introduction of something incongruous or 
by one of the actors? Then have you heard the perfect 
storm of coughs rising from all parts of the house, 
coughs people had been saving while they were 
enthralled? 
Yes, much of our coughing can be suppressed and 
should be, because coughing will aggravate a cough. THREE 
PNEUMONIA, THE APACHE 
ALL acute infectious diseases are enemies of the 
human race. They may be likened to highway- 
men, gunmen and other assassins. But pneumonia is 
the Apache, always lurking in dark places, waiting to 
pounce upon his victim, and with swift sure stroke to 
lay him low. There is nothing slow and insidious 
about pneumonia. One moment you are moving 
happily along, you turn a corner, there is a descent of 
the knife, and you have fallen. A sharp and bitter 
struggle follows. If you are strong enough to get the 
better of your assailant he suddenly gives up and makes 
away. The attack has been swift, the encounter fierce, 
and the departure equally abrupt. 
There are several kinds of pneumonia, but the one 
whose name should be capitalized is Lobar Pneumonia, 
man's deadliest enemy among the acute infectious dis- 
eases. It is responsible for more deaths than any of 
the others, and it is taking more and more human toll 
each year. 
Lobar pneumonia is so called because it usually 
begins in one lobe, the lower lobe of the right lung 
being a favorite site. And though it may confine itself 
to one lobe it often attacks other lobes, at times affect- 
ing both lungs. Then it becomes the dreaded double 
pneumonia. 
By far the most frequent cause of pneumonia is an 
39 40 
THE COMMONSENSE OF HEALTH 
exceedingly small germ called the pneumococcus-a 
deadly germ, but not always equally virulent, and with 
some persons apparently not virulent at all. Certain 
animals, especially the rabbit and the mouse, are much 
more susceptible than human beings; in fact though it 
is probably present in more than half the throats of 
those living in cities by no means all of this number get 
pneumonia. Those who carry about with them these 
bacteria, but who are not affected by them, are called 
"carriers." They can give the germs to others more 
susceptible and themselves remain immune. 
Like other infectious diseases, pneumonia when in- 
troduced among a people to whom it has been a 
stranger creates great havoc. But those used to city 
life are to a certain extent protected. If all persons 
who become the temporary carriers of the pneumococ- 
cus were stricken with pneumonia the disease would be- 
come a scourge more dreaded than all the plagues of 
Pharaoh, because of its high death toll. About one- 
quarter of all those who have pneumonia succumb, so 
it is well for the continuance of the human race that of 
those who frequently harbor the germ in their throats 
not all are susceptible. 
A standard medical work published a few years ago 
states that "The course and outcome of the disease are 
uninfluenced by " and then it names categorically 
practically almost every means which can be used in the 
treatment. And further: "At present the infection is 
beyond our control other than such simple measures as 
tend to spare and support the strength of the patient 
by careful nursing and the alleviation of symptoms. 
Useless medicines should be avoided." 
That is, the medical profession is helpless to prevent 
or to cure. Make the victim comfortable, lessen his PNEUMONIA, THE APACHE 
41 
pain and other distress. Watch him fight the powers 
of darkness alone and unaided-except by the forces 
within himself. They must carry on while the physi- 
cian and friends stand by. The issue will depend 
entirely upon the relative strength and endurance of 
the opponents. 
A black outlook, surely-or it would be if it were 
not modified by certain facts. The first fact is that the 
healthy person stands considerably less chance of get- 
ting pneumonia than one who is below par. It takes 
more than the germs to cause this disease. As with 
other diseases there must be contributing causes. And 
concerning most of these contributing causes, whether 
or not they shall be present to help the pneumococcus 
in his attack upon us we can decide and determine if we 
know what they are. 
The second modifying fact has to do with quite 
recent discoveries in prevention, which were promoted 
by work in camps and hospitals during the war. The 
war brought together the most advanced, the most 
skilled specialists among the medical men of the coun- 
try. It also brought together millions of young men. 
Many of the soldiers, removed from their accustomed 
environment, were taken ill with the various infectious 
diseases. They had every known disease and every 
variation of disease. Moreover, the sick were cared 
for in groups in the great hospitals where their afflic- 
tions could be studied. Also the scientists were there 
to study them. 
Thus was pneumonia observed from every medical 
angle by the members of the hospital staffs and by com- 
missions sent out by the Surgeon General to gather 
facts and to correlate them. And so was forged an- 
other weapon against the monster, not yet perfected, 42 
THE COMMONSENSE OF HEALTH 
but developed so that it has proved its beneficence in 
thousands of instances. Of this weapon more will be 
said in its proper place. 
One who has had pneumonia will not need to be told 
how swiftly it attacks or what havoc it creates. But 
many have not had it, and for this reason it may 
be expedient to enter into a somewhat detailed 
description. 
You may or may not have a cold. Probably you 
have not been feeling well for several days. Perhaps 
you have been losing sleep or overworking or attending 
too many formal dinners or have been committing any 
one or any number of the common physical indiscre- 
tions. 
One day you go home feeling chilly and languid. 
During the next day or two these disagreeable sensa- 
tions continue, but you are too busy to pay much 
attention to them. If you have been coughing for 
several days you attribute everything to the cold. 
Then like the traditional thunderbolt out of a clear 
sky comes a chill. A real chill, not a chilliness, that 
makes you long for all the hot-water bottles in the 
world. And with it a pain. Not a stitch but a stab; 
a continued rhythmic stabbing with every catching 
breath. And a short sharp cough that adds to the tor- 
ture, infinitely increasing the pain. 
"Send for the doctor!" 
He comes, and finds you with a high fever, though 
you may still be shaking with cold. He feels your 
pulse; it is racing. You are breathing rapidly, much 
more rapidly than your fever warrants, because your 
respirations are shallow, caught almost at the very 
beginning by the racking stabs in your side. He listens 
to your heart and to your breathing, but at this stage PNEUMONIA, THE APACHE 
43 
of the disease they disclose little. However, he knows 
by inference. He is cheerful and attempts to reassure 
you, but downstairs he says: "Pneumonia!" You are 
in for it, and may you be one of the seventy-five per 
cent who recover! 
What is taking place in your lungs? Something has 
been happening to you for several days before the 
attack, and you did not know it. In the first place, 
there were the germs. You may have harbored them 
in the throat and air passages for many days, but at 
least you had them for a time before you were stricken. 
Then came the exposure to cold and wet, resulting in 
a cold. Or, whatever it was, something occurred to 
break down your natural immunity, your usual resisting 
power. 
This period between the true beginning and the 
violent onslaught is called the period of incubation. A 
better term would be the period of germination, be- 
cause the seeds, the pneumococci, are plants, and they 
must reproduce millions of their kind before you are 
conscious of trouble. During this time, lasting from 
two to eight days, the symptoms are vague. You may 
feel merely out of sorts. But the poisons created by 
the bacteria are accumulating and are being absorbed 
into the circulation. 
In the meantime, though you have been unaware of 
impending danger, your body knows. It has at once 
begun to fortify itself, to manufacture a tremendous 
number of the opposing forces against the invaders. 
In pneumonia as in other germ diseases it is the white 
corpuscles, certain kinds of them especially, that fight 
for us by destroying bacteria. So, long before your 
chill, before you are laid low, while the germs are 
increasing in number in your lungs, the white blood cor- 44 
THE COMMONSENSE OF HEALTH 
puscles are being manufactured in great numbers and 
are beginning the fight for supremacy. 
One of the first things the doctor wants to know 
when he is called is the amount of your leucocytosis. 
Leucocyte is the proper name of the white blood cor- 
puscle. The number of these fighters may have in- 
creased from two to twenty times the number present 
in the blood in health. And if you have a large num- 
ber of leucocytes your chances for recovery are better 
than if the number were small. But in spite of all this, 
preparation the bacteria have gained headway, and in 
their growth, millions upon millions of them, they have 
created enough disturbance to produce pneumonia. 
The chill, the headache, the muscle pains-all the 
distressing first symptoms are caused by the poisons 
that have been taken up by the blood and distributed 
throughout the body. In the lung, at the site of their 
invasion, there is congestion. This resembles the con- 
gestion of ordinary diseased conditions as a cloudburst 
resembles a shower. It is overwhelming. All the 
blood vessels are swollen and engorged, and they will 
soon discharge certain elements into the groups of air 
cells. The inflammation is so violent that it nearly 
always affects the lining membrane of the lung, the 
pleura. Pleurisy, or better, pleuritis, causes the catch- 
ing pain which occurs with every breath. 
Then comes the exudate, a sticky discharge that soon 
will fill all the air cells and shut off entirely the breath- 
ing space of that lobe, throwing all the burden of 
respiration upon the unaffected parts. The more lung 
shut off from air the greater the task for the rest of the 
lungs. The breathing is now rapid partly because of 
this decrease of air space. 
But the blood has not only absorbed poisons; the PNEUMONIA, THE APACHE 
45 
germs themselves are invading the blood stream. 
Through it they may reach other organs and tissues of 
the body-the heart, the joints, the brain. Even the 
middle ear may be affected. Purulent inflammation of 
the middle ear is a frequent complication. 
The heart has a tremendous burden thrust upon it. 
By the force of its contractions it must send the blood 
stream to every part of the body with sufficient velocity 
to insure a constant circulation of the stream. If there 
is an obstruction anywhere the work, of the heart is 
tremendously increased. And here is a large area in 
which there is obstruction because of the pressure of 
the exudate. Also the heart muscle may be affected by 
the poisons in the blood. And the heart must beat 
faster because of the high fever. The great majority 
of fatal cases are directly due to failure of the heart. 
During the progress of a pneumonia the doctor is 
chiefly interested in six things: First, the amount of 
lung involved, whether there are any fresh invasions. 
Second, the height of the fever; if the temperature 
remains very high the outlook is grave. Third, the 
condition of the heart muscle, as indicated by the 
sounds which he hears through his stethoscope, by the 
rapidity of the contractions and by the blood pressure. 
Fourth, the leucocyte count; he wants to know how the 
numbers of the defensive army are being kept up. 
Fifth, what the other organs of the body, chiefly the 
kidneys, are doing to eliminate the poisons. Sixth, 
whether there are any complications, especially of the 
brain, as evidenced by delirium. 
But let us say you are one of the seventy-five who 
recover, of every hundred persons attacked. One day 
-it may be the third, the fifth, the tenth, any day; 
there is a common but erroneous belief that pneumonia 46 
THE COMMONSENSE OF HEALTH 
prefers an odd-numbered day to stop-one day there 
comes a change. This change is usually as sudden and 
wonderful as the appearance of the sun after a hurri- 
cane. It is a real crisis. There is a peaceful calm, the 
world looks as different to you as you appear different 
to those about you. 
The wreckage remains; you are terribly weak, the 
struggle has left but a shadow of your former self. 
But that shadow will soon take on substance. Conva- 
lescence may not be rapid, but it will be an unspeakable 
joy. Let your joy, however, take the form of passive 
contentment. If your doctor detects any signs of 
bodily activity he will caution you: "A pneumonia 
patient is never out of danger until he is entirely well." 
The heart muscle must recover its strength before one 
can undertake the slightest exertion without risk. 
It is entirely probable that, as you lie there, dread- 
fully weak but with a clear mind, you cannot remember 
much about your illness. It is as though your body 
had lain ill and your mind had been elsewhere. Those 
who watched anxiously your struggle will recall all the 
details, especially the grave assiduous attentions of 
your doctor and nurse. They remember some of the 
doctor's directions as to your care. 
"All the windows up I" he had said. "As much fresh 
air as he can get. Remember, a part of his lungs is 
out of commission and the rest has to do the work. 
He needs all the oxygen he can get." 
"But the weather is cold. He will freeze!" 
"Never fear; have a fire to make the air circulate 
more freely, but cold fresh air cannot hurt him. Cold 
water is used to bring down a high temperature. Why 
is not cold air just as good?" 
And when friends called they were barred from the PNEUMONIA, THE APACHE 
47 
sick room for fear their presence would excite you. 
Also, you were not allowed to move in bed without 
being helped, to avoid unnecessary strain upon your 
heart. And you were sponged frequently, at regular 
intervals, to keep your skin active. To assist your 
kidneys in carrying off the poison you had to drink 
more liquids, especially water, than you thought neces- 
sary. Your sputum was carefully kept and burned, 
that it might not infect others. And the attendants 
washed their hands frequently, that they might not 
convey the infection to their lips. And you were con- 
stantly watched, day and night, for fear that in sudden 
delirium you might attempt to get up or otherwise do 
yourself an injury. 
And so, finally, partly because of these attentions, 
partly because of certain medicines which were given 
for particular conditions such as pain and annoying 
cough and sleeplessness when you were so restless, but 
mostly because you had the elements of fight within 
you, you triumphed over the arch enemy, and he sud- 
denly fled. It was a glorious victory. \ 
But it is probable that under certain conditions the 
victory might have been yours in the first place. You 
might have conquered the germs before they germi- 
nated to cause pneumonia. To say that the pneu- 
mococcus is no respecter of persons is an exaggeration. 
It is no respecter of those who have lost their normal 
resistance to it. Everyone who is stricken has had the 
germs within him many times before and has not suc- 
cumbed. But this one time he has lost something that 
he once possessed and which he might have retained. 
This brings us to prevention. The first thing to 
avoid is a multitude of the germs or rapidly repeated 
infections. Unnecessary contact with those who have 48 
THE COMMONSENSE OF HEALTH 
pneumonia should be shunned. If one's duties are in 
the sick room care should be taken to cleanse the 
hands thoroughly, especially before eating. The 
sputum should be collected and burned frequently. All 
vessels with which the patient comes in contact must be 
washed thoroughly, disinfected, and kept solely for his 
use. Bedclothing and his personal clothing must be 
boiled. 
But there are carriers who are not sick and who do 
not suspect that they harbor the germs. Such persons 
are a constant menace to others. The danger would be 
greatly decreased if everyone who has a cold were to 
cover his mouth and nose when he must cough and 
sneeze, especially in public places where the germs may 
be widely disseminated. 
These precautions will lessen the danger of infec- 
tion, but they will not remove it entirely. The other 
element of prevention has to do with the recipient of 
the germs, the fostering of his natural resisting power. 
The rules of conduct for the prevention of pneumonia 
are exactly the same as those for the avoidance of 
other germ diseases. The pneumococcus is more viru- 
lent than most of the other bacteria, but his method in 
attack is the same. And because of this similarity 
there must be a certain repetition of what has been 
enjoined with reference to colds and coughs. 
Granting, then, that one is likely to come into con- 
tact with this desperate enemy at any time and at fre- 
quent times, what may be done to render him harm- 
less? First, we must remember that bacteria cannot 
harm unless they penetrate the surface. This is just 
as true of the mucous membrane lining the air passages 
as it is of the skin. Something must mar that surface 
if they are to find entrance and a temporary habitat. PNEUMONIA, THE APACHE 
49 
This brings us first and foremost to dust as an irri- 
tant and to mouth breathing. If there remains any 
doubt as to the importance of dust as a cause of lung 
conditions and of nose breathing as a preventive let the 
following evidence from the London Lancet of June 
12, 1919, be read dispassionately. It is a comparison 
of the relative frequency of lung diseases in miners and 
in mine horses: 
"The horse breathes through his nose, which stops 
nearly all the dust. Investigations showed that there 
were no lung ailments among horses; they were hardly 
ever sick, and their average working life was thirteen 
years. The health of the animals was excellent, 
although lung diseases had been common in human 
beings. While experimentally the horse can be given 
pulmonary tuberculosis and develop copious disease, 
their freedom from the same in normal life is probably 
due to exclusive nasal breathing." 
Whether one accepts this conclusion wholly or not 
it is at least worth while to remember dust as an impor- 
tant factor in the susceptibility to pneumonia. Breathe 
through the nose habitually if you can. If you cannot, 
have the obstructions removed, that it may be used as 
it was intended to be used. 
If you have a cold, any inflammatory condition of 
the air passages, avoid indoor crowds. A catarrhal 
condition predisposes to pneumonia, and it is safe to 
say that in every crowd there are carriers of the germ, 
who may be as dangerous to you as a lunatic with a 
weapon. 
Spring and fall are fruitful times for pneumonia, 
because of sudden changes in temperature and humid- 
ity. But at all seasons avoid undue exposure to wet 50 
THE COMMONSENSE OF HEALTH 
and cold. Congestion of the mucous membranes of 
the lungs gives the pneumococcus his chance. 
Other directions are still more general. They may 
apply to the avoidance of most of the diseases that 
affect mankind. Avoidance of worry is one of them. 
Long-continued worry will reduce the bodily vigor. 
Overeating is a predisposing cause. The use of alcohol 
is another. The alcoholic will soon disappear from 
among us, but for a time he will not be quite so extinct 
as the dodo. He has far less chance than others 
against the onslaughts of the pneumococcus, and when 
he is stricken his doctor knows that his prospects for 
recovery are poor. 
It is at least possible that more and more of us are 
succumbing each year to pneumonia because life is be- 
coming increasingly difficult. We hurry too much, we 
worry too much, we play too little. Our lives are top- 
heavy and the equilibrium is unstable. This is obvious 
in theory, but we do not act upon it. Most of us get 
our fresh air through a distant narrowly opened win- 
dow, our recreation at the movies, and our physical 
exercise in walking two blocks to the cars. 
If you should chance to live in any one of our Ameri- 
can cities in certain parts of which thieves and gunmen 
are wont to ply their trade, and were to ask advice 
concerning your personal safety, you would get it some- 
thing after this manner: "Don't frequent places where 
you are likely to meet them." 
"But," you might protest, "my business sometimes 
takes me to such neighborhoods." 
"Very well, then; keep your eyes open. Don't let 
them get you unawares. And keep yourself physically 
fit. You will stand a better chance." PNEUMONIA, THE APACHE 
51 
"Is there no weapon I can carry? "Have I no other 
defense?" 
The fact is that there is no weapon that offers ab- 
solute security to the onslaught of pneumonia, although 
at one time vaccination was very highly endorsed. 
Vaccination is not a new thing. Jenner, in 1798, discov- 
ered smallpox vaccine and the pock-marked face has 
ceased to be a prevailing style of physiognomy. 
Typhoid vaccination practically eliminated that disease 
from the army. Vaccination has been successful in 
combating cholera and plague and dysentry. It is prob- 
able that pneumonia vaccination will be useful. 
What is vaccination and what does it do? It is the 
introduction into or beneath the skin, and thence into 
the circulation, of dead germs which, if living, would 
produce disease. The presence of these germs sets up 
a local irritation and starts the defensive forces of 
Nature. At the place of the injection there is transient 
inflammation, but throughout the body there is a 
righteous indignation, an awakening of antagonistic 
forces. Certain substances are formed in the blood 
that will help the white blood corpuscles in their fight 
against active, living germs of the same kind as the 
dead ones that have been introduced. 
For a longer or shorter time afterward these defen- 
sive products will continue to combat successfully the 
special kind of germ which they have been produced to 
fight. And so vaccination, for a time at least, im- 
munizes, renders one less liable to successful invasion. 
But dead typhoid germs will not immunize against 
cholera, nor plague germs against typhoid, nor either 
of them against pneumonia. Whatever the defensive 
products are which have been manufactured in each 52 
THE COMMONSENSE OF HEALTH 
case, they are different and they protect only against 
that particular kind of germ. 
Therein lies the difficulty with regard to pneumonia. 
There are several kinds of pneumococcus; in fact there 
are four types of which three are constant and the 
fourth because of many varieties, not yet classified. 
For a time, during the war, scientists had high hopes 
that vaccination would solve the problem of preven- 
tion in pneumonia. Of the thousands of men vac- 
cinated as a preventative measure, not more than half 
the number were stricken with the disease as compared 
with those who were unvaccinated. But, unfortunately, 
a subsequent study of these and other cases has shown 
many sources of error, so that physicians are not so 
positive at present concerning the value of pneumonia- 
vaccination. Still, it is believed that medical science is 
on the right track, and that eventually, probably very 
soon, this dreadful disease will be conquered. 
At present, however, the incidence of pneumonia is 
gradually increasing in America. But if science shall 
advance in the future as it has in the recent past with 
regard to other diseases, probably at some not far 
distant day, one will find in medical text books the fol- 
lowing : 
"Lobar pneumonia. A disease of the lungs caused 
by the pneumococcus. Once quite prevalent, but now 
rare." 
For science is moving with giant strides in the right 
direction-toward the goal of prevention. FOUR 
T. B., THE CRIMINAL 
YOU probably know that "T. B." is short for Pul- 
monary Tuberculosis. Just as we often refer to 
certain persons by their initials, so doctors, nurses, and 
even many victims of the disease, call it T. B., and thus 
save both time and breath. 
You may not be a T. B. yourself, nor have had a 
case in your family. But you can doubtless name a 
dozen households in your own acquaintance which have 
been visited by the scourge. If you have not had some 
anxious times about yourself, or about some member of 
your family, you are one among a thousand. 
And yet, although we think and talk a great deal 
about T. B., most persons have vague and mistaken 
ideas about it. Even the medical profession has been 
learning new things about it-and very recently, too. 
They are things which everybody ought to know. 
To begin with, here are a few facts which will prob- 
ably surprise at least some of you: 
Tuberculosis is the most prevalent disease in the 
world, but pulmonary tuberculosis is only one form of 
it. It may attack any tissue in the body, including the 
bones or joints, and the brain and spinal cord. 
Even T. B., or the pulmonary form, is much more 
widespread than is commonly supposed. Many per- 
sons have it and do not know they are sick. 
It is the most curable disease in the world. The 
53 54 
THE COMMONSENSE OF HEALTH 
vast majority of those who have it recover. In nearly 
every community there are persons, oldest inhabitants, 
who will tell you, if you have time to listen, that forty 
years ago Doctor So-and-so told them they had con- 
sumption and were doomed to an early grave I The 
point of the anecdote is that Doctor So-and-so has died 
long since, while the oldest inhabitant is still living and 
triumphant. That is what appeals to the oldest inhabi- 
tant; but the real point is that in all probability Doctor 
So-and-so was entirely right and that the oldest in- 
habitant did have pulmonary tuberculosis and recov- 
ered. 
T. B. is rarely acquired from others after childhood; 
and it is almost never inherited. 
It is so frequently simulated by other diseases that 
there is often great difficulty in recognizing it. As it 
is not nearly so infectious as we once thought it, our 
attitude toward those who have it has been wrong. 
We need not fear them. 
The one exception to this is that the person who 
has T. B. should be removed from contact with 
children. 
You must remember that infants and children are 
susceptible to the infection because they have not yet 
developed what is called immunity, which means a 
fighting antagonism to it. Those of us who have sur- 
vived beyond the period of adolescence have been 
triumphant in so many conflicts with the germ that we 
are, under normal conditions, immune. It is the chil- 
dren with whom we are the most concerned, children 
and young people. 
These are a few of the facts which our experience 
with young men in the army helped to prove and to 
disseminate: T. B„ THE CRIMINAL 
55 
At one of the base hospitals there was a large 
ward given over to the treatment of chronic pul- 
monary diseases. Half of this ward was occupied by 
T. B.'s, and the other half by victims of other condi- 
tions of the lungs. On the T. B. side there was a 
young farmer from Ohio who had grown steadily 
worse for weeks. One day, when his vitality had 
reached its lowest ebb, the surgeon came to him with 
cheering news: 
"I've decided that you haven't tuberculosis," he 
said, "and I'll have you moved over with the non- 
T. B.'s." 
The boy's wan face was lit by the first ray of hope 
that had brightened it in weeks. He was moved, and 
at once began to improve. Hope had revived, and 
hope had tipped the scales in his favor. Eventually 
he was discharged to his home, with a reasonable 
chance of ultimate recovery. 
This incident is not related to illustrate the influ- 
ence of mind over matter, which within certain limita- 
tions is obvious. It is told to emphasize the fatalistic 
attitude so generally prevalent toward tuberculosis. 
And also it points out the difficulty, even to physicians, 
of distinguishing tuberculosis from certain other lung 
conditions. 
T. B. is an ancient enemy, but it was not until 1882 
that the tubercle bacillus was discovered. Now when 
a great criminal has been caught, the police and the 
public at once try to prove him guilty of more crimes 
than he could possibly have committed. It is so in 
the case of The People vs. Tubercle Bacillus. On 
some counts he is not guilty. But he will "get his" 
if he is convicted on the others. Let us consider a 
few facts in his favor: 56 
THE COMMONSENSE OF HEALTH 
First, then, Tubercle Bacillus is not guilty of caus- 
ing all the lung conditions with which he is charged. 
The evidence is often only circumstantial. And, be- 
sides, we now know that many similar crimes were 
committed by another criminal, Streptococcus, one of 
the pus germs. He was especially active in the camps, 
causing great destruction. 
Many severe cases of bronchitis, many pneumonias, 
many chronic lung conditions, were laid at his door, 
after prolonged and numerous investigations. His 
methods are so similar to those of Tubercle Bacillus 
that at times it was quite impossible to decide as to his 
guilt. This was because suspicion had so long pointed 
to T. B. as the guilty one. And it is just as true among 
civilians as it was among the soldiers, that many per- 
sons are called tuberculous who are victims of Strepto- 
coccus and other germs. 
Second, it may be said in extenuation that Strepto- 
coccus often follows in the footsteps of Tubercle 
Bacillus. The victim of the latter becomes an easy 
prey to the former. Most of the advanced cases of 
T. B. die of the ravages of Streptococcus. 
Third, Tubercle Bacillus is not guilty, except in 
the comparatively few cases, of infecting the adult 
from without. He enters the body during infancy, or 
early childhood; and he waits, often for many years, 
until disease, or dissipation, or overwork, gives him his 
opportunity. 
Fourth, granting that Tubercle Bacillus is every- 
where, that he is the universal criminal, it must be 
conceded that he is not the destructive agent we once 
thought him. If he were, not one living soul of us 
would be alive! 
If all persons who had ever had tuberculosis in one T. B., THE CRIMINAL 
57 
form or another had been excluded from our army, 
there would have been no army; or at least one so 
small as to be totally inadequate. Of more than three 
million drafted or enlisted men, there would have 
been left to fight probably not sixty thousand. In 
other words, scientists believe that fully eighty per 
cent of all adults have, or have had, tuberculosis in one 
form or another. Some go further and assert that 
every adult is tuberculous. 
This is not a recent discovery. It has been known 
for many years. But never before had there been an 
opportunity to examine so many young and presumably 
healthy male adults. One of the surprises was the 
discovery of so many who showed scars of previous 
T. B. Even these men were not all excluded, for in 
many the tissue changes were too slight for rejection. 
A large proportion of these men had fought and con- 
quered the disease, totally unaware that they had ever 
had it. 
At least once a year the head of a business concern 
"takes stock." He wants to know the physical condi- 
tion of his plant, how much it has deteriorated, what 
repairs or replacements are necessary. Once in a long 
while a few of us visit the doctor for the same purpose. 
But the vast majority of people, unless overtaken by 
some physical catastrophe, do not stop to "take stock." 
And so it required the catastrophe of a war to bring 
the nation to stock-taking time. For more than a cen- 
tury we had been a going concern. Never until the 
war began was so thorough an inspection of the ma- 
chinery. 
If there was any one thing upon which we prided 
ourselves as Americans, it was upon the health and 
vigor of our young men. We had no knowledge upon 58 
THE COMMONSENSE OF HEALTH 
which to base our confidence, but we "knew" that they 
were the most vigorous and virile in the world. Be- 
cause they were Americans, I suppose, No data were 
at hand. The nation had never taken stock of its 
young men-nor of its old men, nor of its children, 
nor of its women. 
The draft boards, making a preliminary survey, re- 
ceived the first shock. Day after day came the men 
chosen by lot. They came by the thousands, by tens 
of thousands. 
And day after day defectives were cast out. There 
came the lame and halt, the blind (for purpose of 
war), the toothless, the flat-footed, the too fat, the 
too lean. There were days when members of the 
draft boards wondered if there were any young men 
in the land fit to fight. 
Of course the final result was the best army, physic- 
ally, that had ever been assembled in the world. But 
there was another army-hundreds of thousands of 
men who, because of physical disqualifications, were 
compelled to do prosaic things, the menial things, the 
inglorious things. 
And there was the vast multitude of the totally 
unfit. Of a little over three million young men ex- 
amined for military service, about five hundred thou- 
sand were rejected as physically disqualified! More 
than sixteen per cent. These figures are not absolute, 
but they are eloquent enough. 
At first, the requirements were quite strict, but soon 
they had to be relaxed. Take as an example, the teeth. 
There had to be at least four molars, two above and 
two below, and enough anchorage for dental work. 
But so many toothless men presented themselves that 
a change in the rule was absolutely necessary. There- T. B., THE CRIMINAL 
59 
after, a man was accepted who had but two molars, if 
they met for business. 
The world war had been in progress about two 
years when reports began to reach this country 
"through channels" of the great number of cases of 
T. B. in the Allied armies. France alone discharged 
more than 80,000 soldiers for this cause. Later it 
transpired that about 60,000 of these men did not have 
T. B. at all I Most of them had been victims of Old 
Man Strep, and a large proportion of them could have 
been saved to fight. 
For this reason it was extremely necessary that all 
suspected lung conditions should be most carefully ex- 
amined by not one but several competent experts. 
The applicant for life insurance is examined by one, 
possible two, or, at most, three physicians. But the 
man who finally got into the army had been passed by 
fifteen or twenty. And if at any stage of the examina- 
tions there had been doubt as to his condition, he would 
have been sent to the base hospital, where other ex- 
perts would have kept him under observation as long 
as necessary. 
Properly to visualize the birth of a soldier from the 
embryonic stage of the drafted man, let us take a single 
day during the draft examinations and a single hero 
from among the crowd. 
Very well then, William Leander Jones. In that 
previous incarnation, before the draft, Jones may have 
been a banker, a butcher, or a ribbon clerk. Now he 
is merely Citizen Jones, resembling all the others in 
the fact that he is a male and of draft age. 
Having entered the barracks, he is stripped to his 
gooseflesh, for, like the portal of death, nothing of 
this world is carried beyond. Then he is branded with 60 
THE COMMONSENSE OF HEALTH 
a number. Not branded with a red-hot iron upon his 
quivering flesh, but with a pencil upon flesh which 
quivers rather from contact with chill air. 
And so, clad in cutis ansorin#, which is Latin for 
skin of the goose, he starts along the mystic maze of 
medical meandering. From station to station he goes, 
chest to back with the man in front, back to chest with 
the one behind. He is being coldly appraised: Head, 
Eyes, Ears, Teeth, Throat, Limbs, Lungs, Heart, to 
Feet. One by one the defectives drop out, and still 
the stream moves on, steadily, hour by hour. 
But Jones does not consume an hour in the process. 
If they are having a good day, without hitches, in 
half an hour he is through. He has been stripped, 
branded, physically examined as he has never been 
physically examined before, finger-printed, vaccinated 
twice, measured for and fitted with army shoes, and 
uniformed. He has also received his army tag and 
number. 
If Jones had shown the shadow of a suspicion of 
physical disqualification, he would have been held for 
observation. But in one particular he imitates Pippa, 
he passes. Within thirty minutes he has been bereft 
of everything but his birthmarks, and goes through 
the exit of the barracks, not Citizen William Leander 
Jones, but Private Jones, Number 1,400,863, or some- 
thing else. 
Now Jones's mother had, from infancy, considered 
him rather frail. He had always been carefully 
guarded from exposure or hardship. If in his present 
confusion he has a single clear thought, it probably 
takes the form of self-congratulation. He has 
"passed." He is sound. T. B., THE CRIMINAL 
61 
But with regard to T. B., the examiners have not 
committed themselves on two points: First, that he 
never had the disease. Second, that he is now abso- 
lutely free from it. What they have said is that he has 
no scars, no structural changes in his lungs to disqualify 
him. And also that he is not suffering from active or 
manifest tuberculosis. 
Manifest tuberculosis is the T. B. with which we 
are familiar. The germs which have been "lying low," 
perhaps for years, have become active and are playing 
havoc. Activation comes from within, not from with- 
out. We have the germs, the seeds, in our bodies 
always. Improper or insufficient food, dissipation, 
worry, overwork, wasting or acute diseases-these pre- 
pare the soil, and the seeds germinate. 
The draft boards and the special examining boards 
in the camps rejected, on account of T. B., a total of 
a little over 95,000 men. Only about 5,000 men were 
returned from Europe for this cause, an insignifi- 
cant number considering the size of our army. This 
brings the total up to 100,000. And this was mani- 
fest tuberculosis, mind you, or else disabilities due to 
changes in the lungs resulting from previous attacks of 
the disease. 
Unquestionably, the greatest benefit derived from 
these examinations was to the men themselves. A 
large proportion of them learned for the first time 
their condition. And with this knowledge, upon their 
return to their homes they were enabled to take proper 
care of themselves. For you must remember that T. 
B. is a curable disease. And, besides, the knowledge 
which many of them gained in military hospitals has no 
doubt been disseminated in their various communities. 
It may sound like a paradox, but, in the final analysis, 62 
THE COMMONSENSE OF HEALTH 
tuberculosis is not cured in the sanatorium. If the 
patient remains long enough he may have his disease 
arrested; but a cure is not arrived at within several 
years. An institution for the treatment of tuberculosis 
is largely a school where people go to learn, not the 
theory of a cure, but the practical application of it, 
how to live right. The treatment of tuberculosis is 
one of the simplest things in the world, and yet one 
of the most difficult. 
There are really only four essentials. They are 
rest, fresh air, proper food, and contentment of mind. 
Not the least important is the last of these. It does 
not seem complicated, does it? And yet each one of 
these essentials is so complex that they cannot be 
learned by precept alone. 
People so often think they are resting, for instance, 
when they sit down in a chair for a little while each 
day. If anything occurs to break their rest, they 
shorten the rest period, hoping to make it up at some 
future time. But they seldom do, and the rest period, 
must be rigidly adhered to, even if it extends for weeks 
and months rather than hours. As long as there is 
fever, the rest should be continuous. 
Another criterion by which to judge the amount of 
rest needed is fatigue. In health a man becomes 
fatigued after undue or long-continued exercise. A 
normal amount of rest restores him to vigor. But in 
a wasting disease like tuberculosis, a much greater 
amount of rest is needed, even after the slightest exer- 
tion. To some invalids, walking about the room, or 
sitting in the chair, or talking to friends, is over-exer- 
tion. Nothing should be done to create fatigue that 
may not easily be overcome by a reasonable amount of 
rest. T. B., THE CRIMINAL 
63 
Nowadays, everyone knows about fresh air; but to 
many people it means a window raised an inch or two 
if the weather is cold. Or it means plenty of fresh air 
in the daytime, but a stuffy bedroom at night. 
Fresh air, in the proper sense, signifies a house or a 
workshop wide open! It means living in the open just 
about twenty-four hours every day. You do not have 
to run after fresh air. All you have to do is to sit still 
and let it come to you. Many a misguided patient has 
run himself into an early grave seeking that which was 
all about him! 
There is not room in this chapter to discuss the ques- 
tion of food in detail. Proper food means nourishing, 
not necessarily expensive food. It means food properly 
cooked, thoroughly chewed. The processes of diges- 
tion begin in the mouth, but most of us take food as 
we store our coal cellar for the winter. 
One of the greatest fallacies with regard to food 
and the tuberculosis patient is a belief that he must be 
stuffed all the time. No amount of food should be 
eaten greater than that which can be easily taken care 
of and assimilated. You would better put it in your 
pocket than in your stomach, if it cannot be digested. 
Contentment of mind is more easily advised than 
acquired. It must be achieved by almost superhuman 
exercise of patience, but especially by the pursuit of 
light, useful occupations, as soon as they are allowed. 
Where the tuberculous are concerned, the problem is 
largely mental, although the end to be achieved is 
physical. Mental unrest is as injurious in these cases 
as physical overexertion. 
Of all curable diseases, pulmonary tuberculosis is the 
most tedious, the most discouraging. Even the slight- 
est degree of activity requires many months to arrest, 64 
THE COMMONSENSE OF HEALTH 
and graver conditions proportionately longer. Rest, 
then, is absolutely essential to a cure. 
While the disease is active, the patient must be in- 
active. And no half-way business about it either. 
Absolute rest. Now, given a man recently arrived 
at a sanatorium, contrast the enforced idleness of 
a hospital with the bustle and excitement from 
which he has recently been removed. Give him the 
prospect of six months, a year, perhaps longer, of this 
quiet life. He wants to get home. Tell him that if he 
wants to get well he must stay, whether he wishes to or 
not, and what happens to him? He blows up. 
Wouldn't you? 
What is the answer? As soon as his condition will 
permit give him something to occupy his mind-to 
keep it from turning around and biting him as a 
tarantula is supposed under provocation to sting itself 
to death. And Occupational Therapy came into being. 
Not occupation that will in itself cure, but that will 
supply the healthy mind so essential to a healthy body. 
It is said that a change of treatment of any kind 
will help the consumptive for a time. Take away one 
medicine and substitute another, even if it is Worcester- 
shire sauce. The substitution must be accompanied by 
strong recommendation, however. Why does it help? 
Because hope is imbibed with it. And if hope helps, 
so does contentment. The man must have something 
to do, something else than himself to think about. 
This applies with equal force to the home, to public 
and private sanatoria and to hospitals for tuberculosis 
ex-service men and women. How many consumptives 
at home, do you suppose, who, because their minds 
are turned inward and not outward, become dis- 
couraged and fly from one patent medicine to an- T. B., THE CRIMINAL 
65 
other, or from one physician to another, in the 
hope that the doctor or the medicine may do something 
for them which they should be doing for themselves? 
Patent medicines beguile. Each new treatment fans 
the feeble spark of hope into a temporary flame, which 
soon dies out, leaving again the ashes of despair. 
In a hospital in Canada there was, in 1918, a 
Scotch-Canadian soldier who had been invalided home 
because of tuberculosis. For more than six months he 
had been growing steadily worse, until he considered 
himself, and was considered by others, a hopelessly 
progressive case. One day he told his doctor that he 
had given up. But he said he had one great longing, 
one desire that he would like to have granted before 
the end. He wanted to go fishing! The doctor knew 
that he was taking a desperate chance, but being him- 
self reasonably sure that the soldier was not going to 
live long, he had him carried to a little nearby moun- 
tain stream, where he could sit on the bank and cast 
his line. At once improvement began and, strange to 
say, continued to convalescence. 
This is an extreme case. It is not intended to sug- 
gest that every T. B. sanatorium should be located 
near a trout stream, but as an illustration of the salu- 
tary effect of occupational therapy. 
In that same Canadian hospital for tuberculous 
soldiers, until occupational therapy was inaugurated, 
men were mutinous, they deserted, went A. W. O. L.- 
"Absent Without Official Leave.'' After they were 
given something interesting to do, infractions of dis- 
cipline were reduced almost to the vanishing point. 
And, what is more, the percentage of cures rose. 
Specialists in T. B. differ as to the exact stage in the 
disease when the patient may safely be given some light 66 
THE COMMONSENSE OF HEALTH 
occupation of his choice but they are pretty thoroughly 
agreed that the time does come during the progress to- 
ward health. It need not necessarily be a useful occu- 
pation, but it must be something to direct the eyes of 
the mind outward. 
If he can work at anything that will help him when 
he gets well, so much the better. It will give the spur 
to lazy, creeping time. 
Does it help? Ask the fellow who has tried it. He 
will tell you that the lagging hours which stretched 
into weary days, and the days into endless months, 
gather to themselves fresh speed. 
With regard to the treatment of tuberculosis, one of 
the most revolutionary lessons of the war was occupa- 
tional therapy. So much emphasis hitherto had been 
laid upon the rest cure-rest of the body- that mental 
unrest had been totally ignored. Strange that we could 
have been so blind! A disease that requires months, 
often years, to cure, that consumes not only bodily 
vigor but vigor of mind and strength of will! A 
disease full of discouragements that eat the very heart 
of the moral fiber and cause the mind to fret and worry 
at the expense of the body! 
For years we have treated our criminals with more, 
consideration. During a part of each day prisoners 
now have a place in the sun, literally and figuratively. 
And all the years those afflicted with tuberculosis had 
to sit idly-waiting, waiting, for the healing balm 
that so often never came. More of these unfortunates 
have been killed by mental disquietude than by 
neglect. If we have learned this one lesson, and none 
other, then the war, with all its horrors and sacrifices^ 
may have been worth while. FIVE 
THE GREATEST PUMP IN THE WORLD 
WHAT would you say of a pump that kept on 
pumping, averaging at least seventy times per 
minute, every minute in the day, every day in the year 
for, say, sixty or seventy years without stopping 
for rest and repairs? A pretty good piece of 
machinery? 
No, if you were speaking of any other machine than 
the heart you would say it could not be done 1 And yet 
we take the heart's marvelous work for granted, never 
even thinking of it unless something goes wrong. 
If illness anywhere in the body causes a disturbance 
of the heart's action, we are apt to think we have 
heart disease, although the heart may be acting only 
in sympathy, and have nothing wrong with it at all. 
After a day of hard work, possibly after dinner, 
when you are comfortably reading the evening paper, 
you are suddenly stricken with a pain in the left chest 
that causes you to gasp with agony. This pain may b& 
boring or cutting in character. Perhaps you feel a 
sense of constriction in the chest. You place your hand 
over the heart and find it beating wildly, which in- 
creases your alarm. You manage to gasp to someone 
to send for the doctor, and you are not at all sure that 
you will live until he comes. 
Finally, after what seems hours of agonized waiting, 
he enters with that jovial professional air of his, asks 
67 68 
THE COMMONSENSE OF HEALTH 
other members of the family a few irrelevant questions 
and possibly makes some comment on the ball game, 
not realizing your imminent danger. In jerky sen- 
tences you tell him, after he finally gets down to it, that 
you have a pain in your heart, that you cannot get your 
breath, and that you are afraid each one will be your 
last. 
Calmly (why do doctors take things so calmly?) he 
feels your pulse, bares your chest, listens a moment to 
your heart, and then begins boring with his forefinger 
at your back to the left of your spine. You manage 
to tell him that there is nothing wrong with your back; 
it is your heart. 
Suddenly he touches a sore place and you jump. 
You did not know it was there. Then his forefinger 
follows between your ribs until it comes to the front of 
your chest, and you jump again. 
He listens now more carefully to your heart and 
finally, when he is through, you ask him, "Is it serious, 
Doctor?'' He smiles in that tolerant way that doctors 
have and tells you that you have intercostal neuralgia, 
and that your heart was beating wildly because you 
were alarmed. 
Now, pain in the spinal nerves, following the course 
of the ribs around the chest, may come from a diseased 
heart, but more frequently the cause is elsewhere. And 
the pain is never in the heart at all, but in the chest 
wall. It is only because it happens to be in the region 
of the heart that it is ascribed to that organ. 
Have you ever been wakened from sleep by "palpita- 
tion" or paroxysmal rapid beating of the heart? Have 
you ever felt an emphatic thump in your chest after a 
momentary pause in the heart beat? In such cases the THE GREATEST PUMP IN THE WORLD 
69 
heart is the cause of the sensation, but the sensation 
does not necessarily indicate a disease of the heart. 
Have you "poor circulation"? That is, do you suf- 
fer from coldness or perhaps from numbness of the ex- 
tremities? Don't blame the heart. The origin is 
probably in the stomach or the abdomen. 
Do you have dizzy spells? Here, too, the heart 
is nearly always innocent. You would better watch 
your eating and have a general house-cleaning, or re- 
duce your tobacco allowance. Possibly you may need 
glasses, or your ears may be affected. 
Sometimes when you are lying with your head on 
a hard pillow you are able to hear the beat of your 
pulse, and with each beat there is a swish or roughened 
sound. Do not get alarmed. You are constricting a 
small artery by the pressure of your head upon your 
ear, and you only hear the sound of the obstructed 
blood stream. 
Perhaps you are getting short of breath, and notice 
quite suddenly that you are not able to do as much 
as you used to do without discomfort. If you are 
getting fat, remember that it requires more effort to 
take a heavier body around than a lighter one. Per- 
haps you have been indulging yourself, eating rich 
food, taking little exercise, and your muscles are getting 
flabby. Don't accuse the heart; it has enough to be 
responsible for. 
What, then, are symptoms and sensations which in- 
dicate a weak or diseased heart? The sensations are 
very few, as a rule. Pain is quite infrequent, except in 
the condition called angina pectoris. There is no use 
trying to describe the pain of angina pectoris, because 
even the one who has suffered is unable to convey in 
words the full extent of his agony. The heart itself has 70 
THE COMMONSENSE OF HEALTH 
no nerves of sensation, and even the pain of angina pec- 
toris, which is a heart condition, is due to irritation 
of other nerves that do not touch the heart at all. 
Shortness of breath, however, if it is persistent, and 
especially if it is increased upon the slightest exertion, 
points suspiciously to the heart. A continuously rapid 
pulse is another sign, although not quite so definite. 
That obscure nervous condition which science still 
knows very little about, and which is called, for want of 
a better name, Hysteria, may be accompanied by an ex- 
tremely rapid pulse. Diseases of certain ductless 
glands, as the thyroid (goiter) also produce a con- 
tinuously rapid heart action. But if you cannot walk 
upstairs without a pounding in your chest and a feeling 
of suffocation, your heart needs looking after. 
Swelling of the ankles is another indication, which, 
however, may come from dilated veins in the legs, 
causing stagnation of the blood returning from the 
extremities. 
Some night when you are undressing for bed, you 
may notice that your legs above the tops of your shoes 
are swollen and shiny. You press the surface with 
your finger and find that the pressure makes an indenta- 
tion, or pit. This kind of swelling is called oedema, 
and is produced by blood stagnation, which may be 
caused by a weakened heart muscle failing to drive the 
blood stream outward from the heart with sufficient 
force to insure its proper return. Or, as indicated 
above, the flow may be slowed by an obstruction in the 
veins, or by their dilatation, which technically is called 
varicosis. 
It is almost impossible to describe the heart and the 
circulation of the blood without using the simile of a 
force pump. The heart is a force pump. In fact, it THE GREATEST PUMP IN THE WORLD 
71 
is two force pumps working independently and yet in 
unison. 
Each side of the heart has two chambers; a receiving 
chamber, called the auricle, and an expelling chamber, 
the ventricle. There is an opening between them, 
which is closed by valves when the heart contracts, in 
order that the blood may not flow back into the receiv- 
ing chamber, but be driven out into the circulation. 
The openings through which the blood flows out of the 
heart are also protected by valves, which prevent the 
blood that has just been expelled from flowing back 
into the expelling chamber. These openings and valves 
have a great deal to do with some forms of heart 
disease. 
The circulation of the blood through the vessels may 
be likened to an irrigation system; but in this case the 
fluid conveys not only water, but food, oxygen, and 
certain other elements. 
Let us see what the blood contains, where it goes, 
what it does for us, and in what condition it returns 
to the heart. First, the blood from the lungs fills the 
left heart, which contracts, driving it onward. The 
stream contains, first, nourishment from the food we 
have eaten; second, certain little bodies, called red 
corpuscles, which carry oxygen from the lungs; third, 
it bears troops, our defensive army which lives in the 
stream and which helps to destroy the germs of disease. 
These soldiers of ours, the white corpuscles, called 
phagocytes, hasten in great numbers to any part of the 
body from which comes an alarm invasion. They fight 
our battles every moment that we live, whether we aro 
awake or asleep. If it were not for them, disease 
would soon overcome us, and we should be annihilated. 
Leading out from the heart there is the main artery, 72 
THE COMMONSENSE OF HEALTH 
called the aorta, from which smaller arteries branch. 
These divide and subdivide, becoming smaller and 
smaller, until finally they reach the capillaries, which 
pervade every tissue of the body and are so small that 
they get their name from the Latin word for a hair. 
It is through the capillary walls that the nourishment, 
the oxygen and also the defensive troops, get into the 
tissues. 
When a candle burns, the oxygen of the air unites 
with carbon to make carbon dioxide. Exactly this 
change takes place when the oxygen in the blood comes 
in contact with waste matter in the body. As they 
move onward in the stream, the red corpuscles give up 
their oxygen and take up the carbonic acid gas. 
The blood stream also takes up various products 
of waste, which it carries to certain organs, such as 
the kidneys and the lungs, to be eliminated. 
Leaving the capillaries, the blood enters the smallest 
veins, which soon empty into larger ones, and these 
increase in size, diminishing in numbers, until finally 
two large veins return the blood to the right side of 
the heart, to be pumped again into the lungs. This, 
briefly, is the double cycle of the circulation. 
But the heart cannot perform its daily task without 
a stimulus. There must be a pumper as well as a 
pump; and the pumper is the nervous system. Two 
great nerves supply the heart with its incentive to 
work. One is the accelerator nerve, which causes the 
heart contractions, and the other is the inhibitory 
nerve, which controls the heart beats, and without 
which the accelerator nerve would drive the heart too 
fast. 
Ordinarily, the stimulus from these nerves is well 
balanced and the heart beats regularly and with suf- THE GREATEST PUMP IN THE WORLD 
73 
ficient frequency. But if one of them overbalances the 
other, there will be either a slowing or an acceleration 
of the beat, depending upon which one of them pre- 
dominates. These nerves have nothing whatever to do 
with sensation. No nerves of sensation enter the 
heart, but they do connect with the heart nerves at 
certain centers or substations. 
These sensory nerves are distributed over the sur- 
face of the body, mostly to the chest wall and down 
the arms. Any trouble in the heart itself causes an irri- 
tation of the heart nerves; and the sensory nerves, 
in sympathy with those of the heart, become irritated. 
It is in this manner that heart disease, or any long- 
continued disturbance, may produce the sensation of 
pain in the chest wall, or down the arms. 
The heart may be handled, it may be cut, it may re- 
ceive almost any serious injury, without causing pain; 
because it requires long continued irritation of the 
heart nerves to produce a sympathetic reaction in the 
nerves of sensation. Harvey, who discovered the 
secret of the circulation early in the seventeenth cen- 
tury, described how he had handled the exposed heart 
of the son of Viscount Montgomery without causing 
the boy any distress whatever. 
"Heart disease," then, may not be a disease of the 
heart at all. That is, you may have certain sensations 
which you wrongly attribute to a heart condition; or 
your heart may be acting queerly because it is merely 
sympathizing with other organs which are in trouble. 
These sympathetic troubles of the heart are called 
functional diseases, to distinguish them from real or 
organic heart diseases. 
In organic heart disease the fault may lie in one of 
three directions: It may be the pump; it may be the 74 
THE COMMONSENSE OF HEALTH 
piping system; or it may be the pumper, the nerve 
supply. 
With regard to the pump, there may be a disease of 
the heart muscle; of its inner lining, the endocardium; 
or of its outer lining, the pericardium. 
The heart is subject to many infections from other 
parts of the body which reach it through the blood 
stream. If there is an accumulation of pus somewhere, 
as around the teeth, or in the appendix, or the tonsils, 
the blood takes up the germs which cause it, and they 
often find lodgment in the heart, producing an inflam- 
matory disease of the heart lining and also of the 
muscle itself. Certain diseases, such as rheumatism, 
will also cause an inflammatory condition of the heart. 
The damage done in such cases is usually to the 
openings through which the blood flows, or to their 
valves. Wherever there has been a deep-seated in- 
flammatory condition, scar tissue always follows. If 
you burn your hand severely, the burn in healing con- 
tracts and makes a scar. It is this contraction of the 
inflamed tissues of the heart which usually does the 
damage, causing the valves to become too small to 
cover the openings; or the openings themselves too 
narrow, thus obstructing the flow of blood. Valvular 
diseases of the heart are not really active diseases at 
all, but are defects in the valves, due to the shrinking 
of scar tissue, which permits a back-flow of the stream. 
Valvular heart defects used to be considered quite 
dangerous, but we have learned that they are not so 
serious as they were formerly thought to be. A heart 
will go on performing its task in spite of a valvular 
defect, if the heart muscle is strong enough to force 
the stream onward, and, also, if the heart is not given 
too much extra duty to perform. THE GREATEST PUMP IN THE WORLD 
75 
The heart muscle may be weakened by several 
causes; by disease, by overwork, or by undernourish- 
ment. There is a large artery which distributes its 
branches over the heart, conveying nourishment to the 
heart muscle. A disease of this artery may cause 
starvation of the heart muscle and produce that terrible 
condition called angina pectoris. But whatever symp- 
toms may arise from heart exhaustion, the one con- 
stant symptom is shortness of breath. 
Shortness of breath is an expression of air hunger. 
If we do not get sufficient oxygen in the tissues there 
is an accumulation of carbonic acid gas in the blood. 
We may not get enough oxygen because of something 
wrong with our lungs. Or we may get enough oxygen 
through our lungs, but the blood stream may be too 
sluggish for the tissues to receive it. This is the rea- 
son why, in diseased conditions of the heart or blood 
vessels, we breathe rapidly, even when at rest, or pant 
and labor upon the slightest exertion. It is a danger 
signal of great gravity, and requires immediate 
attention. 
If you cannot climb a hill as comfortably as you 
used to; if going up a few steps causes distress, you 
would better take good advice from one competent to 
give it. It may be that you are getting too fat, that 
there is fat around the heart, and it is struggling 
against an incubus. But, on the other hand, it may be 
a weakened, exhausted condition of the heart muscle, 
which requires rest. 
Impairment of the circulation in the vessels is fre- 
quently caused by hardening of the walls of the small 
arteries and the obliteration of many capillaries, which 
occurs mostly in old age. This obliteration of the 76 
THE COMMONSENSE OF HEALTH 
small vessels is considered to be one of the causes of 
high blood pressure. 
Another cause is a chronic disease of the kidneys. 
Recently another theory of the high blood pressure has 
been widely accepted. On the surface of each kidney 
in man and animals is a gland called the suprarenal 
gland. The extract from this gland, called supra- 
renalin, when injected into the blood, causes increased 
blood pressure. This has led to the belief that in 
chronic diseases of the kidneys the suprarenal gland is 
affected, and suprarenalin is increased in the blood. 
What is meant by "high blood pressure"? Nowa- 
days, when you go to the doctor, one of the first things 
he does after getting your story is to put a cloth band 
about your arm, containing a rubber air bag, which is 
connected by a rubber tube to a small instrument con- 
sisting of a dial and a hand that registers the amount 
of air pressure in the rubber bag. By squeezing a bulb 
and pumping air into the bag, he compresses your arm 
and finally stops the beating of the pulse on that side. 
Then, with the finger he feels the wrist artery, or with 
a stethoscope he listens at the crook of your elbow 
and notes on the dial the exact place where, upon grad- 
ually releasing the air pressure, your pulse first reas- 
serts itself. The figure on the dial at this point is put 
down as the amount of your blood pressure. 
Too many people are worried about their blood 
pressure. The healthy heart has a tremendous reserve 
power beyond what it is called upon ordinarily to use. 
The normal heart can endure almost any amount of 
physical exertion that does not cause distress elsewhere. 
If one has a high blood pressure there must be a rea- 
son for it, and to attempt to reduce the blood pressure 
would be folly. It would necessitate reducing the force THE GREATEST PUMP IN THE WORLD 
77 
of the heart contraction, which is needed to send the 
blood out into the body and get it back again. 
If you have a high blood pressure your doctor will 
try to find out three things about you: Are your kidneys 
performing properly? Are they taking enough waste 
matter out of the blood? If not, then you may have 
a chronic kidney disease that needs attention and care. 
How are your artery walls? Are they beginning to 
harden? What is the condition of your heart muscle? 
Is your heart equal to the added task? If he is satis- 
fied concerning these three things you need not worry 
so much about your blood pressure. 
All the drugs in the world cannot keep the blood 
pressure down, anyhow. Only one thing can do it- 
a failing heart muscle. If for some time it has been 
around one hundred and eighty or two hundred, and 
suddenly drops, look out! The heart muscle is getting 
tired. It must rest or it will stop. 
But because anxiety and stimulating foods will 
add to the burden of the heart, the wise doctor will tell 
you to forget your blood pressure, to rest, to restrict 
your diet, and to reduce your allowance of tobacco, 
or coffee, or tea. 
One of the most important conditions that affect 
people of advancing age is arterio-sclerosis, or harden- 
ing of the artery walls. If you will put your finger 
on your pulse at the wrist you will feel the impulse 
of the advancing blood wave, which causes a mo- 
mentary stiffening of the wall. If you press a little 
harder you will be able to collapse the wall until the 
pulse is obliterated. When a doctor examines your 
pulse he wants to know much more than how fast it 
beats. In fact he learns five things about it: First, 
the rate; second, the volume, whether it is thin and 78 
THE COMMONSENSE OF HEALTH 
fine or a full blood stream; third, the rhythm, whether 
it is regular or irregular; fourth, how much pressure is 
required to stop the pulse; and fifth, the condition of 
the artery walls. 
If they are soft and smooth, no marked degenerative 
changes have taken place. But the wall may have a 
hard, inelastic, ringed feel, very much like the feel 
of a rubber hose protected by wire sheathing. This 
last is an indication of an advanced state of arterio- 
sclerosis. 
In general, it may be said that anything which causes 
over-activity of the heart puts a strain upon the blood 
vessels. The anxiety, the worry, the feverish haste of 
modern life, overeating, overdrinking, the excessive use 
of tobacco, all of these, singly or in combination, may 
produce an untimely hardening of the vessels. And 
when the vessel walls are hardened, they are more 
easily ruptured, especially because there is usually in- 
creased blood pressure. Ruptures occur more fre- 
quently in the brain than elsewhere in the body, and 
when this occurs there is a hemorrhage on the surface 
or within the brain which is called cerebral apoplexy. 
We have been talking about the pump and the piping 
system. Now we must consider the pumper. Any- 
where along the course of the great heart nerves, a 
trouble may arise to cause a change either in the rate 
or the rhythm of the heart contraction. Such condi- 
tions are not usually serious, however, unless the 
trouble occurs in the nerve filaments after they have 
entered the heart itself. SIX 
WHY THIS HEADACHE? 
IT WOULD be difficult to find anyone to speak a 
good word for a headache. If the whole tribe of 
headaches of all kinds and degrees could be banished 
by popular vote there would soon be a Twentieth 
Amendment to the Constitution. And the votes in 
favor of the amendment would be cast not only by 
those who are subject to headaches but also by the 
people who suffer from the headaches of others. 
These would include, of course, all immediate rela- 
tives and friends. Nothing makes one more dis- 
agreeable and uncompanionable than a headache. 
Few things so upset the harmony of a home or so 
threaten the integrity of friendship. Few things so re- 
tard the machinery of business. It is the great de- 
stroyer of efficiency. If such a computation were pos- 
sible it would be interesting to know concerning any 
community the number of hours lost in a day, a week 
or a year because of headaches. And if happiness, 
peace, good fellowship, harmony, if these could be 
weighed or measured, the figures representing the total 
loss would be appalling. 
But just as no one is entirely good or wholly bad, so 
headaches are not an unmixed evil. They have their 
uses if we would only stop to realize it. Sometimes one 
is unfortunate if he does not get a headache. For in- 
stance: There are people, nearly everyone knows at 
79 80 
THE COMMONSENSE OF HEALTH 
least one such person, who never have a headache. No 
matter what they do they seem to get off scot-free. 
And they are not loath to boast about it, as though 
the fact proved them to be possessed of some virtue or 
superior quality not belonging to others. Perhaps this 
kind of person has not become entirely extinct, but he 
was more in evidence before the Eighteenth Amend- 
ment was ratified. The morning after the night before 
he was especially obnoxious to those who had been out 
with him and who suffered. They hated him for his 
boisterous gayety and his attitude toward them, a mix- 
ture of pity and superiority, and they envied him. 
Lucky dog! 
Not so lucky, after all. Possibly not so lucky as the 
fellow with the headache. For the feeling of security 
from punishment causes the one to go on repeating his 
crimes against health, while fear of the headache deters 
the other. This merely by way of indicating one of the 
uses of a headache. It needs less emphasis now than it 
did a while ago. But it has its application still. An 
overloaded stomach, indigestion caused by rich foods, 
will produce this kind of headache also, especially if 
augmented by excitement, by much coffee and by much 
smoking. If the headache comes, let it be a warning. 
That road, dotted by the pleasant roadhouses of self- 
indulgence, leads to destruction. Headaches have 
their advantages then; they are not always an unmiti- 
gated evil. In fact, very few of them are, if they serve 
their purpose, which is to warn us that something is 
wrong that needs correction. Almost every abnormal 
condition, either temporary or permanent, may cause a 
headache. 
These causes are so numerous that it would be im- 
possible to mention them all. Among them are a blow WHY THIS HEADACHE? 
81 
on the head, bad vision, acute febrile disease, indiges- 
tion, chronic kidney disease, a stuffy air-tight bedroom, 
nervous shock, a tight collar, catarrhal conditions, 
tumors of the brain, a bad liver, inflammation of the 
brain's lining membranes, and long-continued, intense 
mental effort. Also, migraine, which may be consid- 
ered a condition in itself. 
But with the exception of some of the organic brain 
diseases, and of that most distressing affliction, mi- 
graine, practically all the conditions causing headaches 
fall into two groups-those arising from bad habits 
and those due to bodily defects. Perhaps this state- 
ment needs some clarification. By bad habits is meant 
harmful habits, environments and occupations. By 
bodily defects is implied any condition in the body 
which causes irritation of the sensory nerves that re- 
flexly affects the brain. Examples of this are defective 
vision and catarrhal conditions of the nose and its ac- 
cessory chambers. 
Before taking up particular headaches and their 
causes it may be of interest to inquire what a headache 
is. Pain of any kind is always due to irritation of the 
nerves of sensation. These nerves are the wires of 
communication by which we receive our impressions 
of external things. They are distributed in the great- 
est number upon the surface of the body and all have 
their central station in the brain. 
Protected by its bony covering the brain does not 
come into direct contact with the outer world, except 
as a result of injury. It is surrounded, first by two 
delicate membranes, then by a denser fibrous coat, and 
finally by the thick, rigid arch of the skull. It is the 
central nerve station, in charge of which are the higher 
mental faculties, the will, reason, imagination, all the 82 
THE COMMONSENSE OF HEALTH 
attributes which together form consciousness and 
intelligence. 
To this station in its dark chamber come all com- 
munications from without, along the main trunk, the 
spinal cord, and by special wires from the organs of 
sense. And from it radiate commands to every part of 
the body. In response to messages which it correlates 
and interprets, will pushes the buttons, currents of 
impulse flash along the motor wires, and the result 
is action at remote stations to which the orders go. 
Pain, then, is perceived by the brain, but the brain 
has no sensory nerves of its own. Once the surgeon's 
knife has penetrated its membranes large portions of 
the brain could be removed without the need of an 
anaesthetic. But there are nerves of sensation in the 
head, and a headache from any cause, near or remote, 
is directly due to pressure upon or irritation of these 
nerves. Among other things, increased pressure within 
the skull may cause a headache. A brain tumor will 
do it, especially if it is near certain locations where 
the sensory nerves are distributed in greatest numbers; 
so will an abscess, and inflammatory thickening of the 
membranes, as in meningitis. This last is the cause of 
the most excruciating of all headaches. 
Too much blood in the head will also cause head- 
ache. There are two kinds of congestive headache- 
one in which too much blood is pumped into the head, 
and the other in which too little gets out. The former 
is the violently throbbing headache; the vessels are 
distended, the volume of blood is increased and there 
is a throbbing pain as each succeeding wave beats 
against the sensitive nerves. In the latter, where there 
is merely a damming up of the blood, the pain is not WHY THIS HEADACHE? 
83 
so acute and the throbbing sensation, if present at all, 
is not so marked. 
Irritation of the sensory nerves in the brain is nearly 
always due to the presence of unwonted chemical sub- 
stances in the blood. These poisons may be made in 
the body or they may be introduced into it from the 
outside. The headache following a convivial evening 
is really due to both kinds of poison. The alcohol 
has caused indigestion and fermentation with the pro- 
duction of irritating substances from the food. But 
the alcohol itself is also an irritant to the nerve centers. 
Together they greatly increase the circulation of blood 
in the head, and the blood stream beating against the 
sore nerves produces the regular old-fashioned throb- 
bing headache. 
Coffee is less poisonous than alcohol, but, neverthe- 
less, it is a mild poison. And so is tobacco, but re- 
peated use of both develops a tolerance to them. Even 
after this tolerance has been established an overdose 
of either will cause disagreeable symptoms, such as 
sleeplessness, nervous irritability and headache. The 
coffee headache is usually chronic-that is, it is either 
constant or it reappears often without apparent cause. 
The cause may not be even suspected until in despera- 
tion one stops drinking coffee and the headaches gradu- 
ally disappear. 
We are constantly making poisons in this chemical 
laboratory of the body, and the excretory organs are 
continually throwing them off. As long as they are not 
manufactured in excess and the scavenger organs are 
efficient the balance is maintained. But if elimination 
cannot keep up with production, if the kidneys, the 
sweat glands and the lungs are unable to get rid of 
the waste products, the result will soon be disastrous. 84 
THE COMMONSENSE OF HEALTH 
Often the first and only symptom of this condition 
is headache. 
A good example of the headache of self-poisoning is 
that which occurs after one remains for some time in a 
close room. You may recall at least one such ex- 
perience of your own. You were, possibly, attending 
a meeting. All the windows and doors were shut and a 
lighted stove or two helped the audience to burn up 
the supply of oxygen in the atmosphere. At first you 
were interested in the proceedings, but soon your atten- 
tion began to lag. You became drowsy, so sleepy that 
you could keep awake only by the greatest effort, by 
fidgeting and by frequently pinching yourself. And 
toward the end you had a headache. 
You were poisoned by carbon dioxide, a gas pro- 
duced by combustion in the body by exactly the same 
chemical process as elsewhere. With each expiration 
you throw it off, and with every inspiration you should 
take in oxygen. If the supply of fresh air is limited 
it soon becomes depleted of oxygen and saturated with 
carbon dioxide. And the longer you breathe this viti- 
ated air the more of the gas remains stored up in the 
blood to act as a poison upon the nerve centers of 
the brain. 
This illustrates a very simple form of poison head- 
ache which may occur in any healthy person. There 
are many other poisons than carbon dioxide. In the 
process of living we manufacture them constantly. The 
mere act of living implies energy, and every form of 
energy, whether of mind or muscle, requires combus- 
tion. Also, combustion necessitates something to burn 
up and a constant supply of new material. Tissues are 
destroyed, they are restored by the food that we eat, 
and the waste products must be removed. WHY THIS HEADACHE? 
85 
The blood not only supplies new material but carries 
away the waste, which must be thrown off by the excre- 
tory organs, chiefly by the kidneys and the skin. Perfect 
health requires a nice balance between the amount of 
waste manufactured and the amount eliminated. 
Physical energy increases the waste but it also ac- 
celerates the flow of the blood stream, which in turn 
stimulates the kidneys and the skin to greater activity. 
Mental energy increases the amount of waste material, 
also, without a corresponding effect upon the excre- 
tory organs. In consequence, long-continued mental 
work, especially if accompanied by worry, without suf- 
ficient physical evercise, will eventually result in the 
accumulation of poisons. 
Constantly eating more food than is required for re- 
placement of tissue and for the production of heat is 
another way of upsetting the balance. Unassimilated 
food must be gotten rid of either by burning it up or 
throwing it off as waste. A headache from overeating 
can often be cured by vigorous exercise because the 
increased energy requires more fuel and the skin and 
kidneys throw off more waste. 
Another way to poison the body is to decrease the 
eliminating power of the kidneys. This can be done 
by continually giving them too much to do. Their 
structure is very delicate and yet it is not easily de- 
stroyed, but long-continued abuse will do it. After a 
long time in the constant attempt to get rid of an excess 
of waste material they will finally break down, and 
then they will be unable to take care of even the ordi- 
nary amount of waste. 
Usually following close upon the heels of these 
changes in the kidneys come high blood pressure and 
hardening of arteries, and together they form a most 86 
THE COMMONSENSE OF HEALTH 
unpleasant triumvirate. Before any of them appears it 
would be well for us if we could interpret the occa- 
sional poison headache as a warning. 
Headaches from bodily defects may be called reflex 
headaches. They are caused by irritation of nerves 
somewhere along their course outside the head, which 
by the connection of these nerves with the brain is com- 
municated to the nerve centers. Most conspicuous 
among these are eye headaches, catarrhal headaches 
and those peculiar to women. 
A far greater number of women than men suffer 
from headaches for at least two reasons. As a rule 
they are more emotional. Emotions not only cause 
headaches but they can aggravate those which arise 
from another source. This is because they have so pro- 
found an influence upon all the physical functions, 
especially upon the circulation. Grief, excitement or 
sudden shock may start a headache or make an existing 
one worse. 
But women are especially liable to headache because, 
of physical conditions directly incident to their sex. 
Many of them go on suffering year after year when 
proper treatment or a simple surgical operation might 
relieve them. 
Eyestrain as a prolific cause of headaches is so gen- 
erally recognized that little need be said about it, but 
a few practical suggestions may be helpful. 
The perfectly normal eye may be overworked. It 
requires an effort of the ciliary muscle to thicken the 
crystalline lens in order to focus near objects on the 
retina. For this reason long-continued work tires this 
little muscle and the result may be a headache, which 
a short rest will cure. 
Many of the eye headaches come from farsighted WHY THIS HEADACHE? 
87 
eyes. The ball being too shallow in this defect, the 
crystalline lens must assume a state of extreme thick- 
ness for near objects in order to throw a clear image 
on the retina. One with a farsighted eye must always 
wear glasses when looking at close objects. 
When the front of the eyeball is irregular in shape, 
as it is in astigmatism, all efforts of the crystalline 
lens to obtain a clear image are fruitless. Struggle as 
it will, and it struggles continually, the result is always 
a blur. Those who have astigmatism must wear 
glasses all the time. The practical application of this 
fact is that the astigmatic person cannot obtain relief 
by keeping his glasses in a bureau drawer or on his 
desk. The mere fact of owning them will not be much 
help. 
Another suggestion has to do with the headaches 
of school children. Parents often think that they 
are imaginary or invented for an obvious purpose. 
Such headaches may belong to the poison group, from 
bad air in the schoolroom; but they may, and most 
often do, come from the need of glasses while the child 
is in school. 
The third suggestion concerns the occasional failure 
of glasses to relieve the headache. Sometimes the 
astigmatism is so complicated that it is not entirely 
corrected by the first prescription, and a further ex- 
amination may be necessary. 
Headaches from catarrhal conditions are due to 
pressure on nerves in the nose or its accessory cham- 
bers. These chambers, or sinuses, are connected with 
the nose by more or less narrow and tortuous channels. 
They are lined with mucous membrane and are sus- 
ceptible to all the infections that attack the nose itself. 
When these membranes are swollen or when a sinus 88 
THE COMMONSENSE OF HEALTH 
is filled with mucus or pus the nerves are compressed 
and the result is usually a dull headache, but occasion- 
ally the pain is acute if the pressure is very great. 
Granting, then, that headaches serve a purpose and 
that the purpose is to warn us of conditions present 
and of further trouble to come if the warning is un- 
heeded, does the kind of headache indicate the condi- 
tion which causes it? Not definitely, and yet it may 
serve as a clew. There are many kinds of headache, 
but for present purposes they may be classified as 
throbbing and dull. Of course this is purely arbitrary, 
for any headache may change in character from time 
to time. And, also, the same cause may give rise to, 
different sensations in different people and at different 
times. 
The congestive or throbbing headache is usually 
caused by an acute condition. It occurs in the begin- 
ning of fevers, especially those which, like pneumonia, 
have a sudden and violent onset. It is the headache 
of acute indigestion, of alcoholic poisoning and of 
highly emotional states. If the congestion is very 
severe it may be accompanied by vomiting, caused by 
the intense pressure within the skull. 
Dull headaches are the predominant type in more 
chronic conditions, as, for instance, those in which 
there is a slow absorption of poisons. It is the head- 
ache characteristic of chronic constipation or kidney 
disease and of hardening of the arteries. At times 
there may be attacks of throbbing or acute pain, but 
usually there is a dull, stupefying sensation. Also, in 
chronic catarrh and in defective vision the headache is 
mostly dull. 
Sometimes the location of a headache helps to indi- 
cate its origin. If the pain is always in the same place, WHY THIS HEADACHE? 
89 
a comparatively small spot in the head; if it is con- 
tinuous, grows worse from month to month, and is 
more severe at night-it may be due to some organic 
trouble in the brain. This may be a tumor or an 
abscess within the skull. It does not necessarily follow 
that so grave a condition is present, but at least the 
sufferer should have a competent nerve specialist find 
out. In catarrhal conditions the discomfort is worse in 
the front of the head. The poison headaches are more 
diffuse but the pain is more often in the forehead and 
the back of the head. The top of the head is favored 
by the headaches of nervous, hysterical persons and by 
those suffering from stomach and liver conditions. 
There are several special forms of headaches, each 
in a class by itself, of which only two will be described 
-the neurasthenic headache and migraine. Neuras- 
thenia is a word which carries with it a certain amount 
of opprobrium. A doctor never tells his patient that 
he or she is neurasthenic, not if he wishes to keep the 
patient. In the minds of most people it is synonymous 
with hysteria and implies a certain mental or emotional 
weakness. Neurasthenia, however, means merely 
nerve weakness, exhaustion. It is a condition caused 
by long-continued mental strain, abuse of the mind, 
usually coupled with neglect of the body. 
The neurasthenic headache is in a class by itself, not 
because it is so definite in its manifestations but rather 
because it is so multiform, so changeable and so persis- 
tent. It takes a long time and much persistence to 
develop neurasthenia and, having achieved it, a long 
time to get rid of it. Those who acquire it are, con- 
trary to popular belief, mostly the brain workers, the 
ambitious, those who struggle against odds and who 
usually come off victorious at the expense of health. 90 
THE COMMONSENSE OF HEALTH 
Because it has so many manifestations in different 
individuals the neurasthenic headache is difficult to 
describe. There may be no acute pain at all. More 
often it is a feeling of oppression and heaviness in the 
head. The pressure may be located in the forehead, 
extending to the eyes, or it may involve the whole 
brain. At times only the back of the head is affected, 
but always there is the sense of fullness and weight. 
Other sensations are also variable; the head feels 
hollow, or numb, or hot or cold. If there is actual 
pain it is usually not severe or continuous. There may 
be a sensation of heat all through the brain, with a 
throbbing as though the head would burst if it were 
not bound tightly with a bandage; or a sense of con- 
striction as though an iron band were around it. But, 
however various the symptoms, the neurasthenic head- 
ache has two definite characteristics: It is persistent- 
it may not be always present but it returns on the 
slightest provocation; and, especially, it is aggravated 
by mental work and worry. 
This is a headache of poisons, slow poisons manu- 
factured in the body and stored in the brain. By their 
slow, cumulative action they effect changes in the 
cerebral circulation, chief of which is a gradual dila- 
tation of the blood vessels. There is always too much 
blood in the brain, not a swift-moving stream like that 
which causes the violently throbbing headache of active 
congestion, but a sluggish current which produces pres- 
sure. 
The longer the causes of this condition are allowed 
to persist the more difficult it is to cure. Finally 
organic changes may occur which cannot be cured; the 
vessel walls, on account of long-continued distention, 
will become thickened, and their soft, elastic tissues WHY THIS HEADACHE? 
91 
replaced by lime salts. In other words, cerebral 
arteriosclerosis. 
But long before these changes have occurred, long 
before this poison headache has become neurasthenic in 
character, its repeated warnings should be heeded if 
one wishes to be sure of averting organic changes in the 
cerebral vessels and all that these changes imply. 
Medicines will not cure, they will only relieve 
momentarily. In fact, they are worse than useless as 
they mask, the real condition. The essential thing is 
rest, absolute freedom from the environment and occu- 
pations which brought it on. And the duration of the 
rest must be determined by the length of time the con- 
dition has lasted. Short vacations are of little benefit. 
In fact, they are not of much use to anyone who needs 
a complete rest, because he usually speeds up his work 
before he goes away and makes up for his absence after 
his return. 
The best way to cure a neurasthenic headache is not 
to get it. There are a few people who are extremely 
susceptible because Nature has endowed or cursed 
them with a nervous, irritable temperament. But even 
these unfortunates can avoid trouble by tempering 
work with play, intense application with recreation. 
There is only one migraine, although many different 
forms of paroxysmal neuralgia are mistakenly called 
by that name. It is one kind of headache about which 
nothing good can be said. It does not warn one of any 
danger to be avoided; in fact, it serves no good pur- 
pose whatever. Its victims are innocent, they have 
done nothing to merit punishment and they can do 
nothing to avoid it. 
So many times a month or a year the sufferer spends 
a day or longer in a darkened room, shut away from 92 
THE COMMONSENSE OF HEALTH 
friends, from all the activities of life. It does not 
usually strike suddenly. For some time, perhaps for a 
day or two before an attack, there are premonitions. 
Usually these take the form of mental depression, 
lassitude or perhaps occasional chilly sensations, or 
there may be changeable emotional states, alternate 
exaltation and moodiness. Anyone who suffers from 
attacks of migraine knows what these signs portend. 
Then curious visual phenomena may appear-spots 
of blindness, half vision, flashes of brilliant light or 
zigzag lines. Sometimes the attack wastes itself in 
these threats, but when it does materialize it eclipses 
every interest in life. The pain is agonizing. It begins 
usually over one eye but may spread rapidly so as to 
involve the entire half or even the whole of the head. 
It is intensified by the slightest jar, by light, by any 
sudden noise. It is throbbing, piercing, stabbing, blind- 
ing. During its height there may be mental confusion, 
even torpor. The sufferer's face is pale, pinched and 
drawn, every line and feature depicting agony. 
At the climax there is nausea, and the vomiting may 
be so violent that bile is brought up from the small 
intestine. This fact has caused some to call migraine 
"bilious headache," but the bile is merely brought up 
mechanically by the retching, and the liver has nothing 
to do with the attack. 
These distracting symptoms may last an hour, a day, 
or in some instances several days. Then relief comes 
suddenly and with as little apparent cause for its com- 
ing as had the attack itself. Usually the sufferer falls 
into a natural sleep, from which he awakens perfectly 
normal. 
The causes of migraine are obscure. About all 
that is known is that with many it seems to be heredi- WHY THIS HEADACHE? 
93 
tary, affecting perhaps one person in each succeeding 
generation of a family; and that a single attack may be 
precipitated by conditions which bring on other head- 
aches-indigestion, excitement and overwork. 
There seems to be some resemblance between 
migraine and epilepsy. In the latter disease the 
attacks are sudden and apparently without cause. The 
victim utters a cry and falls unconscious, his muscles 
rigid. This is followed by spasmodic jerking, and 
after a short period the storm passes as quickly as it 
came. 
Epilepsy is a nervous explosion affecting the motor 
centers, and migraine is thought to be a similar explo- 
sion, the seat of which is in the sensory centers of the 
brain. But whatever the theories as to its origin, one 
thing is quite sure-nothing good can be said about it. 
With the exception of migraine the severity of the 
attacks of headaches can be mitigated by drugs. 
Nearly everyone has his favorite remedy, which he 
keeps on hand for emergency. Headache medicines 
vary much in name but little in their ingredients. 
The old-fashioned methods for relief are safer, 
although they are not so prompt in their action-a 
laxative to remove poisons from the system, and the 
application of heat and cold. Both heat and cold are 
useful in the acute congestive headache, cold com- 
presses to the head to drive the blood elsewhere, and a 
hot foot bath to distend the blood vessels in the 
extremities and draw the blood from the head. 
The headaches of chronic poisoning are benefited by 
a course of laxatives and by sweating. Both of these 
methods aid in getting rid of the poisons. A head- 
ache from acute indigestion is best relieved by vomiting 
or, if the stomach contents are acid, by neutralizing 94 
THE COMMONSENSE OF HEALTH 
them with half a teaspoonful of baking soda in hot 
water. 
Sometimes neuralgic pains are better for heat, and 
at other times for applying ice to the affected nerves. 
There is no way of knowing which to use except by 
trying. 
If the purpose of this article has not utterly failed' 
it must be evident by this time that a headache is not a 
condition in itself, but a symptom. It is a protest, 
occasional or often repeated, mild or loud and manda- 
tory, because something has been done that should not 
have been done or something is wrong which needs 
correction. Consequently prevention is infinitely more 
important than cure. 
Another thing to remember is that the mildness or 
severity of the pain is not usually an index to the 
gravity of the condition producing it. An occasional 
severe headache is usually due to a temporary distur- 
bance and is merely a warning not to repeat the indis- 
cretion that brought it on. On the other hand, 
repeated mild attacks may indicate serious trouble 
which it would be well to discover. 
The proper way to regard a headache is to take it 
neither with stoical philosophy as something inevitable, 
nor on the other hand with querulous and futile com- 
plaining, but to make a proper and consistent endeavor 
to find out what is wrong. In the majority of instances 
this search for a cause will require expert help. It may 
necessitate a very thorough physical examination. But 
surely the end to be attained, which is not only greater 
happiness but a possible increase of years, is worth 
all the effort. 
The one thing not to do, however, is to trust solely 
to pills and powders and potions which relieve but do WHY THIS HEADACHE? 
95 
not cure. They give a sense of false security. By 
deadening our sensibility to pain they make us feel safe 
in the presence of danger. Or they tempt us to go on 
doing things that are harmful because we can postpone 
the penalty. 
If we think we can dance and not pay the piper we 
are wrong. Sooner or later the piper must be paid. 
And the longer payment is put off the more usurious 
the interest he will charge. SEVEN 
SYMPTOMS AND SYMPTOM HUNTING 
PATIENTS will not discuss their symptoms." 
Those who frequent or who casually visit hospi- 
tals and sanitariums may have noticed a sign bearing 
these words conspicuously displayed in the rooms 
where patients gather for social converse. Worded as 
above, it is neither a statement of fact nor a credible 
prediction. Patients do and will discuss their symp- 
toms, with or without permission. What the sign 
really means is: "Patients, please do not discuss your 
symptoms any more than you can help. But especially 
do not listen to symptoms, because they are catching." 
The only pleasure one gets out of having symptoms 
is in telling about them. Consequently exchanging 
symptoms is the principal indoor sport wherever the 
afflicted are gathered together. One curious rule about 
the game is that though you give a symptom to your 
opponent and get one of his in return, each of you has 
all his own symptoms and one more. 
The kind meant here is sensations, or subjective 
symptoms, those which you yourself experience. Those 
perceived by others are called objective. They are 
closely allied, and each can give rise to the other. For 
instance, if you feel ill even the least observing of your 
friends will soon note the fact in your appearance- 
and vice versa. You may start the day with the delu- 
sion that you are perfectly well. If you think about 
96 SYMPTOMS AND SYMPTOM HUNTING 
97 
it at all you know that it's a great day and you have 
plenty of work to do and you are going to it. Then 
let several friends in succession remark with concern 
that you are not looking well, or vaguely imply it by 
asking you how you feel and if anything is wrong 
with you. Subjective symptoms will now appear which 
you had not previously noticed. It may require con- 
siderable exertion of will to forget them. 
Subjective symptoms are like children, in that too 
much indulgence spoils them, makes them willful, 
obtrusive and generally obnoxious. On the other hand, 
they should not be entirely neglected, but should re- 
ceive proper attention and be kept in their proper 
places. For the loud, boisterous kind is not necessarily 
more mischievous than the quiet ones. In fact the 
latter, being usually the more neglected, are the more 
likely to cause trouble. 
By sensations alone no one, not even the most 
experienced physician, is able to decide what is wrong. 
He must use his trained faculties of observation, and 
often he must call to his aid all the latest laboratory 
methods-chemistry, the microscope and the X-ray. 
One cannot write a long detailed account of his symp- 
toms to a physician and get a diagnosis by return mail. 
The doctors of long ago were shrewd guessers, be- 
cause often they were compelled to guess, not having 
the benefit of modern scientific methods. 
Patent-medicine manufacturers still fool the credu- 
lous, but they are deluding fewer every year. The old 
medical almanacs were the crudest but most popular 
in their appeal. Who does not remember the kind that 
had on its title page the cut of a human figure, with 
none of its inner works concealed, surrounded by the 
signs of the zodiac, from which lines converged to 98 
THE COMMONSENSE OF HEALTH 
direct the reader's attention to the various parts of the 
anatomy? The other pages were filled with assorted 
symptoms, of which you could take your choice and 
send for the remedy at so much a bottle or box. This 
kind of advertising was successful for two basic 
reasons: First, a nervous, introspective person can be 
made to magnify his troubles-even to adopt symp- 
toms if he has not enough of his own. Second, sub- 
jective sensations may mean very little or a very great 
deal. They may indicate conditions easily remedied or 
those which are exceedingly grave. 
This last fact is the text upon which this article is 
based. In the attempt to prove the truth of the state- 
ment we shall have to discuss certain symptoms in spite 
of the injunction quoted in the beginning. We shall 
limit ourselves to a very few of the many and various 
sensations to which the ill may be subject. They will 
be cited merely in proof of two corollaries to the 
original proposition. The first is that any given 
symptom alone is of little help as a guide in deter- 
mining its physical cause. The second corollary is that 
the severity of a symptom is not a reliable indication of 
its gravity. Stated otherwise, Nature does not always 
warn us through a megaphone; her often-repeated 
whisper may be more significant than her loudest 
shriek. For purposes of illustration, let us select the 
following seven symptoms from any medical almanac: 
"Do you suffer from dizzy spells? Have you specks 
before the eyes? Backache? Pain about the heart? 
Palpitation? Shortness of breath? Are you nervous 
and despondent?" 
The last question in the list is the stinger in the tail. 
Of course you are nervous and despondent if you have 
any of the other symptoms and you get the suggestion SYMPTOMS AND SYMPTOM HUNTING 
99 
intended, that they indicate serious organic disease. 
But do they? Not always-in fact not usually. 
If symptoms are so indefinite, how is one to tell what 
are important and what unimportant, which to regard 
and which to disregard? The answer is quite simple- 
one cannot decide from them alone. But it is equally 
true that in every case where certain symptoms, how- 
ever mild, persist or recur repeatedly, they should re- 
ceive attention. 
Taking up the sample symptoms previously men- 
tioned, not in the order of their frequency or impor- 
tance but simply in the sequence in which they happened 
to be set down, we shall begin with dizziness, or 
vertigo. It is certainly a disagreeable sensation, and 
may range all the way from a mere momentary dizzi- 
ness to a sickening giddiness which makes one wholly 
unable to stand or even to sit upright during an attack. 
The causes are various-bad vision, bad liver, bad 
habits-from these comparatively easily corrected con- 
ditions to changes in the brain. 
It is not an uncommon occurence to have a slight 
dizzy sensation after a full meal. By disturbing the 
equilibrium of the circulation a heavy stomach may 
make a light head. Chronic poisoning is also a 
possible cause, whether the poisons come from without 
or are manufactured in the digestive tract. Alcohol, 
coffee and tobacco may produce attacks of vertigo, and 
so also will poisons of putrefaction in the stomach and 
bowels. When the blood is saturated with them they 
act directly upon the brain, disturbing the centers by 
which equilibrium is maintained. 
The onset of an acute disease is frequently heralded 
by dizziness, due to the action of germ poisons upon 
the nerve centers. The attacks may recur during its 100 
THE COMMONSENSE OF HEALTH 
whole course until convalescence, when the supply of 
poisons ceases and they are eliminated. 
Brain pressure from tumors, or thickening of the 
membranes, or from excessive secretion of the cere- 
brospinal fluid may be an exciting cause. But in thi§ 
case the attacks are persistent, severe, and are accom- 
panied by other symptoms indicating very profound 
disturbance. 
There is a peculiar, comparatively rare disease of 
the inner ear called Meniere's disease, the chief char- 
acteristics of which are vertigo, ringing in the ears, 
impaired hearing and nausea. As all these symptoms 
must be present to complete the picture, the condi- 
tion is mentioned only because of the peculiar mecha- 
nism by which the giddiness is produced. 
Part of the inner ear consists of three small bony 
tubes, called the semicircular canals. 
They communicate with each other by several open- 
ings into a small bony chamber, and through them cir- 
culates a fluid in which float filaments of the auditory 
nerve. The free movement of this fluid has a great 
deal to do with the sense of balance. 
In examining recruits for the air service during the 
war stress was laid upon their ability to balance 
properly; to determine whether in the dark or up 
among the clouds they would be able to know if they 
were upright or upside down. This sense of balance 
has its seat almost entirely in the semicircular canals. 
In determining his fitness for flying the candidate 
was placed in a revolving chair, his eyes bandaged and 
his head bent forward, so that one of the semicircular 
canals in each ear was in a horizontal plane. In this 
position he was turned a certain number of times in one 
direction. Then when the motion was stopped and he SYMPTOMS AND SYMPTOM HUNTING 
101 
was told to sit up straight he made frantic efforts to 
fall over in the direction opposite to that in which he 
had been moving. That is, after having been turned 
to the right he fell toward the left. 
Now this is a perfectly normal reaction, though the 
boys were usually much chagrined. They thought, 
until reassured, that their chances for acceptance had 
vanished. The rotary motion causes a flow of the 
lymph stream, at first very slow, but gradually increas- 
ing until its speed equals that of the body. But when 
the body stops there is an interval during which the 
fluid keeps on moving. During this period the brain 
registers the movement as of the whole body, and it is 
impossible to keep one's balance. 
This phenomenon may be elicited by anyone in a 
very simple manner. First, however, select a wide 
space, unencumbered by breakable or sharp-cornered 
objects-preferably outdoors, where the grass is long 
or the ground soft. Next, have several friends close 
by, well distributed, to catch you. Hold a cane or 
umbrella upright, its ferrule on the ground. Put both 
hands on the handle and, bending over, rest your fore- 
head upon your hands. Shut your eyes, and with your 
head as a pivot turn around this perpendicular support, 
say, about ten times. Then suddenly straighten up, 
open your eyes and walk briskly toward an object pre- 
viously fixed upon as a goal. If you go straight to it 
there is a chance that something is wrong with your 
semicircular canals. But you won't do anything of the 
kind, so why worry ? 
Meniere's disease is rare, and is mentioned here as 
an example of a grave condition which may cause 
vertigo. But slightly increased pressure of the fluid 102 
THE COMMONSENSE OF HEALTH 
in the semicircular canals will upset one's sense of bal- 
ance and bring on mild attacks of dizziness. 
Any condition which causes temporary changes in 
the circulation of the blood in the brain may give rise 
to vertigo, and consequently it is not an uncommon 
symptom with those of middle age or beyond, who 
have hardening of the arteries and high blood pressure. 
Mostly there is merely a sense of fullness, with a fleet- 
ing giddiness, felt on exertion or upon stooping over. 
Many conditions far less grave produce attacks of 
greater severity. But nevertheless it is Nature's warn- 
ing whisper and should be heeded. 
With those under forty-five a frequent cause of 
dizziness is defective vision. There are three kinds 
of defective vision due to the shape of the eye-short 
sight, far sight and astigmatism. The normal eye is 
a perfect camera. Rays of light from objects are 
slightly converged as they penetrate the cornea, the 
transparent front of the eye. In passing through the 
crystalline lens they are still further converged, so that 
they are brought to a focus upon the sensitive plate- 
the retina. The crystalline lens accommodates its 
shape to focus near or distant objects. It becomes 
thicker, more convex, when one looks at something 
near, and resumes its relaxed, flattened shape when one 
looks at a distance. 
This thickening of the lens is accomplished by the 
contraction of a small muscle. If you are looking 
through the window the image of an object on the 
pane is blurred. It requires an effort of the ciliary 
muscle to thicken the crystalline lens so that the near 
object may be clearly seen. 
But very many eyes are not normal; some are too 
deep, some are too shallow, and some have lenses SYMPTOMS AND SYMPTOM HUNTING 
103 
irregular in shape. I£ the eyeball is too deep, light 
rays focus before they reach the retina and they must 
be diverged before they enter the eye, unless the object 
to be seen is held close. One with this defect is near- 
sighted and must wear concave glasses to see clearly 
distant objects. 
If the eyeball is too shallow the rays from near 
objects would focus behind the retina if it were not 
for constant effort on the part of the crystalline lens. 
Farsighted persons, when reading, writing or sewing 
without glasses, are constantly subjecting their eyes 
to strain. 
There is another common defect which does not 
depend upon the depth of the eyeball. Its transparent 
front, the cornea, may be irregular in shape-that is, 
it may have a different convexity in different diameters. 
With such eyes, no matter how distant or near the 
object, there is never a clear image without artificial 
aid. In what is called farsighted astigmatism the 
crystalline lens struggles frantically to focus the light 
rays, but without avail. Those who have this defect 
must wear glasses for both near and far vision. 
Eyestrain, especially from farsighted astigmatism, 
may cause many and various symptoms-inflammation 
of the ball and lids, headache, nervous irritability, 
dizziness, even attacks resembling true epilepsy-any 
or all of which may be banished by adopting the very 
simple expedient of procuring glasses to correct the 
vision. 
There are two important points about vertigo and 
its causes to be remembered: First, that an occasional 
attack may occur in the healthy person from overeating 
or some other indiscretion; second, that its severity or 
mildness does not indicate the gravity of the cause. 104 
THE COMMONSENSE OF HEALTH 
Persistent recurrences of a mild form of dizziness are 
more significant than a single instance of much greater 
violence. In the latter case watch your diet; if the 
attacks recur get competent medical advice. But in 
any case vertigo is a signal that something is wrong 
which needs correction. 
There is a fairly widespread belief that specks 
before the eyes indicate a serious organic condition, 
usually of the kidneys or liver. An imaginative physi- 
ologist long ago gave them the name muscae volitantes, 
or flying flies. They assume various shapes, dots, 
slightly luminous circles and twisted hairs, and are best 
seen against a gray background. They are elusive; 
one cannot look directly at them; they float across the 
field of vision and will not stay still; in a moment they 
are back again, and in a moment gone. 
The eye has two chambers separated by the iris-the 
curtain with a circular hole in it to admit the light, and 
the crystalline lens. These two chambers are filled 
with transparent fluid which is not altogether homo- 
geneous. The fluid in both chambers contains minute 
particles of slightly greater density that throw shadows 
upon the retina. These are the elusive flying flies 
which float back and forth across the field of vision. 
They may be perfectly normal, being present in 
nearly all eyes. We do not notice them when we are 
well, but when sick, tired or nervous they obtrude 
themselves upon our notice, and are especially ob- 
noxious after long-continued abuse of the eyes. That 
is the sum of their significance. 
But black specks which are fixed are of more serious 
import. If there is a black spot in the field of vision, 
constant, always in the same relative position to the 
object upon which the eyes focus, it may be due to one SYMPTOMS AND SYMPTOM HUNTING 
105 
of several causes. There may be a scar on the front 
of the eyeball; it may be that the retina is partially 
detached from the back wall of the eye; there may be 
an advanced kidney disease or an inflammation of the 
optic nerve. 
Pain in the small of the back is often attributed to 
the kidneys. Discomfort in this locality may be a con- 
tinuous more or less aching sensation or a sharp cutting 
pain aggravated by the slightest movement. When it 
assumes the latter character it is nearly always a rheu- 
matism of the muscles and ligaments along the spine, 
called lumbago. But whatever the cause, whether 
rheumatism or injury from a fall or from lifting a 
heavy weight, or exposure to a draft when one is over- 
heated, it does not often indicate a serious condition. 
One important fact to be remembered is that chronic 
disease of the kidneys does not cause pain in the back, 
notwithstanding the general belief. 
Pain in the left chest is equally misleading. Because 
it is near the heart that organ is frequently accused 
when entirely innocent. If the pain is severe appre- 
hension may cause rapid heart action, which seems to 
confirm the suspicion against it. Usually the first time 
this symptom appears the doctor is sent for posthaste. 
"Doctor," the patient manages to say in gasps, "my 
heart-terrible pain-do something quick!" 
But the doctor, undisturbed, proceeds with his 
examination, and finally announces that it is not the 
heart at all, but intercostal neuralgia, or pleurisy, or 
rheumatism of the muscle between the ribs, or indiges- 
tion. 
Then the heart, reassured, stops its wild pounding 
and goes about its ordinary business, its former activity 
having been increased by fear. 106 
THE COMMONSENSE OF HEALTH 
Pain in the chest wall coming on suddenly without 
other symptoms is usually caused by conditions other 
than heart disease. Its location near the heart is 
purely incidental. When it occurs on the right side of 
the chest there is not nearly so much anxiety. 
The heart has no nerves of sensation. If the sur- 
geon could get to it without cutting through the sen- 
sory nerves on the surface of the body he could operate 
upon the heart itself without causing pain. And yet 
pain is sometimes a symptom of heart disease, but it is 
produced in a roundabout way. 
Two great nerves keep up the heart's movements. 
One, the accelerator nerve, supplies the stimulus to 
contract; and the other, called the vagus, regulates the 
speed. When these two nerves are acting equally the 
rate of the heart-beats is normal. The vagus is also 
called the pneumogastric nerve, because it supplies the 
stomach and lungs. But vagus is a more appropriate 
name, because it means wandering, and the vagus 
wanders to most of the vital organs. Branches go to 
the ear, the throat, the bronchial tubes, the stomach 
and the heart, and all of these it supplies with sensory 
fibers, except the heart. 
If the heart cannot feel, how can there be pain in 
heart disease? Branches of the heart nerves go to 
certain sub-centers in the spinal cord, and there they 
connect with the superficial nerves of sensation. Con- 
tinued irritation of the heart nerves is thus communi- 
cated to the surface nerves, and there is reflex or 
referred pain, not in the heart but in the chest wall 
over which the sensory nerves are distributed. 
True heart pain is always due to exhaustion of the 
heart muscle and may be recognized by the presence of 
other symptoms. It is made worse by the slightest SYMPTOMS AND SYMPTOM HUNTING 
107 
exertion; by anything that increases the rapidity of the 
heart's contractions. And nearly always the respira- 
tions are labored and deep, expressing the desire of the 
sluggish blood stream for more air. But the pain is in 
the chest wall, never in the heart. 
More significant than pain is a feeling of constric- 
tion, of tightness in the chest behind the breastbone, 
which may be experienced by those of middle age. It 
is especially noticeable after a full meal, after smoking 
or during exertion. This is another of Nature's quiet 
warnings. It usually accompanies high blood pres- 
sure, with or without hardening of the arteries. The 
more often the sensation recurs, and the more easily 
it is induced, the more attention it demands. 
Symptoms which seem to indicate heart trouble are 
always alarming. No one else is quite so introspective 
and morbid as one who thinks there is something 
wrong with his heart. For this reason palpitation 
often causes great anxiety. 
Palpitation may be caused by grave organic heart 
conditions, but more often it rises from disturbances 
not in the heart at all. The sensation may be that of 
fluttering, a vague consciousness of rapid heart action; 
there may be a pounding in the chest; or one may be 
conscious of a sudden stop, followed after a short 
interval by an emphatic thump. There are all degrees 
of severity from these rather mild manifestations to a 
wild racing of the heart accompanied by a sense of 
suffocation and a fear of impending death. And yet all 
forms, even the most severe, may be caused in the 
healthy heart by indigestion, by tobacco, by anything 
which disturbs the heart nerves through their branches 
which supply other organs. Emotions also effect the 
heart centers in the brain. Sudden shock or a highly 108 
THE COMMONSENSE OF HEALTH 
nervous state from any cause may set the heart to 
beating rapidly and irregularly. 
But if the attacks of palpitation are frequent and 
severe the heart should be examined to eliminate the 
possibility of organic disease. Even the presence of 
organic heart disease need not be unduly alarming. 
The heart has a vast amount of reserve force, which 
enables it to perform its ordinary work in spite of a 
handicap. The important thing to know is how much 
one can do without further crippling it. If a break- 
down has occurred or is imminent other symptoms are 
usually present to give warning, especially shortness of 
breath entirely out of proportion to the amount of 
exertion which produces it. 
Shortness of breath itself, however, is a symptom 
no more positive or definite than palpitation or any of 
those so far enumerated. Everyone experiences it at 
times. Breathlessness is a sign of the desire for more 
air. It may occur in varying degrees of severity, and 
each has a different meaning. A fat man has less wind 
than a thin man, though both may be in good health, 
chiefly because he has more weight to carry. An 
athlete can run better when his stomach is empty than 
when it is full. As a rule men can run farther without 
exhaustion than women, not only because they are more 
muscular but because women for generations wore 
tighter clothing, and they breathe mostly with the 
upper half of the lungs, while men expand the whole 
chest in respiration. 
Any condition which lessens lung capacity increases 
the rate of the respirations. But air must come into 
contact with the blood to fulfill its purpose, and the 
blood must circulate freely in the lungs. The greater 
the exertion the more need of speedy aeration of the SYMPTOMS AND SYMPTOM HUNTING 
109 
blood, and consequently the greater the necessity for 
increased heart action. 
If the heart muscle is weak exactly the same phe- 
nomenon of breathlessness occurs that appears when 
the lung capacity is lessened or for any other reason 
the air supply is not sufficient. One may smother to 
death if he cannot get enough air into his lungs, and 
also when there is plenty of air but the blood cannot 
get to it. 
Breathlessness being a relative condition rising from 
various sources, let us see what it may mean in various 
degrees of severity. When it appears during great 
exertion it is perfectly normal. But great exertion is 
also relative. To one in physical training it has a 
different significance from what it has to one of seden- 
tary habits. In this case its onset, early or late, 
depends entirely upon one's muscular strength. 
If it comes on during moderate exertion it may also 
be due to weak muscles in the otherwise normal person, 
or after an acute disease which has consumed one's 
vitality. To such a person, when a call comes to use 
his muscles they become quickly exhausted, including 
the heart muscle itself. 
The very fat are breathless not only because they 
are heavier but because great layers of fat accumulate 
about the heart and impede its movements. But thin 
people, as well as the fat, can be short-winded from 
another cause-digestive disturbances. Both indiges- 
tion and overeating produce poisons which disturb the 
respiratory centers in the brain. The result is usually 
a rise of blood pressure. 
High blood pressure and arteriosclerosis may 
jointly produce the next step in breathlessness-that 
upon very slight exertion. If one cannot walk upon a 110 
THE COMMONSENSE OF HEALTH 
level, or even talk consecutively, without puffing 
respiration, it may indicate that something serious is 
wrong with his circulation, either with the heart muscle 
or with the arteries. 
If the trouble is in the heart the muscle itself is at 
fault. Such a condition cannot be due solely to valvu- 
lar disease. One may have a leaking valve without 
experiencing the slightest symptoms if the heart is 
strong enough to do its work in spite of the handicap. 
It is only when the muscle gives way under unusual 
strain, or becomes diseased from other cause, that a 
valve leak is significant. 
Anything which greatly lessens the capacity of the 
lungs or impedes the inflow of air will cause extreme 
shortness of breath. It is present in acute pneumonia 
and in advance cases of pulmonary tuberculosis, be- 
cause in each a considerable portion of the lungs is put 
out of commission and the unaffected parts have to do 
all the work. This fact, together with the poisons 
always manufactured during the progress of germ dis- 
eases, causes panting respiration. 
Chronic bronchitis, for a different reason, may be 
another cause. In this disease the bronchial tubes are 
chronically thickened and the smaller bronchioles be- 
come almost entirely closed, so that the air cells are 
always full of used air and great effort is required to 
expel it. This mechanically results in dilatation of the 
air cells, a condition known as emphysema. Emphyse- 
matous persons are chronically short of breath. 
There are two forms of breathing which, because 
they indicate extremely grave conditions, need only be 
mentioned here. One is continued labored breathing, 
even when one is at rest, but much aggravated by slight 
exertion. The other is the inability to hold the breath SYMPTOMS AND SYMPTOM HUNTING 
111 
even for a moment. They are exaggerated signs of 
air hunger and indicate serious heart weakness. 
If one is comparatively breathless, first let him look 
to his general physical health-whether he is eating 
too much, whether he is getting enough exercise. 
What about his habits as to smoking, as to work and 
play? Does he sit all day in a stuffy room and then 
go home to a big dinner, a fat cigar and an easy chair? 
If his shortness of wind is becoming quite noticeable, to 
himself at least, he would better find out whether he 
has an organic disease of the heart, vessels or lungs. 
Then if these possibilities are eliminated let him look 
to his habits of diet, of indolence, of self-indulgence, 
and get rid of them by substituting good habits in their 
stead. 
In the list of symptoms used as a text for this article 
not the least important is the last-"Are you nervous 
and despondent?" Nervous in the sense implied means 
apprehensive, worried, fidgety, fussy, easily disturbed, 
irritable, irascible, given to magnifying troubles and 
looking upon the dark side of things, hypercritical, 
pessimistic, introspective. If one is nervous according 
to this definition of the word, then of course he is also 
despondent. 
Nearly every abnormal state of the body tends to 
make one nervous, but in by far the greatest number 
of instances nervousness is the cause and the physical 
conditions are the effects. Remembering the various 
attributes enumerated under the general term "ner- 
vous," let us see how they can affect the physical 
health. In order to be explicit and merely for pur- 
poses of illustration, without the slightest intention of 
limiting ourselves to age or sex, let us take as an 
example the average business man. 112 
THE COMMONSENSE OF HEALTH 
Anyone who desires to substitute feminine for 
masculine here may-with a few slight changes in the 
text-make it apply to the woman at home as well as 
to the man in the office. 
This man has a nervous temperament. That is, he 
is what his friends calls a fusser-those who work for 
him use other and stronger terms. He worries easily 
and often without sufficient cause. Business in the 
office goes wrong because the office clerks are ineffi- 
cient, and they are inefficient largely because he is 
impatient and hypercritical. When he goes home he 
takes his worries with him, never forgetting them for a 
moment, even while eating his hasty dinner. 
Eating too fast, he eats too much. Now too much 
means no particular quantity, but any amount more 
than is required or can be taken care of. Unpleasant 
emotions retard digestion, consequently in his irritable 
mood any food at all is too much. 
The result in a single instance would be acute indi- 
gestion. But multiply this by three hundred and sixty- 
five, and then again by the number of years it has been 
going on. 
Toward middle life this man will have chronic 
digestive troubles, possibly liver changes and probably 
kidney complications. His blood pressure will be ab- 
normally high and his artery walls will be harder, less 
elastic than they should be. In other words, he will be 
prematurely aged. 
During this aging process he may have any of the 
symptoms mentioned here, and many more-muscle 
pains in the back, the chest; nerve pains anywhere in 
the body; shortness of breath, palpitation, vertigo. 
One might go on through the list indefinitely, but this 
article is intended to be suggestive and not exhaustive. SYMPTOMS AND SYMPTOM HUNTING 
113 
The acute illnesses must not be left out of the reck- 
oning, because anything which weakens the vital forces 
breaks down one's natural immunity to the various 
germ diseases. Why does pneumonia cause more dev- 
astation among the ranks of those beyond middle 
life? Not because there is an inherent affinity between 
that disease and age. Younger people are susceptible 
also, but they have a better chance of recovery. All 
the help of all the organs of the body combined is 
necessary to overcome it, and that person has the best 
chance whose forces are unimpaired. 
The chronic alcoholic has the least chance of all, 
because years of dissipation have produced degenera- 
tive changes in many of his vital organs-the kidneys, 
the liver, the heart and vessels. But mental dissipation 
also will cause these changes, and this kind of self- 
indulgence should receive more consideration. 
Subjective symptoms, unpleasant sensations, are a 
blessing and not a curse if they are treated with re- 
spect. If they did not appear to warn us we should 
rush headlong upon our misguided course-to disaster. 
They should be discussed. Discuss them with yourself. 
Try to discover what they mean, what you are doing 
that is wrong and stop doing it; what correctible defect 
you have and correct it. If you cannot succeed by this 
method discuss them with one who is competent to dis- 
cover their cause. 
But you cannot hand them over to the doctor as 
some parents place their children in schools, hoping 
thereby to absolve themselves of all further responsi- 
bility. They are your symptoms and you must have an 
active part in their correction. 
Above all, do not discuss them indiscriminately, be- 
cause symptoms are catching. EIGHT 
ONE THOUSAND DIAMETERS 
WHEN Johnny Smith came home one day 
with his foot cut-he had been running bare- 
foot-Mrs. Smith knew exactly what to do. She 
washed it thoroughly with soap and water, carefully 
cleansed the wound of dirt, applied tincture of iodine 
to it and bound it up with a first-aid dressing. Nothing 
remarkable about that. Any other sensible woman, 
especially anyone who has taken Red Cross work, 
would have done the same thing. But when Mrs. 
Smith was a child her mother would not have treated 
an injury in that manner. 
Though Mrs. Smith is less than forty, in her child- 
hood they applied flaxseed and bacon rind and other 
kinds of vegetable or animal poultices to open wounds. 
And then when pus appeared, as it almost inevitably 
did, it was called laudable or praiseworthy. 
This difference in the treatment of so slight an 
injury as Johnny's cut is indicative of all the wonderful 
changes that have occurred in forty years in both medi- 
cine and surgery. Forty years ago operation wounds 
were almost never entirely closed. There was always 
a drain left in to allow the exit of the inevitable pus. 
And just as pus was once inevitable but is now con- 
sidered unnecessary, so it is with many of the diseases 
that for centuries afflicted mankind. Many of these 
diseases have become only reminiscences-episodes of 
114 ONE THOUSAND DIAMETERS 
115 
history. They no longer appear and fatten and 
flourish at our expense. 
And all these changes have been brought about by 
one thousand diameters. In other words, it was the 
perfection of the compound microscope that enabled 
men to see the minute structure of the body, and by 
magnifying at least one thousand times, or diameters, 
to bring within their vision the germ enemies of man- 
kind. 
The advances in medical knowledge, though less 
spectacular, have been as great as those in surgery. 
Perhaps the most obvious instance of our progress in 
medicine is the change in our attitude toward malaria. 
Anyone who has lived in a flat marshy district can 
recall the sallowness of the older inhabitants. In their 
early days malaria-chills and fever-was so common 
an affliction that it was looked upon as a necessity. 
The drug stores could hardly keep stocked with quinine 
and calomel. Quinine and whisky went together in 
people's minds-and into their stomachs also, just like 
hot cakes and molasses. In fact, many a man met an 
untimely end because he tried to omit the quinine from 
the combination. 
But how many of the later generation have that 
yellow look? No one before the year 1899 knew that 
the parasites of malaria attacked people from airships 
-that is, a certain kind of mosquito. Nor did anyone 
think of oil as a means of prevention. And yet 
oil, spread upon the breeding places of mosquitoes, has 
made malaria a thing of the past. 
Malaria has been a great scourge of humanity. It 
has numbered millions among its victims. It has 
destroyed nations and submerged civilizations. History 
tells us that the downfall of Greece was due to the 116 
THE COMMONSENSE OF HEALTH 
attacks of invading barbarians upon a decadent people. 
But their decadence resulted from an earlier invasion. 
There had always been marshes and mosquitoes in 
Greece. In the fifth century B. C. malaria was intro- 
duced into the country, and the mosquitoes did the rest. 
When the barbarian hordes appeared they found the 
Greeks ripe for the harvest. 
The same thing occurred in Rome, but there an- 
other disease aided malaria in bringing down the 
mightiest empire the world had ever seen. It was 
called the plague, but history is vague as to whether 
it was smallpox or an epidemic dysentery. Whatever 
it was, together they wrought the destruction of Rome. 
Hannibal brought over from Africa his Cartha- 
genian mercenaries to conquer Rome. He did not 
accomplish his purpose, but the malaria that his 
soldiers brought with them finally destroyed the health 
of the people and made conquest easy for the Goths 
and Vandals. 
Physical deterioration of a people is always followed 
by mental and moral decay. Wherever in history one 
comes upon a healthy people, there one finds a people 
of high intellectual and moral standards. During the 
centuries that the Moors were in Spain they bore the 
flag of civilization. When they were compelled to go 
back to the debilitating climate of Africa their moral 
and intellectual recession began. 
Once malaria won a great victory for Napoleon. In 
1809 an expedition set out from Great Britain to cap- 
ture Antwerp and the French fleet. There was quite a 
formidable array of ships and soldiers, four hundred 
and seventy vessels and forty-four thousand men, and 
there was great anxiety in France. Napoleon, how- 
ever, knew more about the country than the British, ONE THOUSAND DIAMETERS 
117 
and he counted upon the aid of an ally of which the 
British were entirely ignorant. He ordered his gen- 
erals to hold the enemy in check, but not to engage 
them in a decisive battle. And so the British were held 
for many days in the swampy region of the River 
Scheldt. There an ally of the French attacked them 
from the air. Mosquitoes inoculated them with 
malaria and the British casualties from this cause 
alone, in dead and sick, were twenty-seven thousand. 
The British expedition was defeated before it could 
engage the forces of Napoleon. The anopheles 
mosquito had caused more destruction to the British 
than Napoleon's army could have done. But no one 
at that time, nor for many years after, knew the part 
the mosquito played in the campaign. In fact, until 
1880 no one had known the cause of malaria, and the 
mosquito's nefarious business was not discovered until 
nine years later. 
For that matter, it is the same with other diseases. 
Typhus fever, the bubonic plague, smallpox, tubercu- 
losis-one could go through a whole list-all were 
known to the ancients; that is, their effects were known 
and the fact that they are transmissible, but there all 
knowledge stopped. 
Nearly all important discoveries of the causes, 
modes of transmission and means of prevention have 
been made within the past forty years. All those pre- 
vious centuries men were helpless against these foes 
because they could not see them. They were fighting in 
the dark. And so concerning the things of which they 
were ignorant they built up superstitions, and doctors 
cloaked their ignorance with mystery and mysticism. 
About all there is left of that is our prescription Latin. 
But the mystery helped some, because it inspired Faith 118 
THE COMMONSENSE OF HEALTH 
and her handmaiden, Hope, which are more potent 
than all the horrible concoctions of the ancients. 
With the exception of anatomy and physiology, the 
medicine of a little more than one hundred years ago 
was about the same as that of five hundred years B. C. 
All medical knowledge for centuries was at a standstill. 
If one were to compare the prescriptions in the Papyrus 
Ebers, which was written 3500 years ago, with those 
in medical books of the eighteenth century, he would 
discover striking similarities. This is because there 
was no knowledge of the causes of disease until the 
invention of the microscope, and medicine was lost 
in the fog of ignorance and superstition. 
Suppose Johnny Smith, whose mother treated his cut 
so sensibly, had lived in the Middle Ages or at any 
period up to, say, fifty or a hundred years ago. His 
mother would have sent off posthaste for the nearest 
surgeon, or leech, as he was once called. In the mean- 
time she would have given Johnny three, five or per- 
haps ten grains of calomel and a dose of oil and would 
have applied hot vegetable or animal poultices. And 
then the leech would have appeared, armed with a 
lancet and another kind of leeches. He would have 
bled him generously, perhaps more than once, and the 
leeches would have drained him still more. 
From a book published in 1745 here is the cold- 
blooded narrative of a licensed assassin as quoted by 
Mark Twain. The subject, or patient, had a head- 
ache, that is all: 
"I, being called, Order'd Venesection in the Arms, 
the Application of Leeches to the Vessels of his 
Nostrils, Forehead and Temples, as also to those 
Behind his Ears; and likewise Prescrib'd the Applica- ONE THOUSAND DIAMETERS 
119 
tion of Cupping-Glasses with Scarification, to his 
Back; But Notwithstanding these Precautions, he dy'd. 
If any Surgeon, Skilled in Arteriotomy had been 
Present, I should have Order'd that Operation. 
Leeches, venesection, arteriotomy-all for the pur- 
pose of separating the victim from his blood! If 
Johnny's mother should read this she will be thankful 
that she lives in the present and not in the past era of 
medicine, or "notwithstanding," Johnny might have 
"dy'd." 
For centuries roots and herbs were prescribed be- 
cause of their symbolic forms, and diseases were ban- 
ished by incantations. If Johnny had lived in the 
seventeenth century and had chanced to have the 
whooping cough his mother could have found in a 
standard medical work the folowing information- 
archaic spelling omitted: 
"For whooping cough, pass the child nine times over 
and under a donkey, from left to right." 
Mrs. Smith might have wondered what would hap- 
pen if she got in reverse and passed Johnny from right 
to left. But she would not have chanced it-not in 
those days. 
While waiting for someone to produce a docile 
donkey that would consent to cure Johnny, perhaps 
Mrs. Smith idly turned the pages of the medical work. 
If she did she would have been interested in this: 
"It is said that many have been cured of the falling 
evil by drinking of the powder of dead men's skulles, 
burnt." 
The author did not say how one can drink a powder, 120 
THE COMMONSENSE OF HEALTH 
but he was very particular to mention the kind of a 
"skulle" that should be used. 
"But the skulle must be the skulle of one that hath 
been hanged or slain, and not of one that hath died of 
any sickness." 
One can imagine the medical student of those days, 
fired with a burning enthusiasm, yet shivering from 
fear, stealing out on a dark, stormy night to obtain 
the "skulle" of the latest victim of the crossroads 
gibbet. They were considerate enough to hang men 
-and women, too-at the crossroads, which made it 
easier for the doctors. 
Spiders were good for malaria. If you have had 
any doubt in your mind as to what spiders are good 
for, now you know. Most people think spiders are 
good for eating flies and that flies are good for feeding 
spiders, but here is a use that perhaps you did not 
suspect. They are good for malaria. Just how they 
were taken, whether "drunke" or swallowed whole, 
was not mentioned, but you may depend upon it, what- 
ever was particularly loathsome was good for some- 
thing. 
"A good pouder for the jaundice is as follows: 
Take earthworms and cut them small and braye them 
with a little wyne so that ye may swallow it; drinke 
the same fasting." 
The last direction must have been a mistake. It 
should have been: "Drink the same fast!" It is pos- 
sible that the doctor himself did the "braying." 
And then there were snails. Fine ladies had their 
footmen gather snails in the garden before breakfast. 
It had to be before breakfast; after breakfast would ONE THOUSAND DIAMETERS 
121 
not have done. These snails were pounded, shells and 
all: "To be swallowed for a consumption." 
Disease was thought to be a thing, an entity, some- 
thing that entered into the body and must be driven 
out by a remedy stronger than itself. Perhaps 
this idea had something to do with the size of the pre- 
scriptions. Some of them contained more than one 
hundred ingredients. They were built up by succeeding 
generations of doctors. Each doctor had to add one 
drug or more as his contribution to medicine or realize 
that his life had been wasted. After worrying about it 
for years, possibly, one day he would exclaim: "Gad- 
zooks," or "I, faith," or "By my halidome, I've got 
it!" Then he would put into the prescription some- 
thing more terrible and loathsome than all the rest, 
and having done so, when his time came he would pass 
the mess on to his successor before he himself passed 
on, content that his life had been well spent. 
Those were fat days for the druggist. In 1676 Dr. 
Gideon Harvey, physician in ordinary to Charles II, 
wrote: 
"I have oft seen bills of Apothecaries risen to twenty 
pounds and sometimes thirty pounds in the time of a 
fortnight. Not long since an Apothecary of our sub- 
urbs brought in bills to nine patients for less than 
three-quarters of a year's physick amounting to fifteen 
hundred pounds." 
That would have been equivalent in purchasing 
power to about forty thousand dollars at the present 
day 1 All of which goes to prove that compared with 
his ancient prototype the modern druggist is a piker. 
And then there was blistering, a favorite method of 
torture. It was probably the first crude experiment in 122 
THE COMMONSENSE OF HEALTH 
New Thought treatment. It took the patient's mind 
off his other troubles. Being so occupied with the new 
sensation he had no room for the old ones. Some- 
times the desperate victim refused. 
"You must be blistered or you will die!" said her 
physician to the Duchess of Marlborough. 
"I won't be blistered and I won't die!" said the 
strong-minded old Sarah, and she kept her word for 
many years. 
Scrofula was called king's evil and was cured by the 
touch of the king. For hundreds, perhaps thousands 
of years people had clung to this belief, which was 
probably fostered by monarchs to strengthen their 
claims to divine right. Dr. Samuel Johnson was 
touched by Royalty at the age of four, but it did not 
rid him of his taint. Between May, 1662, and April, 
1682, or twenty years, Charles II touched ninety-two 
thousand one hundred and seventy persons. One day a 
week, Friday, was given over to this touching cere- 
mony, so he must have averaged a little more than 
eighty-eight persons at one sitting. On some Fridays, 
when it was necessary to make up for lost time, he 
exceeded the speed limit, touching more than two hun- 
dred and fifty victims of scrofula. But he himself was 
touched also, for it was the custom to give to each a 
small piece of gold, called the "touch coin." 
Another favorite was bleeding. This was the first, 
the middle and the last resort. If the doctor did not 
know what ailed one-and mostly he did not-he bled 
him. If he did know he bled him anyhow. A consulta- 
tion resulted in more bleeding. Either the lancet or 
leeches were used, most probably both-and often. 
Louis XIV was bled generously nine times for 
scarlet fever. In 1765 a London mob attacked the ONE THOUSAND DIAMETERS 
123 
Duke of Bedford's house. This probably caused the 
duchess to have an hysterical fit, for the next morn- 
ing the doctors bled her. George Selwyn was dining 
one night at the home of Lord Coventry and fell, strik- 
ing his head upon a marble table, causing a wound 
which bled profusely. When the surgeon came did he 
lay George down, cleanse and dress his lacerated 
wound? No, that would have been too simple and 
obvious a method for those days. He bled him, though 
Nature was doing the same thing herself! 
Ambroise Pare was a celebrated surgeon of his time 
-earnest, painstaking and indefatigable in his search 
for truth. But truth held her face averted. Pare 
having heard that an Italian surgeon had a wonderful 
dressing for wounds determined to get the secret. He 
gave up his practice, left his home and served a two- 
years' apprenticeship with the Italian. He says: "In 
the end, thanks to my gifts and my presents, he gave 
it to me. Then was I joyful and my heart made glad 
that I had learned his remedy." 
Triumphantly, his soul filled with high enthusiasm, 
he took it back home with him and no doubt used it 
upon wounds thereafter for the rest of his life. This 
marvelous remedy, to learn which he had served two 
years and given presents and gifts, might have been 
used upon Johnny's foot if he had lived in those days. 
It was composed of "Young puppies, boiled in oil of 
lilies, and earthworms prepared with Venice tur- 
pentine." 
But most probably the attending surgeon would have 
used a "sympathetic" powder. A sympathetic remedy 
is one that heals by sympathy. That is, it does not 
come into contact with the wound at all. One removes 
the bandages that have been applied as a first-aid dress- 124 
THE COMMONSENSE OF HEALTH 
ing and dusts them with the sympathetic powder, then 
lays them away in a corner cupboard and the wound 
begins at once to heal. 
You don't believe it? They believed it in the seven- 
teenth century, as the following narrative will attest: 
In 1687 a certain knight attempted to stop a duel by 
stepping in between two adversaries. Like many an- 
other well-meaning go-between before and since he got 
the worst of it, of course, receiving a serious sword 
wound in his leg. Then he promply sought the atten- 
tion of a surgeon, who treated him for some time with- 
out accomplishing anything. In fact, under the treat- 
ment the knight grew so much worse that he began to 
fear for his life; also he began to think that he was not 
getting the right treatment. So he paid off and dis- 
charged this surgeon and called in another. 
Under the treatment used by this second surgeon the 
wound began to heal and eventually our knight became 
entirely well. But when the second surgeon presented 
his bill for the treatment the knight refused to pay him, 
though he had paid without question the bill of the first 
surgeon, who had not benefited him. Naturally, the 
second surgeon entered suit to recover his fee. And 
we should be grateful to the knight for his obstinacy, 
because the records of this trial-and especially the 
judge's charge to the jury-give us a most interesting 
account of the medical knowledge of that day. 
The judge was one Sir Thomas Street, Knight, 
Justice of the Common Pleas Bench. If Sir Thomas 
never did anything else in his life, he made his fame 
immortal by his charge to the jury in this case. In 
those days a physician's calling was too honorable for 
him to receive a fee for his services. He could accept 
an honorarium, which was whatever the donor wished ONE THOUSAND DIAMETERS 
125 
to give, but never a fee. He could not sue, even if the 
patient refused to pay anything. But a surgeon's call- 
ing was lower than that of a physician, consequently 
the judge decided in the beginning of the trial that the 
surgeon was entitled to sue. There is nothing further 
in the records to show that our surgeon had a single 
other decision in his favor. 
This being settled to the satisfaction of the plaintiff, 
the case proceeded. All the evidence having been 
presented on both sides and the attorneys for both 
plaintiff and defendant having delivered their ad- 
dresses, the judge charged the jury. Reviewing the 
facts as established, he recited that the knight had been 
attended by the first surgeon, who used one of two 
approved methods of treatment. That is, approved 
by the medical profession of that day, which of course 
established them as "the usual and ordinary practice," 
according to legal terms. Not improving, the knight 
had dismissed the first surgeon and hired another one, 
"expecting to be treated by the second method." 
Sir Thomas goes quite fully into both methods of 
treatment, but the second method is interesting, be- 
cause it is difficult to believe that anyone could have 
had faith in it in any age. I quote the judge: 
"It is of Roman vitriol, powdered and dried in the 
sun, and is not applied to the wound at all. The sur- 
geon procureth a garter or bandage with which the 
wound was first bound up, and sprinkleth the powder 
upon the blood which is upon the garter or bandage. 
And the patient thereupon feels an intolerable shooting 
and penetrating torment; but this soon vanisheth- 
thenceforth all previous evil symptoms depart; the 
part recovereth its original lively color and manifest 126 
THE COMMONSENSE OF HEALTH 
incarnation and consolidation ensue. This is by reason 
of the sympathy maintained betwixt the blood extra- 
vasated and that yet conserved in the veins and of the 
sovereign balsamic faculty of the vitriol. This is not 
applied to the wound, but is allowed to have its perfect 
work apart. The garter is laid away in a cool place." 
There you are, simple and rational. We have the 
authority of Judge Street for it that k is also effective. 
But the ignorant, obstinate surgeon would have none 
of it, though all his professional brethren sanctioned 
and approved it. 
"Now the plaintiff did naught save wash and tend 
the wound. He used no sympathetic powder or oint- 
ment." 
No, he said that there was no such thing as a "mag- 
netical remedy"-in spite of his medical brethren. He 
said that Nature would do the work herself if she were 
let alone and the wound merely kept clean. But he 
put himself far beyond the pale of the profession when 
by pure reasoning he forecast the germ theory. Again, 
our judge: 
"He even hath in his mind some crochet that pus is 
engendered by some animal or plant; some bug or grub 
or beetle or fungus belike, though he saith he cannot 
prove the existence of such creatures." 
Sir Thomas was facetious there; a bit sarcastic. 
One can imagine the smiles and smirks on the faces of 
the court attendants and the jury. But now his brow 
darkens and in sympathy the features of all the jury- 
men and the tipstaves grow hard and stern: ONE THOUSAND DIAMETERS 
127 
"It might be well for the plaintiff to take heed, lest 
he be condemned by the Holy Church I" 
Guilty not only of medical iconoclasm but of re- 
ligious heresy. Of course the decision was for the 
defendant. The judge said the surgeon did not de- 
serve a fee anyhow, because by his own admission 
Nature had done the healing, and consequently Nature 
-not the doctor-should have the credit. 
The most interesting part of this record is that a 
surgeon in 1687 should have had a germ theory of his 
own invention, though germs were not discovered until 
after the middle of the nineteenth century. 
Doctors were no more ignorant than those who pur- 
sued knowledge by other paths. If in the seventeenth 
century the liver was supposed to be the seat of anger, 
the spleen the home of envy and the heart the habitat 
of love and courage, other scientists believed in the 
transmutability of metals, in the elixir of life, in 
astrology, in magic and witchcraft. One year before 
the founding of Harvard College, or in 1635, a scien- 
tific work was published in which gold was asserted to 
be a combination of quick-silver and sulphur. 
The Witch Statutes of the English Penal Code, 
which were enacted during the reign of Henry VIII in 
1542, were not repealed until 1736. Mackey, in his 
memoirs of Extraordinary Popular Delusions, esti- 
mates that in Europe during the seventeenth century 
more than forty thousand persons were condemned 
and burned at the stake for witchcraft. 
The advance of knowledge was retarded not only by 
the lack of scientific instruments, but very largely be- 
cause of the haphazard, speculative methods of that 
day. This is well shown by the following anecdote: 
Once King Charles II asked his courtiers "whether a 128 
THE COMMONSENSE OF HEALTH 
vessel full of water weighs more if a fish is put into it." 
This profound question started long and heated 
arguments lasting weeks. Finally it was decided that 
a live fish would not increase the weight, but that a 
dead fish would. This conclusion was reached by the 
path of speculation. A long time afterward it occurred 
to someone to find out by putting a fish into a bowl full 
of water. That was the path of experiment. 
The occasional genius who had the temerity to con- 
tradict the fathers of medicine met with very little 
encouragement. Tradition died hard and truth had a 
difficult time of it. 
The great friar, Roger Bacon, is said to have in- 
vented spectacles and to have constructed microscopes 
and telescopes. He was rewarded by ten years' 
imprisonment. 
Vesalius, the great anatomist, was twenty-eight 
years old when, after laboring five years, he published 
his book, The Structure of the Human Body. But he 
had dared to contradict Galen and he brought down 
upon his head a storm of indignant protest. In disgust 
and disappointment he destroyed all his unfinished 
manuscripts, gave up his studies and left Italy, never 
to return. 
Harvey published his discovery of the circulation of 
the blood in 1628 and the result was a cataclysm of 
abuse and ridicule. Medicine was still struggling 
blindly in the fog of metaphysics. Haller, an 
eighteenth century scientist, says in his book on Physi- 
ology: "Our body is gradually built up of gelatinous or 
slimy fluid." And of such "gelatinous and slimy" 
materials were the theories of medicine built up. 
"Up to the year 1830," says Oliver Wendell 
Holmes, "Nature had kept over all her inner work ONE THOUSAND DIAMETERS 
129 
shops the forbidding inscription, 'No Admittance!' " 
It was in that year that the compound microscope 
was perfected. Then men began to see for the first 
time the minute structure of the body and that we are 
all commonwealths of cells of various kinds and 
functions. 
Virchow, in 1858, went further still. He proved 
that all forms of life, whether animal or vegetable, are 
made up of cells. Think of it! Whether germs or 
Germans, parsnips or potentates, all are single cells or 
bundles of cells. 
The microscope has revealed much more than the 
minute structure of our bodies. It has given us the 
germ theory-which is a theory no longer-of the 
origin of many diseases. 
It has disclosed the warfare that is waged continu- 
ously within us in the struggle for existence. Now and 
then in the past a visionary like our surgeon of the 
seventeenth century hazarded a guess. But until the 
past four decades each was forced to say with him that 
he "could not prove the existence of such creatures." 
Now for the first time in all the centuries we can see 
our foes, and seeing, we know what weapons to use 
against them. 
Most disease germs belong to the lowest orders of 
vegetable life. They are infinitesimal, and yet they 
possess all the properties of the vegetable kingdom. 
Being fungi, they grow under the same conditions 
as others of this group of plants. Needing a soil, they 
thrive best in poor soil, and their soil is animal tissues 
broken down by previous illness or any of the many 
conditions that lessen the resisting power of the body. 
In the blood stream float little protoplasmic bodies 
called white corpuscles, which resemble the gelatinous 130 
THE COMMONSENSE OF HEALTH 
form of animal life-the amoeba that floats in stagnant 
water. Like the amoeba, the white corpuscles have a 
peculiar power of locomotion which is achieved by 
projecting a small part of their bodies and gradually 
pulling the rest after it. They can penetrate the walls 
of the smallest blood vessels, the capillaries, and 
wherever there is trouble there they congregate in 
great numbers, because they constitute the army of 
defense. Between them and disease germs, or bac- 
teria, is waged the ages-old war for supremacy. 
Bacteria enter the body by one channel or another, 
get into the lymph stream, or the blood, and finally 
into the tissues; or they may gain entrance directly as 
the result of injury. Their presence sets up an irrita- 
tion and the intelligence is flashed to the nearest head- 
quarters. At once the local blood stream becomes con- 
gested and battalions of the defensive army hasten 
forth. 
What really happened when Johnny cut his foot? 
It is all an open book now, because the microscope has 
revealed it many times. Four things occurred in rapid 
succession-redness, swelling, heat and pain. This 
combination of events is called inflammation and is 
usually regarded as a sinister process, though it is 
really the result of Nature's attempt to guard us 
against destruction. 
Here is the sequence : The injury caused an irritation 
of the nerves of sensation and they communicated with 
the nearest nerve substations. From these word went, 
out to send immediate assistance to the frontier. Then 
the streams that transported the army of defense be- 
came engorged, more blood was rushed forward and 
with it the troops-the white corpuscles. As they ap- 
proached the spot they left the main current and ONE THOUSAND DIAMETERS 
131 
adhered to the capillary walls. Then gradually they 
penetrated the walls by that curious power of locomo- 
tion which they have and assembled in battle array to 
repel the invaders. 
The redness, swelling and heat then were caused by 
dilation of the capillaries, exudation of blood and cor- 
puscles into a confined space. The pain was the result 
of the original injury to the nerves and of the pressure 
upon them in the swollen tissues. 
Wherever an injury occurs to the body, whether 
there is an invasion of germs or not, the same defen- 
sive mechanism is set up. Pain, however, is not so 
constant or so severe in the interior as upon the sur- 
face, because the frontiers are crowded with sensitive 
sentinels-the nerves of sensation. These may be 
entirely absent from the inner citadels. 
But dirt was introduced into the wound and with it 
certain bacteria. Johnny's mother removed all she 
could by scrubbing and she applied a mild antiseptic to 
destroy the rest, but obviously she could not destroy 
them all. The remainder must be attacked by Johnny's 
defensive army. This fight is called phagocytosis. 
In such a fight the home-defense soldiers engage in 
single combat like the knights of old. Meeting a germ 
enemy, the corpuscle enfolds it just as the amoeba sur- 
rounds its food and a struggle begins. If the corpuscle 
is the stronger, the germ is destroyed and digested. 
But if the latter is especially virulent or our champion 
weakened by one cause or another, victory goes to the 
enemy. The germ then begins to subdivide, increasing 
in numbers until finally the corpuscle disintegrates. 
Multiply these single combats, which the microscope 
has enabled us to witness, by hundreds of thousands 
and you may understand the battles royal that occur 132 
THE COMMONSENSE OF HEALTH 
in our bodies when our army is called upon to 
defend us. 
With some of the myriad forms of bacteria we 
rarely come in contact; with some we are frequently 
in conflict; and others-like the poor-are always 
with us. The fact that we have survived implies that 
we have within us a resisting power that has given us 
innumerable victories. This resisting power or immun- 
ity may readily be broken down by improper living, 
worry, overwork, undernourishment, insanitary sur- 
roundings; by dissipation of any sort, whether mental 
or physical. When our immunity is weakened the 
white corpuscles have an unequal fight and the proc- 
esses of disease make inroads upon our health. 
This knowledge of the causes of infectious diseases 
has enabled us to bring another weapon of defense to 
bear upon them, because we have learned also their 
methods of transmission. This weapon is prevention. 
Until 1880 malaria was supposed to be caused by a 
miasma, a vapor rising from swampy ground after sun- 
set. But in that year a French physician, Laveran, 
found the germ, a low form of animal parasite. But 
the cause of its transmission, the anopheles mosquito, 
was not discovered until years after. Also the trans- 
mitting agent of yellow fever was found to be another 
kind of mosquito. Since these discoveries destructive 
campaigns against mosquitoes have gone forward and 
mankind is free. 
One of the plagues sent down upon Pharaoh as a 
punishment is supposed to have been bubonic plague. 
It has always ravaged Asia and at times it has swept 
over Europe. A peculiarity of this disease was noted 
as far back as Herodotus. An outbreak was always 
preceded by a similar epidemic among rats. ONE THOUSAND DIAMETERS 
133 
Not until the year 1890 was the cause found, the 
bacillus pestis, a small rod-shaped vegetable germ. 
But harder still to discover was the connection between 
the rats and the plague. This is the sequence of it: 
The rat has his own kind of flea. If the rat has the 
plague the fleas become the temporary hosts of the 
germ. After the rat dies his body becomes too cold 
to be a habitat for the fleas and they seek other scenes 
and pastures new, sometimes human bodies. The 
germs of plague are so virulent that it is only necessary 
to crush an infected rat flea against one's body to 
acquire the plague. And this-to paraphrase a cele- 
brated classic-is the sequence of the transmission: 
This is the germ of bubonic plague. 
This is the rat that had the germ of bubonic plague. 
This is the flea that bit the rat that had the germ 
of bubonic plague. 
This is the man who got the flea that bit the rat 
that had the germ of bubonic plague. 
Simple enough now to exterminate the plague by 
destroying rats 1 
One by one the lurking places of disease have been 
disclosed and their strongholds stormed and taken. 
For us bubonic plague and typhus fever have merely 
historic interest. Even smallpox has lost its destruc- 
tive power. There are thousands of doctors in the 
United States who have never seen a case. Typhoid 
fever-thanks to sanitary measures and to the use of 
typhoid vaccine-has ceased to be the menace that it 
once was. The mortality from diphtheria is rapidly 
reaching the vanishing point. And so one might go 
on enumerating the former enemies of mankind that 
have been vanquished-until one comes to tuberculosis. 134 
THE COMMONSENSE OF HEALTH 
Will tuberculosis ever be stamped out? That de- 
pends. The difficulty is greater because the common 
carrier of the germ is man himself. He cannot be 
destroyed like rats and mosquitoes, so he must be 
taught. But with this disease, more perhaps than 
with any other, there is one mitigating fact. Every- 
one, almost everyone, has been in conflict with the 
bacillus tuberculosis. Having survived to adult life, 
he has repelled-or his defensive forces have repelled 
for him-many times the onslaughts of the enemy, and 
by his victories he has acquired an immunity that must 
be broken down before he is vulnerable. The breach 
in one's defense may be caused by other disease 
through no fault of his. But more frequently it may 
arise from improper living, overwork or dissipation. 
And so, due to the microscope, the causes of disease 
have been discovered and the means of prevention dis- 
closed-and all this within forty years. But the fact 
which should especially interest all of us is the doctrine 
of immunity-that we have within us certain defensive 
forces against these enemies, forces that we can 
strengthen or weaken as we choose. In many cases the 
fight will go for us or against us, depending upon what 
we do. 
A whole epistle upon this subject could be condensed 
into two words: Live right! Not too hard, not too 
easy; not too fast, not too slow-temperately, moder- 
ately, happily. 
Bromidic? Surely! But so are all great fundamen- 
tal truths. Nature is the great preventer, the great 
restorer-that is, the force within us. In that seven- 
teenth-century trial quoted at considerable length in 
this article the physician had asserted that Nature had 
done the healing; that he had only kept the wound ONE THOUSAND DIAMETERS 
135 
clean. Judge Street remarked with sarcasm but with 
greater truth than he knew, "Then Nature deserves 
the credit!" 
Very well, give Nature the credit! But give her a 
chance! NINE 
THE ETERNAL WARFARE 
IN order to prevent the slightest misunderstanding it 
must be said at once that this chapter has nothing to 
do with the late unpleasantness in Europe, nor with 
any conflict or succession of conflicts between nation- 
alities or individuals of the human race. It will con- 
cern itself with the never-ending fight for supremacy 
between plants and animals, and the bearing it has 
upon our daily peace, health and happiness. 
Even that is too big a subject for a limited space, 
and there will be no attempt to cover it. Merely a 
cross section, a single instance, of the warfare will be 
described, using common conditions as an example. 
And of the many enemies of mankind, a single foe, or 
rather family of foes, will be chosen. 
Plants live upon animal matter, either living or dead 
animals; and animals could not exist without the vege- 
table kingdom. Even strictly carnivorous animals 
must eat flesh that has been nourished by plant life. 
One essential element of all life is nitrogen, which 
must be obtained from the air. Plants alone have the 
mechanism by which living nitrogenous compounds can 
be manufactured. And so all animal life must get them 
secondhand, from plants or from other animals that 
have obtained them from the vegetable kingdom. 
Most plants require that animal tissue shall have 
undergone disintegration before it can be appropriated 
as nourishment. But decay is accomplished by other 
136 THE ETERNAL WARFARE 
137 
plant life, the infinitesimally small bacteria of putrefac- 
tion which attack all dead matter of either kingdom. 
There are notable exceptions to this rule, but they are 
few as compared with the others. The pitcher plant, 
for instance, captures its food alive and digests it. 
But, whether alive or dead, animals are the natural 
prey of plants, and plants of animals. This conflict has 
gone on unceasingly from the time of the separation of 
organic matter into the two great divisions. And it 
will continue as long as both exist. 
Most bacteria are small vegetable organisms of 
simple structure, belonging to the lowest orders of 
organic life. Like members of the higher orders, they 
require food upon which to thrive. And also like 
them, some live upon dead tissue and others upon the 
living. 
The latter are the germs which by their growth in 
the body cause most of the acute infections. If it were 
not for the fact that the very vast majority of such 
conflicts have resulted in victory for the animal king- 
dom these small but exceedingly virulent enemies would 
long ago have annihilated it. 
Mankind is continuously besieged by disease bacteria, 
and yet comparatively few succumb. Why is it that so 
many are called and so few chosen? Because everyone 
is possessed of fighting forces which enable him 
to combat his bacterial enemies. Depending upon 
whether these defensive forces are potent or impotent 
will the issue be either victory or defeat. 
In all infections two elements must be present- 
first, the germs; and second, conditions favorable to 
their growth. By favorable conditions it is implied 
that the bacteria must overwhelm by their numbers or 
virulence, or that the natural resistance to them is 138 
THE COMMONSENSE OF HEALTH 
lessened. Many billions of bacteria in contact with 
the human body do not constitute an infection, unless 
they continue to grow and multiply and throw off their 
poisons, and cause destruction. 
The living body may be likened to a citadel sur- 
rounded by enemies. They attack from every direc- 
tion; they are present in the atmosphere, in the dust 
that collects on the surface of every object touched. 
Always there is skirmishing with some of the commoner 
varieties of the foe, and sometimes they overwhelm 
by their numbers and strength. But as long as the 
outer walls remain intact, the battlements manned with 
defenders, just so long will the citadel be safe. 
It will eventually succumb to age or it may be weak- 
ened by internal causes. But if it be strongly guarded 
and wisely governed, and if the enemy does not attack 
in too great numbers, the siege will last the allotted 
time, until the hour strikes when each human citadel 
must fall, due to failure of the forces within. 
The defenses of the body are of two kinds, outer 
and inner. On the principle that it is better to keep a 
foe out than risk an encounter after he has gained 
a foothold, the outer defenses are very strong. They 
are the skin, which covers the body, and the mucous 
membranes, which line all the inner passages com- 
municating with the outside. 
The mucous membrane is one of the primary de- 
fenses because it also is an outer lining of the body. 
Its location is different, that is all. Nothing is really 
inside the body until it has pierced the outer layers 
of the skin or the mucous membrane. To illustrate 
the analogy between the two, push in the finger of a 
glove, inverting it. The inserted finger of the hand 
is not within the glove; it is still surrounded by the THE ETERNAL WARFARE 
139 
outer covering. To get into the glove by this route, 
that covering must be broken. 
And so it is with the body. To get within the 
body bacteria must penetrate the lining. This is 
usually accomplished by some force or circumstance 
other than that within the germs themselves. An in- 
jury must make the breach or an unhealthy condition 
weaken the defense. 
The coverings of the body, then, are its outer ram- 
parts, its first defense. They are able to withstand 
repeated onslaughts without harmful results. The 
fluids which their glands secrete-sweat, saliva, mucus, 
gastric juice-either kill germs or disarm them. 
But as happens innumerable times to everyone, when 
this first defense at any point is broken down the enemy 
gains entrance. Then the secondary defenses are 
called upon for assistance. Every tissue has this de- 
fensive power, some more than others, but not one is 
without it. All the tissues have one characteristic in 
common. They are all made of the same basic sub- 
stance, protoplasm. Every cell, whether of skin or 
brain, muscle or sinew, mucous membrane or the tiny 
bodies that float in the blood stream-all are pro- 
toplasm. They have many different structures and 
functions, but they are of one material. And they 
have a common antipathy toward bacteria. This ap- 
plies to all germs, to those which cause pus as well as 
to those which produce the acute infectious diseases, 
such as pneumonia, influenza and typhoid fever. 
There is a very numerous and prolific family of 
bacteria called streptococci, the various members of 
which cause pus. Some members of this family are 
more poisonous than others, but they are all capable 
of setting up an infection when they achieve a victory. 140 
THE COMMONSENSE OF HEALTH 
Once having effected an entrance through Nature's 
first defenses, either the skin or mucous membrane, 
an infection will result if the secondary defenses are 
not strong enough to overpower them. 
Suppose two persons receive similar injuries to the 
hand, produced by the same cause, which has broken 
the skin surface and introduced as nearly as possible 
the same number of streptococci beneath the surface. 
Suppose that the first-aid treatments, the cleansing and 
the dressings, are exactly the same. 
One wound heals promptly with very little discom- 
fort and inconvenience. The other not only fails to 
heal but the hand becomes swollen and inflamed; pus 
forms and other disastrous results follow. 
By a fortuitous occurrence in each case the enemy 
finds and gains entrance through a breach in the ordi- 
narily impregnable wall of the citadel. And in each 
case the secondary defensive forces are called upon to 
repel him. At once the cells of that whole neighbor- 
hood are thrown into a state of the greatest excitement 
and activity. They begin to secrete fluids, chemical 
substances, the purpose of which is to weaken the 
violence of the onslaught and to neutralize the poisons 
which the bacteria produce. Chemical warfare, then, 
is the first result. 
But without other help the cells would not be able 
to withstand an attack of the enemy in appreciable 
numbers. A few bacteria may be overcome, slaugh- 
tered, and washed out by the blood flow. Then a blood 
clot may close the opening and further attacks be 
prevented. More often, however, the germs begin 
to attack and kill the nearest cells, throwing off poisons 
as they proceed about their nefarious business. 
These poisons which they create are often their own THE ETERNAL WARFARE 
141 
undoing. Their presence causes an emergency call for 
reenforcements. Soon the troops of the garrison, the 
white blood corpuscles, rush to the rescue. They come 
on the swollen blood streams and pour out through 
the torn vessel walls. They are so small that in times 
of trouble like this they have the power to penetrate 
between the plates which line the unbroken capillary 
walls. Because of this ability to go where they are 
needed, the white corpuscles are called wandering cells. 
How do they obtain the word that they are needed, 
and how are they able to respond so promptly? The 
presence of the bacteria and their poisons irritates the 
small nerves which supply the injured part. The mes- 
sage is transmitted along these nerve wires to certain 
nerve centers, and the answer comes back which dilates 
the vessels and slows the blood stream. This enables 
the corpuscles to debark, and with the constant flow 
of blood through the capillaries more and more troops 
hasten to the rescue from distant parts. 
Then begins an aggressive fight which cannot end 
for individuals on either side except in victory or de- 
feat; there can be no armistice. In 1883 Metchnikof 
was observing a small sea animal, the daphnia, under 
the microscope, and noted that its cells had the power 
of digesting infinitesimally small yeast plants with 
which they came in contact. He saw the daphnia cells 
project a part of their bodies and gradually surround 
the yeast cells. A little later the latter had disap- 
peared, having become a part of the animal cells. 
Here was the story in miniature of the eternal fight 
for supremacy between plant and animal. Later, when 
observing the circulation in a frog's foot, he injected 
into it the germs of tetanus, or lockjaw. Then he 
saw for the first time in the history of science the 142 
THE COMMONSENSE OF HEALTH 
fight between a germ and a white corpuscle. In the 
same manner, because the white corpuscle is a minute 
mass of protoplasm, like the daphnia cell, the hosts 
of the latter consume invading enemies. 
To these hand-to-hand encounters he gave the name 
phagocytosis, and the white corpuscles which fight our 
battles continuously for us are called phagocytes. It 
is they, then, that obey the call of distress and come 
to the rescue when bacteria have penetrated our outer 
line of defense. 
The number of these defenders in normal blood is 
enormous, but when the streptococcus has gained a 
foothold within the body another remarkable phe- 
nomenon takes place. At once the menaced garrison 
begins to mobilize more troops, to call to colors a re- 
serve army of white corpuscles. If the need is great 
this force may increase to more than ten times their 
usual number in the blood. 
Not every kind of bacterial enemy causes an increase 
in the army of white corpuscles. The germ of in- 
fluenza, for instance, and the tubercle bacillus, among 
others, are incapable of inciting this call to arms. 
White corpuscles are of several kinds, some of them 
soldiers and others merely camp followers, having dif- 
ferent duties than that of fighting. Both kinds are 
called by various names, but that common to all is 
leucocyte, which merely means white body; and their 
presence in the blood in increased numbers is called a 
leucocytosis. In order that there may be no confusion 
of names for white blood corpuscles it must be under- 
stood that they are all called leucocytes, but phagocytes 
are the wandering leucocytes that make up the army. 
Pus germs, as has been intimated, invariably cause 
a leucocytosis. So does the germ of pneumonia. On THE ETERNAL WARFARE 
143 
this fact depend two conclusions of tremendous im- 
portance to the victim of either of these bacteria. In 
the case of the streptococcic invasion, however obscure 
and remote the battlefield within the body, microscopic 
examination of the blood which discloses a leucocytosis 
helps the physician to determine the nature of the 
trouble. The body is fighting pus somewhere, and has 
mobilized additional troops. 
Or, if one has pneumonia, the amount of the leuco- 
cytosis gives the attending physician an idea of the 
kind of fight the forces of Nature are putting up, and, 
within certain limitations, what the issue will be, 
whether victory for the defenders or rout and defeat. 
But, to return to the two similar hand injuries which 
resulted so differently, why did one wound heal 
promptly and the other proceed to suppuration? 
The difference in the defense is not so much in the 
white corpuscles themselves as in the tissue cells. 
Neither the former nor the latter can wage a success- 
ful fight alone; they must act reciprocally, each re- 
enforcing the other. In the wound which heals 
promptly the tissue cells are able to secrete a specific 
antipoison in sufficient quantity to lessen the deadly 
activity of the bacteria and to counteract their poisons. 
In the losing fight, however, these secretions are less 
powerful. Something is wrong with an essential ele- 
ment of the defense, perhaps due to an inherent weak- 
ness in the individual, but often the result of other 
conditions over which he has more or less control. 
Not being properly reenforced by the chemical war- 
fare the wandering cells, the leucocytes, wage an 
unequal battle against troops whose numbers rapidly 
increase. It does not take bacteria long to propagate 
their kind. 144 
THE COMMONSENSE OF HEALTH 
The pus germs, not being repulsed at their first on- 
slaught, increase in number and in the violence of 
their attacks. More and more white corpuscles with 
reckless bravery hurl themselves upon the enemy, slay- 
ing millions, but themselves being finally overcome. 
Tissue cells are destroyed, and the bodies of slain 
defenders and enemy alike litter the battleground. 
This debris, with the watery constituents of the 
blood that are poured forth, together constitute that 
resultant thick fluid which is called pus. 
Always aggressive, always fighting, the streptococci 
soon seek to extend their conquests. In the lymph 
streams of the skin they travel, desperate skirmishing 
following their invasion. Now red streaks appear on 
the arm, marking their progress. Eventually, if not 
checked, these will reach the shoulder, especially if 
the pus is dammed up at its source. 
The lymphatics of the arm pass through certain 
small glands in the axilla, the space under the shoulder 
joint. These substations are placed in various parts 
of the body for the purpose of filtering out just such 
invaders as now appear. They check the progress of 
the enemy host, but themselves become swollen and 
inflamed, a sacrifice to the cause, being Nature's third 
line of defense. 
If the pus in the hand has not been given free exit 
by the surgeon's knife it will follow the course of the 
bacteria, and there will be a general infection of the 
arm. The axillary glands will soon break down and 
suppurate. By this time the condition will be extremely 
dangerous. Great destruction will follow if there is 
not immediate relief, if all the pus areas are not freely 
opened and cleaned of debris. For dead germs are THE ETERNAL WARFARE 
145 
poisonous as well as the living, and both the dead and 
the living are in the pus. 
Another great danger lies in the fact that the bac- 
teria may be carried by the blood streams to distant 
parts. When this occurs inflammatory processes may 
appear at any point in the interior. Pus will form 
in other and obscure places. The blood will be teem- 
ing with the enemy and the desperate fighting will be 
general. The whole citadel will then be threatened, 
and will need all the help that science can bring to 
bear. This is the condition known as bacteriaemia. 
The skin is much less vulnerable to infection than 
the mucous membranes. Practically all the bacteria of 
the acute infectious diseases enter by the latter route. 
The skin is impervious to most of them. Typhoid 
fever germs, for example, when rubbed into a broken 
skin surface will cause only a local irritation, because 
Nature's secondary defenses there destroy them. 
But whether bacteria enter by one route or another, 
the methods of attack and defense are the same, and 
the same factors determine the issue. Injury to or an 
unhealthy condition of the mucous membrane secures 
the necessary breach in the outer wall, and, that once 
effected, the tissue cells and the leucocytes must carry 
on. 
The mucous membranes of the nose, mouth and 
throat are favorite points of attack of the streptococci. 
The nose is the proper channel through which air 
should enter the lungs. Streptococci, uncounted num- 
bers of them, are suspended in the impalpable atmos- 
pheric dust. The nose is the natural air filter and 
very few bacteria of any kind get far through the 
normal nose. There they are collected, with the dust, 146 
THE COMMONSENSE OF HEALTH 
and the mucous secretion renders them harmless and 
washes them away. 
But if there are obstructions in the nose or the 
nasal sinuses, those accessory cavities that are con- 
nected by small openings with the nose, an unhealthy 
condition of the membranes results, and the bacteria 
find conditions favorable for growth. Then the mem- 
branes become congested and swollen, blocking the 
exits, and pus accumulates. Not only is the first de- 
fense broken down but the resistance of the tissue cells 
is weakened. Here, then, is created a focus of infec- 
tion, an entrenchment of the enemy, from which he 
may sally forth at any time to wreak destruction 
elsewhere. 
If the pus pocket can be drained freely and fre- 
quently washed out the danger is lessened. Especially 
if all obstructions to drainage are removed Nature 
will have a chance to fight her way to victory. 
In the back of the mouth, at the portal of the 
throat, there are several germ filters, the largest of 
which are the tonsils. They have an important duty 
to perform, especially in infancy, to protect from infec- 
tion the child so recently arrived in a hostile and 
menacing world. But if the tonsils have a greater 
burden than they can withstand they become diseased. 
Then they are a menace to health rather than a 
protection. 
Mouth breathing, to which those are compelled to 
resort who have nasal obstructions, a habitually dust- 
laden atmosphere, sudden exposures to extremes of 
cold and heat-these are the most frequent causes of 
diseased tonsils. They become the depositories, the 
germinating ground, of bacteria. 
Within their pockets, or crypts, the streptococci THE ETERNAL WARFARE 
147 
collect, thrive and multiply. Pus forms and exudes, 
to be absorbed elsewhere. And other bacteria find a 
soil prepared for them, especially those of pneumonia, 
of influenza and of diphtheria. The tonsils and the 
nose are the headquarters from which these deadly 
germs go forth when opportunity offers, to wreak 
havoc. 
Pus germs have another favorite point of attack, the 
teeth, because the teeth and gums are so frequently 
neglected and misused. Particles of food which are 
allowed to collect round the teeth soon undergo de- 
composition, and the result is an admirable medium 
for pus germs. Let the gums be irritated by the fer- 
ments of putrefaction, their margins detached by rough, 
unskillful use of the brush, and all the necessary con- 
ditions are present for the formation of pus pockets. 
Pyorrhea may be confined to one tooth or may affect 
many, but whether single or multiple its effect upon the 
general health is profound. 
Just here it may be well to interpose a word of cau- 
tion. A few years ago if anyone, doctor or dentist, 
had advised tooth extraction as a cure for rheumatism 
or other general bodily ailment it is not difficult to 
imagine what would have become of his reputation. 
Now there is none so poor or ignorant as not to do 
the theory homage. There is no question but that 
this knowledge may be carried too far. Teeth should 
not be extracted upon suspicion, or we should soon 
become a toothless race. If there is the slightest doubt 
an X-ray picture of a tooth root should establish the 
charge of guilt before sentence of execution is 
pronounced. 
One who is otherwise in good health can withstand 
for a long time poisons which are absorbed gradually 148 
THE COMMONSENSE OF HEALTH 
and in minute quantities, whether they are produced 
by bacteria or by any other cause. They are antidoted 
and cast off by the natural forces of the body. But if 
the amount becomes greatly increased or the natural 
resistance is weakened, then the balance of power will 
be upset. 
In the case of the pus pocket in a tonsil or around 
a tooth, for years the germs may have been entrenched, 
relatively dormant, their depredations limited and their 
poisons neutralized. But at any time there may come 
a change. Another disease may affect the general 
health. Perhaps adjoining teeth may become in- 
fected or the bacteria may start up an acute inflam- 
mation of the tonsils. Then the enemies break through 
the walls which have been thrown up about them to 
protect the surrounding territory, and the former inter- 
mittent skirmishing becomes a general combat. They 
are out in force, full of blood lust, eager for plunder 
and destruction. 
As in the case of the hand infection,' they leave by 
the blood or lymph streams. In the latter they find 
their destination and fate in the glands of the neck, 
which swell and become the sites of bitter conflict. 
Those that get into the blood, however, will fare 
farther. Millions and millions will be destroyed, but 
that will not affect the activities of the others. Some 
will find lodgment in a remote organ or in distant 
tissues, where conditions favor their growth. They 
may stop in a joint or in many joints, causing acute 
or chronic arthritis; perhaps in the large muscles, and 
the result will be rheumatism. Or the heart lining 
may be affected and a chronic heart disease ensue. 
If the lungs are susceptible there will be a streptococcic 
pneumonia. Any place where the defense is weak may THE ETERNAL WARFARE 
149 
become the site of their new growth. Focal infections 
of the teeth or nose or tonsils are now charged with 
producing thirty-seven acute and eleven chronic 
diseases. 
Frequently the appendix throws open a hospitable 
door, offering a welcome. This little shriveled rem- 
nant of intestine has a poor blood supply and little 
resisting power. Soon the owner of the tooth abscess 
or diseased tonsil will begin to experience an uneasiness 
deep in the right side of the abdomen that may be 
so ill-defined that he is unsuspicious. That is chronic 
appendicitis, and will bear watching. Or his pain may 
be acute, with fever and all the symptoms of an acute 
fulminating attack. Pus will form and will need im- 
mediate exit. Call the surgeon, for death is approach- 
ing with quickened footsteps. 
The ability to overcome bacteria and antidote their 
poisons is called natural immunity. Everyone pos- 
sesses it, but it varies in different individuals, and at 
different times in the same person. The devastating 
onslaught of one disease may lessen one's immunity 
to another. A prolonged attack of typhoid fever may 
render one susceptible to tuberculosis, the germs of 
which he has been successfully fighting and conquering 
since childhood. 
During the influenza epidemic it was not that disease 
alone which slew so many thousands. It prepared the 
way for the bacteria of pneumonia by destroying all the 
natural defenses against them. After three or four 
days' illness, just at the time when the victim, weak 
and exhausted, was about to come off victorious, he was 
stricken with pneumonia and was unable to put up a 
successful fight. 
Natural immunity may be broken down also by bad 150 
THE COMMONSENSE OF HEALTH 
habits. Starvation will weaken it, but so will over- 
eating, which taxes the liver and kidneys beyond their 
power of endurance, and clogs the blood with waste. 
Care is another friend of bacteria. Constant anxiety 
will reduce all the vital forces of the body. And so one 
might run the gamut of crimes against Nature. Impure 
air, dissipation, lack of bodily cleanliness, want of 
proper exercise, continuous work unrelieved by open- 
air play-all these and many more will lessen the 
natural resistance to disease. 
An additional, greatly increased immunity to cer- 
tain diseases may be acquired by a successful fight 
against them. Smallpox, for instance, and scarlet 
fever seldom succeed in bringing down the same victim 
twice. With certain other diseases, such as typhoid 
fever and pneumonia, this acquired immunity does not 
last indefinitely. Sooner or later the chemical sub- 
stances stored in the blood disappear, and only the 
original natural immunity, the power to manufacture 
them again in case of need, remains. 
But in each disease the acquired immunity is active 
against the bacteria of that disease only. It will anti- 
dote the poisons of no other disease than that for 
which it was made. 
There remain two other kinds of acquired immunity, 
of which one is created within the body, and the other 
is obtained from animals. It is a curious and wonder- 
ful fact that dead germs will rouse Nature's fighting 
forces also. The introduction of dead bacteria will 
not produce a disease, but they will stimulate the manu- 
facture of the chemical antidote for the disease which 
would result from the presence of the living bacteria. 
This is the basis of the theory of vaccination. 
The chemical substances manufactured and stored THE ETERNAL WARFARE 
151 
in the blood serum are another valuable aid in the pre- 
vention and treatment of diphtheria. In the making 
of these the horse is used. The animal is inoculated 
with diphtheria bacilli, and when all his combative 
forces are roused, when his fighting blood is up, a 
quantity of his blood serum is drawn off. This is the 
antitoxin which has saved so many lives. 
All persons who have diphtheria manufacture this 
antitoxin, but it is a slow process and about twenty- 
five per cent of the victims would die if left to their 
own defenses. Help must come quickly from outside 
the body. And the blood serum of a horse that has 
fought and conquered the disease furnishes the neces- 
sary antidote. 
More and more antitoxins are coming into use. The 
terrors of pneumonia will soon grow less and the 
victims of influenza decrease in number. Even the 
ever-present pus bacteria which cause so many and 
varied troubles-boils and rheumatism, sore throat 
and pyorrhea and appendicitis among them-even 
these germs are being combated by the aid of anti- 
toxins. 
This war of two kingdoms has gone on unremit- 
tingly from the beginning of organic life, and will last 
forever, but its human toll is growing less and less 
with every succeeding year. 
It is no longer a fight against unseen enemies. 
Science is bringing to bear in our behalf each year 
new and more potent weapons. 
But science will never conquer of herself alone. 
After all, each one of us has the forces within him 
which outweigh all and every external help. It should 
be the business of each one to conserve them, to keep 
them up to their highest efficiency. TEN 
EATING TO LIVE 
IF we were all as physically active as our early ances- 
tors, if life were as simple and uncomplicated with 
us as it was with them, when men had to hew and dig, 
to hunt and carry and labor with their hands, we 
would not need to concern ourselves with the subject of 
what to eat and would be interested only in the prob- 
lem, how to get enough of it. We should be like the, 
very old lady who was asked to what one thing more 
than any others she attributed her longevity. After 
a moment's serious thought she replied: "I think it 
was vittles!" 
But life is not as simple as it used to be; it is com- 
plicated by a great many things, such as hurry, worry, 
sedentary occupations; and rich viands, without which 
our forbears managed to get along very well. 
In consequence there are all kinds of sectarians in 
diet who are endeavoring to solve the problem, each, 
group not only for themselves, but for the rest of us. 
And they are enthusiastic and vocative, and all are ad- 
dicted to the pen or the typewriter. 
Among these various sects are the Fruitarians. 
They eat nothing but fruits and nuts. Simple Lifers, 
they are called in England, and they go about the 
country eating little and wearing not much more. Then 
there are the Vegetarians, who eat nothing that does 
not grow above ground. And a sub-sect of the Vege- 
152 EATING TO LIVE 
153 
tarian family who refuse all cooked foods but dote on 
raw grains. And the Lacto-Vegetarians, who add to 
their daily menu milk, butter, cheese and eggs. At 
the other extreme are a few persons who eat meat 
only, or at least they go for a more or less extended 
period on an exclusive meat diet. 
And there are no-breakfast devotees, who quote 
from Ecclesiastes: "Woe to thee, O land, when thy 
king is a child and thy princes eat in the morning!" 
The very orthodox of this sect eat but one meal 
a day and periodically they fast. Extremists have set 
up fasting as a cure for all curable conditions, and 
they have been known to deny themselves all suste- 
nance for many days, thus emulating Dr. Tanner and 
Upton Sinclair. 
In all this maze of diction and contradiction re- 
garding food there is some truth. There are certain 
essential facts which are so well established that they 
may be set forth briefly within the limits of this article. 
But perhaps it would be well to begin with an under- 
standing as to what food is, what we do to it, and 
what it does for us. 
The lowest form of animal life is a mere speck of 
jelly-like material, or protoplasm, having no perma- 
nent form and no organs of any kind. The amoeba, 
which floats in the water, is an example of this simple 
life. When the amoeba comes in contact with a 
smaller object it folds itself around it and digests it 
if it is digestible. Any part of the amoeba has the 
power of digestion and absorption. 
Animals a little higher in the scale of life have a 
pouch with a single orifice, into which food is taken 
and from which that part which cannot be used is 154 
THE COMMONSENSE OF HEALTH 
ejected. Still higher animals have two orifices to their 
food receptacle. 
From this on, as we go higher and higher, the 
digestive apparatus becomes more and more developed, 
until we reach man, who has the most intricate and 
complex of all, a digestive tract more than twenty-five 
feet long, with many accessory organs. 
But food in one's stomach is not inside the body 
any more than the tiny speck is inside the amoeba 
that has just enfolded it. Food must be prepared 
for absorption and then absorbed before it really gets 
into the body. In order to understand what we do 
to food and what it does for us, suppose we follow a 
meal into the body proper, and see what becomes of it. 
Let the one who is to eat this meal be hungry. 
Really hungry. What causes hunger? Need of food, 
of course. But what causes the pangs of hunger? 
Strong contractions of the stomach. The stomach con- 
tracts rhythmically when food is present, but these 
movements are strong enough to become uncomfort- 
able when food has been denied a long time. The ex- 
pression, "gnawing hunger," is based upon a real 
sensation. 
Also let this meal be a good, ordinary dinner, of 
sufficient amount, neither stinted nor too abundant. 
Here is the menu: Consomme, steak, a green vegetable, 
potatoes, a salad, bread and butter, and a sweet des- 
sert, ice-cream if you please. The beverage shall be 
milk because it contains all necessary food ingredients. 
Coffee and tea are not, properly speaking, foods. 
Before being called to the table there is an ap- 
petizing odor from the kitchen, and immediately one's 
"mouth waters" in anticipation. Savory odors cause 
activity of the salivary glands because saliva is the EATING TO LIVE 
155 
first aid to digestion. And, although it causes no sen- 
sation, the stomach waters also. The gastric juices 
are beginning to pour out. Unsavory food will not 
cause this phenomenon and lack of appetite will pre- 
vent its occurrence, so that digestion will be delayed. 
Pleasant or unpleasant emotions also have a great 
influence upon digestion. Dr. Lusk says: 
"The appetite is like a magic wand, influencing the 
whole of the digestive process. Fear and anger lead 
to a parched throat, so that food cannot be well 
digested under these circumstances. The appetite is 
affected by the atmosphere of cheer at the table. 
Neither scolding parents nor snarling children facili- 
tate the digestion of the Christmas dinner." 
But in this instance the appetite is sharpened by 
hunger and by the taste of the food, flavor depending 
largely upon the sense of smell. And the surroundings 
are pleasant. Nothing present, past or future, will 
spoil the digestion of our meal. 
First, the consomme. There is not much nourish- 
ment in a clear soup; most of that has been strained 
out, in the solid ingredients. But its use is chiefly as 
an appetizer, further to stimulate the pouring out of 
the digestive juices. 
Then comes the solid food, steak, bread and butter, 
and the vegetables, which will engage the attention of 
the teeth. Human teeth are of two kinds, those char- 
acteristic of flesh eating animals and those possessed 
by the vegetarian. This fact should settle the ques- 
tion whether man was intended to live exclusively upon 
vegetable food. 
How long should each mouthful be chewed? That 
depends upon the kind of food. Digestion of starch 
begins in the mouth, where the saliva starts the chemi- 156 
THE COMMONSENSE OF HEALTH 
cal change of starch into sugar. Starchy vegetables 
should be thoroughly masticated and mixed with saliva. 
Flesh-eating animals bolt their food. Watch your dog 
eat meat. His teeth are meant chiefly for tearing and 
rending. This is not to advocate the bolting pro- 
cedure on the part of man but merely to indicate that 
meat need not be so finely divided as vegetables. If 
it becomes too pulpy it is less easily acted upon by the 
digestive juices, and also it becomes tasteless and in- 
sipid before it is swallowed. On the other hand 
starchy foods are rendered more and more palatable, 
because they become sweeter. 
In the mouth, then, the various ingredients of this 
meal are broken into fragments, mixed with saliva and 
mucus, and swallowed, the mucus being useful as a 
lubricant, to facilitate swallowing. Digestion of starch 
has begun, and the whole mass has been softened by 
moisture. 
When it reaches the stomach it finds some gastric 
juice waiting for it, an amount that gradually will be 
increased during the succeeding three hours until about 
a pint has been used. The principal ingredients of this 
fluid are pepsin and hydrochloric acid, the latter being 
necessary in proper proportion to enable the pepsin 
to act. If there were too little, digestion would be 
retarded, and if there were too much, there would be 
that uncomfortable sensation commonly known as 
"heartburn," a very inappropriate name for over- 
acidity. 
But before this meal goes any further it will be 
necessary to use other terms in describing it than meat, 
vegetables, bread and ice-cream. It consists of pro- 
teins, carbohydrates, fats, many minerals, water and 
certain waste material which cannot be used. EATING TO LIVE 
157 
Proteins are the nitrogenous elements of food. They 
are found in all flesh and in nearly all vegetables, but 
in varying proportions. The starchy vegetables and 
grains, such as potatoes, and the kernels of the grain, 
for instance, contain an extremely small amount of 
protein. 
All protein comes primarily from the vegetable king- 
dom. Animals have no mechanism by which they can 
transform nitrogen into flesh. But plants have that 
power and animals get their protein from plants. 
When we eat meat we get our protein second hand. 
But this meal which we are following contains both 
vegetable and animal protein; in the meat, in the 
wheat bread, in the salad, even in the ice-cream; and 
the stomach begins their digestion. The gastric juice 
does not merely dissolve food, it begins a series of 
chemical changes which are completed further on. 
When finally the proteins have been made ready for 
absorption, they have been transformed into eighteen 
different compounds, from which the tissues will take 
according to their individual needs. 
The carbohydrates, which are the starches and 
sugars, are not changed in the stomach, except that 
the starch is acted upon by the saliva which has come 
down with it from the mouth. The fats also pass into 
the intestine unchanged. 
While the meal is mixing in the stomach there 
will be time to mention the famous Alexis St. Martin 
case. In 1832 Alexis St. Martin's gun discharged pre- 
maturely, tearing a great hole in his abdomen. He 
survived the accident but his wound never healed. By 
good fortune, in the small town near the Canadian 
border where he lived there was a United States army 
surgeon named Beaumont, who possessed an inquiring 158 
THE COMMONSENSE OF HEALTH 
mind. This surgeon cared for the unfortunate St. 
Martin and after he was able to get about, took him 
into his employ. 
For several years Beaumont studied stomach diges- 
tion through the unhealed wound. His reports of 
these observations marked the first great advance in 
this hitherto obscure subject. 
But very little was known of the movements of the 
stomach until the X-ray disclosed them. If, instead 
of an ordinary meal, it contained a simple food like 
cornstarch, or oatmeal, and a substance impervious 
to the X-ray, its movements may be watched through 
the screen. The substance most frequently used for 
this purpose is barium sulphate, the minute particles 
of which coat the stomach walls and outline it plainly 
in shadow on the screen. 
Have you ever watched a horse swallowing and 
noticed the successive waves which pass along its 
throat? These are caused by muscular contractions 
which narrow the tube behind and push forward the 
water or food. The action is called peristalsis, and it 
it continuous throughout the entire length of the 
digestive tract. 
In the stomach which contains the drug these 
rhythmic waves may be seen following one another, 
gradually mixing and advancing the contents, until 
they reach the exit, where at intervals the door opens 
and they are ejected in spurts into the intestine. 
There is time to describe another interesting experi- 
ment by means of which these movements have been 
still further studied. After the barium sulphate meal 
has been swallowed, let the person to be observed take 
a capsule containing a little of the pure drug. It can 
be seen as a small and darker shadow, passed over EATING TO LIVE 
159 
by successive waves but gradually moved on, like a 
cork upon the surface of a pond. 
In this manner food is mixed, partially digested, 
and finally passed out into the intestine where further 
and more complicated processes await it. 
To return to the dinner which we have set out to 
follow, before it leaves the stomach it has become 
semi-liquefied, of about the consistency of a thick 
broth. Very little of it has been absorbed because the 
stomach is almost exclusively a mixing chamber. 
The small intestine is also lined with glands that 
secrete digestive fluids, and into it are poured two very 
important elements, bile from the liver and pancreatic 
juice from the pancreas. The latter helps to complete 
the digestion of the proteins, the sugars and the 
starches. Another important function is to break up 
the fats. But it cannot digest fats without the aid 
of bile. Bile and pancreatic juice must always work 
in combination. 
There is a very ancient medical joke which runs: 
"Is life worth living? Well, that depends upon the 
liver." It is literally true that life and health do de- 
pend upon the liver perhaps more than upon any other 
single digestive organ. The normal secretion of bile 
is about a pint in twenty-four hours. It has many 
uses, among which are to assist the pancreatic juice 
in digesting starches, proteins and fats. Fats, even 
when finely divided, as emulsions, cannot be absorbed* 
The bile changes them into soap, which is soluble. 
This process is much the same chemically as occurs 
in soap factory. 
Bile also helps the forward movement of the di- 
gested food, and hastens the progress of waste ma- 160 
THE COMMONSENSE OF HEALTH 
terial. If it were not for the bile we should all be 
poisoned. 
And the liver is a storehouse for fuel, a coal bin, if 
you please, in which sugars are kept for future con- 
sumption, and fats also. Sugars and fats are our 
chief sources of heat. 
Our meal has now undergone many wonderful 
changes. It is one creamy mass in which the separate 
ingredients could not be recognized. Steak is no 
longer steak, but the meat and vegetable proteins are 
now eighteen chemical compounds. The potato and 
part of the bread are sugar; the sugar which was in 
the ice-cream and cake is modified in form, and the 
fats have become soap and glycerine. 
In the meantime, because digestion does not take 
place all at once, absorption has begun. The liquefied 
digested food, is passing into small vessels that line the 
intestinal walls. And from these it gets into the blood 
stream, in which it will be carried to every part of the 
body. Each tissue, whether skin, bone, muscle, or 
brain, will select the kind of nourishment best suited to 
it. 
Let the experts juggle with carbohydrates and pro- 
teins if they will. We want to know a few practical 
facts about food. And we might begin with the ques- 
tion: What use do we make of it after it has been ab- 
sorbed? Afterwards we may concern ourselves with 
attempting to determine just what is over-eating. 
Taking the first question first, food is of two kinds, 
that which builds up or replaces, and that which burns 
up, to supply heat and energy. The building foods 
are the proteins, the minerals and water. The fuels 
are the fats and those sugar compounds which have 
been made from starch and cane sugar. The sugar EATING TO LIVE 
161 
compounds formed by digestion differ chemically from 
both the original materials. The fats were changed 
into soap and glycerine for the purpose of absorption 
only. After this has occurred the glands lining the 
intestinal walls again transform them back into finely 
divided fat. 
There are several great storehouses for fat in the 
body, where it is kept for future use. One is just 
beneath the surface of the body, under the skin. An- 
other is in the membranes which hang like curtains 
over parts of the intestines. From this latter fat- 
deposit in animals is obtained the suet that we buy 
at the meat shops. 
From these storehouses is drawn the burning ma- 
terial in times of famine or plenty, but in plenteous 
days it is constantly being replaced and the supply 
is not diminished. The hibernating bear during a sea- 
son of foraging lays up great quantities of fat which 
he uses to make heat throughout his long winter's 
sleep. 
The story of the journey of a meal from table to 
tissue would not be complete without a paragraph 
or two about germs, those minute forms of vegetable 
life with which we contend in our struggle for existence 
from the cradle to the grave. Germs may be friendly 
as well as inimical. Life without the friendly germs 
would be difficult if not impossible, and a sterile, germ- 
less existence is inconceivable. 
They do not inhabit the stomach but are present 
both in the small and large intestine, where they are 
an aid to digestion. In the small intestine they assist 
in changing starches into sugar and in digesting fats 
also. In the large intestine they attack the proteins 
which have not been completely changed. And therein 162 
THE COMMONSENSE OF HEALTH 
lies a danger. If one has eaten too much protein food 
in proportion to the amount of starch and sugar, they 
will change it into poisonous compounds. These de- 
composition products are similar to those which oc- 
cur in meat or vegetables too long exposed to the air 
before they are eaten. But they may occur in the 
lower bowel also, especially if waste material is re- 
tained. In either case the result is putrefaction, and 
absorption of such material causes auto-intoxication. 
Which brings up the subject of waste, that part of 
everything edible which cannot be used. The propor- 
tion of waste varies with different foods, but it is 
greater in the vegetable kingdom than in meat, and 
some vegetables contain more fiber, or cellulose, than 
others. One thing certain is that it is necessary to 
health. 
Bulk stimulates the movement of the lower bowels 
and prevents the accumulation of material which be- 
comes poisonous if allowed to remain too long. This 
is another reason why meat, which is a highly con- 
centrated food, should be eaten sparingly. Some of 
the vegetables that are useful because they are com- 
posed of a large amount of cellulose, will be men- 
tioned later. 
There are important food elements called vitamines 
about which comparatively little is known. What is 
known is that they are present in all proteins and that 
without them life could not exist. 
They are in all fruits and vegetables, and in meat 
because they are an essential part of the proteins 
which the animals obtain by eating vegetables. Also 
they are in milk for the same reason. The outer 
layers of cereals, such as wheat for instance, contain 
the vitamines, and hence they are not present when EATING TO LIVE 
163 
these layers have been removed, leaving only their 
starchy centers. The manner of their discovery may 
be interesting. 
Beriberi is a disease much more common in Euro- 
pean and Asiatic countries than in America. Its princi- 
pal characteristics are, pains throughout the body, im- 
poverished blood, dropsy, wasting of the muscles, and 
paralysis. In extreme cases death results from a 
weakened heart muscle. Until a short time ago phy- 
sicians thought that it was a germ disease. Almost 
all obscure diseases are attributed to germs, until an 
alibi is proved. 
Beriberi was once quite prevalent in the Japanese 
army when polished rice was almost the sole ration, 
but it disappeared when the soldiers were given a 
more varied diet. Polished rice is that from which 
the outer layers have been removed, leaving only the 
starchy kernel. 
Then scientists in many places began to experiment 
to see if they could produce beriberi. One of these 
experiments was as follows: Fowls were fed upon 
polished rice exclusively. Within a very short time 
they began to be affected, staggering about drunkenly, 
too weak to stand. In six weeks they were paralyzed. 
Then the rice hulls were added to their diet and they 
all promptly recovered. 
And so it was determined that the vitamines are 
necessary not only to health but to life itself. They are 
contained in concentrated form in the outer layers of 
grains, and for this reason whole wheat flour is much 
more nutritious than white flour. 
The other elements which compose every meal may 
be dismissed with a very few words because they do 
not have to be digested. And yet they enter into every 164 
THE COMMONSENSE OF HEALTH 
digestive process and into the composition of every 
tissue of the body. They are the minerals and water. 
The minerals are derived from every form of food. 
They are many and their compounds are too complex 
to be mentioned in detail here. One important func- 
tion of the minerals is to assist in the chemical changes 
which are involved in the processes of digestion and 
assimilation. 
Finally, our meal has reached the tissues and has 
become a part of them in a manner not yet wholly 
understood. But we know that each, whether bone 
or brain, heart-muscle or hair follicle, skin or mucous 
membrane, has taken the proper sustenance unto itself 
to restore tissues that have broken down and been 
carried away by the blood stream to be cast off, or 
has been burned up to supply the heat and energy neces- 
sary to keep this wonderful machine of ours going. 
A part of it will renew the heart muscle which, by 
its contractions, sends the blood stream through the 
minutest vessels with force sufficient to insure its re- 
turn to the heart. A part will supply the brain, which 
will make an end-product of it in the form of action 
and emotions. And so we might trace this meal, 
in imagination, to great thoughts and heroic deeds. 
Now that we have finished digesting and assimilating 
a well balanced, rational meal, of sufficient quality 
and quantity, we come to the question of overeating. 
And immediately we encounter difficulties because peo- 
ple differ so radically and so variously concerning it. 
Probably more books and magazine articles have been 
written about this phase of the question than about 
any other subject that deals with the human body. 
The Fruitarian thinks that the Vegetarian overeats, 
and the Vegetarian considers it irrational to eat any EATING TO LIVE 
165 
meat at all. And there are an increasing number of 
persons who weigh and balance their food, holding that 
one is a glutton if he satisfies a normal appetite and 
refuses to leave the table hungry. 
These differences of opinion will never be recon- 
ciled as long as there are individuals who think for 
themselves, so there will be no attempt made here 
to settle them. With the advancing centuries the 
standards of eating have changed. In a sense, there 
are more people now who overeat than ever before, 
but it is because there are more people able to indulge 
their appetites. But gluttony is not fashionable any 
more, and the trencherman is no longer a hero. 
It is probable that there were fasters and food 
faddists in ancient times, but on this point history is 
silent. It was the ones who ate the most whose names 
were celebrated in song and story. 
The first name that occurs to one in this connection 
is that of Heliogabolus. It is related that he and 
his banquet guests were wont to eat several meals 
at a sitting. They used the kindly offices of a feather 
in the throat to bring about a reversal of the swallow- 
ing process and thus make room for another meal. 
Such a procedure would be inconceivable nowadays. 
And yet there are modern counterparts of those 
Romans, who differ only in degree, not in kind. For 
instance, there is the parent who allows a child to 
eat too many and too rich viands at a party, knowing 
that there is plenty of castor oil at home. Also the 
man who overindulges in food and drink at a dinner 
because, just before going to bed, he intends to take 
three brown pills and two headache tablets. 
Next in the list of gustatory heroes may be men- 
tioned Louis XIV. When Louis was in form it was not 166 
THE COMMONSENSE OF HEALTH 
at all unusual for him to consume at a single dinner 
the following: Four plates of soup, of different kinds; 
a whole pheasant; a partridge; a salad; several help- 
ings of roast mutton; two large slices of ham; a pastry; 
and preserved fruits and nuts. Note the semicolons 
in the preceding sentence. They are intended to repre- 
sent short pauses between courses, for breath. 
Is it any wonder that the "Grand Monarch'' had to 
take a cure frequently, when he went into retirement 
for several days and was dosed with calomel and sul- 
phur? These periods of retirement, rather than his 
gluttonous habits, enabled him to live to an over-ripe 
old age. 
Savarin immortalizes a General Bisson by relating 
that he drank eight bottles of wine while eating a huge 
breakfast, and tells of a certain Prosper Sibuet who, 
on a wager, ate a whole turkey-after dinner! 
That will do for historic examples. With us, such 
feats are no longer glorified and emulated. But over- 
eating may be just as harmful, although only relative. 
Those who perform severe manual labor or live in an 
extremely cold climate may eat with impunity an 
amount which, if consumed by one of sedentary habits, 
would be unsafe and immoral. 
An Arctic explorer once witnessed an Eskimo eat 
twenty pounds of raw meat, and wash it down with a 
quart of train oil. But the Eskimo needed fuel against 
the cold and his opportunities to obtain it were infre- 
quent and precarious. 
Overeating begins as an occasional indulgence, which 
if often repeated soon becomes a habit, and finally a 
vice. The occasional gustatory spree, usually at a 
formal dinner, or upon a holiday, may do no perma- 
nent harm because Nature takes care of it. An over- EATING TO LIVE 
167 
loaded and indignant stomach will often rebel, to our 
temporary discomfort but lasting benefit. 
In spite of the dictum of those who insist that one 
must always leave the table hungry, physiologists say 
that there is no harm in laying up a small store of 
reserve fuel. It may be needed at some future time 
for extraordinary mental or physical effort. 
But there is no physical or moral extenuation for 
the chronic overeater. The immediate results of such 
a habit are fatigue, drowsiness and finally stupor. 
Do you remember Joe, the fat boy, at whom Mr. 
Wardle was always shouting: "Joe! Damn that boy, 
he's asleep again." Joe had an overpowering pre- 
dilection for meat pies and mutton and roast beef. 
He is a humorous character, in fiction. But in real 
life he would be Tragedy personified, because Joe 
was a victim of chronic poisoning. 
Nature's laws, like the mills of the gods, grind 
slowly. After having established a tolerance for too 
much food one takes on increasing girth. This is 
due not only to the layers of fat in the coal bins of 
the body but to dilatation of the stomach and bowels. 
The liver also becomes engorged. 
Gradually the kidneys become chronically diseased, 
broken down by their increasing labors in carrying 
away the food products which are so greatly in excess 
of the demand. Then degenerative changes take place 
in the blood-vessels, followed by high blood pressure. 
And finally, a weakened heart muscle breaks down 
under the strain. 
Let one who has such conditions more or less ad- 
vanced go to a banquet. Perhaps he is to speak. He 
eats more than usual, even for him. He rises to his 
feet, his face flushed-probably it is dark red-to 168 
THE COMMONSENSE OF HEALTH 
respond to a toast. Then, possibly before he has 
opened his lips, he falls. 
"Indigestion" is the general verdict. But chronic 
indiscretion would be nearer the truth, long continued 
and repeated indiscretions. What has occurred is only 
a climax. A stomach distended with food, and the 
excitement are the final overload upon a weak heart 
and hardening arteries. 
One may be a chronic overeater, although he eats 
sparingly, if he indulges his appetite for meat at the 
expense of vegetable food. The daily ration should 
consist of about one-tenth part meat, by weight. Any 
more is superfluous and much more is harmful. 
Conversely, those who habitually eat too much meat, 
are underfeeding, because they are denying themselves 
certain forms of food which are essential to the 
preservation of a healthy body. If any kind of food 
can be spared without resultant harm it is meat, but 
the well-balanced diet for the healthy person contains 
both meat and vegetables in proper proportion, the 
vegetarians notwithstanding. 
The general rules for rational eating may be 
summed up in the following dietetic decalogue: 
Eat when hungry. 
Most of us eat at least one meal a day for the sole 
reason that it is meal time and not because appetite 
leads us to the table. Omit a meal occasionally if you 
are indifferent to it. Hunger is necessary to perfect 
digestion and lack of hunger makes food a burden. 
Eat less than you have been accustomed to eat, 
especially less meat. 
Thus saith the Preacher, in Ecclesiastes: "Blessed EATING TO LIVE 
169 
art thou, O land . . . when thy princes eat in due 
season, for strength, and not for drunkenness I" 
Eat a variety. 
Here the case of an English physician may point 
the moral. Experimenting with himself in an endeavor 
to find out the minimum amount of food which would 
sustain life, for forty days he lived upon bread and 
water, then for a month upon sugar and water, and 
finally for three weeks upon bread, water and olive oil. 
He proved conclusively that he could exist for 
ninety-one days on bread, sugar, olive oil and water. 
But unfortunately for the experimenter, he died of 
scurvy very shortly afterward. It was not lack of 
bulk that caused death but lack of variety. A very 
small proportion of fresh vegetables and fruits would 
have saved him. 
Chew thoroughly^ but not excessively. 
Observe the golden mean between voracious bolting 
and protracted chewing; discriminate between the 
meats and starchy food in this respect. And by no 
means anxiously count the number of chews to a swal- 
low, or you may become morbid and introspective. 
Besides, the meal will lo^e all its zest. 
Eat plenty of bulk. 
That is, foods which are composed largely of cel- 
lulose, which is necessary to facilitate the onward and 
downward movement in the digestive canal. Among 
these may be mentioned lettuce, spinach, cucumbers, 
tomatoes, cabbage, radishes, onions, celery, asparagus 
and carrots. Skins of fruits, such as the apple and 
the grape, are good also if well chewed. 170 
THE COMMONSENSE OF HEALTH 
If the amount of waste which you are able to get in 
this diet is not sufficient to stimulate the lower bowel, 
take a tablespoonful of bran with your coarse oatmeal 
in the morning. 
Eat fruit. 
Both raw and cooked fruits are good for their 
laxative qualities. Drink fruit juices also between 
meals. Besides, the acid fruits and berries contain 
certain elements which cannot be obtained from other 
sources. This, of course, with the reservation that 
some people cannot take acid fruits, especially raw, 
with impunity. 
Drink water. 
Plenty of it, but mostly between meals and not when 
eating. Do not use water or milk or coffee or tea 
to wash down imperfectly masticated food. A reason- 
able amount of fluid taken with meals will not retard 
digestion, but will pass through the stomach without 
markedly diluting its contents. 
Avoid indigestible combinations. 
Eat sparingly if at all, of fried foods, pies and pas- 
tries. Starch will not digest easily if cooked with ani- 
mal fat. 
Don't forget the vitamines! 
A varied diet, which consists of fresh vegetables as 
well as meat will supply enough of them, but they are 
especially found in the whole grains. For this reason 
whole wheat flour and the old-fashioned coarse oat 
meal are valuable. EATING TO LIVE 
171 
Finally, eat happily. 
Nothing retards digestion more effectively than un- 
pleasant emotions. Everything pleasing to the senses 
is a help, but the greatest stimulus comes from a con- 
tented, happy mind and congenial companions. ELEVEN 
EXERCISE 
TOWARD the end of his long life Senator Evarts 
was once asked by a reporter to state by what 
rule or rules, habits or conditions he accounted for his 
longevity. His reply has been much quoted but prob- 
ably it was intended to be witty rather than a statement 
of the literal truth. It was to the effect that he had 
always avoided every avoidable physical exertion. 
Still, it was approximately true. There are many 
people like the senator, whose bodies are spare, and 
who live long because they have maintained a balance 
between demand and supply. They eat sparingly; 
hence they do not have to burn up the excess; and 
because their physical activities are slight they require 
no surplus nourishment. 
However, man is naturally an active animal and 
needs physical activities to keep in perfect health. Be- 
fore he became involved in the artificial conditions inci- 
dent to modern civilization man was the hewer of wood 
and drawer of water, the provider and defender. 
"Man" is used here in the generic sense. The fact 
is that women did most of the work, men being en- 
gaged in hunting and fighting. Which was a good 
thing for women. Like men, women are better off 
for a little work. Those of either sex who live in 
physical idleness become soft and flabby, less efficient 
mentally and physically. 
172 EXERCISE 
173 
Fewer people of each succeeding generation have 
activities which require muscular effort, because of ma- 
chinery, automobiles and telephones; and to more and 
more people work means effort from the collar button 
up. In consequence, physical exercise, which used to 
mean work, now has a different significance. And it 
has a variety of meanings also, depending upon age, 
sex and muscular development. To the child it means 
play; to young women, dancing, tennis, calisthenics; 
to young men, athletics; to those of middle age, a walk 
or golf. In an endeavor to keep fit some are compelled 
to resort to artificial methods, exercises which can be 
taken in ten or fifteen minutes daily, before or after 
hours of work. 
But whatever its significance to each individual, it 
is a fact that the vast majority of people get too little 
exercise. There is not time in these days of hustle 
and worry, and even when moments of leisure come 
most people are too tired to take advantage of them. 
Mental weight-lifting and long-distance running sap 
the vitality more thoroughly than hard physical labor, 
and so a book and an easy chair lure them away from 
the great outdoors, about which they like better to 
read than to see for themselves. They are content 
to romp through the pages of a swashbuckling romance 
or ride with the movie cow-punchers thousands of miles 
on the screen. Their thirst for adventure is satisfied 
by reading about the perils of the deep. And many 
of the male sex obtain quite sufficient exercise in watch- 
ing a wrestling match or even a game of billiards! 
Those who constitute this majority, the great un- 
exercised, for the most part belong to two groups. 
There are the thin ones, the sallow dyspeptics, who eat 
little and fuss much. They are thin because nervous 174 
THE COMMONSENSE OF HEALTH 
energy consumes tissue quite as fast as physical effort, 
and because those of nervous temperament are often 
dyspeptic. They view with disgust and alarm the ex- 
uberance and the gastronomic feats of others. They 
live long, many of them, because they take good care 
of themselves. A delicate stomach is often a blessing, 
and a robust appetite quite the opposite. 
The other group of the unexercised is the fat ones. 
A good appetite, an easy-going temperament, a certain 
amount of prosperity have brought about greater 
production than consumption. They eat more than 
time and opportunity permit them to burn up. 
Fatness and self-indulgence are reciprocal in effect, 
each begetting and fostering the other. This state- 
ment, if unqualified, may call forth indignant protests. 
So it must be said at once that there are exceptions. 
Some people are just naturally fat; no matter how little 
they eat they get fatter and fatter. They are the jolly, 
good-natured kind whom nothing worries, not even the 
sedentary life they lead. Nevertheless, there is no 
gainsaying that if these people worried more about 
their diet and about the lack of exercise, their tendency 
to corpulency would decrease. 
Fat is cheaper tissue than muscle. It is less complex 
in structure and is more easily manufactured. Also it 
requires less blood supply and is readily stored in places 
where the adjacent muscles are less used. Hence it 
accumulates in masses in and about the abdomen of 
sedentary persons. 
The body is a factory which takes in raw material, 
food, making it into tissue, a part of which it consumes 
in the production of energy. To get the best results 
there should be a continuous turnover. The product 
should be disposed of with reasonable celerity and the EXERCISE 
175 
plant kept running at an optimum speed. As with any 
factory, it is possible to run on half time, but it is not 
a method which promotes efficiency. 
The chief end to be attained by exercise should be 
not to make athletes but to increase the efficiency of the 
body and mind. The immediate result of physical ex- 
ercise is a quickening of the blood current. A brisk 
walk or a game of tennis or golf will send an increased 
blood supply through every organ and tissue of the 
body. Waste matter is taken up and thrown off 
rapidly; there is a general house cleaning which cannot 
be accomplished so thoroughly in any other way. A 
Turkish bath is a poor substitute, though it does dilate 
the capillaries and increase the activity of the sweat 
glands. 
But the blood stream not only carries off debris; it 
supplies nourishment to the tissues, and the result is 
growth. The one exception to this is that fat is not 
increased by exercise. Fat is merely fuel to be drawn 
upon in the production of energy; consequently it ac- 
cumulates during periods of idleness and is lessened 
by physical activity. 
Each time a muscle contracts some of its cells are 
consumed, but during the rest period the loss is more 
than supplied by the absorption of nourishment, and 
new muscle cells are formed. In this manner repeated 
use increases both the size and the number of the 
fibers. Repeated exercise also improves muscle tone 
and quality, thickens the sheathes which bind the 
bundles of fibers compactly together, and strengthens 
the tendons by which they are attached to the bony 
framework. 
This improvement occurs not only in voluntary 
muscles but in those over which the will has no direct 176 
THE COMMONSENSE OF HEALTH 
control, such as the heart. Just as the arm or leg 
muscles of the athlete grow with use, so will his heart. 
The heart of the Marathon runner is larger and 
stronger than that of the inactive person; in fact it 
is his heart which determines his success in the race. 
The capacity of the heart is increased as well as the 
thickness of its walls, and it is able to take in and 
pump out a greater volume of blood with each cycle of 
expansion and contraction. The lungs also expand. 
The volume of air which they are able to take in is 
greater. Exercise develops the air cells, enabling them 
to take in a greater amount of air and to throw off 
with greater facility the gases of combustion which 
the blood brings to them for that purpose. 
Brain tissue is destroyed in the production of 
thoughts in the same manner that muscle tissue is used 
to produce its form of energy, and the blood not only 
washes away accumulated waste but replaces the loss 
by building up new brain cells. Muscles contract in 
response to the will. No movement of the body is so 
simple that it requires the used of one muscle only; 
there must be coordination of several muscles to ac- 
complish the simplest act. The more complex the 
movements the more intelligent must be the mental 
concentration upon them. Tennis, golf, dancing, calis- 
thenics involve mental as well as physical training. 
Consequently continued practice brings to pass a 
greater mental efficiency. 
Why is an athlete able to perform a feat of strength 
or of endurance that would be impossible for one not 
so physically trained? The athlete has better muscles, 
of course, but that is not the only reason. The more 
muscle one has the less waste of tissue will result dur- 
ing the performance of an act of strength. But the EXERCISE 
177 
principal difference lies in the fact that training has 
brought about a better coordination of muscles, which 
permits the athlete easily to perform a feat that other- 
wise would be impossible. 
The better developed one is muscularly, the longer 
he is able to continue any form of physical exercise be- 
fore becoming tired. But exhaustion sooner or later 
will come to the athlete as well as to one who is un- 
trained. Fatigue is a manifestation of poisoning, due 
to saturation of the tissues with the products of com- 
bustion. As long as elimination equals production 
fatigue is postponed, but as the poisons accumulate in 
greater and greater quantity one becomes first tired, 
then exhausted. 
Any occupation will cause fatigue which requires 
long-continued action, however mild in character, with- 
out occasional intervals of rest. The saleswoman 
standing all day in the store becomes utterly exhausted. 
And yet on her way home a brisk walk will restore 
her energy to such a degree that she may be able to 
dance all evening. This paradoxical result is not 
purely mental. It has a real physiological basis. 
Feats of endurance are more profound in their ef- 
fects than those which entail intermittent efforts of 
strength. Standing is more tiring than walking, and a 
slow walk than a brisk one. To balance in an erect 
posture one must keep many muscles in almost continu- 
ous contraction. If these large trunk and leg muscles 
were to become paralyzed for a single instant one 
would fall to the ground in a heap. 
Why, then, does a brisk walk after standing all day 
relieve fatigue? Partly because there is increased 
heart action, and the poisons of fatigue are more 
quickly eliminated. But something else also helps the 178 
THE COMMONSENSE OF HEALTH 
circulation. When the large muscles of the limbs con- 
tract and relax they intermittently press upon the large 
veins which return the poisoned blood to the heart, 
whence it is pumped to the lungs to be cleansed. It 
is self-massage which restores strength and vigor even 
during physical exertion. 
In the same manner the poisons produced by in- 
tense mental concentration are washed away. The 
tired brain worker takes an afternoon off for golf or 
tennis, and comes home revived, invigorated in mind 
as well as in body. 
An instance of extreme physical exertion is the three- 
mile race, because it requires the utmost of effort and 
endurance combined. Let us see what occurs to the 
runner to cause exhaustion. At the beginning of the 
race there is little change. If the runner is in good 
condition his pulse will be slightly increased, his heart 
contractions will be stronger than when at rest, and the 
rate more rapid. His respirations will be fuller and 
deeper, but not much more frequent. Muscle contrac- 
tion, however, causes increased combustion. The ashes 
and gases are thrown into the blood in greater quantity 
than can be taken care of under ordinary conditions. 
Combustion produces carbon dioxide, and this gas, act- 
ing upon the nerve centers of the heart and lungs, 
causes the heart to beat faster and the respirations to 
increase in frequency. The blood flows in greater 
volume and with greater rapidity. The lungs expand 
in volume and more poison is thrown off in the breath. 
The capillaries of the skin dilate, the sweat glands are 
stimulated, and sweat also contains waste matter. 
And so for a time the equilibrium is kept up, the 
poisons being eliminated as fast as they are manu- 
factured. Thus the runner has been able to continue EXERCISE 
179 
without distress. A little later-perhaps during the 
second mile if the pace has been rapid-the runner 
must slow down or the poisons will accumulate in the 
blood and the tissues. He will show signs of distress, 
his breathing will be labored and difficult, and it will 
seem impossible for him to continue much longer. 
Then, about the end of the second mile, or two-thirds 
of the distance, there will come a change. The signs 
of distress will disappear and he will go on, make a 
final tremendous spurt of energy, and cross the line. 
To every trained athlete comes this phenomenon of 
second wind. Athletes hold themselves back until they 
get it; if they did not they could not finish. Two things 
occur to produce it-expansion of the lungs and dilata- 
tion of the heart. The air cells increase in size, allow- 
ing more air to enter with each inspiration, and the 
dilatation of the heart increases its capacity for work. 
In all contests calling for endurance at maximum effort 
the heart dilates. This increases the volume of blood 
which can be taken in and expelled, and, singularly 
enough, stretching adds to the strength of the muscle, 
increasing the heart's resiliency. If this dilatation is 
not excessive a few hours' rest will restore the heart 
to its former size. Heart murmurs resulting from 
dilatation are quite commonly found in athletes, but 
they rapidly disappear. The normal heart may resume 
its former size and tone after extreme dilatation, which 
is evidenced by a weak, thready pulse, blood spitting 
and all the symptoms of collapse. There is danger, 
however, that permanent injury may result in the very 
young or in those beyond athletic age. 
The runner who continues beyond his endurance 
shows exhaustion by his rapid and shallow breathing, 
quick, fluttering pulse, a feeling of constriction in the 180 
THE COMMONSENSE OF HEALTH 
chest and dizziness and throbbing in the head. His 
distress is manifest in every attitude and feature. The 
muscles of his face and neck, are tense, his countenance 
is pale and distorted, the mouth is wide open, the veins 
of the head and neck are swollen. All these symptoms 
gradually disappear after a brief rest as the poisons 
are eliminated. 
But the effects of too arduous exertion may last 
many months. In such a case there is chronic poison- 
ing, which affects the central nervous system also. An 
athlete who has trained too violently or too long 
becomes stale. He is chronically tired, unable to en- 
dure ordinary exertion, his tongue is coated, his diges- 
tion poor. He is cross and irritable. His body being 
saturated with poison his natural defenses are weak- 
ened, and he is more susceptible to infectious disease. 
Even wounds heal less readily. 
Man's natural predilection for physical activities is 
manifest at the earliest age. An infant a day or two 
old is able to hang suspended by its hands. This 
greater strength of the arm muscles as compared with 
those of the legs may or may not be proof of our 
ascent from a long line of ignoble forest ancestry, 
depending upon one's attitude toward the theory of 
evolution, but it does indicate that a child, weight 
for weight, is as strong as the average adult. 
Even a very young infant cannot keep still, and its 
activities should be encouraged. Muscle coordination 
is developed by use. The child instinctively kicks and 
pulls. It should have something to kick against, some- 
thing to grasp. There should be several hours daily of 
freedom from the restriction of clothes, on bed or 
floor. 
The fat placid baby may be not a bit healthier or EXERCISE 
181 
better able to withstand the conditions incident to in- 
fancy, than the thinner, more alert and active child. 
Mothers are inclined to judge children by weight alone, 
not realizing that an excess of fat may be as harmful 
to them as to their elders. 
The natural instinct for exercise should be encour- 
aged. Babies should be played with, in spite of the 
indignant protests of professional child nurses who 
prefer sluggish babies. They should be rolled over, 
picked up, allowed to grasp grown-up fingers; they 
should have something to kick against and something 
to pull. In this manner their physical training is begun 
at the earliest possible age. Properly done, a little 
playtime each day, there need be no fear of teaching 
them bad habits. Sluggishness and apathy are habits 
which may be acquired very early, and are difficult to 
overcome. 
The child loves to climb and this should be encour- 
aged. It will pull itself up by holding to the bars 
of the crib, and laugh with delight as it tumbles. Later 
will come more complex movements, picking up and 
throwing objects, standing and walking. Then there 
should be blocks for building, the sand pile for digging, 
and simple toys, all to accomplish not so much strength 
as muscle coordination, without which strength would 
be useless. 
At about the age of seven a child of either sex begins 
to manifest more diversified activities, as indicated by 
the change in games. No longer content with blocks 
and sand piles, with digging and cutting - tag, 
prisoner's base, hoop rolling, marbles, jacks and one- 
old-cat succeed the plays of infancy. 
Just at this time school breaks in upon their free- 
dom, to keep them indoors, inactive for several hours 182 
THE COMMONSENSE OF HEALTH 
a day. Usually they make up for these quiescent 
periods after school and on Saturdays. Modern school 
authorities recognize the need of children for exer- 
cise, and sessions are broken by short periods of drill 
and play. 
To the age of twelve there is little difference in the 
plays of boys and girls, except that girls early develop 
the mother instinct, as expressed by their love of dolls. 
From twelve years on, however, there is a wide diver- 
gence. Girls are hampered by the restrictions of 
clothes, and besides they cannot enter into competition 
with boys, having no inherited aptitude for throwing 
or striking. And they have no gang instinct. 
This is the savage age with boys. They associate in 
gangs which have a leader or chieftain. Now also 
come the more active sports-swimming, baseball, 
football, skating, basket ball and hockey. The average 
boy from twelve to eighteen has little need of any set 
form of calisthenics to promote his physical education. 
Girls also run, roll hoops and skip the rope during 
the early years of this period, but later their plays 
become more sedentary, and they should be supple- 
mented by class exercises and games. Dancing is an 
efficient form of exercise for both sexes. It develops 
muscle coordination which results in grace of move- 
ment. And by fixing the attention, bringing to bear the 
force of will upon the complicated actions of the body, 
it educates the mental faculties. This is especially 
true of aesthetic dances, in the performance of which 
the muscles of the arms and trunk are used, as well as 
those of the legs. 
From fifteen to eighteen years the average healthy 
boy usually possesses an ambition to become an athlete. 
Gymnasium and track training are begun at this time, EXERCISE 
183 
and are exceedingly useful; but these forms of exer- 
cise should be supplemented by calisthenics and games. 
Feats of endurance should be intelligently supervised, 
and broken by frequent periods of rest. In nearly all 
schools and gymnasiums each boy is given a physical 
examination before beginning training, and at stated 
periods during its progress. 
These examinations should be made by a physician 
who has a knowledge of athletics. Distance running 
and wrestling should not be permitted until after a boy 
has passed his eighteenth year, because of the dangers 
of overstrain and exhaustion. Though the heart nor- 
mally dilates during a long race, the immature heart is 
liable to extreme dilatation, from which recovery is 
slow and often never complete. In the latter case there 
results a permanent organic condition which will impair 
the boy's usefulness in after life and always remain a 
menace. The exhaustion caused by long-continued 
effort may last a long time. During this period a boy's 
vitality is reduced, mental efficiency lowered and de- 
fenses against disease broken down. 
After eighteen there is less danger from violent 
exertion. The more mature heart adapts itself to un- 
usual strain, and the ligaments about the joints are 
stronger, limiting the range of movement and lessen- 
ing the danger of joint injury. Another important 
factor is that the older boy has better judgment and 
will curb his ambition within the limits of his vitality. 
The needs of young people of both sexes are in the 
•direction of physical development, and for this reason 
a part of each day should be spent in the gymnasium. 
The ordinary games are too wasteful of time for the 
small amount of exertion required. Dr. R. Tait 
McKenzie, professor of physical education at the 184» 
THE COMMONSENSE OF HEALTH 
University of Pennsylvania, has estimated that during a 
nine-inning game of baseball an outfielder spends one- 
half of his time standing with his hands on his hips, 
three-eighths sitting on a bench, and the remaining 
one-eighth at bat, running bases and throwing the ball. 
For an expenditure of two hours or more he gets 
nothing but fresh air and a little exercise for his right 
arm and shoulder. 
Football is generally thought to be a rather violent 
form of sport. And yet, says Doctor McKenzie, "in 
one hour of football, the time occupied in actual play 
is about ten minutes, the rest of the time being spent in 
discussion, disentangling the team after a play, and in 
preparing for the next play, the exhaustion following 
a game being largely nervous." 
To most people whose daily duties do not require 
much physical activity, somewhere between thirty-five 
and fifty there comes the realization that youth is 
vanishing. The heralds of middle age are many. 
There may be a lessened appetite, increasing girth, 
sleeplessness, shortness of breath with fatigue on 
moderate exertion, and a gradually diminishing power 
of concentration. In one form or another, perhaps in 
several, these harbingers of age gradually force con- 
viction. 
Some are content to watch the approach of the 
autumnal season with the placidity born either of 
laziness or of a fatalistic philosophy. Winter is com- 
ing anyhow, think these latter; what matter a few 
years more or less? But not so with the majority, 
whom pride, if no higher motive, urges to look about 
for the cause and the remedy, and they are fortunate 
who find a cure in exercise. It is not a panacea, but if 
there is no organic disease it will go far to check the EXERCISE 
185 
speed of fleeting youth. It will make the thin fatter by 
increasing appetite and promoting digestion. In the 
stout it will burn up the superfluous fat, hasten the 
elimination of surplus food products which result from 
overeating; and it will add to mental and physical ef- 
ficiency. 
Though it is no less true that those who are thin 
need exercise as well as the fat ones, pride usually 
impels the latter to seek for a remedy much more in- 
sistently than the former, and to look forward appre- 
hensively to the time when they will not be able to see 
their feet. In this respect men are as much influenced 
as are women. 
Of the fat men many were once physically active, 
and some of them were athletes, but the old training 
days have long since passed, superseded by years of of- 
fice work. The former athlete who assumes the seden- 
tary life usually retains only one of his earlier habits, 
strenuous exercise with his teeth. Good appetite and 
perfect digestion in his case are by no means unmixed 
blessings, because he does not burn up the excess of 
fuel. 
When a man suddenly awakens to a realization that 
something must be done if he is to be kept out of the 
class of the obese he will follow one of several methods 
with that purpose in view. If he has been an athlete 
and there has not been too long an interval since his 
athletic days he may begin a course of systematic train- 
ing. If so he should realize that a man over forty 
cannot safely do the stunts of former years. Distance 
running, weight lifting, any form of violent exertion 
may cause permanent dilatation of the heart or the rup- 
ture of a blood vessel, most likely in the brain. He 
would better begin with the mildest form of activity, 186 
THE COMMONSENSE OF HEALTH 
increasing the time and effort involved gradually as his 
strength returns. 
If his spare time is limited he may take up a course 
of calisthenics at home, using the knowledge acquired 
in his youth or following instructions obtained from a 
correspondence school or an instructor. 
This tabloid form of exercise is all right provided 
he observes two precautions. The first one concerns 
limbering up. Recalling the feats of his youth he may 
attempt to make himself as supple at forty or more as 
he was at twenty. It cannot be done without danger 
of injury to the joints. Ligaments which bind the 
bones together at the joints grow tenser and less elastic 
with advancing years, and are liable to rupture when 
overstrained. It is a common occurrence for adults, 
both men and women, to tear one or more ligaments at 
the juncture of the spine with the pelvis, by bending 
too far forward while in a sitting posture. 
The other precaution has to do with respiration dur- 
ing exercise. The breathing should be easy, deep and 
regular. The practice of holding the breath in full 
inspiration while performing a vigorous movement a 
given number of times is extremely dangerous for those 
of middle age. 
The blood pressure of the person beyond forty is 
normally higher than in those who are younger. In- 
creased force of the heart contractions during exer- 
cise raises this normal pressure, and violent exertion 
may raise it beyond the safety point. If there is a 
weakened vessel wall, which more frequently occurs in 
the brain than elsewhere, it may rupture, and a hem- 
orrhage ensue. Such a condition is called apoplexy. 
• But if the man who decides to get back is wise he 
will take up golf, swimming, rowing; perhaps tennis, EXERCISE 
187 
if he is not too soft. He will take longer and longer 
walks in the country, and if he has opportunity he will 
work in the garden. 
The open air is the proper place to get rid of poisons 
in the tissues; a ten-minute exercise at home once a day 
is much better than no exercise at all, but it is a poor 
substitute for work or play outdoors. 
Two-thirds of the stout persons of mature years are 
women. They are more apt than men to grow fat, for 
several reasons, some of which have to do with en- 
vironment and some are incident to sex. After mar- 
riage many women drop all active pursuits except those 
within the home. Those who do their own housework 
and attend to their children have about as much exer- 
cise as they require. But to the woman with servants 
household duties are exasperating and harassing rather 
than arduous. 
Nature has given to woman a better digestive ap- 
paratus than to man, to enable her to nourish both 
herself and her child. In consequence the average 
woman obtains more nourishment from an equal 
amount of food. 
One day the woman who is growing stouter observes 
in the glass or in the tightness of her bands the start- 
ling fact. At once she thinks of diet, but it is only a 
passing thought to be translated into action at some 
future time. 
As the layers of fat pile up, pride dictates that they 
shall be concealed as long as possible. And so strings 
are pulled tighter and tighter in the desperate attempt. 
Constriction impedes the freedom of the lungs by 
pressing the abdominal contents up against them; con- 
sequently there is shortness of breath. Breathlessness 188 
THE COMMONSENSE OF HEALTH 
in turn lessens physical activity still further, because it 
is so difficult to get about. The result is more fat. 
Comparatively few women ever think seriously of 
exercise as an antidote. If they are sufficiently worried 
about themselves they try dieting. The trials are 
usually intermittent, however, because it is so hard to 
stick to a limited diet when one has a good appetite 
and good digestion. At best, even when followed 
with determination, dieting alone is a precarious 
method because it may be carried far. Many a woman 
has starved both her body and mind by insufficient 
nourishment, and has made herself receptive to the on- 
slaughts of disease. 
The best way to cure obesity is to avoid it. The 
wise mother will keep young with her children. She 
will walk, play running games, dance, swim, skate, ride, 
golf. However, the same precaution applies to her as 
to men, that all exercise should be begun with modera- 
tion, very gradually increasing as the education of her 
muscles progresses. 
There are two criteria by which the kind and amount 
of exertion should be regulated. One is fatigue. The 
tired feeling which results from muscular effort should 
never be painful. Rather it should be pleasant, a 
languor easily relieved by rest and followed by a sense 
of new strength and vigor. After long-continued 
effort the muscles ache, interfering with rest, and the 
lassitude may endure for days. The other criterion 
is shortness of breath. The heart must be strength- 
ened by patient training, because muscle grows only 
by repeated, gradually increasing efforts. 
The most successful cure for obesity is a combina- 
tion of exercise and diet. If one is getting fat men- 
tally as well as physically he would better get busy EXERCISE 
189 
with outdoor exercise and restrict his diet. The 
easiest method of dieting is to omit one meal a day. 
If a reduction in the total amount of food does not 
accomplish results certain fat-forming articles of diet 
should be restricted. These are the fats and the 
carbohydrates. Avoid or take sparingly of bread, 
milk, butter, fat meats, sugar, potatoes, rich puddings, 
pastry. One should especially eat less of anything of 
which one has been particularly fond and in the habit 
of eating to excess. 
The total amount of liquids taken in a day should 
not exceed three pints, unless there is free perspiration. 
But the quantity should not be reduced much below this 
maximum limit or the kidneys will not be able to per- 
form their work properly by excreting the solid waste 
matter in solution. 
In general, one should eat less than the appetite 
seems to demand. It is a well-known axiom that the 
vast majority of people eat much more than they 
require. One who wants to reduce must do one of two 
things, either take in less fuel or burn it up more 
rapidly by increasing his physical activity. The surest 
means is a combination of the two. 
Though much space in this article has been devoted 
to the effect of exercise upon fat, perhaps to the neglect 
of its more important and farther reaching benefits, 
these latter must not be forgotten. After all, health, 
bodily vigor, mental resiliency, buoyancy of spirits- 
these are the great results to be sought. Constant, 
unremitting work of any kind gradually dissipates 
them, and they can be restored only by a change of 
occupation. 
Whether one works with his brain or with his hands, 
at a desk or in the home, there is need of relaxation; 190 
THE COMMONSENSE OF HEALTH 
not rest, but exercise. And it should come at fre- 
quent regular intervals to be of the best service, to 
keep the machinery up to the highest state of efficiency. 
But do workmen need it? Watch a group of mill 
men during the noon hour playing ball or other games. 
They are resting the groups of muscles which are used 
when at work, and employing those which during work 
hours are at rest. Their brains also are stimulated by 
the exhilaration of the sport. And when the whistle 
blows they go back to their tasks refreshed. 
Very little has been set forth here with which the 
reader will disagree. Everyone believes in exercise, 
but the difficulty is to put the belief into practice. 
Perhaps the reader's attitude may be something like 
this: 
"Yes, that's all true enough. I wish I had the time, 
but I'm too busy. Ho, hum! I ate too much dinner 
to go for a walk. Next summer I think I'll go to the 
seashore for two weeks and lie round in the sun." 
And the next morning he or she will spend two hours 
trying to get started for the day. 
The truth is that the more one hates exercise the 
more one needs it. TWELVE 
HOW OLD ARE YOU ? 
THE number of years one has lived is not the sole 
standard by which his age should be judged. 
Some are old at forty and others are young at sixty- 
five or seventy. To the young forty seems old and 
sixty-five incredibly ancient. As the years increase age 
keeps receding, ever ahead, and the man of three score 
salutes his life long friend: "Hello, my boy!" 
One's age, then, is not altogether or essentially a 
matter of years. It depends much more on the state 
of the mind, and most of all on the condition of the 
body. Some people live much harder than others, with 
consequent greater wear and tear upon the machinery. 
And this wear and tear more frequently results from 
abuse than from legitimate use. If one is old at thirty- 
five or forty it is not to be expected that he will live 
appreciably longer than if he had already reached sixty- 
five. As far as concerns himself he might just as well 
be sixty-five if he does not change his method of living 
so as to delay the inevitable end. Age should be 
reckoned not by the length of time one has lived but 
by the years to come. 
The outward and visible signs of age are merely 
indications of what is going on within the body. Bald- 
ness is often an early sign, but it is a sign nevertheless, 
the evidence of impaired circulation in the scalp. Gray 
hair is another; and wrinkles, especially the folds in 
191 192 
THE COMMONSENSE OF HEALTH 
the neck that hang down from the lower jaw, caused 
by absorption of fat; and from the same cause, the 
thinning hands, the skin of which will remain pinched 
up momentarily after pressure has been removed. 
Subjectively there is a gradual lessening of the 
emotions-of joy, of the zest for adventure, of the 
passions; one by one their heights decrease in altitude. 
The appetite for food becomes less keen, and the desire 
for physical activity less insistent. 
But long before these signs appear changes have 
begun that are neither tangible nor visible until well 
advanced. Whether they are to progress with rapidity 
or to be retarded depends at least in part upon our- 
selves. 
Old age is unavoidable and its marks are indelible. 
If it came to all alike, relatively at the same time, 
there would be little use to write about it, and no use 
whatever to warn against it. But to some it comes pre- 
maturely, and of those to whom it comes with acceler- 
ated pace many could have postponed its advent if 
they had taken heed in earlier years. 
As one's years increase there is a gradual deteriora- 
tion of the organs and tissues, with lessening of func- 
tion. This is met by a compensatory slowing up of the 
machine, a restriction of the field of activities. These 
processes normally come on so slowly that the summer 
of life glides into autumn and autumn into winter and 
one does not perceive the transition. That is the 
normal approach of age. 
But senility, premature old age, is a different matter. 
It may be caused by bad habits, self-indulgence, pas- 
sions, greed of wealth or fame-everything which 
overtaxes the delicate parts of the machine. The 
immediate effect of this misuse is the manufacture of HOW OLD ARE YOU? 
193 
poisonous compounds within the body; and their con- 
tinuous manufacture results in chronic poisoning, de- 
struction of organs and decay. Seneca wrote: "Man 
does not die, but kills himself"; which would seem to 
indicate that the Romans were very much like our- 
selves. 
"A short life and a merry one," is a favorite proverb 
with those who believe in going the pace either along 
the highway toward fame or wealth, or through the 
byways of illicit pleasure. But sometime they will dis- 
cover that the short life is not a merry one; that the 
byways are only bright in spots; that even before their 
early termination there are more dense shadows than 
sunlight. Whether made merry by a mad pursuit of 
business or of pleasure, such a life toward the end is 
compassed about with infirmities. 
This is not to decry work in proper measure. Work 
and recreation are both beneficial, both contribute 
toward long life and, what is infinitely more important, 
toward contentment. It is the judicious mixture of 
the two, however, which benefits, and not utter absorp- 
tion in either to the exclusion of the other. 
Premature decay may begin anywhere in the body, 
but there are favorite sites where in the majority of 
cases it is first made evident. These are the blood 
vessels, the heart and the kidneys; not necessarily in 
that order of their occurrence. Changes may have 
been going on in the kidneys long before they are mani- 
fested by any symptoms, and the arteries are quite 
often affected before the heart. 
One may not have discovered anything wrong with 
himself until certain facts are brought out during a 
physical examination, perhaps for life insurance. 
Then,, if the circulation is at fault, it is usually indicated 194 
THE COMMONSENSE OF HEALTH 
by high blood pressure and hardening of the artery 
walls, frequently accompanied by signs of impaired 
kidney function. 
To say that one is as old as his arteries is to express 
a great truth-partially. Remembering that all the 
organs and tissues normally wear out as the years 
increase, and that any one or several of them may be 
broken down by misuse, one is as old as the weakest 
of them. Judged by this standard, how old are you? 
You may have a good digestion, but how about your 
arteries? You may be muscularly strong-are your 
kidneys normal? Your brain may be clear, your think- 
ing consecutive, your capacity for mental tasks as great 
as ever; but how have you treated the other parts of 
the machine? It is as strong only as its weakest vital 
part. 
Each part of this marvelous machine is so dependent 
upon all the others, and the general efficiency of the 
whole upon each and every part, that it would be diffi- 
cult to treat their use and misuse within the limits of 
a single article. And so we shall consider particularly 
the circulation. 
The circulation of the blood is brought about by two 
factors, a pump and a piping system. The latter is 
really an irrigation and a drainage system combined, 
with the added condition that the fluid must be pumped 
through the pipes with such force that it may return 
again to the pump. To accomplish this, much depends 
upon the condition of the pipes. 
Every artery, from the great main, the aorta, to the 
smallest arterial branches, has elastic walls made up 
of muscle and elastic fibers. With every wave caused 
by the expulsive contraction of the heart the vessels 
distend and after the impulse passes they resume their HOW OLD ARE YOU? 
195 
normal size. This expansion and contraction promotes 
the steady flow of the blood through the capillaries and 
its return to the heart by way of the veins. If the 
vessels were rigid the heart would have to exert more 
force with each contraction. 
No pump devised by man ever attained such 
efficiency as the heart, or such power of endurance. 
When one is at rest his heart contracts sixty to eighty 
times a minute, and physical exertion increases this rate 
by about one-half. During a large part of every 
twenty-four hours the healthy person is exercising in 
one way or another. 
Taking the average rate of heart contractions, at 
rest and at work, as eighty per minute, the heart con- 
tracts and expands in one year more than thirty million 
times; and in seventy years the total would be nearly 
three billions. No pulling of fires on Sundays; no 
stopping for rest and repairs, except for the fraction of 
a second at the moment after each expansion. There 
is need, then, that the circulation be unimpeded if dis- 
aster is to be averted. 
Two changes normally occur with advancing age- 
arteriosclerosis, or hardening of the artery walls, and 
increased blood pressure. The aged have more or 
less hardening of the arteries, and because of the 
lessened vascular elasticity the heart must contract 
with greater force. 
Within the vessel walls a gradual change ensues: 
the muscle and elastic fibers disappear, and inelastic 
fibrous tissue takes their place. This not only makes 
the vessels more rigid but lessens their caliber, thereby 
obstructing the circulation. Later, lime is deposited in 
the walls, and they become stiff and ringed, much re- 
sembling to touch a rubber hose bound with wire. 196 
THE COMMONSENSE OF HEALTH 
Blood pressure is a measure of the contractile force 
of the heart. It is high or low, depending in part 
upon the strength of the walls of the expelling cham- 
ber, the left ventricle; in part upon the needs of the 
circulation, the presence or absence of impediments; 
and in part upon the presence or absence of certain 
elements in the blood. Also, it is higher during exer- 
cise than at rest; it rises after a full meal, during the 
processes of digestion, and is increased by the use of 
tobacco and alcoholic drinks. 
Arteriosclerosis and high blood pressure are so 
frequently associated that it is often difficult to decide 
which preceded the other; continued high tension 
causes degenerative changes in the artery walls and 
rigid arteries increase the tension. But as the causes 
which produce them are essentially the same they may 
be considered together. 
Narrowing of the smaller conduit pipes eventually 
causes still further obstruction of the circulation by 
obliterating the capillaries. This is one of the easily 
observed phenomena of age. It is seen upon the sur- 
face of the body, especially the hands and face, in the 
pallor and looseness of the skin resulting from a 
lessened blood supply, and the disappearance of fat. 
Baldness is one of the first signs of this obliteration. 
But the process also occurs elsewhere, though not so 
evident. It may affect the heart muscles and in the 
kidneys it causes replacement of the normal glandular 
structure by fibrous tissue, diminishing their power to 
eliminate waste. This tremendous decrease in the 
footage of the piling system by obstructing the circula- 
tion necessitates more forcible contractions of the 
heart and raises the blood pressure. And so we have 
this vicious circle of three, any of which may be the HOW OLD ARE YOU? 
197 
origin, but all of them reacting each upon the others: 
High blood pressure, arteriosclerosis, chronic kidney 
disease; arteriosclerosis, high blood pressure-begin 
anywhere you choose and the two others, in all prob- 
ability, will be added unto you. 
The approach of premature decay is insidious be- 
cause the changes are slow. They have been under 
way for some time before there are either signs or 
symptoms, but these will inevitably appear, given the 
proper causes, in man or woman, in the stout or the 
lean. However, let us take a typical case, a business 
man somewhere between forty-five and sixty. He may 
have started life with no capital save that best of all 
heritages, a good constitution, but this capital he has 
spent lavishly in exchange for success. His one dissi- 
pation has been work and its handmaiden, worry. 
For purposes of illustration we might consider the 
case of the stout convivial man who has gone and is 
still going the social pace, or the woman of sedentary 
inclinations and habits of dietetic self-indulgence. The 
end is the same, though the minor changes may vary 
somewhat, so let us stick to our example. 
Such a man should be in his prime, his physical 
powers perhaps slightly limited, but his intellect clear 
and his capacity for work at its greatest. In fact he 
will take occasion to tell you that he is as good a man 
as he ever was, not realizing that this very assertion 
implies a doubt. He would not think it necessary to 
tell you that he is honest or that he loves his family. 
Well, perhaps he cannot climb a hill as well as he used 
to; he is a little short-winded, but that is because he has 
not had time to get enough exercise. Too busy at the 
office, too many important deals on to permit his wast- 
ing time with golf or tennis or country walks. Or so he 198 
THE COMMONSENSE OF HEALTH 
thinks. But the fact is that habits of work and worry 
have been formed and though now he could take the 
time he doesn't realize it. Business has absorbed all 
his thoughts not only during business hours but it has 
gone home with him and has been his companion during 
all his waking hours. 
For several years he has had an occasional slight 
attack of vertigo; merely a passing dizziness, which 
he attributed to his liver. For a year or two nothing 
more serious has occurred to attract attention, and the 
dizzy spells have become an old story. But the short- 
ness of breath still persists; in fact, it is getting worse. 
He puffs now after less exertion. And, another thing, 
come to think of it, occasionally he notices, especially 
after dinner, a throbbing in his chest or neck, syn- 
chronous with the beating of his heart. Still there is 
nothing-except business-to worry about. If he is 
getting fat he attributes these slight inconveniences to 
that condition and decides that some day he must take 
up golf. Or if he is lean, nervous and irritable, he 
thinks he needs medicine to aid digestion. 
As time goes on a new symptom obtrudes itself. 
Now and then on going into the cold air there is a 
tightness, a slight sense of constriction, in his chest. 
Several times he has felt it after running upstairs or 
for a train. If things would only let up at the office 
he really must get some exercise. This puffing and this 
tight feeling after slight exertion are annoying. Why, 
he remembers, at college - 
Later, one night after a big dinner preceded by a 
few cocktails, he is roused from sleep by a sense of 
suffocation. He is really alarmed for a time. He 
cannot get his breath; he gasps and wheezes, clutches 
at his throat; he runs to the window and grasps the sill HOW OLD ARE YOU? 
199 
with both hands, fighting desperately for air. In a 
short time relief comes with a loose cough, and he 
breathes more easily. But it was an ugly experience; 
indigestion, of course. He must watch himself at 
banquets. Those cocktails, especially the olives- 
Now of course it was the cocktails and the over- 
loaded stomach, but something else was behind it. 
Periodically for many years he has eaten and drunk 
too much. Why has retribution been so long delayed? 
Because now there is at least the beginning of a serious 
disturbance of the circulation which did not exist in his 
younger days. The attack is called, not altogether cor- 
rectly, cardiac asthma. It is compounded of high 
blood pressure, hardening arteries and faulty elimina- 
tion. The immediate cause was the presence of food 
poisons which his overtaxed kidneys had not been able 
to cast off so readily as when he was younger. 
If this man is not insensately foolish he will obtain 
medical advice and mend his ways. Suppose, however, 
that he does nothing of the kind, that he goes on eating 
and drinking as much as ever, and working as unre- 
mittingly. 
One day, after a good dinner followed by one or 
two of his favorite strong cigars, he is seized with a 
pain. Aud such a pain! It is a stabbing through the 
chest as by a sword thrust. It runs down his left arm 
and at the same time there is a tightness round the 
chest walls like the constriction of an iron band. He 
would scream if he could, but he cannot. Will he live 
to draw another full breath? Cold sweat is on his 
forehead, every muscle of his body tense, his face 
pallid, his pulse racing at an incredible speed. 
That is angina pectoris. The attack usually does 
not last longer than a few seconds, or at most a few 200 
THE COMMONSENSE OF HEALTH 
minutes, but it seems quite long enough to the sufferer. 
True angina pectoris is caused by starvation of the 
heart muscle from hardening of the arteries which 
nourish it. Fortunately there are many cases of 
pseudo-angina which resemble the real disease but 
which are not caused by so grave a condition. Exces- 
sive use of tobacco, for instance, may give rise to these 
attacks, and their recurrence will cease if smoking is 
discontinued. 
It would be unwise to discuss here the treatment of 
angina pectoris, because it is a condition which requires 
especial consideration of each individual case. The 
point to be emphasized, however, is that it lies at the 
end of the rdad along which our patient was journey- 
ing, and might have been avoided by a change of habits 
in earlier years. 
Suppose that instead of ignoring earlier symptoms 
he had sought competent advice when shortness of 
breath first attracted his notice or the first spells of 
dizziness. Even at that time there was high blood 
pressure and a slight rigidity of the artery walls, and 
also, perhaps, evidence of chronic kidney change. 
In such a case what would the doctor have advised? 
First, a complete change of habits. Less food, prob- 
ably an exclusive milk diet for a while, with complete 
rest in bed, followed by a much restricted diet without 
meat. Then meat only once daily, in small quantity, 
and gradually increasing activity. Absolute interdic- 
tion of alcoholic drinks forever, and the use of tobacco 
reduced to a minimum. Freedom from excitement and 
strong emotions of every kind, especially worry. Then, 
after going back to the office, a certain amount of time 
spent daily in exercise, to be increased very slowly HOW OLD ARE YOU? 
201 
as the muscles developed; also plenty of recreation in 
the open, but never any kind of violent exertion. 
But above all the doctor will counsel moderation in 
all things. If his patient obeys implicitly these instruc- 
tions he may hope with reason to improve and, what is 
most important, to check the progress of degenerative 
changes and to live out the time of his expectancy. 
Before taking up the causes of senile changes a com- 
paratively recent discovery of a cause of high blood 
pressure deserves attention. Sometimes high arterial 
tension is not associated with degeneration of the 
arterial walls, but nearly always in such cases there is 
chronic kidney disease. Once the theory was advanced 
that obliteration of the capillaries in the kidneys in 
itself raised the pressure, but that explanation was not 
satisfying. Later, attention was drawn to two little 
bodies, ductless glands, that lie one upon the surface 
of each kidney. They are called adrenals and the sub- 
stance which they secrete, adrenalin, when injected 
into the blood acts on the nerve centers, elevating the 
blood pressure. In some kidney conditions these 
glands are overactive. Emotions such as fright or 
great sorrow also cause an excess of adrenalin. 
This accounts in part for the high blood pressure of 
those of nervous temperament who for a long time 
have been under great mental strain. The other causa- 
tive element lies in the digestive tract. Worry is 
usually attended by indigestion, faulty assimilation and 
overproduction of waste. 
The harassing cares of modern business have the 
same effect as physical labor, producing waste in large 
abundance, but the sedentary life of the business man 
does not facilitate its elimination. Hence the irritating 
poisons remain in the blood and tissues, and can be 202 
THE COMMONSENSE OF HEALTH 
gotten rid of only by indulging in frequent periods of 
mental rest and agreeable physical occupations. Hard 
work of any kind, in proper dosage, never killed any- 
one. It is injurious only when it becomes a passion to 
the exclusion of everything else; then it takes the form 
of a dissipation as harmful as any other kind of self- 
indulgence. 
Someone has said that we dig our graves with our 
teeth, to indicate the potent force of diet in determin- 
ing longevity. Certainly nearly all of us eat much 
more than is necessary for our daily needs. What be- 
comes of this excess? Part of it is stored up as fat, 
to burden us with overweight. Part lies in the lower 
bowel to ferment, the poisons of putrescence being ab- 
sorbed. And the rest must be thrown off by the 
kidneys, which at best have all they can do as scaven- 
gers of the body. 
Meat in excess is especially harmful to the kidneys, 
because its end-products, manufactured in the process 
of digestion, irritate their delicate mechanism and 
long - continued overwork will destroy it. Meat 
products in the blood also change the nature of that 
fluid and increase the blood pressure. For these 
reasons meat as an article of diet is forbidden if one 
has a high blood pressure with or without hardening 
of the arteries. But even healthy persons should 
avoid much meat if they wish to avoid destructive 
changes. 
It may not be necessary to enlarge upon the effects 
of alcohol on the liver, the kidneys and the blood 
vessels as well as upon all other organs and tissues of 
the body, but it would be interesting to know just how 
many years it has taken off the average life of those 
who used it. There are other poisons not nearly so HOW OLD ARE YOU? 
203 
powerful but nevertheless sufficiently so to deserve a 
word of warning. Tobacco, in excess, raises the blood 
pressure, not only by its influence upon the nerve 
centers but by its direct effect upon the heart. When 
smoke is inhaled the nicotine gets into the circulation in 
the lungs, and is carried at once to the heart, with irri- 
tating effect. 
Even to the most hardened habitue excessive use is 
harmful, especially when accompanied by the inhala- 
tion of the smoke. The poison accumulated is in excess 
of the antidotes manufactured by the body, and among 
the evil effects is a raised blood pressure, which in turn 
brings the menace of degeneration of artery walls. 
Consequently the interdiction of tobacco is indicated 
when this process threatens. 
Constant excessive use of coffee and tea is also harm- 
ful, because they also contain alkaloids which act upon 
the nerve centers of the heart. 
Volumes and volumes have been written upon certain 
phases of the subject of health, especially about diet. 
The difficulty about most of these books is that their 
authors are enthusiasts, each one the champion of a 
special method or regime which has fitted his own case 
admirably but which may not be suitable for universal 
application. 
The immediate incentive to write this chapter came 
from reading a little book written by an old man who 
himself had long outlived his generation and who 
desired to help others by telling them what methods 
he had used to ward off early decay. There is noth- 
ing didactic, in his narrative, nothing complicated or 
difficult to follow. The first edition was published in 
Padua in 1558, when the author was ninety-one. It 
was called La Vita Sobria. All its precepts may be 204 
THE COMMONSENSE OF HEALTH 
summed up by that title, The Temperate Life, which is 
much better than that given to the English transla- 
tion, The Art of Living Long. 
Surely the testimony of one who has run a long race 
should be valuable to other runners, and for this 
reason this book of Cornaro's deserves consideration; 
in fact for five hundred years it has been a classic in 
Italy and has been translated into many languages. It 
is of especial interest because he began life handi- 
capped. One may say of some who have preserved 
their health and vigor to an incredible age that they 
had been better equipped than the average mortal at 
the beginning. But read the author concerning him- 
self : 
"Because I was born with a poor constitution I fear 
I shall not live much beyond a hundred years. Yet all 
those who are born delicate, like myself, would no 
doubt reach, in perfect health, the age of a hundred 
and more years, as I feel will be the case with me- 
were they to embrace the temperate life as I have 
done." 
Luigi Cornaro was born in Venice in 1467 and died 
in Padua in 1566. Inheriting a delicate constitution, it 
was his good fortune to discover before it was too late, 
and to adopt, a manner of life which so marvelously 
prolonged his years. And yet, though he confined him- 
self to a most rigid regime he did not attempt to force 
it upon others. He recognizes that each one must dis- 
cover for himself just what particular articles of diet 
and what amounts of exercise, work and recreation are 
suitable to his needs. In substantiation of this truth 
he quotes an ancient proverb: "A man cannot be a 
perfect physician save of himself alone." HOW OLD ARE YOU? 
205 
He limited his own diet to the least amount of food 
possible to sustain active life. For many years it con- 
sisted of soup, bread, the yolk of an egg; in all, but 
twelve ounces of solids daily, and fourteen ounces of 
a light wine. But he did not recommend this diet to 
others. 
"However, those persons who are blessed with 
strong constitutions may make use of many other kinds 
and qualities of food and drink and partake of them 
in greater quantities than I do; so that even though 
the life they follow be the temperate one it need not 
be as strict as mine, but much freer." 
In other words, no particular diet is applicable to 
all. Moderation is the essential requisite; to eat less 
than one's appetite seems to demand, and to stick tena- 
ciously to this self-made rule in spite of the temptation 
to eat more, in spite of the importunities of well-mean- 
ing relatives and friends. 
Once Cornaro himself weakened in this regard. 
When he was seventy-eight his family conspired to per- 
suade him that he was not eating enough for one of his 
age, and the doctors added their arguments. He pro- 
tested that he had lived and thrived on that amount 
of food for many years. 
"I maintained, furthermore, that it was in harmony 
with reason that as my age increased and my strength 
lessened I should diminish rather than increase my 
quantity of food. This was true; since the digestive 
powers of the stomach were also growing weaker in 
the same proportion as my vigor became impaired. 
To strengthen my argument I quoted: 'Whosoever 
wishes to eat much must eat little'-which means 
simply that the eating of little lengthens a man's life 206 
THE COMMONSENSE OF HEALTH 
and by living a long time he is enabled to eat a great 
deal." 
The wise old man understood better than his doc- 
tors or his friends the application to himself of the law 
of supply and demand. Nevertheless their arguments 
prevailed, and he yielded. To please them he added 
to his diet by taking two ounces more of food per 
day I Whereat he became sick, and they all thought 
he would die. Then, having proved his point at great 
inconvenience to himself, he went back to the original 
daily allowance, and lived twenty or more years longer. 
But Cornaro did not rely solely upon a restricted 
diet. He observed moderation also in other direc- 
tions. "I have also preserved myself, as far as I have 
been able, from those other disorders from which it 
is more difficult to be exempt; I mean melancholy, 
hatred and other passions of the soul, which all appear 
greatly to affect the body." 
He knew nothing of the poisons created by anxiety, 
and anger or by intense, unrelieved mental strain; 
nothing of the ptomaines resulting from the fermen- 
tation of excess food; nothing of blood corpuscles or 
germs. And yet his Temperate Life contains the very 
heart of the whole matter. He lived a life of activity 
in the fresh air, ate only what his body required, and 
kept his mind tranquil. Two words contain the whole 
of his gospel-temperance and tranquillity. 
Is it worth while? Not if age implied merely weari- 
ness of body, racking pains, stupor of mind; in a word, 
infirmities. But if it means quite the opposite, it is 
very much worth while. A certain broad philosophy 
comes with vigorous old age, a calm but vivid interest 
in people and events, a better perspective. 
"And who would not enjoy life at an age when it is HOW OLD ARE YOU? 
207 
free from the innumerable miseries by which we all 
know the younger ages are afflicted I" Cornaro wrote 
that with his own hand at the age of ninety-one, eight 
years before he passed away like one who sinks into a 
calm and peaceful sleep. 
The sooner one realizes how much the sum of his 
remaining years can be shortened or lengthened by his 
own conduct, the greater that sum is likely to be. And 
so the question with which this article began perhaps 
would better be stated differently-not How old are 
you? but How old will you be at thirty, at fifty, or at 
sixty? For to repeat what was said at the beginning: 
One's age should be reckoned by the number of years 
which are to come. THIRTEEN 
HOW HARD SHOULD WE WORK? 
THERE are times when everything we do is easy, 
and we accomplish an incredible amount without 
becoming tired. We are full of energy, nothing 
troubles us, and we are happy in the consciousness of 
work well done. Again, there are days when nothing 
goes right, and difficulties which ordinarily would be 
insignificant seem almost insurmountable. At such 
times we look foward with longing to the time when 
we shall not have to work at all, when we shall have 
laid aside enough money so that we can loaf to our 
hearts' content. Nothing to do, no responsibilities, 
life will be very much like heaven as the old Sunday- 
school songs describe it. But as long as things are 
going well that kind of life, of beatific banality, either 
here or hereafter, has little attraction for us. 
Whether we wish to or not, most of us have to work. 
Some of us do too little, and a few, a very few, do too 
much. How can we know how hard we should work? 
It is not a simple matter, for which a standard can be 
set, because people have different capabilities and dif- 
ferent powers of endurance. To one person a certain 
task may be easy while to another it would be the 
hardest kind of labor. In fact, both to work and to 
labor have, each, two different meanings. The dic- 
tionary says: 
Work, v. To make effort to attain anything; to be 
occupied in business or labor; to strain or labor. 
208 HOW HARD SHOULD WE WORK? 
209 
Labor, v. To work; to take pains; to be oppressed; 
to move slowly. 
Both work and labor may be pleasant or unpleasant, 
healthful or harmful, depending upon various factors: 
upon our interest in what we are doing and the 
pleasure we get out of it. Also upon whether we are 
accomplishing anything; because interest and pleasure 
are enhanced by achievement. And finally upon the 
presence or absence of other distractions which tend to 
pull us away from our task, to cause us to strain and 
labor. 
An instance of such a distraction is occurring at the 
very moment of writing this chapter. It is a gala day 
outside. The city is dressed with flags and bunting. 
Bands are playing and the crowds are cheering. Down 
on the street a great parade is going by, soldier and 
civilian organizations; nearly everybody is either 
marching or on the side lines as a spectator. Distrac- 
tion everywhere. Writing at this time is not only to 
work but it is to labor, to move slowly, to be oppressed. 
Any kind of work, physical or mental, pleasant or 
unpleasant, causes fatigue; and to be tired afterward 
is perfectly normal, even to be very tired if the languor 
and lassitude disappear after an interval of rest or a 
change of occupation. It is only when the uncomfort- 
able sensations persist from day to day, when one 
awakens tired and goes to work spiritless in spite of a 
night's sleep, that one may be said to have something 
wrong with him. 
Overwork usually means one of two things-either 
too long continued effort or effort misdirected. Hard 
work of itself never injured anyone when taken in 
proper doses. The fatigue which comes with it can be 
overcome and one's natural buoyancy restored. Physi- 210 
THE COMMONSENSE OF HEALTH 
cal work and mental work are analogous in their pro- 
cesses and in their effects upon the body. Both are 
forms of physical activity, one expressing itself in the 
movements of muscles and the other having its princi- 
pal seat in the brain. Thoughts are just as much a 
form of energy as are muscular contractions. In the 
production of both, tissues are consumed and waste 
products formed. It is the accumulation of these ashes 
and gases of combustion which causes all the symptoms 
of fatigue. That it is very largely a matter of chem- 
istry has been proved many times. Scientists have in- 
troduced a small quantity of the blood of an exhausted 
animal into the circulation of one that was perfectly 
fresh, and have reproduced the languor and exhaustion 
in the fresh animal. 
The two most important chemical compounds 
formed are carbon dioxide, a gas that remains in the 
tissues until carried off by the red blood corpuscles to 
be eliminated, and lactic acid. Tired muscle contains 
an excess of lactic acid. Injecting a dilution of this 
acid into a healthy muscle will weaken its contractions, 
and a larger amount will stop them altogether. The 
presumption is that it has a similar inhibiting action 
upon the brain. Not until the excretory organs have 
removed the excess of these waste products is the 
normal condition restored. 
If one is constantly tired, not lazy or indolent but 
actually tired, it is because his production of these 
poisons exceeds his power to get rid of them. But 
one may become fatigued if he overuses certain muscles 
only, while other groups are passive; and also if he 
uses certain brain centers alone while the others remain 
idle. For this reason rest may be brought about by 
changing the direction of one's energy. Brain workers HOW HARD SHOULD WE WORK? 
211 
often achieve it merely by directing their thoughts into 
other channels, by taking up another kind of mental 
activity; and athletes avoid fatigue by changing the 
form of exercise. The man in training works a while 
with the wall machine, punches the bag a few minutes, 
uses the parallel bars, wrestles, and finally walks or 
runs a mile or two in the open air. For the same 
reason mechanics play games during lunch hour. All 
morning they have been using certain muscles and at 
noon these are rested while those which have been dor- 
mant are active. The best way to rest by change of 
occupation is to make the change complete. If the 
brain is tired, physical exercise is the best antidote. 
It quickens the movement of the blood stream, in- 
creases the capacity of the lungs, stimulates the activity 
of the sweat glands and kidneys and, what is of equal 
importance, it directs the mind toward a pleasurable 
occupation. 
The pleasure we get out of a job has a great deal to 
do with its effect upon us. Interesting work is not 
nearly so tiring as that which is uninteresting. This is 
largely because it is easier to fix one's attention upon 
the former and almost impossible to keep the mind 
upon anything disagreeable. 
No matter how simple a task may be, a certain 
amount of brain work is required for its performance. 
There is no purely physical effort which does not neces- 
sitate the use of more than one muscle. Usually 
many groups of muscles are brought into play and their 
coordinate movements are affected through the brain 
centers. The more complicated the movements the 
harder it is to learn the coordination necessary to per- 
form them properly. Learning to play the piano is an 
instance of this difficulty. It cannot be accomplished 212 
THE COMMONSENSE OF HEALTH 
until long and laborious practice has finally made well- 
worn paths between the various nerve centers in the 
brain. Later the movements become almost auto- 
matic, but for a long time each separate act is accom- 
plished only by fixing attention upon it. And attention 
cannot be held long without fatigue, especially if there 
is no pleasure in the thing itself. It is almost impos- 
sible to learn anything very complicated if one gets no 
pleasure out of it or can see no reason for learning it. 
One who has no interest in what he is doing very 
quickly becomes tired. It is a well-known fact that 
prisoners have an exceedingly limited capacity for work 
on this account, and if they are forced beyond their 
very meager limitations they soon begin to show signs 
of exhaustion. 
A boy will play hard all day at the most strenuous 
games, but if he is put to sawing wood his powers of 
endurance are soon dissipated unless he has an incen- 
tive, a reward of some kind to which to look forward 
when his work is done. If he knows that he will get 
money with which to buy a ball or bat, or to add to his 
fund for a football outfit, the knowledge will add tre- 
mendously to his vitality. If he realizes that he can go 
swimming or play with the fellows after he is through, 
his celerity and eagerness to work will be almost 
alarming. 
We are inclined to be somewhat cynical regarding 
this characteristic of the young, but we grown-ups have 
it as well. The difference lies merely in the fact that 
the ends we desire to achieve are usually more remote. 
In our case they are power, recognition, wealth and the 
ultimate chance to do what we please, while children 
look but a few hours ahead. 
One thing that lessens interest is monotony, having HOW HARD SHOULD WE WORK? 
213 
to do the same thing day after day in exactly the same 
way. Whether they are mechanical or mental, such 
occupations eventually produce torpor, stagnation, lack 
of ambition and incentive. The bookkeeper or bank 
•clerk, the mother of a large family who is constantly 
occupied with house work and the care of her children, 
the man at a machine, the shopgirl doing piecework- 
all of them must have resources within themselves. 
All of them must have an occasional change, something 
else than their work to look forward to, or they are in 
danger of becoming mere automatons. Their intel- 
lectual centers will become atrophied and the lower 
centers over-developed; after a while they will be 
utterly unfit for any other kind of work than that which 
they have so long been doing. Even in that particular 
work their efficiency will gradually lessen and fatigue 
will appear from slighter causes. 
Another cause of fatigue lies in the emotional 
sphere. Everyone has noticed how little he can do 
when he is worried, without becoming tired. We 
worry when things are going badly, when our purposes 
are being frustrated or their ends delayed. For in- 
stance, you have a certain amount of work which must 
be done in a given time. In order to accomplish this 
you must give it your closest attention, the greatest 
mental concentration. You go to the office, confident 
that you will get through with it. Then there come 
interruptions and distractions. Someone comes to see 
you on business that could easily be postponed, but you 
do not like to offend him; it would not be politic. A 
friend from a distance drops in to chat because he hap- 
pens to be passing through the city. You like him and 
would be glad to see him if you were not busy. Half 
a dozen unnecessary telephone calls break into your 214 
THE COMMONSENSE OF HEALTH 
morning. Still you struggle on, because you are getting 
further and further behind your schedule. Finally a 
subordinate comes in timidly to say that he is sorry to 
interrupt, but-and tells you about something wrong 
with the business. 
You go home that night with nerves on edge, exas- 
perated, utterly worn out. The chances are that you 
will sleep badly and awaken tired. 
Our work may be harassing for other reasons also, 
reasons that exist within ourselves. If we have not 
learned just how to do a thing, if we lack skill, we make 
many false moves and we suffer from lost motion and 
exasperating delays. 
Or we have habituated ourselves to attend to small 
details that should be delegated to others. The per- 
formance of these unnecessary acts not only consumes 
a certain amount of energy in itself but retards the 
progress of larger, more important enterprises. Some 
business men need an efficiency engineer more than they 
need medical advice. 
A friend put his finger on the trouble of a very ner- 
vous business man recently when he said: "You waste 
a lot of time in answering the telephone. Why don't, 
you let other people do that? You've had five calls in 
the past half hour, and only one was of the slightest 
importance." Did his remark have any effect? Prob- 
ably not, because a habit of long growth cannot easily 
be changed. 
A third element in fatigue production has to do with 
physical conditions about us, in office or shop or store; 
chiefly bad air and bad light. Of these much has been 
said in previous chapters and it will suffice merely to 
emphasize that by their effect upon the health they 
lessen endurance. HOW HARD SHOULD WE WORK? 
215 
But no matter how much interest we have in our 
work or in the ends to be achieved, no matter how many 
different things we are doing or how much pleasure 
we get out of doing them, after prolonged application 
we become fatigued. Attention lags, efficiency is 
lowered, and a night's rest does not restore them; or at 
least they do not last throughout the day. Then it is 
time to take a rest, and the sooner we get it the better. 
The longer it is postponed the more time will be re- 
quired to recover the old resiliency of mind and spirit. 
If we go on working in spite of growing languor and 
lassitude sooner or later we shall become stale. The 
athlete knows what staleness is, and he knows that the 
only thing to do is to stop all training for an indefinite 
period. Staleness comes to the brain worker as well as 
to the athlete, and its manifestations are quite similar. 
The symptoms of chronic fatigue are more than a 
mere tiredness that remains day and night. They are 
various in character and variously located; chiefly in 
the head, the muscles, the digestive organs. Nearly 
always there are loss of appetite, coated tongue, slug- 
gish digestion; the muscles may be sore, there may be 
pains and uncomfortable sensations in different parts of 
the body; also frequent or continuous headache and 
often confusion of mind, inability to think consecu- 
tively. It takes considerable time and persistence to 
become stale. And recovery usually takes at least as 
long. 
The final breaking point can be avoided, however, 
if heed is given to an early warning, the gradually les- 
sening ability to work. The symptoms develop very 
insidiously. At first the change is scarcely noticeable, 
merely a slowing up. There may be occasional spurts 
of speed, but they do not last, the reaction comes 216 
THE COMMONSENSE OF HEALTH 
quickly, the tired feeling grows more pronounced and 
lasts longer. Later it is present almost all the time. 
And finally, if we ignore the warning, there are other 
signs; ambition is lost, and mental alertness; no spur, 
no incentive can bring back the old efficiency. 
Then it is certainly time to stop whatever we are do- 
ing and rest long enough to restore health and vigor, 
no matter how long it may take. To one already tired 
even very slight additional work increases the fatigue 
out of all proportion. No good can be accomplished 
by attempting to go on, because by doing so the break- 
ing point will be advanced rather than retarded, and 
when it comes the wreckage will be more complete. 
One reason for this is that anything attempted when 
in a state of chronic fatigue is much more difficult of 
accomplishment. We struggle against this inability to 
do what we have formerly done easily, and the con- 
stant struggle adds tremendously to our handicap. 
Adverse emotions are awakened, worry, irritability, 
anxiety, exasperation; all of which are as harmful as 
their antitheses, pleasure and interest, are stimulating. 
In fact, the emotions have more to do with produc- 
ing excessive fatigue than all other causes combined. 
When work is congenial one can stand an almost un- 
limited amount of it and remain normal. But in times 
of storm and stress, when new and unexpected difficul- 
ties arise, they are apt to cause an unsettled state of 
mind. This in turn reacts upon the physical condition, 
the earliest evidences of which are languor, impaired 
digestion and disturbed sleep or a deep sleep resembling 
the stupor produced by a narcotic, from which one 
awakens unrefreshed. 
The question of overwork, then, is not so much a 
matter of how much we are doing as how well we are HOW HARD SHOULD WE WORK? 
217 
doing it. It may be that we are attempting something 
beyond our powers and therefore futilely. Perhaps, 
because of unsettled nerves, we are taking things too 
hard, worrying unnecessarily, and getting nowhere. 
Or there may be an underlying physical cause which 
should be remedied. And, finally, perhaps we are try- 
ing to do the wrong kind of work, for which either we 
are not suited or in which we have no interest. 
As with every other abnormal condition the effects 
of excessive fatigue are much more easily prevented 
than cured. Getting rid of them is a slow process, but 
prevention is rather a simple matter. It requires the 
application of certain common-sense principles the 
adoption of which makes for greater happiness and 
also for greater efficiency. The chief requirement is 
the substitution of certain good habits for harmful 
habits. 
Harmful habits are not always vicious. They may 
have been acquired through ignorance or indolence 
rather than because of willful neglect. But however 
acquired they are difficult to throw off. 
Here is the law of habit formation: "Every time we 
perform a certain action, either mental or physical, or 
allow ourselves to be affected in any way, we have more 
proneness to, and greater facility in, the performance 
of that action or in experiencing that affection under 
similar circumstances than we had before.'' 
The ease with which our ordinary habits are formed 
has been illustrated by the following: A man moves 
into a new neighborhood. His new home is in the 
middle of the block. The first morning on the way to 
the street car on the next parallel street he has the 
choice of going to the corner of either cross street, the 
distances being exactly the same. On a sudden im- 218 
THE COMMONSENSE OF HEALTH 
pulse, perhaps without having made any conscious 
choice, he turns to the right instead of the left. The 
next morning it is easier for him to turn to the right, 
and thereafter he will always go in that direction unless 
he determines otherwise and consciously directs his 
footsteps toward the left. 
Children learning to speak or walk and later to play 
games, or older persons learning a complicated task, 
find difficulty at first. Later, habit shortens the routes 
between the brain centers. We do an accustomed thing 
automatically without wasting so much nervous energy 
upon it. In other words, habit makes movements ex- 
act, or, as the psychologists say, it "sets" them and 
lessens fatigue. 
After we have learned by the shortened or automa- 
tic method, in order to perform a complicated act we 
have only to will to do it and let the mechanism do the 
rest. Driving an automobile is a good example. 
While learning we worry and fuss and make many false 
moves. Greater ease comes with practice and finally 
we become expert, we can drive just as we walk, with- 
out thinking about it. When the car skids we right it. 
Then perhaps someone asks: "How did you do that?" 
We cannot tell how we did it. The various compli- 
cated things we did to stop the skidding had been 
learned gradually, had become automatic, and we can- 
not give them in sequence without much more thought 
than was required to perform the act. If we had to 
wait to think how to avoid danger there would be an 
infinitely greater number of accidents. 
The comparatively simple act of walking requires so 
many muscular movements that if we attempted to tell 
how we walked down street we should become as 
confused as the centipede: HOW HARD SHOULD WE WORK? 
219 
The centipede was happy quite 
Until the toad in fun 
Said? "Pray, which leg comes after which 
When you begin to run?" 
This wrought his mind to such a pitch 
He lay distracted in a ditch, 
Uncertain how 'twas done. 
Habits may be our very best friends or our most 
treacherous enemies. They govern everything we do_. 
We can determine which we shall have by beginning 
early to form the right kind. Professor William 
James says: "Could the young but realize how soon 
they will become bundles of habits they would give 
more heed to their conduct while in the plastic state. 
We are spinning our own fates, good or evil, never to 
be undone. Every smallest stroke of virtue or of vice 
leaves its never-so-little scar. The drunken Rip Van 
Winkle in Jefferson's play excuses himself for every 
fresh dereliction by saying 'I won't count this time 1' 
Well, he may not count it and a kind Heaven may not 
count it, but it is being counted, nevertheless. Down 
among his nerve cells and fibers the molecules are 
counting it, registering and storing it up to be used 
against him when the next temptation comes. Nothing 
that we ever do is, in strict scientific literalness, wiped 
out." 
He means that the effects cannot be wiped out, not 
that we can never eradicate a habit. If habits were 
fixed and unchangeable it would be useless ever to give 
advice to another or to attempt to change one's own 
conduct in the slightest degree. A habit, however, can 
be wiped out only in one way, by the substitution of its 
opposite habit. We cannot get rid of indolence, for 220 
THE COMMONSENSE OF HEALTH 
instance, by saying, "Now I am not going to be in- 
dolent any longer." We must gradually replace it by 
cultivating mental alertness and physical activity. 
Everything we do which affects injuriously our men- 
tal or physical health makes work harder because it 
lessens efficiency; inefficiency causes worry, and worry 
conduces to ill health-a vicious circle, out of which 
there is no way except by a change of habits. 
The rules of health are in the main really quite 
simple and obvious. But obvious truths are so often 
ignored that they require much repetition, and for this 
reason a few suggestions concerning mental and physi- 
cal hygiene may be of use. 
If good work is dependent upon good health it is 
better to keep the body as nearly up to par as possible 
than to wait until the damage has been done. Many 
go on as long as possible doing things that they know 
to be wrong, trusting to luck or to an inherited good 
constitution, or at most hoping that at some future day 
they will have time to take care of themselves. Just 
now they are too busy, but then they will have nothing 
to do but look after their health. If that day ever 
comes the chances are that they will have no health 
to look after. A little present attention to such mat- 
ters will avoid future trouble. 
One of the most persistent of small habits is that 
of taking too little exercise. A man who has worked 
in an office all his life is possessed of the idea that the 
business cannot go on without him for a moment. 
Granting the truth of this in some cases, it must be con- 
ceded that there is time before and after hours that 
can be used to advantage. 
The first hygienic rule, then, is exercise-a little 
every day, don't lump it all once a week. Walk to the HOW HARD SHOULD WE WORK? 
221 
office in the morning, or at least part of the way. 
There isn't time? Get up half an hour earlier. This 
implies going to bed that much sooner the night before, 
because sleep is essential. Of course exercise is recom- 
mended to those whose occupations are more or less 
sedentary. Those who work at manual labor need a 
complete change of activity, which would better take 
the form of mental diversion. 
If one sits at a desk all day a single dose of exercise 
every week or so will no more suffice than a single meal 
followed by a prolonged fast. A brisk walk before 
taking up the business of the day clears the brain and 
speeds up thought. Most of us confuse hard thinking 
with clear thinking, but the former by no means always 
implies the latter. 
Walk part of the way home after office hours. Or 
if the season permits take to an outdoor game rather 
than to an easy-chair. Adopt a hobby; which is to say, 
get a good habit as a substitute for the old one of in- 
dolence. A hobby implies something interesting to do, 
something in which the interest carries over from day 
to day and grows by cultivation. A man may buy a 
farm, not because he expects to make a living by farm- 
ing but because of the outdoor occupation it supplies 
for his leisure time and the pleasure he derives in 
watching things grow. In this case a farm is a valuable 
asset even though most of the bookkeeping be on the 
wrong side of the ledger. 
Comparatively few are financially able to take up 
farming as a diversion. Those who have a small plot 
of ground at home are not badly off if they use a part 
of it for a kitchen garden. If the garden is worked 
assiduously the crop will be more than peas, beans and 
radishes. 222 
THE COMAIONSENSE OF HEALTH 
If you put into the ground sufficient sweat, you will 
get out of it for your personal use a large amount of 
health and efficiency. And somewhere in the garden 
you will lose your brain fag. 
There are many healthful forms of exercise, and 
the choice must depend upon the opportunity of each 
individual; but the essential thing is to get it regularly 
and as often as you can. If you live in a big city there 
are gymnasiums and bowling clubs and swimming pools. 
The only difficulty about availing oneself of these 
diversions is in the beginning. It is hard to start, but 
in a very short time a good habit is formed and there 
is no trouble keeping it up. 
The next rule of health is-don't take business 
home; leave it at the office. This can be done in spite 
of many opinions to the contrary. Especially, don't 
take worries home, because they grow when carefully 
tended. Very often a difficulty which seems great at 
close of office hours will shrink if left alone, because 
the next day it is attacked by a rested mind. Another 
reason for this rule is that worry lessens the appetite 
and retards digestion. One way of getting rid of 
fatigue is by supplying food, properly digested, to take 
the place of tissue that has been used up in the day's 
activities. 
Worry also interferes with sleep. The exhaustion 
which we think comes from legitimate work is often 
due to disturbed sleep, brought about by lack of exer- 
cise, indigestion and the habit of making bedfellows 
of our worries. 
Worry and the habit of haste are more potent 
causes of digestive disturbances than the kind of food 
we eat. Imperfect mastication is a fault common to a 
very great majority of people. We rush through HOW HARD SHOULD WE WORK? 
223 
breakfast in our hurry to get to the office, we rush 
through lunch in our haste to get back to work, rush 
through the afternoon, rush home, and do not know 
how to slow down when we get there. Cultivate the 
habit of eating slowly. Gladstone achieved it by 
fixing the number of chews to each bite, thirty-two. 
This was purely arbitrary, but it was his method of 
obtaining the desired result. 
All the other rules of health are just as simple, just 
as obvious, and by most of us just as little observed. 
They have to do with states of mind as well as with 
purely physical conditions, because of the intimate 
relation between the mind and the body. 
Take the habit of pessimism, for instance. If the 
body is out of sorts one becomes pessimistic. Many 
dyspeptics excuse their crabbedness and irritability on 
the ground that they are not well. But often the be- 
ginning of a physical disorder is a state of mind. One 
who suffers from melancholia almost invariably has a 
coated tongue and other signs of digestive disturbance. 
Mental habits are even harder to overcome than 
those which are purely physical. But, as with the 
latter, the former may be conquered by the law of 
habit, which is the law of contraries. They can be sup- 
planted by their opposites-pessimism by optimism, 
irritability by placidity. Happiness is one of the 
corner stones of good health, and so is contentment. 
Without them neither physical nor mental efficiency 
attains its maximum. 
No matter how congenial our work may be and how 
efficient we are, somewhere in the minds of all of us 
lurks the ambition to have nothing to do. Some day, 
we assure ourselves, this mad rush will be over and 
we shall "loaf and invite our souls." The desire is 224 
THE COMMONSENSE OF HEALTH 
not always uppermost, but it is there nevertheless. It 
provides the incentive to struggle hard in order that it 
may be gratified. But we must not allow it to domi- 
nate us or we run the risk of seeting too rapid a pace 
and of breaking down before we have reached our 
goal. 
In the meantime, however, during the long years of 
striving, habits of work are formed that we cannot 
easily tear from us; we become set, no longer plastic; 
it is difficult to change without breaking. In fact, with 
some it is impossible. 
Of two men of the same age, both healthy, life-insur- 
ance experts consider the one who retires from business 
the worse risk. He has less expectancy of life. Actu- 
aries estimate a man's expectancy at two-thirds the dif- 
ference between his present age and eighty. At sixty 
the average man will live thirteen years longer, or until 
he reaches seventy-three, provided his present health is 
good. But the expectancy of the average business man 
who retires at sixty is not so long, although the exact 
amount by which it is shortened has not been accurately 
estimated. 
Some of the large railway systems retire their men 
at the age of seventy. The rule applies to officers as 
well as to the others and has no regard for health or 
vigor of mind. Not invariably but so commonly as to 
be expected, very soon after his retirement a man be- 
gins to slump. "He is getting the pension look," his 
friends say. His mental alertness deteriorates, he 
slouches in gait and posture, even his face shows the 
change. His only salvation is to find something to do 
and to do it. 
Sudden stopping of physical occupations has the 
same effect. A good example of this was recently HOW HARD SHOULD WE WORK? 
225 
observed by a physician to whom a man and his wife 
had come for advice. A thorough examination brought 
out many physical and mental disturbances-among 
them indigestion, coated tongue, loss of appetite, ner- 
vousness, insomnia, irritability of temper. He was at 
a loss to account for them, especially as the symptoms 
were so similar in both patients, until close questioning 
brought out the fact that they had recently changed 
their mode of living. All their lives they had lived on 
a farm, each working hard, without other help. Then 
they had struck oil, acquired sudden wealth and had 
moved to the city to live the life of ease to which they 
had so long looked forward. The physician's prescrip- 
tion was-go back to the farm. 
So far we have been discussing how much work we 
can do without injury and how best to conserve our 
energies in order to do it. But there is another view- 
point from which to discuss this question. To some it 
means, How little can I do and get away with it? 
Unhappily the number of those who so construe the 
query seems to be growing rapidly. Someone has said 
that the trouble with the world nowadays is not the 
spirit of unrest that is abroad so much as the spirit 
of rest. 
Those who hold this faith make the mistake of 
thinking of the world in terms of themselves rather 
than of themselves in terms of the world. But even if 
one's individual welfare were of paramount impor- 
tance it cannot be attained by minimum effort. Neither 
body nor mind can be run on low gear to advantage. 
Health and vigor of both can be attained only by 
keeping the speed just within the limits of safety. Less 
than this means perfunctory work, perfunctory work 226 
THE COMMONSENSE OF HEALTH 
soon grows monotonous, and monotony is deadly to 
body and soul. 
When we have nothing to do the mind turns inward, 
we magnify small symptoms until they assume abnor- 
mal size and we become anxious, nervous, apprehen- 
sive, pessimistic. These emotions have their legitimate 
reaction upon the body and the result is real, not imag- 
inary illness. When we are busy we have not time to 
observe ourselves too closely, our minds being occupied 
with important things. The same truth applies to our 
attitude toward external things. The busy, healthy 
man is happy, he does not look at the world with a 
jaundiced eye. But idleness breeds social unrest, it 
fosters the creation of imaginary wrongs and class 
hostility. 
How hard should we work? The great majority of 
us do not work hard enough. Professor James put it 
very well when he wrote: "Men, as a rule, habitually 
use only a small part of the powers which they actually 
possess and which they might use under appropriate 
conditions. The human individual lives far within his 
limits. . . . His life is contracted like the field of 
vision of an hysteric subject, but with far less excuse, 
for the poor hysteric is diseased while in the rest of us 
it is only an inveterate habit, the habit of inferiority 
to our full self, and that is bad." FOURTEEN 
YOUR NERVES AND YOUR JOB 
"Suppose that this here vessel," says the 
skipper, with a groan, 
Should lose her bearin's, run away and 
bump upon a stone; 
"Suppose she'd shiver and go down, when 
save ourselves we couldn't!" 
The mate replies, 
"Oh, blow me eyes! 
Suppose agin, she shouldn't." 
TWO men work in the same office in positions of 
trust and similar responsibilities. In order to 
distinguish them one from the other, and also as in- 
dexes of their mental characteristics, we shall call 
them Weeks and Wells. They are both hard and con- 
scientious workers, but in other respects they differ 
widely. 
Wells takes everything-petty details as well as im- 
portant matters requiring decision and judgment-as 
part of the day's work. Nothing ruffles him. He goes 
home at night reasonably tired but having the pleasant 
consciousness of a day well spent. 
Weeks, on the other hand, is known as a fusser. 
The least untoward incident is likely to throw him off 
his balance. There are days when even the ordinary 
routine upsets him, and on these occasions he is given 
to forebodings concerning the business, his own future, 
and in fact any subject that comes uppermost in his 
227 228 
THE COMMONSENSE OF HEALTH 
mind. At the end of office hours he is nervous and 
irritable. Many things have gone wrong with him, 
and most of them he charges to the incompetency of 
others. When he get home Mrs. Weeks expects him 
to be irritable and faultfinding, because it is his usual 
mental state. He has had to curb his feelings to a 
certain extent all day, but now he can explode. Indeed 
on rare occasions when he does not, when he is at least 
passive if not actually amiable, she wonders vaguely 
what is wrong and whether he is ill. She is as appre- 
hensive as Mrs. Wells would be if her husband were to 
storm and fuss as Weeks does in his ordinary moods. 
What is the difference, or rather, what are the dif- 
ferences between these two types of men? They differ 
in temperament surely. But temperament means 
merely the manner in which one reacts to external 
impressions and to subjective sensations. By some it is 
called "nerves," which is even less enlightening. It 
does not imply that any particular nerve or group of 
nerves is diseased, nor that there is anything wrong 
with the brain or spinal cord. There are many kinds 
of disease affecting the brain and the nerves which one 
may have and yet not be nervous. 
On the other hand almost any physical indisposition 
may cause nervousness, from serious disease to tooth- 
ache or a tight shoe. There is such a close interrela- 
tion between the mind and the body that little can be 
said about either without including the other. Disease 
of the body affects the emotions, and exaggerated emo- 
tions in turn may produce a disordered physical state. 
One cannot be entirely happy if he has indigestion, and 
great unhappiness retards both digestion and assimila- 
tion. But the same degree of sickness will affect dif- 
ferent persons differently. One will be merely less YOUR NERVES AND YOUR JOB 
229 
exuberant, less buoyant than usual. Another's whole 
outlook upon life will be changed; he will become 
almost impossible to his friends. The difference is 
personal; it lies in the different attitude to one's emo- 
tions, whether he controls them or is dominated by 
them. 
Some fussers seem to get along fairly well in busi- 
ness. Indeed a certain percentage of them live longer 
than those who, because of a great inward driving 
force, always push themselves to the limit of endur- 
ance. Weeks, for instance, may outlast Wells, because 
he indulges his whims. He takes holidays quite often 
and considers himself delicate. Precautions hedge him 
about much like the quills upon the fretful porcupine. 
He may live longer, but the chances are that he will 
not. Violent emotions use up energy. One cannot 
give way to frequent fits of rage without wasting 
strength that might otherwise be better employed. 
Also they lessen efficiencyi because an unhappy tem- 
perament interferes with that fine adjustment to one's 
surroundings that makes a smooth-running machine. 
On his bad days Weeks throws the whole office force 
out of gear and comes home exhausted, but with enough 
misdirected energy left to disrupt his entire household. 
There is a man in the same office with Weeks and 
Wells whom we shall call Doolittle. Weeks is afflicted 
with an hypertrophied emotional nature. Wells has his 
days of depression as well as his days of elevation, but 
in spite of these he goes steadily on, smoothly, effi- 
ciently, purposefully. Doolittle, however, seems to 
have no emotions whatever. He appears to be entirely 
contented with his lot; he is a plodder, without ambi- 
tion or incentive. It can be predicted of Doolittle that 
he will stick to his job. He will be doing the same 230 
THE COMMONSENSE OF HEALTH 
thing in the same way twenty years from now. He 
represents the other emotional extreme; he never has 
violent outbursts of rage or periods of great happiness. 
With him life is a dead level. The only change Doo- 
little will make will be when, as he gets older, the firm 
gives him a job carrying less responsibility and less pay. 
Temperament is very largely dependent upon three 
factors, one of which is heredity. Some people are 
born with nervous tendencies and others are so unemo- 
tional as to be called phlegmatic. Another factor 
which influences temperament is early training. It 
would not be extraordinary, would it, if Weeks' chil- 
dren should acquire his unpleasant mannerisms. In- 
heritance may be partly responsible, but no small part 
is due to the atmosphere of continual bickering and 
emotional storms in which they pass the formative 
period of their lives. Unless Mrs. Weeks is as wise as 
her husband is foolish, their early education at home 
will be neglected. They are not being taught self- 
control at the time when lasting impressions are made. 
The third factor is intelligence, which is the most im- 
portant of all. 
Mrs. Wells' house and children are well cared fort 
and yet she has time for other activities, time even for 
life's amenities. She cleans, darns, does fancywork, 
and still manages to go to the theater occasionally and 
to keep fairly well posted about the world outside. 
Let us suppose, however, that Mrs. Weeks is much 
like her husband in temperament. Mrs. Weeks is 
busier than Mrs. Wells, but she never seems to finish 
anything. If you were to spend a day in her house 
you would understand why. You would see her go 
many times in quick succession from the kitchen to the 
bedroom and back to the dining room and kitchen, con- YOUR NERVES AND YOUR JOB 
231 
stantly driven from task to task, always beginning 
something new before completing what she is doing. 
False moves and wasted energy! You would realize 
that she is the slave and not the mistress of her emo- 
tions. The doorbell and the telephone annoy her. She 
says they drive her almost wild. If you give her the 
slightest chance she will tell you her troubles in all their 
details, and in the telling her voice will become high- 
pitched and querulous. All through the day there will 
be lost motion, and many high peaks of emotion, by 
both of which energy is wasted. 
To a very great extent efficiency is dependent upon 
energy. Now energy is partly physical and partly 
mental. A healthy man will do more and better work 
than a man of equal intelligence who is handicapped 
by a physical disability. The exceptions to this rule 
are only apparent, not real. There are men who carry 
on great enterprises and achieve marked success in 
spite of ill health, but they do so because of superior 
intelligence and force of character. Still, energy is 
largely determined by digestion and assimilation, by 
strength of heart and by the quality of the blood which 
supplies the tissues. 
In choosing a man for a job, among the requisites 
sought should be good health. Ill health is distracting; 
its influence upon thought and judgment is profound. 
Also he should not be too emotional-much irritated 
by slight occurrences or easily depressed. Because of 
the effect upon emotions, if possible his home condi- 
tions should be reasonably pleasant, so that he may 
be free from extraordinary worries. Still, if he has 
equanimity this need not be a barrier to his acceptance. 
He should be reasonably sure of himself, not too 
modest, not too self-confident. 232 
THE COMMONSENSE OF HEALTH 
Possessing all these qualifications, the final and most 
important requisite is the ability to learn, which is in- 
telligence. It is in intelligence that men differ most. 
These differences are not always apparent, because we 
confuse intelligence with knowledge. The one is in- 
herited; it is a matter of brain cells and their grouping, 
in which no two persons are exactly alike. The other 
is acquired. A certain amount of intelligence is neces- 
sary in order that we may accumulate knowledge, but 
in some cases it seems to need very little. 
Intelligence has been likened to a machine, 
and knowledge to the raw material. Even a com- 
paratively low-grade mind can acquire knowledge, 
but it takes one of high grade to use it to best 
advantage. 
We can all remember at least one prodigy of our 
school-days, the boy or girl with an almost uncanny 
capacity for acquiring knowledge. They got their les- 
sons by rote and recited them when called upon in 
class without omitting a single word, hardly missing 
the punctuation. At examinations they received high 
marks, and were objects of envy of all the others. 
Great things were predicted of them by the teachers. 
But somehow or other they didn't size up so well 
among the students, who knew more about them in 
their other activities. And after leaving school they 
dropped almost completely out of sight. They had 
plenty of knowledge but not enough intelligence to 
apply it. Such a person is like one with an enormous 
appetite and capacity for food but who lacks ability 
to transform it into tissue. 
In respect of intelligence one fact is absolutely cer- 
tain, belief to the contrary notwithstanding. All men 
are not born equal. Orators on occasion are wont to YOUR NERVES AND YOUR JOB 
233 
declaim that they are, and certain radical political sects 
hold to it as the very foundation of their creeds. But all 
the laws that could be formulated cannot make men 
equal. 
Opportunity has a great deal to do with success, but 
there are those who have much of it and yet fail, and 
others whom neither adverse circumstances nor poverty 
nor ill health can keep down. The truly great ones of 
the earth overcome all handicaps and reach the top- 
most level. Beneath them are many substrata of those 
who will not rise no matter how much fortune favors 
them. 
We all recognize this fact in specific instances. We 
know that Jones is a good bookkeeper but that under 
no circumstances could he have fitted himself to be 
President of the United States; that Smith is a medi- 
ocre lawyer but no amount of training could have made 
him a success as the manager of a big industry, a job 
which requires vision, force and the ability to handle 
men. 
These isolated facts concerning human intelligence 
have been universally if rather vaguely recognized, but 
it remained for the science of psychology to formulate 
them into law. During the first half of the last decade 
systematic studies of mentally defective children were 
begun almost simultaneously in France and in America. 
Later these investigations were extended to groups of 
normal children. 
Certain mental tests were devised and improved 
until at the present time they are fairly standardized. 
In thousands of instances in both countries their ac- 
curacy in determining the mental capacities of children 
was proved. 
And then came our entrance into the war and the 234 
THE COMMONSENSE OF HEALTH 
mobilizing of our young men. Millions of them had 
to be classified mentally as well as physically in order 
that they might be so placed that they could be of most 
service to their country. Very soon at every camp 
there was not only a medical examining board but a 
group of psychologists. More than 1,700,000 were 
tested for their intellectual abilities and classified. 
Neither knowledge of warfare nor previous schooling 
had anything to do with their grades; the tests were 
based upon intelligence, the ability to learn, to under- 
stand orders and to carry them out. 
Uniform sets of test questions were given out and 
the men were graded according to the number of points 
made in the examinations, the grades being A, B, C 
plus, C, C minus, D, D minus and E, or eight in all, 
of which A was the highest and E the lowest. In 
the examinations the highest number of points obtain- 
able was 212, but as low as 135 points placed a man 
in the A grade. The B's were those who scored from 
125 to 134 points, and so on down to those of the D 
minus and E grades, who scored less than fifteen. 
These examination questions were not of the ordi- 
nary kind, based upon book knowledge; they were de- 
vised to bring out a man's ability to perceive, to 
comprehend, and to exercise his judgment. A few 
of the simpler questions are given here in order that 
this fact may be understood: 
Are cats useful animals because they catch mice, or 
because they are gentle, or because they are afraid of 
dogs? 
Do these two words mean the same or opposite: 
Wet-dry? 
Rearrange each of these groups of words into a 
sentence and tell whether it is a true or false statement: YOUR NERVES AND YOUR JOB 
235 
Lions strong are. 
days there in are week eight a. 
leg flies one have only. 
Write the next two numbers in this series: 
3, 4, 5, 6, 7, 8. 
In this series: 
15, 2°, 25, 30, 35. 
From the four words in heavy type select one that is 
related to the third word in italics as the second is 
to the first: 
gun-shoots : : knife-run cuts hat bird 
Each question was fully explained and the men had 
ample time to finish the examination. No one was 
rated D minus who answered correctly any fifteen 
questions of the list. 
Under Explanations of Ratings the report of the 
Surgeon General states: 
"The rating a man earns furnishes a fairly reliable 
index of his ability to learn, to think quickly and ac- 
curately, to analyze a situation, to maintain a state of 
mental alertness, and to comprehend and follow in- 
structions. The score is little influenced by schooling. 
Some of the highest records have been made by men 
who had not completed the eighth grade. The mean- 
ing of the letter ratings is as follows: 
"A. Very Superior Intelligence. This grade is 
ordinarily earned by only four or five percent of the 
draft quota. The A group is composed of men of 
marked intellectuality. A men are of higher officer 
type when they are also endowed with leadership and 
other necessary qualities. 
"B. Superior Intelligence. B intelligence is su- 
perior but less exceptional than that represented by A. 
The rating B is obtained by eight to ten soldiers out of 
a hundred. 
"C plus. High Average Intelligence. This group 236 
THE COAIAIONSENSE OF HEALTH 
includes about fifteen to eighteen per cent of all 
soldiers, and contains a large amount of non-commis- 
sioned officer material with occasionally a man whose 
leadership and power to command fit him for com- 
missioned rank." 
The grades run all the way down through C, C 
minus, D and D minus, to E. 
The immense contrast between A and D minus in- 
telligence is shown by the fact that men of A intelli- 
gence have the ability to make a superior record in 
college, while D minus men are of such inferior men- 
tality that they are rarely able to go beyond the third 
or fourth grade of the elementary school, however 
long they attend. In fact, most D minus and E men 
are below the mental age of ten years, and at best 
are on the border line of mental deficiency. B intelli- 
gence is capable of making an average record in college. 
C plus intelligence cannot do so well, while mentality 
of the C grade is rarely capable of finishing a high 
school course. 
The conclusions were many times corroborated by 
experience. For example, nearly all the officers had 
received their rank before the tests were made and 
yet 82 per cent were found to be in the A and B groups. 
Before a certain army unit went overseas the officers 
rejected as mentally unfit for overseas service 306 men. 
Subsequent mental tests showed that 90 per cent of 
these men were of a mental age of ten years or under. 
If we grant that the results of these army tests were 
even approximately accurate we are forced to the con- 
clusion that the rest of us grade mentally about as the 
men did in the Army. Nearly two millions of them, 
from all parts of the country, from all walks of life 
and with all degress of education and ignorance, they YOUR NERVES AND YOUR JOB 
237 
can reasonably be regarded as a standard by which 
to judge the other hundred-odd millions of us. 
Let us see, then, how the people of this country 
average up in accordance with the doctrine of mental 
levels. Remember that children are included in this 
estimate, because it is based upon the attainment of or 
the ability to reach a certain mental development, and 
not upon knowledge. On the basis of 100,000,000 
there are in the United States: 
Of A grade, Very Superior Intelligence 4,500,000 
Of B grade, Superior Intelligence 9,000,000 
Of C plus grade, High Average Intelligence 16,500,000 
Of C grade 25,000,000 
Of C minus grade 20,000,000 
Of D grade, those whose mental age is 9% to 11% 
years 15,000,000 
Of D minus and E grades 10,000,000 
D minus persons have the mental age of a child of 
ten years or less. They are not capable of advancing 
beyond the third or fourth grade of the elementary 
school, no matter how long they may attend. Those 
of the E group are mentally deficient. Many of them 
belong to that class of the feeble-minded called morons. 
To go back to the army examinations for a moment, 
if a certain large proportion of men between the ages 
of twenty-one and thirty-one or over had the mental 
development-that is, the intelligence-of young chil- 
dren, is it possible that any kind of education, however 
eagerly pursued, would have brought them up to the 
B or A grade? If not, we come logically to the law 
of mental levels, which is this: 
Every human being comes into the world with a 
potentiality for mental development that will carry 
him so far, and, barring accident, nothing can affect 
the mental level which he will attain. 238 
THE COMMONSENSE OF HEALTH 
That sounds like the doctrine of predestination ap- 
plied to mundane things, and in a sense it is. How- 
ever, it merely states as a general proposition what 
everybody knows-that we cannot all be great, meas- 
ured by the same standards. Unless we deny this 
fundamental and self-evident truth we must recognize 
the absurdity of the doctrine of intellectual and social 
equality. If social and economic equality could be 
brought about, how could it be achieved? By bringing 
all those of the A, B and C groups to the D level, or 
by raising the D's to the A and B grades, or by bring- 
ing both extremes toward the middle? 
If by edict and legislation this could be done, how 
long would it last? Probably not the span of a genera- 
tion. Even in the matter of an equal division of prop- 
erty, it would not take long for the A's and B's and 
C's to get back more than their equal share. 
Two fundamental truths are ignored by those who 
hold the doctrine of equality. One is that those of 
lesser intelligence are invariably guided by the more 
intelligent. Even a soviet government must have its 
leaders, whom the rabble follow with a blind faith. 
The other truth is that each mentality has its own 
standards of happiness and success, and each would 
suffer if raised or lowered from the plane to which it 
belongs. Sooner or later each would drift back to its 
own level. 
What is absolutely essential to a healthy democracy 
is a widely disseminated feeling of mutual confidence. 
Noticeable lack of it at the present time is the cause 
of so much social unrest, for which the A's and B's 
are at least as responsible as the C's and D's. 
An ideal society would be that in which every one 
of us had exactly the kind of work to do for which he YOUR NERVES AND YOUR JOB 
239 
is best fitted; but for obvious reasons that is not pos- 
sible. Many conditions may interfere; such as, for 
instance, lack of early education, ill health, poverty, 
inherited nervous tendencies, and in many cases mis- 
taken choice of occupation. 
This last is of more frequent occurrence than is com- 
monly supposed. Even the professions have their mis- 
fits, who, through mistaken choice or because they 
followed in the line of least resistance, have become 
physicians or lawyers or preachers and have not dis- 
covered their error until too late. It is a true saying 
that many a good mechanic has been spoiled in the 
making of an indifferent doctor or preacher. It is just 
as true that many a poor mechanic would have done 
better in a profession. 
A great many people do not achieve their proper 
measure of success because they are miscast. Strug- 
gling against the inexorable law of mental levels they 
attempt tasks beyond their ability; they worry and fret 
and ultimately break down. There are many C men 
in B jobs, at which they are at least relative failures. 
Take our friend Weeks, for example, who stands 
for the nervous, overwrought, irascible type of per- 
son. Isn't it possible that he is mentally an under- 
weight, or at least that he is not doing the kind of 
work for which he is best suited? Some of the 
Weekses are, that is certain. Some of them would 
better be on a farm or in a mill than in an office, en- 
compassed about with harassing details and responsi- 
bilities. 
And on the other hand there are plenty of B or 
A men doing C work, either because of a scarcity of 
the higher jobs or by reason of an inherent diffidence 
or on account of a combination of circumstances not 240 
THE COMMONSENSE OF HEALTH 
within the power of the individual to control. The 
law of mental levels does not predicate that every- 
one will achieve success or reach that station in life 
which he deserves. It merely states that each of us 
has a certain capacity for intellectual development be- 
yond which he cannot rise. It has nothing whatever 
to do with our efficiency or success in life within our 
limitations. A person of C intelligence may be as 
successful in his way as the man on a higher plane. 
And the latter may be as much of a failure as the 
former. 
Efficiency depends not only upon the ability to learn 
but upon the amount of useful knowledge we acquire. 
In this respect we are the masters of our souls, the 
arbiters of our destiny. We are like mountain climb- 
ers; some have strength to reach the topmost peaks, 
others can climb but to lower levels. And some of us 
are content to let others, weaker than ourselves, ex- 
cept in spirit, pass on and leave us behind. 
This may be due in part to lack of ambition. But 
it may be due also to temperament. The word 
"temperament" is used here to indicate our reactions 
to the smaller annoyances of life; in other words, the 
proneness to worry or the ability to keep from worry- 
ing is an important factor in efficiency. It may be 
contended that this in itself is a manifestation of in- 
telligence or the lack of it, but on the other hand 
worrying is largely a matter of habit, and bad habits 
are due to early training, carelessness and self- 
indulgence. 
Provided one chooses wisely the things to worry 
about, a reasonable amount of worry is not bad. This 
is well illustrated in the case of Wells. Doolittle, on 
the other hand, does not worry at all. But Weeks YOUR NERVES AND YOUR JOB 
241 
is a chronic worrier and uses no discrimination. It 
is usually the petty annoyances that cause the most 
trouble to a chronic worrier, as might easily be seen if 
you were to spend a day with the Weekses. 
You would note that he jumps every time the office 
boy slams the door. He fumes because his stenog- 
rapher chews gum, and watches her with intense 
fascination until he arrives at a state bordering on 
delirium. At home, in the evening, he keeps shouting 
at Willy to stop that constant clearing of his throat. 
Mrs. Weeks also has her pet aversions. She insists 
that Susie sit in another chair because the incessant 
rocking nearly drives her crazy. In this manner the 
pleasant family intercourse proceeds until finally 
Weeks jumps up indignantly and storms out of the 
room, saying that he cannot stand all this bickering. 
With each of them intolerance of little things has 
become a habit. 
Another bad habit is intolerance of the personality 
or opinions of others. Some of us live in a little world 
of our own in which all our companions are of like 
tastes and thoughts, all cut to a pattern. Those who 
do not conform with our ideas are outside our circle. 
Weeks hates Thompson because he boasts, and 
Robinson for his cold and distant manner. Now 
Thompson is a rather fine chap when you get to know 
him. He has a harmless exuberance of spirits and a 
tendency to mild exaggeration which strangers some- 
times mistake for boastfulness, but he is really rather 
modest. And Robinson's aloofness is due to diffidence, 
not to indifference. Really Weeks has developed and 
nourished a spirit of hypercriticism that has not only 
made him uncompanionable and unhappy but has in- 
fluenced his usefulness in business. 242 
THE COMMONSENSE OF HEALTH 
Another source of worry to many people is the 
weather. They are constantly quarreling with it. The 
day is either too hot or too cold, too wet or too dry. 
A dull day depresses them, their spirits sink, their 
minds turn inward, they conjure up imaginary troubles 
and magnify little ones. Someone has suggested that 
instead of fighting the weather we make friends with 
it. We should remember that as long as we live at 
least three days out of four will not meet our desires 
in this respect and that worrying about it is of little use. 
It is the same regarding health. If Mrs. Weeks 
gets a slight pain or a bit of indigestion or a headache, 
at once she begins to think of all the possibilities that 
may occur. She finds it difficult to believe the doctor 
when he tries to assure her that nothing serious is 
wrong. There are people like Mrs. Weeks, who have 
an ideal of perfect health which they seldom attain. 
They do not reason that they cannot feel perfectly 
well all the time, and when they do not they become 
apprehensive. 
When certain ideas become so persistent that they 
obtain possession of us they are called obsessions. In 
the strict scientific use of the word an obsession is a 
harmful idea, one which interferes with the orderly 
conduct of our lives, usually based upon a fear. Most 
of us have at least one or two fears which, if we 
acknowledge them at all, we call superstitions. 
You are walking down the street with a friend when 
he suddenly clutches your arm and drags you toward 
the curb. "You almost walked under that ladder," 
he says, and you both laugh. But you didn't walk 
under it, although it would have been much more 
convenient than to go around. In the morning you 
start to put on the left shoe first when you suddenly YOUR NERVES AND YOUR JOB 
243 
remember that it might bring bad luck and you take 
it off. 
Exaggerated self-consciousness is another and more 
serious handicap in the pursuit of success and content- 
ment. Nearly everyone is painfully self-conscious at 
times. On entering a street car, if your mind is not 
preoccupied, you may be suddenly aware that all eyes 
are centered upon you. For a second you are discon- 
certed. Then you realize that the gaze of the idle 
always follows a moving object, and your momentary 
bashfulness disappears. 
Suppose, however, that you dread to enter a car 
or a crowded room, that when compelled to do so you 
become agitated, you tremble and blush furiously; your 
whole body becomes hot and suffused. Your agitation 
is increased by the knowledge that your state of mind 
is apparent to others. 
If you are a victim of this morbid type of self- 
consciousness you have what the psychologists call 
erythrophobia, or the fear of blushing. 
Between these two extremes there are many degrees 
of bashfulness, all of them more or less disconcerting 
at times and the more severe types positively painful. 
Strange to say, this failing is not based upon diffidence 
so often as upon an exaggerated self-importance. If 
we could see ourselves always in proper perspective 
we should not be so shy. We should understand that 
what we do or say, how we are dressed and the manner 
in which we conduct ourselves at the moment are of 
very much less concern to others than to ourselves. 
A still more fertile source of worries is doubt. All 
of us have our moments of doubt and uncertainty, even 
about comparatively trivial matters. Night is an espe- 
cially favorable time for doubts because then our minds 244 
THE COMMONSENSE OF HEALTH 
are not distracted by more important things. As we 
are about to fall asleep, or if we awaken toward morn- 
ing, a disconcerting thought about an occurrence of 
the previous day presents itself. We wonder if we 
offended Jones when we addressed to him that 
facetious remark. It wasn't funny anyhow, and would 
have been better left unsaid. Or we are uncertain 
about that important contract, whether anything es- 
sential was omitted. Or it occurs to us that we may not 
have locked all the windows before retiring. 
The occasional appearance of such doubts is per- 
fectly natural. But if they continually assail us, pre- 
venting sleep and harassing our waking hours, they 
are becoming morbid doubts. Suppose, fdr example, 
that we are impelled to get out of bed not once but 
several times every night in order to assure ourselves 
that the doors and windows are locked. Then we 
should be obsessed by the folly of doubt. 
The doubting folly has many phases, of which the 
following are instances taken from life: 
A certain business man spends a precious hour or 
two each morning reading the carbon copies of the 
previous day's letters because he is afraid that he may 
have omitted something important from one of them. 
The president of a bank in a small town insists upon 
locking the safe and the doors himself at the close of 
banking hours. Then, part way home, he invariably 
returns and tries all the locks. 
Others who have the doubting folly are chiefly con- 
cerned with the future. They are always afraid that 
whatever they contemplate doing will turn out badly. 
"Suppose," they argue, "that I should do so and so, 
and such a thing should occur." And so they don't 
do it. Sometimes their doubts are as baseless as those YOUR NERVES AND YOUR JOB 
245 
of the little girl who, when asked why she was crying 
so bitterly, said that she had been thinking that if she 
grew up and married and they had a child and the 
child grew up and there should be another war, he 
might be killed. 
The antidote for this kind of doubting is to insist 
upon thinking the opposite. 
"Suppose she'd shiver and go down, when 
save ourselves we couldn't!" 
The mate replies, 
"Oh, blow me eyes! 
Suppose agin, she shouldn't." 
Doubt often takes the form of argumentativeness. 
When the argumentative doubter is told to do a thing 
he can advance a dozen reasons why it should be done 
differently or why it should not be done at all. In 
this way he consumes more time and energy than 
would be required to do what he is told; he exhausts 
both himself and others. 
The habit is easily acquired by the young if parents, 
in their desire to be fair, are willing to listen to argu- 
ment upon every subject proposed. The judicial atti- 
tude toward children is proper enough, but it may be 
carried too far. Children, and adults also, often argue 
not from stubbornness but because they are in doubt 
about what course to pursue. If allowed to bring 
every act into court for prolonged discussion children 
are in danger of becoming chronic doubters, never 
sure of themselves or of others, never going straight 
toward a goal by the shortest route. 
The ability to go straight toward a goal, however 
distant, is an attribute of intelligence. Provided the 
object to be attained is worthy of the effort, the more 246 
THE COMMONSENSE OF HEALTH 
difficulties that must be overcome to reach it the greater 
the intelligence required. This brings us logically back 
to the law of mental levels, which predicates that in- 
tellectually we are not all cut to the same pattern. 
But granting that we cannot all be intellectual 
equals, that literally it takes all kinds of people to 
make a world, success and failure are only relative. 
It is also perfectly evident that, within these limita- 
tions, if one sticks to the kind of work for which he 
is best fitted both by intelligence and training he can 
be as successful and as happy in the consciousness of 
achievement as the fellow just a little higher up or a 
little lower down in the mental scale. 
A few of the conditions that surround us are not 
within our power to change. We cannot change our 
ancestry or our early environment, for instance. But 
we have something to say about our habits, both good 
and bad. And among these perhaps the habits that 
have the most influence over our daily lives are those 
of worry and irritability of temper. 
The habit of fussing about little things has its source 
in an exaggerated ego. Those who fuss will utter an 
indignant protest here-that is, provided they can be 
brought to acknowledge that they do fuss. However, 
they do, either consciously or unconsciously, look in- 
ward instead of outward. Their personal feelings, 
tastes and predilections have been magnified out of all 
proportion to their real importance. 
Exactly the opposite state of mind-diffidence, un- 
sureness of oneself, from which arises the folly of 
doubt-is the next most potent factor in retarding one's 
progress. This can be cured only by cultivating the 
ego, which is often a long and tedious process but which 
will eventually bring results. The best antidote for YOUR NERVES AND YOUR JOB 
247 
the small worries ol any kind is to take one's weakness 
out for a mental airing every now and then. Hold 
it up to the light and look at it. Compare it in all 
its puny insignificance with the bigger things of life. 
Laugh at it. Laugh at yourself. 
Not long ago a successful business man was asked 
how it was that he could carry so many great responsi- 
bilities without showing or feeling the wear and tear. 
He answered in nine words, but they deserve a para- 
graph all their own: 
"I always play the game with the white chips." 
For the benefit of that small minority of persons 
who are not familiar with the national indoor sport 
it may be said that the white chips are the least com- 
mon denominator of exchange in poker. 
A good poker player does not give too anxious con- 
sideration to the value of the chips. He plays the 
game to the best of his ability, unhampered by doubts 
and worries. And, win or lose, after one hand has 
been played there will be a new deal. 
In the game of life each day's hand should be played 
for all one is worth. If fortune does not favor to-day, 
don't worry! To-morrow there will be a new deal. FIFTEEN 
WHAT ARE YOU AFRAID OF? 
JUST offhand, without stopping to think, you will 
probably say: "Nothing. Only silly, weak-minded 
people are afraid." But if you do stop to think you 
will revise that statement. You will realize that you 
are often afraid, and sometimes without sufficient 
cause. Only weak-minded, very weak-minded, persons 
have no fears. No, I am wrong. There is no one in 
the world whose actions are not governed by fear, 
and those who have the fewest fears need attendants to 
watch over them. 
But there is a difference between a normal fear and 
an exaggerated fear, although it is not often well 
marked. Why do you stop at the curb and look both 
ways before crossing a crowded street? Because you 
are afraid of being run down by a car or a bus. If 
you did not take this precaution you would show a 
lack of intelligence, wouldn't you? In such circum- 
stances some people show more timidity than others; 
they stand upon the pavement, hesitating, then dart 
across, although there may be very little danger in 
crQSsing deliberately. But if you stopped, hesitated, 
then walked a square farther and still failed to bring 
your courage up to the starting point, and finally some- 
one had to take you by the arm and lead you across, 
that would be an exaggerated fear, wouldn't it? 
Suppose you were afraid to cross any open space, 
alone. Then you would be a victim of "agoraphobia," 
248 WHAT ARE YOU AFRAID OF? 
249 
or the fear of open spaces. If you have ever seen a 
city cat cross the street, you need no further description 
of "agoraphobia." You see how difficult it is to draw 
a line between a perfectly normal fear and an exag- 
gerated fear. Even the possession of an exag- 
gerated fear does not necessarily mark one as mentally 
unbalanced. There may be an excellent reason for it, 
of which the possessor is unaware. But, conscious or 
unconscious, it controls many of his actions. 
You are about to start upon a long journey, when 
someone exclaims: "My goodness, you are not going 
to leave on Friday, are you?" Or, worse and worse, 
"You must not go on Friday, the thirteenth!" And 
so you change your plans. 
On your way downtown you happen to notice a 
ladder up against a building, with its base far out on the 
pavement. No matter how worried you may be with 
household or business cares, you walk around the 
ladder, even going out to the gutter, if necessary, to 
avoid going under it. 
One day, when a friend of the family is calling, you 
notice that he appears nervous and fidgety. His con- 
versation is jerky, and he moves about from place to 
place in the room. Finally, in desperation he tells 
you the reason: He is afraid of the cat, the family 
cat, the children's pet. With a tolerant smile you put 
the cat out, and all is serene. You realize that your 
friend has an exaggerated fear, but you do not think 
that he is insane. 
I know a surgeon, fearless in his profession, a man 
who in emergency has operated on his own child with- 
out a tremor. And yet he cannot endure the sight 
or even the thought of maggots, the larva? of flies. 
Most of us who are afraid of rats or of snakes smile 250 
THE COMMONSENSE OF HEALTH 
in a superior way at the woman who jumps upon a 
chair when a mouse runs across the floor. Wherein 
lies the difference? Some aviators who like to fly 
thousands of feet above the ground are unable to look 
down from a high building without great mental dis- 
tress. Many perfectly sound and healthy persons go 
about their daily tasks absolutely convinced that they 
will die of cancer, and no amount of reasoning or 
argument can obliterate their terror of it. 
There is hardly anybody in the world who has not 
some particularly aversion or fear. It may be argued 
that the disinclination to leave home on Friday or 
to walk under a ladder is only conformance to a 
superstition; but if we conform to the superstition 
it is fear that makes us do so, however much we hate 
to acknowledge it. Everyone who possesses an ab- 
surd fear realizes its absurdity, but neither persuasion 
nor ridicule can rid him of it. The fear remains and 
cannot be entirely obliterated. 
The reason for this is that the cause lies much 
deeper than the trivial incident, or object, or idea, 
which brings the fear to the surface of the mind. It 
has its roots in an early experience which our heredi- 
tary instincts and certain curious, hidden, unconscious 
mental processes have perverted or exaggerated. In 
order to understand the matter we shall have to learn 
something about fear itself, what it does to us and 
what it does for us. 
Once upon a time, so those who believe in evolu- 
tion tell us, very shortly after we had evolved from 
primordial protoplasm, millions of years before we 
had brains or even spines, in other words, when we 
were invertebrates, it did not affect us much if we 
lost parts of our bodies in conflict or by accident, WHAT ARE YOU AFRAID OF? 
251 
because we had the power of reproducing them. Not 
having much ability to defend ourselves, our very 
existence depended upon the amount of injury which 
we could make good by regrowth. As we grew up in 
the scale of existence and became better able to defend 
ourselves, this regenerative power gradually disap- 
peared, because it was less needed. 
Whether you believe the theory of evolution or not 
makes little difference in this argument, because you 
can see the power of regrowth in lower animals. 
Reptiles replace fangs that have been lost, and crabs 
and lobsters sprout new claws very soon after battle. 
Now, we cannot grow a new leg or a new arm if 
we have lost it, but we are better able to protect our- 
selves by forethought and by our ability to avoid 
danger or to overcome it. And we have also a defen- 
sive power which the lowest orders of animals do not 
possess. We have it in greater degree than any of the 
animals, but we do not always treat it with the re- 
spect it deserves; we rather look down upon anyone 
who has it more than we have. It is called fear. 
In fact, we are often ashamed of it because we 
think it a sign of weakness; whereas fear is really a 
beneficent, protective mechanism given to us as a safe- 
guard from harm. 
There are two kinds of natural fear, instinctive fear 
and conscious fear. Instinctive fear is the kind which 
we see so often in the lower animals. Newly hatched 
chickens run to their mother at the sight of a hawk 
even before she has given the warning signal. Young 
dogs will bristle and growl at the sight of a wild ani- 
mal or even at its pelt, although nothing in their ex- 
perience can have taught them either fear or antipathy. 
Such instincts have the obvious purpose of preserving 252 
THE COMMONSENSE OF HEALTH 
life and are handed down from their wild ancestors. 
Very young children have instinctive fears. Nearly 
every mother has noticed that her baby shows a fear 
of falling, although it may never have fallen. 
Even those of us who are grown up, with fully 
developed powers of reasoning, have instinctive fears, 
and we often give expression to fear in ways that are 
similar to those of animals. This is especially the case 
when something utterly new and sudden alarms us, 
because we are not prepared and can put up no other 
defense. For the same reason, those who are in posi- 
tions of great danger from which they cannot escape 
are apt to display fear. 
During the war soldiers were so frequently placed 
in such circumstances and had to endure them so long 
at a time that it is small wonder that some of them suc- 
cumbed to terror. One of the reactions to fear is 
anger, which is spent upon the object feared; but if 
you cannot see the object your terror becomes all the 
greater. For weeks on end our soldiers did not see 
the enemy, and yet the enemy shells were bursting all 
around them, tearing great craters in the earth, burying 
them beneath walls and ramparts, destroying their 
companions. 
The normal reaction to the fear would have been 
to go out and destroy the enemy, which conditions did 
not permit them to do. Often they did not have even 
the shelter of a dugout. They had only to wait and 
wait during long periods of inaction, which increased 
their mental strain until finally the breaking point came 
and they suffered from the peculiar complex of 
symptoms which was called "shell shock," a real con- 
dition, although it affected the mind and not the body. 
When fear increases and becomes terror it has many WHAT ARE YOU AFRAID OF? 
253 
physical manifestations. The heart beats wildly or it 
may fail to act; a pallor overspreads the body; the 
breathing is labored, the wings of the nostrils dilate and 
contract; there is a convulsive tremor of the lips; the 
eyes are fixed and staring, the pupils dilated; the hands 
alternately clench and open, and somtimes the arms are 
extended as though to war off danger. Often the 
muscles are rigid and tense, the body assumes a crouch- 
ing posture, there is a cold sweat and the will itself 
seems paralyzed. At other times there may be an 
irresistible impulse to flee. 
Curiously enough, we nearly always refer to the 
region or part of our body most affected by the fear. 
We say: "I am not afraid, but my stomach is." Or, 
there is a feeling of weight in the chest because the 
heart is beating wildly and laboriously. Fear so often 
affects the heart that it has given rise to a very com- 
mon expression. One says of a coward that he is 
"faint-hearted." "Faint heart ne'er won fair lady" 
does not mean that the man with a weak heart cannot' 
get a wife; it indicates timidity. Many a man who has 
failed to meet a situation requiring boldness has said 
afterward that he had been determined to face it, but 
his legs had run away with him. 
Now, many of the manifestations of fear belong to 
the lower animals as well as to man. The frightened 
cat assumes a crouching attitude and the dog bristles. 
When we are terribly afraid we have the sensation, at 
least, of our hair standing on end. It is not cold alone 
that gives us goose flesh or creepy-crawly sensations. 
They are also caused by terror. Most of these in- 
stinctive manifestations of fear are given us for the 
purpose of protection, but there are others which have 
no beneficial action. Fear may stimulate thought and 254 
THE COMMONSENSE OF HEALTH 
activity, but it may also paralyze them. It may even 
wipe out consciousness itself. Fear will affect the 
appetite and all the processes of digestion. 
Many of our natural fears are based upon our 
higher intellectual processes, as for instance upon 
memory or a well developed imagination. These are 
just as normal as our instinctive fears. We fear in- 
jury because we have been injured; we fear danger 
in battle because our reason tells us that to go into 
battle will expose us to injury and death. 
We have also other intellectual faculties, moral 
forces which counteract our normal fears and which 
lead us to do things that we know to be dangerous, to 
hazard injury and possible destruction. The great and 
strong of this world fear as much as the weak, but 
fear is held in subjection by will. Man has always 
been beset by fears, but as he has struggled upward to 
higher planes he has become more and more emanci- 
pated from this long oppression. 
It is almost invariably the unknown which causes 
great fear. Mankind is a curious mixture of fears and 
bravery. A brave man on the ground may be timorous 
in the air. An aviator may fear the water and not 
dare to face the dangers of the ocean. A soldier may 
fear smallpox which has no terrors for a physician. 
To everyone his own fear; to everyone his own courage. 
Everyone who conquers a fear gains new courage. 
Just as physical exercise strengthens the muscles, so 
each new moral conquest strengthens the will and the 
desire to conquer further. Finally, the overcoming 
of a fear begets a love of the fear itself, and gives 
it a fascination for the strong. 
But in sleep, when our higher intellectual faculties 
are submerged and we become merely automatons, our WHAT ARE YOU AFRAID OF? 
255 
instinctive hereditary traits, our primitive tendencies, 
which we usually keep in subjection, come to the sur- 
face. We start, we scream out from imaginary terrors 
because we have no self-control in sleep. One reason 
for this is that although with us night is the time of 
the greatest shelter and safety, with our ancestors 
night was the time of the greatest danger. They slept 
very lightly and started at the slightest sound. Even 
in daytime primitive man was subject to sudden terrors 
because he knew nothing of the laws of nature, and any- 
thing new was considered dangerous and terrifying. 
Up to the present we have been considering only 
normal fear, which was vouchsafed us as a defense. 
Any form of fear which is not protective, but helps to 
injure or destroy us, is called a morbid fear. Such 
fears are the unreasoning ones which are often entirely 
out of proportion to their inciting causes. They are 
called technically "phobias," and take on many and 
varied forms. A few are indicated in the beginning of 
this article. Each has its own scientific name, which is 
a compound of the Greek word which is the name of 
the thing feared, and "phobia," which is the fear itself. 
There are.more than one hundred and fifty phobias to 
which people are subject. There are "acrophobia," 
for instance, which means fear of heights; "agora- 
phobia," fear of open spaces; "claustrophobia," a fear 
of being shut in, and even "erythrophobia," the fear of 
blushing. 
If you have one of these phobias you will realize by 
this time that you are not in a class by yourself. You 
may be sure that many other people in the world have 
your particular fear. And not necessarily weak- 
minded people either. The strongest mind has its 
weak spots. Some of the greatest men of history have 256 
THE COMMONSENSE OF HEALTH 
been what might be called "phobiacs." A great British 
general, the hero of many campaigns, who often had 
braved death in battle, was terribly afraid of cats. So 
you see your hypothetical friend mentioned in the be- 
ginning of this article, in deference to whose aversion 
you put out the cat, is in very good company. King 
James I fainted at the sight of a naked sword, and 
Peter the Great could not cross a bridge without suffer- 
ing from nausea and cold sweat, or goose flesh and 
tremors, or some of the various manifestations of a 
great fear. 
Instead of objects some of us fear abstractions, such 
as becoming insane, being buried alive, dying of cancer 
or of consumption. Now these fears do not always 
trouble us with the same intensity. Overwork or great 
mental strain, especially when they cause loss of sleep, 
will increase them to greater proportions until they 
may become obsessions. Then, as the mind recovers 
its vigor, the fear fades again into the background. 
Not long ago a man of brilliant achievement in the 
business world said to a friend: "For several months 
I have been terribly afraid of becoming insane. Day 
and night I have seen insanity just ahead of me. I am 
in constant fear of overtaking it." Several months 
later he said to the same friend: "I am not afraid of 
insanity any more, because I have caught up with it 
and passed it." 
His language, of course, was symbolic, but it de- 
scribed a real condition of his mind. At some time or 
other in his life there had been created a fear that he 
would become insane. While he was otherwise men- 
tally normal this fear was in subjection, probably 
appearing only in dreams or as an idea of little impor- 
tance, easily put aside and forgotten. But when busi- WHAT ARE YOU AFRAID OF? 
257 
ness worries and long-continued mental strain had 
undermined his mental powers, the fear assumed 
immense proportions, towering above and dominating 
all his mental faculties. Then, as his business cares 
diminished and his mind regained its vigor, the fear 
receded. 
Some time in his life, probably in early childhood, 
there had been an experience which had made a lasting 
impression upon him. Perhaps a member of his family 
had been insane. It is possible that in his impression- 
able period the fear had been implanted by his over- 
hearing a discussion of insanity in the family, and that 
his mind had received a shock from which he had never 
recovered. 
Whether you fear cancer or cats, bridges or blood, 
insects or insanity, you may be reasonably sure that the 
origin of your phobia was an experience or impression 
in early childhood which left a scar. If you will search 
your memory you may be able to trace back to a fright, 
an incident, a tale, a threat, something or some com- 
bination of things, that left its imprint upon your child- 
ish mind. But whether you can recall it by any con- 
scious effort or not, the fear undoubtedly arose from an 
early experience, even though the recollection has been 
obliterated. Heredity also may be an indirect cause. 
One may inherit a nervous, high-strung, impressionable 
temperament, but the direct cause lies in experience. 
Every victim of a phobia is ashamed of it; he knows 
that his fear is foolish, and yet he cannot control his 
emotions. Reason with himself as he will he cannot 
get rid of it, because the origin of his fear lies partly 
in the unconscious mind. 
This brings us to the two individuals which are in 
every one of us. You remember the four Johns of 258 
THE COMMONSENSE OF HEALTH 
"The Autocrat of the Breakfast Table." There was 
first the John whom other people knew; then there 
was the John whom John himself knew; there was the 
John as he wished himself to be known; and finally 
there was the real John. Now a psychologist would 
divide this real John still farther. He tells us that we 
have two minds, the conscious and the unconscious. 
We know a lot about our conscious minds, but we 
know practically nothing about our unconscious minds. 
Before we go any deeper into this deep subject of the 
unconscious mind, perhaps we would better clear up 
a possible misunderstanding of the word "uncon- 
scious." In the ordinary sense, a man who is uncon- 
scious is entirely oblivious of his surroundings, of any 
emotions, pleasant or unpleasant. But in the sense in 
which the psychologist uses the word, unconscious 
means "not aware of." He tells us that we have 
thoughts of which we have no conscious knowledge, 
which we cannot call up or become aware of by any 
effort on our own part, but which nevertheless largely 
control our conscious thoughts and actions. 
And he further subdivides the unconscious mind into 
two. If we keep on we shall have John so fragmented 
that we shall never be able to put him together again. 
But let us go this once with the mind analyst as far as 
he wishes to take us. We have, then, the real John, 
made up of John the conscious and John the uncon- 
scious, and we are about to separate the latter into two. 
Our dissector of minds says that John the unconscious 
is made up of the preconscious mind and the uncon- 
scious mind proper. Let us try to understand what he 
means by this. 
The preconscious mind is the reservoir of all our 
thoughts that lie just beneath the surface of conscious- WHAT ARE YOU AFRAID OF? 
259 
ness. They cannot be brought to light by any effort on 
our part, but may be by association. Here is an 
example: You are trying to recall to memory a friend 
of your early days, but every effort is vain. Neither 
his name nor his appearance can be evoked. One day 
you are approaching the scenes which were associated 
with him, when suddenly, before you have reached the 
place, before you have come to one single familiar 
haunt, up pop his name and his features, and he stands 
before your conscious mind, visualized, a reality. 
There, in your preconscious mind, these thoughts 
have lain for years, ready to come up, but it required 
something outside of yourself to recall them. That 
much for the preconscious mind; now we come to the 
unconscious mind proper. 
Far beneath the preconscious stratum lie the uncon- 
scious thoughts, those of which we are not aware, and 
which cannot be brought into consciousness by any ef- 
fort or by association. It seems a bit paradoxical to say 
that we have thoughts which we do not "think" in the 
active sense, but we have, plenty of them. It will be 
clearer if we say that we have impulses, desires, wishes 
unfulfilled, predilections and aversions that have never 
been formulated, and of which we have never been 
more than vaguely aware. They are instinctive, egois- 
tic, selfish, and have been repressed by our growing 
conscious mind because they are in constant conflict 
with our gradually acquired ideas regarding our rela- 
tions to external things. They are not immoral, they 
have no standards of morality; they are unmoral and 
hence we unconsciously repress them. 
This unconscious repression has an analogy in the 
conscious mind in our ability to "forget" things which 
have unpleasant associations. Why will an honest 260 
THE COMMONSENSE OF HEALTH 
man, for instance, forget to pay a debt and yet remem- 
ber all his own debtors? Not by effort of will surely, 
because one cannot forget in that way. The more one 
consciously tries to forget anything unpleasant the 
more it sticks up like a sore thumb. You "just natur- 
ally forget" it; it sinks of itself beneath the stratum of 
your conscious mind. 
What has all this to do with morbid fears? Let us 
take "a case," as the doctors say, and see if we can 
find out by analyzing it. Here is a young man with a 
simple phobia. He is otherwise perfectly normal, but 
he has a haunting fear, the name of which is "acro- 
phobia." He cannot stand upon even a slight eleva- 
tion without great mental suffering. Merely the idea 
alone fills him with terror, and his dreams are largely 
made up of falling. When he stands upon a high place 
his fear is greatly increased if there happens to be an- 
other man near him, because he is afraid that he will 
be pushed off by a man, not by a woman. 
Finally, the fear getting beyond his control, he does 
the wisest thing: he consults a specialist, a physician 
skilled in the science of the mind, who gradually leads 
him into telling the story of his life. Searching the 
past for forgotten incidents is by no means an easy 
thing to do, because unpleasant thoughts, you remem- 
ber, are repressed automatically and can only be 
brought up by association with other ideas. 
The first significant memory that comes up is that of 
an incident which occurred when he was about ten years 
old. One night he attended a village entertainment 
with a grown-up friend. The hall was crowded and 
the little fellow was placed upon a window sill just 
above the stairway. He was terribly afraid of falling, 
but he held on, conquering his fear for perhaps half an WHAT ARE YOU AFRAID OF? 
261 
hour, when he was compelled to confess and was lifted 
down. 
Now there appears another memory brought up by 
association with the first. At nine years of age his 
father had taken him to the top of a high tower upon 
which was a circular projecting balcony and, although 
it was protected by a railing, the child had been in 
mortal terror. His father, whom he feared anyhow, 
had laughed at him and compelled him to walk around 
the platform. 
He remembers a still earlier experience. When he 
was about seven years old, one day at school, a fool 
teacher had held him by the feet, suspended head 
downward from the top of a high wall, threatening to 
drop him. This playful joke had made a deep impres- 
sion. You will notice that his memories are coming 
up one by one, each in succession from a deeper level. 
Now comes the last, the deepest of all. When a child 
of three, one day at home he had been crying a great 
deal, much to the annoyance of a male visitor, who 
picked him up and carried him to a rain barrel outside 
of the house, threatening to drop him into the water 
if he did not shut up. 
He has disclosed three elements in his mind injury: 
First, the fear of falling; second, that of being 
dropped; and third, in all four of his terrifying experi- 
ences the offender had been a man. Up to the time of 
his consulting the physican he had never realized the 
causes of his trouble, had never even recalled the inci- 
dents of his childhood. Now he knows that his fear, 
is the logical result of mind injuries, and he is relieved 
of the fear of his fear, which riddance will help to 
restore his mental balance. It is the fear of a fear 262 
THE COMMON SENSE OF HEALTH 
that does the most damage. It causes us to become 
introspective, to examine and misinterpret our every 
action, to magnify and misconstrue the slightest devia- 
tion from the usual and ordinary. 
What can be done about our phobias? Well, most 
of us can laugh at them-and then go on unconsciously 
making our daily lives conform with them, walking 
around and not under ladders; doing important things 
on the twelfth or the fourteenth of the month instead 
of on the thirteenth; jumping into a feather bed when 
it thunders; keeping away from cats; refusing to look 
down from a height; going to a doctor occasionally to 
be assured that we have neither cancer nor consump- 
tion nor corns nor chilblains, nor any other mortal 
disease! We can laugh at them, and we should laugh 
at them, not take them too seriously. It will help us, 
although we may not need help, if we recall the past 
and find the cause in some childish experience, just as 
we look at a scar on the surface of the body and say: 
"Oh, yes, I was scalded badly when I was a child." 
Ordinarily, we should not bother any more about a 
mental scar than about a physical scar; but if you 
suddenly discovered a scar on your body that you could 
not account for, it would worry you somewhat, 
wouldn't it? Then, when you had finally remembered 
the cause, you would stop worrying. You will not be 
troubled if you can keep your sense of proportion, 
your "table of values." You can do this by avoiding 
as far as possible other worries and occupations which 
cause long-continued mental strain. They tend to 
bring on a morbid state of mind, especially if you have 
been losing sleep, and make you get things all out of 
proportion, magnifying the insignificant, just as a small WHAT ARE YOU AFRAID OF? 
263 
object held near the light casts a big shadow on the 
wall. Get back your perspective, and see where this 
little trouble belongs in relation to the big things of 
life. 
Keep your body clean and your mind clean. Get 
plenty of play. It is a national failing that so few of 
us know how to play. We are so pushed from behind 
or pulled from the front by the necessity of high living, 
or by ambition to get ahead, that we rush gasping and 
panting through life, often to a fall. 
If your mild phobia is becoming an obsession, take 
warning. You are not going crazy. It means merely 
that you have temporarily lost your mental poise. 
Brace up! Take a little time off for relaxation and 
amusement. Take your trouble out and look at it in 
the sunlight. 
If you cannot do this alone go to a specialist and tell 
him all about yourself. He will help you to "get 
back." He will ask you a lot of questions, giving you 
a chance to let the light into dark corners. He will get 
you to tell him about your dreams, your foolish, discon- 
nected, absurd sleep fantasies that are an index to your 
mental processes. Remember that dreams are mind 
realities and are not caused alone by pie, pork or plum 
pudding. He will fit together your dreams and your 
waking thoughts to make a complete picture which you 
yourself can look at and comprehend. And seeing the 
whole design and composition will help you to get 
back the proper sense of values. 
But how can phobias be prevented? If it were 
possible, the best time to begin would be with one's 
ancestors, but the next best time is with parents, which 
is entirely feasible for the newest generation and for 264 
THE COMMONSENSE OF HEALTH 
generations to come. If you will remember that 
nearly all phobias are due to early impressions, mind 
injuries, harrowing experiences, the solution is clear 
enough. So many of these are the result of careless- 
ness, indifference and neglect upon the part of parents. 
So many children are raised vicariously, the most im- 
portant time of their lives supervised, if at all, by 
ignorant servants; or the white, unwritten tablets of 
their minds are scrawled upon with distorted caricaT 
tures of life, of morals, of sex, of every serious rela« 
tion between the child and external things. 
They hear ghost stories, tales of goblins, of bogy 
men lurking in the dark; fairy tales, the themes of 
which are murder and violent death. Is it any wonder 
that when they grow up they are afraid to come up 
out of the cellar, afraid to look back into the dark? 
Even very young children receive lasting impressions 
at a time when we consider them too young to know 
and understand what is going on about them. Distur- 
bances at home, quarrels, deliberate maltreatment, 
bickerings of nervous, irritable parents-all these are 
more potent in creating mental injuries and have far 
more to do with morbid states of mind in after life 
than heredity. 
Is it any wonder that children raised in such environ- 
ment conceal within themselves, because they think 
them lewd, all questions of sex? If a child of six or 
seven years has not yet asked any questions about sex, 
scientists tell us that it is because he has been held 
back by a lack of confidence or by some repression 
from within. How much should be told the child is 
not necessarily the consideration. Certainly not more 
than is asked, provided there is a free, mutual confi- WHAT ARE YOU AFRAID OF? 
265 
dence between parent and child. But one thing is abso- 
lutely certain: the child should never be told a lie or an 
equivocation. You cannot fool a child, but you can 
destroy his confidence. And confidence, once shattered, 
can never be put together again by all the King's 
horses and all the King's men. SIXTEEN 
THE BIRTHRIGHT 
SHORTLY after the beginning of the War of the 
Revolution a certain young man joined one of the 
many military organizations then being formed to de- 
fend the country. Like hundreds of other young men 
of his time, he was of good pioneer stock and had in- 
herited at least the average sound mind and sound 
body. At the tavern in the town where troops were 
being mobilized he met a feeble-minded girl by whom 
he became the father of a feeble-minded son, thus be- 
coming the progenitor of a long line of ignoble 
posterity. 
After the war was over and he had returned to civil 
life this young soldier married a girl of good family 
and sound mind by whom also he became the ancestor 
of numerous descendants. 
The history of these two families has been traced 
with painstaking and meticulous care and recorded 
under the name of The Kallikak Family, a family 
name invented by the investigator to conceal the real 
one. 
Several years ago, while conducting a clinic for 
psychological research, Doctor H. H. Goddard and 
his assistants became interested in the family history of 
a feeble-minded girl, called Deborah, and after long 
and laborious research, they finally came upon the 
young Revolutionary soldier, Martin Kallikak, her 
great-great-great grandfather. One fact which made 
266 THE BIRTHRIGHT 
267 
these investigations successful was that the illegitimate 
son of Martin Kallikak had been given his father's 
name and surname. In consequence there are two lines 
of descendants of the same name which converge to 
the first Martin Kallikak. 
The illegitimate son passed on to posterity his 
father's name and also his mother's mental weakness. 
Of four hundred and eighty direct descendants definite 
information was obtained concerning one hundred and 
eighty-seven, and of these one hundred and forty-three 
have been feeble-minded. 
Four hundred and ninety-six persons are known to 
have sprung from Martin Kallikak's union with the 
girl of sound mind every one of whom has been men- 
tally normal. Among them were doctors, lawyers, 
judges, educators, business men and farmers, some of 
them prominent in their communities and all of them 
respected citizens. 
Here we have striking proof that mental as well as 
physical characteristics are transmissible. And also we 
have a striking instance of fraud committed upon a 
number of innocent persons. Long before they were 
born, these victims had been cheated out of their 
birthright. 
Every child has a right to receive at birth the heri- 
tage of a sound body and a sound mind. But that one 
branch of Martin Kallikak's family had been disin- 
herited while the others received each his proper share. 
Not all feeble-minded children are born feeble- 
minded, there are numerous cases of arrested mental 
development after birth. This is especially true of 
those who, although below normal, are not so far 
below as to be mentally defective. 
At one time, not so long ago but that most of us can 268 
THE COMMONSENSE OF HEALTH 
remember it, we assumed one of two attitudes towards 
backward children. We said, "Oh, well, what if he is 
a little slow, he will outgrow it later.'' Or we were 
hopeless about it: "What's the use? She's just stupid. 
Nothing can make her learn!" And she was neglected 
for the brighter children. Neither of these attitudes 
is right in the majority of cases and neither is entirely 
wrong. 
Conditions after birth may retard an orderly and 
progressive mental development, as may be seen by 
the following instance: To the psychological clinic of 
the University of Pennsylvania was brought a boy of 
eleven with a history of five wasted years in school. 
His case seemed so hopeless that almost any one would 
have considered him feeble-minded. But a physical 
examination disclosed a number of physical defects. 
He had adenoids, diseased tonsils, imperfect vision and 
decayed teeth, and besides, he was poorly nourished. 
Then began a general physical house renovating. 
The adenoids and tonsils were removed, his vision cor- 
rected by glasses, his teeth cleaned and filled. He was 
sent to a school for backward children during the 
summer but returned to his former class in the fall and 
within six months he had advanced two grades. Re- 
storing his birthright by ridding him of his physical 
defects had transformed a stupid boy into one of more 
than average intelligence and guaranteed to the com- 
munity a useful citizen. 
If left to himself, the stupid child will become a 
stupid adult and stupid citizens are a liability to the 
state. Many of them are troublesome members of 
society and from their ranks come most of the crim- 
inals. On the other hand, if properly cared for, a very 
large proportion of prospective dull citizens may be THE BIRTHRIGHT 
269 
salvaged. For these reasons it is important to see how 
we assay mentally and if anything is wrong, what, if 
anything, can be done about it. 
Before the war we were rather smugly complacent 
about ourselves. We thought that, on the whole, we 
ranked rather high physically as compared with the 
people of other nations. The physical examinations 
of our boys taught us a lot about that and we shall 
remember it for a long time. 
We thought that we were rather superior intellect- 
ually, that Uncle Sam, meaning our average selves, was 
pretty shrewd, at least a little shrewder and brighter 
than the average selves of any country. We have no 
figures to show how we compare with other nations in 
this regard, but certainly the psychological examina- 
tions of our soldiers did little to elevate our self- 
esteem. 
Of the nearly two million men, both officers and re- 
cruits, who were examined psychologically, more than 
fifty per cent had the minds of children of thirteen 
years or under. Of these, forty-five per cent had a 
mental age of twelve or less; one-third of this forty- 
five per cent were mentally as children of ten years and 
ten per cent of the nearly two million soldiers were of 
still lower levels, or mentally defective. 
It is a reasonable inference that our young soldiers 
were not, as a whole, mentally inferior to those who 
stayed at home. Consequently we must believe that 
more than fifty million people in this country are below 
normal in intelligence, including several million persons 
of all ages and of both sexes, who are mentally de- 
fective. 
That was rather a shocking disclosure which the war 
brought about. In a sense the psychologists of the 270 
THE COMMON SENSE OF HEALTH 
army merely reduced to tables of figures what we 
already knew, that some people are bright and some 
are not. But the real disclosure, however, lay in the 
fact that so few are really bright, and also that there 
are, among adults as among children, so many differ- 
ent grades or levels of intelligence. As a nation is a 
composite of the individuals in it and is not merely a 
country with certain geographical boundaries and 
physical resources, it can be no stronger and better 
than the composite physical and mental strength of its 
people. Consequently the only way to secure the future 
life and health of the nation is to get at the individual* 
in order to raise the average of intelligence as well as 
the average of bodily fitness. 
All that a human being is and all that he will ever 
become in this life depend upon two factors, heredity 
and environment. And all that a nation is or will ever 
become is determined by the minds and bodies with 
which its people were endowed at birth and the man- 
ner in which their heritage is cultivated. 
For the simple reason that one cannot choose his 
parents and grandparents, no one can determine the 
quality of his mental or physical endowment. At some 
time, let us hope in the not too far distant future, 
society will do that for the generation to come. It will 
declare that those with transmissible diseases or with 
defective minds shall not bring forth their kind. At 
present this protective attitude toward posterity is 
rather nebulous, although a few states have already 
passed or are considering laws with this end in view. 
The foundations of a healthy body are laid before 
birth and during childhood. If these are secure and 
strong, by the time the child reaches full growth he 
has a good chance of living out his expectancy, barring THE BIRTHRIGHT 
271 
accident and an overwhelming disease. The same 
thing is exactly true of the mind. Given a good aver- 
age brain at the start and normal, healthful surround- 
ings for both mind and body, and there need be little 
apprehension for the child's mental development. 
This fact makes the period of infancy and childhood 
so important to the welfare of the nation and gives an 
added value to the present brilliant achievements of 
modern psychology in the study of the child mind. 
Twenty-five years, or one generation, ago, as com- 
pared with the knowledge of the present day little was 
known about the psychology of children and its bear- 
ing upon their future mental development. At that 
not very remote period a child had but one age, that 
which was reckoned from birth. Now we speak glibly 
of the mental age, which may be totallv different from 
the other. In fact we know that every child has four 
ages, which may be all alike or may vary materially, 
each from the others. 
Now, if an intelligent mother is asked concerning 
her offspring the simple question, "How old is 
Willie?" she may overwhelm and confuse the casual 
inquirer by saying: "Willie was ten last Tuesday. He 
is also twelve and ten and twelve." Every parent 
knows the chonological age of his child but it is a wise 
parent who is acquainted with the other ages. 
Because of their bearing not only upon the mental 
development of individuals and upon the future intel- 
lectual and moral standards of the whole nation, it is 
important to know something about these other ages. 
One knows, of both children and adults, that some are 
brighter than others. But it is not so generally under- 
stood that a marked intellectual discrepancy in early 
childhood will remain throughout life. Very backward 272 
THE COMMONSENSE OF HEALTH 
children will still be relatively very backward when 
they grow up. They will never catch up with those 
who show markedly greater intelligence. 
The doctrine of mental levels was a direct result of 
exhaustive examinations of children, supplemented by 
investigations into the minds of our soldiers. The 
science of the mind has recently caught up with the 
science of the body. Just as new appliances and ap- 
paratus are coming into use to test the functions of the 
various physical organs, so new methods are being 
devised and perfected to sound the depths of intelli- 
gence, to measure the intellectual faculties and to pre- 
dict with reasonable accuracy the extent to which they 
can be developed. 
Francis Galton was the pioneer in these studies. In 
1883, after having devoted many years to his investi- 
gations he wrote concerning those first crude mental 
tests: 
"It is to obtain a general knowledge of the capacities 
of a man by sinking shafts, as it were, at a few critical 
points. In order to ascertain the best points for the 
purpose the set of measures should be compared with, 
an independent estimate of the man's powers. We 
may thus learn which of the measurements are the most 
instructive." 
After Galton there were many independent investi- 
gators both in Europe and in this country. But it re- 
mained for Binet in France and his assistant, Simon, 
to devise a set of mental tests and to correlate them 
with the various ages of children. These tests have 
been considerably modified in this country until at the 
present time they are fairly accurate gauges of intel- 
ligence. 
A child's mental age is the age at which the average THE BIRTHRIGHT 
273 
normal child can do certain things which he could not 
do at an earlier age. For instance, if a child passes 
all the tests that a normal child of ten can pass, his 
mental age is ten years, no matter what his chronologi- 
cal age may be. If he can pass the eleven-year test 
his mental age is eleven, and if he fails to pass the nine- 
year-old tests it is below nine. It can be readily seen, 
then, that a child may be ten years old dating from 
birth and yet have a mental age of seven or eight or 
twelve. 
Although the Binet-Simon tests have been somewhat 
modified by psychologists in this country, for purposes 
of illustration a few of them are given here to show 
that they are based upon the ability to learn, upon 
mental alertness, rather than upon the exact amount of 
knowledge acquired at any given age. The following 
examples will serve this purpose: 
Mental Age Four Years. 
1. Gives sex of self. 
2. Names familiar objects (as key, hat, watch). 
3. Repeats correctly three digits (as 3-9-1). 
4. Tells which of two lines is the longer. 
Mental Age Five Years. 
1. Tells which of two weights is the heavier. 
2. Copies a square so that it can be recognized as 
a square. 
3. Repeats ten syllables (as "John went out. He 
went to the store forbread."). 
4. Counts four objects placed in a row. 
5. Re-forms a card from two pieces formed by 
cutting a card diagonally. 
Mental Age Ten Years. 
I. Names nine different pieces of money. 
2. Draws two simple geometrical figures. 
3. Repeats six digits. 274 
THE COMMONSENSE OF HEALTH 
4. Answers intelligently some simple problem ques- 
tions (as "What ought one to do before undertaking 
something important?"). 
5. Uses three words, as New York, hat and street, 
in one sentence. 
Mental Age Twelve Years. 
I. Repeats correctly seven digits once in three trials. 
2. Defines charity, justice, goodness. 
3. Repeats a sentence of twenty-six syllables. 
4. Resists suggestion. 
5. Solves problems of fact (as, "My neighbor has 
been having strange visitors. He has been receiving 
one after the other a physician, a lawyer, and a clergy- 
man. What has happened at the house of my neigh- 
bor?"). 
Intelligence increases from birth to about the age of 
fifteen. A certain proportion of persons reach higher 
levels but the majority do not get beyond the mental 
age of fourteen. This statement may be considered 
as disparaging to the average intelligence, but the fact 
is that the boy or girl of fourteen has intelligence 
enough to carry him through all the emergencies and 
vicissitudes of life. What he lacks he can acquire later, 
knowledge and experience. 
One of the most interesting facts brought out by 
these investigations of the minds of children is that at 
any given age the final mental level can -with reason- 
able certainty be predicted. For example, if a child 
is ten years old chronologically and has a mental age 
of ten, his mental age at fourteen will be normal, or 
fourteen. If at five or seven or ten years old, he is 
brighter than the average child of his age, he will be 
about that much brighter, or more than fourteen years 
old mentally, when he reaches his fourteenth year. 
Also if, for example, at ten years of age he has the THE BIRTHRIGHT 
275 
intelligence of a boy of seven, he will never wholly 
make up the discrepancy. No amount of education 
can bring him up to the normal level, because intelli- 
gence is the ability to learn and, lacking it, the intake 
and assimilation of knowledge will be limited. 
The reader may argue: 
"Well, if intelligence is a matter of heredity, if 
every one is born with just so much capacity for devel- 
opment and no more; if no amount of training can get 
him beyond the final level to which he was foreorr 
dained, what of it? What is the use of worrying about 
it if nothing can be done?" 
But it isn't true. And especially it isn't true con- 
cerning the great intermediate class, those who are not 
too far below the normal at birth. Something can be 
done about it if it is done in time. As this has to do 
with the brain and its development it will be taken up 
later. Just now we are concerned with the other two 
ages of a child. 
Let us suppose, then, that a child is ten years old 
and that his mental age is also ten. Of course he is 
going to school. What grade is he in? The fourth? 
Then another of his ages is normal. His pedagogical, 
or school age, corresponds with the other two ages. 
He is in the proper grade for a child of ten. 
But he might be in a lower grade and still be as 
bright as any one in the ten year class. He might have 
started late in childhood, and have been moved on step 
by step, without reference to his brightness but merely 
in conformity with the regular order of progression. 
Our schools have not yet adopted the policy of treat- 
ing scholars as individuals. Most schools are like 
machines. The raw material goes in at one end and 
in due course of time there comes out at the other end 276 
THE COMMONSENSE OF HEALTH 
a more or less finished product. If a child goes into 
the machine at eight instead of six years his school or 
pedagogical age will probably remain below normal to 
the end. 
The trouble with our school methods is that they 
are not flexible. This is especially the case where a 
child is backward in one or two studies, although 
normal in the others. His particular needs are not 
usually taken into consideration. He goes through 
the mill steadily like the little raw material that he is. 
Binet, visiting a boy's school one day, asked the 
teacher which was his brightest scholar. 
"The boy over there," he said, pointing to a youth. 
"Indeed," said Binet. "How old is he?" 
"He is twelve years old." 
"I suppose, then," said the great psychologist, "that 
the other boys are of about the same age?" 
"No," answered the teacher, "the fact is that the 
rest average about ten years." 
"Then he is not the brightest boy in the room, but 
the dullest." Whereat, of course, embarrassment on 
the part of the teacher and a new light. 
Now the idea which Binet had in mind was abso- 
lutely right, but there is another side to be considered. 
Suppose this boy had entered school two years later 
than the rest and had been caught in the machine. Or, 
suppose that he was under-developed physically. This 
latter supposition brings us to the fourth age of the 
child. 
In every school about one-fourth to one-third of the 
scholars are mentally backward. Some of these just 
manage to get through and progress from grade to 
grade with the others; and some are repeaters, that is, 
they remain in each grade an extra term. Their THE BIRTHRIGHT 
277 
teachers may take greater pains with them but it is of 
no avail; they are just stupid. At least that was always 
the verdict, without any attempt at discrimination be- 
tween them, until something was learned about this 
fourth age. 
Now, however, the up-to-date teacher does not so 
classify them all indiscriminately until the school physi- 
cian passes upon them. If this physician is also up-to- 
date he will examine each backward child as to his 
eyes, ears, mouth, nose and throat, lungs and heart to 
determine whether there are any physical handicaps. 
And, if he is so modern as to know about the fourth 
age he will look at the teeth, not only for defects, but 
exactly for the same reason that a prospective pur- 
chaser looks into the mouth of a horse. A child's age, 
not in years but his fourth, or physiological age, can be 
estimated by the teeth. In more than fifty per cent of 
children the permanent teeth appear at periods and 
any variations indicate variations in the age of the 
body. If a child has more permanent teeth than nor- 
mal for his age his body is older than his age in years. 
And if he has fewer permanent teeth than he should 
have he is physiologically younger. 
Another reliable indication of the age of a child's 
body is to be found in the bones, especially of the 
wrist. The wrist contains eight small bones, the de- 
velopment of which from cartilage is normally com- 
pleted at a definite time. An X-ray picture will 
disclose the physiological age of a child by the shadows 
which these bones show. The more completely they 
are ossified the denser and more definite their shadows 
on the plate. 
This fourth age is an important factor in determin- 
ing mental ability and especially in predicting its final 278 
THE COMMONSENSE OF HEALTH 
mental level. It would be obviously absurd to say of 
a child whose mental age is below his age in years, 
that he is dull, if his body is that of a younger child. 
Another instance of the difference in physiological 
age is the period of pubescence. This change usually 
appears at about fourteen years, but with some it is 
delayed two or three years longer, and with others it 
is advanced. 
Girls mature about two years earlier than boys. 
This difference in physiological age between the sexes 
is evident very early in life, being well marked by the 
end of the first year. At four a girl is physiologically 
one year older than a boy of the same age. At seven 
and a half she is as old, structurally, as a boy of nine, 
and at twelve and a half she equals a boy of fifteen. A 
knowledge of this fact may console those males who 
have so often been told that girls are brighter than 
boys. 
They are, chronological age for age, but psycholo- 
gists assure us that it is because their bodies, and con- 
sequently their brains, are older. Later on the boys 
will catch up and reach, let us say, the final mental 
level of their sisters. 
The law of mental levels asserts that every human 
being is born with certain possibilities of intelligence, 
potentialities for reaching a final stage of mental devel- 
opment which under favorable circumstances he will 
attain. We are not all equipped alike at birth; some, 
like the men in the parable, receive five talents and 
others less. Some will develop their intellectual inheri- 
tance and some will bury it and be content. And by no 
means all of us have equal opportunities for invest- 
ment and increase. Development of brains depends THE BIRTHRIGHT 
279 
not only upon the amount of the original capital but 
upon that other great factor, environment. 
Intelligence is a matter of neurons, which is the 
name for the nerve cells and their fibres. Each person 
is endowed at birth with a certain number but their 
development is a matter of conditions after birth. 
Every process of the mind is due to a physical func- 
tioning of the brain. There is a direct relationship be- 
tween the growth of intelligence and the increase in* 
size of the nerve cells as well as the increase in the 
number and size of the fibres which connect them with 
each other. 
Like every other organ and tissue of the body the 
brain's growth depends upon the amount and kind of 
nourishment it receives. It can be starved or well 
nourished, according to conditions elsewhere in the 
body. Like other organs it grows in size and weight. 
But there is this exception, that the brain at birth 
weighs about one-fourth of its final weight and other 
organs are about one-tenth to one-fourteenth as heavy 
as they will be at maturity. 
There is another peculiarity about the brain which 
is of greater significance. During the first year its 
weight increases two and one-half times and by the 
middle of the fifth year it has attained over ninety per 
cent of its growth. After that the rate of increase 
rapidly diminishes and by the age of fifteen it ceases. 
Unless caused by a disease of, or an injury to, the 
brain, there is no danger that a child will become 
feeble-minded after the age of six. The tremendous 
significance of this lies in the fact that if the brain is 
well nourished during those early years it will have 
completed most of its growth and the ultimate intelli- 
gence will be fixed. 280 
THE COMMONSENSE OF HEALTH 
It can readily be seen, then, that this is the most 
critical period life. If a child has inherited the 
proper number of normal neurons and passes the first 
six years of life under proper conditions, well nour- 
ished and not handicapped by bodily defects or in- 
firmities, nothing, except disease or accident, can 
prevent its reaching the final mental level for which it 
was equipped at birth. 
Let us suppose that a child has been born of healthy, 
normal parents, both of whom have at least the aver- 
age intelligence. Every child is entitled to this but by 
no means all get it. Some are born of those either 
physically or mentally deficient, or both. The next 
right of the child is to be breastfed. There is no sub- 
stitute for mother's milk. It was intended to pass 
direct from mother to offspring, and was never meant 
to see the light of day. Some mothers unfortunately 
are unable to nourish their infants, but on the other 
hand many of them voluntarily relinquish this high 
function of motherhood. The only valid excuse for 
doing so would be a lack of supply or its inferior 
quality. 
After weaning, the child should receive a well-bal- 
anced diet. Fully half of all children are undernour- 
ished in one way or another. This applies to those of 
well-to-do parents as well as to the others, because, 
unless carefully watched, they eat too much starch and 
sugar and not enough of the whole-grain cereals, which 
contain not only bone-forming minerals but also the 
essential vitamines. These are found in small propor- 
tion in almost all foods except the starches, but they 
are more abundant in fresh fruits and vegetables and 
in the outer layers of grains. 
After a child reaches the school age his diet is THE BIRTHRIGHT 
281 
largely left to chance and his own selection. Usually 
he sleeps late in the morning, bolts his breakfast, rushes 
off to school and halfway through the morning he is 
hungry. At every opportunity he satisfies his hunger 
with candy, spoiling his appetite for lunch. Then, 
midway through the afternoon, there is the same 
hunger and the same method of allaying it. 
Of the backward school children, whose school ages 
are less than their chronological ages, some lack native 
intelligence, but with many the cause is undernourish- 
ment. This has been proven time and again by investi- 
gators in many cities. In Philadelphia, for instance, 
in a school in the poorer district, the experiment was 
tried of giving the scholars an extra meal, all they 
could eat once a day during school hours. Within a 
year most of the dullards had caught up with the 
others. Esau sold his birthright for a mess of pottage. 
Many a child's intellectual birthright could be secured 
to him by one good mess of pottage a day. 
A good deal might be said concerning physical de- 
fects, but this deserves especial consideration. In 
many schools the children are now examined by regu- 
larly appointed physicians. But some day it will be 
more generally understood that the time to examine 
children for defects of any kind, mental or physical, is 
before the school age, during that period of wonder- 
fully rapid changes in the brain, between birth and the 
sixth year. It is at this stage of a child's development 
that its future can be made or marred. 
Defective vision might be allowed to await correc- 
tion until the school age, but adenoids should be re- 
moved as early as possible and all other causes of 
obstruction to the free passage of air into the lungs, 
including diseased tonsils. 282 
THE COMMONSENSE OF HEALTH 
But what can be done with those children who are 
physically normal but through whose thick skulls 
knowledge percolates slowly if at all? Here is a case 
in point, as narrated by a correspondent: 
"We have in Iowa, as in most states, a compulsory 
educational law keeping youngsters in school until they 
are fourteen years of age, a certain length of time each 
year. We had three brothers attending school, young- 
sters from ten to fifteen years, all in very low grades 
and seemingly unable to learn. 
"An epidemic of scarlet fever left one of our 
teachers without scholars for about two weeks and 
we put those three youngsters with her to see if by any 
possibility, by any intensive training, she could do any- 
thing with them. Their minds seemed like a rubber 
ball; as long as you put a little pressure on you could 
see some slight effect, but the moment the pressure was 
withdrawn back went the mind to the old status with- 
out retaining anything. 
"After that teacher had given her best to those 
youngsters for a couple of weeks with no results we 
decided that the best interests of the school did not 
require the waste of time on such pupils." 
Here was a distinct and laudable attempt to solve 
a problem with regard to the individual. But the 
narrative points indirectly to two weaknesses. First, 
the experiment did not last long enough. At least a 
whole school-year would be required to get results, 
and probably longer. Wherever communities can 
afford it, and no community is too poor to ignore this 
problem of the backward child, special classes should 
be established for just such cases, with teachers who 
are chosen because of their high order of intelligence THE BIRTHRIGHT 
283 
and their knowledge of the psychology of children. 
In the second place, those who are hopelessly unable 
to learn from books should not be given up, left to 
shift for themselves, allowed to grow into men and 
women without equipment of any kind for earning a 
living. Many of them can be taught to work with their 
hands so that they will have useful occupations later 
on. 
Money spent in saving a life to usefulness is the best 
investment in the world. And the poorest economy is 
saving money and thereby creating a human derelict. 
Human derelicts are expensive. A large majority of 
delinquent adults, variously estimated at from fifty to 
eighty per cent, are of inferior mentality. They are 
unfitted both in mind and training for any useful occu- 
pation and they resort to their poor wits to procure a 
living by dishonest means. The average criminal is 
shrewd rather than intelligent. In his astigmatic 
brain, where images of realities are distorted, he has 
one fixed idea. The world owes him a living. 
With one slight modification it does. It owes him a 
chance to earn a living, by having his birthright, how- 
ever small or great, developed to the limit of its possi- 
bilities. But payment of the debt should have begun in 
infancy and childhood, not allowed to stand until too 
late and it has become outlawed. 
Most of the social unrest in the world arises in the 
ranks of the mentally and emotionally inferior. The 
misfits are the malcontents. They need only shrewd 
leaders of a somewhat higher grade to crystallize their 
discontent into some sort of ism, which promises a 
panacea for all economic and social ills. Blind fol- 
lowers of the half-blind. 
Here is a recipe for making a malcontent. The 284 
THE COMMONSENSE OF HEALTH 
directions, like those one frequently finds in a cook 
book, "a pinch of salt," "a lump of butter the size of 
an egg," and "sweeten to taste," are somewhat elastic. 
So these ingredients may be large or small in quantity, 
according to taste or chance; and any one or several 
may be left out altogether. 
Take at least one feeble-minded ancestor, or several 
whose mental grades were below normal. No, this is 
not necessary. Once in a while a genius arises in such 
a family, and also, occasionally, a feeble-minded person 
is the fruit of a sound tree. Suppose we start at birth. 
Take a child who is poorly nourished, especially dur- 
ing that magic period when the brain grows and the 
neurons develop with such marvelous rapidity. It 
would be better to have the mother sickly so that the 
child would be illy nourished before birth. Neglect 
him up to the sixth year; let him breathe bad air, give 
him little sunlight, have his surroundings as dark and 
damp as possible. 
As he grows up beyond infancy, give him improper 
food, coffee as early as possible, and sodden bread; 
fried meat like leather, pastries and candy bought with 
every spare dime. The moral atmosphere also should 
not be forgotten. Let him hear his elders quarreling. 
Let him witness repeated instances of brutality in the 
family. Punish him often, unjustly, and fail to mete 
out the promised punishment that he deserves. 
Leave the matter of schooling entirely to himself 
and his teacher. If he does not attend school regularly 
the teacher and the truant officer are paid to attend to 
that. By this time he is duller than others of his age. 
But many school laws say that a child must attend 
school until fourteen, so let him remain, a frequent THE BIRTHRIGHT 
285 
repeater, learning nothing from books and nothing 
useful to do with his hands. 
At fourteen he will not have reached nearly to the 
highest common school grade but he will be educated 
as much as the law requires. He will either loaf or 
hunt a job, the former if his family, perhaps a working 
sister, supports him; the latter if necessity presses. 
Because he is poorly equipped, even with such useful 
knowledge as his brain could have acquired, he will go 
from job to job, dissatisfied with each in turn, or he 
will be discharged from each as an incompetent. 
Now he is ripe for revolt. Let some one hold up to 
him the picture of a change in the existing order of 
things, a change that will secure to him an equal share 
with those more prosperous. It will make little differ- 
ence to him how the change is to be brought about, 
whether peacefully or by violence, he is for it. 
If his early life has been spent with criminal com- 
panions he may choose to fight society single handed 
and take for himself on occasion that which he thinks 
has been unjustly acquired by others. Or, if not crim- 
inally inclined, he may find solace in an "ism" and shout 
for equality. 
If one wants to make a cake or a pie one-half or 
one-third as large as the recipe calls for, the quantity 
of the ingredients is reduced by that much. Analo- 
gously, if one wishes to make merely a misfit in the 
world the ingredients that go to the making of an 
enemy of society should be reduced in quantity, perhaps 
some of them left out altogether. By properly mixing 
and judiciously measuring them it might be possible to 
make almost any kind of square peg for the round holes 
of life. 286 
THE COMMONSENSE OF HEALTH 
And also, by using other ingredients, the opposite of 
those mentioned, the result in all probability will be a 
useful citizen, fully come into his inheritance, at least 
half of which has been put in trust for him at his birth. SEVENTEEN 
WHAT IS WRONG WITH OUR YOUNG MEN? 
NATIONS, like individuals, are subject to delu- 
sions, because the national mind is a composite 
of individual minds. The war dispelled several of our 
national delusions-some of them with difficulty, 
others more or less easily. The one about fighters 
being born and not made and an army springing up 
overnight, like Minerva fully armed from the head of 
Jove, vanished before we got into the war. As a 
delusion it was a failure, because it fooled compara- 
tively few of us. 
There was another one, however, that caught more 
of us and for a long time refused to be downed. This 
was the belief that we were the strongest, most vigor- 
ous, healthiest people on the footstool. 
"Look at our boys!" we said. "Aren't they bigger 
and brawnier than any other in the world? Isn't their 
average height greater, and the chest development? 
Why, we have more and better food, more and better 
public schools, more outdoors, more personal freedom. 
We are on the way to develop a new race-the Ameri- 
can-with food and exercise and fresh air as founda- 
tions." 
When the war came, with its enlistments and its 
draft, gradually it began to drift in on us that we were 
going to have trouble in getting an army. 
The draft boards saw it first, and later the camp 
examiners. These boys of ours had all sorts of things 
287 288 
THE COMMONSENSE OF HEALTH 
wrong with them. They had bad teeth, bad eyes, bad 
hearts and bad feet. Before long our physical 
standards had to be lowered somewhat in order to get 
an army of sufficient size. Other nations had had to 
resort to this expedient, but we thought we were differ- 
ent. And we formed another army, of substandard 
men, an army of noncombatants, who were just a little 
below the physical standards. 
Now the army finally assembled was the finest in the 
world, physically and mentally. But to get the first 
two and a half million men about three and a quarter 
million were examined. And of this two and a half 
million several hundred thousand more were placed 
in the limited-service ranks because of partial dis- 
abilities. 
Sixteen per cent of our boys were found totally dis- 
qualified and perhaps another sixteen per cent were 
not quite fit to fight because of defects which lessened 
their efficiency. Some of these defects were compara- 
tively trivial, but they were serious enough to debar 
men from active military service. 
All this is a matter of record, but what of it? What 
are we going to do about it? Well, the Army did a 
lot about it. Many of the substandard men got rid of 
their partial disabilities in the Army. 
Outdoor life accomplished a part of this change, 
but intelligent treatment, physical exercise and in many 
instances comparatively slight surgical operations did 
more. For instance, mild degrees of flat foot were 
cured by the wearing of army shoes instead of the 
narrow-toed, mal-shaped, stylish variety worn by most 
civilians. And many thousands of men were operated 
upon for hernia, or rupture-a simple operation, not 
at all dangerous to life in skilful hands, but which WHAT IS WRONG WITH OUR YOUNG MEN? 
289 
added to their life expectancy and their efficiency, 
either civil or military. 
Even in the graver conditions which caused their 
rejection many were benefited. Most of them had 
never been examined before. They learned their 
weaknesses for the first time, and knowing them they 
were able when they returned home to safeguard them- 
selves against disaster. 
The war gave us the first opportunity to find out 
what is wrong with our boys, and of course by inference 
what is wrong with the rest of us. It cannot be sup- 
posed for an instant that the boys have a monoply of 
these disabilities. Be sure that other people have 
them also, and in about the same proportion; that 
where our boys were found wanting the rest of the 
nation will average no better. 
Before the war we knew what people died of; we 
had plenty of mortality statistics. But we had no 
statistics of the conditions which do not necessarily 
cause death-the ills and disabilities that lessen effi- 
ciency, that cause discomfort, that subtract from the 
sum of human happiness. Since the war we can arrive 
at an approximate idea of these and in what proportion 
they occur among us all. 
The seven conditions to be discussed here, ranging 
all the way from the apparently trival to the very 
serious, from bad teeth to bad heart, were selected for 
two reasons: First, they together were responsible for 
more than half of all the disabilities in the army exam- 
inations and may be considered as quite common to all 
of us; second, they can be either prevented, corrected 
or ameliorated, if we have the proper knowledge. 
It would be a discouraging occupation, this survey of 
our physical disabilities, if it were not for the fact that 290 
THE COMMONSENSE OF HEALTH 
in most instances they result from carelessness or igno- 
rance rather than necessity. 
This is obvious, for instance, in the case of defective 
teeth. There may be some excuse for the vacancies in 
one's mouth, but certainly there is none for the neglect 
of one's teeth. Tens of thousands of men were dis- 
qualified for this cause. Many of them had more 
decayed than good teeth. Many mouths were filled 
with snags and blackened disintegrating stumps and 
diseased gums. 
Bad teeth are not only a source of great discomfort 
but are an actual menace to health. They cause in- 
numerable troubles, both near and remote. Bad teeth 
prevent proper mastication of food, which is the first 
requisite of good digestion. The teeth are placed in 
the vestibule of the digestive apparatus and were not 
intended entirely for their cosmetic effect. Many 
people use them like the girl in the tooth-powder ad- 
vertisements-only for ornamental purposes. A great 
number of us bolt our food whole, washing it down 
with water or coffee or milk, forgetting that if we do 
not use them our teeth will not always be an ornament. 
Disuse brings indigestion and dental decay. 
One hears of focal infection quite often now, even 
in general conversation. Figuratively speaking, 
pyorrhea seems to be in everyone's mouth. Bad teeth 
are a common cause of focal infection, because the pus 
which forms about their roots is absorbed and causes 
much general disturbance, not the least of which is 
arthritis, or inflammation of the joints. It is not at 
all unusual nowadays for one to go to his dentist to be 
treated for rheumatism. Even apparently good teeth 
may be infected at their roots, causing many forms of 
severe but obscure illness. WHAT IS WRONG WITH OUR YOUNG MEN? 
291 
In these days, when dentistry has become a fine art, 
and in the United States, where it has reached nearer 
perfection than in any other country, specific directions 
for the care of the teeth may not be considered neces- 
sary. In general it may be said that they should be 
used, should be kept clean, cavities should be filled, 
defects removed-and finally that they should be dis- 
carded when they have become useless and a menace to. 
health. 
The reasons for including flat floot in our category 
may not at first be apparent, especially to one who is 
so afflicted. He considers himself a victim of circum- 
stances over which he had no control. If you are not 
a sufferer from this cause take this bit of advice: Do 
not speak of it jestingly to a flat-footed acquaintance 
unless you happen to be bigger than he. Joke as much 
as you like about anything else, however grave, but 
spare him, and yourself, on this one subject. His flat 
feet are apt to make him hypersensitive at both ends- 
antipodally, as it were. Here is some more advice: If 
you speak of it as a minor ailment please hasten to 
explain that by "minor" you mean "not fatal." That 
is about the only good thing to be said about it. It 
causes an infinite amount of suffering, but no deaths. 
If all the flat-footed persons in this country could be 
mobilized they would make an army of several millions 
-but not as a standing army. It is about the com- 
monest minor ailment that affects mankind, and it is a 
respecter neither of age, sex, color nor condition of 
servitude. 
Perhaps the army figures will give some idea as to 
its prevalence. Of the first million men examined 
177,45° were flat-footed. Not all in the same degree, 
however; and by no means that many were rejected. 292 
THE COMMONSENSE OF HEALTH 
Some were benefited in the camps by certain prescribed 
exercises and by wearing army shoes, and were made 
over into soldiers. But most of those who were not 
rejected were put into noncombatant organizations and 
given occupations more or less sedentary. 
Now, if more than one hundred and seventy-five 
thousand young men out of a million had flat foot one 
has only to multiply the first number by one hundred 
to arrive at an estimate as to the whole country. This 
stupendous result-more than seventeen millions- 
may not be accurate, but as we have no other figures, 
each of us may adopt for himself any which appeal to 
his reason or to his imagination, and still have enough 
fallen arches to go around. 
The term "flat foot" includes any degree of mildness 
or severity, from a slight stretching of the ligaments, 
which bind the bones of the foot into an arch, to the 
arch which makes a hole in the ground. Even the 
mildest is painful, however, and all more or less in- 
capacitate the victims. 
Shoes are one cause of flat foot. Primitive man 
walks upon his naked or sandaled feet; he does not 
cramp or bind them, and the foot muscles-having per- 
fect freedom of movement-are all of them used in 
walking. Primitive man walks. He does not stand 
much, to stretch and strain his foot muscles without 
giving them proper exercise. And above all, primitive 
man is not a slave to the modern shoe with narrow toe 
that is made to fit no foot in its natural shape. Also, 
the savage walks with his feet parallel, which places 
the weight of the body on the outer half of the foot, 
and not with the toes turned outward, which is an un- 
natural posture. And in walking he lifts his weight WHAT IS WRONG WITH OUR YOUNG MEN? 
293 
upon the ball of his foot, thus exercising and strength- 
ening all the muscles. 
To avoid flat foot children should be properly shod. 
They should be taught to walk and stand properly. 
Of course these rules also apply to adults. If you have 
weak arches learn to walk with the feet parallel or 
pointed slightly inward. 
You may remember that you were taught in child- 
hood to turn your toes out. This is considered to be 
the correct method in walking or standing and to 
lend an air of gentility to one's appearance, but it 
does not conduce to one's endurance in walking. Also 
the glide may seem an elegant method of locomotion, 
but the proper thing is to rise each time on the ball 
of the foot so as to exercise the muscles and ligaments. 
This also implies that the toes must have plenty of 
room for free movements. 
A few simple exercises will help to strengthen the 
arch. If you are suffering from flat foot in any but the 
extreme degree take this home and try it, not upon 
your piano but upon your bedroom floor, after you 
have shed the cares and the habiliments of the day: 
Standing with the feet parallel or slightly toed in 
and firmly planted, rotate the thighs outward from 
the hip without bending the knees. This exercise will 
correct the tendency to throw the weight upon the inner 
surface of the foot, thus exercising the proper muscles. 
Lift the toes forcibly as far as possible from the 
floor. Also, separate the toes by muscular effort, one 
from another, either in the same or in a separate exer- 
cise. 
Standing upon a board or anything above the sur- 
face of the floor with the ball of the foot upon the 294 
THE COMMONSENSE OF HEALTH 
edge, forcibly bend the toes downward and back a 
number of times. 
Each exercise may be repeated as often as time per- 
mits or inclination dictates. 
To jump abruptly from one extremity to the other- 
from the feet to the head-anyone not a student of 
psychology might think that mental defects do not be- 
long in our list because they are neither avoidable nor 
curable and because they could not have occurred with 
great frequency among our young men. 
But there are many kinds and degrees of mental de- 
fects. Every insane asylum has its idiots and its crim- 
inal insane, almost every community its village fool, 
every schoolroom its stupid child. Many families 
possess one member who does not measure up to the 
rest in intelligence. In other words, mental defectives 
grade all the way up from those who are mentally void 
to those who are merely slow, and they cannot be 
grouped together any more than physical defectives. 
Not more than two centuries ago the insane were 
either totally neglected or they were venerated because 
they were considered "possessed." No attempt was 
made to classify them or to treat them intelligently. 
And until recently mental defectives of the higher 
grades, those just below normal intelligence, were not 
classified. Stupid men and women were just fools, that 
was all, and backward children were merely stupid or 
lazy. 
Now we know that many children are backward be- 
cause they cannot see clearly, needing glasses. Or they 
cannot hear well, or cannot breathe properly because 
of obstructions in the nose or throat. And these de- 
fects are being discovered by systematic examinations 
of school children, and removed when possible. WHAT IS WRONG WITH OUR YOUNG MEN? 
295 
Last of all, we are beginning to show a little gleam 
of intelligence here and there throughout the country- 
it is by no means general-in our treatment of children 
who do not have imperfections of sight or hearing or 
respiration but are merely mentally slow. Tests are 
used by which they may be graded according to age, 
not of their bodies but of their minds. These tests are 
many and varied. They include, among others, tests 
of their ability to copy from memory both simple de- 
signs and sentences. Also questions are asked which 
require analysis and judgment in the answers as, for in- 
stance : 
You are walking along a country road and see upon 
a blacksmith shop a sign: "Three miles to Jonesville. 
If you cannot read, ask the blacksmith." Or, answer 
this: "What would you do if you missed your train?" 
If anyone sprung these on you suddenly you would 
probably think him mentally deficient, but if you failed 
to see the absurdity in the first proposition or to 
answer properly the second you yourself would be so 
classified, and your mental age would be placed at 
about seven or eight. Many a prospective soldier 
failed in the mental tests. 
Of five hundred thousand men rejected more than 
twenty-five thousand were mentally defective. 
Mental development, like physical development, is 
partly a matter of proper nourishment in childhood. 
Many a backward child has been brought up to normal, 
intelligence by being fed one good wholesome meal a 
day. In some of the schools of our large cities chil- 
dren have been given at noon all the milk they could 
drink, with bread and butter and a cereal. Within a 
few months the stupid children had caught up with the 
others. This is not a startling fact. It is quite ob- 296 
THE COMMONSENSE OF HEALTH 
vious, and the wonder is that it was not sooner recog- 
nized. The brain, to function, needs nourishment just 
as much as the rest of the body-and also fresh air. 
Stuffy schoolrooms make sluggish minds, and children 
in open-air schools thrive mentally as well as physi- 
cally, because mental activity depends upon physical 
well-being. 
One of the indefensible customs with regard to 
school children has been our grading them according to 
their ages without reference to their minds. One 
might as logically order a suit of clothes by mail, giving 
his age only. Children of the same age come in as- 
sorted sizes mentally as well as physically. Many a 
boy or girl quite fully grown possesses the mind of a 
child of seven or ten. The child's thought processes 
must be developed according to his individual needs. 
Within a generation or two our intellectual average 
will be higher than it is to-day because we are begin- 
ning to see these things. Here and there the psycholo- 
gist is at work in the schools analyzing the minds of 
the children, discovering their mental quickness or 
slowness, their visual and auditory memories and their 
natural aptitudes for certain lines of study. 
In our gradual approach from milder to graver con- 
ditions the next subject on our list is hernia. Logically 
hernia, or rupture, might be classified as an unavoid- 
able condition, but this would be only partly correct. 
Of rupture it may be said that some are born with it, 
which is a matter entirely beyond their control; some 
acquire it, by unnecessarily violent exertion; and some 
have it thrust upon them, by accident or by emergencies 
that require extreme muscular effort. 
That it is not a rare condition may be inferred from WHAT IS WRONG WITH OUR YOUNG MEN? 
297 
the fact that more than twenty-eight thousand men 
examined for the Army were ruptured. 
Strictly speaking, a hernia is the protrusion of an 
internal organ or tissue through an abnormal or an 
abnormally enlarged opening. For instance, one may 
have a hernia of the brain through the skull if a part 
of the bone is gone and there is increased pressure 
from within. But ordinarily rupture means the pro- 
trusion of a part of the abdominal contents, and this is 
the sense in which the word is employed here. 
Now the explanation of rupture is simple. The ab- 
dominal wall consists of: First, the skin; then fat, more 
or less; then strong muscular bands that hold the con- 
tents in place. Upon the firmness or relaxation of 
these muscular bands depends the shape of the abdo- 
men. Flaccid muscles cause it to be more or less pen- 
dulous. The shape also of course depends upon the 
amount of fat in the wall, but this we need not consider 
in discussing the mechanics of rupture. Lining the 
inner side of the abdominal wall and also the intestines 
are two layers of a smooth, shiny, self-lubricating 
membrane, the peritoneum. 
The two layers of this membrane glide one upon the 
other as the intestines move about in performing the 
act of digestion. The intestines, it may be said, are 
seldom entirely still. This absolute freedom of move- 
ment without friction gives to the abdomen one charac- 
teristic of a bladder full of water. That is, pressure 
exerted upon it anywhere causes an equal pressure from 
within at every point. Now if you press upon a filled 
hot-water bag, for instance, there will be equal pressure 
of the water upon every part of the inner surface of 
the bag and any weak place will give way. 
There are certain naturally weak places in the ab- 298 
THE COMMONSENSE OF HEALTH 
dominal wall where the muscles cross, which are points 
of exit for cords or ligaments which belong partly 
within and partly outside of the abdomen. These 
weak spots are the usual sites of rupture. Violent pres- 
sure, as from great muscular exertion in lifting, may 
cause these natural rings, as they are called, to stretch 
and allow the exit of a small part of the abdominal 
contents. In protruding, the intestine pushes ahead of 
it the inner lining of the wall, which forms a sack 
like the finger of a glove. 
The danger of a hernia lies in the fact that if not 
pushed back and held in place by a truss it tends to 
increase in size. But the greatest danger is that it 
may be caught and choked where it emerges through 
the ring. Strangulated hernia is the proper name for 
this unfortunate condition. And strangulated hernia is 
an instant menace to life, requiring immediate opera- 
tion. Whether or not one who has a rupture is in any 
way responsible for its cause, there is but one safe 
thing to do about it, and that is to have it corrected 
by an operation. This is the only sure cure. Trusses 
are a poor substitute. They are intended to press upon 
and close the ring, but they are often inaccurately fitted 
and are easily misplaced. The operation for hernia is 
usually quite simple, and in skillful hands is entirely 
safe. 
It is not so easy to classify venereal diseases, because 
one must consider not only those who willfully put 
themselves in jeopardy but also the innocent victims- 
the women and the children. 
There are no statistics concerning the prevalence of 
venereal diseases in this country, because they are not 
usually reported as are other communicable diseases. 
In the examinations for the Army, however, these WHAT IS WRONG WITH OUR YOUNG MEN? 
299 
matters were brought to light. Of the first million 
men nearly twenty-nine thousand were victims of the 
various forms of active venereal disease. Compara- 
tively few were examined for the chronic forms, but it 
has been estimated that if every man had had a thor- 
ough examination for the chronic as well as the active 
forms of venereal disease more than five hundred 
thousand would have been found to be afflicted. 
It was one of the greatest problems with which the 
Army had to deal, because it was necessary to protect 
from infection the men who had been accepted. An 
outstanding fact was that comparatively few men con- 
tracted any venereal disease after they became soldiers. 
The army solution is just as applicable to private 
life. It was twofold. First, publicity. The Army set 
out to tell the soldier all about the dangers of venereal 
disease. A moving picture very frank in its treatment 
of the subject was shown to all the men in the camps. 
It carried a heart-interest story which held attention, 
but the very frankness was gripping. There was noth- 
ing of mock modesty or innuendo in it, nothing to rouse 
grins, nudges or whispers. The men were intensely 
interested, and results showed that most of them took 
the lesson to heart. 
And then there was prophylaxis, or prevention. 
Men who had exposed themselves to the possibility of 
infection were obliged under penalty for disobedience 
to report at once to their officers for treatment. This 
rule obviously was not based upon highly moral 
grounds, but its enforcement saved a great many 
young men. 
Experience in the Army taught the need of frank- 
ness in such matters in the home and in public talks. 
Also it emphasized the need of public clinics in all com- 300 
THE COMMONSENSE OF HEALTH 
munities for purposes of treatment and prevention. 
Knowledge would not only keep many from transgres- 
sing but would do away with a great deal of suffering 
among the innocent; and especially it would prevent a 
certain virulent eye disease of the newly born, which 
causes by far the most cases of blindness. 
Innocent babes acquire this disease of the eyes at 
birth from mothers who are themselves innocent and 
totally ignorant of their own condition. To avoid the 
destruction which almost inevitably follows it is now 
a practice among physicians to instill into the eyes of 
the child immediately after birth a mild solution of 
nitrate of silver. Many doctors have adopted this 
routine practice at all births, even though there may be 
no suspicion on their part that the contagion is present. 
But because this is not universally the custom many 
babies are still blinded every year. 
Syphilis may be inherited or acquired. If inherited 
the sequence is usually as follows: The father has 
been infected and has been cured, as he thinks. He has 
not been under intelligent medical supervision. Prob- 
ably he has had proper treatment for a short time and 
then has stopped going to the doctor. Or he has 
changed doctors frequently because he thought he was 
not getting results and has finally given up in disgust. 
Or he has pinned his faith to patent medicines, taking 
one after another, following the lure of specious ad- 
vertisements. He enters the marital state unclean; the 
mother becomes infected and she unwittingly passes 
it on to the child, who-if it survives the first weeks or 
months of infancy-will carry the effects of an almost 
incurable disease as long as it lives. 
Only compulsory reporting of venereal disease will 
lessen the evil. But in order to bring this about it must WHAT IS WRONG WITH OUR YOUNG MEN? 
301 
be universally understood that reporting does not mean 
publicity. And infected persons should not be per- 
mitted to marry until they have been pronounced clean. 
Here is another of the diseases that are both avoid- 
able and unavoidable-pulmonary tuberculosis, com- 
monly called consumption. Its victims of both sexes 
and all ages may be estimated by the tremendous num- 
ber of men who were excluded for this cause from the 
Army-ninety-five thousand. Most people believe 
that the only way to prevent consumption is by keeping 
away from those who have it. But in spite of our pre- 
cautions we are all exposed to it almost every day of 
our lives. 
Why do we not all get it? The answer is that we 
have something within ourselves strong enough to 
antagonize it. 
Pulmonary tuberculosis is probably the most feared 
of all diseases, for two reasons: We are afraid that 
we will get it from others, and we believe it to be 
fatal. Both fears are very largely baseless. The in- 
evitability of death from consumption is a foolish be- 
lief and is rapidly disappearing. Even the consump- 
tive himself soon learns that he has a good chance to 
conquer the disease and that he must help to make the 
chance a certainty. 
But the other fallacy is harder to disprove. It 
must suffice to say that the preponderance of evidence 
is to the effect that in by far the greater number of 
instances adults infect themselves and do not get the 
disease from others; that all or nearly all of us are 
tuberculosis in that we harbor the germs and contend 
against them continually. Not that we all have active 
tuberculosis or consumption, but that the tubercle bacil- 
lus is within us, waiting its chance to set up housekeep- 302 
THE COMMONSENSE OF HEALTH 
ing in our weakest place, which in the majority of cases 
is the lungs. 
This activation, when it occurs in the lungs, is what 
we know as pulmonary tuberculosis. Now, activation 
may be prevented by keeping well. That is, by keeping 
up or building up our resistance to the disease. But 
children, especially infants, have not been long enough 
in contact with the germs to have developed sufficient 
resisting power, and their resistance is more easily 
overcome. For this reason they should be removed 
from contact with those who have the active disease. 
Is this clear? It may be simply stated thus: Infants 
and children are prone to get the disease from others, 
but adults with few exceptions get it because they 
already have the germs within them and their natural 
resistance has been broken down. Disease germs do 
not thrive in healthy bodies. 
Now the tubercle bacillus is a minute vegetable, a 
living, rodlike organism so small that it must be magni- 
fied a thousand times in order to be seen at all. It 
multiplies by dividing, which sounds paradoxical. 
That is, one bacillus fully grown, and each of these 
into two and so on, which for a single germ would soon 
result in a family of many millions-under the most 
favorable conditions, however. But conditions are 
never absolutely favorable, and in the vast majority of 
cases they are extremely unfavorable for the germ. 
Heart diseases surely belong to the unavoidable 
conditions? Not necessarily, but most people think so. 
In the course of a casual conversation your friend 
says to you: "By the way, have you heard about Sallie 
Smith? She has heart trouble." 
You shake your head sadly: "And with two little 
children!" WHAT IS WRONG WITH OUR YOUNG MEN? 
303 
Just like that. As though you had been informed 
that Mrs. Smith's death warrant had been duly signed, 
leaving only the date space blank. 
There are many kinds of heart disease, most of 
which are not fatal. Of one million men examined for 
the Army about 12,000 were rejected for conditions of 
the heart or blood vessels. But many times this num- 
ber of men had heart conditions and were accepted as 
soldiers, because they had functional and not organic 
troubles. And it is quite reasonable to assume that the 
lives of one-half or perhaps three-quarters of those re- 
jected were prolonged by the examinations simply be- 
cause they learned about themselves. 
If there is any one class of conditions in which ignor- 
ance is an especial danger it is conditions of the heart. 
The reason why some people die of heart disease is 
partly due to the fact that their attention has never 
been called to their condition until too late. It is only 
when the heart is almost completely broken down that 
we are conscious of it at all. There are no nerves of 
sensation in the heart muscle. The pains suffered are 
reflex or referred pains in other nerves, many of them 
quite remote, which are connected through the spinal 
cord with the motor nerves of the heart. Many pains 
which we call heart pains because they are in the chest 
wall near the heart really do not have their origin 
in the heart at all. And many a person dies of heart 
disease whose only symptom has been shortness of 
breath. 
As has been said in a previous chapter the heart is 
a force pump, a great muscle or bundle of muscles 
which, by contracting, send the blood coursing through 
the vessels to the remotest parts of the body with 
such force that it flows back to the heart, to receive 304 
THE COMMONSENSE OF HEALTH 
a new impetus. It is not what is wrong with this 
pump, as with any other pump, which is most im- 
portant. It is what the pump can do in spite of its 
defects, and especially what it cannot do. It is ex- 
tremely necessary to give the pump no greater task 
than it can perform safely. Hence one must know 
where the dividing line is between work and overwork. 
One of three things may be the fault in what is 
called heart disease. It may be the heart itself-that 
is, either the valves, the orifices through which the 
blood flows-or it may be the heart muscle. To carry 
on the analogy of a pump, it may not be the pump at 
all, but the piping system-that is, the blood vessels. 
Penally, it may be the pumper, or the force which 
causes the heart to pump-which is the nerve supply. 
In case the piping system is at fault there may be 
an obstruction somewhere which hinders the onward 
flow of the blood, causing the heart to labor. This 
may become so great as to stop the heart action 
altogether. 
The most frequent cause of obstruction to the stream 
is arteriosclerosis, or hardening of the vessel walls. 
This usually comes on with advancing age, but it may 
appear earlier under certain conditions. One of the 
theories of the cause of arteriosclerosis is based upon 
the extreme high pressure of modern life. We are 
a nation of fast livers, always hurrying, always driven 
by pressure from within. In the arterial walls are 
elastic and muscle fibers which lengthen and contract 
with each wave of the onward flowing blood. These 
degenerate with advancing years after continued high 
living and are replaced by inorganic matter which 
renders the artery walls hard and inelastic. WHAT IS WRONG WITH OUR YOUNG MEN? 
305 
Now, it requires more force to pump fluid through 
a lead pipe than through a rubber hose, which by its 
own contractions helps to drive the stream onward. 
So hardening of the arteries compels stronger heart 
contractions and finally this overexertion may exhaust 
the heart altogether. 
If the pumper is at fault, and not the pump or the 
vessels, the cause is elsewhere. Something is wrong 
with the nerve stimulus of the heart. The heart action 
may be too rapid-as for instance, from excitement 
or overexertion. It may be too slow, as in wast- 
ing diseases, or it may be irregular. Diseased condi- 
tions of the other organs may act reflexly upon the 
heart through the nerve centers and the heart itself 
not be at fault at all. 
The practical application of all this is that one must 
learn the cause. If it is remote the cause must be 
corrected, if possible, and many so-called heart con- 
ditions will disappear. Many forms of heart mani- 
festations may be prevented by proper care during the 
progress of other diseases. If the fault lies in the 
heart itself one must learn what can be done with 
safety. Get competent advice, not from your neighbor 
or your plumber, but from a physician, and then live 
it. Do not follow the example of the man who said 
that he would not pay for his doctor's advice because 
he did not intend to take it. 
Above all, do not despair. Remember that a pump 
may perform its task with a leaking valve-if the 
pumper realizes the defect and pumps accordingly. 
But he must not attempt to pump to the point of ex- 
haustion. Nor always at the same speed. Occa- 
sionally he must rest. 306 
THE COMMONSENSE OF HEALTH 
This is the end of the string of seven as set forth 
in the beginning, which were assembled here for the 
sole reason that the army examinations proved how 
much they make up the sum of human ills. If there is 
anything helpful in this chapter it will be by suggestion 
only, because lack of space does not permit exhaustive 
treatment, and many of these ailments have been dis- 
cussed in previous chapters. 
It is plain that any attempt to segregate these con- 
ditions into avoidable and into unavoidable is at least 
partly artificial. Not one of them in all circumstances 
belongs in either class. The important thing to know, 
however, is that those of us who are not already victims 
may avoid most of them if we choose, and that the 
dire consequences of every one of them may be 
averted. 
Ignorance lies at the bottom of most of our physical 
ills-ignorance or willful carelessness. Many of us 
do what we know to be wrong, hoping some day to 
stop doing it before it is too late. Many of us 
hide our weaknesses, refusing to confide even in the 
doctor. Many of us get advice and, having received 
it, throw it away unused, which is far less sensible than 
dropping a newly purchased garment in the sewer on 
the way home from the store. 
Many are held by the fear of an operation that may 
be far safer than doing without it. Many are lured 
by specious promises of patent-medicine manufacturers 
whose motive is to fill their pockets. 
It takes moral courage to reckon up our physical 
liabilities, and many of us shrink from the attempt, 
postponing it fatally. 
Even in the case of minor evils, which cause only WHAT IS WRONG WITH OUR YOUNG MEN? 
307 
discomfort and lessen our efficiency, we go on suffer- 
ing rather than take the time or the trouble to get rid 
of them. 
These are days of business efficiency; why not prac- 
tice a little personal efficiency with regard to our 
bodies?