A Handbook of Health

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[Illustration: Currying the cow

Washing the udders

CLEANLINESS BEFORE MILKING]

Boards of Health all over the world now are insisting upon absolutely
clean barns and cleanly methods of handling, shipping, and selling milk.
In most of our large cities, milk-men are not allowed to sell milk
without a license; and this license is granted only after a thorough
examination of their cattle, barns, and milk-houses. These clean methods
of handling milk cost very little; they take only time and pains.

Nowadays, in the best dairies, it is required that the barns or sheds in
which cows are milked shall have tight walls and roofs and good
flooring; that the walls and roofs shall be kept white-washed; and the
floor be cleaned and washed before each milking, so that no germs from
dust or manure can float into the milk. Then the cows are kept in a
clean pasture, or dry, graveled yard, instead of a muddy barnyard; and
are either brushed, or washed down with a hose before each milking, so
that no dust or dirt will fall from them into the milk. The men who are
to milk wash their hands thoroughly with soap and water, and put on
clean white canvas or cotton overalls, jackets, and caps. As soon as the
milk has been drawn into the pails, it is carried into the milk-room and
cooled down to a temperature of about forty-two degrees--that is, about
ten degrees above freezing point. This is to prevent the growth of such
few germs as may have got into it, in spite of all the care that has
been taken. Then the milk is drawn into bottles; and the bottles are
tightly capped by a water-proof pasteboard disc, or cover, which is not
removed until the milk is brought into the house and poured into the
glass, or cup, for use.

[Illustration: THE MILKING HOUR AT A MODEL DAIRY]

Milk handled like this costs from two to four cents a quart more to
produce than when drawn from a cow smeared with manure, in a dark,
dirty, strong-smelling barn, by a milker with greasy clothing and dirty
hands; and then ladled out into pitchers in the open street, giving all
the dust and flies that happen to be in the neighborhood a chance to get
into it! But it is doubly worth the extra price, because, besides
escaping stomach and bowel troubles, you get more cream and higher food
value. There is one-third more food value in clean milk than in dirty
milk, because its casein and sugar have not been spoiled and eaten by
swarms of bacteria. How great a difference careful cleanliness of this
sort can make in milk is shown by the difference in the number of
bacteria that the two kinds of milk contain. Ordinary milk bought from
the wagons in the open street, or from the cans in the stores, will
contain anywhere from _a million_ to a _million and a half_ bacteria to
the cubic centimeter (about fifteen drops); and samples have actually
been taken and counted, which showed _five_ and _six millions_.

[Illustration: MILKING BY VACUUM PROCESS

This method is used in many large dairies to avoid handling the udders
or the milk. Its chief drawback is that the long tubes are very
difficult to keep clean.]

Such a splendid food for germs is milk, and so rapidly do they grow in
it, that dirty milk will actually contain more of them to the cubic inch
than sewage, as it flows in the sewers. Now see what a difference a
little cleanliness will make! Good, clean, carefully handled milk,
instead of having a million, or a million and a half, bacteria, will
have less than ten thousand; and very clean milk may contain as low as
three or four hundred, and these of harmless sorts. The whole gospel of
the care of milk can be summed up in two sentences: (1) _Keep dirt and
germs out of the milk._ (2) _Keep the milk cool._

[Illustration: WASHING THE BOTTLES AT A MODEL DAIRY

The inside of the bottle is thoroughly cleansed by the revolving brush.]

Besides the germs of the summer diseases of children, which kill more
than fifty thousand babies every year in the United States, dirty milk
may also contain typhoid germs and consumption germs. The typhoid germs
do not come from the body of the cow, but get into the milk through its
being handled by people who have, or have just recovered from, typhoid,
or who are nursing patients sick with typhoid, and who have not properly
washed their hands; or from washing the cans, or from watering the milk
with water taken from a well or stream infected with typhoid. It is
estimated that about one-eighth of all the half million cases of
typhoid that occur in the United States every year are carried through
dirty milk.

[Illustration: BACTERIA IN CLEAN AND IN DIRTY MILK]

[Illustration: DANGER FROM DIPPED MILK

The milk that spills or spatters over the hand drips back into the can
and may seriously infect the main supply.]

The germs of consumption, or _tuberculosis_, that are present in milk
may come from a cow that has the disease; or from consumptive human
beings who handle the milk; or from the dust of streets or houses--which
often contains disease germs. The latter sources are far the more
dangerous; for, as is now pretty generally agreed, although the
tuberculosis of cattle can be given to human beings, it is not very
actively dangerous to them; and probably not more than three or four per
cent of all cases of tuberculosis come from this source. The idea,
however, of allowing the milk of cows diseased from any cause to be used
for human food, is not to be tolerated for a moment. All good dairymen
and energetic Boards of Health now insist upon dairy herds being tested
for tuberculosis, and the killing, or weeding out, of all cows that
show they have the disease.

[Illustration: MILK INSPECTION AT THE RETAIL STORE

It is well to have the quality and purity of the milk tested just before
it goes to the consumer, but it is far more important that it should be
examined by State Inspectors at the dairy farms.]

Cheese. Cheese is the curd of milk squeezed dry of its liquid
(_whey_), salted, pressed into a mould, and allowed to ferment slowly,
or "ripen," in which process a considerable part of its casein is turned
into fat. It is a cheap, concentrated, and very nutritious food, and in
small amounts is quite appetizing. But unfortunately, the acids and
extracts which have formed in the process of fermentation and ripening
are so irritating to the stomach, that it can usually be eaten only in
small amounts, without upsetting the digestion. Its chief value is as a
relish with bread, crackers, potatoes, or macaroni. In moderate amounts,
it is not only appetizing and digestible, but will assist in the
digestion of other foods; hence the custom of eating a small piece of
"ripe" cheese at the end of a heavy meal.

CHAPTER V

THE COAL FOODS (_Continued_)

STARCHES

Sources of Starch. The starches are valuable and wholesome foods. They
form the largest part, both in bulk and in fuel value, of our diet, and
have done so ever since man learned how to cultivate the soil and grow
crops of grain. The reason is clear: One acre of good land will grow
from ten to fifteen times the amount of food in the form of starch in
grains or roots, as of meat in the shape of cattle or sheep.
Consequently, starch is far cheaper, and this is its great advantage.

Our chief supply of starch is obtained from the seed of certain most
useful grasses, which we call wheat, oats, barley, rye, rice, and corn,
and from the so-called "roots" of the potato. Potatoes are really
underground buds packed with starch, and their proper name is tubers.

Starch, when pure or extracted, is a soft, white powder, which you have
often seen as cornstarch, or laundry starch. As found in grains, it is
mixed with a certain amount of vegetable fibre, covered with husks, or
skin, and has the little germ or budlet of the coming plant inside it.
It has been manufactured and laid down by little cells inside their own
bodies, which make up the grains; so that each particular grain of
starch is surrounded by a delicate husk--the wall of the cell that made
it. This means that grains and other starch foods have to be prepared
for eating by grinding and cooking. The grinding crushes the grains into
a powder so that the starch can be sifted out from the husks and
coating of the grain, and the fibres which hold it together; and the
cooking causes the tiny starch grain to swell and burst the cell wall,
or bag, which surrounds it.

Starches as Fuel. The starches contain no nitrogen except a mere trace
in the framework of the grains or roots they grow in. They burn very
clean; that is, almost the whole of them is turned into carbon dioxid
gas and water.[7]

This burning quality makes the starches a capital fuel both in the body
and out of it. You may have heard of how settlers out on the prairies,
who were a long way from a railroad and had no wood or coal, but plenty
of corn, would fill their coal scuttles with corn and burn that in their
stoves; and a very bright, hot fire it made.

One of the chief weaknesses of the starches is that they burn up too
fast, so that you get hungry again much more quickly after a meal made
entirely upon starchy foods, like bread, crackers, potatoes, or rice,
than you do after one which has contained some meat, particularly fat,
which burns and digests more slowly.

How Starch is Changed into Sugar. As we learned in chapter II, the
starches can be digested only after they are turned into sugars in the
body. If you put salt with sugar or starch, although it will mix
perfectly and give its taste to the mixture, neither the salt nor the
starch nor the sugar will have changed at all, but will remain exactly
as it was in the first place, except for being mixed with the other
substances. But if you were to pour water containing an acid over the
starch, and then boil it for a little time, your starch would entirely
disappear, and something quite different take its place. This, when you
tasted it, you would find was sweet; and, when the water was boiled off,
it would turn out to be a sugar called _glucose_. Again, if you should
pour a strong acid over sawdust, it would "char" it, or change it into
another substance, _carbon_. In both of these cases--that of the starch
and of the sawdust--what we call a _chemical change_ would have taken
place between the acid and the starch, and between the strong acid and
the sawdust.

If we looked into the matter more closely, we should find that what has
happened is that the starch and the sawdust have changed into quite
different substances. Starches are _insoluble_ in water; that is,
although they can be softened and changed into a jelly-like substance,
they cannot be completely melted, or dissolved, like salt or sugar.
Sugar, on the other hand, is a perfectly _soluble_ or "meltable"
substance, and can soak or penetrate through any membrane or substance
in the body. Therefore all the starches which we eat--bread, biscuit,
potato, etc.--have to be acted upon by the ferments of our saliva and
our pancreatic juice, and turned into sugar, called glucose, which can
be easily poured into the blood and carried wherever it is needed, all
over the body. Thus we see what a close relation there is between starch
and sugar, and why the group we are studying is sometimes called the
starch-sugars.

Wheat--our Most Valuable Starch Food. The principal forms in which
starch comes upon our tables are meals and flours, and the various
breads, cakes, mushes, and puddings made out of these. Far the most
valuable and important of all is wheat flour, because this grain
contains, as we have seen, not only starch, but a considerable amount of
vegetable "meat," or gluten, which is easily digested in the stomach.
This gluten, however, carries with it one disadvantage--its stickiness,
or gumminess. The dough or paste made by mixing wheat flour with water
is heavy and wet, or, as we say, "soggy," as compared with that made by
mixing oatmeal or corn meal or rice flour with water. If it is baked in
this form, it makes a well-flavored, but rather tough, leathery sort of
crust; so those races that use no _leavening_, or rising-stuff, in their
wheat bread, roll it out into very thin sheets and bake it on griddles
or hot stones.

Most races that have wheat, however, have hit upon a plan for overcoming
this heaviness and sogginess, and that is the rather ingenious one of
mixing some substance in the dough which will give off bubbles of a gas,
_carbon dioxid_, and cause it to puff up and become spongy and light,
or, as we say, "full of air." This is what gives bread its well-known
spongy or porous texture; but the tiny cells and holes in it are filled,
not with air, but with carbon dioxid gas.

Making Bread with Yeast. There are several ways of lightening bread
with carbon dioxid gas. The oldest and commonest is by mixing in with
the flour and water a small amount of the frothy mass made by a germ, or
microbe, known as _yeast_ or the _yeast plant_. Then the dough is set
away in a warm place "to rise," which means that the busy little yeast
cells, eagerly attacking the rich supply of starchy food spread before
them, and encouraged by the heat and moisture, multiply by millions and
billions, and in the process of growing and multiplying, give off, like
all other living cells, the gas, carbon dioxid. This bubbles and spreads
all through the mass, the dough begins to rise, and finally swells right
above the pan or crock in which it was set. If it is allowed to stand
and rise too long, it becomes sour, because the yeast plant is forming,
at the same time, three other substances--alcohol, lactic acid (which
gives an acid taste to the bread), and vinegar. Usually they form in
such trifling amounts as to be quite unnoticeable. When the bread has
become light enough, it is put into the oven to be baked.

The baking serves the double purpose of cooking and thus making the
starch appetizing, and of killing the yeast germs so that they will
carry their fermentation no further. Bread that has not been thoroughly
baked, if it is kept too long, will turn sour, because some of the yeast
germs that have escaped will set to work again.

[Illustration: A THOROUGH BAKING, AND A VALUABLE CRUST

Note the cleanly way of handling the food.]

That part of the dough that lies on the surface of the loaf, and is
exposed to the direct heat of the oven has its starch changed into a
substance somewhat like sugar, known as _dextrin_, which, with the
slight burning of the carbon, gives the outside, or crust, of bread its
brownish color, its crispness, and its delicious taste. The crust is
really the most nourishing part of the loaf, as well as the part that
gives best exercise to the teeth.

Making Bread with Soda or Baking-Powders. Another method of giving
lightness to bread is by mixing an acid like sour milk and an alkali
like soda with the flour, and letting them effervesce[8] and give off
carbon dioxid. This is the mixture used in making the famous "soda
biscuit." Still another method is by the use of _baking-powders_, which
are made of a mixture of some cheap and harmless acid powder with an
alkaline powder--usually some form of soda. As long as these powders
are kept dry, they will not act upon each other; but as soon as they are
moistened in the dough, they begin to give off carbon dioxid gas.

[Illustration: AN IDEAL BAKERY WITH LIGHT, AIR, AND CLEANLINESS]

Neither sour milk and soda nor baking-powder will make as thoroughly
light and spongy and digestible bread as will yeast. If, however,
baking-powders are made of pure and harmless materials, used in proper
proportions so as just to neutralize each other, and thus leave no
excess of acid or alkali, and if the bread is baked very thoroughly,
they make a wholesome and nutritious bread, which has the advantage of
being very quickly and easily made. The chief objection to soda or
baking-powder bread is that, being often made in a hurry, the acid and
the alkali do not get thoroughly mixed all through the flour, and
consequently do not raise or lighten the dough properly, and the loaf or
biscuit is likely to be heavy and soggy in the centre. This heavy, soggy
stuff can be neither properly chewed in the mouth, nor mixed with the
digestive juices, and hence is difficult to digest. If, however, soda
biscuits are made thin and baked thoroughly so as to make them at least
half or two-thirds crust, they are perfectly digestible and wholesome,
and furnish a valuable and appetizing variety for our breakfast and
supper tables.

[Illustration: A BASEMENT BAKERY--A MENACE TO THE PUBLIC HEALTH

Disease germs multiply in the dark and damp of the basement. The
clothing hanging up in this bakery is a very probable source of
infection.]

Bran or Brown Bread. Flour made by grinding the wheat-berry without
sifting the husks, or bran, out of it is called "whole-wheat" meal; and
bread made from it is the brown "bran bread" or "Graham bread." It was
at one time supposed that because brown bread contained more nitrogen
than white bread, it was more wholesome and nutritious, but this has
been found to be a mistake, because the extra nitrogen in the brown
bread is in the form of husks and fibres, which the stomach is quite
unable to digest. Weight for weight, white bread is more nutritious than
brown. The husks and fibres, however, which will not digest, pass on
through the bowels unchanged and stir up the walls of the intestines to
contract; hence they are useful in small quantities in helping to keep
the bowels regular. But, like any other stimulus, too much of it will
irritate and disturb the digestion, and cause diarrhea; so that it is
not best to eat more than one-fifth of our total bread in the form of
brown bread. Dyspeptics who live on brown bread, or on so-called "health
foods," are simply feeding their dyspepsia.

"Breakfast Foods." The same defect exists in most of the breakfast
cereals which flood our tables and decorate our bill-boards. Some of
these are made of the waste of flouring mills, known as "middlings,"
"shorts," or bran, which were formerly used for cow-feed. The claims of
many of them are greatly exaggerated, for they contain no more
nourishment, or in no more digestible form, than the same weight of
bread; and they cost from two to five times as much. As they come on
our tables, they are nearly seven-eighths water; and the cream and sugar
taken with them are of higher food value than they are. They should
never be relied upon as the main part of a meal.

Corn Meal. Corn meal is one of the richest meals in nutritive value
for its price, as it has an abundance of starch and a small amount of
fat. It is, however, poor in nitrogen, and like the other grains, in
countries where wheat will grow, it is chiefly valuable for furnishing
cakes, fritters, and mushes to give variety to the diet, and help to
regulate the bowels.

Oatmeal. Oatmeal comes the nearest to wheat in the amount of nitrogen
or protein, but the digestible part of this is much smaller than in
wheat, and the indigestible portion is decidedly irritating to the
bowels, so that if used in excess of about one-fifth of our total
starch-food required, it is likely to upset the digestion.

Rye. Rye also contains a considerable amount of gluten, but is much
poorer in starch than wheat is; and the bread made out of its flour--the
so-called "black bread" of France and Germany--is dark, sticky, and
inclined to sour readily. Most of the "rye" bread sold in the shops, or
served on our tables, is made of wheat flour with a moderate mixture of
rye to give the sour taste.

Rice. Rice consists chiefly of starch, and makes nutritious puddings
or cakes, and may be used as a vegetable, in the place of potatoes, with
meat and fish. It is, however, lacking in flavor, and when properly
cooked, contains so much water that it has to be eaten in very large
amounts to furnish much nutrition.

Potatoes. The only important starchy food outside of the grains is
potatoes. These contain considerable amounts of starch, but mixed with a
good deal of cellulose, or vegetable fibre, and water, so that, like
rice, large amounts of them must be eaten in order to furnish a good
fuel supply. They, however, make a very necessary article of diet in
connection with meats, fish, and other vegetables.

As a rough illustration of the fuel value of the different starch foods,
it may be said that in order to get the amount of nourishment contained
in an ordinary pound loaf of wheat or white bread, it would be necessary
to eat about seven pounds of cooked rice, as it comes on the table;
about twelve pounds of boiled potatoes; or a bowl of oatmeal porridge
about the size of a wash-basin.

SUGARS

Where Sugar is Obtained. The other great member of the starch, or
carbohydrate, group of foods is sugar. This is a scarcer and more
expensive food than starch because, instead of being found in solid
masses in grains and roots like starch, it is scattered, very thinly,
through the fruits, stems, and roots of a hundred different plants,
seldom being present in greater amounts than two or three per cent. It
is, however, so valuable a food, with so high a fuel value, and is so
rapidly digested and absorbed, that man has always had a very keen
desire for it, or, as we say, a "sweet tooth," and has literally
searched the whole vegetable kingdom the world over to discover plants
from which it could be secured in larger amounts. During the last two
hundred years it has been obtained chiefly from two great sources: the
juicy stem of a tall, coarse reed, or cane, the sugar-cane, growing in
the tropics; and (within the last fifty years) the sweet juice of the
large root of a turnip-like plant, the beet. Another source of sugar, in
the earlier days of this country, was the juice or sap of the sugar
maple, which is still greatly relished as a luxury, chiefly in the form
of syrup.

Honey is nearly pure sugar together with certain ferments and flavoring
extracts, derived in part from the flowers from which it is gathered,
and in part from the stomach, or crop, of the bee.

The Food Value of Sugar. In the early days of its use, sugar, on
account of its expensiveness, was looked upon solely as a luxury, and
used sparingly--either as a flavoring for less attractive foods, or as a
special treat; and like most new foods, it was declared to be
unwholesome and dangerous. But sugar is now recognized as one of our
most useful and valuable foods. In fuel value, it is the equal, indeed
the superior, weight for weight, of starch; and as all starch has to be
changed into it before it can be used by the body, it is evident that
sugar is more easily digested and absorbed than starch, and furnishes
practically a ready-made fuel for our muscles.

How We should Use Sugar. The drawbacks of sugar are that, on account
of its exceedingly attractive taste, we may eat too much of it; and
that, because it is so satisfying, if we do eat too much of it either
between meals or at the beginning of meals, our appetites will be
"killed" before we have really eaten a sufficient supply of nourishing
food. But all we have to do to avoid these dangers is to use common
sense and a little self-control, without which any one of our appetites
may lead us into trouble.

On account of this satisfying property, sugar is best eaten at, or near,
the close of a meal; and taken at that time, there is no objection to
its use nearly pure, as in the form of sweet-meats, or good wholesome
candy. Its alleged injurious effects upon the teeth are largely
imaginary and no greater than those of the starchy foods. The teeth of
various tropical races which live almost entirely on sugar-cane during
certain seasons of the year are among the finest in the world; and any
danger may be entirely avoided by proper brushing and cleaning of the
teeth and gums after eating.

[Illustration: CANDY, LIKE OTHER FOODS, SHOULD BE CLEAN.

Candy sold on the street is always questionable. It should never be
bought from a cart or stand that is not covered with glass.]

If eaten in excess, sugar quickly gives rise to fermentation in the
stomach and bowels; but so do the starches and the fats, if
over-indulged in. Its real value as a food may be judged from the fact
that the German army has made it a part of its field ration in the shape
of cakes of chocolate, and that the United States Government buys pure
candy by the ton, for the use of its soldiers.

FOOTNOTES:

[7] On this account, they are often spoken of as carbohydrates, or
"carbon-water stuffs."

[8] See page 11.

CHAPTER VI

THE COAL FOODS (_Continued_)

ANIMAL FATS

The Digestibility of Fats. We have now come to the last group of the
real Coal foods, namely, the fats. Fats are the "hottest" and most
concentrated fuel that we possess, and might be described as the
"anthracites," or "hard coals" of our Coal foods. They are, also, as
might be expected from their "strength" or concentration, among the
slowest to digest of all our foods, so that, as a rule, we can eat them
only in very moderate amounts, seldom exceeding one-tenth to one-sixth
of our total food-fuel. It is not, however, quite correct to say that
fats are hard to digest, because, although from their solid, oily
character, they take a longer time to become digested and absorbed by
the body than most other foods, yet they are as perfectly and as
completely digested, with the healthy person, as any other kind of food.
Indeed, it is this slowness of digestion which gives them their
well-known staying-power as a food.

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