Hygiene: a manual of personal and public health (New Edition)
Obvious typographical errors have been silently corrected. Variationsin hyphenation have been standardised but all other spelling andpunctuation remains unchanged.
The original makes extensive use of „. This has been replaced by theoriginal text in some cases where this improved clarity or layout.
The mathematical and chemical formulae accurately represent the originalbut have not been error checked.
Personal and Public Health
ARTHUR NEWSHOLME, M.D., F.R.C.P., Lond.,
UNIVERSITY SCHOLAR IN MEDICINE; DIPLOMATE IN PUBLIC HEALTH, UNIV. LOND.; MEDICAL
OFFICER OF HEALTH OF BRIGHTON; MEMBER OF THE COUNCIL AND EXAMINER TO THE
SANITARY INSTITUTE; EXAMINER IN STATE MEDICINE TO THE UNIVERSITY OF
LONDON; LATE EXAMINER IN PREVENTIVE MEDICINE TO THE UNIVERSITY OF
OXFORD, AND PRESIDENT OF THE INCORPORATED SOCIETY OF MEDICAL
OFFICERS OF HEALTH.
NEW EDITION, 1902. ILLUSTRATED.
Geo. Gill & Sons, Ld., Minerva House, Warwick Lane.
The writing of a preface is perhaps superfluous for a book which hashad a large and steady sale for nearly twenty years, and which hasevidently met with the approval of a large constituency. A few wordsof introduction appear, however, desirable in view of the facts that thepresent edition has been almost entirely re-written; that a large amountof new matter has been introduced; and that, so far as is known, thecomments on each subject represent the most recent and authoritativeknowledge upon it.
An attempt has been made to meet the requirements of medicalstudents, as well as of science students and general readers, for whomformer editions were chiefly intended. A large class of medical studentsand practitioners do not require the detailed statement of the subjectcontained in the larger text-books. For them, and, it is hoped, also fora large number of candidates for diplomas in public health and in sanitaryscience, the present edition will prove to be useful. At the same time,the subject has been treated as non-technically as is consistent withaccuracy, in order to retain its suitability for non-medical readers. Alarge number of new illustrations have been introduced.
The new chapters dealing with Dietetics, Trade Nuisances,Meteorological Observations, Tuberculosis, Disinfection, and VitalStatistics will, it is believed, enhance the value of the book.
Attention is also drawn to the solutions of mathematical problemsin the different branches of hygiene, of which a table of contents is givenon page viii.
In its new form, it is hoped that this work will be found to haveretained its value as a plain and straightforward account of its subjectfor the general public and for science students; and to have become apractical guide to sanitary inspectors and to medical students, whetherpreparing for a diploma in public health, or studying hygiene as animportant branch of medicine. The use of smaller type for speciallytechnical matter of less general interest will facilitate discriminativereading.
February 28th, 1902.
TABLE OF CONTENTS.
|III.||—The Varieties of Food||9|
|IV.||—Diseases due to Food||23|
|VI.||—The Preparation and Preservation of Food||38|
|VII.||—Condiments and Beverages||45|
|X.||—The Storage and Delivery of Water||74|
|XI.||—Impurities of Water||78|
|XII.||—Origin and Effects of the Impurities of Water||89|
|XIII.||—The Purification of Water||94|
|XIV.||—Composition and Properties of Air||100|
|XV.||—Suspended Impurities of Air||105|
|XVI.||—Gaseous and Other Impurities of Air||111|
|XVIII.||—The Examination of Air||125|
|XIX.||—The Purification of Air||129|
|XX.||—General Principles of Ventilation||132|
|XXI.||—Problems as to Ventilation||137|
|XXII.||—Methods of Ventilation||146|
|XXIII.||—Ventilation by the Introduction of Warmed Air||155|
|XXIV.||—The Warming of Houses||158|
|XXVI.||—Cesspools and Main Sewers||183|
|XXVII.||—Problems as to Flow in Sewers||187|
|XXVIII.||—The Disposal of Sewage||190|
|XXX.||—Position of the House||201|
|XXXI.||—The Materials used in the Construction of a House||205|
|XXXII.||—Construction of the House||209|
|XXXIV.||—Climate and Weather||227viii|
|XXXVIII.||—Personal Hygiene—Rest and Sleep||257|
|XLII.||—The Rôle of Insects in Spreading Disease||281|
|XLIV.||—Acute Infective Diseases||291|
|XLVI.||—Notification and Isolation||317|
SPECIAL TABLE OF CONTENTS FOR ARITHMETICALPROBLEMS IN HYGIENE.
|Problems in Milk Analysis||12|
|Problems in Dietetics||35|
|Problems in Water Analysis||86|
|Problems in Air Analysis||126|
|Problems as to Ventilation||137|
|Problems as to Flow in Sewers||187|
|Problems in Meteorology||242|
|Problems as to Work||254|
|Problems in Vital Statistics||336|
In classical mythology, Æsculapius was worshipped as the god ofMedicine, while his daughter Hygeia had homage done to her asthe sweet and smiling goddess of Health. The temples of thesetwo deities were always placed in close contiguity; and statuesrepresenting Hygeia were often placed in the temple of Æsculapius.In these statues she is represented as a beautiful maid, holding inher hand a bowl, from which a serpent is drinking—the serpenttypifying the art of medicine, then merely an art, now establishingits right more and more to the dignity of a science.
That considerable attention was paid in very early times tomatters relating to health, is also shewn by the elaborate directionscontained in the Mosaic law as to extreme care in the choice ofwholesome foods and drinks, in isolation of the sick, and attentionto personal and public cleanliness. It is not surprising, therefore,to find that the Jews, throughout the whole of their history, haveapparently enjoyed a high standard of health.
In this country great ignorance of the laws of Health has priorto the last fifty years prevailed, and consequently preventiblediseases have been rampant, and have claimed innumerable victims.Each century has been marked by great epidemics, which haveswept through the country, scattering disease and death in theircourse. In the fourteenth century, for instance, there was the BlackDeath, a disease so fatal that it left scarcely one-fourth part of thepeople alive; while Europe altogether is supposed to have lostabout 40 millions of its inhabitants, and China alone 13 millions.A century and a half later came the Sweating Sickness (thoughthere were a score of minor epidemics in between). This wascarried by Henry the Seventh’s army throughout the country, andso great was the mortality, that “if half the population in any townescaped, it was thought great favour.” Considerable light is thrownon the rapid spread of this disease after its importation, when weremember that there were no means of ventilation in the houses;that the floors were covered with rushes which were constantly puton fresh without removing the old, thus concealing a mass of filth2and exhaling a noisome vapour; while clothing was immoderatelywarm and seldom changed; baths were very seldom indulged in,and soap hardly used.
In the sixteenth and seventeenth centuries there were five or sixepidemics of The Plague, and it was only eradicated from London,when all the houses from Temple Bar to the Tower were burneddown in the Great Fire of September 2nd, 1666, which destroyedthe insanitary and necessitated the building of new and largerhouses.
Scurvy, jail-fever, and small-pox, are other diseases which wereformerly frightfully prevalent. Jail-fever, the same disease as themodern typhus-fever, has now become practically extinct in itsformer habitat, owing largely to the noble work of John Howard,“whose life was finally brought to an end by the fever, against theravages of which his life had been expended.” This disease wasfostered by overcrowding, ill-ventilation, and filth.
Scurvy formerly produced a very great mortality, especiallyamong sea-faring men. In Admiral Anson’s fleet in 1742, out of961 men, 626 died in nine months, or nearly two out of every three,and this was no solitary case. Captain Cook, on the other hand,conducted an expedition round the world, consisting of 118 men;and although absent over three years, only lost one life. He waspractically the first to demonstrate the potency of fresh vegetablesin preventing scurvy.
The striking facts respecting small-pox will be found on page293. The general death-rate has also greatly declined. Thus whilethe annual death-rate in London 200 years ago was 80 per 1,000, itonly averaged 18.8 in the four years 1896-99; and the death-rate ofEngland and Wales has declined from 22.4 in 1841-50 to 18.7 per1,000 in 1891-95 and 17.6 in 1896-99.
That much still remains to be done is evident on every hand.There is little doubt that the general death-rate might be reducedto 15 per 1,000 per annum, instead of the present 18, were the lawsof health applied in every household and community. It has beenestimated that on the average at least 20 cases of sickness occur forevery death; therefore nearly half of the population is ill at leastonce a year. A simple calculation will show how much loss thecommunity annually suffers from this vast mass of preventiblesickness. It amounts to many millions of pounds, leaving outof the reckoning the suffering and distress which are alwaysassociated with sickness. For details relating to special diseases,see page 297.
In the prevention of this mass of sickness, the knowledge of itscausation is half the battle; when once a disease