A Handbook of Health

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Another group of bacteria, which float about in the air almost
everywhere, are the yeasts, which we harness to our use for the very
wholesome and healthful process of bread-making. Millions upon millions
of bacteria of different sorts live and grow naturally in our stomachs
and intestines; and while they are probably of no special advantage to
us, yet at the same time the majority of them are practically, within
reasonable limits--not to exceed a few billions or so--harmless.

Insect Pests. One kind of "dirt" that should be avoided with special
care is insects of all sorts. No one needs to be told to try to keep a
house, or a room, clear of fleas, bed-bugs, or lice; indeed to have
these creatures about is considered a mortal disgrace. Not only is their
bite very unpleasant, but they may convey a variety of diseases,
including plague and blood poisonings of various sorts. But there is
another insect pest far commoner and far more dangerous than either
fleas or bed-bugs, whose presence we should feel equally ashamed of; and
that is the common house fly. This filthy little insect breeds in, and
feeds upon, filth, manure, garbage, and dirt of all sorts, and then
comes and crawls over our food, falls into our milk, wipes his feet on
our sugar and cake, crawls over the baby's face, and makes a general
nuisance of himself. Take almost any fly that you can catch, let him
crawl over a culture plate of gelatin, put that gelatin away in a warm
place, and you will find a perfect flower-garden of germs growing up all
over it, following the pattern made by the tracks of his dirty feet. In
this garden will be found not "silver bells and cockle shells and pretty
maids all in a row," but a choice mixture of typhoid bacilli, pus germs,
the germs of putrefaction, tubercle bacilli, and the little seeds which,
if planted in our own bodies, would blossom as pneumonia or diphtheria.

[Illustration: AN EDUCATIONAL FLY POSTER]

The fly is an unmitigated nuisance and should be wiped out. No half-way
measures should be considered. Fortunately, this is perfectly possible;
for his presence is our own fault and nothing else, as he can lay his
eggs and hatch only in piles of dirt and filth found about our own
houses, barns, and outbuildings. He is not a wild insect but a domestic
one and is practically never found more than a few hundred yards away
from some house or barnyard. His favorite place for breeding is in piles
of stable manure, especially horse manure; but neglected garbage cans,
refuse heaps, piles of dirt and sweepings, decaying matter of all sorts,
which are allowed to remain for more than ten days or two weeks at a
time, will give him the breeding grounds that he needs.

[Illustration: A BREEDING PLACE OF FLIES AND FILTH]

It takes him about two weeks to hatch and get away from these breeding
places; so that if everything of this sort is cleaned up carefully once
a week, or if, where manure heaps and garbage dumps have to remain for
longer periods, they are sprinkled with arsenic, kerosene, corrosive
sublimate, chloride of lime, or carbolic acid, he will perish and
disappear as surely as grass will if you wash away the soil in which it
grows. The presence of a fly means a dirty house or a dirty yard
somewhere, and to discover a fly in your house should be considered a
disgrace. Until people are aroused to the need of such cleanliness as
will make flies disappear entirely, in most places it will be necessary,
as warm weather approaches, to screen all doors and windows, and
particularly all boxes, pantries, or refrigerators in which food is
kept. If you cannot afford screens, use fly paper. These are all,
however, only half-way measures and will give only partial relief. The
best prevention of flies is absolute cleanliness. No dirt, no flies.

Dust, a Source of Danger. Dust is an easily recognized form of dirt.
It is dangerous in itself and nearly always contains germs of one sort
or another mixed in with it. Shops and factories whose processes make
much dust are usually very unhealthy for the workers, who are likely to
show a high death-rate from consumption.

Dust should be fought and avoided in every possible way. City streets
should have good modern pavements,--preferably asphalt or some crude
petroleum, or sawmill-waste, "crust," or coating,--which will not make
any dust, and which can be washed down every night with a hose. In
smaller towns where there is no pavement, dust may be prevented by
regular sprinklings during the summer, preferably with some form of
crude oil. Two or three full sprinklings of this will keep down the dust
for the greater part of the summer.

If these measures are properly carried out, they will prevent most of
the dust that accumulates in houses, as nearly all of this blows in
through the windows or is carried in on shoes or skirts. When this has
once floated in and settled down upon the walls, furniture, or carpets,
be very careful how you disturb it; for, as long as it lies there, it
will do you no harm, however untidy it may look. The broom and the
feather duster and the dry cloth do almost as much harm as they do good;
for while they may remove two-thirds of the dust from a room, they drive
the other third right into your nose and throat, where the germs it
contains can do the most possible harm. Dusting should always be done
with a damp cloth; sweeping, with a damp cloth tied over a broom; and,
wherever possible, a carpet sweeper, or, better still, a vacuum cleaner,
should be used instead of a broom.

Carpets, window curtains, and any hangings that catch dust should be
abolished--rugs that can be rolled up and taken out of doors to be
shaken and beaten should be used instead; and too many pieces of
bric-a-brac and ornaments should be avoided. All surfaces of walls,
ceilings, and floors should be made as smooth and hard and free from
angles, ledges, and projecting lines as possible. The colds usually
caught by members of the family during "spring cleaning" are usually due
to the swarms of germs stirred up from their peaceful resting places.
Let those sleeping germs lie, until you can devise some means of
removing them without brushing, or whisking, them straight into your
nostrils.

CHAPTER XXVII

ACCIDENTS AND EMERGENCIES

Ordinarily, Accidents are not Serious. Accidents will happen--even in
the best regulated families! While taking all reasonable care to avoid
them, it is not best to worry too anxiously about the possibility of
accidents; for a nervous, fearful state of mind is almost as likely to
give rise to them as is a reckless and indifferent one. Fortunately,
most accidents, especially with growing boys and girls, are
comparatively trifling in their results, and to a considerable extent
must simply be reckoned as part of the price that has to be paid for
experience, self-control, and skill. To have keen senses, vigorous and
elastic muscles, and a clear head, is better protection against
accidents than too much caution; it is also the best kind of insurance
that can be taken out against their proving serious. The real problem is
not so much to avoid accidents as to be ready to meet them promptly,
skillfully, and with good judgment when they occur, as they inevitably
will. As the old masters of swordsmanship used to teach, "Attack is the
best defense."

Luckily, healthy children are as quick as a cat and as tough as
sole-leather--if they weren't, the race would have been wiped out
centuries ago. Children in their play, on errands, going to and from
school, and in excursions through the woods and the fields, run, of
course, a great many risks. But in spite of all these dangers, the
number of children killed, or even seriously injured, in these "natural"
accidents, is not half of one per cent of those who die from disease or
bad air or poor food or overwork.

Another cheering thing about accidents is that ninety-nine out of every
hundred of them are not serious; and if you are only wise enough to know
what to do--and still more what not to do--in taking care of them, you
can recover from them safely and quickly. The bodies of healthy children
have an astonishing power of repairing themselves. Their bones are not
so brittle as those of "grown-ups"; and even when one of them is broken,
if properly splinted and dressed, it will heal up in a little more than
half the time required by the adult. And wounds and scratches and
bruises, _if kept perfectly clean_, will heal very rapidly.

Probably the commonest of all accidents are cuts and scratches. So
common is it for us to "bark" our knuckles, or our shins, or scratch
ourselves on nails and splinters and drive pins into ourselves, or let
our pocket knives slip and cut our fingers, that, if the human skin had
not the most wonderful power of repairing itself,--not merely closing up
the cut or the scratch, but making the place "as good as new,"--we
should be seamed and lined all over our hands, arms, faces, and limbs
like a city map, or scarred and pitted like a tattooed man, before we
were fifteen years old. But of course, as you know, the vast majority of
cuts and scratches and tears heal perfectly. They hurt when they happen;
and they burn, or smart, for a few hours, or hurt, if bumped, for a few
days afterward; but they heal soon and are forgotten.

On the other hand, some cuts and scratches will fester and throb and
turn to "matter" (_pus_) and even give you fever and headache and blood
poisoning. What makes the difference? It is never the size, or depth, of
the scratch or cut itself, but simply _the dirt that gets into it
afterward_. If a cut, or scratch, no matter how deep or ragged, be made
with a clean knife-blade or sliver and kept clean afterward, it will
never "matter" (_suppurate_) or cause blood poisoning. So if you know
how to keep dirt out of cuts and scratches, you know how to prevent
ninety-nine per cent of all the dangers and damage that may come from
this sort of accident.

Not more than one cut or scratch in a thousand is deep enough to go down
to an artery, so as to cause dangerous bleeding, or to injure an
important nerve trunk. So, though no one would by any means advise you
to be reckless about getting cut and scratched, yet it is better and
safer to run some risk of cuts and scratches in healthy play when young,
and learn how to keep them clean, than to grow up pale and
flabby-muscled and cowardly.

How to Prevent Infection in Wounds. It is not just dirt that is
dangerous,--although dirt of any sort is a bad thing to get into wounds
and should be kept out in every possible way,--but dirt that contains
those little vegetable bacteria that we call germs. The dirt most likely
to contain these germs--called pus germs, because they cause pus, or
"matter" in a wound--is dirt containing decaying animal or vegetable
substances (particularly horse manure, which may contain the tetanus, or
lock-jaw germ) and the discharges from wounds, or anything that has come
near decayed meat or unhealthy gums or noses or teeth. This is why a cut
or scratch made by a knife that has been used for cutting meat, or by a
dirty finger-nail, or by the claw of a cat, or by the tooth of a rat, is
often likely to fester and "run." Animals like rats and dogs and cats
often feed upon badly decayed meat; and hence their teeth, or claws, are
quite likely to be smeared with the germs that cause decay, and these
will make trouble if they get into a wound.

Fortunately, the care of a cut or scratch is very simple and practically
the same in all cases. Just make the wound thoroughly clean and keep it
so until it is healed. For a slight clean cut or scratch, a good
cleanser is pure water. Hold the hand or foot under the faucet or pump,
and let the cool water wash it out thoroughly. If you are sure that the
thing you cut it with was clean, let the blood dry on the cut and form a
scab over it. If the wound is large, or there is any danger of the water
of the well, or tap, having sewage in it (see chapter IX), it is better
to boil the water before using it. Unless the blood is spurting in jerks
from a cut artery, or bleeding very freely indeed, it is better to let
the wound bleed, as this helps to wash out any dirt or germs that have
got into it. When the bleeding has stopped, do not put on sticking
plaster, because this keeps out the air and keeps in the sweat of the
skin surrounding the wound, which is not healthful for the wound, and
may also contain some weak pus germs.

If the wound is small, the old-fashioned clean white rag that has been
boiled and washed is as good as anything that can be used for a
dressing. Tear off a narrow strip from one to two inches wide and as
many feet long, according to the position of the wound, roll it round
the finger or limb three or four times, and then take a turn round the
wrist or nearest joint, to keep the bandage from slipping off. If the
wound be likely to keep on oozing blood, put on first a thickness of
surgeon's cotton, or prepared cotton-batting, an ounce of which can be
purchased for ten cents at any drugstore. This is an excellent dressing,
because it not only sucks up, or absorbs any oozing from the wound, but
is a perfect filter-protection against germs of all sorts from the
outside. Ninety-nine simple wounds out of a hundred dressed in this way
will heal promptly and safely without danger of pus, or "matter."

If the wound happens to have been made with a knife or tool that you are
not absolutely sure was perfectly clean, or if the wound gets manure or
road-dirt or other filth rubbed into it, then it is best to go at once
to a doctor and let him give it a thorough _antiseptic_ dressing, which
consists of cleaning it out thoroughly with strong remedies, called
antiseptics,--which kill the germs, but do not injure living
tissues,--and then putting on a germ-proof dressing as before. This is
one of the "stitches in time" which will save not only nine, but
ninety-nine.

If you have a wound with dirt in it, and cannot reach a doctor, one of
the best and safest antiseptics to use is _peroxide of hydrogen_. This
is non-poisonous, and can be poured right into the wound. It will smart
and foam, but will clean out and kill most of the germs that are there.
Another safe antiseptic is pure alcohol. It is a good thing to have a
bottle of one of these in the medicine-closet, or in your "war-bag" when
camping out. A package of surgeon's cotton and two or three rolled
bandages of old cotton, linen, or gauze also should be on hand.

Dog-bites, rat-bites, or cat-bites should always be dressed by a doctor,
or made thoroughly antiseptic, mainly on account of the germs that swarm
round the roots of the teeth of these animals, and also because
treatment of this sort will prevent _hydrophobia_--although this danger
is a rare and remote one, not more than a few score of deaths from
mad-dog bites occurring in the whole United States in a year.

The wonderful progress made by surgery within the last twenty or thirty
years has been almost entirely due to two things: first, the discovery
of chloroform and ether, which will put patients to sleep, so that they
do not feel the pain of even the severest and longest operation; and,
second, but even more important, keeping germs of all kinds out of the
wound before, during, and after the operation. That sounds simple, but
it really takes an immense amount of trouble and pains in the way of
baking the dressings; boiling the instruments, and scrubbing with soap,
alcohol, hot water, and two or three kinds of antiseptics, or
germ-killers, the hands of the surgeon and of the nurse and the body of
the patient. How enormous a difference this keeping of the germs out of
the wound has made may be gathered from the fact that, while in earlier
days, before Lister showed us how to avoid this danger, surgeons used to
lose seventy-five per cent of their amputations of the thigh, from pus
infection, or blood poisoning, now they can perform a hundred operations
of this sort and not lose a single case. We can open into the skull and
remove tumors from the brain; open into the chest and remove bullets
from the lungs, and even from the heart itself; operate in fact upon any
part, or any organ, of the body with almost perfect safety and wonderful
success. Whereas, before, two-thirds of the patients so operated upon
would die, probably of blood poisoning.

How to Treat Bruises. Bruises are best treated either by holding the
injured part under the faucet, or pump, if convenient, or by plunging it
into very hot water and holding it there for ten or twelve minutes. Then
if the bruise still continues to throb or ache, wrap it up lightly with
a bandage of soft, loose cotton or linen cloth, and pour over it a
lotion of water containing about one-fourth alcohol until the bandage is
soaked, moistening it again as fast as it dries. This is also a useful
treatment for wounds that have been made by a fall, or by something
blunt and heavy, so that there is bruising as well as cutting. Most of
the household applications for wounds or bruises, such as arnica,
camphor, witch-hazel, etc., owe their virtues to the five or ten per
cent of alcohol they contain, which, by evaporating, cools the wound and
relieves inflammation, kills germs and so acts as an antiseptic, and
cleans the wound and the skin around it very thoroughly and effectively.

Bruises of all sorts, however, unless very severe, are much safer than
cuts or scratches, because they do not break the skin, and consequently
no germs can get into the tissues of the blood. Our skin, as you
remember, is one of the most wonderful water-proof, germ-proof,
hot-and-cold-proof coatings in the world; and as long as it remains
unbroken, none but a few of the most virulent disease-germs can get
through it into the body.

Boils and Carbuncles, their Cause and their Cure. Boils and carbuncles
are almost the only instances in which pus germs can get into the body
without some actual cut, tear, or breaking of the skin. They come always
from other boils or ulcers or discharging wounds and are caused by the
pus germs in these either being rubbed into the skin until it is almost
chafed through, or else being driven down into the mouth of one of the
hair follicles, or "pores." Here they proceed to grow and form a little
gathering, which soon turns to pus; and this stretches the skin and
presses upon the sensitive nerves in it so as to cause much pain. The
best way to treat them in the beginning is to give a thorough scrubbing
with hot water and soap, and then to drop right over the point, or
"head," of the gathering two or three drops of a strong antiseptic, like
formalin or peroxide or carbolic acid. If this does not check them, then
they had better be opened up freely with a sharp knife that has been
held in boiling water, or a needle that has been held in a flame until
it is red hot and allowed to cool. Then pour peroxide into the opening,
put on a light dressing, and keep soaked with alcohol and water, as for
a bruise. This evaporating dressing is far superior to the dirty,
sticky, germ-breeding poultice. If this does not clear it up within
twenty-four hours, go to a doctor and have him treat it antiseptically.

How to Stop Bleeding. If a cut should go deep enough to reach an
artery the size of a knitting needle, or larger, then the blood will
spurt out in jets. There is then some danger of so much blood being lost
as to weaken one. Our blood, however, has a wonderful power of clotting,
or clogging, round the mouth of the cut artery, so that the risk of
bleeding to death, except from quite a large artery, like that of the
thigh, or the armpit, is not very great.

For a wound in the hand or foot, that spurts in this way, it will
usually be sufficient to grasp the arm firmly above the wrist or the
elbow, or the ankle, as the case may be, with the thumb over the artery,
or even to press directly over the wound, until the bleeding stops and
the blood is thus given a chance to clot. If the wound is small and
deep, like that made by the stab of a knife, or the slip of a chisel,
then firm pressure directly over the wound itself with a thumb, or both
thumbs, will usually be sufficient to stop the bleeding.

[Illustration: A TOURNIQUET

A stone laid above the cut under the bandage will help to increase the
pressure at this point.]

Should, however, the spurting be from an artery like that of the pulse,
or from that at the bend of the elbow or the knee, then the best thing
to do is to tie quickly a handkerchief or strip of tough cloth loosely
around the limb above the wound and, slipping a short stick or bar into
the loop, twist upon it, as shown in the picture, until the blood ceases
to flow from the wound. It is much better to use a handkerchief or piece
of cloth than a cord, because the latter may cut into and damage the
tissues, when drawn as tight as is needed to stop the circulation. It is
not best to allow a bandage twisted tight enough to stop the
circulation--called a _tourniquet_--to remain tight for more than half
an hour at a time, as this may give rise to very dangerous congestion,
or serious "blood starvation" of the tissues below it. It should be
gently untwisted every half hour until the arm, or limb, below it
reddens up again, and then, if the spurting begins, should be tightened
as before. There is, however, a good chance that if the cut artery is
not too large, the blood will have clotted firmly enough in this time
to stop the bleeding; though the tourniquet had better be left on the
arm, ready to be tightened at a moment's notice, until the doctor comes.

The Treatment of Burns. Burns require more careful treatment on
account of the wide surface of the skin usually destroyed. The layer of
the skin that is most alive and most active in the process of repair is
the outer layer (the epithelial, or epidermis). A burn, or scald, if at
all severe, is likely to destroy almost the entire thickness of this,
over its whole extent. This gives both a wide surface for the absorption
of pus germs and a long delay in "skinning over," or healing. As the
same heat that made the burn has usually destroyed any germs that may be
present, it is not necessary to wash or clean a burn, like a wound,
unless dirt has been rubbed or sprinkled into it after it has been made.
The first thing to be done is to coat it over so as to shut out the air;
and this, for a slight burn, can be very well done by dusting it over
with baking soda or clean flour or with one of the many dusting, or
talc, powders on the market, containing boracic acid, or by laying over
the burn a clean cloth soaked in perfectly clean olive oil or vaseline.
If the oil or vaseline is not perfectly clean, put it on the top of a
stove and heat it thoroughly before using. Dress with soft, clean cotton
rag or lint as before, keeping wet with the alcohol lotion (one part of
alcohol to eight of water) if there be much pain, or throbbing.

If the burn is deep or the pain at all severe, it is best to call in a
doctor, as bad burns are not only agonizingly painful, but also very
dangerous on account of the wide, raw surface that they leave open to
entrance of pus germs for days and even weeks. Until a doctor can be
secured, coat it over with some non-irritating powder or oil, as for
lighter burns, or hold it in warm water to exclude the air. Do not try
to clean a burn. You only increase the pain of it and probably add to
the risk of infection.

If your clothing ever catches fire, wrap yourself up at once in a
blanket or rug to smother the flame. Remember that running will supply
more air to the flame and cause it to do more damage. If you have
nothing at hand in which to wrap yourself, lie down on the floor, or
ground, and roll over and over until you have smothered the flame.

What should be Done in the Case of Broken Bones, or Fractures. Broken
bones, or fractures, as they are called, are more serious, but
fortunately not very common. They should, of course, always be treated
by a doctor, to prevent shortening of the limb, or to prevent the bones
from growing together at an angle, or in a bad position, so as to
interfere with the use of it. Where a doctor cannot readily be had, or
the patient has to be taken to him,--as, for instance, where the
accident occurs out in the woods,--take two light pieces of board, or
two bundles of straight twigs, or two pieces of heavy paper folded
fifteen or twenty times--two folded newspapers, for instance--and,
wrapping them in cloth or paper, place one on each side of the broken
limb, at the same time gently pulling it straight. Then take strips of
cloth, or bandage, and bind these splints gently, but firmly and snugly,
the length of the limb, so that it cannot be bent in such a way as to
make the ends of the bone grate against each other. The patient can then
be lifted, or carried, with comparative comfort. Most fractures, or
broken bones, in children or young boys or girls, heal very rapidly; and
if the limb be properly straightened and splinted by competent hands, it
will be practically as good and as strong as before the accident.

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