The enduring tension: Personal discipline versus structural provision in the history of air hygiene

“ There can be absolutely no doubt that impure air is the root-cause of disease in ninety-nine cases out of every hundred. It follows that the best way of avoiding disease is to live and work in the open air. No doctor can compete with fresh air in this matter. Consumption is caused by the decay of the lungs, due to the inhaling of impure air, just as a steam engine which is filled with bad coal gets out of order. Hence doctors say that the easiest and the most effective treatment for a consumptive patient is to keep him in fresh air for all the 24 hours of the day. ”

“ What constitutes health, wealth, joy, and peace? In the first place, good pure air is the greatest sustainer of animal life. Other elements of life we can dispense with for a time, but this seems to be essential every moment; hence the necessity of well ventilated dwelling-houses, especially the rooms occupied for sleeping. You can live without water and food longer than you can without air, and water is of more importance than meat and bread. ”

“ The former treats of the influence of habits, cleanliness, exercise, clothing, and food on health; while the latter is concerned with the interests of the community at large, as affected by a pure supply of air and water, the removal of all excreta, the condition of the soil, and with the administrative measures required to secure the removal of evil conditions. It is obvious, however, that these two divisions are not mutually exclusive. What is important to the health of the community, is equally so to each individual member of it. ”

“ Thus the laws of health are disregarded; and when fever comes, it finds a wide field to work upon: in undrained and filthy streets and back-yards,—noisome, pestilential districts,—foul, uncleansed dwellings,—large populations ill-supplied with clean water and with pure air. There death makes fell havoc; many destitute widows and children have to be maintained out of the poor's-rates; and then we reluctantly confess to ourselves that Ignorance is Power. ”

“ Men lash themselves into furious excitement over the differences between tweedledum and tweedledee in politics, while they can be aroused to only a languid and careless attention to the life-and-death interests of daily family life. Say what we will, the next great subject in order in the development of civilization is that of hygiene. To use this world rightly, and get the most out of it, health is the first condition, and there is no interest so important both to the individual and to the community as its promotion and preservation. ”

“ Fresh air kills the microbes of certain diseases, e.g., consumption, and is hostile to all disease. The stools of typhoid patients should be disinfected, and great care taken that no water or other fluid is contaminated by them through imperfect sanitation, etc. (see Fever, Typhoid) . Seeing that the seeds of disease are all around us, the best method of warding off their attacks is to keep the body in a state to resist their inroads by strict attention to diet, exercise and ventilation. ”

“ They do so in virtue of better resisting power, rather than because no seeds of disease ever reach them. In case of epidemic, then, besides daily sponging with acetic acid or vinegar, and scrupulous cleanliness, everything should be done to increase health and vitality in the household. Plenty of fresh air and sunlight, open windows day and night, and good plain food, are most powerful aids to resisting disease. The milk and water used in the household should all be boiled and allowed to cool before use, the boiling lasting half-an-hour. ”

“ So you should always try to get your houses well ventilated, that means to let the air be often changed, and free from impure mixtures; and you should avoid crowding many into one room, and be careful to keep everything clean, and put away all filth; for filth is not only disgusting to the eye and the nose, but is dangerous to the health. ”

“ These things which result, not from set lessons, but from self-discipline, self-reliance, self-knowledge, determine the success of a boy or girl in life, and these qualities the public school must seek to develop through every means and every force at its command.
Looked at from any point of view, economic or moral, physical health is the fundamental material good of mankind. Yet what contribution does the ordinary public school make towards hygiene? As a rule it crowds fifty or sixty children into a room that, under the most favorable conditions, has fresh air enough for only thirty. ”

“ As pure air is one of the essentials of good health, it follows that one of the chief duties of a housekeeper is to see that the family supply of this necessary element is properly regulated. Very few housekeepers realize the importance of ventilation in promoting the general health and comfort of the family. ”

“ Yet if we do not provide a regular supply of pure air within our houses, we shall inevitably suffer for our neglect. A few specks of dirt may seem neither here nor there, and a closed door or window would appear to make little difference; but it may make the difference of a life destroyed by fever; and therefore the little dirt and the little bad air are really very serious matters. The whole of the household regulations are, taken by themselves, trifles—but trifles tending to an important result. ”

“ As stated in the introduction to our study, the fundamental law of hygiene is the law of harmony: Habits of living must harmonize with the plan of the body. Having acquainted ourselves with the plan of the body, we may now review briefly those conditions that help or hinder its various activities. The hygiene already presented in connection with the study of the various organs may be condensed into general rules, or laws, as follows:
1. Of exercise: Exercise daily the important groups of muscles. ”

“ Teach the people the true nature of the tuberculosis, that no one ever has tubercular consumption unless the tubercle bacilli find their way into their lungs. 2. Teach them, also, that, even if it finds its way there, it will not grow unless the conditions are right. Teach fathers and mothers how to rear healthy boys and girls. Tell them what to eat and what to wear, to exercise, to breathe fresh air. This alone would exterminate phthisis. 3. The contagion must be destroyed. Fortunately, in this disease there is no need of isolation. Disinfection is enough. ”

“ The Digestion and assimilation of food are aided by exercise, especially when taken in the open air.
7. The nervous system is improved in nutrition and power by a moderate amount of exercise. In fact, a certain amount of muscular exercise is essential for a healthy mind.
8. The elimination of urea is not increased by exercise. Evidently then it is not the metabolism of the nitrogenous substance of the muscles which supplies the energy for muscular contraction ”

“ Every part of the body ought to be exercised. This is done spontaneously by the infant. Every muscle of his body acts in sheer delight. The evils of exercise confined to particular groups of muscles have been already described. Lawn tennis is very valuable as affording exercise for both limb and trunk muscles.
6. Exercise should not be taken immediately after meals, as thus digestion is interfered with.
7. Exercise should be taken, as far as possible, in the open air. A small amount of exercise out of doors is much more invigorating than a large amount indoors. ”

“ But to do this, we must first have good, healthy, well-developed lungs and elastic chest walls, which can come only from plenty of vigorous exercise in the open air, combined with good food and well-ventilated rooms. We must have a healthy stomach, which will not fill up with gas and keep our diaphragms from going down and enlarging our chests properly; we must have clear nasal passages, good teeth, well-shaped mouths and flexible lips, which we are willing to use vigorously in articulating, or cutting up our voice sounds; and we must have good hearing and a well-trained ear. ”

“ There is no royal road to health any more than there is to learning. Like all things made precious and to be really enjoyed, health must be earned.
It may be said that, for all persons whose regular occupation is sedentary, exercise in the open air is to be preferred. The oxygen of the air is essential to the life of the blood. It is well also to take exercise as much as possible in company. One person encourages another. A man will often take part in exercise with a companion so as not to disappoint him, even if he would not exercise for his own sake. ”

“ Now we have seen how our own bad habits render the air impure, and what we can do to keep it pure. Next we shall consider how to inhale the air.
As already mentioned in the last chapter, the air is to be inhaled through the nose, and not through the mouth. There are, however, very few persons who know how to breathe correctly. Many people are in the pernicious habit of inhaling through the mouth. If very cold air is inhaled through the mouth, we catch cold and sore throat. Further, if we inhale through the mouth, the particles of dust in the air go into the lungs and cause great mischief. ”

“ With the hands on the hips, the shoulders drawn back and down, the chest pushed upward and forward, and the chin slightly depressed, draw the air slowly through the nostrils until the lungs are completely full. After holding this long enough to count three slowly, expel it quickly from the lungs. Avoid straining. To get the benefit of pure air, it is generally better to practice deep breathing out of doors or before an open window. ”

“ Portions of the lungs to which air does not easily penetrate fail to get the fresh air and exercise which they need. As a consequence, they become weak and, by losing their "power of resistance," become points of attack in diseases of the lungs.35 The breathing of each individual should receive attention, and where from some cause it is not sufficiently full and deep, the means should be found for remedying the defect. ”

“ The habit of spitting indiscriminately on the verandahs, court yards, and such like places is also very bad. The spittle, especially of consumptives, is very dangerous. The poisonous germs in it rise into the air, and, being inhaled by others, lead to a spread of the disease. We should keep a spittoon inside the house, and if we have to spit when out on the road we should spit where there is dry dust, so that the spittle may be absorbed into the dust and cause no harm. ”

“ Smoking also leads to an appreciable reduction of digestive powers. The smoker feels no appetite for food, and in order to give it some flavour, spices and condiments have to be freely used. His breath stinks, and, in some cases, blisters are formed on [Pg 38] his face, and the gums and teeth turn black in colour. Many also fall a prey to terrible diseases. The fumes of tobacco befoul the air around, and public health suffers in consequence. I cannot understand how those who condemn drink can have the temerity to defend smoking. ”

“ When the circumstance is present that you say, according to hygiene, induces disease, whether it be air, exercise, heredity, contagion, or accident, perform your office as porter, and shut out these unwelcome guests; exercise the mind's authority over the body, and protest against their entering your castle, and you can keep them out; nothing can affect your body to the issues of pain or pleasure, unless the mind says it or fears it, and like a frightened porter forsakes his watch and admits the intruder through fear, concluding he is not strong enough to guard the entrance. ”

“ Show samples of soap—pure castile, Ivory, and a cheap scented variety—and explain the right and wrong uses of soap.
Personal hygiene may be defined as the wise and systematic care of the body. The reasons why every girl should take care of her body are:
First, good health means power to do one’s work in life well.
Second, health is an aid to happiness and personal attractiveness.
[2]
CORRECT POSTURE WHEN STANDING
Good health helps to give a person an active, cheerful mind, and this makes one alert, capable, and able to work to the best advantage. ”

“ When physiologists say that pure air, much exercise, comfortable and airy dress, frequent bathing, sufficient sleep, a plain, simple diet, and regular habits, with a [Pg 19] peaceful and active mind, are essential to health, how many young women heed the instruction? Now of what avail will a good character be without health to apply its forces to the work of life? Of what avail is a good boiler and a high pressure of steam to the engineer if his engine is all out of order, so that it has neither strength nor freedom to work? ”

“ Not until such measures as these, under the controlling influence of a sense of personal responsibility extending to every member of the [403] community, have long been put into practice, can we hope to see man on the earth risen to his full stature, healthy in body, noble in spirit, beautiful in both alike, moving spaciously and harmoniously among his fellows in the great world of Nature, to which he is so subtly adapted because he has himself sprung out of it and is its most exquisite flower. At this final point social hygiene becomes one with the hygiene of the soul. ”

“ Even the cockroach, which lives on what we call filth, spends the greater part of its time in the cultivation of personal cleanliness. And all social hygiene, in its fullest sense, is but an increasingly complex and extended method of purification—the purification of the conditions of life by sound legislation, the purification of our own minds by better knowledge, the purification of our hearts by a growing sense of responsibility, the purification of the race itself by an enlightened eugenics, consciously aiding Nature in her manifest effort to embody new ideals of life. ”

“ Its other smoke-impurities, dirts and dusts, escape, or are blown away so rapidly that they are seldom thick enough to be injurious to health, except in the narrowest and darkest streets; so that it is always safe to open your windows wide for air, wherever you may live. The principal danger from smoke is that it cuts off the sunlight.
The Necessity for Ventilation—Impurities of Indoor Air. The worst impurities in air are those that come from our own breaths and our own bodies; and, unexpectedly enough, carbon dioxid is not one of them. ”

“ Others again, where the kitchen is not properly ventilated, get the smoke of frying and the smell of cooking all through them. But such sources of impurity, while injurious and always to be strictly avoided, are neither half so dangerous when they occur, nor one-tenth so common as the great chief cause of impure air—our breaths and the other gases from our bodies, with the germs they contain. ”

“ Therefore we insist on fresh air, especially for children in schools, for employees in factories, for clerks in offices. All places of public resort should be provided with proper ventilation. The breath from the lungs is loaded with poisonous organic matter, and if continually re-breathed poisons the blood. The smell of a room is often an indication of whether the air is pure or not, especially in the nostrils of one entering from the outer air. Let all windows be kept open day and night, and let fresh air and sunlight continually flood the room. Nothing will kill disease germs quicker. ”

“ I allude to the fact that our skins, by perspiration and by other means, are a source of much impurity to the atmosphere; a fact which will be more fully explained and illustrated in the chapter on Bathing and Cleanliness. It is only necessary to say, in this place, that it is not the matter of perspiration alone which, issuing from the skin, renders the air impure; there are other exhalations more or less constantly going off from every living body, especially from the lungs; and carbonic acid gas is even formed all over the surface of the skin, as well as by means of the lungs. ”

“ Wherever any number of persons live together, the atmosphere becomes poisoned, unless means be provided for its constant change and renovation. If there be not sufficient ventilation, the air becomes charged with carbonic acid, principally the product of respiration. Whatever the body discharges, becomes poison to the body if introduced again through the lungs. Hence the immense importance of pure air. A deficiency of food may be considerably less injurious than a deficiency of pure air. ”

“ As the air contained in an inhabited room cannot be kept as pure as the outside air, the object of ventilation is, by the admission of the pure external air, so to minimize the impurities that the air respired may not be detrimental to health. ”

“ In dwelling-rooms natural ventilation by doors, windows and chimney usually suffices, especially if the products of combustion of gas are removed through a special flue. Natural ventilation is always occurring, and only needs a little aid in domestic life. For large rooms occupied by many persons artificial ventilation is necessary to maintain pure air. ”

“ Ventilation.—Very few people in cities spend more than one hour a day in the open air, which means that they are housed up for the other twenty-three hours, so that no pains should be spared to bring up the quality of the indoor air to approximate as nearly as possible that of the outdoor air. The air of houses contains many more microbes than that of the street.
For dwelling-houses 3000 cubic feet of fresh air is needed every hour. It is said that in the country the only bad air is in farmers’ houses, whence it has no chance to escape. ”

“ Taking into consideration the amount of air breathed into the lungs per hour and the amount of impurities carried into the breathing zone by the expired air, it can readily be seen that the problem of supplying a sufficient volume of pure air in the house is no small problem.
The amount of fresh air needed for the average adult is estimated to be 3,000 cubic feet per hour. The ventilating system that does not provide this amount of air per hour without objectionable draughts does not meet the requirements of modern hygiene. ”

“ As the air of an inhabited room cannot, at the best, be as pure as the external atmosphere, the problem of ventilation is to reduce the impurities of respiration to the point where health will not manifestly suffer by drawing them into our lungs again.
In order to keep the ratio of carbonic acid and its associated animal impurities down to this limit, it has been found by experiments that it is necessary to supply 3,000 cubic feet of perfectly pure air each hour for every adult person who is vitiating the atmosphere of a room by his breath. ”

“ A momentous question in our city life is whether, in the construction of our houses, and stores, and hotels, and public halls, the quantity of air which each person requires for his health is provided for by processes or appliances of ventilation. The quantity of air required for a healthy life is generally estimated by the number of cubic feet needed for respiration alone. This is a mistake. Each person needs vastly more—enough to secure a thorough aëration of his clothing and to destroy by oxidation all the hurtful emanations of the body. ”

“ In houses, moreover, the needs of large quantities of pure air for the aeration of clothing, basements, kitchens, closets, and the closets in which clothing is kept, are probably as great as for respiration. ”

“ The disease I have elsewhere shown occurs most severely with a high temperature of the air and a deficient rainfall, and its fundamental cause is an unclean soil, the particulate poison from which infects the air, and is swallowed most commonly with food, especially milk. ”

“ Wind clears the air of impurities, and is only harmful when it carries dust with it, or when it is so strong that it impedes the respiration or bodily movements. Very weak persons get out of breath easily when battling against the wind.
Town Air.—Even the outdoor air of towns has its full quota of oxygen,—21 per cent.,—and so is healthier than indoor air. The carbonic acid in the air varies from 0.2 to 0.6 per cent. Among the impurities of the air are smoke, fog, and dust. ”

“ Then sanitary science, under the strict observance of hygiene, will reach perfection; the rude, gross habits of living will be corrected; a system of perfect drainage and ventilation will be inaugurated; pure air and fresh water supply will be furnished to every public and private house; only pure, unadulterated foods will be on the markets; every hotel, private and boarding-house will furnish properly prepared diets, and universal cleanliness will be the law. ”

“ In researching effects on health, EPA must assess whether pollutants are hazardous to health. Researching whether pollutants are hazardous to health necessarily entails assessing the risk such pollutants pose to health. Thus, researching health effects is indistinguishable from assessing risk to health. Congress' directives to research the effects of indoor air pollution on human health and disseminate the findings encompass risk assessment as defined by NRC and explained by EPA's Risk Assessment Guidelines. ”

“ In the Radon Research Act, Congress directed EPA to gather information on all aspects of indoor air quality, research indoor pollutants' effects on health, characterize sources of pollution, and disseminate the findings. Determining whether Congress authorized risk assessments requires defining risk assessment. "Risk assessment is the use of the factual base to define the health effects of exposure of individuals or populations to hazardous materials and situations." ”

“ It is nothing uncommon to find six or eight people crowded into one dormitory not larger than 10x15, and that not only in a New York tenement but in a modern hospital. Every intelligent person professes to believe that “Pure air is as important as pure food in the production of vital energy of the body and mind, but it is another case of not living according to one’s belief. What we greatly need is a realization of the fact that hygiene is not alone a science to be studied, but an art to be practiced, in the hospital, in all its departments and elsewhere.” ”

“ Although all the above requirements and others relating to the internal hygiene of the domestic arts are of extremely great importance and suffer frequent neglect, it is the purpose of this paper to point out some of the larger and more positive relations of the manual arts to national health.
The problem of vitality underlies almost every social and political situation confronting us. We are becoming acutely conscious of the possibilities of conservation in the line of health and efficiency. ”

“ Therefore, in all our efforts at prevention, the path of duty lies straight before us, and consists in conserving these two elements of the body by laying a good foundation in infancy, by preserving the organs of digestion, by eating an abundance of rich and nutritious food, such as fat, butter, meat, milk, eggs, etc., by breathing pure air, by living on dry soil, by wearing warm and comfortable clothing, by taking plenty of physical exercise, and by avoiding disease and injurious occupation. ”

“ Pure air, pure water, and a frugal nutritious diet are Nature's great preventives for the thousand ills of life. These are the great essentials in sustaining the healthful and normal condition of the system, always of primary importance in preserving its tone and energy, and rendering it impervious to any miasmatic or epidemic influences. ”

“ In 1864 was published the first edition of Parkes’s “Manual of Practical Hygiene,” a masterly book, accurate, learned, clear, full, and of the highest interest to the thoughtful mind. The introduction to this work opens with a clear definition of the subject. “Hygiene is the art of preserving health; that is, of obtaining the most perfect action of body and mind during as long a period as is consistent with the laws of life. In other words, it aims at rendering growth more perfect, decay less rapid, life more vigorous, death more remote.” ”

“ In a system of ventilation it is not only a question of providing a certain volume of air from the outside, but the great problem is to provide a sufficient volume of pure air of proper temperature and of proper humidity. Air that is laden with smoke, dust and suspended matter, or that which contains gas or foul odors, is objectionable and does not meet the requirements. Therefore, the source of the air becomes important. The ventilating system must also keep the air in proper circulation at a proper velocity. ”

“ Physical health and vigor, and mental strength and power, are to a great degree a matter of hereditary transmission, over which the individual has no control. Yet, taking our natures as they are, we can renovate, reinvigorate, and advance them by attentive study of and conformity to the laws upon which health and vigor are based. I propose in the present article briefly to glance at the chief physical agencies—air, exercise, clothing, food, and rest—and at some of the mental and moral influences, by the bad or good employment of which the physical stock is deteriorated or improved. ”