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[Illustration: J H Craven (signature)]




  A TEXT-BOOK
  ON
  HYGIENE AND PEDIATRICS

  _From a Chiropractic Standpoint_

  BY

  JOHN H. CRAVEN, D.C., Ph.C.

  DEPARTMENT OF HYGIENE AND PUBLIC HEALTH;
  PROFESSOR OF PHILOSOPHY, DEPARTMENT OF ORTHOPEDY,
  THE PALMER SCHOOL OF CHIROPRACTIC,
  DAVENPORT, IOWA

  FIRST EDITION
  1924

  PUBLISHED BY
  JOHN H. CRAVEN
  DAVENPORT, IOWA
  U. S. A.




  COPYRIGHT 1924, BY
  JOHN H. CRAVEN, D.C., Ph.C.
  DAVENPORT, IOWA


  _Printed in the United States of America_


  HAMMOND PRESS
  W. B. CONKEY COMPANY
  CHICAGO




DEDICATION


In grateful recognition of his wise counsel and valuable aid in
the production of this work, in sincere appreciation of the firm
principle for which he has ever stood even in the face of almost
overwhelming opposition and many times alone save for the few who
understood him, and because of the love I bear him for having saved
the life of my son, I count it a privilege as well as a very great
pleasure to dedicate this book to B. J. Palmer, D.C., Ph. C.,
scientist, philosopher, author, but best of all just my plain, frank,
candid friend, B. J. of Davenport.

  JOHN H. CRAVEN




PREFACE


More than ten years ago when I began teaching hygiene in the Palmer
School of Chiropractic, I realized the need of a text-book that would
deal with this subject from a chiropractic standpoint.

Many points maintained by hygienists are not in accord with the
teaching of Chiropractic, since they are proven untrue by our
philosophy. For this reason much subject matter in such text-books
was of no value to our students; hence the necessity for a
chiropractic hygiene text.

It has been no easy task to prepare this subject matter in view
of the conflicting teachings and ideas pertaining to the various
phases of hygiene, but the principles of Chiropractic are in no
way compromised and the student, from a casual perusal of any one
particular phase of the subject, should not draw conclusions that any
medical theories of dis-ease are being tolerated.

An effort has been made to include only that part of hygiene
pertaining to our science. Since sanitation pertains especially to
the environment, the approach to its study is the same regardless of
the viewpoint from which it is considered.

Section II, dealing with the care of the infant and the adjusting of
children, has been written in response to the hundreds of inquiries
which have come in from the practicing chiropractors in the field
requesting such a work. This is not intended as an exhaustive study
in the care of the infant; its purpose is merely to give a general
understanding to those who are interested in adjusting babies.

The technic used in adjusting children is of great importance and is
so considered.

It is sincerely hoped that this hygiene will fill the long-felt need
on the part of our Faculty for such a text, and that pediatrics
considered chiropractically will be of assistance to those in the
field who have requested a work on this subject.

  February, 1924.      JOHN H. CRAVEN




TABLE OF CONTENTS


                                                                  PAGE

  Dedication                                                         5

  Preface                                                            7


  SECTION I

  CHAPTER                                                         PAGE

  I. Introduction                                                   13

  II. Housing Hygiene                                               28

  III. Air                                                          44

  IV. Ventilation                                                   65

  V. Heating                                                        79

  VI. Lighting                                                      95

  VII. Water                                                       103

  VIII. School Hygiene                                             140

  IX. Industrial Hygiene                                           156

  X. Definitions                                                   171

  XI. Immunity                                                     181

  XII. Germs                                                       195

  XIII. Disinfection and Fumigation                                207

  XIV. Hygiene and Sanitation of the Sick Room                     217

  XV. Food                                                         231

  XVI. Food Poisons                                                245

  XVII. Milk                                                       254

  XVIII. Meat                                                      267


  SECTION II

  I. The Baby                                                      277

  II. Dentition                                                    299

  III. Analyzing Infants                                           307

  IV. Adjusting Infants                                            321

  V. Respiratory System                                            327

  VI. Digestive Tract                                              353

  VII. Miscellaneous                                               373

  Index                                                            393




CHAPTER I

INTRODUCTION




INTRODUCTION


  ORIGIN OF WORD HYGIENE

  HYGIENE DEFINED
    PERSONAL
    PUBLIC

  SANITARY SCIENCE

  SANITARY ART

  DISTINCTION BETWEEN SANITATION AND HYGIENE

  AIM AND FUNCTION OF HYGIENE AND SANITATION
    TO INCREASE INTERNAL RESISTANCE
    TO IMPROVE ENVIRONMENTAL CONDITIONS

  INTERNAL AND EXTERNAL CLEANLINESS
    ESSENTIAL TO HEALTH
    CHIROPRACTORS INTERESTED IN

  SEWERAGE SYSTEM OF THE BODY
    CHYME
    CHYLE
    ABSORPTION
    ELIMINATION

  THREE VIEWPOINTS ON HYGIENE
    MEDICAL
    LAYMAN’S
    CHIROPRACTIC

  ADVANTAGES OF PROPER SANITARY ENVIRONMENT

  CAUSE OF DIS-EASE
    NOT RESULT OF EXTRINSIC CONDITIONS
    INTERFERENCE WITH TRANSMISSION OF MENTAL IMPULSES

  SOURCES OF COMMUNICATION
    MAN
    ANIMALS
    SO-CALLED COMMUNICABLE DIS-EASES




SECTION I

CHIROPRACTIC HYGIENE




CHAPTER I

INTRODUCTION


Origin of the Word Hygiene

Hygeia was the name given the Greek goddess of health. In her statues
she was always represented as a woman of perfect health and beauty,
and was worshipped as the goddess of health. She was supposed to be
the daughter of Esculapius, the god of medicine. In Greek mythology
Esculapius attained great fame as a physician, having power not only
to prevent dis-ease, but also to raise the dead. A temple was erected
to Hygeia near that of her father. Here the people came to worship.
There was even a statue of Hygeia in the temple of her father.
Thus we see, from time immemorial, health and medicine have been
associated.


Hygiene Defined

From the word Hygeia we get the word hygiene, which means health.
Hygiene is defined as the science and the art of promoting health;
the science of the preservation of human health by the removal of the
cause of dis-ease. It is sometimes defined as the science of health.
Hygiene is divided into two classes, personal and public.

=Personal Hygiene= is the science of the promotion of the
individual’s health and deals with personal habits, such as eating
and drinking; personal cleanliness; personal activities such as work,
recreation, self-restraint. The handling of children comes under this
branch of hygiene. The human machine is limited by the limitations
of the physical, which necessitates the observance of these laws
governing the expression of life.

=Public Hygiene= deals with the methods and processes necessary to
preserve and promote the health interests of the public. It deals
with man collectively rather than individually. This includes
consideration of the environment, such as cleaning of streets,
disposal of the dead, and proper hygienic methods in buildings and in
public places.


Sanitary Science

Sanitary science includes the sum total of the knowledge of those
principles and processes necessary to maintain personal and public
health. It is an inductive science and therefore depends upon
observation and verification in determining the general laws and
truths of health and the relation between cause and effect in public
and personal health.


Sanitary Art

Sanitary art is the practical application of those principles which
are necessary to create a proper environment for man in his present
artificial state of living, not only for the individual, but for the
public as well.


Distinction between Sanitation and Hygiene

The term sanitation or sanitary science is often used synonymous with
the term hygiene although there is a difference in their meaning and
usage. The term sanitation or sanitary science has been used largely
in Great Britain and in this country, although both terms are used in
America but with somewhat different meanings.

In reality there is a very important distinction between the two
terms hygiene and sanitation. Hygiene may be considered the broader
term which may be made to include everything relating to health, but
more particularly those things which relate to the person. Sanitation
or sanitary science relates more to the environmental conditions and
their relation to the health of the individual or the community.

This distinction is drawn more sharply by reason of the developments
along the line of sanitary engineering on the one hand and the
biological and physiological developments on the other.

Sanitary science has been largely under the supervision and in the
hands of sanitary engineers, while hygiene has been almost entirely
in the hands of the medical profession.


Aim and Function of Hygiene and Sanitation

Medically the aim and function of hygiene is to increase the internal
resistance of the individual and thus prevent dis-ease and prolong
life. The aim and function of sanitation or sanitary science is to
improve the environmental conditions and thus prevent dis-ease and
prolong life of the individual.

Doctor Price gives the aim and function of hygiene as: “The
prevention of dis-ease, the prevention of premature death, and the
promotion of normal health of individuals and the community by
the removal of the causes of dis-ease, destruction of the causes,
improvement of the environmental conditions, and by the increase of
the vital resistance of the individual and members of communities.”
The premise here is correct, but the conclusions as to the methods
which are to be used in accomplishing the desired end are erroneous.


Internal and External Cleanliness

There is a distinction between internal cleanliness and external
cleanliness. It is a mistaken idea that because the external is
clean, the internal will be correspondingly clean. Cleanliness
is absolutely essential to health, but by this we mean internal
cleanliness. There must be external cleanliness also, but perfect
external cleanliness will not necessarily result in perfect health.

Vital resistance of the body is not determined by the degree of
external cleanliness nor by the perfect sanitary condition of the
environment. However, it can never be said that Chiropractic does not
believe in cleanliness. Chiropractic, of all the sciences, lays great
stress on hygiene and sanitation. Our greatest teacher in all things
is Nature and if there is any one thing that Chiropractic insists
upon more than any other, it is that we live according to the laws
of Nature and the closer we live to Nature, the more normal will be
our functions. When we study the laws of Nature, we find the secret
of sanitation. Everywhere in Nature we find laws in operation which
result in the destruction of waste material and in the purification
of the environment.

From the standpoint of common decency we are interested in sanitation
or cleanliness, yet an immaculately clean environment will not result
in perfect health or in the cure of dis-ease. The streets and alleys
of the city may be kept clean and in a sanitary condition, yet the
inside of the homes may be filled with filth. So the environment of
man may be in a perfect condition so far as sanitation is concerned,
yet the body may be filled with all kinds of poison and refuse.


Sewerage System of the Body

The human body is a machine which performs certain functions and in
order that these functions be performed there is a constant process
of activity; this means that the tissues which make up the body are
being constantly worn out the same as the part of any other machine.
This necessitates a constant process of repair.

In order that this process of reparation be carried on, new material
must be added to the machine; this is done by means of food. The food
is taken into the mouth and properly masticated and mixed with the
secretions of the glands of the mouth; it is then carried through the
esophagus into the stomach. Here other digestive juices are added
to it and thoroughly mixed by the vermicular motion of the stomach
until the process of gastric digestion is completed; then this chyme,
as it is now called, passes into the small intestines, where other
secretions are added and chemical changes are brought about until
this process of intestinal digestion is completed. This product is
given the name of chyle.

During the time these processes have been going on, the process of
absorption has been taking place whereby this digested food has been
utilized in building up the tissue cells that are being constantly
worn out by the activities of the body. The digested products are
being taken up by the serous circulation and carried to every cell in
the body. That which one cell gives off as an elimination, another
may take up as food, finding just the chemical composition necessary
to its life and development. Finally all of the waste material
is collected and eliminated from the body through the organs of
elimination. Innate Intelligence has provided a wonderful sewerage
system for the purpose of taking care of the sewage of the body. This
system is much more perfect than any system ever invented by man, but
it is possible for it to get out of order. The remarkable thing about
it is that the Intelligence within the body is capable of correcting
the disorders if the interference with transmission to the affected
parts is removed. All that is necessary from the outside is to
remove that which is interfering with the transmission of the mental
impulses.

As long as there is interference with the transmission of mental
impulses we may apply all the laws and principles of hygiene and
sanitation, yet the internal condition will not be hygienic or
sanitary. We may, by an artificial means, remove the waste material
that has accumulated, but this will not stop the process of
accumulation.

In view of the fact that the above mentioned processes of absorption
and elimination are taking place, let us assume that there is a
subluxation at the kidney place (K.P.) impinging the nerves and
interfering with the transmission of mental impulses to the kidneys.
With decreased current the kidneys are unable to perform their normal
amount of function and as a result the waste material, poisons, or
in other words the sewage that is supposed to pass out through this
channel of excretion, are retained in the body. The poison thus
retained is spread over the entire body and there is likely to be
excessive perspiration which will have a strong odor of urine. This
is because the skin, in its excretory function, is called upon to
throw off the waste material which normally should be excreted by the
kidneys. Although there is no perspiration there will still be a very
offensive and objectionable urinary odor from the patient’s body.
From a hygienic standpoint it is necessary for that patient to bathe
very often, but no matter how often he bathes, there is still that
odor of urine and it is impossible for him to get rid of it. One may
thoroughly and frequently cleanse that patient externally, but there
will remain that unsanitary internal condition.

Trying to get rid of the odor of urine and to create a sanitary
internal condition in a case of this kind by external bathing and by
the observance of sanitary laws would be like trying to keep a boat
from sinking by dipping the water out when it was running in twice as
fast as one could dip it out. It would be better to stop the leak. If
the roof of one’s house leaks he does not try to keep the house dry
by mopping up the water and putting chlorid of lime about the rooms
to absorb the moisture. This may be done as an adaptative measure to
the condition that exists because of the defect in the roof, but to
correct the condition one must go directly to the roof and repair it
so that no more damage may be done the interior of the house.

So in the case of the K.P. subluxation and the unsanitary condition
resulting from the accumulation of waste material in the body, it
is folly to try to correct the condition by any other method than
by removing the cause. The sewage must be carried out through the
natural channels and any attempt to dispose of it by any other or
artificial means will meet with absolute failure.


Three Viewpoints on Hygiene

According to Dr. B. J. Palmer there are three viewpoints of hygiene;
that is to say, there are three aspects from which the subject of
cleanliness may be considered: namely, the medical, layman’s and
chiropractic hygiene. The chief differences are: the medical hygiene
tries to make the internal condition sanitary by the application of
external means; the layman’s hygiene makes the external condition
sanitary by the application of external means; the chiropractic
hygiene makes the internal condition sanitary by permitting the
internal forces to operate unhindered in the body.

We see that from every viewpoint, hygiene means cleanliness. The only
real difference in these viewpoints consists in the methods used to
obtain this desired end. The layman maintains a sanitary external
condition by observing the laws of Nature. When dirt accumulates on
the outside which creates an unhygienic and objectionable condition,
he uses soap and water to cleanse the outside. His unhygienic
condition is outside of the body and he uses outside means to
rid himself of that condition. It is very obvious that this is a
perfectly proper procedure and if correctly and systematically
applied it will produce a hygienic external in so far as that
condition is influenced by external environment.

The most baffling unsanitary and unhygienic conditions are the
internal, and yet if these conditions are considered in the light
of the same common sense as is applied to the external conditions,
no great amount of difficulty will be experienced in coping with
them. However, great difficulties will be experienced if an effort
is made to keep the internal in a proper sanitary condition by the
application of external means. This has been well demonstrated in
the application of medical hygiene. However, the author does not
want to be understood as implying that a great deal of good has not
been accomplished in the investigations that have been made along the
line of hygiene and more especially in sanitary science. But when
chiropractic philosophy is properly understood, it will be readily
seen that it is far better to clean the inside from the inside
than to attempt cleaning the inside from the outside. With all due
regard it must be said that up to the time of the introduction of
chiropractic hygiene all the efforts were to clean the inside from
the outside, but Chiropractic says the inside must be cleansed from
the inside and this contention has been amply proven in the results
obtained through chiropractic adjustments.


Advantages of a Proper Sanitary Environment

The body is capable of great possibilities in intellectual
adaptation. It is possible for Innate Intelligence to maintain a
degree of health in widely different conditions. Even where the
environment is extremely adverse and objectionable Innate will adapt
herself to the abnormal condition and maintain the normal processes
of life in the body. However, it must be remembered that a greater
amount of internal force is required to bring about an intellectual
adaptation to an adverse environment than to a normal, natural or
more perfect environment.

There must be a constant process of adaptation to the environment
even though that environment be a most desirable one. All internal
processes must of necessity be adaptative to external conditions.
Drummond says, “Life is uninterrupted correspondence with proper
environment.” This is true of the expression of life. If the
correspondence with the environment is interfered with there will be
a corresponding interference with the expression of the life in the
body.

The more adverse the environment the greater the amount of force
required to bring about this adaptation. Likewise, the reverse is
true—adaptation to a more desirable environment requires less
internal force. We should not compel Innate Intelligence to do things
that we could do educationally and save the body that extra amount of
internal force. To illustrate, one should not unnecessarily expose
his body to the cold and thus force Innate to expend internal energy
to adapt the body to that condition. One might better put on proper
clothing to protect the body. On the other hand, one should not go to
the other extreme and make a hothouse plant of his body.

A proper sanitary environment should at all times be maintained that
there may not be an unnecessary drain on the adaptative forces of the
body.


Cause of Dis-ease

Chiropractic does not accept the theory that dis-ease is caused
by extrinsic conditions. There may be a great variation in the
environment and yet Innate Intelligence be able to maintain health.
If there is sufficient interference with the transmission of mental
impulses through the nerves, there will be dis-ease in the body
regardless of the perfect environment that may be artificially
produced. If the transmission is normal the individual may take the
so-called dis-ease germs into his body and feel no ill effects for
they will be excreted as so much waste material which can not be
used in the metabolism of the body. But if there are subluxations
which interfere with the transmission of mental impulses and reduce
the process of excretion the tissues will become abnormal and proper
culture media will be formed in which there will be developed the
germs which act as scavengers for the purpose of destroying the waste
matter which accumulates. The cause of dis-ease is within the body
itself. The cause of dis-ease is interference with transmission of
mental impulses from the brain to the periphery, thus preventing the
organ from performing its full and normal function. This results
in a lack of coördinate action between the organs of the body and
interferes with the intellectual adaptation to external conditions.

The question may be raised at this time relative to the effects
produced by the introduction of poison into the body and relative to
germs being classed as poisons producing certain effects in the body.

We will not endeavor at this time to fully deal with these questions,
for in order that the student understand thoroughly the chiropractic
idea of these things, it will be necessary to study many points,
both in connection with the hygiene and also with the philosophy of
Chiropractic.

This point is thoroughly covered in the philosophy under the head of
the Poison Cycle. We will simply state briefly here that a poison
is anything which can not be used in the metabolism of the body and
which, if allowed to remain in the body, will be carried to the
tissue cells and do harm. In this event Innate will at once begin a
process of elimination. If the channels of excretion are not normal
and the organs are unable to do their work properly because of the
interference with the transmission of mental impulses, it can readily
be seen that the poison will be retained in the body and do harm.
The character of the injury will be governed by the character of the
poison retained.

Again, it is clearly explained in the philosophy how the introduction
of poison into the body may produce subluxations and thus cause an
interference with transmission and reduce the adaptative action on
the part of Innate to the poison introduced. The student is referred
to Volume V, Chiropractic Library, for further explanation on this
point.


Sources of Communication

Generally speaking, there are two main sources whereby dis-ease is
communicated: (a) man himself; (b) the animals. Almost all of the
so-called communicable dis-eases of man are peculiar to man alone and
are not found in animals except as they are communicated to them
for experimental purposes. It is interesting to note that the lower
animals are much more free from contagious dis-eases than man. As a
matter of fact, the lower animals are seldom found to be infected. It
is true that the domesticated animal is more susceptible to dis-ease
than the wild animal living in the natural state.

Following is a list commonly given as communicable dis-eases peculiar
to man and according to medical theory communicable from man to man.
Even among those who accept this theory there is quite a difference
of opinion as to the dis-eases that should be included in this list.
Smallpox, chickenpox, cholera, leprosy, dengue, relapsing fever,
measles, mumps, scarlet fever, infantile paralysis, typhus fever,
yellow fever, malaria, syphilis, tuberculosis and typhoid fever. It
is maintained by hygienists that the greatest source of infection is
man himself. No longer is it thought that the environment is the main
source of infection. It is believed by Rosenau and others that the
water, soil, air and food may be the media conveying dis-ease from
man to man; these, however, are not now considered as the main source
of infection. Rosenau says, “Most of the microörganisms causing
the communicable dis-eases of man are frail and soon die in our
environment, as in the air, soil or water. Most of them are obligate
pathogens and can not, or do not, grow and multiply under the adverse
conditions of our environment.” And yet these frail little creatures
are supposed to cause dis-ease in man. We wish the student to bear
this in mind for we will have more to say in this respect later on.

It is sufficient to state here that the above named dis-eases
maintained by some to be caused by germs are corrected by
chiropractic adjustments. Chiropractic has proven that instead
of dis-ease being caused by the germ the germ is produced by the
dis-ease.




CHAPTER II

HOUSING HYGIENE


  HOUSING HYGIENE

  GENERAL CONSIDERATIONS

  SITE
    RELATION TO HEALTH
    EFFECT OF DAMP SITE

  ASPECT
    MOST SUITABLE
    ARRANGEMENT OF ROOMS
    DIRECT RAYS OF THE SUN

  Soil
    RELATION TO HEALTH
    MOST SUITABLE SOIL

  GROUND WATER AND GROUND AIR
    FLUCTUATION OF
    DISTANCE OF GROUND WATER FROM SURFACE
    GROUND AIR FORCED INTO BREATHING ZONE
    DRAINAGE OF GROUND WATER
    ASSISTANCE IN PROCESS OF PURIFICATION
    ILL EFFECTS OF WATER-LOGGED SITES

  STAGNANT WATER
    ILL EFFECTS OF
    METHODS OF DISPOSAL

  BUILDING CONSTRUCTION

  FOUNDATION
    RELATION TO THE BUILDING
    CHARACTER AND PREPARATION OF
    PREVENTION OF DAMPNESS

  WALLS
    MATERIALS USED
    CONSTRUCTION

  FLOORS
    SANITARY REQUIREMENTS
    MATERIALS USED
    CONSTRUCTION

  ROOF
    MATERIALS TO MEET SANITARY REQUIREMENTS
    FIREPROOF
    HEAT CONDUCTION THROUGH

  HOUSE DAMPNESS
    OBJECTIONS TO
    SOURCE OF DAMPNESS
    METHOD OF PREVENTION
    ILL EFFECTS OF HOUSE DAMPNESS

  FIREPROOFING
    ADVANTAGES OF FIREPROOFING
    METHODS USED IN FIREPROOFING
    CONSTRUCTION

  HOUSE PLUMBING
    SYSTEM OF PIPES
    FIXTURES
    TRAPS
    SEAL
    WATER TO CARRY AWAY SEWAGE




CHAPTER II

HOUSING HYGIENE


GENERAL CONSIDERATIONS

=Site=

From a hygienic standpoint the building site bears a certain relation
to health and this should not be overlooked. This is in perfect
accord with the chiropractic philosophy as to the expression of life
in the body. The building site may be so unnatural as to create an
environment which would draw too heavily upon the adaptative forces
of the body. In this case Innate would find difficulty in maintaining
a state of coördination.

[Illustration: Model Site]

The artificial methods of living must be made to conform as nearly
as possible to the needs of the body. Damp surroundings might have
no ill effects upon the individual who was living a very active life
outdoors “roughing it,” but place that individual in a damp, poorly
lighted and poorly heated house where he is less active and his
expression of life will be materially affected. Innate requires a
proper environment, although not necessarily a perfect one, but it
must be such that an adaptation can be maintained.

[Illustration: Unsanitary building site.]

If the building site is damp it will require special methods to
prevent the dampness from entering the house. This is expensive
and if the site is too humid such a method will prove highly
unsatisfactory. If the location is cold the house is very likely to
be cold. The site should be well adapted to the needs of the building.


Aspect

The importance of the aspect should not be overlooked. A
southeasterly facing is generally considered best, because it is dry
and mild and has the morning sun and yet is not exposed to the hot
afternoon sun.

The main living rooms should be so arranged as to admit the
direct rays of the sun some time during the day. This can best be
accomplished when these rooms are on the southeast. Each room should
be so arranged with respect to window space that there will be ample
lighting and proper ventilation of the whole house. Care must be
exercised, however, that there is not too much window space which
will give excessive heat in summer or too much cold in winter.

In large dwellings there is a tendency for the halls and stairways to
be poorly lighted and poorly ventilated. This should not be. Ample
provision supplying light through windows, and ventilation from the
outside should be made to insure plenty of light and air.

Bedrooms should be well lighted and if possible direct sunshine
should be admitted some time during the day, preferably in the
morning.


Soil

The soil bears a close relation to health. The porous soils such as
sand and gravel are considered the most healthful because they are
driest. But there are objections to these, since they are easily
polluted by leaky drains and cesspools, and are capable of holding
a notable volume of ground water and ground air. Such air is almost
invariably impure. The rain percolates through the soil until it
reaches an impervious stratum which prevents it from penetrating any
further, and it is held in the interstices or interspaces of the soil
and forms the ground water.


Ground Water and Ground Air

There is a certain fluctuation of ground water and ground air. As the
water rises the air is forced out of the ground, and as it recedes
air is drawn in to occupy its place. There are other factors which
influence the ground air, such as the perflating action of the wind
and certain climatic changes. Thus the ground may be spoken of as
breathing.

If the ground water is near the surface the ground air will be
noticeably moist and will produce a dampness of the atmosphere
which will result in a decided cooling of the air by evaporation.
If the ground water is deep the ground air will be comparatively
dry, although the ground near the surface is generally moist owing
to the capillary attraction and evaporation from the surface of the
ground water. For this reason it is important that damp soils be
properly drained to permanently lower the level of the ground water.
This may be accomplished by properly laid tile. This will reduce the
fluctuation of the ground water since it will be carried off when it
rises to the level of the drains. In this way the ground air will not
be forced out into the breathing zone to pollute the atmosphere.

The ground air is impure due to the organic matter in the soil. This
organic matter is decomposed by microörganisms that feed upon such
material and break it up into simpler combinations, carbonic acid,
ammonia and water. These processes of fermentation and decay result
in a purifying action converting the complex organic matter into
products which growing vegetation is capable of assimilating. The
presence of oxygen, moisture and warmth is essential to the proper
execution of these processes. We can thus see that ample provision
has been made for the natural purification and utilization of animal
and vegetable matter. Nature provides the oxygen in the ground air,
the necessary moisture is derived from the ground water and the
temperature of the earth is generally sufficient to supply the needed
warmth for this natural process of purification.

If the ground water rises too near the surface or if the building
site is water-logged, the water may be drawn off by means of a
subsoil drainage. This will also prevent fluctuation of ground
water, for as this water rises the ground air is forced out and
causes the atmospheric air to become damp. This brings about a
cooling of the air. The moisture will ascend by capillary attraction
into the walls of the houses; in the evaporation from the inner
surfaces, heat will be absorbed from the surrounding objects and this
will cause the houses to become damp and cold.

This drainage may be accomplished by placing unglazed porous tiles
with the ends in apposition, but not jointed in the subsoil. The
fluctuation of ground water is of little consequence in itself; but
we can see that in this way the water in wells may become polluted,
impure ground air may be forced into houses, and dampness may thus be
produced.


Stagnant Water

Stagnant water favors the breeding of mosquitoes and the development
of certain dis-eases, malaria and cholera for example; hence the
necessity for proper drainage. Trees are sometimes planted in such
districts and they, together with the subsoil drainage, render the
conditions more healthful. The trees and other vegetation in hot
climates absorb the water from the ground and then it is evaporated
from the leaves and in this way soil is made drier.


BUILDING CONSTRUCTION


Foundation

In the building of a house the foundation must receive just
consideration. As the foundation holds the entire structure, such
material must be used as to give adequate support to this weight.
Care must be exercised in the evacuations that the basement be
protected from dampness and that the entire site beneath the
foundation be properly drained. The ground water should be ten feet
beneath the surface of the site.

It is recommended by some hygienists that the basement floor be of
cement six inches thick to prevent the entrance of ground air and
moisture. This should be covered with a wood floor.

The preparation of the foundation is comparatively easy where the
ground is solid, but if the site be water-logged, marshy, quicksand,
or entirely under water, its preparation then becomes a problem that
may baffle the best engineers. Artificial foundation beds may have
to be resorted to. These are accomplished in several ways. One very
common method is to drive wooden piles into the ground, saw off the
tops and construct the foundation on these piles. Another method is
that of the cofferdam.

The foundation having been properly prepared, care must be taken that
the footings or base course of the walls are of sufficient strength
to bear the weight of the superstructure. The footings should be of
stone or concrete and should be a little thicker than the walls.

Precautions for a dry basement must also be considered. This subject
will be discussed under House Dampness.

The air of the basement must be kept pure by proper ventilation,
since it is being constantly drawn up into the house. This will
receive some attention in the chapter on Ventilation.


Walls

The walls of the house may be of brick, stone, timber or concrete.
The method of construction will depend upon the material used. If
timber is utilized the security of the walls will be governed by
the timber posts, sills and plates. The materials used should be as
little absorbent of moisture as possible. All wood should be well
seasoned.


Floors

In order to meet all sanitary requirements the “floors must be secure
and proof against air, dust, sound, vermin, fire and water.” But
it is not often that the floors meet all these sanitary demands.
Ordinary floors are made of hard boards tongued and grooved, tightly
fitted and laid upon joists placed about one foot apart; the under
surface is lathed and plastered to form the ceiling of the room
below, or some sort of patent ceiling may be used. However, there
is great objection to the space thus left between the floor and the
ceiling, as it becomes a receptacle for dust and greatly endangers
the spread of fire.

It is better, according to sanitary demands, to have the floor of
reinforced concrete, or the space within filled with mineral wool
or asbestos; or the floor may be made of steel beams encased in
terra-cotta with interspaces made of concrete.


Roof

For roofing some non-absorbent material is best. Wood shingles are
possibly the most common in this country, although they are rapidly
being replaced with composition shingles. The wood shingles are
somewhat absorbent and are inflammable. Slate and tile are also
used. The slate is a good conductor of heat, and is hot in summer
and cold in winter. Tiles are heavy but are warm in winter and cool
in summer. Lead, zinc and copper have all been used, but they are
good conductors of heat and for various other reasons are not exactly
desirable. The best method of preventing too rapid conduction of heat
is to have an air space between the roof and the ceiling of the top
floor.


House Dampness

Great care should be exercised to prevent the entrance of moisture
into the house. A damp house is very objectionable. In a newly
constructed building there is always more or less dampness coming
from green lumber, mortar and plaster. This is known as building
water. Before a new house is occupied it should be thoroughly dried
by a fire in stoves or furnaces. Dampness from building water is only
temporary and easily eliminated.

Moisture in houses from damp sites, leaky drains, porous building
material which admits rain and other similar causes, require the
attention of an engineer who understands water-proof construction.

Moisture from the ground water may ascend the walls of the building
by capillary attraction. This may be prevented by properly draining
the site and by placing a horizontal water-proof course in the walls.
This may consist of asphalt one-half inch thick or a course of slate
or other material through which the moisture will not penetrate.

The ill effects of a damp house upon the health of the occupants can
hardly be overestimated. Such houses are cold, being difficult to
heat and ventilate. The bodily heat is too rapidly withdrawn. This
necessitates adaptative action on the part of Innate Intelligence and
requires an unnecessary expenditure of internal energy.

Aside from a damp house having an ill effect upon health by creating
an environment which is not conducive to the expression of life
indoors, the dampness tends to produce moulds and otherwise injure
the furniture and hangings. This results in a musty odor and creates
a condition conducive to the development of cockroaches and water
bugs. These conditions are repulsive to the finer sensibilities.

It is a recognized fact that Innate Intelligence is able to adapt the
body to various conditions and people who appear to be in a state of
comparatively good health may be found in such environments, but why
should we force Innate to adapt the body to such adverse conditions
when we may educationally improve the surroundings and make them
more healthful? The educated mind is the expression of the same
Innate Intelligence that is adapting the body to the environment,
so it is only reasonable that the educated mind should be used in
as intelligent a manner as the Innate mind. It is the function of
the educated mind to bring about an educated adaptation to the
environment through the educated body and to study the laws of
nature and adapt them to the needs of the body.

So it is in perfect accord with chiropractic philosophy that a proper
dwelling be provided wherein the condition is such that there may be
perfect adaptation to all the needs of the body. This is as much a
part of the chiropractor’s work as is any other part of his duties
and obligations to the sick. He need not be able to do all these
things, but he should know what conditions are conducive to the
expression of life in the body and why others are not.


Fireproofing

The expression, fireproof, is a misnomer. There are no materials
that are absolutely fireproof, but there are many that, are fire
resisting. A material may be ignition-proof but not capable of
resisting high temperatures. Some metals will withstand higher
temperatures than others.

Fire protection is important from the standpoint of hygiene, since
it is a factor in preventing loss of life and property. It will also
be observed that fire-resisting material and fireproof construction
is more sanitary than soft absorbent materials and improper house
construction.

Three methods are used in reducing the danger from fire: First,
by the use of fire-resisting building material; second, by proper
fireproof construction; third, by providing ample fire escapes and
fire extinguishers.

In a fireproof building all inflammable materials are eliminated and
such materials as brick, reinforced concrete, stone and burnt terra
cotta are used. As has been stated before, these materials are not
fireproof but only fire-resisting. They will all be affected by fire
if the intensity is great enough.

In the construction of fireproof buildings, only fire-resisting
materials are used. No wood nor other combustible materials are
utilized. All spaces, air wells and air shafts are eliminated as far
as possible. The floors are constructed of rolled wrought iron on
steel floor beams, or of Portland cement. The roofs are made of burnt
terra cotta, rolled wrought iron or cement.

The stairways and landings are of brick, stone, cement, iron or
steel, all wood being eliminated even for windows and doors. The
partitions are constructed of fireproof material such as hollow tile.

Every building should be provided with ample fire escapes to furnish
plenty of exits in case of fire. This is accomplished by providing
wide stairways and by furnishing sufficient fire escapes on the
outside of the building. These fire escapes should be constructed of
metal or some fire-resisting material.


House Plumbing

A system of house plumbing consists of pipes carrying the water into
the house, the fixtures or receptacles which are used to receive
the waste and refuse from the household and the processes that are
performed in the house. The latter includes the fixtures of the
bathroom—the stool, bath tub, lavatory and foot tub; those of the
kitchen such as the sink; those of the laundry; and the system of
pipes which carry the refuse from the house into the main sewer.

Between the pipes which carry the water into the house and those
which carry the sewage out are placed the house fixtures. There is a
pipe leading to each fixture which carries the water to dilute the
sewage, and a pipe leading from each of these fixtures carrying the
sewage to the main house drain. The admission of sewer gas into the
house through the fixtures is prevented by the trap which contains
water known as the seal. The trap is of no value unless it is
properly sealed. The trap is simply a bend in the pipe, as shown in
the illustration, in which water is contained. This water keeps the
sewer air from coming back into the house.

A system of house plumbing, in order to meet the requirements of
hygiene, must be properly trapped. There is a small trap for each
fixture and in some cities an additional outside trap is required
which protects the entire system.

[Illustration: bowl and trap]

When some fixture loses its seal then there is great danger of
sewer air coming into the house. The main causes for traps becoming
unsealed are: the forcible ejection of the seal by the momentum of
the flush; loss of seal through siphon; the evaporation of the water
when the fixture is not in use; and by capillary attraction as when
waste paper or some similar material is left in the trap and projects
through. Siphonage is caused by a large volume of water passing down
through a vertical pipe with which the fixture is connected.

The loss of the seal by evaporation may be prevented by frequent
use of the fixture, or if the fixture is not to be used for some
time the trap may be filled with oil or some substance that will
not evaporate. The loss of the seal from momentum may be averted by
providing proper flushing tanks, while the protection from capillary
attraction may be effected by not allowing anything to remain in the
trap which will exert this capillary attraction on the water in the
trap.

Prevention of siphonage is accomplished by providing proper
ventilation for each trap so there may be a column of air which may
be drawn upon in lieu of the seal.

Care should be taken that the seal does not become foul. The fouling
of the seal is the result of back pressure from the sewer and may be
avoided by providing a vent pipe through which the air may pass from
the sewer and thus relieve the pressure on the seal.

The sewage is carried from the house by the house sewer into the
street sewer, from the street sewer into the district sewers, and
then into the large trunk sewers. There are also relief sewers, storm
sewers, under drains, and intercepting sewers. The entire system is
known as the sewerage system.

The amount of water required to carry away the sewage varies in
different cities. In the smaller towns it may be as low as fifty
gallons a day per capita, while in some of the larger cities it may
be as much as 200 gallons per capita per day.

At one time the sewer gas was considered the greatest menace to
workmen in the sewers. But it has been found that there is little
danger from this gas. Sewer air is very objectionable because of the
very foul odor, but even those who contend that germs cause dis-ease
maintain that there is little danger of contracting dis-ease from
breathing sewer air.




CHAPTER III

AIR




AIR


CONSTITUENTS OF AIR

  GENERAL CONSIDERATIONS
  AIR, MIXTURE OF GASES
  ATMOSPHERE
  AQUASPHERE
  PETROSPHERE
  FUNCTION OF AIR

  OXYGEN
  PER CENT OF OXYGEN
  USE IN BODY
  AMOUNT REQUIRED VARIES

  NITROGEN
  MORE IMPORTANT TO PLANT LIFE
  USE IN BODY

  ARGON
  MEANING OF NAME
  AMOUNT IN ATMOSPHERE
  ARGON GROUP

  CARBON DIOXIDE
  AMOUNT IN AIR
  SOURCES OF
  PROPERTIES OF
  COURSE IN BLOOD

  OZONE
  NOT CONSTANT ELEMENT
  WHERE FOUND
  HOW FORMED

  AMMONIA
  HOW PRODUCED
  WHERE FOUND

  OTHER CONSTITUENTS
  HYDROGEN PEROXIDE
  HELIUM
  KRYPTON
  NEON
  XENON
  NITROGEN AND SULPHURIC ACID


AIR PRESSURE

  NORMAL AIR PRESSURE
  AVERAGE PRESSURE
  INTELLECTUAL ADAPTATION

  REDUCED AIR PRESSURE
  INCREASED RATE OF BREATHING
  EXPERIMENT
  SYMPTOMS IN REDUCED AIR PRESSURE

  INCREASED AIR PRESSURE
  CONDITIONS IN SAME
  DANGER FROM

  CAISSON DIS-EASE
  SEVERE PAIN IN MUSCLES AND JOINTS
  DIVER’S PALSY
  BENDS


HUMIDITY AND TEMPERATURE OF AIR

  HUMIDITY
  RELATIVE
  ABSOLUTE

  COLD DRY AIR
  ADAPTING BODY TO CHANGE
  HEAT STROKE
  HEAT EVAPORATION NECESSARY

  WARM MOIST AIR
  INTERFERENCE IN ADAPTATION
  EFFECTS UPON BODY

  COLD DAMP AIR
  PRODUCES CHILLING OF BODY
  INTERFERES WITH INTELLECTUAL ADAPTATION

  WARM DRY AIR
  VERY DESIRABLE
  LOSS OF MOISTURE FROM BODY

  PROPER TEMPERATURE AND HUMIDITY




CHAPTER III

AIR


CONSTITUENTS OF AIR

Air is a mixture of gases, not a chemical compound, which envelops
the earth and it is estimated to be at least one hundred miles high.
This gaseous envelope is known as the atmosphere. The water upon
the earth’s surface is called the aquasphere. The solid substance
composing the earth is known as the petrosphere.

Air performs a very important function in the interchanging of gases
in respiration and in the regulation of bodily temperature. The gases
contained in the atmosphere are given by most authorities in the
following proportions, per volume:

  Oxygen             20.93%
  Nitrogen           78.10%
  Argon               0.94%
  Carbon Dioxide      0.03%

  With traces of helium, krypton, neon, xenon, hydrogen, ammonia,
  ozone and hydrogen peroxide.

It is also found that there is a varying amount of water in the air,
as well as dust and other substances. It is worthy of note that the
air maintains a wonderful uniformity of composition over the entire
surface of the earth. This is undoubtedly due to the fact that the
atmosphere is in constant motion which maintains its proper mixture.
It must also be noted that the air is not a chemical compound but is
a mixture of gases.


Oxygen (O)

Probably the most important element in air is the oxygen which
represents about one-fifth of its composition. This percentage is
maintained with very slight variation; for instance, the percentage
of oxygen in towns will be slightly less than 20.93%, about 20.87%.

When the atmosphere contains only 11% or 12% of oxygen it becomes
dangerous, and death results when the percentage gets as low as 7.2%.
A candle will not burn with the oxygen at 16%. Slight variation in
the amount of oxygen is of no special importance.

The amount of oxygen in the air has little to do with the amount
absorbed in respiration, as this is governed more by the need of the
body than by the amount taken into the lungs.

Nature has made a wonderful provision in the protection of the
body from extreme changes in the amount of oxygen in the air. This
provision increases the degree of intellectual adaptation which is
possible in the body. This is shown by the fact that there is a
larger amount of oxygen contained at all times in the lungs than is
required to supply the red blood cells. It is maintained that the
alveolar air contains normally 16% of oxygen. The red blood cells are
practically saturated with oxygen as they leave the lungs; however,
this amount of oxygen may not be needed by the tissue cells which the
red blood cells supply and the amount they absorb upon their return
will depend upon what they have given off to the tissue cells.

It can readily be seen that the air in the lungs at no time contains
the full percentage of oxygen, since one at no time completely
exhales the entire amount of air. In this way the residual air loses
some of its oxygen and collects carbon dioxide.

Animal life is sustained by the oxygen in the air while the carbon
dioxide is essential to plant life. The oxygen is carried into the
lungs during the inhalation which is produced by the expression of
Innate Intelligence through the organs of respiration. The oxygen
passes into the blood and is combined loosely with the hemoglobin of
the red blood corpuscles; then under the direction of Innate it is
carried to all the tissue cells of the body. Here the oxygen leaves
the blood and is used in the oxidation which is necessary in the
metabolism of the body.

The amount of required oxygen varies with different conditions that
obtain in the body and is dependent upon age, the activity of the
individual and his condition of health. Some authors assert that
the average person will inhale about thirty-four pounds of air in
twenty-four hours. This would mean a little over seven pounds of
oxygen. Only about one-fourth of the oxygen inhaled is absorbed;
therefore, according to these figures the individual would absorb on
an average of about two pounds of oxygen in twenty-four hours.


Nitrogen (N)

The nitrogen in the air is of more importance to plant life than to
animal life. It is of little significance from a hygienic standpoint,
yet it is an important constituent of all matter containing protein.
Nitrogen tends to regulate or influence the rate of combustion
by diluting the oxygen in the air. Respiration does not seem to
affect the amount of nitrogen in the air as there is no noticeable
difference between the amount of nitrogen in the inspired and expired
air.


Argon (A)

In 1894 Lord Rayleigh and Prof. William Ramsay discovered a gaseous
substance in the atmosphere which had no chemical affinity. They gave
this element the name argon which means in the Greek, “inactive.” So
far as is known argon will not combine with any other element.

The atmosphere contains about 0.94% argon, but so far, according
to Rosenau, it has not been demonstrated in the body. Argon has no
hygienic significance. Helium, krypton, xenon, neon and argon form
what is known as the =argon group=, since they will not unite with
other elements to form compounds. These elements are all found in
very small quantities in the atmosphere.


Carbon Dioxide (CO_{2})

Carbon dioxide is a gas, a very small amount of which is found in the
atmosphere. About 0.03% is ordinarily expressed. This means there are
three parts of carbon dioxide in 10,000 parts of atmosphere. This is
a very small percentage, but when we consider the enormous bulk of
atmosphere we appreciate the fact that the total amount is beyond
our comprehension. It is claimed that there is more carbon in the
atmosphere in the form of carbon dioxide than there is in all other
forms on the earth.

In densely populated areas there is a slight increase in the amount
of carbon dioxide. It may reach 0.04% or even 0.05%. There is also
likely to be more carbon dioxide in the air close to the soil than
there is a few feet above. This is because the processes going on in
the soil tend to produce this gas and hence the soil air contains
a larger percentage. The air receives its carbon dioxide from such
sources as respiration, fermentation, from chemical action in the
soil, from mineral springs, and from oxidation of organic matter.

Carbon dioxide is a transparent, odorless and colorless gas. It is
a very important constituent in the atmosphere and a very slight
variation either in its increase or decrease will vitally interfere
with both animal and vegetable life. Green plants in the sunlight
absorb great quantities of carbon dioxide and give off oxygen. The
body obtains its carbon from the food that is taken in while the
oxygen is obtained from the air that is breathed. It is maintained
that one acre of ordinary tree land will withdraw as much as four
and one-half tons of carbon dioxide from the air in one season.
Carbon dioxide is also absorbed by water; hence the oceans and other
large bodies of water perform a very important function in this
respect. In certain localities, such as industrial centers, a very
large amount of carbon dioxide is given off into the air; but this
is quickly taken up and thoroughly mixed with the atmosphere by the
constant motion which is maintained by the varying temperature, air
pressure and other involved factors. It is not allowed to accumulate
in any one place in larger amounts than normal. In this way the
proportion is kept the same at all times.

Hygienists maintain that the regulation of breathing is largely
dependent on the concentration of carbon dioxide in the air cells
of the lungs. This, however, is not true since the process of
respiration is not a question of chemical action nor the influence of
any chemical element in the lungs or in any part of the respiratory
system. The breathing, like all other functions of the body, is under
the direct control of Innate Intelligence within the body.

Innate Intelligence, recognizing the need for more oxygen in the
tissue cells, will bring about an intellectual adaptation by
increasing the respiration. This does not take place, however, until
the need has exceeded the already adaptative possibility when the
reserve amount of oxygen contained in the residual air in the lungs
has been exhausted.

In inspiration the air is taken into the lungs and the oxygen is
taken up by the hemoglobin of the blood as before stated; then the
oxygen is given off to the tissue cells. The hemoglobin absorbs the
carbon dioxide from the tissues and it is then carried back to the
lungs where the process is reversed. That is, the carbon dioxide is
given off and the oxygen is absorbed by the hemoglobin.

The carbon dioxide which is carried to the lungs by the venous blood
escapes into the air cells. The resistance which it meets here
depends upon the percentage of carbon dioxide present in the alveolar
air. Normally the percentage of the carbon dioxide in the alveolar
air is maintained at a pressure of about 5% of an atmosphere. If
the pressure becomes less than this Innate Intelligence will adapt
herself to this condition by decreasing the respiration until the
normal percentage is again attained; or if the pressure goes above
normal Innate will increase the rate of respiration until the amount
of carbon dioxide has been decreased in the alveolar air, for this
poisonous gas must be eliminated. This shows how Innate at all times
is working in an adaptative way to maintain equilibrium in the body.


Ozone (O_{3})

Ozone is not a constant element in air, although of such potency
that a very small amount may be of great importance. In centers of
population it is usually absent. In thickly wooded sections and at
sea it will be found in large quantities, but even here only traces
will be found. It is thought to be formed by the friction of the
sea water against the air in connection with the respiration of
vegetation. It is also formed in nature by electric discharges during
storms.


Ammonia (NH_{3})

Normally there is only a trace of ammonia in air. It is produced by
the decomposition of organic matter. This accounts for the larger
amount being found in the air near the ground. Ground air may contain
ammonia in sufficient quantity to be perceptible to the senses.


Other Constituents

Hydrogen peroxide is a very active oxidizing agent. Rain water and
snow contain very small traces of it. Hydrogen peroxide is not
constant in air, but may be found in very small quantities.

Air also contains small traces of helium, krypton, neon, xenon,
which have no important bearing from a hygienic standpoint. Nitric,
sulphuric and other acids will at times be found in the atmosphere.
These acids are formed principally from industrial processes and
will, therefore, be found near industrial centers, rather than in the
open country or at sea.


AIR PRESSURE


Normal Air Pressure

Ordinary air pressure on the surface of the earth at sea level is,
in round numbers, fifteen pounds to the square inch. It has been
found that the average sized man is exposed to about 34,000 pounds
of pressure. This pressure may be increased or decreased, and if the
change takes place gradually so that Innate Intelligence will have
time to adapt the body to the change, no harm will result. There is a
limit, however, either in a decrease or in an increase of pressure to
which the body may be adapted.

This intellectual adaptation obtains in every tissue cell of the body
as well as in all of its secretions and chemicals so it can be seen
that any sudden change in the atmospheric pressure will disturb the
equilibrium of the entire body.


Reduced Air Pressure

When the atmospheric pressure is decreased it has the same effect on
the individual that the breathing of rarefied or diluted air has. In
this event the adaptation consists in an increased rate of breathing.
It is also asserted that the number of red blood corpuscles is
increased, which in turn increases the capacity of the blood to carry
oxygen. In the diminished air pressure there is a marked decrease in
the amount of oxygen absorption and this accounts for the increase in
the respiration and quickened pulse rate.

As previously stated, if the change from a normal air pressure to a
greatly decreased pressure takes place gradually, thus giving Innate
sufficient time to bring about an adaptation, man will be enabled
to live in a healthy state in a rarefied air. As the altitude is
increased the air pressure is decreased. This is because there is
less air above to exert pressure. Naturally the air near the earth
has the greatest weight above it to exert compression. The air
pressure decreases gradually until, it is assumed, it is gradually
thinned into a perfect vacuum. If oxygen is added to the air it is
possible to maintain life at a remarkably reduced air pressure. A
bird was kept alive by P. Bert in oxygenated air at a pressure of 0.1
of an atmosphere.

The =symptoms= produced in diminished air pressure will vary with
the general conditions of the individual. People suffering from
cardiac disturbances will be affected most by high altitudes. This is
possibly the first symptom to be manifested in rarefied air. If there
is any inclination toward heart weakness it will be observed when the
air pressure is decreased.

The effects of reduced air pressure will vary with circumstances.
There will be increased and deep breathing, with an increase in the
pulse rate. There is likely to be dizziness and ringing in the ears.
The sense of hearing, of sight and possibly of sensations, become
impaired. There may be drowsiness and the patient may have a strong
desire to sleep. The intellectual faculties become dull. Where the
change has taken place very suddenly to the decreased air pressure
there will be syncope, dyspnea, dizziness, nausea and weakness. These
symptoms are commonly known as mountain sickness.


Increased Air Pressure

The greatest air pressure in nature is at sea level. Even the
increased pressure in the deepest mines is so slight that it has
no physiological significance; hence man is exposed to increased
air pressure only under artificial conditions. This subject will be
referred to again under the head of Industrial Hygiene.

Some of the conditions under which man is exposed to increased air
pressure are, for example, divers in diving bells and diving suits,
and caisson workers. At a depth of ten meters of water the air in a
diving bell is compressed to one-half its original bulk, and as a
result the pressure of air is doubled. At thirty meters, or about
100 feet, the pressure is quadrupled, exposing the diver to four
atmospheres or about sixty pounds per square inch.

The danger in increased air pressure is not in going from a normal
pressure to a high pressure, nor does the danger come from the high
pressure. The danger is not from the compression, but rather from
the decompression. The individual must be brought from the increased
air pressure to the normal air pressure very gradually, allowing
Innate sufficient time to adapt the body to the normal pressure of
fifteen pounds to the square inch. If this is done no great amount
of harm will result, although there are some men who are not able to
withstand these changes. This shows a lack of intellectual adaptation
through the body on the part of its Innate. In an experiment P. Bert
exposed dogs to an air pressure of ten atmospheres, or about 150
pounds to the square inch, and then released them very gradually,
producing no ill effects.

When the air pressure is increased it results in an increase in the
absorption of the gases of the atmosphere. There is an increased
amount of oxygen taken up by the blood and the tissues absorb large
amounts of nitrogen. When the pressure is released slowly these gases
gradually escape from the lungs and no bubbles will be formed.

During compression the symptoms are not so severe as those during
and after decompression. During compression the symptoms are a
deepening but slowing of the respiration, a slowing of the pulse
rate, and an interference in evaporation in the water vapor. The
increased pressure on the ear drums will cause pain in the ears and
sometimes the ear drums rupture. There may be an alteration in the
voice, headache and dizziness. However, in a short time, intellectual
adaptation takes place and equilibrium is established by the
internal change and there is at least temporary relief from these
symptoms.


Caisson Dis-ease

The greatest risk to health and life occurs during the time the
individual is coming from the high to normal pressure after the
decompression has entirely taken place. This may produce a condition
known as caisson dis-ease. It may be several hours after the workman
has been taken from the decompressing chambers before the symptoms
appear. Gradual decompression is the only thing that will prevent the
manifestation of these symptoms. When the workman shows any symptoms
of caisson dis-ease he should be rushed back into the compression
chambers and kept there a short time until Innate has a chance to
establish equilibrium in the pressure of the body, and he should then
be taken very gradually through the decompression chambers.

The =symptoms= that appear after decompression are vertigo, nose
bleeding, nausea and vomiting. The most common symptom is the
severe pains in the muscles and joints which is known by the layman
as bends. There may also be temporary or permanent paralysis
called diver’s palsy. In the more severe cases there will be
unconsciousness, and even death.

When the workman is taken too quickly from the high pressure there
is formed gas and air emboli. These may form in the labyrinth of the
ear, in the spinal cord, in the brain, in the heart, or in any other
vital part of the body and not only be distressing but may even prove
fatal.

It must be remembered that the conditions produced by changes in
the air pressure may be classed as traumatic, immunity from which
is not entirely a question of uninterrupted transmission. If
there are subluxations in the spine at the time the workman goes
into the caisson, or if subluxations are produced at the time of
decompression, the interference thus produced will interrupt the
process of intellectual adaptation. Such subluxations should be
adjusted, but it must be remembered that if emboli are formed or if
bends occur the result or the relief is a question of the natural
processes of Innate in the body, and the results will depend entirely
upon the ability of Innate to cope with the traumatic condition.
Innate Intelligence operates through the body according to law, and
it is possible for the body to become so affected and deteriorated
that it becomes a physical impossibility for her then to repair it
and restore it to normal.

We have seen that the normal air pressure at sea level is fifteen
pounds to the square inch. In order that the body will not be crushed
by this weight it is necessary to have an internal resistance to
equal this weight. This internal resistance is maintained in the body
by the tone of all of its parts; it is maintained by the expression
of mental impulses in the tissue cells.

We have also observed that the combining of chemicals is influenced
by the pressure exerted; therefore, in order that the chemical
combinations of the body be constant there must be equilibrium
established between the external pressure and the internal
resistance. This is maintained through the adaptability of the
expression of Innate in the body. As the change takes place
externally there is a corresponding adaptative change taking place
internally and this all requires time. Therefore, in passing the body
from one air pressure to that of another degree, there must be a
sufficient amount of time intervening to allow Innate Intelligence to
bring about the necessary adaptation.

The changes that take place under differing degrees of air pressure
are not purely the result of chemical changes in the body as is
maintained by some, but in all these processes we see the evidence of
intelligent action which we believe is the result of the reasoning
of the intelligence in the body. One evidence of this is that when
the workman is brought gradually from an increased air pressure to
the normal air pressure the gases that have been absorbed by the
tissues under the abnormal condition will be given off through the
normal channels, and less injury will be done. It is interesting to
note that in Nature, man is not exposed to a greater air pressure
than that at sea level; it is only under artificial, man-invented
environments that the body is called upon to withstand a greater
pressure than the normal. It may also be noted that without the
inventions of man it requires quite a little time for man to be
transported from the air pressure at sea level to that of the higher
altitudes as on the mountain tops. This gives Innate Intelligence an
opportunity to bring about an adaptation to this change, since the
change in the pressure takes place so gradually. But with man-made
inventions, such as the automobile and aeroplane, one may transfer
himself from sea level to great heights where the pressure is less in
a very short time. This does not allow sufficient time for adaptation
to take place and is much different from the slow process of climbing
the mountains.

So we see that, after all, most of the necessity for immediate
adaptation of the body to changed environmental conditions is the
result of the work of the educated mind of man, and not the result
of the laws of Nature. In Nature we seldom see the necessity for
sudden or extreme adaptation. But under our present artificial means
of living there are such cases, and these necessitate a study of
the artificial conditions as well as a study of the Innate laws
of adaptation that there may be as far as possible an educated
adaptation to the environment.


HUMIDITY AND TEMPERATURE OF AIR


Humidity

Water vapor is present at all times in the atmosphere. It is the
least constant of all of the air constituents, varying greatly under
different conditions. The temperature produces a greater change in
the amount of aqueous vapor in the air than any other factor. There
may be so much water vapor in the air that the air is spoken of as
being completely saturated. This is known as absolute humidity. If
there is any excess over and above this complete saturation, it
is given off as dew; it is spoken of then as having reached the
dew point. It must be remembered that this absolute humidity does
not represent a constant amount of water vapor, for the amount of
moisture necessary to produce complete saturation varies with the
degree of temperature. It is erroneous to speak of the air holding
water.

“As a matter of fact, the air has nothing to do with it, for it has
always been clearly observed that the presence of water vapor in
any given space is independent of the presence or absence of air in
the same space. The amount of aqueous vapor which a space contains
depends entirely upon the temperature and not upon the presence of
the air.”—Rosenau in _Preventive Medicine and Hygiene_.

The higher the temperature the greater the amount of water vapor in
one cubic foot of air at a temperature of 10° F., while at 100° F.
there would be 19.1 grains at complete saturation. Since increased
temperature increases the amount of aqueous vapor and this aqueous
vapor in turn absorbs heat, we thus see a reciprocal action of the
aqueous vapor upon the temperature.

=Absolute humidity= is all of the water vapor that may be contained
in the air at a given temperature. =Relative humidity= is the
difference between the amount of water vapor that must be contained
in the air at a given temperature to reach absolute saturation and
the amount actually contained in the air at that same temperature.

If the relative humidity of the air in a room becomes as high as
85% the moisture will begin to condense and form on the walls and
objects. This makes the room damp and interferes with the ventilating
and heating of the room.

There is less water vapor contained in the air at high altitudes, the
air being cooler. A large amount of rainfall does not necessarily
produce an increase in the relative humidity. That is to say, a
country with a very high average of rainfall is not necessarily a
damp country so far as the atmosphere is concerned.


Cold Dry Air

Cold dry air is exhilarating and tends to quicken metabolism in
the body, while warm damp air is depressing and tends to retard
metabolism.

The body possesses great possibilities of adaptation to the varying
degrees of temperature and humidity through the action of Innate
Intelligence. With the aid of the educated mind in bringing about
adaptation in the way of clothing, for example, it is possible to
increase the range of temperature and humidity to which the body may
be adapted.

Due to the fact that heat is being constantly formed in the body by
the different processes that are carried on within, it naturally
follows that this heat must be carried out of the body or it will
accumulate and result in harm to the tissues, producing what is
known as heat stroke. This heat dissipation is greatly influenced
by the humidity, or in other words, the amount of water vapor in
the air. The temperature of the air also has some influence on heat
dissipation.

Cold air is made to feel colder by an increase in the amount of
moisture while warm or hot air is made hotter by increasing the
moisture. The reason for this is that the moisture in the cold air
favors heat conduction, hence draws the heat from the body at a more
rapid rate than is normal, while the moisture in the hot air hinders
evaporation.

Innate Intelligence is able, through the specially devised machinery
of the body, to maintain a perfect balance between heat production
and heat dissipation or heat loss. Even though the temperature of
the air may rise, yet if the body is normal it will not produce an
increase in the bodily temperature. Indeed, it is asserted that when
the temperature of the air goes above 70° F. the bodily temperature
would rise if it were not for the perspiration which Innate will
produce through the sweat glands. As long as the perspiration is
produced and is evaporated from the surface of the body the heat
production and heat loss will be kept in perfect balance. But when
something interferes with this adaptative process of Innate and
the individual can not perspire, there will soon be symptoms of
overheating and the temperature of the body will begin to rise.

Evaporation is decreased in an atmosphere in which the humidity is
high. The reason for this is obvious; the atmosphere already filled
with water vapor is slow to take up more. This is because molecules
of vapor given off from the body collide with those in the air and
are returned to the surface of the body as moisture. When this
condition obtains there is an adaptation produced by increasing the
amount of blood to the skin; this increases the temperature of the
surface of the body, but allows for an increase in the heat loss by
radiation, conduction and convection.

The conductivity of the atmosphere for heat is increased by an
increase in the humidity; hence a cool damp air will chill the body
for the reason that the conductivity is increased and bodily heat is
lost more rapidly through conduction. Increased humidity interferes
with the evaporation of perspiration; hence a hot, moist air is
heating to the body and deprives the body of force, making the
patient feel sluggish and fatigued.

There is much moisture given off from the body each day. It is
estimated by Pettenkofer, Voit, Rosenau and others that the average
individual under ordinary circumstances will give off through the
lungs about 290 grams, and from the skin from 500 to 1800 grams
daily. If this fact is kept in mind some idea of the necessity of
proper ventilation will be appreciated.


Warm Moist Air

Workers fatigue much more easily when in warm moist atmosphere. Work
is done much more rapidly in cool dry air and the efficiency of the
worker is noticeably raised; in warm damp air the bodily temperature
rises and the pulse rate increases.

Mental and physical activities are reduced in an atmosphere of
high humidity and increased temperature. This is due mainly to the
reluctance on the part of the individual to put forth an effort
sufficient to perform any great amount of work. There is a general
feeling of languor because of the enervating effect of the air.

There is no serious injury resulting from working in such an
atmosphere, unless there is an increase in the bodily temperature,
and then there may be serious results to the health unless relief
is obtained. When the humidity has reached the point of complete
saturation and the temperature is above 88° F., compensation can no
longer obtain through evaporation and heat stroke may result. The
most noticeable effect of warm moist air under ordinary circumstances
is reluctance to put forth any mental or physical exertion, and a
loss of appetite. With a temperature at 75° F. and the relative
humidity 80%, an individual not accustomed to such will require
complete rest.

It will be noticed that under such conditions Innate Intelligence is
constantly working to bring about intellectual adaptation and that
she is able to do so to a remarkable degree. The glands of the body
are used to produce secretions which constantly bathe the tissues
and keep them cool in the high temperatures, and at a proper degree
of warmth in the low temperatures. The fact that the individual is
indisposed to mental and physical activity in such an atmosphere
is adaptative on the part of Innate. This inactivity is suggested
by means of the languid feeling in order that the body will not be
over-exercised and thus will not increase the amount of heat in the
body; because under these circumstances the process of evaporation
is interfered with and this is one of Innate’s principal means of
regulating the temperature of the body.

Perspiration is an adaptation on the part of Innate, for in this way
the surface of the body is kept moist and as this moisture evaporates
the body is cooled; otherwise the temperature of the body would
increase with every rise in the temperature of the atmosphere. Not
only does this help to regulate the bodily temperature, but it keeps
the surface tissue of the body soft. If there was no perspiration,
the surface of the body would soon become dry, parched and hard. The
skin would become scaly and would crack and become chafed.

Because of these adaptative processes it is possible for the body to
be adjusted to great extremes in temperature. The body may become
accustomed to extremely high temperatures even with high relative
humidity, providing the change takes place gradually and sufficient
time is allowed for the processes of adaptation to take place.

It is very important that the kidneys be able to perform their normal
function in order that these processes of adaptation may take place.
The kidneys are important not only because of the function which they
perform in the excretion of poisons, but because of the function
which they perform in relation to the serous circulation. This is
important because of the secretions that are involved. This subject
will be treated more fully under the subject of Water.


Cold Damp Air

The body quickly becomes chilled in a cold damp air because the
increase in the water vapor increases the conductivity of the air for
heat. It can thus be seen that the heat producing processes of the
body must be increased in order to maintain the normal temperature
of the body. As we know, all activity of the body requires an
expenditure of energy, so if the body is exposed to a cold damp air
for an abnormal length of time it will necessitate an increased
expenditure of internal energy to meet the increased demands for
heat and thus dissipate forces that should and would, under normal
conditions, be utilized in the metabolism of the body. If the heat
production is at a minimum in the body, which it may be, due to
several factors such as old age, infancy, or dis-ease, this exposure
to lowered temperature and high humidity will result in injury to the
body.

An interference with the transmission of mental impulses to the
kidneys resulting in a decrease in their functional activity may
mean a retention of poisons in the body and produce a condition
diagnosed as rheumatism, for example; or an interference with
the serous circulation may result in the tissue cells being
under-nourished. Both of these conditions will interfere with the
processes of intellectual adaptation. Educationally, man may help in
the adaptation by proper clothing and by giving attention to proper
exercise.


Warm Dry Air

By far the most desirable air is the warm, relatively dry air; but as
has already been noted, it is possible to have an atmosphere with a
relative humidity that is too low. If the air is abnormally dry, and
at the same time warm, there will be a great loss of body moisture
due to the increased evaporation. When the loss of water from the
body reaches 21% death ensues. In an experiment performed by Rubner
and Lewaschew it was found that a man weighing about 127 pounds gave
off about 54.1 grams of water in an hour in a temperature of 68° F.
with a relative humidity of 82%; the same individual in a temperature
of 68° F., but with a relative humidity of 82%, gave off only 15.3
grams.


Proper Temperature and Humidity

The most desirable atmospheric conditions are obtained at a
temperature of 68° F. to 70° F., with the relative humidity from 40%
to 60%. This is given only as a general average and will necessarily
vary with many conditions, such as seasons of the year and occupation.

Moderately cool and relatively dry air increases the activities of
the body, makes breathing easy and more frequent, and hence increases
the circulation of the blood. Innate is thus enabled, in such an
atmosphere, to bring about more perfect metabolism.

Proper temperature and humidity of the air in houses, impurities
found therein, source of impurities and their effect upon health,
will all be considered thoroughly under Hygienic Housing.




CHAPTER IV

VENTILATION




VENTILATION

  INTRODUCTION
      VENTILATION DEFINED
      RATE OF RESPIRATION
      VOLUME OF AIR INSPIRED AND EXPIRED
      CAPACITY OF THE LUNGS
      AMOUNT OF AIR REQUIRED PER HOUR
      OBJECT OF VENTILATION

  SOURCES OF IMPURITIES IN AIR
      RESPIRATION OF PERSONS
      IMPURITIES FROM HEATING AND ILLUMINATION
      ACCIDENTAL SOURCES
      EFFECTS OF FOUL AIR

  REQUIREMENTS OF A VENTILATING SYSTEM
      EXCHANGE AND CIRCULATION OF AIR
      ILL EFFECTS OF VITIATED AIR
      REBREATHING AIR
      NATURE’S PURIFICATION METHODS
      NECESSITY FOR VENTILATION

  NATURAL MEANS OF VENTILATION
      THROUGH WINDOWS AND DOORS
      AMOUNT OF CUBIC SPACE PER PERSON
      THROUGH SPECIAL DUCTS

  MECHANICAL VENTILATION
      DEVICES REQUIRED
      PLENUM SYSTEM
      VACUUM SYSTEM

  WASHING THE AIR BEFORE ADMITTING TO HOUSE




CHAPTER IV

VENTILATION


Introduction

Ventilation as defined by Webster is, “To cause fresh air to
circulate; to cause inside resident impure air to be removed and
replaced with fresh, pure air, whether it be in building, streets,
mines, or sewers.”

Shakespeare speaks of sleep as “Nature’s second course.” Fresh air
may well be called “Nature’s tonic.” Everything else necessary for
good health may be provided, but if there is not a sufficient amount
of fresh air the tissues of the body can not perform their functions.
It is quite as necessary to have plenty of fresh, pure air as it is
to have a proper amount of wholesome food and pure water. Ordinarily
not enough attention is given the subject of ventilation, especially
of the average home.

The average adult breathes at the rate of seventeen or eighteen
respirations per minute. At each respiration about thirty cubic
inches of air passes in and out of the lungs. The air in the lungs
loses 4% of oxygen and absorbs about 3.5% to 4% carbon dioxide. The
nitrogen remains the same. The temperature of expired air is raised
to about 98.4% F. and contains approximately 5% aqueous vapor.

This volume of air inspired and expired during gentle respiration,
which is, as has been said, about thirty cubic inches, is known as
tidal air. By forced inspiration another 100 cubic inches of air
in addition to the tidal air may be taken into the lungs. This is
known as complemental air. By forced expiration it is possible to
expel from the lungs 100 cubic inches of air over and above the 30
cubic inches of tidal air; this is known as the supplemental air.
There is another 100 cubic inches which can not be expelled by the
most violent expiration; this is the residual air. The supplemental
air can, by forced expiration, be expelled from the lungs, but the
residual air can not. Altogether there is in the lungs during forced
inspiration about 330 cubic inches of air. An average adult gives off
about 0.71 cubic feet of carbon dioxide per hour.

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.

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.

The ventilating system of an ordinary building might seem a very
simple proposition, but when considered carefully it is a very great
problem and one that requires the careful attention of engineers
trained in that particular line.

It is not the object of ventilation to provide an indoor condition
identical with that outdoors, but it is to maintain a condition
indoors conducive to a normal expression of indoor life. It is
quite obvious that if indoor conditions were maintained identical
with outdoor conditions the desired results could not possibly be
obtained, for indoor life demands a much different environment. It is
necessary to give any system of ventilation as much attention as is
given a heating system in order to obtain the best results. No system
will work itself.


Sources of Impurities in Air

There are many processes carried on within the house that add to the
impurities of the air. Such sources may be classified as follows:
respiration of persons, impurities from heating and illumination, and
accidental sources from processes carried on within the house, such
as house cleaning and laundering.

It will be observed from a study of the amount of air inspired and
expired and the impurities carried from the body in the process that
one of the most common sources of vitiation of the air in houses is
respiration. That these expired poisons may be diluted or carried
out of the breathing zone it becomes necessary to have an adequate
ventilating system. If the room is heated by a stove impurities will
be added from coal dust and the dust of ashes. When the iron is
overheated it gives off carbon dioxide and other gases. Open fire or
an open blaze for lighting purposes consumes oxygen, gives off carbon
dioxide, raises the temperature and increases the amount of aqueous
vapor.

Vitiation from accidental sources consists of dust particles of
organic and inorganic detritus which are added to the air from walls,
floors, furniture and hangings. Other processes such as laundering
will add a certain amount of poisons and suspended matter to the air.
All this reveals the necessity for exchanging the inside air for pure
outside air.


Requirements of a Ventilating System

A ventilating system must not only bring about an exchange of air,
but it must also keep the inside air in proper circulation during
the time it is contained inside. Proper circulation of air is one of
the most important functions of ventilating systems.

The value of air circulation will be appreciated when it is known
that an aerial envelope is formed around the body when the air is
not kept moving and the temperature and humidity of this air will
resemble that of a very hot, humid summer day. The effects will also
be similar to those of heat exhaustion. This shows the importance of
keeping the air in circulation in order to carry away the poisons
that are being constantly excreted from the skin and through the
respiratory tract.

The effects of foul air are usually manifested as headache, fatigue,
lassitude, vertigo, nausea, vomiting, collapse and even death.
The chronic effects are anemia, debility, lowered vitality and
disturbances in digestion. Prolonged exposure to vitiated air will
necessitate increased adaptation on the part of Innate Intelligence.
If this exposure is carried to an excess it will draw upon the
adaptative forces of the body and make it more susceptible to the
invasion of toxins and subject to changes which it would not be when
under more natural environmental conditions.

It is now affirmed by the best hygienists that there is no great
objection to rebreathing air if provision is made for diffusion of
the carbon dioxide and if the bodily odors are eliminated. In this
way air may be properly warmed and kept recirculating; thus there
is a saving on fuel. If air is to be rebreathed it must first be
washed. There is, of course, a limit to the length of time air can
be recirculated. At no time is the recirculated air equal to outside
air and because this method is not properly regulated and carefully
controlled it is not considered safe for use.

Before considering methods for obtaining pure air it is interesting
to look at Nature’s purifying system. The effect of vegetation upon
the air is to consume carbon dioxide, especially in the sunlight.
The purifying effects of the sun’s rays on the organic particles,
the washing of the air by the rain which carries down the dissolved
gases and suspended impurities, the natural constant diffusion of the
air due to the wind, are all natural processes tending to keep the
outside air in a state of purity.

Man so far has been unable to find any artificial means of purifying
the air and therefore must provide means of admitting air from the
outside in a state conducive to sustaining indoor life.


Natural Means of Ventilation

Outside air may be polluted with dust, smoke and suspended matter and
it is then necessary to free the air of these impurities before it
enters the house. Especially is this true in cities and where large
buildings are to be ventilated. The most satisfactory methods of
ventilating a large building is the plenum and the vacuum systems.

[Illustration: _Window Ventilation._]

In the ordinary home, ventilation is through the natural openings
such as windows and doors, although special openings may be provided
which will admit fresh air and carry out the vitiated air. A great
deal of air is admitted through the crevice and openings around
windows and doors. A very simple method of airing a room in cold
weather when a direct draught is objectionable is to place a board
a few inches wide and as long as the width of the window beneath
the lower sash. This prevents the air from coming through the open
window, but permits it to enter between the upper and lower sashes.
This also has the advantage of directing the air current toward the
ceiling. This is very effective in the sick room and is so simple
that any one can use it.

[Illustration: _Window Mopper_]

The size and shape of the room to be ventilated must be taken into
consideration as well as the number of persons therein. The minimum
amount of space allowed for each person has been placed by various
authors at from 300 to 1,000 cubic feet, depending upon the nature of
the work carried on, the size and shape of the room and the type of
ventilation depended upon. In hospitals where fever cases are cared
for 2,500 cubic feet are desired, while in government barracks each
soldier is allowed 600 cubic feet.

[Illustration: _Window Ventilation_]

The necessity for a sufficient supply of pure air can not be
over-emphasized. When the windows and doors are used to ventilate the
house they should be thrown open at different times so that the house
air may be completely changed. We must not, however, go to the other
extreme and jeopardize the health of the occupants by keeping the
temperature too low, yet it has been proven that cool, fresh air is
more easily heated than warm vitiated air.

When air is admitted by special ducts they should be so arranged that
air may be evenly distributed over the room. The relative position of
the inlets to the outlets is a question upon which the engineers are
not exactly agreed. It is obvious, however, that their arrangement
must admit of a complete change of air at proper intervals and that
draughts will not be established directly between inlets and outlets.
It is generally conceded that the best results are obtained when
the inlet is placed above near the ceiling, and the outlet placed
directly below near the floor. In this way there seems to be a more
equitable distribution of the entering air and less likelihood of a
direct draught between the inlet and outlet. The outlet should never
be directly opposite the inlet, since the air will pass directly
through the room and there will be very little mixing with the room
air. If the room is crowded it is more desirable to admit the fresh
air from beneath, but when this is done there must be a great number
of inlets. In this way the fresh air is admitted more directly into
the breathing zone and at the same time advantage is taken of the
natural air currents in the room.

There are many patent devices on the market for ventilating through
the windows. Such devices are very good and may be used to an
advantage. Usually they are so built that the air is directed toward
the ceiling as it is admitted. The same desired end is accomplished
by placing a board under the lower sash as described above.


Mechanical Ventilation

By far the most satisfactory method of ventilating large buildings
is the mechanical method. This is not practical for small buildings
or homes because of the special devices that are required and the
expense of operation. Mechanical ventilation may be accomplished by
the plenum system, the vacuum system, or by the combined plenum and
vacuum systems. The most desirable results are obtained when both
systems are used and used in connection with the heating system.
Heating and ventilating are so closely related that they must be
considered one with the other. A poorly ventilated room is more
difficult to heat and an improperly heated room is difficult to
ventilate.

The =plenum system= consists of a fan to force the air into the
rooms. These fans are run by water motors or electricity whereby
the air is forced through ducts into the rooms. This system is made
necessary by the great buildings, basements and large steamships,
which could not be inhabited if natural ventilation was the only
method employed.

The =vacuum system= consists of suction fans whereby the vitiated
air is drawn out of the rooms and replaced by fresh air through
the natural openings. In this way natural ventilation may be made
more efficient, but this method in itself is not adequate for large
buildings.

The two systems, vacuum and plenum, are commonly used together
and when employed in connection with the heating device the very
best results are obtained. The amount of air, the temperature and
humidity, and the purity of the air may be regulated to a nicety in
this way.

A complete system of =vacuum and plenum= consists of plenum fans
for forcing the air into the rooms, vacuum or suction fans for the
removal of vitiated air, the ducts for conducting the air to and from
the rooms, the necessary machinery to run the fans, and a proper
heating system whereby the air may be warmed in the winter and cooled
by ice coils in the summer. It is also necessary to have a device for
washing the air.


Washing the Air

As the air is drawn into the buildings by the plenum fan it is passed
through a chamber where it is washed. This is done by forcing the
air through a spray of water. A water curtain is formed by forcing
water through perforated pipes placed across the chamber from each
other and the water thus sprayed made to intercept. As the air passes
through this curtain of water many of the impurities such as dust,
cinders, bacteria, some of the gases, particles of decomposition, and
epithelial cells, are removed. Washing does not remove carbon dioxide
or bodily odors. Washing is one of Nature’s methods of cleaning the
air as is seen in rain.

[Illustration: _Central heating with washed air._]

After the air is washed it is passed over tempering coils. In the
winter the air is warmed and in the summer it is cooled in this
way. The humidity is also controlled. It can thus be seen that
this method, although rather expensive, is the only real method of
ventilating large buildings satisfactorily.




CHAPTER V

HEATING




HEATING

  GENERAL CONSIDERATIONS
      HEAT FROM HYGIENIC STANDPOINT
      COMBUSTION
      MOLECULAR THEORY
      BODY HEAT
          HOW MAINTAINED AT CONSTANT TEMPERATURE
          INFLUENCE OF BODY HEAT ON HOUSE AIR
          INFLUENCE OF TEMPERATURE ON AIR OF BODY
      PROPER TEMPERATURE OF BUILDINGS
      REQUIREMENTS FOR HEATING SYSTEM

  LOCAL HEATING
      RADIATION
          PRINCIPLE OF
          OPEN FIRE
          OBJECTION TO
      CONDUCTION
          HEATING BY STOVE
          OBJECTION TO

  CENTRAL HEATING
      CONVECTION
          CENTRAL
          HOT AIR
          HOT WATER
          STEAM




CHAPTER V

HEATING


GENERAL CONSIDERATIONS


Heat from Hygienic Standpoint

The subjects of heating, lighting and ventilating will be treated
purely from a hygienic standpoint and in no sense from the standpoint
of engineering. The proper manner of heating a building is not within
the scope of hygiene, but becomes a question of proper engineering
and a subject to be considered from that angle. We are concerned only
as the heating of buildings influences the health of the occupants.


Combustion

In parts of the country where the temperature goes below 60° F. it
becomes necessary to provide artificial heat to warm houses in order
that health may be maintained at the least possible expenditure
of energy. The most common method of producing heat for heating
purposes is by combustion. Its obedience to certain physical laws
is infallible. Heat is liberated from such material as coal and
wood by combustion and is the result of the chemical action of this
combustion; it is then transmitted to the rooms to be heated either
by air, water, or steam unless the combustion takes place in the room
to be heated; then it is distributed throughout the room by radiation
from the open fire or conduction from above.


Molecular Theory

Up until the beginning of the nineteenth century heat was believed
to be a substance that had no weight and the name caloric was given
this hypothetical substance. Davy and Rumford, through a series
of experiments, proved that heat is a violent agitation of the
molecules of matter. From this we have the molecular theory that
as the velocity of the molecules is increased heat is produced
and the temperature raised. The words heat and temperature are
not interchangeable. Heat is the cause and temperature is the
effect. Temperature indicates the presence of heat and the degree
of temperature represents the intensity of the heat, but not the
quantity. Heat in the same amount may be imparted to two bodies of
the same substances, but different mass, and one will be hotter than
the other; therefore, the specific heats of the two substances are
different. To illustrate: Place in the sun a receptacle containing
two gallons of water and one containing one gallon of water, both the
same temperature. Leave them for a given length of time and they will
become warm, but the one gallon will be warmer than the two, because
of the difference in the amount of water to be warmed. The same
amount of heat was applied to each, but this did not produce the same
temperature in both. Again the same quantity of different substances
may be exposed to the same heat, but the temperature will not
necessarily be the same, for some substances heat more rapidly than
others. It requires more heat to raise the temperature of water to
a given degree than it does the same weight of any other substance,
except hydrogen. This is the reason water gives off more heat than
any other substance that cools through the same number of degrees.

Normal heat is produced in the body by the expression of calorific
mental impulses and by the oxidation which is carried on in the
tissue cells. The amount of heat produced in the body is adaptative
to the needs of the body and is under the direct control of Innate
Intelligence.

Air is carried into the lungs in respiration and by the action of
Innate the oxygen is absorbed in the air cells and passes into the
blood. It is carried in the blood by the hemoglobin to the tissue
cells where it comes in contact with the calorific mental impulses
and combustion takes place.


Body Heat

The normal bodily temperature is 98.6° F. Variation above or below
this point indicates abnormality. This heat can not be supplied
artificially from without. It must be generated within the body. It
therefore becomes obvious that the temperature outside of the body
is not regulated for the purpose of supplying the body with heat.
The temperature of the atmosphere must, however, be regulated in
order that there may not be an abnormal loss of the bodily heat. The
bodily heat is being constantly lost to the outside air as follows:
30% by contact with the air, about 43% by radiation and about 27%
by exhalation and other losses. We may sit in a room that is warm
enough, say 75° F., and yet if we are near a cold wall we will feel
chilly. We say we feel the cold coming from the wall, while in
reality we feel chilly and cold because the body is losing its heat
abnormally to the cold wall by radiation through the air.

When the air is comparatively dry the equality of the bodily heat is
maintained by a steady but imperceptible evaporation from the skin.
In moist air this evaporation does not take place so readily since
the air is already laden with moisture, so instead of the moisture
being absorbed by the air it forms on the surface of the body as
perspiration. This is why one perspires more in a moist air than in
an atmosphere having a low humidity. When the air is kept in constant
motion there is an increase both in the evaporation from the surface
of the body and also in the heat conduction by the constant supply
of fresh air to take the place of the moisture-laden and heated air
around the body.

The normal heat given off from the body raises the temperature of
the air surrounding the body and tends to create upward currents.
This is Nature’s method in freeing the body from the envelope of
vitiated air which surrounds it as a result of the natural processes
carried on through it. Therefore, if the temperature of the room
is too nearly the same as that of the body it will be necessary to
make more provision for the ventilation since the temperature of the
body would not be enough greater than that of the surrounding air to
create sufficient movement to carry the vitiated air away from the
body. That is why a cool room does not require the same amount of
ventilation that a hot room does.

Innate Intelligence is capable of adapting the heat of the body to a
great range in atmospheric temperature, but in order to do this there
must be a sufficient length of time to enable Innate to bring about
the necessary adaptative changes in the body. If the atmospheric
changes take place too rapidly this adaptation cannot be effected and
the metabolic equilibrium of the body will be disturbed. This makes
it necessary to exercise care in properly heating our dwellings.


Proper Temperature of Building

It is certain that temperature of the dwelling should be properly
regulated and that it should not vary with the temperature outdoors,
especially in the winter time. The heat equilibrium of the body may
be easily disturbed by sudden changes in the temperature of the
dwelling. Because there is an increased expenditure of the internal
energy to bring about adaptation, the internal forces are dissipated
and this lowers the resistance of the body and makes the individual
susceptible to incoördination.

A high temperature with a relatively low percentage of humidity will
cause an abnormal evaporation from the skin and mucous membrane. This
gives not only a sense of chilliness but causes an abnormal dryness
of the skin and produces an irritation in the throat and nose. On
the contrary, the bodily heat will be withdrawn too rapidly in a
temperature that is too low.

There are many factors to consider in determining the proper
temperature of a room or a dwelling. The time of year, the processes
carried on within the dwelling, the use of the rooms—that is, whether
they are used for sleeping-rooms, living-rooms, or workrooms—all
tend to influence the degree of temperature most advantageous to the
inmates of the room.

In determining the proper temperature of a room the relative humidity
that is to be maintained must be considered. A hot dry air is more
desirable than a cool damp air. In winter the variation in the
temperature of the average dwelling should be between 58° F. and 70°
F. with a relative humidity of 40% to 60%. The temperature should be
lower in the bedroom than in the living-room.

The great objection to the average heating system is that the air is
kept too dry; therefore, it is necessary to keep the temperature of
the rooms too high in order for the individuals to keep warm.


Requirements for Heating System

In order for a system of heating to meet the demands of hygiene
there must be a minimum cost of production and absence of impurities
produced in the process of heat; the heat must be equitably
distributed over the house; the temperature must be kept even, thus
insuring continuous heating; and there must be a proper degree of
humidity. There must also be freedom from explosions and danger from
fire.

There are three methods of heating; radiation, conduction and
convection. There are two systems by which these methods are used:
they are local and central. In local systems the heat is produced in
the room by combustion or burning of fuel in grates and stoves.

In central heating the heat is produced at a central place outside of
the rooms and conveyed to them by hot air, hot water or steam.

Even though these three methods of heating are usually given, it
is difficult to draw hard and fast lines of demarcation between the
different methods, for, as a matter of fact, they overlap to quite an
extent. The element of radiation is involved in both conduction and
convection.


LOCAL HEATING


Radiation

The vibrating molecules of a heated substance will set into motion
the ether of space and in this way the heat may be transmitted as
wave motion. We have an illustration of this in the transmission of
heat to the earth from the sun. Ether waves are generated by the
violent vibration of the molecules of the sun and the vibrations
are transmitted to the earth and they in turn generate molecular
vibrations of the bodies of the earth. This is spoken of as radiant
heat and is illustrated by the heat from the open fireplace.

Open fireplaces give off heat by direct radiation. This is the oldest
method of heating and has been in use for many generations. It is not
a satisfactory method, however. The radiation of heat takes place
through air very readily, but air is not a good conductor of heat.
Heat may be radiated from the body very rapidly through the air to
cold objects. As for instance, sitting near a cold wall one will feel
chilly due to the radiation of the heat from the body to the cold
wall, although the air in the room may be sufficiently warm to be
otherwise comfortable.

Heat may be readily radiated from an open fire, but it must be
remembered that the intensity of the radiated heat is inversely
proportional to the distance of the heated object from the place
where the heat is produced. To illustrate: If one object is one foot
from the source of heat, the open fireplace, and another object is
three feet from the fireplace, the object that is farther away will
receive only one-ninth as much heat as the one nearer. This is one
of the disadvantages of the open fireplace as a means of heating
a room. A fireplace is very cheery and gives a room a comfortable
appearance and is very popular in the modern home. It is adequate
to take the chill away when the weather is not very cold, but it is
certainly a very undesirable means of heating a house in cold weather.

[Illustration: _Local Heating_]

Another objection to the open fireplace is that it requires a great
deal of fuel. About 75% of the heat is lost through the chimney.
There is, however, an advantage in the open fireplace since it
affords an excellent means for ventilation; there is always a draft
up the chimney.


Conduction

Heat is carried through such metals as iron by molecular action and
such heat transference is known as conduction. The fact that heat is
transferred through metals by conduction is of vital significance
in the question of heat losses and dissipation, as through walls of
buildings for example.

If heat be applied to any part of an iron bar or piece of metal it
will be transferred to all parts of that iron by the molecular action
until it is all heated. This can be illustrated nicely by placing the
end of the poker in the furnace fire and in a short time the heat
will be felt in the other end of the poker.

[Illustration: _Undesirable Local Heating_]

The =stove= is a good example of the conduction of heating. The heat
is conducted through the iron of the stove to the air in the room,
and then by convection through the air to all parts of the room. The
molecules that are in contact with the fire first have their motion
accelerated by the heat and this motion is passed from molecule to
molecule until all the molecules in the entire iron are accelerated
in their motion and thus the temperature of the metal is increased.
Some metals are better conductors of heat than others, owing to the
difference in the character of the connection between the molecules.
Silver forms the best conductor of heat among the metals and is used
as a standard of conductivity.

In conduction heat is produced inside a fire pot, as in a stove, and
conducted through the iron then radiated from its outer surface. This
is also called indirect radiation and is a more satisfactory method
than the direct radiation since the material of the stove will retain
the heat for a longer period of time and allow for its more equitable
distribution. In this way it is possible to heat the room more evenly
than with an open fire.

One of the objections to this method is that it is local and has
all the disadvantages of a local heating system. The combustion
takes place in the room and as a result there are certain amounts of
impurities that are admitted into the breathing zone. There is the
added disadvantage of having dirt and dust from the fuel and from the
ashes and refuse from the process of combustion. These disadvantages
are not encountered in a central system.

In extremely cold weather the stoves are likely to become overheated
in an effort to keep the rooms warm, and overheated stoves not only
increase the hazard from fires, but tend to scorch the air. Red hot
iron consumes oxygen and gives off carbon dioxide which produces an
unfit atmosphere for breathing. It is difficult to maintain an even
heat in a room that is heated by a stove for the stove requires a
great amount of attention.


CENTRAL HEATING


Convection

The most desirable system of heating is the central. In this system
the heat is conveyed from the central heating plant to the rooms
either by air, hot water, or steam. The heat may be produced in the
house that is to be heated, usually in the basement, or it may be
produced at a distance, as in the case of steam plants, and carried
through pipes to the house. There are three principal systems of
central heating: Hot air, hot water, and steam.

Heat is carried through air by convection. The air exposed to heat
becomes specifically lighter and hence rises and the cooler air takes
its place. In this way the air of a room is heated by its constant
movement brought about by this phenomenon. The air becomes heated in
the air jacket of the hot air furnace and creates an upward draft.
As soon as the cool air rushes downward to take its place a downward
draft is formed through the cold air ducts. In this way the air in
the room is kept in circulation and at the same time properly warmed.

=Hot air=, or as it is sometimes called, furnace heating, is a very
satisfactory system for an ordinary dwelling or small building.
It consists of a large stove much as that used in local heating.
Surrounding this stove is a jacket with an air space between it
and the stove. Pipes lead from the air space through the top of
this jacket and convey the air that is heated by the stove to the
different rooms. The cold air is taken from the rooms and conveyed
through the cold air pipes back to the furnace and is admitted to the
air jacket from beneath. In this way the warm air, being lighter than
the cold air, passes upward through the hot air pipes and is replaced
by the cold air through the cold air pipes. In this way there is a
constant circulation of air through the pipes.

This kind of a furnace requires much attention, but not as much as
a local heating stove. Great care must be taken that the air is not
overheated in the air jacket. If it is, the air in the room will be
dry and stuffy and may even have a scorched odor. The furnace should
be equipped with a water receptacle inside the air jacket. This
receptacle should be kept full and in this way a proper relative
humidity will be maintained. If this is not done, the air in the room
will be too dry and it will require a higher temperature to keep the
room comfortable. Another objection to this system is that dust and
dirt are likely to enter the rooms from the furnace.

The =hot water= is a very desirable system of heating. Heat
convection through water is practically the same as that through air.
The particles of water at the point where the heat is applied become
lighter as they become heated and because of this change naturally
rise to the top and the particles that are cooler and therefore
heavier sink to the bottom, thus forming currents. For this reason
water heats much more rapidly when the heat is applied to the bottom
than it does when heat is applied at the top of the receptacle. These
principles are utilized in hot water systems. The hot water rises in
the radiators and gives off its heat to the cooler atmosphere and the
cool water returns to the boiler to be reheated. In this way there is
a constant circulation of the water through the system.

The hot air system is entirely satisfactory for small buildings, but
is not so desirable for large buildings. For large dwellings and
public buildings the hot water system is much more satisfactory.
In the hot water system a water jacket is provided instead of an
air jacket. The water is carried from the boiler over the fire
box through pipes to the different rooms where it passes through
radiators and is returned to the boiler by continuous pipes. At the
top of the pipes an expansion tank is placed to take care of the
expansion of the water when heated. The heated water circulates
freely through the system of pipes. Each radiator is provided with
a valve to regulate the amount of water admitted and in this way the
degree of heat may be regulated in the different rooms. Each radiator
is provided with an air valve to allow the air to escape when the
water is admitted, or to allow the steam to escape in case the system
becomes overheated and the water is converted into steam.

[Illustration: _Central Heating Showing boiler, pipes, and
radiators._]

This system is easily cared for and easily operated. It requires
a relatively small amount of coal and maintains a very even heat,
and when properly operated there will be no sudden changes in the
temperature of the rooms. There is less danger of overheating the
air and lowering the humidity with this system than with the hot air
furnace.

The radiators may be placed in the rooms that are to be heated or
they may be placed in the basement and the air admitted and passed
over the radiator and warmed and then forced into the rooms. This
is known as the indirect method and is used in connection with the
system of ventilation. It is used more with steam than with hot water.

Heating by =steam= is by far the most satisfactory method, especially
for larger dwellings and buildings. This system is somewhat like
that of hot water, except the water is converted into steam. The
temperature of the pipes and radiators is therefore higher than with
hot water, but the pipes and radiators do not need to be as large.

Very often this system is used in connection with the ventilation.
The radiators are placed in the basement or in another convenient
place and cool fresh air from the outside is passed over them and
warmed. It is then forced into the rooms. Very often this air is
washed, as described in the chapter on ventilation, and thus freed
from suspended matter. At the same time the relative humidity can
be controlled and this is very essential, not only as a means of
providing air that is most desirable for breathing, but also in point
of fuel economy, since air of high humidity is more easily heated and
is more desirable in conserving the heat of the body as has already
been explained. Steam heating is especially suitable for high and
irregularly shaped buildings. The fact that the radiators and pipes
are empty when not in use reduces the risk of damage to the house
furnishings from bursted or leaky pipes.

It is well to have the radiators placed near windows so that in
ventilating the air will pass over them and be warmed before entering
the room.




CHAPTER VI

LIGHTING




LIGHTING

  ADAPTABILITY OF EYE TO LIGHT
      DIFFERENCE IN INTENSITY OF LIGHT
      TIME REQUIRED FOR ADAPTATION

  THE EYE
      MECHANISM OF EYE
      ACTION OF LIGHT UPON THE EYE
      INTELLECTUAL ADAPTATION NECESSARY

  VALUE OF SUNLIGHT
      EFFECT UPON HEALTH
      ACTION IN NATURE

  NATURAL LIGHT IN BUILDINGS
      DIRECT RAYS OF THE SUN
      FACTORS DETERMINING THE AMOUNT OF LIGHT ADMITTED
      REFLECTED LIGHT
      LOSS OF LIGHT THROUGH DIFFERENT GLASS
      WINDOW AREA REQUIRED

  ARTIFICIAL LIGHTING
      EFFECT UPON THE EYES
      EVOLUTION OF LIGHTING SYSTEMS
      BEST MEANS OF LIGHTING
      OBJECTIONS TO OPEN BLAZE FOR LIGHT
      DIRECTION OF LIGHT

  PSYCHOLOGICAL EFFECT OF LIGHT
      INFLUENCE UPON THE EMOTIONS
      SOFT LIGHT SOOTHING
      BRIGHT LIGHT STIMULATING

  SYSTEMS OF LIGHTING
      DIRECT
      INDIRECT
      SEMI-INDIRECT
      EFFECT OF INSUFFICIENT LIGHT




CHAPTER VI

LIGHTING


Adaptability of Eye to Light

The eye has a great range of adaptability to the intensity of light.
This is evidenced by the fact that the eye is readily adapted to the
intensity of the bright sunlight or to the soft rays of the moon. In
both instances there is no disturbance in vision, even though the
intensity of illumination at midday when the light is brightest is
almost a million times greater than the illumination from the full
moon on a clear night. This adaptation takes place so perfectly and
so independent of the educated mind that we give little thought to
the great difference in intensity of light.

It must be remembered, however, that although this adaptation takes
place so perfectly and without any apparent difficulty, it requires
an expenditure of Innate force to accomplish this action. If the
change takes place too rapidly from a soft light to an intense light,
without sufficient time for adaptative action to take place, the
delicate structure of the eye will be damaged by the violent light
vibrations. The change from the soft rays of the moonlight to the
intense illumination from the bright sun takes place gradually.
First, the night; next, the gray dawn of morning; and then comes the
sun, whose rays are softened as they pass through a maximum amount
of atmosphere near the horizon, and as the sun approaches the dome
of the arc, the rays become more intense, since they pass through
less of the earth’s atmosphere. Then the process is reversed as the
intense light from the sun gives way to the softer rays from the moon.

This gives Innate plenty of time to bring about the adaptative
processes so necessary to adjust the eye to these extremes, time
being a very important factor in all the processes of the body.

Thus it is appreciated that the subject of lighting is important
from a hygienic standpoint, since improper lighting necessitates an
unnecessary expenditure of energy and causes impaired health.


The Eye

That we may better appreciate this adaptability and have a clearer
understanding of the mechanism through which Innate Intelligence
accomplishes this adaptative action we will review briefly the organ
through which we perceive light—the human eye.

The eye consists of a crystalline lens, powerfully refractive, held
between two transparent liquids called the aqueous humor, which is in
front of the crystalline lens and the vitreous humor, which is behind
or posterior to the crystalline lens. The aqueous chamber is divided
into an anterior and posterior chamber by the diaphragm called the
iris, through which is an opening called the pupil, permitting
communication between the chambers of the aqueous humor. The retina,
which is composed of nervous tissue, lines the posterior five-sixths
of the inner surface of the posterior wall of the eyeball. At the
back of the retina and in the direct visual axis is a spot known
as the macula lutea, a yellow spot, in the center of which is a
depression known as the fovea centralis. At this point the vision
is clearest and it is this spot used when we turn our eyes and look
directly at an object.

With such a delicate instrument as the eye it is only reasonable
that special care and arrangement should be supplied to protect it
from sudden changes in the intensity of light. Otherwise the eye
would be greatly injured by the glare of light. This adaptation is
accomplished by means of regulating the amount of light admitted
to the retina. This is done through the expression of Innate by
regulating the size of the pupil.

When the eye is exposed to light, vibrations are carried to the brain
through the afferent nerve fibers and Innate Intelligence becomes
aware of the light. If it is intense and is allowed to remain in
contact with the retina the delicate nerve tissue will be injured. To
compensate for this Innate Intelligence sends motor impulses to the
circular fibers in the iris, causing them to contract and decrease
the size of the pupil and thus shut out a part of the light rays.
In a less intense light or in the darkness the muscular fibers are
relaxed, enlarging the pupil and admitting more light. In all of this
adaptative action there must be sufficient time, although the action
does take place almost instantly. This action is not automatic as
some would have us believe, but is intelligent and under the direct
control of Innate Intelligence.

If we were living in the natural state of man’s existence there
would be no need for a consideration of these natural laws governing
the working of the human body and the intelligence which controls
these manifestations; but as man has increased his knowledge and
has made for himself a more or less artificial environment, it
becomes necessary for him to understand the natural laws that he
may adapt his artificial environment to them. If man lived in the
open outdoors there would be no need for the artificial lighting of
buildings; but since he has created buildings it becomes necessary
for him to study the laws of nature that he may produce a condition
in this environment conducive to the expression of life. In providing
artificial light for our buildings the laws of the physical organ
of sight must be considered. However, the question of lighting is
not alone one of artificial production of light in our buildings,
but also deals with proper admission of natural light from natural
sources.


Value of Sunlight

The value of the sunlight in respect to health has been recognized
from time immemorial. Direct rays of the sun are essential in the
development and expression of animal and plant life. The sun’s rays
are Nature’s greatest germicide. They destroy almost all forms of
germ life. Most of the chemical reactions are hastened or induced by
the action of light. Light prevents or retards the development of the
lower forms of life but promotes the growth of the higher forms.


Natural Light in Buildings

From the foregoing statement it is quite obvious that a proper
amount of light, and if possible the direct rays of the sun, must
be admitted to the home if it is to afford an environment at all
conducive to the expression of life. It is therefore necessary to
make special provision for the admission of light. The amount of
light admitted to a building will be determined by its location and
aspect, the source of the light, whether direct or reflected, the
location and size of the openings, and the kind of glass used. The
character of the walls and other inside surfaces will determine the
light diffusion.

Since direct rays of the sun give more light than those reflected, it
is desirable to admit them to the house as much as possible rather
than to depend upon reflected light from the surfaces outside, such
as the trees and buildings.

There is a certain loss of light as it passes through window glass.
This loss is about 8% through plate glass while through double glass
the loss is 10%, and through milk glass there is a loss of 50%. The
amount of light in a room may be increased by the use of prism or
ribbed glass which results in a more even distribution of light over
the room.

The window area of rooms in a home should be not less than 10% of
the floor area, or not less than one square foot of glass surface
for every seventy cubic feet of interior to be lighted. This is
not sufficient, however, for a schoolroom or for factories. The
schoolroom should have a window area not less than one-fourth of the
floor space.

Windows should be placed so as to admit direct rays of the sun and
should extend within six inches of the ceiling. Window shades may
be used to regulate the amount of light admitted, but care should
be exercised in keeping down the dust, since it accumulates on the
shades and is disturbed when they are adjusted. The dust then gets
into the breathing zone and becomes objectionable from a hygienic
standpoint.


Artificial Lighting

With the present day modern methods of artificial lighting it seems
there would be little difficulty in lighting our homes and other
buildings; but the question is not alone one of how they are to be
lighted, but also how this can best be accomplished and not interfere
with health and produce eye strain and other conditions that are
likely to follow improper lighting.

It is interesting to note the evolution of the lighting systems from
the primitive man who carried a burning stick from the campfire into
his cave and thus realized the pleasure of the privacy of his own
dwelling, up to the modern lighting systems. For centuries man burned
wood and other materials in their natural state and depended upon
these for his illumination. Then it was discovered that by dipping
this raw material in animal fat more light could be obtained. Later
the oil was placed in a container and a wick used. Then from this
crude grease lamp with its wick evolved the candle, which was a
great improvement over the former method. And so mankind groped in
comparative darkness through centuries. It was not until the closing
years of the nineteenth century that he found a better means of
illumination. In 1879 Edison brought out his wonderful invention,
the electric light. Even the evolution of this light would be
interesting for there have been many improvements over the original.

It is very obvious that the best method of lighting is by the use of
the incandescent electric light. It produces the desired intensity,
does not vitiate the air, requires little attention, and is operated
at a minimum expense.

The objections to the open blaze for illumination are that oxygen is
consumed from the air, carbon dioxide and other impurities are given
off, the light is not constant, since there is a tendency to flicker
and especially so in a draft, it requires more attention, is unhandy
to operate and does not give the proper amount of illumination. Most
of these objections are overcome in the electric light.

The source of light must be so placed that it will not strike
the eyes directly. Care must be taken that there are no surfaces
reflecting light directly into the eyes. The lighting system must
provide illumination of sufficient intensity, yet without a glare
which produces eye strain. While our modern methods of artificially
producing light are a great boon to civilization, they may also be
a great detriment to health to say nothing of the discomfort that
is caused by improper methods of lighting our homes, schools, and
workshops.


Psychological Effect of Light

It is not out of order at this time to mention the effect of
light upon emotions of the human family. Proper illumination is
commensurate with the particular functions carried on within the
place illuminated. Note the soft light effects of the cathedral and
the influence it has on the people who visit the place. Enter a
church building with its “dim religious light” and note the calming
effect which it has on the assembly Of worshippers. To be sure they
have gathered in the place for worship and are in that state of mind
which would be expected of those in a revered mood, yet there is no
question as to the influence of the surroundings and especially of
the lighting. It would be quite out of keeping to have the cathedral
as brilliantly lighted as the “Great White Way.” The architecture,
the furnishings and the lighting all have a certain influence upon
the minds of the individuals.

As the dim, soft light has a quieting influence so the bright,
dazzling light has a stimulating effect. This is observed in the
lighting of amusement places where the predominating feature of the
entertainment is hilarity. The pulse may be made to beat faster, the
thoughts turned from the serious things of life to the less serious,
and the mind made to desire the activities of the pleasurable things
of worldly enjoyment by the peculiar environment and the intensity of
the illumination. Or the mind may be soothed into the tranquil moods
and the entire being made to surge with emotion, while the mind is
directed from the more frivolous subjects to the deepest thoughts
of the philosopher with a proper arranging of the surroundings and
a soothing and delicate lighting over all. While these things do
not bear directly upon the subject of hygiene in the more commonly
accepted way, yet they do have a certain bearing upon health and the
physiological functions of the body, especially from the standpoint
of environmental influence upon the body and its adaptation through
the action of Innate Intelligence.


Systems of Lighting

Direct lighting is secured by fixtures which throw the light downward
into the room from which the eyes are protected by properly adjusted
shades. Indirect lighting is from bowl-like fixtures in which
electric lights are placed and the light rays are reflected upward
toward the ceiling with no light penetrating the bowl. Semi-indirect
is accomplished by using a bowl which will permit some of the light
rays to penetrate.

The best results are obtained by a combination of the direct and
indirect methods of lighting and in some cases by a semi-indirect
way. It has been observed that the direct rays of light should not
fall squarely into the eyes. It is also quite essential that in
some cases there should be direct rays on the work or object under
observation. To accomplish this and at the same time to keep the
light out of the eyes there must be a judicial use of shades and
other means of softening the light.

There are some objections to the indirect method in that all the
light is thrown on the ceiling. This gives a very soft light in the
room, but is not sufficiently bright and faces lose their expression;
there is insufficient modeling of objects, and the interior will be
almost devoid of character. This form of lighting, therefore, is
undesirable for home and offices, but is not objectionable for places
of amusement.

There are also objections to the direct system since the strong
direct light makes too harsh shadows and a light glare which is very
objectionable. By properly diffusing this direct light and adding
sufficient upward light we get a much more effective and pleasing
illumination.

By using the two systems, or better still, by combining the two
systems into the semi-indirect, a method is obtained which will
furnish an abundance of light and at the same time give one that is
so perfectly diffused there will be no objectionable shadows and no
harmful glare.

Insufficient light may be quite as injurious to the eyes as too much
light. As a matter of fact it is not so much a question of too great
an intensity as it is of the proper light direction; it is hardly
possible to get a light of greater intensity than that of the sun,
but we are very careful that the sun’s direct rays do not enter the
unprotected eye; neither is it good to permit the reflection of the
rays into the eyes, as from a printed page.

(For schoolroom lighting see chapter on School Hygiene.)




CHAPTER VII

WATER




WATER


GENERAL CONSIDERATIONS

  NECESSITY FOR PROPER SUPPLY

  HISTORY OF PUBLIC SUPPLY

  COMPOSITION OF WATER
      CHEMICAL ELEMENTS
      FOREIGN INGREDIENTS

  STATES OF AGGREGATION

  UNIVERSAL SOLVENT

  NECESSITY FOR WATER IN BODY

  CHEMICALLY PURE WATER
      HOW OBTAINED
      TASTE OF WATER

  HARD AND SOFT WATER
      PERMANENT
      TEMPORARY

  ELIMINATION OF WATER FROM BODY

  AMOUNT OF WATER NEEDED FOR ALL PURPOSES
      FOR THE BODY
      FOR DOMESTIC PURPOSES
      FOR CITY USE

  WATER WASTE
      CAUSES FOR
      USES OF METERS


SOURCES OF WATER SUPPLY

  RAIN WATER
      SUPPLY NOT RELIABLE
      EASILY POLLUTED
      FILTERING NECESSARY
      DESIRABLE FOR LAUNDRY PURPOSES

  SURFACE WATER
      STREAMS
      LAKES
      IMPOUNDING RESERVOIRS
      SOURCES OF IMPURITIES IN SURFACE SUPPLY
  GROUND OR SUBSOIL WATER
      WELL WATER
      SPRING WATER
      TEMPERATURE IN WELLS
      SHALLOW AND DEEP WELLS
      CONSTRUCTION OF WELLS
      SOIL AS A FILTER


METHODS OF PURIFICATION

  NATURAL METHODS OF WATER PURIFICATION
      BY FREEZING
      SELF-PURIFICATION
      WATER VEGETATION
      DILUTION
      STORAGE AND SEDIMENTATION
      SUNLIGHT

  ARTIFICIAL METHODS OF WATER PURIFICATION
      DISTILLATION
      BOILING
      FILTRATION
      CHEMICAL PURIFICATION

  SWIMMING POOLS
      SANITATION OF
      SWIMMERS INSTRUCTED IN POOL SANITATION


SEWAGE AND REFUSE DISPOSAL

  METHODS OF SEWAGE DISPOSAL
      DRY
      WET

  SEWAGE PURIFICATION
      SCREENED
      SEPTIC METHOD

  REFUSE DISPOSAL
      INCINERATION
      CITY COLLECTORS


CHAPTER VII

WATER


GENERAL CONSIDERATIONS

Necessity for Proper Supply

One of the most important requisites in maintaining the organization
of the material in the living body is a proper supply of water. It is
absolutely indispensable to the expression of animal and vegetable
life. Although not classed as a food it enters into the composition
of food and hence becomes an essential article of diet.

The greatest value has always been placed upon a sufficient supply
of pure water. The history of the race shows that the earliest
settlements were made with a view to obtaining a supply of water;
they were either on waterways or in places where water was easily
obtainable from springs or shallow wells.

Water is needed not only as an article of diet, but it is also
required for sanitary purposes: for cleansing the body externally,
for washing clothes, and also for sprinkling streets and for other
purposes such as sewage disposal in the thickly populated centers.
Even in ancient times great sums of money were expended for the
public supply of water.


History of Public Water Supply

A bit of history on this subject might be of interest to some. It is
asserted by historians that there are aqueducts in China dating back
to prehistoric times. Channels cut in solid rock have been revealed
in Jerusalem in recent excavation which indicate that they were
used for conveying the water supply from the country near Bethlehem
and Hebron. There have been found in these excavations channels of
earthen pipes cemented together and covered with rough rocks. The
fact is also quite well established that water was brought to Athens
from Mount Hymettos and Mount Pentelikon.

As early as 312 B. C. water was carried to Rome through an aqueduct
ten miles long. It is estimated that the cost of construction of
this aqueduct was about $12,700,000. Another was begun in 272 B. C.,
the length of which was forty-five miles. The water carried by this
aqueduct was not used for drinking but for irrigating purposes and
for flushing drains.

Altogether there were at least nine aqueducts that supplied the
ancient city of Rome. Of these nine, three are still used to supply
modern Rome. One of these was finished by Agrippa in 27 B. C.

We see by the foregoing that from time immemorial there has been a
great expenditure of energy and money in producing a proper water
supply for the human family. It also reveals the fact that the
ancients knew something about engineering projects which some of us
are likely to consider as modern accomplishments.


Composition of Water

Water is not, as was previously supposed, an elementary substance.
In 1781 it was shown by Cavendish that it consisted of two parts of
hydrogen and one part of oxygen (H_{2}O), and that it could be made
synthetically by combining hydrogen and oxygen in this proportion,
and that it could be separated analytically by various methods into
its component parts.

By volume, water is composed of two parts of hydrogen to one part of
oxygen; by weight, one part of hydrogen to eight parts of oxygen.
However, pure water does not exist in Nature since water is a
universal solvent and in Nature it comes in contact with so many
substances; therefore, it contains many substances in solution.
Chemically pure water is found only in the chemist’s flask.

Water is a liquid which is clear, colorless and odorless. To be
palatable it should be cool, soft, well aerated and free from
sediment and suspended impurities. One cannot judge the purity of
water by any one of these qualities, for water that is palatable and
gives no offense upon drinking might be polluted with that which
would be detrimental to health. The palatability of water may be due
to the carbonic acid present, which results from the decomposition of
products contained in it.

The carbon dioxide, which is present in rain water, is obtained
from the air through which the rain passes. Carbon dioxide is also
taken up by the water as it percolates through ground covered with
vegetation. The presence of this gas increases the solvent powers of
the water. Water may also contain metal in solution such as iron,
arsenic and copper.

The important foreign ingredients in water are those of organic
origin, such as microscopic plants, vegetable fungi, detritus of
vegetable life, minute insects, infusoria, ova of insects, minute
parasites, and animal debris. Water usually contains millions of
various micro-organisms, mostly harmless, although at times it may
also contain so-called pathogenic germs.


States of Aggregation

Water is formed into the solid state, ice, at zero degrees
centigrade. At 100° C. water boils and is converted into gas or
vapor, although water is contained in the air in the gaseous form
at ordinary temperatures. Between these two limits, 0° C. and 100°
C. water obtains in the liquid form which is its most common state.
Water is the most widely distributed of all the substances. It is
practically incompressible. When heated it contracts until it reaches
4° C, or 39.2° F., and is at this point taken as the basis for
specific gravity of liquids and solids.


Universal Solvent

Water is the most universal solvent known in Nature. Practically
all substances yield to it. Most of the water taken into the body
passes through unchanged, although it is only reasonable to suppose
that some of it is broken up into its elements and united with other
compounds of the body.


Necessity for Water in Body

Water composes about 70% of the entire weight of the body (about
58.5% per volume). A very great amount of water is required by the
tissue for the performance of the bodily functions. As the gears of
machinery must be bathed in oil to prevent undue wear, so must the
tissue cells be bathed in water (secretions) that there be no undue
wear. The tissue cells are spoken of as being aquatic in their habits.

Rosenau in summarizing the use of water in the body says: “It
enters into the chemical composition of the tissues; it forms the
chief ingredient of all the fluids of the body and maintains their
proper degree of dilution, and thus favors metabolism; by moistening
various surfaces of the body, such as mucous and serous membranes, it
prevents friction; it furnishes in the blood and lymph a fluid medium
by which food may be taken to remote parts of the body and the waste
material removed, thus promoting rapid tissue changes; it serves as a
distributor of bodily heat; it regulates the body temperature by the
physical process of absorption and evaporation.”


Chemically Pure Water

Chemically pure water can be obtained only by distillation; it
is undesirable, however, for drinking purposes because of its
insipidity. Before such water is agreeable for drinking it must
be aerated; this may be accomplished by agitation or by passing it
through a porous substance containing air. One of Nature’s methods
of aerating water is found in mountain streams where the water flows
down over rocks. The same thing is accomplished by fountains and
waterfalls. It is the mineral matter and the gases held in solution
that give water its taste, and it is the difference in these minerals
and gases that causes the individual to dislike the taste of water
which he is not accustomed to drinking. But this is purely a matter
of taste and has no value from a hygienic standpoint, for the most
impure water, water that contains so-called pathogenic germs, may
taste very good.

Turbid or muddy water is not necessarily impure from a hygienic
standpoint when found in rivers, but when subsoil water becomes
turbid it should be regarded with suspicion.


Hard and Soft Water

The question of hard and soft water is one that must of necessity
receive some consideration, but it is of more importance from an
economic standpoint than from a sanitary standpoint. Soft water is
generally considered to be more desirable for drinking purposes,
and it is certainly more desirable for cooking. From an economical
standpoint, soft water is more preferable as the hard water requires
more soap to produce a lather.

Hardness of water is spoken of as being temporary or permanent.
If the water remains hard after having been boiled it is known as
permanently hard water. Hardness of water is due to the presence of
the soluble salts of the alkaline earth metals, especially calcium
and magnesium. Temporary hardness is due to calcium or magnesium
carbonate held in solution as a bicarbonate by the dissolved carbon
dioxide. The hardness is temporary because the carbon dioxide is
driven off by boiling, and the soluble bicarbonates are precipitated
as insoluble carbonates.

Permanent hardness, on the other hand, is due mainly to sulphates
and chlorides of calcium or magnesium. These salts are stable and
therefore are not precipitated by boiling.


Elimination of Water from Body

Water is excreted from the body through the various channels. The
kidneys excrete about 50%, the lungs about 20%, the skin about 28%,
while the other 2% is excreted through the feces and other minor
channels.


Amount of Water Needed for All Purposes

The amount of water needed for all purposes varies just the same
as the amount of water needed by the body varies with conditioning
factors. The locality and the climate will enter into the
consideration of the amount of water needed to meet the requirements
of hygiene and sanitation.

The amount of water required by the human body in twenty-four
hours varies with many factors. The age of the individual and his
occupation and health, and climate would be conditioning factors.
However, authorities are pretty well agreed as to the amount
necessary. It is estimated that the body requires a little less than
one gallon of water per day, about two quarts taken as drinking water
and the balance in food.

There is a wide range of difference in the amounts estimated, for
under some conditions, a minimum of seventeen gallons, or even twelve
gallons, would be sufficient, while under other circumstances and in
other localities as much as 300 gallons per day per individual would
not be an excessive or wasteful amount. The average amount estimated
per individual per day for domestic purposes is placed at seventeen
gallons for all purposes. In 1918 the statistics showed that Buffalo
used an average of 260 gallons per capita per day, but many cities
used much less. In Berlin in 1913 the water consumption amounted to
an average of twenty-four gallons per capita per day.

The hygienic importance of these figures is insignificant since they
are only approximate. There are a number of factors that are not
taken into consideration. The figures are estimated on the number of
gallons of water pumped and no account whatsoever is taken of the
water waste through precipitation and loss through leaky pipes. Some
engineers maintain that fully half the water pumped is lost in these
various ways. Another thing that must be considered when comparing
the amount of water used by different cities is the industries. Some
industries require much more water than others, therefore, if a
just comparison is to be made between cities only the water that is
actually passed through the private meters must be considered.


Water Waste

Consideration of the subject of water would not be complete without
some reference to the amount of water that is wasted. It seems a
small matter to waste water. We sometimes say there is plenty in the
river. But the proposition of preparing the water for use and getting
it to the individual for consumption may involve many phases of
hygiene from several different angles and one of these angles may be
industrial hygiene. To get water into the home and factory requires
a great many processes such as laying and maintaining water mains,
purifying the water and pumping. This involves several industries and
trades, so the problem of a water supply is far reaching and is of
vital importance to the community.

There should never be a sacrifice on the part of hygiene and
cleanliness for the purpose of saving water. A sufficient amount
of water should at all times be insisted upon, but certainly there
should be a strenuous effort to eliminate undue waste.

The main causes of water waste will be found to be leakage in mains
and service pipes and waste from defective fixtures in the house.
All of this leakage and waste should be properly attended to because
of the direct relation which it bears to hygiene and particularly to
industrial hygiene.

The introduction of meters has been an important factor in reducing
water waste. It is not the thought to limit the amount of water used
or to deprive one of a sufficient amount, but there is nothing to
be gained by an unnecessary waste. The introduction of meters in
Milwaukee reduced the amount of water used per tap from 1,781 gallons
per day to 644 gallons per day without putting any restrictions upon
the consumers. It is an enormous task to provide a sufficient amount
of pure clean water for a large city and certainly an effort should
be made to avoid waste.


SOURCES OF WATER SUPPLY


Rain Water

The sources of our water supply may be classified as: Rain and snow
water, surface water and ground or subsoil water.

The rain and snow water provide a supply for domestic purposes.
This source cannot be relied upon in some sections of the country
because of the variable amount of rain fall. Rain water is pure from
the fact that it has been vaporized and then condensed the same as
in distillation; but it does not remain long in this pure state
since it is exposed to so many sources of pollution. This water is
collected in receptacles called cisterns and tanks and used mostly
for household purposes. It can readily be seen that water thus stored
might become polluted from the surfaces with which it comes in
contact. To prevent this special care would be necessary, and in the
majority of cases the need for this precaution is not recognized.

This source of water supply is not very desirable since its quantity
is variable and also because of the difficulty in storing large
quantities and in providing protection so that it will not become
contaminated and thereby rendered unfit for household use.

While rain water in its unpolluted state is a pure water, it is
not suitable for drinking purposes until it is properly aerated.
The air contains dust and other suspended impurities which will be
precipitated with the rain and thus pollute the water. However,
the amount of pollution is so small that it is of little sanitary
importance. After the air has been cleared of these suspended
impurities the rain water will be relatively pure. It will be noticed
that after a rain the air seems clear and clean; this is due to the
rain actually washing the air.

It is necessary to filter rain water collected from the surface of
roofs because roofs collect impurities from smoke and dust. The
average filter used for this purpose is usually inadequate and
receives such little care that it is of slight value.

In the large cities or even in the larger towns the cisterns have
been replaced with more modern and more satisfactory means of water
supply. Rain water is soft and therefore is most desirable for
laundry purposes and is also very desirable for cooking. It is not
considered as satisfactory for drinking, however, as ground water or
properly filtered surface water. It always contains gases such as
nitrogen, oxygen, and carbon dioxide. The amount of solids varies.
The storage of water in cisterns forms a good breeding place for a
certain kind of mosquito, stegomyia calopus, which is supposed to
cause yellow fever; but regardless of the supposed pathogenicity of
this mosquito it is quite objectionable.


Surface Water

Surface water is derived from ponds, lakes, rivers and creeks; in
fact, any water which is in contact with the atmosphere is known
as surface water. Surface water forms really the most desirable and
satisfactory source of public water supply.

=Streams= form natural sewers for the regions which they drain and
ponds and lakes form convenient dumping places for the sewage carried
by the streams, therefore it will readily be seen that the surface
water is liable to great pollution from these sources. It therefore
becomes necessary to purify it by some means before it can be used
for domestic purposes.

At one time it was thought that streams purified themselves in their
flow, but this is now disputed and has been proven to be erroneous
and should be strenuously denied. There are many factors at work in
Nature which purify water in its natural state. Before civilization
brought about so many artificial and unnatural conditions it was
true that, with the small amount of waste material emptied into the
streams, Nature would, through her natural processes, keep the waters
of the streams in a state of natural purity. But in the present day
with not only the sewage of our large cities pouring into the rivers
and lake, but also the waste material from factories and different
industries, it becomes necessary to use some artificial methods for
water purification.

=Lakes=, from a sanitary standpoint, form a more desirable source
of public water supply than rivers. There are several reasons
for this. First: there is possible a greater dilution of the
impurities that reach the lake. Second: there is greater opportunity
for sedimentation which is a very important process in water
purification. Third: the water is softer than river water and freer
from organic impurities.

The greatest problem that a city getting its water supply from a lake
has to solve is how to keep its sewage from polluting its own water
supply. To prevent this, it is necessary to place the intake for
the water supply far out in the lake. The danger from pollution has
become so great in some places, as in Chicago, that special canals
have been constructed to carry the sewage into other channels rather
than empty it into the lake.

The impurities from the sewage may travel a great distance into the
lakes. Serious sewage pollution was found ten miles out in the lake
from the mouth of the Detroit River. Pollution has been found as far
as eighteen miles from the shore in some places.

So it is readily observed that, notwithstanding the fact that the
lakes and ponds furnish a more desirable public water supply, yet
this source is not, by any means, free from objections.

The =impounding reservoir=, which is an artificial reservoir for
the purpose of storing up water, is another very reliable source
of public water supply. These reservoirs are often built in the
mountains by placing a dam across a ravine or canyon. The largest
dam in the world is the New Croton across the Esopus Creek in the
Catskill mountains in New York. It is 248 feet high, 185 feet thick
at the bottom and eleven feet thick at the top. This impounding
reservoir furnishes an addition to the water supply of New York City.

There are many advantages to the impounding reservoirs, but there
are also many disadvantages. One advantage is that the area drained
is comparatively small and therefore the pollution from that source
is lessened; also the storage factor which is experienced in this
reservoir is an advantage. In this way many of the so-called
pathogenic microörganisms die before they are carried to the
consumer. A disadvantage is that they are open to the atmosphere
and light and this is conducive to stagnation because the water is
still. This results in an increase in the growth of algæ and other
microscopic organisms. The stagnation of the water results in an
increase of the products of decomposition. This, together with the
microörganisms and algæ, produce the foul smell and bad taste of the
water.

The stagnation of impounding reservoirs and small lakes may become a
vital factor from a hygienic standpoint. If the water is less than
twenty feet deep it will be kept in motion by the wind and in this
way will not become stagnant, but if it is more than twenty feet
deep the lower portion will remain still. This prevents the water
from mixing and therefore the under portion will become stagnant
while the surface will not. If the water supply is taken near the
surface there will not be so much danger from the stagnant water,
but even then there are times of the year when there is a complete
stirring up of the water. This mixing of the surface water and the
bottom water takes place twice a year, in the spring and in the fall.
This mixing is the result of the changing of the temperature of the
surface water. During the summer the surface water becomes warm and
the temperature may reach 80° F. In this way the warm water remains
on top but is kept stirred up by the wind. The wind will not usually
create a disturbance for more than twenty feet except in very large
lakes where it may be as great as forty feet.

As winter approaches the water cools until finally the temperature
of the surface water becomes the same or more nearly the same as the
bottom water. Then the wind exerts a deeper influence and the surface
and deep water will mix. During this process vertical currents may
be produced. This mixing continues until all the water has been
thoroughly mixed and until the temperature of the surface water goes
below the point of maximum density which occurs at 4° C. The cold
water accumulates on the surface where ice is often formed. In the
spring the process is just reversed. The fall mixing of the water is
much more thorough and intense than the spring mixing.

The changes brought by this mixing are obvious. The surface water
contains a large amount of oxygen. The bottom water contains much
less oxygen but a great quantity of decomposed products. The oxygen
is carried to the bottom and there oxidizes and neutralizes some of
the products of decomposition.

The =sources of impurities= in surface water are various. One of the
most menacing sources is from the sewage which is carried from the
centers of population. In the rivers it is the sewage of the towns
and cities situated above. In the lakes it is usually the sewage of
the city itself that is likely to pollute its own water supply. Under
the present conditions it seems that it is easier to purify the water
supply than to purify the sewage or provide some other method for its
disposal.

Naturally the water of rivers is purest near the source. The reason
for this is that the rivers form a natural drainage for the land
through which they flow. The waste products from every process
carried on in that territory find their way into the streams as a
natural result of the law of gravity. The water will be found to
contain large amounts of mineral and organic matter after passing
through populated and cultivated areas. Purification of rivers is
considered under Water Purification.


Ground or Subsoil Water

In the consideration of the three sources of water supply it is
difficult to draw definite lines of demarcation since the rain and
snow water soon becomes surface water and the surface water may
percolate through the ground and become subsoil water.

=Well water and spring water are classed= as ground or subsoil water.
From a hygienic standpoint water obtained from wells or springs forms
a very reliable and satisfactory source of supply.

Especially is well or spring water desirable for private domestic
use, since it is usually in a reasonable degree of purity and does
not, therefore, require any artificial process for purification. The
sources of water supply used for public purposes, made necessary
because of the volume of water required, are not so satisfactory for
a private or domestic supply because its purification would entail
too great an expense to warrant the practicability on such a small
scale. Therefore, the most desirable source when only a limited
amount of water is required is the wells.

Wells may be used for public water supply and are in some of the
smaller towns, but they are not so practicable as their supply is
likely to be inconstant. In other words, there is danger of the wells
going dry, and since they are put down at a great expense, this would
be too great a risk to take even though the water thus obtained is
satisfactory from a hygienic standpoint.

[Illustration:

  The above illustration shows the fluctuation of ground water. When
  the ground water is at the low mark the shallow well becomes dry;
  as the water rises it flows into the well. When the water has
  reached the high mark the intermittent spring becomes a flowing
  spring. The pressure of the ground water is great enough to produce
  flowing wells down on the level.]

Not all wells, by any means, will furnish a pure water supply. There
are many factors to consider from the viewpoint of the pollution
of well water and these will be considered in due time. When water
reaches an impervious strata it remains at that level and moves in a
horizontal plane. Water may form in beds or be found in underground
streams. It is only in the limestone regions that water forms in
streams under the ground.

[Illustration: Poorly constructed well, polluted by seepage thru
limestone.]

The depth at which water is found beneath the surface varies. The
water directly beneath the surface, or that which is derived from
surface drainage and the rainfall, is, by some, styled the ground
water. This is the shallow water. That which is found at a lower
level is called the lower subsoil water or underground water.

The ground water does not provide a very desirable source of well
water because there is danger of pollution from the surface. The
degree of this impurity will depend largely upon the character of the
soil. If it is sandy and thus provides a good filter medium there
is little danger from pollution; but if the soil is of a limestone
formation it makes a very poor filter and the shallow water is likely
to be polluted from the surface drainage.

The subsoil water moves in the direction of the nearest body of
water. That is, if it is near a river or lake its movement will be in
the direction of this river or lake. For this reason a well near the
seashore will contain fresh water.

In wells less than fifty feet deep the temperature of the water will
be influenced by that of the atmosphere. It will be warmer in summer
and cooler in winter. Some authors put this depth at much less than
fifty feet, maintaining that the atmospheric temperature will have no
influence whatsoever at such a depth. It is true, however, and the
fact is undisputed, that in wells 50 feet deep or more the water is
cool and the temperature remains constant. It is not influenced by
the change in atmospheric temperature.

Sand and gravel deposits form the best source through which to obtain
subsoil water. To supply any very great amount there must be a number
of wells and these must be far enough apart so as not to draw from
the same territory. Seventy-eight million gallons of subsoil water
per day is provided at Brooklyn from twenty-four separate pumping
stations. Memphis, Tennessee, is the largest city in the United
States which gets its entire water supply from sand and gravel
deposits.

[Illustration: Poorly constructed well, polluted by surface drainage.]

Sandstone rock furnishes an excellent source for subsoil water since
it makes an excellent filter. Because of the limited amount of water
obtained in a sandstone formation this source is practicable only for
a very limited supply.

Limestone formation is the most undesirable source of subsoil water
supply from a hygienic standpoint. Limestone is not porous and
therefore has no filtering qualities. If water does pass through this
sort of a formation it must travel through its crevices and fissures.

It is very difficult to know where the pollution of water passing
through limestone originates. As these fissures are usually very
long, and as the water is in no way filtered as it passes through
them, the contamination might enter the water at a point far distant
from where the well is sunk. The water supply from limestone is
likely to be inconstant because the water is not contained in the
limestone, but flows through the cracks and crevices. In this way it
may soon flow away unless the source is replenished by rain or snow.

Water from the subsoil is obtained, as has been stated, from wells.
Wells are classified as shallow and deep. By a shallow well is
commonly meant one that is dug and not more than thirty feet deep.
This type is usually walled up with brick or stone and is from five
to six feet in diameter. Shallow wells may also be driven. That is,
a gaspipe with a sand point is driven into the ground until the
water-table is reached, the water being pumped out with an ordinary
suction pump.

Shallow wells must never be considered a satisfactory source of water
supply where there are conditions existing which would result in such
pollution of the ground that the water percolating through can not be
more or less filtered. Sewage polluted soil never is satisfactory for
shallow wells.

[Illustration: Showing a properly constructed well in unsanitary
locations.]

Deep wells are drilled and are from six to eight inches in
diameter. The water from deep wells may be free from contamination
but may contain a great deal of mineral in solution and different
salts which render it permanently or temporarily hard. This decreases
its value from a sanitary viewpoint and more particularly from an
economic standpoint.

Special attention should be given the construction of the well. The
casing or walls should be as tight as possible. Special care should
be exercised against the possibility of surface water percolating
through the casing as this drainage will bring impurities.

The casing should project far enough above the surface of the ground
to insure against water running from the surface. It should extend at
least eighteen inches above the ground. The well should have a tight
covering.

The ground possesses great filtering qualities and therefore great
quantities of impurities will be taken from the water as it filters
through. The danger is when the ground becomes so filled with
impurities that its filtering qualities have been destroyed or when
there is not sufficient distance between the source of pollution and
the water level; also when the soil is of a limestone formation and
the water, instead of percolating through it, passes through cracks
and crevices, in which event it will in no sense be filtered.

It was at one time considered that wells should be ventilated and
a great deal of stress was laid upon it. When it is taken into
consideration that the water under ground is in no way ventilated
except through the natural means, it will readily be understood that
it is not necessary to provide ventilation merely because the water
has been tapped by a well.

If the origin of pollution, such as cesspools, is too near the
well or the well is too shallow, not allowing enough distance for
purification, there will be great danger from such sources. The
greatest danger is in the shallow wells. However, these are entirely
satisfactory as a source of domestic supply, providing the soil is of
a sandy or gravel formation and there are no barnyard or cesspools,
for example, too near the wells. A shallow well in a limestone region
is not satisfactory and should be discarded when at all possible.
If it is necessary to use such, every precaution possible should be
taken to eliminate the possibility of contamination.


METHODS OF PURIFICATION


Natural Methods of Water Purification

In considering the subject of water purification it is not our
thought to go into detail and explain the processes that are
necessary to accomplish a pure water supply, but to deal with the
subject in a general way that we may appreciate what is necessary in
this line.

We will first take note of the methods used by Nature in purifying
water. Nature’s method of obtaining chemically pure water is by
evaporation and condensation. The result of this method is the snow
and rain water. About three-fourths of the earth’s surface is covered
with water. The sun acts as a great furnace and the atmosphere as
a vast still. In this way we see that a great quantity of water is
distilled and returned to the earth in a state of purity. It is
estimated by Summerville that “186,240 cubic miles of water are
annually raised from the surface of the globe in the form of vapor
chiefly in the intertropical seas.”

It is entirely erroneous to assume that the impurities in water
are eliminated by freezing. Ice may contain great quantities of
impurities, even so-called pathogenic germs. It has been shown that
many germs are not destroyed by freezing. It is true, however, that
ice will be purer than the water from which it is taken.

There are certain processes which result in a purifying influence as
water is crystallized. As ice forms it excludes suspended matter and
even under certain conditions will exclude dissolved substances. It
will thus be seen that even though ice may not be pure, the danger
from its use is greatly reduced. It is not advisable to use water
from melted ice for drinking purposes.

Manufactured ice is supposed to be free from impurities, but this is
not necessarily true. If ice is produced artificially from distilled
or properly filtered water it will naturally be pure, provided it
does not become polluted in the process of manufacture.

At one time it was believed that river water would become pure in
a flow of seven miles. This, however, could not be true since the
distance of the flow is of less importance than the time required for
the flow.

The greatest aid in this method of water purification comes from
the impurities mixing with the volume of water as it flows. The
impurities become diluted and if sufficient time elapses the bacteria
and microörganisms will die a natural death.

The principal process involved in self-purification of water is
the oxidation of nitrogenous organic matter which is a chemical
process. In the course of time the microörganisms die as a result
of the biological action. Then there is the effect of dilution,
sedimentation, especially in lakes and still water, and the effect of
sunlight.

Food for the bacteria is lessened as a result of the destruction of
the organic matter through oxidation. The minute infusoria, amœbæ
and water worms feed upon organic matter and bacteria and thus aid
in the process of purification. The plants known as algæ play a very
important part also in water purification. They take up the organic
substances and perform other functions similar to the vegetation on
the land. The purifying effects of water vegetation is very important.

One of the chief sanitary safeguards in Nature is dilution. A small
amount of pollution may be quickly diluted by a volume of water until
it is practically harmless. In its concentrated state, however, there
might be enough poison, the strength of which would be greater than
the internal resistance of the individual. This would produce toxic
conditions, or it might even be great enough to produce subluxations.

=Sedimentation= is another of Nature’s methods that is of great
value. This process has been aped by man in the coagulation produced
by the use of chemicals. This action is largely mechanical. During
the process of sedimentation it is only the suspended matter that
settles; but it is maintained that the bacteria and microörganisms
become entangled and are carried to the bottom and in this way the
water is freed from more than simply the mechanical impurities. If
allowed to remain in storage a sufficient time, the harmful bacteria
will die a natural death. There are processes, however, that take
place during the time of storage which are objectionable, but these
relate more to the taste or smell of the water than to the production
of harmful ingredients.

During sedimentation there is a natural settling of the suspended
particles. Not only is the desired result obtained in freezing the
water of solids, but as the suspended matter sinks to the bottom many
of the bacteria will also be carried down. Sedimentation, however, is
not a method that can be used promiscuously. It is usually employed
in connection with some other method; with a slow sand filter, for
example, or when mechanical filtration is used.

Sunlight is Nature’s greatest germicide. Direct sunlight destroys
germ life and renders much aid in maintaining sanitary environmental
conditions. It has a purifying effect upon water in this way. When
the water is in motion or during times of turbidity great good is
accomplished from a sanitary standpoint by the direct rays of the sun.


Artificial Methods of Water Purification

The only way to obtain chemically pure water is by distillation.
However, since this method is very slow and expensive, it is not at
all practicable for the purification of even a private water supply,
and since a chemically pure water is not required for drinking or
other domestic purposes it would be entirely unnecessary to provide
it. Again, distilled water is not desirable for drinking purposes
since its taste is insipid until it is aerated.

When only a small amount of water is required it may be freed of
organic poisonous substances by boiling. This will not, however,
render water that contains lead and other stable chemical substances
injurious to health safe for domestic use.

[Illustration: Sand Filter.]

The dissolved gases are given off by boiling and this leaves the
water with a flat taste which may be improved by aerating; this may
be done by stirring or by placing the water in a jar and shaking it.

=Filtration= is by far the most practicable method of water
purification. There are many different methods used. The two most
used are known as the natural and mechanical.

Under what is known as the natural methods, the sand filter seems
to have precedent. The efficiency of this filter depends upon the
material used, the velocity of the water through the filter and the
care, such as proper cleaning which the filter receives.

As a matter of information the student should become somewhat
familiar with the general construction of a sand filter. The size
of the filter, that is, the area it covers, will be governed by the
amount of water to be filtered per day, which in turn will depend
upon the demands. The greatest objection to a slow sand filter is
that a very large tract of land is required to provide sufficient
surface for the percolation of the water.

The bottom and sides of the filter-beds are water-tight and are
constructed of cement with proper drains to carry off the filtered
water. A layer of very coarse gravel is placed on the bottom of the
filter, then on top of this is a layer of fine gravel. This is then
covered with fine sharp sand about three feet deep. Ordinarily the
entire filter medium is from four to six feet deep.

On top of this layer of fine sand a thin scum is formed which
increases the efficiency of the filter, its action being biological.
As this scum accumulates it becomes necessary to remove it. This
is done by special devices. It is necessary to remove only a small
portion of the sand, for it will be clean immediately below the
surface. This process is continued until the layer of sand has
decreased in depth to about twelve inches when it is replenished with
new, or with polluted sand which has been removed and thoroughly
washed with filtered water.

The filter is first filled by admitting water from beneath for the
purpose of forcing the air out. The depth of water is kept about
three feet above the sand.

The rate of filtration is controlled and kept at a velocity of about
two inches per hour. At this rate a filter of one acre area will
provide about 3,000,000 gallons per day.

A first class slow sand filter should free the water of 99% of the
bacteria. Hygienists claim that filtered water should not contain
more than 100 bacteria to a cubic centimeter. Water from a new filter
or one that has just been cleaned should be tested before it is used.
By this method one can determine whether the desired results are
being obtained.

It may be necessary to store the water in reservoirs before it is
passed through the sand filter for the purpose of sedimentation.
This will rid the water of the small particles of sediment which is
contained in the turbid water. If turbid water is passed through a
sand filter the smallest particles will pass on through with it. This
causes a tendency to fill the filter with clay and other substances.

Instead of the water passing slowly through the sand, it is forced
through in mechanical filtration. The sand is contained in cylinders
or tanks and the water is forced through either as the result of
gravity and weight of the water above or by mechanical means.
Before it is passed through the sand in the mechanical filter, it
is treated chemically to coagulate and precipitate the suspended
impurities. This process is not only mechanical in the sense that
it is accomplished by means of certain machinery, but the action on
the water is mechanical. There is no bacteriological action which
is so essential as this mechanical action in the process of water
purification.

The mechanical method of water filtration has not been found to
be as satisfactory as the slow sand filter process, although very
large amounts of water may be filtered in much less time. One great
disadvantage of this method is that the filters require such frequent
cleaning and in this respect are very expensive to maintain.

=Chemical purification= is not considered by some hygienists as a
satisfactory method for purifying large water supplies. There are
many objections to this method. Even though the water is freed from
the impurities it has received in its natural course, it is laden
with chemicals that may be as injurious to health as the impurities
themselves.

The chemicals used are: Chlorine, bromine, copper sulphate, metallic
iron, ozone and sodium bisulphate.


Swimming Pools

In connection with the subject of water a word relative to the
sanitation of swimming pools will not be out of place. There are many
municipal swimming pools in operation and while they are intended to
improve the sanitary conditions, they may at the same time become a
great menace to hygiene if they are not properly conducted.

No individual should be allowed to enter a swimming pool without
first having taken a shower bath with a liberal use of soap. No one
should be allowed in the pool who is infected with skin dis-eases
of any kind, ulcers, running sores, conjunctivitis, or venereal
dis-eases.

The water should be properly filtered when it enters the pool and
there should be a constant process of disinfection. There should be
not only right construction, but also fit maintenance of the pool.
The swimmer should be properly instructed relative to swimming pool
sanitation.


SEWAGE AND REFUSE DISPOSAL


Methods of Sewage Disposal

One of the greatest problems the hygienists and sanitary engineers
have to solve is the disposal of sewage and refuse without
contaminating the water supply and in other ways rendering the
environment unhealthful.

The methods used for the immediate removal of sewage may be either
the dry method or the water method. By far the more common one in
towns and cities is the water carriage system. In small towns,
however, the more prevalent way is to provide a house some distance
from the dwelling which contains a privy vault.

Where sewage is removed by the water method and carried through
sewers to the waterways, such as rivers and lakes, the great problem
which the sanitary engineers have to solve is how to dispose of the
sewage and not pollute the water supply of the city.

When there is a sufficient amount of water to insure proper dilution
sewage may be emptied directly into it without treatment. But where
there is a limited amount of water, as in a small stream, and a
very large amount of sewage to be disposed of, the water may become
overloaded and thus the supply of other towns become polluted.
When sewage is disposed of in the ocean, oyster beds may become
contaminated as well as the bathing beaches.


Sewage Purification

It is considered cheaper and at the same time satisfactory from a
hygienic standpoint to depend more upon proper filtration than upon
any other method of purification.

There are many different methods used for sewage purification. Sewage
may be screened. This frees it from the larger particles. It is then
placed in tanks and by a slow process of sedimentation relieved of a
large amount of the suspended matter that passes through the screens.
After these processes it may then be carried to fields for subsurface
irrigation. It is carried through porous tile pipes ten to eighteen
inches below the surface and two feet to three feet apart. In this
way the sewage seeps through into a sandy soil. An acre will take
care of the sewage from 150 to 250 people a day. This method can not
be used at all in clay soil.

The crude sewage may be applied to the surface of the land and
carried by means of ditches, but this is not considered satisfactory.
Sand filters are also used, but they require frequent cleaning and
renewing.

According to Price the most desirable method of sewage disposal is
known as the septic method. In this method the sewage is sorted and
the action that follows is bacteriological. The bacteria present act
in the absence of air or oxygen. The sewage thus undergoes a process
of decomposition, fermentation and purification.

The next step is to pass the sewage that has come from the septic
tank through open sand filters very slowly. These sand filters must
be properly cleaned and renewed at regular intervals and must at no
time be overloaded. This makes the effluent from the filter beds
entirely free from germs and harmful matter. It is not necessary for
us to consider the construction of these septic tanks. There are any
number of different types, but the results are supposed to be the
same. The construction of such tanks is in the province of sanitary
engineering and not in that of practical hygiene.

Price states that the water which comes from the filter beds after
the sewage has first been through the septic tank is free from
injurious substances, is capable of supporting life and that even the
drinking of it has been known not to be followed by injurious results.


Refuse Disposal

Another great problem is the disposal of refuse such as ashes,
garbage, and in the larger cities, street sweepings. It is estimated
by Whipple that in the larger cities like New York the refuse will
be in round numbers a ton per capita per year. This is an enormous
amount of material and the disposal of it becomes a great problem.
This is not only of hygienic importance, but also one of economical
significance.

The collection of waste material is objectionable from the social
viewpoint; also an accumulation of ashes and dust will irritate
the eyes and respiratory tract, while piles of garbage and other
filth are conducive to the breeding of flies and mosquitoes. Such
collections result also in the development of ill-smelling odors and
unsightly streets and alleys.

There are different methods used to dispose of this waste material.
It may be collected and burned. This method is called incineration.
Or the refuse may be collected separately and disposed of. When it
is to be disposed of separately there are usually city ordinances
which require the householder to keep the garbage and ashes separate
and they are then collected by the city in separate wagons. In most
cities tall garbage cans are required and the garbage is drained and
wrapped in paper, the ashes are placed in cans or containers. They
are used for filling in low lands while the garbage is taken away and
buried or burned.

For the collection of garbage specially constructed wagons or carts
are used. The garbage must be collected frequently and at regular
intervals before it becomes decomposed and gives off objectionable
odors. The wagons must be properly cleaned for the same reason. In
the removal of ashes and other refuse, care should be taken not to
create a dust and the wagons should not leak so as to litter the
streets and alleys.




CHAPTER VIII

SCHOOL HYGIENE




SCHOOL HYGIENE


SCHOOL BUILDING

  SITE

  STAIRWAYS

  CORRIDORS

  BASEMENT

  SCHOOLROOM
    SIZE
    LIGHT WALLS
    FLOORS

  LIGHTING
    AMPLE WINDOW AREA
    SHADES HUNG FROM BOTTOM

  VENTILATION
    PURE AIR INDISPENSABLE
    EFFECTS OF VITIATED AIR
    ARTIFICIAL MEANS NECESSARY

  HEATING
    LOCAL HEATING INADEQUATE
    HOT WATER OR STEAM HEAT BEST

  SCHOOL DESKS
    ADJUSTABLE
    PROPER PLACING OF CHAIRS

  BLACKBOARDS
    SLATE, BEST MATERIAL
    LOCATION OF
    DUSTLESS CHALK

  CHARTS
   PRINTED MATTER LARGE
   GLASS SURFACES AVOIDED

  CLOAKROOM
    ONE FOR EACH CLASS
    PROVISION FOR DRYING WRAPS

  WATER SUPPLY
    AMPLE WATER
    FOUNTAINS

  TOILETS
    PROPER VENTILATION
    AUTOMATICALLY FLUSHED
    MATRON IN CHARGE


PERSONAL FACTORS

  FUNCTIONS OF SCHOOL LIFE

  AGE OF BEGINNER

  PLAY PERIODS NECESSARY

  PECULIARITIES OF CHILD CONSIDERED

  POSTURE

  RECESS
    RECREATION NECESSARY
    PLAYGROUND EQUIPMENT

  SCHOOL DIS-EASES

  PROPHYLAXIS




CHAPTER VIII

SCHOOL HYGIENE

SCHOOL BUILDING


Site

In the consideration of school hygiene we will first briefly discuss
the school building. Its site should be carefully chosen. It should
be reasonably high; the soil should be porous, if possible, and
properly drained to insure dryness. The building should not be
located near a manufacturing plant or other places where there is
much noise, smoke, gases or fumes. The buildings should be plain but
artistic, and should by all means be modern, fireproof, substantial
and sanitary.

The building should be surrounded by sufficient yard room to provide
ample playground. There should be plenty of shade but not so many
trees that there will be an interference with the sunlight and
ventilation of the grounds. Some attention should be given the
beautifying of the yards, for it must be remembered that the entire
child goes to school—physical, mental and spiritual natures must all
be developed.

The number of stories a modern school building should have is
somewhat of a mooted question; however, it is quite obvious that
there are many objections to a building of more than two stories. A
two-story building certainly is an advantage and especially is this
true when the pupils have to change for their different classrooms.


Stairways

Stairways should be of ample width, allowing pupils to pass up and
down without danger of crowding. The risers should be no more than
six inches and the treads not more than twelve inches. Where the
pupils are compelled to go from one floor to another several times a
day it is much better to have inclines instead of stairs.


Corridors

The corridors should be wide enough so that the children in passing
and repassing will not have to crowd. They should be at least ten
feet in width and should be supplied with plenty of doors for exits,
ventilation and light and also windows for ventilation and light.
When practicable the corridors should be along the north side.
This insures sufficient lighting and at the same time does not
interfere with the lighting and ventilating of the schoolroom. It is
more important that the direct rays of the sun be admitted to the
schoolroom than to the corridors.


Basement

The basement should be well protected from dampness; therefore it
should be well ventilated and properly heated, as well as arranged so
that the direct rays of the sun may reach at least a part of it.

The basement should not be used for classrooms unless it is for
machine shops, or workrooms. It should not be used for playgrounds
or gymnasium, but may be used for bathrooms and toilets. It should
occupy the entire space under the building.


The Schoolroom

In planning the building it must be remembered that the schoolroom
is the unit of the building and therefore must receive primary
consideration. The entire building should be a collection of
schoolrooms properly arranged.

The schoolroom should be about twenty-five feet by thirty feet with
not less than a thirteen foot ceiling; this size room will be large
enough for thirty pupils and no teacher should be required to take
care of more than this number in a class. There should be plenty of
entrance and exit doors for each room.

The interior of the classroom should be attractive but plain, the
surfaces smooth, the junctions of ceiling and floor with walls should
be concave. All mouldings, projections, ledges where dust and dirt
could lodge should be eliminated. The walls should be of such a color
as to absorb as little light as possible and prove least taxing to
the eyes. A light green-gray is favored. The walls must be so treated
with paint or some other method employed so as to be readily washed
or otherwise cleaned. White ceilings which reflect the light are
best. Floors are made of hard wood in narrow planks with matched
joints, or they are dovetailed. This may be laid over false floors
of boards or reinforced concrete. The walls, floors, ceilings and
partitions must be proof against sound, dampness, fire, vermin, and
dust.


Lighting

The lighting of the schoolroom, the amount of glass surface or window
area, will be governed by the aspect, the location of the building,
direction from which the light is admitted, shape of the room and
the proximity of other buildings or objects which might obstruct the
light. The window area must be ample to insure sufficient light in
every part of the room even on dark, overcast and cloudy days. The
rule is that the window area should be at least one-fourth of the
floor space and it is practically impossible to have an excessive
window area for the light may be toned down and softened by shades
and awnings. Prism glass is more practicable because it refracts the
light and gives a more even distribution over the entire room.

Most of the light should be admitted over the left shoulder of the
pupil so as to eliminate annoying shadows, but it is not necessary
that all the light come from the left. The windows should reach to
the ceiling and the height of the sill from the floor should be about
four feet. Light should never enter from the front and strike the
eyes of the pupil. The upper fourth of the window furnishes one-third
of the light, also the best light; therefore it can readily be seen
that window shades should not be hung from the top but from the
bottom, and should be rolled upward. In nature the light comes from
above, hence this being natural it is consequently best.


Ventilation

Pure air is absolutely indispensable for mental work. Much time and
energy is wasted by teacher and pupil in trying to work in vitiated
atmosphere. The educational results obtained in the school will
be influenced more than has been conceded by the character of the
air the pupil and teacher are forced to breathe. Vitiated air will
produce sluggishness, headache, listlessness, inattention, lack of
energy and a depression of mental vigor which will prevent the child
from doing his best work. The same influence will be felt by the
teacher and the result will be inefficiency in instruction.

Natural means of ventilation should not be relied upon since it is
difficult to get a sufficient amount of fresh air into the rooms in
winter time without creating objectionable drafts which interfere
with heating. Regardless of the method employed in ventilating it is
a good plan to open all of the doors and windows occasionally during
the day and flush the rooms with fresh air. At such time the children
should exercise or employ some means to prevent them from taking cold.

Schoolhouses should be provided with the combined plenum and vacuum
system and operated in conjunction with the heating plant in cold
weather. In this way the air that is admitted can be regulated not
only as to quantity, but also the velocity can be controlled and
likewise the humidity and temperature.


Heating

The relation between ventilating and heating must be kept in mind.
It is not only a question of providing a proper amount of pure air,
but also a question of the proper temperature of the air. A poorly
ventilated room is always more difficult to heat and an improperly
heated room is very difficult to ventilate. Local heating should
never be used in a schoolroom except when impossible to provide
better means.

The best arrangement for heating school buildings is hot water or
steam in connection with the ventilating system in which the air is
passed over hot radiators before being forced into the classrooms and
corridors. This is supplemented by heat from the radiators placed in
proper locations throughout the building. In this way the temperature
of the room may be kept at the proper degree and at the same time the
air circulation and the humidity properly regulated. Best work is
accomplished by the children when the temperature is kept at about
68° F.


School Desks

The furniture most important to the health of the child is the desk
and the desk chair. These should be very carefully adjusted to the
child; if this is not properly done the child will have a tendency
to assume a faulty posture which will favor the development of
curvatures of the spine and other physical defects.

The height of the desk should be such that the pupil will not find
it necessary to raise the shoulder in placing the arm on the desk to
write, or so low that he will have to bend forward. The top should
slope at an angle of about fifteen degrees. The best distance from
the eyes is from twelve to fourteen inches.

The height of the chair from the floor should be very carefully
adjusted to the student and it should allow the feet to rest
comfortably on the floor; that is, when the student is seated the
thighs should be level and the leg at right angles to the thigh, thus
allowing the feet to rest on the floor. If the chair is too low there
will be too much weight thrown on the back of the thighs while a
chair that is too high produces too much flexion of the lumbar region
of the spine. The slope of the seat should be slightly backward and
downward and the depth about two-thirds the length of the thighs. The
back of the chair should slope slightly backward and should be made
to fit the curve of the back.

The chair should be placed far enough from the desk so that the
abdomen will not touch its edge. When properly adjusted in most cases
the edge of the chair will project under the edge of the desk about
one inch. In the lower grades it is best to adjust the seats and
desks to the child twice a year.


Blackboards

The best material for blackboards is slate, which furnishes a surface
that is not shiny and will not reflect the light. They can be
washed and easily kept clean and thus lessen the nuisance of dust.
Blackboards should never be placed between windows. When possible
there should be no windows on the same wall because when pupils are
looking at the board there should be no light shining in their eyes.
The blackboards are best placed opposite the principal light.

Dustless chalk is best and the use of colored crayons made of arsenic
or sulphide of mercury should be prohibited, since the dust from
these crayons is poisonous.

The blackboards should be plainly visible to all the pupils and care
should be taken that all writing or other work on the board is large
enough for the pupils to see without eye strain. The distance of each
pupil from the board should be governed by the strength of vision.


Charts

If charts are used the printed matter should be large enough
for the pupils to read without undue strain on the eyes. Glass
surfaces should be avoided to prevent objectionable reflections
and all figures and illustrations should be plainly visible, but
objectionable bright colors and clashy combinations should be avoided.


Cloakrooms

In school buildings having no lockers the pupils must place their
wraps in a cloakroom. There should be such a room for each classroom.
The cloakroom should be well ventilated, lighted and heated and
should be connected with both the hallway and the classroom.

Special attention should be given the wet clothing and provision made
for drying the same. This can be nicely taken care of during school
hours by the janitor. Children should never be allowed to sit in damp
clothing during the school hours. All dressing-rooms, cloakrooms and
lockers should be kept clean.


Water Supply

It is very essential that an ample supply of fresh, pure water
be provided. The old drinking cup is a thing of the past, except
possibly in some of the smaller country schools, and it is fortunate
that a more modern method has taken its place. The supply fixtures,
such as the drinking fountains, should be conveniently located and in
a part of the building easily accessible to the pupils. A sufficient
number of fountains should be provided so there will be no necessity
for crowding. They should be placed in a well lighted and properly
heated portion of the building and special care taken that the
floor does not become damp and unsanitary. The fixture which allows
a constant bubbling of the water is most satisfactory, since it
eliminates the necessity for the child to operate and hence lessens
the temptation for the child to play in the water.


Toilets

Ample toilet facilities should be provided and separate toilets
arranged for the girls and boys. The toilets may be placed in the
basement of the school building, but special attention must be given
to their proper ventilation. They should be kept so clean that it
will not be necessary to use deodorizers; they should be constantly
and automatically flushed. The floors should be of cement to allow
thorough washing every day and the urinals of slate or some other
hard, non-absorbent material. In the girl’s toilet the seats of the
water closets should not be too high. Where practicable there should
be a separate toilet for the little girls and stools provided with
U-shaped seats. This will assist very materially in maintaining
cleanliness. The toilets should be well ventilated and lighted.
This is of special importance and should receive the most careful
attention. A matron should be in attendance to help care for the
kindergarten children and also those of the lower grades. The toilets
at all time should be under supervision of a competent, dependable
person.


PERSONAL FACTORS


Function of School Life

A large part of the child’s life is spent in the schoolroom and it
must be remembered that it is that part of the child’s life when
he is most susceptible to environment and is therefore most easily
influenced mentally, morally and physically. The entire child goes
to school, therefore the function of the school is to develop the
physical and moral as well as the mental.

Youth is the time of unrest and intense activity and the schoolwork
should be so arranged that the energies of childhood and youth may
be directed so as to develop the pupil into a symmetrical adult. With
such intense activity a great amount of energy is used up; thus it is
clear that the child needs plenty of sleep and the proper amount of
good, nourishing food and if he is deprived of these he can not do
his best work mentally.


Age of Beginner

We have not yet fully realized that our present school system, well
organized as it is, has certain ill effects on the health of the
children. Many of the reasons are peculiar to the circumstance under
which the child must attend school and can not be relieved, but
there are many that can be corrected and in time will be. Children
are often sent to school at too early an age and as a result the
growth is retarded and in some cases results in an actual defective
physical development. The physical development is often retarded
by prolonged fatigue. This fatigue may be the result of improper
ventilation, forced attention to subjects that are too difficult,
strict discipline, lack of sufficient relaxation and many other
factors connected with the ordinary school.

One of the greatest mistakes in our modern system of education is
sending the child to school too young. Six years of age is plenty
young; seven years old is better. Even at this age some are not
sufficiently sturdy to endure the mental and physical strain of the
schoolroom and the application to the studies that is usually exacted
of them.


Play Periods Necessary

The school affords an environment that is entirely different from
that which the child has been accustomed to; therefore the beginner
should be allowed much liberty and should not be compelled to
remain in his seat more than one-third of the time. This should be
divided into short intervals, alternating work and play. It must
be remembered that the small child is active; therefore it is
imperative that he be given various exercises that will call into
play the different muscles of his body. This will have a tendency to
relieve the fatigue from sitting at the desk. When children first
start to school they usually lose weight and become more or less
nervous during the first few days or weeks.

The child should be allowed sufficient free time during each day for
play and for the development of initiative. The amount of home work
required should be very carefully considered and regulated according
to the capacity and ability of the child; yet care must be taken or
the especially bright child will be overworked and will not be given
enough time for play and the development of a real childhood.


Peculiarities of Child Considered

The peculiarities of the child should be considered and the
curriculum arranged accordingly. The methods of study should receive
proper consideration as well as the methods of teaching. Special
classes should be arranged for the backward students. Many cases of
backwardness or mental deficiency are due to the child’s inability
to see clearly or hear distinctly, and when these conditions are
corrected the child will be normally bright. Many times a child is
unjustly disciplined because of some physical defect or handicap
which should be corrected.

Statistics show that tests and examinations have a detrimental
effect upon the health of the pupils. Experiments have shown that
children lose weight during such tests and examinations; that they
are restless at night and suffer loss of appetite. All these have a
bearing upon the health of the child.


Posture

Attention should be given the habits of the children and especially
the posture of the child as he sits in the seat at his desk. A faulty
posture may result in an adaptative curvature of the spine which
in later years will do much harm. The sitting posture is of more
importance than the standing posture since the child sits so much
more than he stands.

The pupil should not be allowed to sit in a stooped position over
his desk as this cramps the chest and interferes with respiration,
makes the heart action labored and produces round shoulders; it also
tends to produce a kyphosis in the dorsal region of the spine. If
a child persists in sitting in this stooped position and finds it
difficult to sit in the proper position, attention should be given
the spine, for subluxations will be found which are interfering with
the transmission of mental impulses to the muscles of the back, thus
making it difficult for the child to sit in the normal posture. Or it
may be defective eyes which make it difficult for the child to see
his work and he therefore stoops that the work may be brought nearer
the eyes. In this case a cervical subluxation will be found and when
properly adjusted no more trouble will be experienced. It may be
this tendency to stoop is the result of fatigue; to overcome this
he should be given periods of rest and relaxation from time to time
during school hours; or this fatigue may be due to poor elimination
from the kidney place subluxations.


Recess

During the morning and afternoon sessions the pupils should be
given a recess for fifteen or twenty minutes, and when the weather
will permit all the children should be required to go outdoors and
engage in some form of play or exercise, properly supervised by a
thoroughly competent individual. This will not only benefit the
pupils physically, but will also make the mind more active and aid
very materially in their mental development. In addition to this
exercise, some time during the day the windows should be opened,
except possibly in extremely cold weather, and the teacher and pupils
should engage in some form of calisthenics. This will tend to keep
the pupils in a fit physical condition and mentally alert for the
balance of the day.

The school grounds should be provided with modern equipment for
the proper development of the children physically and should be
supervised by kind and well trained attendants. Every school should
have a well equipped and properly supervised gymnasium.


School Dis-eases

At one time the school was thought to be largely responsible for the
spread of dis-eases among children, but this idea is changing in
later years. In reality there are no specific school dis-eases. The
dis-eases that have been so referred to are merely those abnormal
conditions incident to childhood and youth. Rosenau gives a very
interesting article on this subject. He says: “Parents naturally
come to regard the school as a veritable pesthouse for the spread
of communicable dis-eases of childhood—especially measles, whooping
cough, mumps, diphtheria, scarlet fever, common colds, etc. Many of
these dis-eases prevail in epidemic form during the summer time,
when school is closed, and under other circumstances which show the
epidemics may be independent of school attendance. It is difficult to
determine just what part is played by the commingling of the pupils
in school in the spread of such dis-eases and what part is due to
other factors. Some dis-eases take a sudden jump in the autumn with
the opening of school. Further, these dis-eases are not contracted by
the school children alone, but are carried home to the other members
of the household, and thereby create secondary foci. This problem
of the communicable dis-eases and the school is far from solution;
the spread of these dis-eases has not been conquered by medical
inspection, and their relation to school attendance is one that needs
careful observation and study.”

Thus we see that the cause of school dis-eases has not been answered,
and we find in this article that which strengthens the contention of
Chiropractic—that the cause of the dis-ease is in the child and not
something introduced from the outside.

The environment of the school creates a necessity for certain
internal adaptative actions, and if this adaptative action can not
take place the result will be an abnormal condition peculiar to
the necessity for adaptation. The lack of adaptation may result in
incoördinations of the respiratory tract; incoördinations of the
eyes, involving not only the sight but the different tissues and
secretions of the eyes; incoördinations involving the heart, throat
and mouth and many conditions of eruptions of the skin. Especially
do we find deformities and incoördinations of the spine and spinal
column.

In diagnostic terminology these conditions would be called
bronchitis, bronchopneumonia, pleurisy, myopia, catarrhal
conjunctivitis, trachoma, cardiac dis-eases, such as endocarditis,
etc. The mouth, nose and throat dis-eases would be coryza, adenoid
growths, enlarged tonsils, tonsilitis, nose bleed, etc. These
conditions could all be prevented or corrected by adjusting the
causative subluxations.


Prophylaxis

It is not necessary for us to go into an explanation of the spinal
column and how subluxations are produced. It is sufficient at this
time to call the student’s attention to the fact that subluxations
are often produced, and especially is this true during childhood.
The children are subject to falls during their play at school and
they are most likely to produce subluxations. This being true,
the children should be analyzed periodically to determine the
subluxations and then they should be adjusted. When parents realize
the good that is to come from such procedure they will take their
children to the chiropractor and have their spine palpated and the
subluxations adjusted. When this becomes a universal practice there
will be a marked decrease in the so-called school dis-eases or
children’s dis-eases.




CHAPTER IX

INDUSTRIAL HYGIENE




INDUSTRIAL HYGIENE


GENERAL CONSIDERATIONS

  DEFINITIONS
    NECESSITY FOR INDUSTRIAL HYGIENE
    PROPER ENVIRONMENT

  EFFECT OF OCCUPATION UPON HEALTH

  PERSONAL FACTORS

  CHOICE OF OCCUPATION
    IDIOSYNCRASIES CONSIDERED
    SEX REGARDED

  EFFECT OF LABOR UPON CHILDREN
    MAY CAUSE CURVATURES
    CHILD LABOR PROHIBITED

  PLACE OF WORK

  EFFECT OF POSTURE
    SEDENTARY OCCUPATIONS
    ACTIVE OCCUPATIONS

  FATIGUE
    HOW PRODUCED
    RESULT


HYGIENE AND SANITATION OF INDUSTRIAL ESTABLISHMENTS

  SPACE PER INDIVIDUAL

  CHARACTER OF BUILDING

  LIGHTING, HEATING AND VENTILATING WORK PLACES
    LIGHTING
    TEMPERATURE
    HUMIDITY
    AIR PRESSURE
    LOCATION OF WORK

  INDUSTRIAL DUSTS
    MECHANICAL VENTILATION
    CLASSIFICATION OF DUSTY TRADES


INDUSTRIAL POISONS

  LEAD POISONING
    SYMPTOMS
    PREVENTIVE METHODS

  ARSENIC POISONING
    SYMPTOMS
    WHERE USED

  MERCURIAL POISONING
    SYMPTOMS
    HOW CONTRACTED
    PREVENTIVE METHODS

  PHOSPHORUS POISONING
    TWO VARIETIES
    SYMPTOMS
    WORKERS AFFECTED

  CHROMIUM POISONING
    HOW CONTRACTED
    PARTS AFFECTED




CHAPTER IX

INDUSTRIAL HYGIENE

GENERAL CONSIDERATION


Definition

That branch of hygiene dealing with industries is of very great
importance. This will be readily recognized when we consider that
practically the entire population is involved in some sort of gainful
occupation.

Industrial hygiene is concerned in creating conditions in industry
which will prevent accidents, promote public and personal health
by eliminating adverse influences, and in creating environmental
conditions which will prolong the worker’s life by improving the
conditions under which he labors. Public health, mortality and
morbidity are influenced more by the environmental conditions in
the occupations than by any other factor in human life. At least
two-thirds of the entire human life is spent in some occupation and
the danger of life, limb and health is well known to all.

The various industries differ largely in their effects upon the
workers, the mortality in some being greater than in others;
accidents are more numerous in some than others, some occupations
being more hazardous. Some dis-eases occur more frequently in certain
occupations. The environment may necessitate a greater adaptation in
one part of the body than in another; a very dusty work, for example,
will affect the respiratory tract while another occupation will
affect a different part of the body.


Effect of Occupation upon Health

It is obvious that occupations have a certain effect upon the
adaptative processes of the body as well as producing traumatic
conditions from accidents, which result in total or partial
disability, sudden death, or acute or chronic conditions from
poisoning for example. In the industries there may be such adverse
environments as to draw so heavily upon the adaptative forces that
the body will be reduced to a greatly weakened state. The personal
health of the individual enters as a conditioning factor, as well as
do his peculiarities and personal weaknesses.


Personal Factors

The individual with low vitality, poor nutrition and poor elimination
will be affected to a greater extent in some occupations than in
others. The person with a subluxation at lung place, lessening
the resistance of the tissues in this zone, will find that an
occupation which necessitates breathing air laden with dust will
affect the lungs because of their already weakened condition. Many
accidents which jeopardize the health and life of workers result from
carelessness or from a lack of knowledge about the devices employed.


Choice of Occupation

Great care should be exercised in the choice of an occupation.
This should not be left to chance nor to the ignorant fancy of the
youth. The occupations which will best suit the idiosyncrasies of
the individual both mentally and physically should be selected. Many
lives are shortened because of the unwise choice of occupation. The
individual with defective lungs should not select a dusty trade, nor
the physically weak person a trade which requires an enormous amount
of muscular strength. In other words, a trade should be carefully
selected with a view to the weak and strong points of the individual.

In this question of a choice in employment the sex should be taken
into consideration. While there are many occupations in which women
are as competent or more competent than men, yet there are several
factors to be weighed. Taken as a general rule, women are not as
strong physically as men. There are some occupations which have a
very detrimental effect upon the reproductive organs. Statistics
show that women are more easily affected by industrial poisons than
men. Congestion of the reproductive organs during menstruation is
increased and if women are compelled to work at certain occupations
during this menstrual period, they will certainly find it detrimental
to their health.

It is a recognized fact, according to many authorities on the
subject, that there is a larger percentage of abortions and
miscarriages among women in industries than among women in domestic
life. The infant mortality is also very much higher. Many abortions
and miscarriages result from the effects of industrial poisoning, as
well as from heavy and continuous work.


Effect of Labor upon Children

The most injurious effects from occupation are those upon children
since they are more susceptible to the ill effects than adults. The
child should have every advantage for the development of all parts of
his body that there may be no interference with its proper growth.
Attention should be given to his mental and moral development. These
things can not receive proper attention if the child is forced to
labor under adverse conditions just at the time when the body is
developing.

Many occupations are such that curvatures of the spine are produced
and different parts of the body overtaxed. Child labor should be
prohibited. There is no labor so expensive to our country as child
labor. If our children are not given an opportunity to develop
physically, mentally and morally, we will suffer in citizenship in
the next generation. There is bound to be a deterioration from such
procedure.

The organs of the child are peculiarly susceptible to the effects
of overwork and fatigue; the entire body is in the process of
development and its development may be retarded and its growth
seriously hindered. It is a most excellent thing to keep the child
employed and active, but there certainly should be a means of
protecting him from the avarice and greed of heartless employers. The
best way to do this is to keep him out of gainful employment until
there has been sufficient physical development to insure against
overtaxing the young body.


Place of Work

The influence of the occupation upon health will be governed not
only by the character of the work, but also by the environment in
which the work is performed. Whether it is indoor or outdoor work,
whether it is an active or sedentary occupation, and whether there
are extremes in the temperature, humidity, air pressure or light, or
whether the work is on the surface or below it as in mines, are all
factors. The position of the worker, the length of the working hours,
the physical, mental and nervous strain all have a bearing on health.
Outdoor work is preferred, especially for those who are inclined to
pulmonary or respiratory disorders, because of the difference in the
purity of the air. Outdoor workers suffer less from fatigue and their
mortality rate is lower.


Effect of Posture

Posture of the workman is not without its effect upon the health and
its bearing upon industrial hygiene is very important. There are
many conditions that have their beginning in the occupation, such as
faulty development of different parts of the body, curvatures of the
spine, and especially those which are adaptative. Many subluxations
are produced by posture assumed during long hours of work. In
analyzing such cases chiropractically, the history of the occupation
and the posture assumed should be carefully considered so that in
adjusting the subluxated vertebrae there may be no opposition to
the adaptative processes of Innate Intelligence in her endeavor to
compensate for the faulty posture.

Sedentary occupations such as typing, bookkeeping, shoe-making,
engraving and tailoring result in lack of muscular activity and
produce characteristic occupational disorders and deformities. It is
not natural for an individual to remain in any one posture for the
greater part of the day. Innate needs to have the body more or less
active so that the proper adaptative processes can be carried on
within the body.

Sitting constantly at a desk will create a tendency to stooped
shoulders and thus cramp the respiratory organs. The result will
be a lack of proper oxygenation of the blood which will have its
effect upon the metabolic processes of the body. There will be a
sluggishness of the liver and other vital organs, and a tendency to
anemia, constipation, general lack of muscular tone and low vitality.

Active occupations exercise the natural processes of the body and
create a necessity for the action of Innate in all parts of the
body. Activity keeps the muscles in tone and makes the processes of
elimination more active. Activity is one of Nature’s laws and is
essential in the vital expressions of life in the body. This is shown
by the provisions Nature has made for such activity. Especially are
the active occupations to be preferred over the sedentary for young
people and for those up to the age of forty-five or fifty. After this
age the sedentary occupations are not so detrimental.


Fatigue

Fatigue comes as a result of overwork and is a purely personal factor
since the amount of work that may be performed before producing
fatigue will vary in different individuals. Fatigue is produced
by an accumulation of toxines and waste material in the body when
katabolism is greater than anabolism. This may be brought on by
overtaxing the body to the point where it is impossible for Innate
Intelligence to rebuild the tissues as rapidly as they are being torn
down. It can readily be seen that if there should be an accumulation
of waste material from faulty metabolism due to interference with
transmission, fatigue would be produced sooner and with less work
than in the individual normally excreting the poisons.

If one part of the body or one set of muscles is overworked fatigue
neurosis will be produced. There may be loss of motor function due,
not to interference with transmission of motor mental impulses,
but to the fact that the organ, usually a muscle, becomes an
unfit medium for the expression of the mental impulses. A good
illustration of this is writer’s cramp, and cramps among typesetters
and telegraphers. In these cases, however, there are usually local
subluxations that should be adjusted.


HYGIENE AND SANITATION OF INDUSTRIAL ESTABLISHMENTS


Space Per Individual

In some states the legislatures have established a minimum of 400
cubic feet of space for each individual, but this is not sufficient
in some occupations and under some conditions. The amount of space
per workman must of necessity be governed by several factors: namely,
character of the work performed, character of the building, the
hygienic conditions of same, the type of ventilation used, whether
natural or mechanical, and the methods of heating and lighting. In
some trades and under certain conditions 1000 cubic feet space per
workman would not be excessive.


Character of Buildings

When practicable the building should be constructed especially for
the kind of work to be carried on within. It should be fireproof and
of a material that will lend to the hygienic demands in industry.

We do not want to pass over this subject without calling the
student’s attention to the effect which may be produced by the
physical, mental and nervous strain under which the work is
performed. If the worker is under great tension a great amount of
energy will be used up and fatigue will appear early. This will
have a marked effect upon the individual and tend to lessen his
efficiency. If work is performed under great physical strain, the
muscular activity is greater than the muscles are able to express.
Then there will be not only fatigue but actual injury done the
muscles and other structures. Under such conditions the vital organs
will also be overtaxed. This may result in dilatation of the heart,
hernia, aneurysms, or in a general weakened condition of the body.
The results of mental strain, responsibility and worry are not
without their adverse effects.


Lighting, Heating and Ventilating Work Places

Industrial hygiene should be concerned about the temperature,
humidity, air pressure, light, ventilation, and heating of the work
place. The building should be well lighted. If possible natural
light should be provided even though the first cost is considerably
greater than that of artificial lighting. There will not only be a
better grade of work done in natural light and with less eye strain,
but the general health of the workmen will be better. If artificial
lighting is used it should be electric light, since it produces less
impurities and provides a more even light. The light should be evenly
distributed and of a proper distance from workmen so that it will
not be reflected directly into their eyes. If the occupation takes
the worker out of doors then these features can not be controlled,
but in this event attention must be given to the clothing of the
workman. Sudden changes in the temperature should be avoided as much
as possible. Innate is capable of adapting the body to extremes in
temperature, but must be given a sufficient amount of time in which
to bring about these changes. Men may work in the frigid temperature
or in the torrid temperature and if properly clothed and acclimated
will suffer no ill effects.

In many industries the laborers are forced to work in artificially
high temperatures. Blast-furnace workers, glass blowers, miners,
bakers, and stokers must remain in extremely high temperatures.
The body may be adapted to such temperature, but the effect of
the continued expenditure of energy necessary to bring about
this adaptation will show adverse effects upon the body. There
is a tendency to respiratory disorders and a thickening of the
blood plasma which disrupts the circulatory system. Heat also has
a detrimental effect upon the eyes and there is a tendency to
rheumatism.

Air of a high relative humidity is objectionable from a hygienic
standpoint because it interferes with perspiration and evaporation.
Workers constantly exposed to atmosphere that is too damp will
have a tendency to incoördinations involving the bodily secretions
and respiratory disorders. The ill effects of such an environment
are rather marked and if it is necessary to maintain a high
relative humidity because of the processes carried on there must be
special provision to guard the health of the workers. This may be
accomplished by short hours and frequent periods of rest and relief
from the high humidity.

Normal air pressure is fifteen pounds to the square inch, but there
are many industries in which the work must be done under a greater
or a less pressure. Mountain climbers are subjected to decreased
air pressure while caisson workers and divers must work under
greatly increased air pressure. Decreased air pressure is especially
detrimental to those suffering from cardiac disorders, and may in
some cases result in death. The effects of increased air pressure
have been elaborated upon in another chapter and the student is
referred to that section.

The location of the work is important. Subsurface work is more
detrimental to health than surface work unless special precautions
have been taken to make the place of work conducive to the expression
of life. Subsurface workers such as miners are subjected to great
heat, lack of proper light and ventilation, accumulated gases,
dampness and poisons. There is also greater danger from accidents and
explosions.


Industrial Dusts

In a trade in which much dust is produced there should be proper
mechanical ventilation. The vacuum and plenum system should be
employed. There is no factor in the industrial life more detrimental
to the workman than that forcing him to breathe vitiated air laden
with dust and other impurities produced by the processes employed in
the trades.

The extremely dusty trades should be separated from the less dusty
ones and special provision made to carry away the dust. It is often
possible to substitute machinery for handwork in these trades. When
the laborers are forced to work in very thick dust they may be
protected in a measure by the use of respirators worn over the mouth
and nose. These will catch some of the dust and act as filters.

It is often possible to place hoods directly above the machines in
these trades and by means of a vacuum fan the dust is carried out
through tubes.

The effects of dust upon the worker depend upon many factors.
These might, however, be classified as conditioning factors in the
individual and the character of the dust inhaled.

Dust from metals and minerals may produce mechanical injury to
the membrane of the respiratory tract because of the sharp edges.
Inhalation of dust might also bring about catarrhal conditions and
coughs. There may be deposits of dust in the bronchi and even in the
parenchyma of the lungs from long exposure to and inhalation of
dust. This may result in consolidation and other conditions which may
be purely adaptative on the part of Innate Intelligence to compensate
for the presence of the foreign substances.

In F. Hoffman’s Bulletin of the Bureau of Labor, Vol. LXXIX, he
gives the following classification of dusty trades according to the
character of the dust produced:

  “=Group I=—Exposure to Metallic Dust: Grinders, polishers, tool and
  instrument makers, jewelers, gold leaf and brass workers, printers,
  engravers and pressmen.

  “=Group II=—Exposure to Mineral Dust: Stone, marble and cement
  workers, glass blowers, glass cutters, diamond cutters, potters,
  plasterers, paperhangers, moulders, core makers and lithographers.

  “=Group III=—Exposure to Vegetable-fiber Dust: Cotton ginning,
  textile, linen, hemp, cordage and paper manufacturers, weavers,
  spinners, hosiery knitters, lace makers, jute and wood workers.

  “=Group IV=—Exposure to Animal and Mixed Dust: Furriers,
  taxidermists, hatters, silk, wool, and worsted workers, carpet,
  rug, rag, and shoddy workers, hair mattress workers and
  upholsterers.”

The mortality rate from pulmonary tuberculosis and other respiratory
incoördinations is very high in the dusty trades.


INDUSTRIAL POISONS

In the case of poisonous gases and fumes the necessity becomes
even greater for proper prophylactic measures. The methods used
in dusty trades may be here employed, but with greater care. All
poisonous materials should be eliminated as far as possible and less
objectionable material substituted. This may be done in a great many
instances without decreasing the value of the article manufactured.
An illustration of this is in the substitution of red phosphorus for
the use of the more poisonous yellow phosphorus in the manufacture of
matches. This eliminates danger from phosphorus poisoning.

Price states: “The chief industrial poisons are lead, arsenic and
mercury, although phosphorus, copper, zinc, brass, and chromium
poisoning are frequently met with in various industries.”


Lead Poisoning

The symptoms produced by lead poisoning are: lead colic in acute
cases, loss of appetite, cramps, pain in the joints. There will be
bluish lines found along the edge of the gums; wrist drop and loss of
motor function in the hands and feet; arteriosclerosis, indigestion,
restlessness during sleep, anemia, lead palsy, loss of strength and
weight and constipation. The patient experiences a disagreeable
sweetish taste, and there will be a grayish pallor and pinched
expression of the face. In severe cases there may be blindness, great
fatigue, apoplexy, insanity and death.

The greatest danger from lead comes in the form of dust or fumes
and therefore the poison enters the body principally through the
respiratory tract, but it may enter through the digestive tract and
through the skin.

Prophylactic measures include devices to protect the workmen by means
of respirators, but special effort should be made to keep the air in
the breathing zone free from the dust and fumes. Since the poison may
be taken in through the skin, special provision should be made to
protect the hands and arms in fingering the materials. The workmen
should exercise the greatest cleanliness and precaution to prevent
ingestion of the lead into the digestive tract. Care should be taken
that it is not brought into the mouth by the fingers or by pipe, for
example. There is a high mortality from pulmonary tuberculosis among
lead workers.


Arsenic Poisoning

The mouth, lungs and skin are the portals of entry for arsenic
into the body. Arsenic poisoning is characterized by catarrhal
inflammation of the eyes and respiratory tract, anemia, neuritis,
gastritis, and degenerative changes in the liver and kidneys. Many of
the symptoms of arsenic poisoning resemble those of lead poisoning
such as gastric disturbances, anorexia, anemia and loss of strength.
There may be progressive muscular atrophy, eczematous eruptions and
ulcers of the lips, nostrils and in the folds of the skin.

Arsenic is used in the manufacture of wall paper, artificial flowers,
textile fabrics; by taxidermists and as a preservative for hides; it
is also used in different preparations to kill insects and parasites.


Mercurial Poisoning

Mercury enters the body through the digestive and respiratory tracts
and through the skin. The symptoms usually manifest in this kind of
industrial poisoning are headache, gastric disturbances, stomatitis,
metallic taste in the mouth and fetid breath; there is swelling and
ulceration of the gums that cause the teeth to become loose, and
there may be an excessive flow of saliva with a swelling of the
submaxillary glands. In severe cases there may be tremors, paralysis,
melancholy and loss of memory.

Mercury is used in the manufacture of incandescent lamps where
they employ mercury pumps, in the manufacture of barometers and
thermometers, in the felt and fur industries, in the manufacture of
pharmaceutical preparations and chemical works, and in photography.

Methods used to prevent mercurial poisoning are almost identical with
those used in lead poisoning. Special devices should be provided to
keep the air in the breathing zone free from the fumes. This can
best be accomplished by providing a proper system of mechanical
ventilation. The workmen should wear rubber gloves to lessen the
possibilities of the absorption through the skin. The workmen should
also practice cleanliness and exercise care that mercury is not
carried into the mouth by the hands which should be thoroughly washed
before eating.


Phosphorus Poisoning

The industrial poison of next importance is phosphorus. This
poisoning is confined almost entirely to the match industry.
There are two kinds of phosphorus, the yellow or white, and the
amorphous or red. The yellow is poisonous and is used in making the
“strike anywhere” matches. This, however, is being replaced by the
non-poisonous, or more harmless red phosphorus. The safety matches
contain no phosphorus and are harmless.

Phosphorus poisoning produces gastric disturbances, bronchial catarrh
and caries of the teeth with necrosis of the lower maxillary. Other
bones of the body may also be affected by necrosis.

Brass, copper, zinc, and bronze workers are also affected by the
dust and fumes from these poisons. Brass workers suffer with brass
founders’ ague in which there are chills, vomiting, headache and
general depression.


Chromium Poisoning

Chromium is also responsible for industrial poisoning. It is used
in the manufacture of dyes and in the coloring of wall paper and
fabrics. It affects the mucous membrane lining the nose and throat
and produces an inflammation of the eyes and ulceration of the skin.




CHAPTER X

DEFINITIONS


DEFINITIONS

  DIS-EASE
  CLASSIFICATION
  ACUTE AND CHRONIC
  STAGE OF EXPOSURE
  PERIOD OF INFECTION
  STAGE OF INCUBATION
  PERIOD OF INVASION
  DEGREE OF INFECTION
  CONTAGIOUS
  INFECTIOUS
  MORBIFIC AGENTS
  PATHOGENIC GERMS
  NON-PATHOGENIC GERMS
  COMMUNICABILITY
  HOST
  PARASITES
  COMMENSAL
  ANTIBIOSIS
  SYMBIOSIS
  ANTIBODIES
  ANTIGENS
  SAPROPHYTES
  OBLIGATE SAPROPHYTES
  SEPTICEMIA
  TOXEMIA
  SAPREMIA
  EPIDEMIC
  ENDEMIC
  SPORADIC
  PANDEMIC
  FOMITES




CHAPTER X

DEFINITIONS


Dis-ease

Webster defines dis-ease as, “an alteration in the state of the body
or of some of its organs, interrupting or disturbing the performance
of the vital functions, or a particular instance or cause of this;
any departure from the state of health presenting marked symptoms.”
In using this word chiropractically it is always hyphenated to
indicate that it is a condition wherein there is a lack of ease.
Incoördination is the term used in Chiropractic, meaning a lack of
coördinate action in the body which is caused by interference with
transmission of mental impulses.


Classification

Dis-eases are usually classified as constitutional and environmental.
A constitutional dis-ease is one that is due to defects in the
structures of the body such as dis-ease of digestion, while
environmental dis-eases are attributed to extrinsic environmental
conditions. The infectious dis-eases are given in this class.
Chiropractically all dis-eases are brought on by interference with
transmission of mental impulses caused by defective mechanism
of the spinal column. The so-called environmental dis-eases
are chiropractically the result of the lack of adaptation to
environmental conditions.


Acute and Chronic

Dis-eases are also considered to be acute or chronic. A dis-ease is
in the acute stage when there is a “hot box” found at the causative
subluxation. When adaptation has taken place and the “hot box” has
disappeared, the condition is in the stage of chronicity. Taut
fibers will then be present and by their presence the palpation and
location of the major subluxation may be verified.

It is well for the student to understand what is meant by such
expressions as the stage of exposure, the period of infection, the
stage of incubation, the period of invasion, the degree of infection,
even though we have no particular reason to use such terms in our
chiropractic explanations of dis-ease.


Stage of Exposure

The time during which the person is exposed to the morbific agents is
known as the stage of exposure.


Period of Infection

The period of infection is the time during which the pathogenic germs
actually enter the body.


Stage of Incubation

The stage of incubation is the time during which the morbific agents
develop within the body and for the time being have overcome the
natural resistance. The incubation period varies greatly in different
so-called contagious dis-eases, it being governed largely by the
character of the invading germs and the general health of the patient.


Period of Invasion

The time during which the germs remain in the body is called the
period of invasion.


Degree of Infection

The vital resistance of the body, the portal of entry and the
character of the invading germs determines the degree of infection.

We wish again to call the student’s attention to the fact that these
expressions are not used chiropractically to explain the cause of
dis-ease nor the different stages through which dis-ease passes.


Contagious

A contagious dis-ease is one that is thought to be transferred from
one individual to another by personal contact. From the etymology
of the term (contingere, to touch) we would conclude that only such
dis-eases as syphilis would come under this category. But as the
term is generally understood it includes such dis-eases as smallpox,
measles and chickenpox.


Infectious

An infectious dis-ease is one that is supposed to be conveyed from
one individual to another indirectly through some medium. Typhoid
fever has been given as an infectious dis-ease.

Today it is generally considered that the terms, contagious and
infectious, do not have a precise meaning which will scientifically
differentiate them, for most of the so-called communicable dis-eases
may be conveyed in many different ways. The so-called infectious
dis-eases may be contagious and the so-called contagious dis-eases
are infectious; so we see the terms lack scientific precision and
this has led to confusion many times.


Morbific Agents

Morbific agents are those agents which are thought capable of
producing dis-ease when introduced into the body. They are of
vegetable or animal origin. Those of vegetable origin are classed
under the general name of bacteria. The most important are named
according to their form. Those of the spherical shape are known as
cocci; the elongated, rod-like form, as bacilli; and those of spiral
form, as spirilli. The streptococcus pyogenes, pneumococcus and
gonococcus are illustrations of the cocci. The most common pathogenic
bacilli are bacillus anthracis, bacillus tetani, bacillus typhosus,
bacillus tuberculosis and bacillus influenzæ. The most usual
spirilla are vibrio cholera asiatica, spirillum of relapsing fever
and spirochæta pallida. Pathogenic action of germs upon the body may
be mechanical, biological or chemical. The mechanical action is an
interference with the physiological activity of the organs, causing
stasis and hemorrhage. The biological action causes inflammation,
infiltration and abscesses in the tissues. The chemical action is the
result of the toxins formed by the action of the germs. This is by
far the most important action.


Pathogenic Germs

Microörganisms are spoken of as being pathogenic and non-pathogenic
according to the adaptative action produced by Innate Intelligence
when they are introduced into the body. Pathogenic germs are those
which will do harm to the host when introduced under certain
circumstances. It has been demonstrated that a germ may be pathogenic
to one host and non-pathogenic to another. A germ may be pathogenic
to a host at one time and not at another, showing that immunity is
not constant in the same individual. The pathogenicity of a germ
depends upon the host and not upon the germ. Chiropractic has proven
that germs will not harm the body unless there is interference with
the transmission of mental impulses so that Innate Intelligence can
not bring about the proper adaptative action to the presence of the
germs.


Non-Pathogenic Germs

When there is complete adaptative action on the part of Innate
Intelligence and the germs are excreted immediately without the
production of symptoms or ill effects to the body, the germs are said
to be non-pathogenic. This is not so much because of the character
of the germs but because of the ability of Innate to excrete them as
waste material.


Communicability

This term refers to the ease with which the germs pass from one
host to another. Chiropractic has proven the fallacy of the theory
that dis-ease is produced in this way. Patients become ill with the
so-called communicable dis-eases and are not exposed to the germs
that are supposed to cause the dis-ease. It is also a proven fact
that the so-called germ dis-eases develop in many cases in which
there are no germs to be found in the pathological tissue.


Host

The host is an organism which affords lodgment and sustenance to
parasite and commensal organisms. The invading organisms may be
beneficial, they may be harmful or they may produce no effect.


Parasites

Parasites are those living organisms, either plant or animal, which
live in, on, or with some other living organism, known as the host,
from which they obtain their food, shelter and other advantages.
They are of two classes—ectoparasites and endoparasites—and may be
either plant or animal organisms. An ectoparasite is one that lives
upon the outside of another living organism known as the host. The
endoparasite is one that lives within the body of the host.


Commensal

A commensal is an organism which lives in or on another organism and
shares the shelter and partakes of the same food as the host, but is
not in reality a parasite. It is a close association of two organisms
for the benefit of one or both.


Antibiosis

This is a form of parasitism which is harmful to either host or
parasite or to both. By this process of antibiosis water may be
purified of many of the pathogenic germs. It is also maintained that
in many instances there is but one major condition in the body at one
time as a result of this process.


Symbiosis

In this form of parasitism the organisms are dissimilar, but neither
is harmful to the other while the state is beneficial to one or
both. Symbiosis will result in one condition becoming conducive to
another condition as, for example, presence of certain microörganisms
favors the development of tetanus. Germs are sometimes cultivated in
symbiosis with other germs. This has been done with the germs that
are found in leprosy.


Antibodies

Antibodies are bodies as the term would indicate, but refers to
specific properties of the blood supposed to be produced by antigens
and thought to accomplish a certain degree of immunity.


Antigens

Antigens are the substances which produce the antibodies in the
blood and body fluids. These are merely terms used to designate the
mechanism of immunity.


Saprophytes

Saprophytes are microscopic organisms which feed upon dead organic
matter. A saprophyte is a vegetable organism.


Obligate Saprophytes

Obligate saprophytes are saprophytes which can not be made to develop
under any circumstances in living tissue, but will develop in dead
tissue in which they produce toxins. The diphtheria and tetanus
bacilli develop in a localized area of dead tissue and produce the
toxins peculiar to this condition.


Septicemia

Septicemia is a condition wherein so-called pathogenic bacteria and
their accompanying poisons are present in the blood. These bacteria
may develop within the blood or they may be carried into the blood
from some local point where they are developing due to the condition
of the tissues as a result of interference with transmission of
mental impulses.


Toxemia

Toxemia is a condition caused by the absorption of toxins from the
bacterial activity. This is commonly known as blood poisoning.


Sapremia

Sapremia is a condition wherein the blood contains the putrefactive
products of saprophytic and non-pathogenic bacteria.


Epidemic

When a great number of people are affected in a community by the same
dis-ease in a short period of time it is said to be an epidemic. An
epidemic is said to obtain when dis-ease breaks out suddenly and
involves a number of persons at one time. There is a wide difference
of opinion as to the percentage of individuals necessarily involved
to constitute an epidemic.


Endemic

A dis-ease that is limited to a certain class of people or peculiar
to a certain locality or district is said to be endemic. Endemic
differs from epidemic in that epidemic refers to a dis-ease that is
more or less constantly present.


Sporadic

A dis-ease occurring singly or affecting only a few people is said to
be sporadic.


Pandemic

When an epidemic involves a large number of people in a large number
of countries, it is known as pandemic. There is a question as to
whether or not the word can ever be properly used. It is claimed that
the influenza epidemic of 1918-19 could really be considered pandemic
in view of the fact that the condition was found in all countries.

These terms are used very loosely and are applied largely to suit the
circumstances. A number of cases of a so-called contagious dis-ease
occurring about the same time in a community may be considered an
epidemic by some. There is no established rule designating the
percentage of individuals that must be affected by the same condition
in order that an epidemic may be established. An endemic dis-ease may
become epidemic at certain times of the year or when a greater number
of people than usual become affected. A sporadic dis-ease may become
epidemic when a greater number of people become affected.


Fomites

Fomites are substances capable of absorbing and retaining infectious
germs. The term is applied to inanimate objects and usually refers
to bedding, especially mattresses, clothing and more particularly to
woolen clothing. Such vectors, however, are not now receiving as much
consideration as they did previously. It is no longer thought that
such objects as books and furniture play any particular part in the
spreading of so-called infectious dis-ease.

The foregoing definitions will give the student understanding of the
terminology in general use. We will now take up a consideration of
the study of the subject proper of immunity.




CHAPTER XI

IMMUNITY




IMMUNITY


  DEFINED

  NATURAL

  ACQUIRED
      ACTIVE
      PASSIVE

  EXHAUSTIVE THEORY OF PASTEUR

  RETENTION THEORY OF CHAVEAU

  VARIOUS THEORIES

  ADAPTABILITY OF THE BODY
      ENVIRONMENTAL CONDITIONS
      CARRYING CAPACITY OF THE NERVES
      RESERVE ENERGY
      VITAL RESISTANCE
      REDUCED CARRYING CAPACITY OF NERVES
      INTERFERENCE WITH TRANSMISSION

  DIS-EASE THE CAUSE OF GERMS




CHAPTER XI

IMMUNITY


Defined

Immunity is defined as the ability of Innate Intelligence to maintain
metabolic equilibrium in the body in the environments in which man
finds himself; or that power of Innate Intelligence to rid the
living body of poisons and invading organisms; or that resistance
which is accomplished through the expression of mental impulses in
the tissue cells whereby all invading microörganisms or toxins are
expelled from the body, thereby enabling the normal expression of
life in the body. The degree of immunity may be represented by the
degree of intellectual adaptation possible in the body, and this in
turn depends upon the freedom in the transmission of mental impulses
through the spinal nerves. Immunity may be considered as the degree
of protection which Innate is able to give the body and varies from
a slight adaptation to the utmost adaptation or protection from all
invading agencies.

Immunity is one of the most interesting and yet the most illusive
and complicated subjects which we will have to consider from the
standpoint of chiropractic philosophy, for in order to understand
immunity we must understand the adaptative processes carried on
within the body. From time immemorial man has made an effort to
immunize himself from the ravages of dis-ease. In former times he
tried to accomplish this through the use of charms which led to many
superstitious practices, some remnants of which have survived to the
present day. In recent years large sums of money have been expended
in scientific research in an effort to discover the secret which
would make the human race immune from dis-ease, but to no avail.
It is a recognized fact that great good has been accomplished in
improving conditions and creating an environment in which there
might be a more perfect expression of life with less necessity for
an excessive expenditure of adaptative energy. But man himself
has not been made immune by these methods. The procedure has been
wrong for the cause of dis-ease is not in man’s environment, but
within man himself. Chiropractic will accomplish the most desired
end by restoring to normal the transmission of mental impulses to
all parts of the body so there may be a complete adaptation to all
environmental conditions that may arise. The body will then be
protected from the supposedly deadly microörganisms that are accused
of being responsible for human ills.

If the public could read what the hygienists have to say on the
subject of immunology and could read it in the light of chiropractic
philosophy they would realize that chiropractic adjustments will
not only restore health to the sick, but will prevent the well from
getting sick.

In order that the student may understand the subject more fully
we will now consider briefly in a general way some of the former
theories of immunity and then take up a careful study of the
chiropractic philosophy of immunity.

On page 528 of _Preventive Medicine and Hygiene_, by Rosenau, we
read: “We are still ignorant of the mechanism by which the body
protects itself against many dis-eased states.” He also gives us the
idea that the mechanism of immunity varies not only in different
infections, but in the same infection when under different and
varying conditions.


Natural Immunity

Immunity is classed as natural, acquired and artificial. Natural
immunity is that natural resistance of Innate Intelligence through
the activity in the normal body whereby all invading organisms and
poisons, as well as all the products of katabolism are excreted
before they have an opportunity to act upon the tissues or otherwise
interfere with the vital processes in the body.


Acquired Immunity

Acquired immunity is the result of the adaptative processes of Innate
Intelligence during the time the so-called dis-ease is active in the
body which results in the recovery of the patient. To illustrate:
During the attack of measles there is an adaptative process carried
on which results in the recovery of the patient. During the process
of this adaptation Innate produces changes in the body which makes
possible the excretion of this kind of poison when introduced into
the body in the future. It is a recognized fact, however, that having
a dis-ease will not always prevent the recurrence of the dis-ease. In
other words, to put it in the terminology familiar to all, having a
dis-ease will not always produce immunity.


Artificial Immunity

Artificial immunity is classified as active and passive. George
M. Price, M.D., in his _Hygiene and Public Health_, says: “Active
immunity is produced by the following conditions: (1) Recovery
from dis-ease. (2) Inoculation with virulent living bacteria. (3)
Vaccination with attenuated bacteria; (4) with dead bacteria; (5)
with bacterial extracts. Passive immunity is conferred by antitoxins
and serums.”

The idea here presented is that the immunity is active if it is
the result of a necessity for internal intellectual adaptation on
the part of Innate Intelligence, and when this adaptation takes
place there will be immunity from further attacks. That the passive
immunity is produced by the introduction of antitoxins or serums
taken from the bodies of animals in whose bodies these adaptative
processes have taken place.

There is no possible way of producing immunity except by creating
a condition in the body which will enable Innate Intelligence to
transmit the mental impulses to the tissues in such quantity and
quality that there may be perfect adaptation carried on regardless of
the character of the poison or microörganism that may be introduced
into or manufactured within the body.


Exhaustion Theory

In 1888 Pasteur advanced the exhaustion theory wherein he maintained
that the body which had no food for the germ to feed upon would be
immune; in other words, when the food supply was used up the germ
could no longer develop and grow. An illustration of this is the
yeast which will cease to grow when the sugar in the culture media is
exhausted. This theory was rejected but has since been revived and
is now considered to have some merit. This theory comes very nearly
agreeing with the chiropractic idea, which will be discussed later.


Retention Theory

Another theory is that of Chaveau, which is known as the retention
theory. This is just the opposite of the exhaustion theory and
maintains that the products of metabolism within the microörganisms,
the excreta of the germs, form a toxin or a substance which is
retained in the body of the host and protects it against the growth
and development of the germs, in this way producing immunity.

That which can not be used in the metabolism of an organism will
naturally be excreted, for if it is allowed to remain in the body
it will impair the tissues. The excreta of the germ then can not be
used in its own metabolism and is therefore a poison to the germ as
well as to the host. This waste accumulates until the germ eventually
is destroyed by the poison of its own excreta. This is given as an
explanation of self-limited dis-eases. It is further explained by
this theory that this poisonous excreta of the germ is retained in
the secretions of the body of the host and acts as a protection
against further invasion, for when other germs of the same character
enter the body they come in contact with this poison and are
destroyed. In this way immunity is supposed to be maintained. But
this is not logical, since the excreta of these germs can not be used
in the metabolic processes of the human body. It is a poison and will
be dealt with by Innate as such. Innate does one of two things when
poison enters the body or when it is manufactured within the body.
One is to eliminate it through the normal channels of excretion; the
other is to produce an antidote in the form of an internal secretion
to neutralize the poison. In either event the excreta of the germ
would lose its potency as a germicide and could therefore have
nothing to do with the production of immunity.


Various Theories

Again, it is claimed that the phagocytes perform a very important
function in protecting the body against invading microörganisms by
attacking, destroying and digesting them. Another theory is that
the antibodies of various kinds play an important part in keeping
the body free from undesirable invaders. It is also asserted that
immunity is produced in a negative way by the absence of a specific
affinity between the tissue cells and the toxin.

Immunity may be the result, according to other theories, of a
positive factor due to the presence of antibodies which neutralize
the toxins. In some cases immunity is associated directly with cell
activity while in others it is resident in the blood and fluids of
the body. Rosenau further says, “The unsatisfactory state of our
knowledge in certain fields of immunity is well illustrated in the
case of anthrax. The mechanism of protection is not at all understood
in this infection, which was the first and classic illustration of
a germ dis-ease. The mechanism of immunity in common colds is also
complex and obscure.”

Many other authors could be quoted to show that the real philosophy
of immunity is not understood nor why a germ will seem to cause
dis-ease in one individual and not in another. But this is sufficient
to indicate the unsatisfactory results that have been obtained in
research work along this line.


Adaptability of the Body

It is a known fact that there is a wide range of adaptability and a
vast difference in the vital resistance of different individuals, and
even in the same individual at different times. There must be some
reason for this difference.

It is also a known fact that an individual may be apparently well
one day and sick the next, although there may be no change in the
subluxations existing in the spine of the individual. Environmental
conditions are constantly arising which necessitate adaptative
action on the part of Innate Intelligence. This action must be in
addition to the normal action taking place under the normal and
usual environments. In order to accomplish this increased functional
activity the current must be increased to accomplish this, the
carrying capacity of the nerve must be greater than the current
necessary to maintain the ordinary metabolic process in the body.

Under the stress of environmental necessity it is possible for Innate
Intelligence to increase the functional current of mental impulses
up to the full carrying capacity of the nerve, and to augment the
functional activity at the periphery to the full capability of the
physical structure to express that current of mental impulses. Were
it not for this possibility of increased functional activity there
could be no adaptative processes in the body. In order that there may
be an increase in the functional activity there must be an increase
in the functional current of mental impulses. This necessitates that
the current transmitted under normal conditions be less than the
carrying capacity of the nerve.

Psychologists tell us there is a certain amount of reserve energy
stored up in the body. Chiropractic maintains that it is not a matter
of energy being stored up, but that this reserve energy is a question
of increasing the functional current so as to increase the process of
adaptation in the tissues. The degree of adaptation is represented
by the difference in the current transmitted through a nerve under
normal conditions, and that transmitted when the full carrying
capacity of the nerve is taxed. In other words, the reserve energy is
the difference between the current that is being transmitted and that
which it is possible to have transmitted.

As the adaptative action is increased in response to the necessity
there will be, in adverse ratio, a decrease in the reserve carrying
capacity of the nerve. In other words, as the current is decreased
the reserve carrying capacity of the nerve is increased. The degree,
therefore, of vital resistance is represented by the reserve carrying
capacity of the nerve and as this is decreased there will be a like
decrease in the vital resistance of the body.

Some individuals are immune from certain so-called contagious
dis-eases and we are told that this is because the vital resistance
is greater in them than it is in others. This statement is true, but
there should be some reason for this difference in resistance and
Chiropractic gives us that reason. The possibility for adaptative
action in the body is decreased by subluxations in the spine and its
degree depends upon the combination of subluxations, the functions
involved and the organs in which the functions are expressed
abnormally.

The question, however, arises that if there are subluxations in the
spine, why are there no incoördinations but merely the possibility of
decreased adaptation. To this question there is a specific answer.
It is contained in the principles involved in and underlying the
philosophy of Chiropractic, therefore it is not possible here to go
into details. It can be considered from a general viewpoint only.

There may be a combination of subluxations existing in the spine and
yet not enough pressure to prevent Innate Intelligence getting a
current through great enough to meet all the ordinary demands of the
average environment. But when subluxations do exist and a condition
arises necessitating increased functional activity, Innate, because
of the decreased carrying capacity, is unable to increase the current
of the periphery. Hence adaptation can not take place and there is
incoördination which would not have obtained if the carrying capacity
of the nerves had not been decreased by the subluxation. It must
be remembered that even in the normal condition when there are no
subluxations, health is a question of intellectual adaptation; that
dis-ease is a question of the lack of intellectual adaptation. As
the possibilities of intellectual adaptation are decreased, the
possibilities of incoördination are increased.

An individual will be immune so long as the carrying capacity of
the nerves remain normal or so long as the carrying capacity is not
decreased. Germs ingested or taken into the body will be excreted
as so much waste material and will not be permitted to remain in
the body. This is not only true of germs and microörganisms, but of
all poisons. The carrying capacity of the nerves is limited, but in
the normal condition is 100%. If the poison introduced is stronger
than the internal resistance then the meeting of the two forces will
produce a concussion, and if this concussion is greater than the
normal resistance of the spine a subluxation will be produced. In
this way an individual may be immune from one poison and not another,
or from one particular germ and not another, or he may be immune at
one time and not at another time. For the philosophy of subluxations
being produced by poison, the student is referred to Chiropractic
Library, Vol. V, Palmer, under the heading of poisons.

The particular mechanism of immunity is not so vital so long as
we understand that it is produced by the operation of Innate
Intelligence, and know what is necessary to enable Innate to produce
this condition.

Under the exhaustion theory of Pasteur it was maintained that when
food upon which germs fed was exhausted they could no longer develop
and the body in which there was no food for the germs would be immune
from the germ dis-eases. Chiropractic maintains that the germ is a
scavenger and feeds upon dead tissue, never upon live tissue; that
there must be a proper culture media for the development of the
germs and this can obtain only in tissue that is below the normal
condition. Therefore, if the tissues are maintained in a state
of normality by the normal transmission and expression of mental
impulses, there will be no food for the germs and they will be
excreted. On the other hand, if the tissues are below normal in their
resistive powers, due to the interference with the transmission of
mental impulses, the germs finding food and a culture media conducive
to their development will remain and multiply and their excreta will
act as a poison and necessitate a further process of adaptation, the
character of the symptoms depending entirely upon the character of
the poison produced.

It is not necessary to kill the germ that the patient may recover.
All that is necessary is to adjust the subluxation or subluxations
that are causing the interference with the transmission so the
tissues may become normal and the germs will starve to death and be
excreted as dead material.


Dis-ease the Cause of Germs

Dr. Alexander M. Ross, Fellow of the Royal Society of England,
said in speaking of germs, “They are the result, not the cause, of
dis-ease. They are scavengers; their legitimate work is to clean out
the sewers of our bodies.”

John B. Fraser, M.D., CM., writes, “The reasons for questioning the
germ theory are mainly three, viz.:

“1st. The divergent views of bacteriologists as to which germ caused
the dis-ease.

“2nd. The stronger claim of the bio-chemic theory.

“3rd. The absence of germs at the onset of dis-ease (as the following
sample cases show).

“(a) A man crossing a river broke through the ice, was rescued,
later became ill, and the doctor, fearing pneumonia, tested for
pneumo-cocci—there were none present; when the pneumonia developed
they appeared.

“(b) After an oyster supper some men had cramps and diarrhœa,
followed by typhoid fever—no Eberth bacilli were present in the first
stools, but were present later.

“(c) Hurrying, a girl arrived at her shop sweating; as the shop was
cold, she became very chilly; next day complained of a sore throat,
but no Klebs-Loffler bacilli were found; later, when a diphtheretic
patch appeared, the bacilli were present.

“Here in each case the bacilli followed the onset of the dis-ease.

“Believing that the above germs were the result and not the cause
of the dis-eases, tests of the germs of diphtheria, typhoid and
pneumonia were made.

“The first test was whether the Klebs-Loffler bacilli would cause
diphtheria, and about 50,000 were swallowed without any result. Later
100,000, 500,000 and a million and more were swallowed, and in no
case did they cause any ill-effect.

“The series of tests was to decide whether the Eberth bacillus would
cause typhoid, but each test was negative; even when millions were
swallowed. The third series of tests showed that one could swallow
a million (and over) pneumo-cocci without causing pneumonia, or any
disturbance.

“The investigations covered about two years and forty-five (45)
different tests were made, giving an average of fifteen tests each. I
personally tested each germ (culture) before allowing the others to
do so; and six persons (3 male, 3 female) knowingly took part in the
tests and in no case did any symptoms of the dis-ease follow.

“The germs were swallowed in each case, and were given in milk,
water, bread, cheese, meat, head-cheese, fish, and apples—also tested
on the tongue.

“Most of the cultures were grown by myself—some from stock tubes
furnished by Parke, Davis & Co., and one tube furnished by the
Toronto Board of Health through one of their bacteriologists.

“As the tests were carefully made, they prove that there is not the
danger from germs that bacteriologists claim; they also may stimulate
other Canadians to undertake further experimental work, for the
actual test on man decides the truth of the theory.”


Germs Do Not Cause Dis-ease

Germs do not cause dis-ease, but they may be considered as any
other foreign substance taken into the body, which can not be used
in its metabolism. Any foreign substance which can not be used in
the processes of metabolism will injure the tissues if allowed to
remain in the body. If germs are taken into the body and if there are
subluxations which prevent Innate from producing normal function in
excreting these germs, and if there is waste material due to impaired
metabolism, these germs will find a culture medium conducive to their
development; then in their natural processes of development and
metabolic processes, secretion and excretion, toxins will be formed
which will result in certain symptoms from such poisons, all due to
the fact that there are subluxations producing pressure upon nerves
interfering with the transmission of mental impulses.

Immunity, then, is a question of keeping the body in such a physical
condition that there will be no abnormal tissue upon which the germs
may feed. But this would imply that in order to have dis-ease there
must first be abnormal tissue AND the germs. This, however, is not
the case for there may be dis-ease without the presence of the germ,
even in the so-called germ dis-eases. Dis-ease is not a question
of germs being present, but it is the decreased current of mental
impulses to the tissue cells.

The best way to produce immunity is to have the subluxations adjusted
so there may be a normal transmission of impulses to all parts of
the body so that intellectual adaptation may be at par. Immunity
from any and all dis-eases may be produced by the restoration of
transmission. This does not mean that after momentum has been gained
dis-ease will be at once overcome and the process of restoration
will be accomplished without a sufficient amount of time to enable
Innate Intelligence to bring about the necessary processes of
restoration. But we do mean to say that if all subluxations were
adjusted the individual would be immune from all incoördinations.
Still subluxations could be produced by trauma and also by the
introduction of poisons into the body. In order to maintain constant
immunity the individual should periodically visit his chiropractor
for an analysis. By so doing subluxations that have been produced may
be detected and adjusted.




CHAPTER XII

GERMS




GERMS


  ORIGIN OF THE GERM THEORY AS CAUSE OF DIS-EASE

  ACTION OF GERMS IN THE BODY A NATURAL PROCESS

  BACTERIA
      CLASSIFICATION OF
      DIPHTHERIC GERMS IN THROAT
      FOUND EVERYWHERE

  SOURCE OF COMMUNICATION
      MAN AND ANIMALS
      MEDIA OF CONVEYANCE

  MODE OF TRANSFER
      DIRECT
      INDIRECT
      INTERMEDIATE HOST
      CARRIERS

  CHANNELS OF ENTRY
      THE RESPIRATORY TRACT
      DIGESTIVE TRACT
      THE SKIN
      THE GENITO-URINARY TRACT

  TERMS INFECTIOUS AND CONTAGIOUS




CHAPTER XII

GERMS


Origin of Germ Theory

The average individual, who thinks of the cause of dis-ease and
then associates germs as that cause, probably does not realize that
the germ theory of the cause of dis-ease only dates back to about
1880. He does not realize that the man who decided germs cause
dis-ease died in 1895. However, it is true that as early as 1675 a
Dutch lens-maker published the fact that he had manufactured a lens
of such high power that “animalcules” could be seen in water. He
also asserted that microörganisms could be found in feces. However,
they were associated with dis-ease only in a speculative way; even
Aristotle in the second century speculated on microörganisms as the
cause of dis-ease, but this was only theory as he could not prove it,
having no microscopes with which to study the germs nor any methods
of isolating them. It was not until Louis Pasteur began his research
work in bacteriology that scientists considered there was proof that
germs caused dis-ease, and since that time medical science has gone
to the extreme along this line.

The germ theory of dis-ease has gained such favor that great
amounts of money and the very best talent have been lent to the
investigations. But as time has gone on and the zenith of this
doctrine has been reached, we find the theory has been questioned
until today even those who were previously advocates of this theory
are now doubting or rejecting it. Many questions are being raised
concerning dis-ease being the direct result of the introduction of
bacteria and germs into the body. It is now maintained by the best
authorities, among those who previously asserted that germs were the
cause of dis-ease, that dis-ease is the cause of the germs.


Action of Germs a Natural Process

The action of microörganisms, inside as well as outside the body, is
a perfectly natural process and one that has been provided in Nature
as a part of her general plan. It is a natural method just the same
as her method of purifying the air or the self-purification of water
or any of her other beneficent processes are natural. Milk will not
sour without bacteria. Putrefaction is the result of the activity
of the bacteria. Did it ever occur to you that the process of
putrefaction is one of Nature’s methods for keeping our environment
sanitary? Even this process is obtained only through bacterial
action. Bacteria are always present in the intestinal tract and aid
in intestinal digestion.

The term is applied to all microscopic organisms, whether vegetable
or animal. Vegetable microörganisms are known as bacteria while
animal microörganisms are called protozoa.


Bacteria

Bacteria are the simplest form of vegetable life and also the
smallest. They vary greatly in size and are grouped in three classes
according to their shape: cocci, which are minute spherical cells,
bacilli, rod-shaped cells, and spirilla, which have a spiral form.

There are three types of bacteria: the rod or bacillus, the sphere or
coccus, and the spiral or spirillum, all so named because of their
shape. They divide by what is known as fission, each cell dividing
into two and so on. When the conditions are favorable this division
may take place as often as every thirty minutes.

They may be produced artificially in a proper culture medium. It is
generally supposed by the layman that the bacteria are very hardy
little creatures and will develop in the body and cause dis-ease
under the least provocation. This, however, is quite erroneous for
they are very delicate and their propagation is difficult. The
temperature and moisture must be exactly right and they must have
just the proper kind of food or they will not multiply. They will
live in an environment, sometimes for a great length of time, that is
not suitable for propagation.

Diphtheric germs are found in the throat of the average person. These
germs, however, will not multiply nor develop until the tissues of
the throat are depleted. The tissues then become pathological and
form food for the bacteria, but even then they will not develop
unless the temperature and moisture are exactly right. Bacteria
multiply very rapidly when there is waste material in the tissue
of the throat which furnishes food and when the environment is
conducive to their development. The tissues weakened by the decrease
in the flow of mental impulses are not able to expel the germs and
they accumulate, not as the cause of dis-ease, but as a result of
dis-ease. The bacteriologist examines a culture from the throat of
the patient and because he finds the germs present he says the germs
cause the dis-ease, since no other cause is known; strange to say,
however, when the patient is adjusted and the tissues become normal
it is not necessary to kill the germs. They will starve to death and
Innate will excrete them.

Bacteria are found everywhere and in almost everything. In food,
water, on the walls and floors, and in the pores of the skin. All
life is due to the action of these bacteria. The action of the germs
soon produce fermentation and putrefaction of dead animal tissue and
of vegetables, thus reducing them into simpler elements which furnish
nourishment for plant life. The plants furnish food for animals and
man, and thus we have what is known as the food cycle. So we see
that vegetation is dependent upon bacterial action for its supply of
food. If the bacteria were all destroyed there would soon be an end
of food and plant life would die because of starvation. If there was
no plant life the animal kingdom would be robbed of its food supply.
Thus we see the important function performed by the bacteria.

The so-called dis-ease germs may be found in the healthy body,
but that body does not have the dis-ease merely because that germ
is present. If, however, there is a subluxation which interferes
with the transmission of mental impulses the tissues soon become
pathological and proper environment is created for the development of
the germ. Then this germ propagates and soon there is a large number
present. These germs will, however, disappear as soon as the tissues
become normal. In other words, when the incoördination is restored to
coördination the germs disappear.


Source of Communication

There are two recognized principal sources of communicable dis-ease
common to man, namely, man himself and the lower animals. It is
interesting to note that most of the so-called communicable dis-eases
are peculiar to man alone. They are not found in the lower animals
except as they are communicated by man for experimental purposes. It
is true that domesticated animals are more susceptible to dis-ease
than wild animals.

From the standpoint of hygiene there must be a distinction made
between the source of infection and the media of conveyance.
Man and animals are considered the main sources of infection.
Environment is regarded a source of infection. It is maintained
that water, food, air, and soul form a media for conveyance, but
they are not considered sources of infection. Rosenau, one of
the leading hygienists, states that “most of the microörganisms
causing the communicable dis-eases of man are frail and soon die
in our environment, as in the air, soil or water.” Notwithstanding
this fact, some still maintain that these frail little germs cause
dis-ease.


Modes of Transfer

Hygienists assert that germs are transmitted either by direct or
indirect means. The vehicles of transmission may be man himself,
animals, or anything that will carry the germs from one person to
another. Price says, “The most frequent and demonstrated mode of
infection is by direct contact of dis-ease with the healthy, of the
persons surrounding the infected one, such as physicians, nurses,
etc.”

We must differentiate between the mode of transmission, or, as it
is sometimes called, the mode of infection, and the channel of
infection. The channel of infection is the passage through which
the germs enter the body. In tuberculosis the channel of entrance
might be the respiratory tract, through the skin, or by means of the
digestive tract, while the mode of infection or mode of transfer
might be by such means as milk or sputum.

There are two principal modes of transference: (a) direct or contact
infection, (b) indirect infection. Under this second heading would be
included carriers or intermediate host. Direct or contact infection
is from person to person and may be accomplished through discharges
from the nose and mouth or other excretions from the body. There are
many dis-eases supposed to be transferred from person to person by
direct contact. Such dis-ease as diphtheria, tuberculosis, scarlet
fever, syphilis, gonorrhea and skin dis-eases belong in this class.
It is also asserted that these same dis-eases may be transmitted from
person to person by intermediate agents. For example, typhoid germs
may be transmitted in fecal matter into the water supply and ingested
into the body. The gonococci may be deposited upon fomites, such as
bedding, and transferred to other individuals. From a chiropractic
standpoint these incoördinations will be produced only when there
is interference with transmission of mental impulses, preventing
intellectual adaptation taking place in the body.

Indirect infection is accomplished from person to person through
such means as water, food, air and soil. It is claimed by medical
hygienists that dis-eases may be transferred great distances by these
vehicles. However, some of the so-called pathogenic germs are short
lived and will therefore not infect after any length of time.

It is affirmed by some that a person may be a carrier of a dis-ease
and not himself be suffering from the dis-ease. As, for instance,
there are cases on record where an individual has been a carrier of
diphtheria, having the germs in his own throat and from his throat
the germs have found their way into the throats of others. In other
words, there were pathogenic germs in his body which were doing
no harm to him, but when they entered the body of others caused
dis-ease. People have been found with every imaginable dis-ease germ
and yet have themselves been perfectly well. Such persons are known
as “carriers.” From a chiropractic viewpoint this condition is very
easily explained. In such people the transmission of mental impulses
is sufficient to permit Innate Intelligence to maintain a sufficient
degree of adaptation to prevent the propagation of the germs, but not
sufficient to enable Innate to excrete the germs as waste material.

The course followed in preventive medicine in these cases is
isolation of the individuals and the strictest sanitation. Their
occupations are controlled so that they will not handle food intended
for other people. In these ways danger from carriers is lessened.

Pathogenic bacteria live in the bodies of infected persons, in
their secretions and excretions, and in the discharges of the body,
but they are not found free in Nature. The principal vehicle of
transmission is man himself. He is also the principal recipient of
infection. Germs may be found in the various secretions such as
those from the eye, ear, nose, throat, from wounds and in the pus
from abscesses; they may be found also in sputum, urine and in the
solid excretions. In these ways they may be transmitted from one
individual to another. They may also be carried by animals, insects,
food, milk, water, air or any other mode or vehicle. The most common
mode of transference, however, is from person to person.


Channels of Entry

The channels through which germs enter the body are grouped as
follows: (a) respiratory tract, (b) digestive tract, (c) skin, (d)
genito-urinary tract.

Since the air contains many germs at all times, it can readily be
seen that the respiratory tract forms an excellent portal of entry
through the mucous membrane of the eyes, nose, mouth, throat and
lungs. It is asserted by those who believe that germs cause dis-ease,
that the germs of diphtheria, scarlatina, measles and pneumonia enter
the body through the respiratory tract. It can readily be seen that
since the air contains bacteria at all times, even of the so-called
pathogenic type, that they would be taken in with every breath and
if these germs were the cause of dis-ease every individual would
have all kinds of dis-ease. It is quite evident that these germs do
not remain in the body except under the most favorable conditions,
obtaining only when there is interference with transmission which
makes the tissues abnormal.

It is maintained by exponents of the germ theory that the greater
number of germ dis-eases are caused by the germs that enter the
body through the mouth into the alimentary tract. There are many
pathogenic and non-pathogenic germs contained in the food that we
eat and the water that we drink, and yet these germs do not produce
dis-ease in every individual, yet the exponents of the germ theory
hold that typhoid fever, cholera, dysentery and many other dis-eases
are transmitted to the body through the alimentary canal by means of
food and water.

As a portal of entrance for germs into the body, the skin is
considered of least importance since the germs will not penetrate the
normal skin under ordinary circumstances. If there is an abrasion
or wound infection may be produced by the entrance of germs, but
this will take place only when there is sufficient interference with
transmission of mental impulses to make it impossible for Innate
Intelligence to bring about proper reparatory processes. Animal
parasites may find a portal of entrance through the skin.

The genito-urinary tract furnishes a portal of entrance into the body
for such germs as those of gonorrhea, syphilis and tuberculosis,
either by direct contact or through intermediary agents. Infection
of the body is by means of some of these entry channels which differ
with the different bacteria. The bacteria may be entirely innocent
when entering one part of the body, yet when they enter through some
other portal they may be considered pathogenic. In other words, some
germs will thrive in one part of the body but not in some other part.


Terms Infectious and Contagious

The terms infectious and contagious are not clearly defined and have
no scientific precision. “A contagious (contigere, to touch) dis-ease
is one that is readily communicable—in common parlance, ‘catching.’
Formerly a contagious dis-ease was considered as one which is caught
from another by contact, by the breath or by effluvia. A contagious
dis-ease implies direct or personal contact. If contagious dis-eases
are limited to those contracted by direct contact or touch, as
the etymology of the word signifies, only syphilis and dis-eases
similarly contracted would be contagious. As a matter of fact,
smallpox, measles and influenza are types of contagious dis-eases,
and the term is now usually understood.”

“An infectious (inficere, to put in, dip in, or mix in) dis-ease is
usually considered as one not conveyed directly and obviously, as in
the case of contagion, but indirectly through some hidden influence
or medium. In the days when specific febrile dis-eases were regarded
as caused by miasmata and noxious effluvia, the term ‘infectious’ and
‘miasmatic’ dis-eases were more or less synonymous. Typhoid fever was
often taken as a type of an infectious dis-ease. Malaria was the type
of miasmatic dis-ease.” (Rosenau, _Preventive Medicine and Hygiene_.)

Most authors consider that an infectious dis-ease may be contagious
and a contagious dis-ease is also infectious. Contagion implies more
of a personal contact as a mode of transfer, while infection implies
more of an indirect mode. The communicable is more specific, but does
not refer to any particular mode of transference.

There are many so-called communicable dis-eases, yet let it ever be
remembered that if Innate Intelligence is operating at par in the
body there will be an immunity from these dis-eases, although the
germs that are supposed to cause them will still exist.




CHAPTER XIII

DISINFECTION AND FUMIGATION


DISINFECTION AND FUMIGATION

  DEFINITIONS

      DISINFECTION

      STERILIZATION

      ANTISEPTIC

      INSECTICIDE

      ASEPSIS

      GERMICIDE

      DEODORANT

      FUMIGATION
          FORMALDEHYDE
          SULPHUR DIOXIDE

  MEANS OF DISINFECTION

      NATURAL MEANS
          DILUTION
          DESICCATION
          SUNLIGHT
          TIME
          ANTIBOSIS

      OTHER AGENTS
          FIRE
          DRY HEAT
          BOILING
          STEAM

      OTHER DISINFECTANTS
          CARBOLIC ACID
          CREOLINE
          LYSOL
          SAPROL
          BICHLORIDE OF MERCURY




CHAPTER XIII

DISINFECTION AND FUMIGATION

DEFINITIONS


Disinfection

When an object is contaminated with so-called pathogenic germs it
is said to be infected. To disinfect an object it is necessary
to destroy the microörganisms. The destruction of all so-called
pathogenic germs, whether in the substance of the object or on its
surface, is called disinfection. All lower forms of animal and
vegetable life are destroyed in sterilization, while in disinfection
only the germs which, from the medical standpoint, are the cause of
dis-ease, are destroyed. The agent used in disinfection is known as a
disinfectant or germicide.


Sterilization

The destruction of all germ life in or on an object is known as
sterilization. From the standpoint of hygiene sterilization is
unnecessary except in dis-eases such as anthrax, tetanus, and
other spore-bearing dis-eases, the spore being highly resistive
and not so easily destroyed as the vegetative cells. Sterilization
will disinfect but disinfection will not necessarily sterilize.
Disinfection is thoroughly efficient in almost all cases.
Sterilization destroys all life.


=Antiseptic= (Anti, against, and septos, putrid)

An antiseptic prevents putrefaction but does not necessarily destroy
the microörganisms. A substance may act as an antiseptic by delaying
or preventing the processes of decay and decomposition, but still
not be a germicide. In other words, anything that will hinder the
development of germ life acts as an antiseptic. Thus cold has a
preservative action, although it will not destroy the microörganisms.
A disinfectant may be diluted and used as an antiseptic. A 10%
solution of formalin is a good disinfectant and will kill bacteria in
a relatively short space of time, but formalin in a solution of one
to fifty thousand will be a very good antiseptic. The germination of
anthrax spores may be prevented by the use of bichloride of mercury
in as weak a solution as one to three hundred thousand, but it will
require a solution of one to one thousand to destroy the spores.
A disinfectant is also an antiseptic but an antiseptic is not a
disinfectant.


Asepsis

Asepsis is an absence of putrefactive bacteria. This may be
accomplished without the use of germicidal agents by cleanliness
which excludes all so-called pathogenic germs.


Insecticide

An insecticide is an agent capable of destroying insect life. Many
of the germicidal agents are also insecticides. There is a great
difference in the resistance of different insects. Formaldehyde is
a good germicide but is not an insecticide. There are four ways of
using insecticides. In liquid form, powder, vapor form and those
placed in food to be eaten by the insects.


Germicide

A germicide and a disinfectant are the same for they both destroy
germ life. Many germicides are so powerful that they completely
sterilize or destroy all life.


Deodorant

A deodorant is not in any sense a disinfectant and has no power
to destroy germ life. It is an agent which neutralizes unpleasant
odors. A disinfectant destroys germs but does not necessarily
destroy odors. A deodorant must not be confused with a substance
having pungent odor which merely substitutes one odor for another. A
deodorant destroys the unpleasant odor.


Fumigation

Fumigation is a means of disinfection by use of fumes or gases, and
is used generally for the purpose of destroying germ life only on the
surface of objects. For this reason fumigation should not be used as
a substitute for disinfection. Formaldehyde and sulphur dioxide are
used largely for fumigating purposes.

Of these two gases formaldehyde is the better since it is not
poisonous, does not injure the surface of objects and will not damage
the most delicate fabrics nor destroy colors. Sulphur dioxide is very
destructive and therefore less desirable. However, all the gaseous
agents lack sufficient penetrative power to accomplish more than a
surface disinfection. Formaldehyde is a good germicide and this adds
to its efficiency.

To obtain the desired results in fumigating there must be special
attention given the preparation of the rooms or spaces to be
fumigated. All objects in the room should be so exposed that the gas
may readily get to all surfaces. All furniture and other objects
should be moved into the room away from the walls and all doors and
drawers of bureaus and boxes should be opened so the gas may find
free access to every nook and corner. Much of the gas may escape
through cracks and crevices, therefore special care must be exercised
that these openings are all properly closed before the fumigation is
started. In view of the fact that the gas is non-destructive there is
no harm done even to the most delicate materials.

The best results are obtained from the formaldehyde when the
temperature of the room is 65° F. or over, with a relative humidity
of at least 60%. While formaldehyde has the power to kill spores
it is not considered sufficient to disinfect in such dis-eases as
anthrax and tetanus.

Formaldehyde gas kills all forms of microörganisms almost instantly
but is not particularly destructive to higher form of life.
It produces a marked irritation in the mucous membrane of the
respiratory tract which may result in death to animals exposed to the
gas for any length of time. It is not considered an insecticide.

In fumigating a room with formaldehyde great care must be exercised
that the individual does not remain in the room after the gas begins
to be liberated. After the process of fumigation has been completed
the windows and doors should all be opened that the gas may escape.
It is always best to have the doors and windows open from the outside
so that it will not be necessary for any one to go into the room
until the gas has blown out.


AGENTS OF DISINFECTION


Physical Agents

The physical agents of disinfection are sunlight, electricity,
pressure, dry heat, burning, boiling, and steam.


Chemical Agents

Chemical agents of disinfection are divided into two
divisions—gaseous and liquid disinfectants. The gaseous disinfectants
are: formaldehyde gas, sulphur dioxide gas, hydrocyanic acid gas,
chlorin, oxygen, and oxone.

Some of the most important liquid disinfectants are metallic salts,
bichloride of mercury, silver and zinc salts, coal-tar creosote,
carbolic acid, phenol, lysol, creolin and formalin.


MEANS OF DISINFECTION


Natural Means

Nature’s means of disinfecting are by dilution, sunlight,
desiccation, time and antibiosis. The direct rays of the sun are
Nature’s greatest germicide. Few of the microörganisms will live in
the direct rays, but there are none that will withstand them for more
than a few hours. Germs can not withstand the effect of dryness.
Thus we see there is in Nature that which works as a most efficient
germicide. The combination of sunlight and dryness forms a most
desirable means of disinfection. When germs become attenuated through
the effects of these natural processes they do little harm when
introduced into the body.

One of the most important adjuncts to the work of disinfection is
personal cleanliness and sanitation of the environment.


Other Agents

=Fire= is not a practical disinfectant. It can be used only with
those articles that are of little or no value since the article
that is being disinfected is destroyed. The burning of all refuse
and garbage is by all means the best method. Burning is the most
satisfactory and cheapest method in disinfecting sputum and other
excreta from the body, and in disposing of articles of little value
saturated or contaminated with such.

The =dry heat= method of disinfecting requires specially built
apparatus such as dry air sterilizers. This form is not practicable
for use in disinfecting fabrics and other materials that are
destroyed or injured by extremely high temperature required to
destroy the germ life. Metals are easily injured by this method as
they are likely to be scorched. All forms of life are destroyed in an
hour’s time when exposed to a temperature of 150° C. Such articles
as glassware will withstand this heat or even higher and may be
thoroughly sterilized in from one to two hours. This insures proper
penetration and sufficient heat to completely destroy all life.

=Boiling= is one of the most satisfactory and easiest methods of
disinfecting. Continuous boiling for an hour in water at 100°
C. will result in the destruction of most germs of the so-called
infectious dis-eases. There are some of the spores, such as those of
anthrax and tetanus, that will survive the most strenuous processes
of boiling. However, most of the germs will be destroyed before the
boiling point is reached.

Boiling is the best method to be used in disinfecting bedding, body
linen, towels and other fabrics which will not be harmed by this
process. There is a great variety of articles that may be disinfected
in this way, such as utensils and bed pans. The surfaces of the
floors, walls, beds, and other objects may be cleansed with boiling
water. In this use it is advisable to add some disinfectant to the
water.

=Steam= is not only a disinfectant but it is also a sterilizing
agent. All forms of germ life, including spores, are completely
destroyed. It is therefore our best known disinfectant. There are
many objects that are injured and some ruined by steam, such as
silk, wool, furs, oilcloth and rubber goods, and articles containing
varnish or glue. There is danger from staining and running of colors.
Disinfection may be either with streaming steam or with steam under
pressure. For the use of streaming steam no particular device is
necessary. Some means of providing the steam and some place to hang
or place the objects and articles to be disinfected are the two
essentials for this method. It is not necessary to have an air-tight
place. To use steam under pressure there must be a specially
constructed apparatus. There are many such devices on the market
and they are used in institutions where it is found necessary to
disinfect with steam.

Sterilization may be accomplished in twenty minutes with steam at
about one atmosphere of pressure which will give a temperature of
about 120° C. A temperature of about 125° C. is obtained with the
pressure at about twenty pounds to the square inch. This reduces the
time for sterilization to about fifteen minutes.


Other Disinfectants

Carbolic acid which is a good antiseptic but a comparatively mild
germicide is another disinfectant. It has very little penetrating
power and is of most value in a 3% to 5% solution for washing floors,
walls and woodwork. The cresoles are more powerful and effective
disinfectant than carbolic acid. The most common of this group are:
creoline, lysol, and saprol. Their use is about the same as that of
carbolic acid. Bichloride of mercury may be used in a solution of
from one to two thousand, to one to five hundred and forms a very
good disinfectant. It kills germs but corrosive sublimate will kill
spore-bearing bacteria only in a solution of one to five hundred. In
weaker solutions it forms a very good antiseptic. Lime forms a very
good disinfectant, especially for excreta, cesspools and cellars.




CHAPTER XIV

HYGIENE AND SANITATION IN THE SICK ROOM




HYGIENE AND SANITATION IN THE SICK ROOM


  FACTORS IN NORMAL EXPRESSION OF LIFE
  UNHINDERED TRANSMISSION
  NORMAL METABOLISM
  PROPER NUTRITION
  PROPER DIGESTION

  IMPORTANCE OF ENVIRONMENT
  INFLUENCE OF CHANGE
  NECESSITY FOR ADAPTATION

  FUNCTION OF EDUCATED MIND

  NEED FOR CONSERVING ENERGY
  TEMPERATURE OF SICK ROOM
  VENTILATION
  LIGHTING
  FURNITURE AND HANGINGS
  BED AND BEDDING
  DISPOSAL OF EXCRETA

  HYGIENIC MEASURES IN SO-CALLED COMMUNICABLE DIS-EASES
  QUARANTINE
  DISINFECTION OF STOOLS, URINE AND SPUTUM, LINENS

  CHIROPRACTIC CAUSE OF SO-CALLED COMMUNICABLE DIS-EASES
  INTERFERENCE WITH TRANSMISSION
  EXPLANATION OF PRESENCE OF GERMS
  NO COMPLICATIONS UNDER ADJUSTMENTS




CHAPTER XIV

HYGIENE AND SANITATION IN THE SICK ROOM


Factors in Normal Expression of Life

In case of incoördination in the body there are always existing
conditions which require educated adaptation. It is the study of
these conditions to which the sickroom hygiene and sanitation must be
directed.

We will first consider the environment necessary for the normal
expression of life in the body. Unhindered transmission of mental
impulses alone will not give us the processes of metabolism. To have
normal metabolism in the body oxygen must be carried to the tissue
cells and there must be an uninterrupted transmission of mental
impulses. Nutrition is derived from the food taken into the body and
oxygen from the air is breathed into the lungs. The mental impulses
are transformed in the brain by Innate Intelligence and transmitted
by efferent nerves; hence the necessity for a proper amount of food,
a sufficient supply of pure air and unhindered transmission. But the
nutrient elements contained in the food are not in a state to be
utilized by the tissue cells when taken into the body; therefore it
is necessary that the food be broken up by the process of digestion
that it will be rendered usable by the tissue cells.

This process of digestion requires a great expenditure of internal
energy or, in other words, a functional activity of the mental
impulses. Thus it is seen that the body as a machine must be supplied
with the material necessary to keep it in repair and running order,
and that this material is taken in and prepared within the body for
bodily use.

Not only must provision be made for supplying the body with the
proper amount of food, but attention must be given to a proper supply
of oxygen for the lungs. This seems a very simple thing to do, and
it is simple under natural conditions, but when we consider the
unnatural conditions that have been created by man and under which
the human race in civilized countries is living, it becomes a problem
that requires great engineering skill. The ventilation of great
buildings, streets and subways is no small problem and yet if the
processes of metabolism are to be maintained in the body ventilation
must be given attention.


Importance of Environment

If these internal processes are to be maintained there must also be a
certain environmental condition which will enable Innate Intelligence
to bring them about. The temperature, humidity, and atmospheric
pressure are all important in their proper relationship. Innate
Intelligence is capable of adapting the body to extremes in these
different environmental conditions, but the transition from one
degree to another, such as temperature, must take place gradually to
allow sufficient time for the adaptative changes.

It will be observed that these changes take place more or less
gradually in Nature, but man is inclined to pass from one extreme
into another without thought of time needed for adaptation. For
example he passes from a highly heated room into one with a very low
temperature, or comes from compressed air chambers, where the air
pressure is greater than the normal, into the normal atmospheric
pressure without sufficient precaution to the sudden change. These
sudden changes not only draw very heavily upon the adaptative forces
of the body, but actually interfere with the normal functional
activity of Innate Intelligence and produce subluxations. The more
natural the environment, the less energy will be required to bring
about adaptation and maintain the equilibrium of the functions. Even
though the environment is perfect, there must be a current of mental
impulses sufficient to produce adaptative action. When there is an
interference with the transmission of mental impulses to such an
extent that this adaptation can not take place there will be lack of
function.

An environmental condition that will require as little adaptative
energy as possible should be maintained. There should, therefore,
be some attention given to the sick room, not that the hygienic and
sanitary measures will in any sense cure the dis-ease, but that the
forces in the body may not be used up and dissipated because of an
environment that requires an abundance of force for adaptation.

The patient’s weakness in many incoördinations is purely adaptative
on the part of Innate Intelligence to prevent the patient from
continuing at work or doing other things that would require an
expenditure of the adaptative energies of the body. In other words,
it is for the purpose of conserving the energies that are needed in
the reparatory and restorative processes necessary to bring about
coördination.

For the above reason it is necessary to give attention to the sick
room in maintaining a condition to which Innate may easily bring
about intellectual adaptation and not draw upon the reserve carrying
capacity of the nerves.


Function of the Educated Mind

The expression of Innate Intelligence through the educated brain has
functions to perform that are quite as essential and important in
their way as are the functions produced by the expression of Innate
Intelligence through the innate brain. Here is an illustration of
what is meant: Innate Intelligence sends mental impulses to the
liver and produces bile independent of educated brain. But if a man
is walking across the street and falls to the ground unconscious
he will be mutilated by traffic unless some one picks him up and
protects him. Innate is still in the body of the unconscious man,
but is not being expressed through the educated brain. The Innate
is powerless to protect that body from harm—it requires the
expression of an Innate Intelligence through the educated brain of
some other person to bring about an adaptation to circumstances and
protect the unconscious man. In this case the educated mind of one
individual is substituted for that of the other and the desired end
is accomplished. This educated function could not be expressed in the
unconscious man because of the inability of Innate Intelligence to be
functioning through the educated brain.

The functions of the educated mind as pertaining to the expression
of life in the body have to do mostly with the environment. It
is, therefore, within the scope of Chiropractic to study the
environmental conditions in order that the best interests of Innate
Intelligence in the expression of life in the body be protected.


Need for Conserving Energy

Reference has already been made to the fact that adaptation
to environment requires an expenditure of energy in case of
incoördination. When an individual is sick there is need for
conservation of energy to the fullest degree. At this time there
must be no unnecessary drain upon the body in order that all forces
may be centered upon the one thing—restoration. This leads us to a
consideration of removing every unnecessary demand upon Innate for
expenditure of energy so that all the forces may be utilized in the
process of restoration.

There are a number of points to be considered in the care of the sick
room where the patient is confined to his bed. There should be an
even temperature maintained at all times and great care taken that
the room is never overheated. The degrees at which temperature is
to be maintained will be governed somewhat by the character of the
incoördination. In conditions involving the respiratory tract the
room may be kept quite cold. The temperature of the sick room may
vary from 50° F. to 70° F. according to the incoördination.

One of the most important features in the sick room is proper
ventilation and the elimination of dust and odors. The patient at all
times should be provided with an abundant supply of pure air free
from dust and other impurities. The room should be so ventilated
as to eliminate objectionable drafts. This may be accomplished by
placing screens in front of open windows or stretching a gauze over
the opening in the window which will admit the air but not rapid
enough to produce a draft.

In some cases of incoördinations involving the eyes it is advisable
to maintain a subdued light in the room. This may be obtained during
the day by drawing the shade part way down and during the night
by placing shades over the lamps or electric lights. If the eyes
are very sensitive to light an unnecessary adaptation may thus be
avoided, thus enabling Innate to use her forces in a more desirable
way.

[Illustration: _Changing Sheets._]

In severe cases some attention should be given to the furniture and
hangings, not so much because of any special benefit to the patient,
but for the convenience of the attendants and to insure a better
sanitary condition by eliminating everything that would tend to
catch dust and dirt and matter given off into the breathing zone.

[Illustration: _Lifting Patient with Draw Sheet._]

The bed and bedding should be kept clean and fresh. The patient
should be placed between sheets and not between blankets even in
the winter time. The top cover on the bed should be white or of a
light color. All soiled linen should be removed immediately and the
pillows should be kept well aired. If the patient is weak, or for
other reasons must be handled by attendants, a draw sheet will be a
great convenience; a sheet may be folded about three times for this
purpose and placed under the patient’s hips on top of the bed sheet.
This may be used to turn the patient, move the patient from one side
of the bed to the other, or it may be found of service in placing him
on the adjusting bench. This draw sheet may be left under the patient
without discomfort. At all times care should be exercised that the
sheet, draw sheet and covers are kept free from wrinkles. The bed
clothes should be changed in such a way as to disturb the patient as
little as possible. One-half of the bed should be changed at a time
and the patient moved over on the clean sheet with the aid of the
draw sheet. It is not expected that the chiropractor will find it
necessary to do all these things himself; indeed, if the patient is
ill enough to require this kind of care there should be a nurse on
the case. However, even though he is not going to do these things
himself, he certainly ought to know how they should be done.

[Illustration: _Draw Sheet in position for lifting patient to
adjusting table._]

If the patient is forced to use a bed pan, great care should be
exercised that the bed clothes and clothing of the patient are not
soiled. If they are they should be immediately changed or at least
as soon as practicable. The disposal of the excreta is of vital
importance. It should be removed from the sick room immediately.
From a hygienic standpoint the fecal matter, urine and sputum should
be disinfected with a 10% solution of formalin and allowed to stand
for an hour, or by adding bichloride to make a solution of one to
one thousand. The fecal matter should be placed in a receptacle and
enough hot water added to cover it, then a cup of unslacked lime
added and this allowed to stand covered for a couple of hours before
throwing into the sewer.

The patient confined to the bed should receive proper care. His
hands and face should be bathed and he should be given a sponge bath.
This may be done without disturbing the patient materially and may
add greatly to his comfort. If the incoördination is in the fever
family there will be no danger of the patient taking cold, but if
it is not a febrile dis-ease, great care must be taken to prevent
this complication. Everything possible should be done to add to
the comfort of the patient and to create a pleasant and cheerful
atmosphere about the sick room.

[Illustration: _Lifting a patient with draw-sheet to place on
adjusting table._]


Hygienic Measures Used in So-called Communicable Dis-eases

In discussing hygienic measures to be used in so-called communicable
dis-eases, it must be understood that these measures are in no sense
considered to be curative. If subluxations were adjusted as soon as
produced there would be no occasion for such considerations, for man
would remain immune and there would be no communicable dis-eases.
Since subluxations are not always adjusted as soon as produced, but
remain and become chronic and dis-ease is allowed to gather great
momentum before adjustments are given, it becomes necessary to bring
about an adaptation educationally to the incoördination. During the
course of the dis-ease certain hygienic measures should be used in
order to maintain a proper environmental condition.

[Illustration: _Patient adjusted and ready to be lifted to the bed
with draw-sheet_.]

The so-called communicable dis-eases are quarantinable and should be
reported to the proper health authorities in the states requiring
such procedure, in compliance with the law. There are certain
sanitary and hygienic measures that should be used from a standpoint
of pure cleanliness and common decency. The hygienic measures
ordinarily recommended may be summed up as follows: The stools,
urine, sputum and other excretions should be thoroughly disinfected.
The urine may be disinfected by adding bichloride to make a solution
of one to one thousand or by adding 10% formalin and allowing
the solution to stand for an hour or so. It is more difficult to
disinfect fecal matter. The masses should be thoroughly broken up and
disinfected with bleaching powder, 3%. A 5% solution of carbolic
acid may be used or formalin 10%. Another easy and effective way is
to add enough hot water to cover the entire stool and then add a
cup of unslacked lime or about one-fourth as much lime as bulk. The
receptacle should then be covered and allow to stand for a couple of
hours. In this way there will be enough heat generated by the lime to
destroy the microörganisms. The sputum should be burned.

It is recommended that the bed linen, towels and handkerchiefs used
by the patient be disinfected by immersing for at least an hour in a
solution of bichloride of mercury, one to one thousand, a 5% solution
of carbolic acid, or 10% solution of formalin.


Chiropractic Cause of So-called Communicable Dis-eases

Chiropractically the cause of the so-called communicable dis-eases
is interference with the transmission of mental impulses, which
results in lack of function. Where there is an interference with
the functions resulting in abnormal metabolism there is always an
accumulation of waste products and poisons. The accumulation of the
waste products and the correspondingly lowered resistance in these
structures provide a fertile field for the growth and development
of the bacteria that are found in the particular incoördination.
These germs are present as scavengers for the sole purpose of
consuming the waste material and these bacteria will disappear as
soon as the subluxated vertebrae are adjusted and the tissues become
normal, for they can not live on normal tissue and will be excreted
as waste. However, if there are subluxations which interfere with
the transmission of mental impulses resulting in lack of functions
in the body and microörganisms are allowed to enter the body, the
abnormal tissues will furnish them with food and a proper culture
medium in which to develop. From a chiropractic standpoint the best
prophylaxis is adjustments to restore transmission to normal and
the germs will find no food or fertile field in which to develop and
will be excreted as so much material that can not be used in the
metabolism of the body.

Under chiropractic adjustments the incoördination (so-called
contagious dis-ease) will not run its full course; as a matter of
fact, the recovery may be so rapid that the patient will be sick only
a very few days. Under adjustments there will be no complications or
sequelæ and for this reason there is not the necessity for hygienic
measures to the same extent as under ordinary treatment, but during
the time the patient is sick hygienic measures should be observed.




CHAPTER XV

FOOD


FOOD


GENERAL CONSIDERATIONS

  NECESSITY FOR FOOD
      DEFINITION OF FOOD
      TRANSFORMATION INTO BODY TISSUE

  DISTINCTION BETWEEN APPETITE AND HUNGER
      APPETITE DIRECTED BY EDUCATION
      HUNGER DIRECTED BY INNATE
      OVEREATING
      SYMPTOMS OF OVEREATING

  STARVATION
      DEFINITION
      SENSATION OF HUNGER

  INANITION
      DEFINITION
      MALNUTRITION

  BALANCED RATIONS
      IMPORTANCE OF
      CONTENTS OF


CLASSIFICATION OF FOODS

  SOURCES OF FOOD
      ANIMAL
      PLANT
      MINERAL

  CHEMICAL COMPOSITION
      NITROGENOUS
      NON-NITROGENOUS

  PHYSICAL PROPERTIES

  FUNCTION OF FOODS
      PROTEINS
      CARBOHYDRATES
      FATS
      CONDIMENTS
      INORGANIC SALTS
      VITAMINS




CHAPTER XV

FOOD


GENERAL CONSIDERATIONS


Necessity for Food

Food is defined as nutritive material absorbed or taken into the
body of an organism for purposes of growth or repair and for the
maintenance of the vital processes. Food is derived from two
sources—the animal kingdom and the vegetable kingdom.

The body is composed of materials which are constantly wearing out
under the processes carried on in the functioning of the body, and
this tissue must be replaced with new material. This is supplied in
the form of food that is taken into the system and acted upon by the
secretions in such a way as to break up and properly combine the
chemicals so that Innate Intelligence may bring about an assimilation
in the tissue cells.

The variety of articles that Innate can use as food in the body is
varied. It is not necessary to have a perfect food or a perfectly
rationed diet in order for Innate to maintain the anabolism of the
body. The ease with which the processes of digestion are carried on
depends upon the freedom with which mental impulses are transmitted
to the organs of digestion.

As there is a constant flow of mental impulses through the nerves and
a constant expression in the tissue cells so there is a corresponding
change taking place in the tissues of the body. To this change there
must be a constant adaptation so that new tissue will be provided to
replace that which is worn out. To accomplish this there must be a
proper supply of nutrition at properly stated intervals.

It is not the purpose of chiropractic hygiene to say what a person
should or should not eat. Innate Intelligence is the best judge as to
that. Chiropractic philosophy teaches that a person may eat anything
that does not disagree with him; or to put it otherwise, a person
should eat what agrees with him. It also teaches us that pain and
discomfort from eating that which does not digest is Innate telling
the educated mind that this particular article is not being digested
and that he should not eat it. This lack of digestion is not the
fault of the food, but is due to an interference with transmission
which prevents Innate from bringing about an adaptation to this food.
In other words, the interference with transmission prevents Innate
from producing the secretion that is needed in the digestion of this
particular article or diet.


Distinction between Appetite and Hunger

It is quite necessary that we make a distinction between appetite
and hunger. Hunger is Innate calling for food. It is the expression
through the educated brain of the vibratory interpretations which
are received from the tissue cells that are in need of nutrition.
These vibrations are interpreted by Innate Intelligence and Innate
becomes aware of the need of the tissue cell. Thereupon she expresses
this interpretation through the educated brain and we become aware,
educationally, of this condition which is interpreted as hunger.

Hunger is an Innate interpretation while appetite is an educated
interpretation. Hunger is a desire for food while appetite is a
desire for a certain kind of food. The appetite decides what kind of
food we will eat to satisfy the hunger. Appetite may be perverted.

When there is a condition which interferes with the process of
digestion Innate Intelligence takes away the desire for food. When
this is true there should be no effort on the part of the educated
man to tempt the appetite. If the appetite is tempted in such a case,
the food will not be properly digested, or if it is, it will be
necessary for Innate to employ force that should be used for some
other purpose.

If the processes of digestion are normal the individual may eat
any article of food and it will be properly digested and he will
not be conscious of this process. But if the process of digestion
is abnormal he may not be able to digest even the most scientific
diet. The severity of the indigestion will depend upon the degree of
interference with function. In such event appetite is not reliable
because it may call for something that can not be digested. Innate
knows nothing of the different foods. She calls for nutrition, but
the educated mind says beefsteak and eggs. Now if we become sick
after eating beefsteak and eggs this is Innate trying to let us know
that the food is not being digested and should not be taken into the
stomach.

On the other hand we may find that Innate will revolt when we try to
eat food which can not be digested. Innate will cause us to lose our
desire to eat such food, the very thoughts of it being repulsive.

Chiropractic philosophy maintains that a patient should eat anything
that agrees with him and that Innate is the best judge. A food is
anything that can be used in the metabolism of the body. A poison is
anything that can not be used in the metabolism of the body and if
allowed to remain in the body will injure the tissues. That which is
food for one may therefore be poison for another.

If there was no interference with the transmission preventing the
normal expression of Innate Intelligence through the educated brain,
we would eat only those things which could be digested. It might
be said that Innate is a great dietitian and one that would never
make a mistake if there could always be a perfect expression. The
trouble is that we substitute educated for Innate and therefore make
mistakes and eat those things which can not be digested because of
interference with transmission of mental impulses.

The amount of food and the kind required by man will be governed
largely by the character of the work he does. The state of health,
the climate and season, occupation, clothing, exercise, body weight,
sex and age all have an influence on the quantity of food required to
maintain bodily health.

The appetite could be relied upon to determine just the quantity
and quality of our diet were it not for the fact that, in this day
of civilization when cooking is a fine art and the appetite is so
stimulated, we eat beyond the normal requirements of the body. As
a result the stomach is overloaded with food that is not required
for the normal health and vigor of the individual. The digestive
organs are overworked. There is an engorgement of the liver, and
degenerative changes, such as fatty heart, take place.

The symptoms of overeating are: headache, feeling of lassitude,
drowsiness, mental stupor, the liver becomes congested, the
intestines are engorged, the secretions of the body are altered in
their composition, the urine is heavily loaded with salts, there is
constipation, maybe biliousness, and the tongue is heavily coated.
There may also be obesity and gout.


Starvation

Food must be taken into the body in sufficient quantity and quality
so that bodily function may be maintained. The term starvation is a
technical one meaning a lack of sufficient food, although it is used
loosely to mean a condition resulting from lack of assimilation.
After the food in the stomach has been completely digested and the
process of assimilation has reached a certain stage, vibrations
are carried from the tissue cells to the brain. These enable the
intelligence to know in what stage of assimilation the food is, and
these vibrations are interpreted as hunger, the sensation being
localized in the stomach. In the normal individual this sensation
will appear soon enough to enable the introduction of food into the
stomach so that its digestion may be completed before any injury
from lack of nutrition occurs to the tissues. In other words, a
provision has been made whereby food will be called for in sufficient
time to enable Innate Intelligence to prepare this food for the
tissue cells, so that there will be a new supply as soon as the
process of assimilation has been completed. If food is not taken into
the stomach when the sensation of hunger is manifested this sensation
in the course of time will result in extreme bodily weakness and
faintness. In certain incoördinations sensations may be produced
which will be interpreted by the educated mind as hunger. Therefore,
it is necessary to make a distinction between the sensations of
hunger and the sensations from incoördinations of the stomach. In a
dyspeptic condition there is an almost constant sensation of hunger,
and the individual may eat much more food than can be digested. Very
often, in these cases, the food is taken into the stomach so rapidly
that there is not sufficient time for the gastric secretions to act
upon it. In this way much more food may be taken into the stomach
than is actually required by the tissue cells. It is obvious that
we must have a proper amount of food in balanced rations, and also
that this food be properly digested in order to be assimilated by the
tissues. If food is not properly digested it can not be assimilated.


Inanition

There may be a condition obtained in the body resulting from a
lack of assimilation of food by the tissues, even though there is
a sufficient amount of food taken into the body. This condition
is known technically as inanition. Death will result in a short
time when food is completely withheld whether the condition is
that of starvation or inanition. There may be an interference with
transmission of mental impulses to the digestive organs. This will
interfere with digestion, and inanition will result because the
food which is not properly digested can not be assimilated even
though the tissue cells are perfectly normal. Inanition may also
result from an interference with transmission, which prevents the
tissue cells from performing their normal function in the process of
assimilation. In this way the tissues starve for the want of food,
not because there is a lack of nutrition in the body, but because
the food taken into the system has not been properly broken down
by the digestive secretions, or if it has been properly digested
it has not been assimilated. It is a recognized fact that a large
percentage of growing children are underweight. Authors differ as to
the percentage. It ranges all the way from 15% to 60%. This condition
is not necessarily caused by an insufficient amount of proper food,
for the condition has been found more prevalent among the children of
the wealthy than among those of the poorer classes. This shows that
the cause for such malnutrition is within the child and not in the
food that he is eating. In the large majority of cases it is either
because the food is not being properly digested or is not being
assimilated after it has been digested. It is quite necessary that
there be a properly balanced diet, but even a perfectly balanced diet
will not guarantee perfect assimilation. This can be accomplished
only through unhindered transmission and expression of mental
impulses in all parts of the body.


Balanced Rations

Properly balanced rations will enable Innate Intelligence to
promote the growth and maintain the processes of the body with the
greatest ease and the least necessity for the adaptative expenditure
of internal energy. Much attention has been given the science of
nutrition. At one time there was great importance attached to the
chemical composition of foods, special attention being given to the
proteins, carbohydrates and fats contained in the diet. Later it was
thought that certain inorganic salts were necessary. Great stress has
been placed upon the caloric value of food. The latest students in
the science of nutrition have emphasized the value of vitamins.

A properly balanced diet should contain sufficient calories and
inorganic salts, especially iron, phosphorus, calcium and iodin.
There should be a sufficient variety of foods to provide the
necessary vitamins. It is also thought that a certain amount of
roughage is necessary. If we expect the best results from our
digestive tract we should strive to keep the balance approximately
the same each day. This is not because Innate Intelligence is unable
to adapt the body to a great variety of food, but it is more to
prevent a necessity for such extreme adaptation. To illustrate:
If we constantly introduce too much acid into the stomach, it
necessitates an adaptative action on the part of Innate Intelligence
in the production of an alkali to neutralize the acid. Since we
know so little educationally about nutrition, it is wise for us to
eat as great a variety of foods as possible, and especially is this
necessary in providing a balanced ration for growing children.

In considering food we must not forget the importance of proper
digestion and assimilation. In Chiropractic the diet is of little
importance, providing the functional activities of the body are
maintained at normality.


CLASSIFICATION OF FOODS


Sources of Food

Foods are classified according to source, chemical composition,
physical properties and function.

In classifying food as to its source we have three classifications:
animal, plant and mineral. Meat, fowl, fish, shell-fish, eggs, milk
and its products, animal fat and gelatin help to constitute the
animal foods. Seeds, roots, leaves, cereals, vegetables, fruits,
sugar and vegetable oils are plant foods. From the mineral there are:
iron, potassium, phosphorus, iodin, sulphur. These are obtained from
the animal and plant foods. Water is not classed as a food, but it
enters into the diet as a very important constituent.


Chemical Composition

From the standpoint of chemical composition foods are grouped into
two classes, nitrogenous and non-nitrogenous. Both the animal and
vegetable kingdom contribute foods to each of these classes, although
the animal substances belong more to the nitrogenous, while the
vegetable kingdom belongs more particularly to the non-nitrogenous
foods. The nitrogenous foods consist chiefly of carbon, oxygen,
hydrogen and nitrogen and are considered to be essentially tissue
builders. Hygienists speak of the non-nitrogenous foods as being
force producers, asserting that these foods supply energy for
muscular action.


Physical Properties

Under this heading foods are classified as: (a) solids, semi-solids
and liquid foods; (b) fibrous, gelatinous, starchy, oleaginous,
crystalline and albuminous foods. The indigestible residue is called
roughage.


Function

Foods are classified as: Proteins, carbohydrates, fats, condiments,
inorganic salts and vitamins.

=Proteins= are the tissue builders of the body. They are derived
from meat, milk, eggs, peas and beans for example. Some foods are
much richer in protein than others, and there is also a difference
in the quality of the protein. Some protein is more valuable from
the standpoint of food than others. Casein is very rich in protein
which is of great food value. The protein found in meat is also of
good quality, but it is not as valuable as that found in milk. Such
cellular organs as the liver and pancreas furnish a good source
of protein. There is a very small amount of protein of excellent
quality found in leafy plants. There is a difference of opinion
among authors as to the amount of protein needed per day by healthy
individuals. Some advise a very small amount of protein while others
recommend a diet containing as much as 125 grams, approximately four
and one-half ounces, per day.

The =carbohydrates= furnish the body with the necessary material
for forming adipose tissue and heat through oxidation. It is very
essential that the body be provided with sufficient starches. This
is evidenced by the fact that starch constituents are so universally
found in food from whatever source taken. For example, carbohydrates
or starchy foods are found in cereals, tubers, such as potatoes, and
sugars of cane, beets and fruits, and glycogen in flesh.

=Fats= come from animal and vegetable sources and are represented by
butter, fats of meat, olive oil, cottonseed oil, nuts and seeds. Oily
substances are found in practically all vegetables. A vitamin known
as fat soluble A is found in certain fats, but not in others. It is
found in the fat of milk and usually in other fats of animal origin;
and also in eggs and in leafy plants. Lard and oil of plant origin
furnish very little of this vitamin. It can readily be seen by this
that all fats do not have the same food value.

The =condiments= are the spices such as pepper, mustard, cloves,
coffee, tea and alcoholic beverages.

=Inorganic= salts are not ordinarily classed as a food. However, it
is essential in the maintaining of life. It performs a very important
function in the building of bone and assists also in digestion and
metabolism. The vegetable acids, such as tartaric from grapes, lemon
and citric, will be found in combination with the bases calcium,
sodium and potassium, for example, especially when they are taken
from fresh vegetables and fruits. When absorbed they form carbonates
and are therefore indispensable in the process of metabolism, since
they aid in maintaining the alkalinity of the body. If the food of
the growing infant is deficient in calcium phosphate, or if there
is an interference with transmission which hinders the activity of
calcium phosphate in the body, the bones of the child will be poorly
developed and will become abnormally soft. In this case they yield
under the weight of the body and become deformed. A good illustration
of this is seen in rickets.

Milk forms an excellent source of calcium in large quantities and in
a utilizable form. The fact that milk is deficient in iron must be
taken into consideration when it is used as a sole article of diet
for growing children.

Vitamin is the name given to a chemical substance found in yeast and
in rice polishings. It was so named by Dr. Casimir Funk, a Russian
chemist, in 1913. The chemical nature of the vitamin is unknown,
but it has been proven that it possesses great growth-producing
qualities, a small amount producing great results. Only three
vitamins have been recognized. One is soluble in fat and has been
called fat soluble A, the other two are soluble in water and are
known as water soluble B and water soluble C.

Fat soluble A is found in the leaves of plants, spinach, carrots,
peas, peanuts, but more abundantly in eggs, butter and milk; it is
also present in such glandular organs as the liver and kidneys. Cod
liver oil is found to contain this vitamin. It is found to be almost,
if not entirely, missing from lard and the fats of vegetable origin;
sugar from cane, milk and beets, bolted flour, starch and glucose and
polished rice are entirely devoid of this vitamin, while the rice
polishings are exceedingly rich in fat soluble A.

Experiments have been made upon rats and dogs which show that if they
are fed upon a diet devoid of this vitamin they develop a condition
similar to rickets. Their eyes become inflamed and dry and eventually
blindness results.

The vitamin known as water soluble B is probably the most widely
distributed of the vitamins. It is obtained in tubers, seeds,
leaves of plants and in animals, but not in the oils or fats of
either vegetable or animal origin. This vitamin promotes growth.
The prolonged absence of it induces beriberi. Water soluble B is
not destroyed by boiling the foods in which it is found. This
vitamin is found in yeast, navy and soy beans, milk, parsnips,
potatoes, spinach, whole grain, rice, maize, carrots, onions, oats,
cauliflower, celery, rutabagas and whole wheat bread. This vitamin is
present in very small quantities in such foods as cabbage, tomatoes,
peas, eggs and wheat bran. All ordinary foods contain this vitamin.
Water soluble B is known as the antineurotic vitamin.

The water soluble C vitamin is known as the antiscorbutic vitamin. In
experimentations it has been found that animals entirely deprived of
this vitamin have developed scurvy. The condition disappeared when
the vitamin was included in the diet.

The experiments by which it has been hoped to associate many
dis-eases with vitamins have not proven satisfactory, and while it
is a recognized fact that they play an important part in the bodily
metabolism yet dis-ease can not be corrected by a scientific endeavor
to supply the needed vitamins through diet.

Water soluble C is found in such foods as: apples, cabbage, tomatoes,
spinach, peas, onions, lettuce, oranges, potatoes and milk.




CHAPTER XVI

FOOD POISONS


FOOD POISONS

  SOURCE
      FORMATION PERIOD
      SYMPTOMS

  FOOD INFECTION
      INCUBATION PERIOD
      SYMPTOMS
      MORTALITY RATE

  FOOD INTOXICATION
      BOTULISM
      SOURCE
      PERIOD OF INCUBATION
      SYMPTOMS
      MORTALITY RATE

  ADULTERATION OF FOOD
      MEANS OF
      MOST COMMON ADULTERATIONS




CHAPTER XVI

FOOD POISONS


Sources

In most instances such poisoning comes from food that is preserved in
some way. Very seldom do we find this poisoning in fresh foods. Such
prepared foods as chopped meats, sausage, meat pies and salads, for
example furnish the best sources for this poisoning. The formation
period of the poison usually covers from eight to twenty-eight hours.
There are two classes of food poisoning: first, food infection;
second, food intoxication. Clinically, there is a great difference
between them. Food infection is an acute condition in which there is
nausea, vomiting, cramps, diarrhœa and fever. Food intoxication is a
febrile condition characterized by nervous symptoms, paralysis and
constipation.

In food infection the mortality is seldom above 1%, while in food
intoxication it runs from 50% upward. The condition resulting
from food intoxication is known as botulism. The statistics which
are available on food poisoning would indicate that it is not
very prevalent and the number of persons involved in outbreaks is
comparatively small.

Many conditions in which there are gastro-intestinal symptoms might
be mistaken for food poisoning. Such symptoms as nausea, cramps,
vomiting or diarrhœa may be due to acute gastric indigestion, and may
not be in any way associated with food poisoning.

Foods containing such poison should be thoroughly cooked so that the
heat may penetrate to the very center. A temperature of 70° C. is
sufficient to render the food free of the poison.


Food Infection

The incubation period of food infection is usually from six to twelve
hours from the time the food is taken into the stomach until the
manifestation of symptoms. This period may in some cases be reduced
to only four hours, while in others it may be extended to seventy-two
or more hours. This class of food poisoning is sometimes called meat
poisoning from the fact that meat forms its chief vehicle, but milk
and milk products and even vegetables may contain it.

The =symptoms= are characterized by acute gastro-intestinal
disturbances. The onset is usually sudden. The first to appear are
severe griping pains in the abdominal region, there may be various
nervous manifestations, such as drowsiness, muscular twitchings and
more or less restlessness. The abdominal pains may be accompanied
with diarrhœa, nausea and vomiting. There may be chills and headache.
As the condition progresses the stools become a greenish color and
of a very watery consistency. There may be chills and headaches,
marked muscular weakness, faintness and possibly prostration. The
temperature runs from 102° F. to 103° F. There is excessive thirst,
skin eruptions and herpes. There is often oliguria. The severity of
the symptoms will depend upon the amount of poison taken into the
system and the freedom of transmission of mental impulses, which will
enable Innate Intelligence to bring about her adaptative processes.
Usually the attack lasts only a few days, although the fulminating
cases may prove fatal within twenty-four hours. Warm weather seems
to be conducive to the formation of this poison, since the greater
number of outbreaks occur in the summer time.


Food Intoxication

This form of food poisoning is called botulism. The poison which
forms is the specific toxin produced by the activity of the bacillus
botulinus. The botulis itself lives on decayed organic matter,
therefore it is of the saprophyte type. This poison is found in a
great many different foods of both plant and animal origin. The
intoxication in botulism affects the central nervous system. It is a
febrile condition and there are no gastro-intestinal disturbances.
Usually the symptoms in botulism will appear from eighteen to
thirty-six hours after the poison has been taken into the stomach.
There are cases on record in which the symptoms have appeared within
four hours. The period of incubation depends upon the amount of toxin
ingested and the ability of Innate Intelligence to adapt the body to
the poison.

The =symptoms= usually begin with headache and dizziness, feeling
of fatigue and muscular weakness. One of the early symptoms is a
disturbance of vision which may progress until the patient is blind.
Both the extrinsic and intrinsic muscles of the eye become involved.
There is blepharoptosis and the pupils become dilated. There is
diplopia and the loss of adaptative response of the eye to the
light. There is soon complete loss of accommodation, opthalmoplegia,
nystagmus, strabismus and in some cases photophobia.

Concurrent with the beginning of the disturbances of vision there
is difficulty in swallowing and talking, with a feeling of throat
contraction. There may be frequent attacks of strangling, with
extreme dryness of the mouth and throat, which result in a cough.
Stubborn constipation results from lack of peristalsis. Beginning in
the intestines and passing gradually upward there is progressive,
ascending paralysis. The lack of proper nervous tone is evidenced
by fatigue, drowsiness, headache and unsteadiness in walking which
may result in a steppage gait, there is great muscular weakness and
incontinence of urine. Other prominent symptoms are an insufficient
secretion of saliva, sweat and tears and a deficiency in the
excretion of urine. This results in a typical “dry man” condition.
Later in the course of the dis-ease the temperature is subnormal
and the pulse rapid. There may be paralysis of the laryngeal and
pharyngeal muscles, which results in an inability to swallow.
There may be complete aphonia. The case is very likely to develop
bronchopneumonia, in which event there will be temperature. The
facial expression is that of great anxiety and utter helplessness.
The sensation of strangling becomes more frequent and there is a
struggle for breath, death eventually resulting. The duration of this
dis-ease varies greatly. Death may result in forty-eight hours after
the poison has been ingested. Seldom will a condition run more than
eight days. In cases that recover, convalescence is very slow. The
patient may be many months recovering. The prognosis in botulism is
considered very unfavorable, the mortality being as high as 100% in
some outbreaks. The lowest mortality, according to statistics, is
37.5%.

Microscopic examination of the bodies which are the victims of
botulism has revealed a great congestion of the central nervous
system and also of the abdominal and thoracic viscera. Some have
shown a great number of hemorrhages at the base of the brain and
the upper portion of the spinal cord; the lungs are also congested.
Originally it was supposed that food intoxication came only from
sausage or other meat, but it has later been proven that this poison
might develop not only in meat but in such food as string beans,
cottage cheese, corn, asparagus, spinach and ripe olives. It has
also been found in turkey, chicken and fish. Most cases of botulism
result from the eating of foods that have received some preservative
treatment; seldom will it be caused from the eating of fresh foods.
Chiropractically this condition is in the poison family and would
involve S.P. and K.P. as a major.


Adulteration of Food

Food adulteration may consist in:

  1—Extraction of nutritive substances.

  2—Addition of substances lowering the quality of the food.

  3—Substituting inferior grades of food.

  4—Fraudulent labeling of food.

  5—Changing the appearance of food by coloring or other methods
  which will conceal the inferior quality.

  6—Adding injurious substances for the purpose of preserving the
  food.

The Pure Food Act of 1906 makes the following classification in a
statement of the methods which are considered in the adulteration of
foods:

  1—“If any substance has been mixed and packed with it so as to
  reduce or lower or injuriously affect its quality or strength.

  2—“If any substance has been substituted, wholly or in part, for
  the article.

  3—“If any valuable constituent or article has been, wholly or in
  part, abstracted.

  4—“If it is mixed, colored, powdered, coated or stained in any
  manner whereby damage or inferiority is concealed.

  5—“If it contains any poisons or other added deleterious
  ingredient, which may render such articles injurious to health.

  6—“If it consists in whole or in part of a filthy, decomposed or
  putrid animal or vegetable substance, or any portion of an animal
  unfit for food, whether manufactured or not, or if it is the
  product of a dis-eased animal or one that has died otherwise than
  by slaughter.”

Rosenau gives the following as the most common adulterations:

  “Cottonseed oil is sold as olive oil; honey may contain glucose;
  cocoa and chocolate are frequently mixed with both starch and
  sugar; coffee is extensively adulterated with caramel, pea-meal,
  chickory and saccharose extracts; lard is mixed with cheaper
  fats or cotton seed oil; saccharin is substituted for cane sugar;
  cereals give bulk and weight to sausages; gypsum or bran is added
  to flour; barium sulphate to powdered sugar, flour to turmeric or
  corn-meal to mustard; oleomargarine is sold as butter; distilled
  and colored vinegar is sold as cider vinegar; ground spices are
  adulterated with cocoanut shells, rice, flour and ashes; water,
  sugar and tartaric sold as lemonade; wines and liquors are
  sometimes adulterated with alum; baryta, caustic lime, salicylic
  acid, wood alcohol and hematoxylin, terra alba, kaolin, and various
  pigments are sometimes added to candies; gum drops are largely made
  with petroleum paraffin products; much of the maple sugar formerly
  sold was made from glucose and coloring matter.”

A good illustration of separating the nutritive substances is the
extraction of cream from milk and certain elements from meat. There
is really no objection to abstracting nutritive elements from food
if afterward that food is properly labeled; there is no objection in
taking cream out of milk and selling the skim milk, providing it is
not sold for whole milk.

An illustration of lowering the quality of the food is the addition
of water to milk, of bran to flour, of bariumsulphate to powdered
sugar.

An illustration of substitution would be to substitute saccharine for
sugar, oleomargarine for butter, cottonseed oil for olive oil.




CHAPTER XVII

MILK


MILK


COMPOSITION

  MILK AS A FOOD

  PROTEINS
      CASEIN
      LACTALBUMIN
      LACTOGLOBULIN

  FAT
      CREAM
      SKIM MILK
      BUTTER

  VITAMINS
      FAT SOLUBLE A
      WATER SOLUBLE B
      WATER SOLUBLE C

  LACTOSE OR MILK SUGAR
      DEFINED
      LACTIC ACID


SANITARY MEASURES IN PRODUCTION

  MILK, A GERM MEDIUM

  CARE IN THE MILKING

  CARE OF THE COWS

  BARNS AND BARNYARDS
      FREE FROM MANURE
      GROUND WELL DRAINED
      STABLES PROPERLY VENTILATED

  BOTTLING
      STRAINING
      IN SEPARATE MILK HOUSE

  PROPER TEMPERATURE
      NOT ABOVE 50° F. IN TRANSPORTATION
      STERILE MILK

PREPARATION OF MILK AND MILK PRODUCTS

  PASTEURIZATION OF MILK
      DESTROYS SO-CALLED PATHOGENIC GERMS
      DOES NOT CHANGE DIGESTIBILITY
      FURNISHES PURIFIED MILK
      ARTIFICIAL PRESERVATIVES DANGEROUS

  CONDENSED MILK
      SOME OF WATER REMOVED
      POOR IN VITAMIN C

  DRY MILK
      IN POWDER FORM
      POOR IN VITAMIN C
      SUBSTITUTED FOR FRESH MILK

  BUTTER
      CHURNING
      CONSTITUENTS
      OLEOMARGARINE

  CHEESE
      PROCESS
      NITROGENOUS SUBSTANCES




CHAPTER XVII

MILK


COMPOSITION OF MILK


Milk as a Food

Milk contains all the elements necessary in a balanced diet for the
adult and furnishes an almost perfect food for the suckling. Milk
is lacking in iron and roughage and is therefore not suitable for
the sole diet of adults. This is compensated for in the infant by a
large amount of iron which is contained in the spleen and furnishes
this necessary element during the suckling period. There is no other
single food that will so well promote the growth and development in
young children. Milk is easily digested, is palatable, and forms one
of our best and most important articles of food. It is asserted that
the consumption of milk in the United States will average about 0.6
of a pint per capita per day. In many countries there is practically
no milk used. In the United States about 16% of the dietary consists
of milk and its products.

Milk is an animal secretion produced by the mammary gland and is
exceedingly complex in its composition. It consists chiefly of water
containing various solids in solution. Cow’s milk consists of 87%
water and 13% solids. The solids consist of fats in emulsion, milk
sugar, albumin, casein and mineral matter. Milk also contains such
gases as oxygen, nitrogen and carbon dioxide. It contains enzymes,
phosphatids and vitamins, also antibodies and other substances.

Fresh normal milk is an opaque fluid of white or yellowish-white
color and has a sweetish taste and rather pleasant odor. In reaction
milk is amphoteric, that is, it is acid to litmus and alkaline to
turmeric. The specific gravity of cow’s milk is from 1.027 to 1.035.
Under the microscope it is found to contain fat globules and cells,
also bacteria and other objects. The oxygen and nitrogen that are
found in milk are thought to be carried into it mechanically from
the air during the process of milking. Lecithin, cholestrin, citric
acid, lactosin, orotic acid and ammonia are found in milk in small
quantities.


Proteins

Casein, lactalbumin, and lactoglobulin are the three proteins found
in milk and are usually constant in a given species.

Casein is found nowhere in nature except in the secretion of the
mammary glands. It is highly specialized and, as a nucleoalbumin,
contains a certain amount of phosphorus. Lactalbumin is a protein
found in quantities varying from 0.2% to 0.8%. It is similar to the
serum albumin in blood and coagulates at 70° C. There is a mere trace
of lactoglobulin in milk. It is insoluble in water.


Fat

Milk contains fat in emulsion; that is, the fat is suspended in the
serum of milk in the form of emulsion. The fat is lighter than the
milk serum and therefore rises to the top in the form of cream,
or the fat may be separated from the milk by centrifugal force.
Cream does not consist in fat globules alone but contains the same
constituents as the milk, only it is very much richer in fat. By
agitating the cream, as in a churn, or by means of shaking, the fat
globules will coalesce and form into lumps of butter. It is stated
by some authors that cream contains a larger number of bacteria than
skim milk. The fore milk, or that which is first milked from the
udder, has a small amount of fat; the last that is taken, which is
known as the strippings, may contain as much as 9% or 10% of fat. An
increase in the temperature of the milk will retard the rising of
the fat and if the temperature is kept above 65° C. for any length
of time, cream will not form on top. Therefore, it follows that a
moderately low temperature will increase the rapidity with which fat
rises to the top of the milk.

Parkes says, “Milk should not have less than 12.5% of total solids of
which 3.5% is fat and 0.7% is salts; ... the percentage of cream by
volume not less than 10%.”

Infants placed on a diet of milk that is too rich in fats will
thrive for a while, but in time will lose weight and show other
symptoms, indicating the inability of Innate to digest the food. The
stools become hard and dry, of a pale color and composed largely of
fat soaps. This shows that Innate is unable to furnish sufficient
alkaline bases through the body to saponify the excessive amount
of fat in the intestines. This results in a condition resembling
acidosis.


Vitamins

Milk is found to contain all three vitamins, A, B, and C, known
as the fat-soluble A, water-soluble B, and water-soluble C. Cream
is rich in vitamin A. This vitamin increases growth and promotes
nutrition and is therefore valuable in the diet of the young. Vitamin
A and B are not destroyed by heat, unless it be a very great degree
for a long period of time; they also resist drying and age. For
this latter reason milk may be used in cooking and still retain the
virtues of these two vitamins, as well as do evaporated milk and
dried milk. Vitamin C is impaired and may be completely destroyed by
high temperature and deteriorates with age and with drying. There
is no article of food (diet) that is superior to milk in dietetic
and nutritional value, and especially is this true of butter fat.
The standard by which milk is tested is the amount of butter fat it
contains.


Lactose or Milk Sugar

Milk contains what is known as milk sugar or lactose. It is white
crystalline sugar, has a slightly sweet taste and is soluble in
water. When acted upon by microörganisms it is changed into glucose,
and the glucose is then reduced to lactic acid, the lactic acid being
the cause of the milk souring. Milk sugar is found nowhere else in
Nature.


SANITARY MEASURES IN PRODUCTION


Milk, a Germ Medium

Milk, because of its characteristic qualities, forms a medium in
which all kinds of bacteria and germs, or low forms of life, thrive.
When we consider the processes necessary to obtain the milk and
deliver it to the consumer, even though the most rigid sanitary
methods are observed, it can readily be seen that milk is exposed to
almost all kinds of dirt and to the different forms of organisms.

It is very difficult to obtain milk in a state of purity and if
germs played as important a part in the production of dis-ease as is
thought by some, one of the most important articles of diet would be
lost to mankind. Great quantities of these germs are ingested into
the stomach of individuals who drink milk.

These bacteria are carried into the milk during milking and in the
handling of the milk and the retainers. Bacteriological standards
have been established, but vary a little with different authors.
Usually it is agreed that certified milk should not contain more than
10,000 bacteria per cubic centimeter. Market milk should not have
more than 1,000,000 bacteria per cubic centimeter in the raw state
and not more than 50,000 per cubic centimeter after pasteurization.

It can be seen by this standard that even the relatively pure milk
contains great numbers of bacteria and yet these bacteria are
ingested into the digestive tract and no harm done. As a matter of
fact, this helps to substantiate the contention of Chiropractic that
these germs and the different bacteria are essential to life. There
is no question, however, that poisons may be contained in milk,
and when these are taken into the stomach Innate may not be able
to properly adapt the tissues and thus a toxic condition will be
produced.

Because of the characteristic qualities of milk, the strictest
sanitary measures should be observed in all the processes involved,
from the time the milk is taken from the cow until it is delivered to
the customer.

Milk undergoes certain physical, chemical and biological changes as
soon as it is taken from the cow: the cream rises and thus it is
separated from the milk; there is also a separation of the solids
from the fluids.


Care in the Milking

A sanitary environment should be provided for the cows and special
care should be taken in the process of milking to prevent the milk
from becoming contaminated with dirt and filth. Those who handle this
milk should take proper precautions to prevent dirt from getting into
it. All utensils should be kept clean, sweet and free from sour milk.

Sanitary measures should include: Proper care and feeding, or the
health of the milch cows; (2) proper regulation of the bottling and
transportation of the milk. The cows should by all means be healthy,
inasmuch as milk is an animal secretion. It is certain that if the
animal is suffering from dis-ease, this secretion will not be normal.
Over-exertion and fright will also affect the milk. Care must be
exercised to detect dis-ease and such dis-eased animals should be
separated from the herd and their milk not used.


Care of the Cows

The cows should have plenty of exercise, but care should be taken
that they are not frightened or over-exerted. They should be provided
with proper protection from the weather and should have plenty of
fresh hay, ground whole grain, and, when possible, be allowed to
graze. Spoiled vegetables or fruits, foul or fermented foods are
detrimental to dairy cows. A proper supply of salt is necessary and
plenty of pure, fresh water is absolutely essential for the health of
cows.


Barns and Barnyards

The barns and barnyards where milch cows are kept should be free from
manure, pools of stagnant water, dirt and refuse. The ground should
be well drained so that it will not become water-logged. Such ground
should be located on elevations to assure proper drainage. The habit
of allowing the refuse to accumulate in large quantities before
hauling it away is not only repulsive but very unsanitary and may
become a source of pollution of the milk supply.

[Illustration: barn stalls]

Stable should be constructed to assure proper ventilation and to
provide proper shelter for the animals. The floors should be of
material that is non-absorbent, well drained, and easily cleaned.
Concrete is best. Each cow should have a separate stall furnished
with a stanchion. The walls should be of material that can be
cleaned. There should be 600 cubic feet space for each cow in the
barn.


Bottling

Milk should be strained through gauze placed over the wire strainer.
All the utensils should be thoroughly cleaned after each milking and,
if possible, sterilized in a steam sterilizer. The straining should
not be done in the barns where the cows are, but in special separate
milk houses. The bottling should be done only in establishments
specially fitted for such purpose.


Proper Temperature

Milk should be kept at a temperature not above 50° F. during
transportation. The cans or bottles should be properly covered,
sealed, and the milk protected from too much agitation.

Because milk undergoes a very rapid change, beginning almost as soon
as it is drawn from the cow, it is necessary to either consume it
in a short time or provide some means of preserving it. Milk soon
deteriorates, becomes sour and unfit for use as food.

The best means of preserving milk is to keep it at a low temperature.
Bacteria are not destroyed in low temperature, but the activity
is inhibited and their development retarded. In this way milk is
kept from souring and from undergoing fermentative changes. The
digestibility and character of milk are not changed by cold, and it
will be sweet for a day or even longer if kept at a temperature under
50° F.

An entirely sterile milk may be furnished only by raising the
temperature to 248° F. for at least two hours, but this destroys the
milk ferments. There are certain changes produced by boiling milk
which renders it less desirable for food, making it less digestible.
It is, therefore, especially undesirable for infants.




PREPARATION OF MILK AND MILK PRODUCTS


Pasteurization of Milk

In pasteurizing milk it is heated to a temperature of 60° C. (140°
F.) for a period of twenty minutes. This destroys the so-called
pathogenic germs, yet does not destroy the ordinary milk ferments. It
does not change its digestibility nor alter the taste or appearance.

All of the so-called pathogenic germs, such as tuberculosis, typhoid,
dysentery and diphtheria, for example, are completely destroyed by
pasteurization, but the ferments are not destroyed and the milk is
in no way altered. This process may be accomplished on a large scale
and thus furnish as safe milk for commercial consumption. Pasteurized
milk should be rapidly cooled after heating, and if kept cool
furnishes a clean, healthy milk entirely safe and satisfactory for
infant food as well as for adults.

Pasteurization furnishes a purified milk but not a pure milk. It is
undoubtedly the best means of preservation and may be considered as
bearing the same relation to purification of milk as filtration bears
to purification of water.

The use of formaldehyde, borax and boracic acid is as objectionable
in artificial preservation of milk as in the preservation of meat and
other foods and should not be tolerated.


Condensed Milk

Milk is condensed by removing some of the water. It is made either
from skim or whole milk. It may be unsweetened or sweetened with cane
sugar. Condensed and evaporated milk should contain a label stating
the grade of milk used. Condensed and evaporated milk are poor in
vitamin C.


Dry Milk

It has been found that by certain processes it is possible to dry
milk, taking all the water out and leaving a powder. This may be
accomplished and still retain most of the nutritive value of the
milk. Vitamin fat soluble A and water soluble B remain practically
the same, but water soluble C vitamin is diminished. Babies fed
on dried milk will thrive, but orange juice or some other food
containing antiscorbutic properties must be given to compensate for
the loss of vitamin C. Dried milk provides an adequate supply to many
parts of the country and to the cities, where it is difficult to
obtain fresh milk.


Butter

Butter is produced by placing cream in a proper apparatus and
agitating or churning it until the fat globules coalesce into lumps.
These lumps are then taken out of the serum known as the buttermilk
and the water and milk worked out until it becomes more or less
solid. When butter has had the milk and water worked out of it the
constituents should be in about the following proportions: Fat,
83.5%; curd, 1.0%; ash, 1.5%; milk sugar, 1.0%; water, 13.0%. By
weight butter should never contain more than 16% of water and should
contain at least 80% of fat.

Owing to the conversion of the fat into fatty acids butter will, in
the course of time, become acid, rancid and unfit for table use.

Oleomargarine is a product resembling butter. It is manufactured from
animal fats and vegetable oils. It is not as desirable an article
of diet as butter. It contains margarine fat and only .5% of the
volatile fats, while butter fat contains about 8%.

Oleomargarine may be distinguished from butter by boiling. Butter
boils more quietly and a foam is formed on top, while oleomargarine
sputters much like oil mixed with water and there is little or no
foam produced.


Cheese

Cheese is manufactured from skim milk, whole milk, or milk to which
cream has been added. The more cream the richer is the product.
Coagulation of the milk is accomplished by adding rennet; the curd is
then pressed to expel the whey; next it is placed in molds and kept
in a cool place to ripen. After cheese has been properly ripened it
makes an excellent article of diet. It contains a large proportion of
nitrogenous substances. There are many grades of cheese, the quality
depending not only upon the process involved in the manufacturing,
but also upon the richness of the milk from which it is made.




CHAPTER XVIII

MEAT


MEAT

  MEAT, AN ARTICLE OF DIET

  COMPOSITION OF MEAT
     TOUGH MEAT
     TENDER MEAT
     CHANGES AFTER SLAUGHTER
     REFRIGERATION

  FOOD VALUE OF MEAT
     BEEF EXTRACTS
     BEEF JUICE

  SOURCES OF MEAT

  CARE OF FOOD ANIMALS
     FOOD
     WATER
     SHELTER

  MEAT UNFIT FOR FOOD
     ADULTERATED
     SPOILED MEAT

  DANGER FROM SPOILED MEAT
     DIFFERENT INFECTIONS
     TAPEWORM
     PARASITE
     ECHINOCOCCUS




CHAPTER XVIII

MEAT


Meat, an Article of Diet

Meat is used as an article of food by most of the civilized races.
It, however, as a universal diet, is of quite recent origin. Since
the modern, efficient refrigerating processes, canning, and improved
facilities of transportation, the use of meat as an article of diet
has become very popular and economic.


Composition of Meat

Meat is composed of muscle tissue and the associated structures,
such as connective tissue, adipose tissue, blood vessels, nerves and
lymphatic vessels. Chiefly, meat is found to be composed of proteins,
fats, ash carbohydrates and water—the percentage of water varying
from 10% to 78%, depending upon the cut. Whether the meat is tough
or tender depends upon the thickness of the walls of the muscle
tubes and the presence of connective tissue, which binds the muscles
together. Flesh of young domesticated animals is more tender than
flesh of old animals or of wild animals. Flavor of the meat is also
affected by the animal’s age. Muscle tissue in its inorganic content
resembles the seed more than the leaf elements of diet, both in
amount and in its relative proportions. Albuminoids and gelatinoids
are also contained in meat to quite a degree.

Immediately after slaughter, meat has an alkaline reaction and
is found to be tough and of a sweetish taste and of a somewhat
unpleasant flavor. Sarcolactic soon develops, giving an acid reaction
to the meat. Autolytic enzymes soon form and this action, together
with the bacterial action, softens the connective tissue and fibers.
This results in the meat becoming more tender and also of a more
desirable flavor. For these reasons meat should be allowed to remain
under proper refrigeration for a sufficient length of time so that
this action can take place. It is obvious, therefore, that meat is
not so desirable for food immediately upon slaughter. Great care must
be taken during the period of refrigeration that it does not become
contaminated.


Food Value of Meat

The presence of proteins and fats in meat determines its nutrient
value. Nitrogenous extracts, also known as meat bases, have but
little value as foods. As already stated, meat compares more
favorably with seeds that are used for diet rather than the leaves
of plants. As a matter of fact, this food, more particularly muscle
tissue, differs from seeds only in one respect. This is in the
quality of proteins. In meat the proteins are complete while those
of seeds are incomplete. Meat is relatively poor in the vitamin, fat
soluble A. There are many articles of diet which have a much higher
nutritive value than meat.

There is prepared from beef a soup stock which is known as beef
extract. Manufacturers of this soup stock assert that one pound of
beef extract contains the nutrient properties of many pounds of
meat. Doctor Wiley, however, says that this assertion is erroneous.
These extracts are of value since from them there may be obtained a
more speedy, soluble nutrient which may be desirable for patients
in a weakened condition. There should be a distinction, however,
made between beef extract and beef juice. Beef juice is obtained by
putting the meat under pressure and forcing the juices out. Thus,
this juice contains a larger percentage of albuminous nutrient
material than does beef extract.


Sources of Meat

Cattle, sheep and swine form the principal source of meat, although
horse flesh and even the flesh of dogs is used in some countries.
From a hygienic or sanitary standpoint there are no particular
objections to the use of horse or dog meat for food. Horse meat is
very much coarser than either beef or pork; it does not have the same
marble appearance and has a sickening odor. When properly prepared it
is difficult to distinguish it from beef.

From a hygienic standpoint there are certain conditions which render
the meat of animals unfit for food. They are: First, the death of
animals from old age, dis-ease or accident; second, animals dying
from injury, drugs, overwork or fright; third, animals that are too
young.


Care of Food Animals

Proper care of the animal bears a close relationship to its health
and consequently to the health of the people who feed upon its flesh.

The domestic animals should be properly housed and protected from the
weather, should have plenty of pure water and should be provided with
wholesome food. They should be properly inspected before they are
slaughtered and after the animals are slaughtered and prepared for
market the meat should be thoroughly inspected.


Meat Unfit for Food

Meat is often rendered dangerous to health by the adulterating
processes through which it is put. There are many ways in which meat
may be adulterated. (See table under Food Adulteration.)

Slightly spoiled meat is a great source of danger. It is very
difficult to recognize spoiled meat, even though the deteriorating
processes which have taken place are great enough to injure the
health of those who eat it. We are not referring to decomposed meat,
for it is a very easy matter to recognize this by its offensive
odor. The appearance may not thoroughly be affected by even the
most serious infection of the deadly poisons. However, inspectors
are supposed to reject meat that does not possess the raw, fresh
appearance, or meat from which any amount of fluid of an abnormal
color exudes upon pressure.


Danger to Health

From a hygienic standpoint the danger to health from meat may be
classed as: (a) infection from entozoa; (b) infection by bacteria;
(c) toxins and ptomaines. These conditions may result from: (a)
dis-eases of the food animals; (b) postmortem changes that may take
place in the meat; (c) infection of the meat; (d) adulteration; (e)
the use of preservatives. Such parasites as tapeworm, trichina and
echinococci may result from spoiled meat.


Tapeworm

Meat infection may result in two species of tapeworm, the tænia
saginata and the tænia solium. The tænia saginata is due to
infection from beef, which is known in lay terms as measly beef. The
tænia solium is due to infection from pork, which is known in lay
terminology as measly pork. The larva of the tænia solium appears in
hogs and is known as bladder worms, from the fact that it is found
incased in small cysts in the intestines, the muscle fibers, brain
and other parts. The larva of the tænia saginata is found in the
muscular fibers and connective tissue of cattle and when ingested in
man develops into the tænia saginata.


Trichinosis

There is a parasite known as trichina spiralis which is found as a
minute spiral worm in the muscular fibers of pork. It is visible to
the naked eye as white specks. The ingestion of this parasite into a
person with subluxations, causing interference with transmission of
mental impulses, produces a condition which is called trichinosis.
It is an acute condition and the symptoms resemble typhoid fever. It
often results fatally.


Echinococcus

The echinococcus is sometimes found in the meat of hogs, sheep and
cattle. When the eggs are ingested in man they hatch and the embryo
pierces the mucosa and lodges in the tissues, forming a hydatid or
cyst. These cysts develop and increase in size as the larvæ multiply.

As the eggs are ingested into the digestive tract of man there is
created a necessity for adaptative action on the part of Innate
Intelligence for the purpose of expelling them. This action will be
sufficient to result in the expulsion of the larvæ if there is no
interference with the transmission of mental impulses to the tissue
cells. When this action takes place there will be no injury done, but
if the action does not take place the eggs remain in the body and
hatch, producing what is known as a hydatid dis-ease.




SECTION II

CHIROPRACTIC PEDIATRICS




CHAPTER I

THE BABY




CHAPTER I


THE BABY

Chiropractic has nothing to do with obstetrics, but the chiropractor
should be informed on the subject of child hygiene. It must be
remembered that our idea is not to substitute here for the services
of the obstetrician, a food diet for the infant when the mother is
unable to nurse her child. The proper application of Chiropractic
will eventually enable the mother, who might otherwise be unable to
do so, to nurse her baby.

The child is the most helpless of the animal kingdom and requires
special attention. This must come through the observation of Nature’s
laws and an educated adaptation by means of substituting the educated
mind of the adult for that of the infant.


Feeding

The child that is normal will give little trouble since Nature has
made provision for all processes necessary to maintain the normal
functions of the body. In order that these processes be maintained
it is necessary to have food, proper environment, and sufficient
exercise. When the mother is able to nurse the babe the problem of
nourishment is solved. If the mother is unable to nurse the child and
if the condition which makes this impossible is of such long standing
that adjustments will not get results on the mother within the
nursing period of her child, then the question of baby food should be
left to the obstetrician who can prescribe the proper diet.

If the child has difficulty in digesting the food, adjustments should
be given to enable Innate to bring about the proper adaptation.
The bottle fed baby will require more care than the breast fed
baby. Special care must be exercised to keep the bottles and other
receptacles in a proper sanitary condition. This can be done by
boiling them. Great care must be taken that the nipples used on the
bottle are not allowed to become sour and otherwise unhygienic.

Cows’ milk may be used for bottle fed babies, but the most rigid
sanitary measures should be used in producing and delivering the
milk. There are many baby foods on the market, but the prescribing
of food for the bottle-fed baby does not come within the scope of
the chiropractor. This should be left to the obstetrician who has
specialized in this work. It is not within the scope of Chiropractic
to prescribe the kind of food that a bottle-fed baby needs, but the
chiropractor must realize the importance of the right kind of food
and the necessity for a proper innate adaptation to the kind of food
given. Proper feeding is necessary for normal development, although
it alone will not insure proper growth and development. The digestive
organs must work normally and there must be proper coördinate action
between the glands of the body. For this proper balance to be
maintained there must be a normal transmission of mental impulses to
all parts of the body.

The child that is getting a properly balanced ration and still is not
developing normally should receive immediate attention at the hands
of a competent chiropractor. No phase of the chiropractor’s work
brings such gratifying results as the care of infants and babies, yet
in no other phase will he find so much to baffle him. If the child is
unable to digest the food then adjustments should be given.


Sleep

The infant requires much sleep and for the first two or three days
this sleep will be very deep. The ordeal of labor is very trying on
the infant and in cases involving great labor difficulty the first
sleep of the infant may be so profound that it may appear to be coma.
This may last for several hours, but if there are no convulsions or
contractures there is no occasion for alarm; otherwise, this might
indicate an incoördination in the brain.

After this first deep sleep, and especially after the first month,
the infant will not sleep so soundly, although the sleep will be
quiet. The deep, heavy sleep of childhood will be observed after the
second or third year. The healthy infant sleeps almost all the time
during the first few weeks, usually from twenty to twenty-two hours
out of twenty-four. After that and for the first six or eight months,
he sleeps from sixteen to eighteen hours out of the twenty-four. The
healthy infant a few weeks old will awaken only when disturbed or
when hungry. A child one year of age should have at least fourteen
hours of sleep and more would not be excessive. This sleep should be
taken about twelve hours at night and the balance during the day.
A child two years of age requires about the same amount. At four
years, eleven to twelve hours may be sufficient. Up to six years of
age the child should take a daily nap. Ten to eleven hours’ sleep is
considered sufficient from the age of six to ten years. The youth up
to sixteen or seventeen years of age should have not less than nine
hours of sleep and even more will not be excessive.

The nervous mechanism of the infant is a very delicate organization
and often the fond parents do the child an injustice by not giving
due consideration to the environment surrounding him the first year
of life. The greatest development of the brain takes place during the
first two years. To have the proper development of the nervous system
there must be a quiet environment and the elimination of anything
that will excite the child or tend to create nervousness. If the
child is unduly susceptible to noise and is irritable and nervous,
cries out or is too easily startled, there is a cause for this and a
very careful analysis should be given and the causative subluxations
found and adjusted immediately. The nervousness may be due to some
disorder such as gastric, intestinal indigestion, poor elimination or
directly to a cervical subluxation.

Playing violently with the young child should not be indulged in.
It is a common failing of parents to want the baby to make a good
appearance and therefore he is often stimulated to laughter by means
that are detrimental to his health. This should not be done.


Exercise

The need for exercise is quite apparent and this need is as great
in the infant as in the adult. Proper exercise is important from
the standpoint of hygiene and we will readily realize this when we
observe the provisions which have been made in Nature to take care
of this very important process. The child gets his exercise from
the natural instincts in his nature to run and play. His curiosity
performs an important function in this respect. This keeps him
running about to investigate the things about him. This takes care
of the child that is thrown in a natural environment where there is
plenty of room for him to run and play indoors and out, but it does
not take care of the infant and the child in the city or apartment
who gets the proper amount of exercise only where there is special
provision made for it.

The infant gets his exercise by kicking, therefore the clothing
should not be too tight. If it is, it prevents this natural exercise
which is an adaptation on the part of Innate Intelligence. It is
advisable to place the nude baby on his back for a few minutes at
a time, preferably following the bath. In this way he can kick to
his heart’s content. Crying is another means of exercise open to
the child. The lusty cry of the infant is an advantage enabling the
expansion of the lungs and the exercising of the abdominal muscles,
the diaphragm and other structures that would otherwise get very
little exercise. Of course attention must be given the crying child
to see that there is nothing wrong. The crying may be the result of
pain or discomfort from the clothing, but it does not take a mother
or nurse long to recognize the different cries.

The child gets a certain amount of exercise from the handling which
he receives. A child that is left in the crib and does not get the
proper handling will be fretful and will not do well. Of course
the infant must not be handled roughly and at no time should he be
disturbed from sleep. The child who is given opportunity to exert
himself and who receives the proper exercise through handling will
relish his milk, digestion will be normal, other things being equal,
and in every way he will present a more healthful appearance.

Children old enough to creep will get a sufficient amount of exercise
in this way. Precautions must be taken, however, that the child is
not allowed to remain on the floor when there are drafts or when the
floor is cold as it is likely to be in winter in homes that are not
provided with furnace heat. It must be remembered that the child is
very curious and is likely to get hurt unless properly protected. He
should not be restrained in creeping and he should be permitted to
spend some time romping on the floor each day. Children should not be
encouraged to stand when too young since the weight of the body tends
to produce bow-legs.

Outdoor exercise should be provided for the children at an early
age. This should include every sort of exercise and play. It is an
advantage to have systematic games, for this not only gives a regular
amount of exercise but also has an influence on the mind of the child
which will aid in forming regular and systematic habits of thought
and action. In early childhood there need be no difference in the
exercise of the two sexes. It is necessary only to regulate the
amount of exertion for the more delicate children. In this respect
competitive games may tend to stimulate children to play too hard
in an effort to win. Especially is the delicate child likely to
overdo since no child likes for other children to know that he is not
as physically fit as his playmates. There are no objections from a
hygienic standpoint, for the exercise to be sufficiently strenuous
to produce muscular fatigue, but it must never be so strenuous
or so prolonged as to produce muscular exhaustion. The exercise
should develop all parts of the body. In this way there will be a
symmetrical body development.


Playroom

In stormy weather and in winter time when children can not get
outdoors they should get exercise indoors. In practically every home
a room could be fitted up as a playroom or nursery. It need not be
elaborate and could be a bedroom used for a playroom during the day.
This room should be well lighted and not kept too warm. The right
temperature is about 55° F. Since an abundance of light is necessary
the room should not be on the north, for the direct rays of the sun
are to be desired and some provision should be made to admit them.
All drafts must be avoided, yet a sufficient amount of air must be
admitted so as to prevent the air from becoming vitiated. The best
method of accomplishing this is by means of ventilators placed in the
windows. Occasionally the doors and windows should be opened and the
room thoroughly aired. This should be done while the children are
absent from the room.

The furniture in the playroom should be substantial and of such
a character that it can easily be cleaned and kept in a sanitary
condition.


Sleeping Rooms or Nurseries

When it is possible in a home a room should be set aside for the
nursery. This room should be well lighted, properly ventilated, and
the heat and humidity should be carefully regulated. This room is to
be the chief home of the infant for the first few months. Therefore
it should meet the needs of the infant. It should receive the direct
rays of the sun during the day. No processes, such as preparation of
food, or washing of diapers, for example, should be permitted in this
room. As far as possible gas plates, heaters, or gas lights should be
avoided.

The nursery should not be kept too warm. A temperature of 70° F. is
proper during the day. During the first few weeks it should not be
allowed to drop below 65° F. through the night. For children over two
months of age the temperature during the night may go as low as 60°
F. but not below 50° F.

It is more sanitary for the infant to have a separate bed. Both
mother and babe will rest better and there will not be the tendency
for the baby to nurse too frequently during the night. The infant
should be placed in a crib without rockers. A basket or bassinet
is very convenient and sanitary. The sides of the bassinet may be
lined and this will prevent drafts and assist materially in keeping
the baby warm. The pillow should be small and soft. It is advisable
to change the position of the child occasionally while sleeping.
It must be remembered that the child is unable to turn should he
become cramped or should he become tired from lying in one position.
The average mother knows how to take care of her child in a general
way and nurses have had special training in this respect, but
these simple necessities should not be beneath the notice of the
chiropractor. Especially is this of importance in determining the
cause of irritability in the infant. Attention must be given to skin
irritation, especially resulting from carelessness in the changing of
the diaper and in keeping the body of the child otherwise clean. It
is not, however, the intention of the author to present in this text
complete instruction in the care of infants except from the general
viewpoint of hygiene. The chiropractor is not to be a nurse, but he
must know the rules of hygiene since there are many conditions of
infancy which result from a violation of these rules.

After the first week or two the infant should be taken out of doors
if it is in the summer. The open air is healthful for the young
children and they should be kept outdoors a part of each day. The
eyes must be protected from the sun and the head from the wind. The
child, of course, should be properly dressed for out of doors. At
first the child must be kept out only a few minutes, since sufficient
time must be allowed for adaptation to take place, or in other words,
for the child to become accustomed to the change. Before children are
taken out the first time it is well to get them accustomed to the
change by opening the doors and windows of the room that there may be
a gradual cooling of the temperature. The child born in the fall or
winter must not be deprived of fresh air even though the weather will
not permit the outside airing. The child may be dressed as for an
outdoor airing, then the doors and windows opened. Great care must be
exercised or the child will take cold.


Control of Bowels and Bladder

While the chiropractor will have little if anything to do in advising
mothers how to train their children to answer the “call of Nature,”
yet he should be familiar with methods that are suggested for such
training and certainly he should recognize the importance from a
hygienic standpoint of such regular habits. It might be stated here
that the normal movement of the young infant’s bowels should be at
least twice a day.

At a very early age children learn to evacuate the bowels when placed
upon a nursery chair. This requires a great deal of patience and
regularity on the part of the mother or nurse. Even at the early
age of three months the child may be trained to such a degree that
the napkin will seldom be soiled from the movements of the bowels.
This saves an enormous amount of work and certainly is more pleasant
for the child, and much more sanitary. There is, however, another
advantage having the young child form this regular habit; it is
very probable that a habit formed this early will be followed the
entire life, and thus the tendency for the educated mind to neglect
this very important innate function will be averted. The best time
to place the child upon the nursery chair is immediately following
feeding.

Training the child to empty the bladder at stated times is more
difficult, although with patient and intelligent effort this may
be accomplished. Many children at the age of one year are able to
indicate when they desire to empty the bladder. This adds materially
to the comfort of the child and certainly makes it very much easier
to care for him. Some mothers are able to dispense with the diapers
during the day by the time the child is a year old and some even at
an earlier age. If there is no special effort put forth to train the
child in this respect it will be necessary to keep him in diapers as
late as two and a half years. After this age the child should have no
difficulty in holding the urine during the night. If there is such
difficulty adjustments should be given to correct the cause for the
nocturnal enuresis.


Growth and Development

Since growth of the child is the best evidence of health, some
attention should be given it and should there be any arrest in
development the cause should be carefully determined. Arrested
progress always indicates that something is wrong and therefore
adjustments are needed. Although normal growth does not prove perfect
health by any means, yet if the child is not growing and properly
developing he is not enjoying proper health.


Weight

From observation made of a great number of cases by authorities the
average weight for girls at birth is a little over seven pounds,
while that of boys is about seven and a half pounds. Some weigh more,
some less. There is a loss of weight the first three days, this
being greatest the first day. After the third day the child begins
gradually to increase in weight and by the tenth day will have gained
all that was lost the first three days, reaching the birth-weight
about the tenth day. The artificially fed babies gain more slowly,
even though they may be perfectly healthy and vigorous. The greatest
increase that is made in the weight of children the first year is
during the first three months. Normally the average child will gain
from five to six ounces each week during the first six months, but
only about half this much the second six months. The data given here
must be considered only as an average, no standard can be set, but
the variation must be within certain limits, otherwise it will be
indicative of abnormality.

During the first two years the weight of children is considered with
reference to age, but after this it is studied with relation to
height. This latter method is much more accurate. The age, however,
must always enter into the consideration, for of two children of the
same height but of different ages the older should be the heavier.
There is much less variation in weight with reference to height
than with reference to age. Normal weight differs with different
individuals and is governed by various conditions so that a stated
weight can not be decided upon as normal in all cases. The degree of
deviation from the average weight that one may experience and still
be within the normal range is a matter of opinion. If the weight of
the child is more than 10% below the average for his height it is
a fair indication that there is a lack of proper nutrition, either
because he does not have proper food or because the tissues can not
assimilate the nutrition due to interference with transmission.
In a case of this kind the child should be carefully analyzed and
adjusted. The disturbance may be in the digestive tract or due to an
impairment in the serous circulation.

Children twelve years of age and over gain less regularly and more
spasmodically. For this reason there will be a greater degree of
variation at this age. The weight may fall as much at 12% below the
average and still the child not be considered underweight, or as
much as 20% above the average before being considered overweight. If
an observation of the weight is to be of any value it must be made
over a period of time. The important thing is to observe whether or
not there has been a gain in weight over that period of time. Loss
of weight over a period of time indicates that Innate is compelled
to draw upon the physical in her processes and that there is no new
material with which to replace the old. This is a warning from Innate
that should be heeded. The following table will give the idea of the
average weight for the given height of the child.

This table is based upon a general average taken from various
authentic sources and is for the purpose of giving the chiropractor
a general basis upon which to make observations in growing children.
The average weight is given with relation to the average height
and approximate age from the second to the sixteenth year of life
inclusive.

Separate weights have not been given for boys and girls. The average
weight of boys is about two pounds heavier than that of girls at the
same age up to about the thirteenth year. From fourteen to sixteen
years of age the average weight of girls is from three to ten pounds
above that of boys. The greatest increase in the weight of girls
takes place between the thirteenth and fourteenth year, while with
boys this increase is between the sixteenth and seventeenth year.


  APPROXIMATE      AVERAGE         AVERAGE
       AGE         HEIGHT          WEIGHT

     2 yrs.     2 ft. 9½ in.      27.5 lbs.
     3 ”        3  ”  0     ”     32.2  ”
     4 ”        3  ”  4     ”     37.3  ”
     5 ”        3  ”  5     ”     40.5  ”
     6 ”        3  ”  7     ”     44.2  ”
     7 ”        3  ”  9     ”     48.6  ”
     8 ”        3  ” 11     ”     54.0  ”
     9 ”        4  ”  1     ”     58.8  ”
    10 ”        4  ”  3     ”     64.8  ”
    11 ”        4  ”  5     ”     70.6  ”
    12 ”        4  ”  7     ”     77.2  ”
    13 ”        4  ”  9     ”     90.3  ”
    14 ”        5  ”  0     ”    101.9  ”
    15 ”        5  ”  2     ”    111.5  ”
    16 ”        5  ”  3     ”    118.8  ”

The following table compiled by A. B. Hender, M. D., D. C., Ph. C.,
Dean of the Faculty of The Palmer School of Chiropractic, gives
the average weight of the child from birth to one year of age. Dr.
Hender has had years of experience as an obstetrician, and is well
known to the chiropractic profession. These statistics are compiled
by him from personal observation made of over 5,000 children,
covering a period of over twenty-five years of active practice as an
obstetrician.

   AGE       WEIGHT          AGE         WEIGHT

  1st mo.   7 to 10 lbs.    7th mo.    14 to 17 lbs.
  2nd ”     8 ”  11 ”       8th ”      15  ” 18 ”
  3rd ”    10 ”  13 ”       9th ”      17  ” 19 ”
  4th ”    12 ”  14 ”      10th ”      18  ” 20 ”
  5th ”    13 ”  15 ”      11th ”      19  ” 21 ”
  6th ”    13 ”  16 ”      12th ”      20  ” 24 ”


Height

The same thing can be said about height as about weight of children.
There is no standard, since there are so many variations to consider,
but there is a general average. The average length of the infant at
birth is about twenty and one-half inches. The average normal growth
the first year is about nine inches. Growth in height of the child
does not indicate much in the way of nutrition, since a child may
grow in height and at the same time lose in weight. The greatest
growth in height is made at the time of puberty. Girls begin this
rapid growth about twelve years of age and will mature more rapidly
than boys, since boys do not begin this rapid growth until the
thirteenth or fourteenth year; but, in the fifteenth year the boys
will be taller than the girls.

Growth in height is not retarded by malnutrition to the same degree
as is weight. The average growth of the normal child during the
second year is about four inches; for the third year a little less;
for the fourth year still a little less, about three inches. Bowditch
tells us that after the fifth year the average growth is about two
inches a year up to the time of puberty.


THE SPECIAL SENSES


Sight

The eyes of the infant are very sensitive to the light and every
effort is made by the child to avoid bright light and thus protect
the eyes from glare; the eyes will innately close when a bright light
is brought before them. For the protection of the infant’s eyes the
room should be kept darkened for the first few weeks. A subdued light
will usually attract the attention of an infant and as early as the
sixth day the child may even turn the head in an effort to follow the
light with the eyes.

It is not uncommon for the eyelids to remain partly separated during
sleep and for the movement to be more or less irregular during
the first few weeks of life. The muscles of the eyeballs do not
always coördinate in their action. This often results in temporary
strabismus when the infant is looking intently at an object. Perfect
coördinate action is often as late as the third or fourth month.


Hearing

The hearing of the infant is very acute, although it is asserted that
the child is unable to hear for the first twenty-four hours after
birth. This is due to the absence of air in the middle ear. During
the process of respiration air is gradually admitted to the middle
ear and hearing becomes very acute, so much so that sharp noises will
startle the child. For this reason the nursery should be so located
that it may be as free as possible from noise. Noise is trying on the
nervous system and should be avoided as far as possible. As early as
two months of age the infant will turn his head in the direction of
the noise.


Touch

Certain portions of the infant’s body are more sensitive than others.
The tactile sensibility of the lips and tongue is highly developed.
This facilitates the process of nursing. The forehead and external
auditory meatus are more sensitive than other parts. This creates a
necessity for protection of these parts. The child’s head should be
covered, but not the face, when taken out of doors. Touch is less
acute in the infant than in the older child.

The tongue of the young infant is very susceptible to temperature.
He will show a dislike for the bottle if the milk is too hot or too
cold.


Taste

At one time it was thought that the child at birth had no sense
of taste, but now it is agreed that even at birth this sense is
extremely acute. The newly born infant is unable to distinguish
sweet, sour and bitter. The sucking movement is excited by the
taste of sweet, some authorities believe. With bottle-fed babies a
difference in the taste of the food will be quickly noticed and it
is with difficulty that he can be induced to take anything that is
distasteful such as sour or bitter substances. The child very early
will show that he enjoys sweets.


Smell

The acuteness of this sense is not so easily determined in the
infant, although there is sufficient evidence to warrant the
conclusion that sense of smell exists from the beginning; however,
the ability to detect different odors is not developed to any great
extent until later in childhood. It is believed that the sense of
smell plays an important part at the beginning in the child finding
the mother’s breast.


SPEECH

The age at which the child begins to talk varies with individuals
and also with circumstances and environment. Girls on the average
will learn to talk earlier than boys; the average is about two months
earlier. The average child begins to say such words as mamma and
papa a little before one year of age. Other simple and easy words
are learned until by the second year he is putting words together.
How early a child learns to talk depends to a great extent upon the
amount of time given him by adults in trying to teach him. The words
that he learns depend largely on what is taught at the beginning. The
reason for the average child learning to say papa first is largely
due to the efforts of the mother who induces the child to say this
word; then naturally an effort is made to get the child to say mamma
and from this word attention is directed to any pets there may be in
the family. Then the names of objects are learned. Verbs are usually
next learned then adverbs and adjectives. Following these in order
are the conjunctions, prepositions, and articles. Personal pronouns
are the last to be learned.

Children who are permitted to associate with other children will
usually learn to talk earlier than those who are reared alone. If the
child has not learned to talk at two years of age he may be mentally
deficient; or failure to talk may be the result of being deaf or some
other incoördination of the vocal apparatus may exist. As soon as a
child is discovered to be mute he should have immediate chiropractic
attention. Many such cases are on record which show excellent results
obtained through adjustments.


HEAD

The occipito-frontal measurement of the child at birth is from 13.52
inches to 13.90 inches. The most rapid growth of the head takes place
during the first year. With the average child this growth is about
four inches. For the first few months the growth is about half an
inch per month. During the second year the circumference of the head
increases only about one inch and for the next three years, about one
and one-half inches. From this time until puberty, about five years,
it increases only about half an inch. The head develops so rapidly
so early in life that it appears to be all out of proportion for the
body.


Sutures

In syphilitic infants or in premature birth, the cranial bones may be
distinctly separated. This condition does not, however, necessarily
prove that either exists for often subluxations are produced at the
time of birth and these prevent the normal expression of Innate
Intelligence in bringing about the adaptative processes necessary to
close the sutures. This is an abnormal condition and should receive
careful consideration at the hands of the chiropractor. Normally the
main sutures ossify at about the end of the sixth month, although
there may be some mobility at the end of the ninth month. If after
this the sutures have not entirely ossified the child should be
carefully examined for subluxations.


Fontanels

Under normal conditions the anterior fontanels should be completely
closed at the age of one and a half years. If at the end of two
years they have not completely closed it is abnormal and indicates
cretinism, rickets or hydrocephalus. In case of hydrocephalus the
sutures will be distinctly separated and the head will be enlarged.
This condition may also obtain in rickets. When the fontanels are
slow in closing the child should be very carefully analyzed and an
effort made to find symptoms of other conditions which might be
responsible for this abnormality. Most excellent results have been
obtained from chiropractic adjustments in these cases. It is quite
as objectionable for the fontanels to close too soon as it is for
them to be too slow in closing and it may be much more serious. There
are many cases on record in which the fontanels have been closed
when the child was born. A case of this kind is ordinarily beyond
the reach of Chiropractic. The closure of the fontanels during the
first few weeks, or even at the middle of the first year, indicates
microcephalus.

Normally the anterior fontanels should be completely closed about the
eighteenth month, although it may be as late as the twenty-second
month. In rachitic children it may be as late as the third year. In
cretinism the fontanels may become very large and sometimes do not
close until the eighth year. In hydrocephalus also the fontanels
become very large, the head develops rapidly to an enormous size and
this results in the spreading of the sutures. If these cases receive
adjustments early enough in life, excellent results are obtained.

The posterior fontanel is very much smaller than the anterior and
closes about the second month, normally.


Shape

In most cases the head of the infant is more or less compressed
during labor. In hard labor it may be so greatly compressed that it
gives the appearance of being deformed, but this apparent deformity
soon disappears, usually from the third to the fifth week. Healthy
children and especially good natured ones are sometimes neglected and
permitted to lie in one position for such a length of time that the
head becomes misshapen. Usually in such cases the child is placed on
his back. This results in the flattening of the back of the head.
This, however, may be easily corrected by changing the position of
the child occasionally. These variations should not be mistaken for
actual deformities of the head.


THORAX

The average chest measurement of the child at birth is from thirteen
to thirteen and four-tenths inches; thus it is seen that at birth the
circumference of the chest is about a half inch less than that of
the head. The circumference of the abdomen is about equal to that of
the chest. The transverse diameter is practically the same as that
of the antero-posterior, but as time goes on and the child develops,
the transverse diameter increases more rapidly until about ten years
of age when the shape of the thorax becomes about the same as that
of the adult. The diameter of the chest increases at the rate of
about one inch per year until the average of thirty inches is reached
at about the age of fifteen. During childhood the thorax should be
carefully observed for deformities.

Subluxations in the upper dorsal region may result in faulty
postures, which in turn will result in various deformities of the
thorax. If this faulty posture is not corrected and the child is
permitted to grow into adult life with the deformity, it can readily
be seen that such deformity will become permanent. In such cases
the dorsal subluxation should be adjusted early in life to overcome
the faulty posture. Innate will then take care of this temporary
deviation from the normal shape of the thorax. Deformities of the
thorax often indicate Pott’s dis-ease, curvatures of the spine,
rickets, emphysema, empyema and cardiac disturbances. In such cases
a very careful analysis should be made and the subluxations adjusted
to remove the cause of the condition to which the deformity is
adaptative.


ABDOMEN

The abdomen of the infant is very large in comparison with its
proportion in later childhood. Up to about two years of age the
circumference is the same as that of the chest, after which the
chest develops more rapidly and the abdomen gradually assumes
the proportions of the adult. However, the abdomen remains
proportionately large up to the age of puberty. Unless this fact
is recognized by the practitioner, he may suspect an abnormal
enlargement of the abdomen. There are conditions in which an
enlargement of the abdomen is typical, such as in various intestinal
disorders and especially in rickets. In rickets the abdomen becomes
gradually extended and is known as pot belly, but with this there
will be other symptoms of the dis-ease. If the abdomen seems
abnormally large the chiropractor should carefully analyze the child
to determine whether this is the result of some incoördination or
whether it is simply an idiosyncrasy of the child.


WALKING

The age at which children are able to sit alone, stand and walk,
varies greatly. Some infants walk as early as the tenth month, while
others are as late as the eighteenth month. The average age at which
children are able to walk alone is from thirteen to fifteen months.
Other things being equal, the age at which a child walks has little
significance. The first voluntarily directed movements of the child
occur at about four months of age, sometimes a little earlier, when
the child begins to make an effort to grasp objects which he sees
about him.

At about four or five months of age the average child is able to
hold the head erect when the body is properly supported. Between the
seventh and eighth month the muscles have developed sufficiently for
the child to sit erect by himself for a few minutes at a time. From
this on, the child develops the sense of equilibrium very rapidly.
Not later than nine months of age the child will indicate a tendency
to stand and to bear the weight upon the feet. He may even be able to
stand with a little assistance; then, in a very short time, if placed
upon the floor he will show a tendency to pull himself up by a chair
and stand alone. This is soon followed by the first steps and by the
thirteenth month the child is walking alone freely.

Mechanical devices intended to assist the child in learning to walk
are of little value and may be an actual detriment. If the child is
normal, has the proper care and a reasonable environment, Nature will
put him on his feet at the earliest possible moment without injury
to the delicate structures of the body. If the child is extremely
backward in learning to walk a careful analysis should be made to
determine the reason. Rickets is a very common cause for backwardness
in children, not only in walking but in other functions as well. If
a child is backward in learning to walk he should not be urged, but
the reason for this backwardness should be sought out and the cause
adjusted.




CHAPTER II

DENTITION




CHAPTER II

DENTITION


The age at which the child begins to cut teeth varies greatly in
the different individuals with no apparent reason. There are twenty
deciduous or milk teeth and they make their appearance in the
following order and at an average time as shown in the data. From
six to eight months of age the lower central incisors appear. The
four upper incisors do not appear until from the seventh to the
tenth month; then the two lower lateral incisors and four anterior
molars come through between the tenth and fourteenth month. From a
year and a half to two years of age the four canines put in their
appearance, and from two years to two and a half the four posterior
molars. This completes the set. By the time a child is one year of
age he should have six teeth; at the age of one and a half years,
twelve teeth; at two years, sixteen teeth; and by the time he is two
and a half years of age he should have the entire set of twenty. The
table below gives the order in which the deciduous teeth appear and
the approximate time when they may be expected. This time is subject
to great variation. This variation does not necessarily indicate an
abnormality. In some children the teeth appear much earlier than in
others. The appearance of the first teeth may be as late as the tenth
month in perfectly healthy children. However, if the delay is too
great attention should be given the child.

   6 to  8 months of age  the two lower central incisors.
   7 to 10   ”    ”   ”   the four upper incisors.
  10 to 14   ”    ”   ”   two lateral incisors, four anterior molars.
  16 to 24   ”    ”   ”   four canines.
  22 to 30   ”    ”   ”   the four posterior molars.

Normal children cut their teeth without any very severe symptoms. If
the child is below normal, or if there are meric zones in which the
structures are not receiving a sufficient amount of mental impulses,
symptoms will be produced.

At the time of dentition many incoördinations may appear, not because
the process of cutting the teeth produces these conditions, but
because the process requires a great expenditure of internal energy
to produce the eruption of the teeth, hence at such times the forces
of the body are very heavily drawn upon. The force that might be used
in bringing about adaptation to other conditions must be used in this
process. If the child is normal the growth of the teeth will produce
no more symptoms than the growth of the nails. During the time
teeth are coming through the gums there may be increased salivation
and drooling and a tendency for the child to chew on the fingers.
Irritability and restlessness at night are very frequent symptoms. It
is quite common to have gastro-intestinal disturbances and especially
diarrhea.

In delicate and neurotic children all symptoms may be greatly
exaggerated and may become alarming. There may be fever and acute
indigestion. Diarrhea may become very severe and the child show
marked decrease in weight as a result. If the child is having
difficulty cutting the teeth it is evident that Innate Intelligence
is unable to get the forces to the periphery. In this case the child
should have immediate chiropractic attention. It is not uncommon
for a temperature to run during the time just before the teeth come
through the gums. In such cases a very careful analysis should
be made and the child adjusted regularly until the symptoms have
disappeared.

In the majority of cases when there is incoördination during the
process of dentition it will be found upon careful analysis that
there are conditions responsible for the symptoms other than
difficult dentition and they are only exaggerated by the dentition.

After the teeth have made their appearance care should be taken that
they are kept clean. This may be accomplished by washing the teeth
and mouth.

The eruption of the permanent teeth causes no great disturbance
and there are usually no symptoms connected with their appearance
other than a little discomfort locally. The appearance of the first
permanent teeth do not disturb any of the temporary teeth, since they
develop just posterior to them. These are the six-year-old molars.
Following these we find the incisors displacing the incisors of the
temporary teeth. Then comes the bicuspids taking the place of the
temporary molars. These are followed by the canines which displace
the canines of the temporary set. The next to appear are the second
and third molars which occupy a place back of the canines where room
has been made by the development of the jaw.

The following table is given to enable the student to get at a glance
an idea of the approximate age that the different permanent teeth
make their appearance.

   6th year of age  First molars just posterior to the temporary
                    molars.
   7th  ”   ”   ”   First incisors displacing the former incisors.
   8th  ”   ”   ”   Lateral incisors displacing the first lateral
                    incisors.
   9th  ”   ”   ”   Bicuspids displacing the temporary molars.
  11th  ”   ”   ”   Canines displacing the canines of the temporary
                    set.
  14th  ”   ”   ”   Second molars appearing posterior to the first
                    permanent molars.
  18th to 21st year Third molars or wisdom teeth posterior to second
                    permanent molars.


Hygiene of the Teeth

It should be remembered that these are the teeth that must serve the
child during his entire life and therefore should receive the best
of attention. Want of cleanliness is without doubt responsible for
much of the trouble with the teeth of children. This is especially
true among the poorer class of people and those who do not appreciate
the value of proper personal hygiene. Even before there are any
teeth the infant’s mouth should be washed and properly cleansed,
and attention should be given the teeth as soon as they appear. The
child should be taught early in life that it is very essential that
the teeth be washed and cleaned regularly. Before the child is old
enough to do this the nurse or attendant should do it for him. Food
permitted to remain between the teeth will soon decompose in the
temperature of the mouth, therefore care should be exercised that all
particles of food be removed as soon as possible. Decomposing food
has a very destructive effect upon the teeth and tends to destroy the
enamel due to the chemical reaction. When there are no subluxations
Innate will bring about an adaptation as far as possible, but it is
impossible to change the reaction of a chemical without neutralizing
it. Undoubtedly Innate does this in many instances, but it should not
be necessary for Innate to do this extra work when the filth may be
removed educationally.

Lack of cleanliness is entirely too prevalent among some classes of
people and it will be found that children who have not had the proper
care of the teeth will suffer more or less with dental caries. The
common belief that many conditions and incoördinations are caused
from the teeth has been proven erroneous by Chiropractic, but the
chiropractor should recognize the necessity for the proper care of
the teeth and when they are in need of attention the patient should
be sent to a dentist. Poor teeth interferes with mastication and
prevents the food being properly prepared for gastric digestion.
Severe nervous symptoms may arise from toothache.

It must be remembered that proper hygienic methods alone are not
sufficient to preserve the teeth in perfect condition. The teeth
may be kept strictly clean and yet they decay, as a result of
subluxations causing interference with the transmission of mental
impulses. If the teeth are decaying the child should be given a
thorough analysis and the subluxations should be adjusted. However,
the chiropractor does not take the place of the dentist. The child
should be taken periodically to the dentist to have the teeth
examined and any defects attended to; likewise he should be taken
regularly to the chiropractor to have his subluxations adjusted.


Adjustments during Dentition

Most excellent results may be obtained in difficult dentition from
chiropractic adjustments. The major for the local condition is
M.C.P., but if there are accompanying conditions such as diarrhea
or indigestion, the combination will include the zones that may be
involved. If there are gastric symptoms then we will include an S.P.;
if the intestinal tract is involved then it will be necessary to
adjust a lumbar. There are some cases that require adjustments at
K.P. During dentition the child should be taken to the chiropractor
for an analysis and should receive adjustments to keep him in a
healthful condition. Certainly it is much better to have the child in
perfect health during the time the teeth are appearing for under the
most favorable conditions the cutting of the teeth is very trying on
the child. The idea that cutting the teeth is responsible for many
abnormal symptoms in children is very old, but it is now generally
conceded that the eruption of the teeth in the healthy child will
cause no disturbance in his health.




CHAPTER III

ANALYZING INFANTS




CHAPTER III

ANALYZING INFANTS


One of the most baffling situations the chiropractor meets is in
caring for sick babies. There are several reasons for this: The
baby can give no assistance in the way of subjective symptoms. It
is difficult to nerve trace with any degree of satisfaction and
assurance of accuracy; it is even very difficult to keep the child
still for palpation. Therefore, it becomes necessary to rely largely
upon the objective symptoms and the palpation, with what verification
may be obtained from nerve tracing and the spinograph. However, there
is no class of patients in which the results are so gratifying as
with the babies and small children, for they respond to adjustments
more readily than does the adult.

There is no time in the practice of the chiropractor when he
needs to have better self-control than when he is taking care of
infants. There is great need of every faculty that is employed in
the analyzing and adjusting, especially if the child is seriously
ill. Usually the parents are more or less excited and worried and
are likely to keep urging the chiropractor to do something and thus
unduly influence him unless he is accustomed to such cases. If the
child is in pain and crying it is likely to get on the nerve of every
one present and this will tend to make the chiropractor nervous. He
must be careful that these things do not influence him to act too
hastily before he has had time to make a careful analysis.


History of the Case

Great care must of necessity be exercised in taking the analysis
of the baby and of the small child. A very careful history should
be taken. This, of course, must be obtained from the parents or
nurse. This history should include such points as whether birth
was instrumental or natural, whether it was premature or full term,
whether there were any peculiarities of respiration at birth, whether
there have been any convulsions and what sickness, if any, the child
has suffered with. Inquiry should be made relative to the condition
of the bowels and kidneys, how the child sleeps, and if there is a
tendency to cry out during sleep. If the child refuses to nurse or
nurses with difficulty it may indicate an incoördination of the mouth
or the throat.


Objective Symptoms

In view of the fact that the child can give no aid in the way of
subjective symptoms, it is necessary for the chiropractor to make
most careful observations and substitute, as far as possible, the
objective symptoms for the subjective ones. About the first thing
we see when we begin the analysis is the baby’s face. It may reveal
valuable information. A very careful study should be made of the
facial expression and the condition of the eyes. In the face we take
into consideration the color. We should look for pallor, cyanosis and
jaundice; we notice whether there is perspiration, whether the face
is cold and clammy or warm and moist; also we observe the expression
as to the muscular condition, since there may be muscular spasms
which will produce grimace. This is either the result of pain some
place in the body or an abnormal action of the facial muscles. There
may be a pinched expression or a look of fear or anxiety. In some
severe cases the face will be expressionless, while in others it may
be that of an adult.

The condition of the eyes is important. They may have a dull
expressionless look. The lids may droop and the eyeballs be sunken.
In cerebral incoördinations there may be strabismus, or the eyeballs
may be rolled upward and inward. These symptoms are significant and
should all be very carefully noted, for, as has been stated, there
will be no chance to profit by subjective symptoms.

After a careful observation of the face and facial expression has
been made, the child should be undressed and placed in a convenient
position for further observation. Before the clothing is removed the
room must be heated to a proper temperature so the infant will not
take cold or be exposed to an atmosphere that will be distressing.
A temperature suitable for the bath will be satisfactory. The child
should be placed on his back and every movement of the body observed.
Such movements as the flexing of the thighs on the abdomen, as in
abdominal pain, may lead the chiropractor to a conclusion on the zone
involved.

The general appearance of the child must be carefully considered,
whether the child is properly developed and whether or not there
are any deformities. The chiropractor should look for dyspnea and
other objective symptoms. A very careful inspection should be made
of the spine to determine any malformations or marked curvatures.
The character of the cry is sometimes important, as for instance in
pneumonia or bronchitis there is a short, catchy cry; the cry of
laryngitis and croup will be hoarse. In extreme prostration, as in
many cases of malnutrition, the cry will be very feeble.


Respiration

Since the chiropractor must depend almost entirely upon objective
symptoms and upon the palpation of the infant in determining the
character of the incoördination he should be thoroughly familiar with
the characteristics of the normal child. The rate of respiration
of the infant, especially during sleep, is of some importance. The
following table is given by Holt and Howland and indicates the normal
rate of respiration at different ages:

  At birth                         35 per minute
  At the end of the first year     27  ”    ”
  At two years                     25  ”    ”
  At six years                     22  ”    ”
  At twelve years                  20  ”    ”

Respiration is very much faster than this when the child is awake. If
the child is at all active it may be twice as fast. It is advisable
to observe the respiration to determine whether it is normal or
labored, shallow or deep, regular or irregular.

Irregularity of respiration in infants is characteristic and must not
be mistaken for indications of incoördination. The least excitement
will disturb the rhythm; as a matter of fact, the only time there
will be perfect rhythm is during sleep. In observing infants it will
be found that the lungs sometimes do not expand equally. This is due
to the delicate muscular walls of the thorax and does not necessarily
indicate incoördination. It is well to take this into consideration
when observing the infant. This must be very carefully considered
when incoördinations of the lungs are suspected. Placed in certain
positions one lung may expand very much more than the other in
normal respiration; or in some positions, and sometimes for unknown
reasons, there may be practically no expansion in one lung for a
short time. This peculiarity is due to the inability of Innate to
maintain adaptation through the delicate structures of the thorax to
the atmospheric pressure. This might be very misleading and result in
the conclusion that one lung was badly affected when there would be
nothing at all wrong. However, if there are symptoms which indicate
an incoördination in the lungs there should be a very careful
palpation made of the upper dorsal region to locate the subluxation
and the hot box.

In infants the respiration is altogether diaphragmatic; it is
irregular at times; it may be superficial for a time and then
deep. This irregularity continues in the child more or less until
the seventh year. After this such an irregularity indicates some
disturbance and should receive consideration.

The muscular walls of the thorax are very feebly developed and are
therefore very soft and yielding; a slight obstruction in respiration
will result in a marked sinking of the thorax from the normal
atmospheric air pressure.


Pulse Rate

It is not necessary to take the pulse of the infant, but it might be
well to know what the normal pulse rate is at different ages. The
following table will give the desired information:

  At birth the pulse rate is from     130 to 150 per minute
  One month of age                    120 to 130  ”    ”
  One year of age                     108 to 120  ”    ”
  Two years of age                     90 to 108  ”    ”
  Three years of age                   80 to  90  ”    ”
  Seven years of age                   72         ”    ”

Very slight disturbances will often increase the pulse rate out of
all proportion to the severity of the condition. The heart will beat
very much faster just from the handling of the child in making the
analysis, or as a result of any excitement or crying. It may be very
difficult to count the pulse because of its rapidity.

Often a very moderate incoördination will result in a marked increase
in the pulse rate and especially is this true in cases in which there
is slight fever.

An increase of the heart action does not, necessarily, mean that
heart place should be adjusted. This increased action may be due to
the natural adaptation because of handling or to nervousness at the
presence of strangers. Especially is this likely to be true of the
child that is old enough to notice things. It is not uncommon to have
the pulse beat increased as much as 25 beats per minute in this way.

During sleep the pulse may be slightly irregular, even when the
child is normal. In cerebral disturbances it will be slow and
irregular. In cerebral tumor it may be as slow as 40 or 50 beats
per minute. In acute incoördinations the pulse rate may be very
greatly increased. With incoördinations in such families as the
poison, fever, degeneration, and some incoördinations in the spasms
family, the pulse rate may be very high, even when the condition
is not at all alarming. It is well to take this into consideration
when observing a case so that the chiropractor will not be misled
in making the analysis and that the objective symptoms may be of
greatest value to him.


Zones Involved

In analyzing an infant it is well to keep in mind the zones in which
incoördination is most commonly found. In the majority of cases these
zones will include the gastro-intestinal tract, the respiratory
tract, the kidney zones and the brain. Very frequently there will be
incoördinations of the pharynx, tonsils and mouth.

The incoördinations found in the digestive tract will include all
forms of indigestion and dysentery. Such incoördinations as pneumonia
and bronchitis will involve the respiratory tract. From the kidneys
there are the various conditions involving the poison family due
to improper elimination. Meningitis and all forms of cerebral
incoördinations as well as conditions of the eyes and ears are common
to infancy and childhood.

It must be remembered that with an infant grave symptoms may develop
in a very short time, likewise recovery may take place very quickly
following even the most alarming symptoms. However, no chances
should be taken for it is not uncommon for an infant previously in
good health to become sick very suddenly and die within a few hours.
Therefore, in handling children most careful attention should be
given and conditions should always be regarded more or less serious
until developments prove otherwise. The chiropractor must realize
that his success in handling infants does not depend entirely upon
his observations of the case, for with every patient there must be
a thorough and complete analysis of the spine. The only value to be
received from the observations is that they may lead him to specific
regions of the spine.


The Child’s Cry

It is not uncommon for an infant to cry with no apparent localized
cause. This crying may continue for hours with no other symptoms.
There will be no indication of colic or other symptoms to denote
the seat of the pain. The crying is constant and, while in some
cases may be quite violent, yet there are no paroxysmal attacks;
this indicates that the pain is constant. It is easily distinguished
from a hunger cry in that the child usually refuses to nurse. If the
crying persists for hours there will be more or less exhaustion.
Such cases are very pitiful and draw heavily upon the sympathies of
the chiropractor as well as upon other attendants. In such cases
the first thing to do is to strip the infant of all clothing and
look for open safety pins, rough places in the clothing, such as
folds or wrinkles; foreign objects, as small buttons, for example.
Usually, however, this will be done before the chiropractor is
called. It may be an advantage for the chiropractor to observe the
infant very carefully for a few minutes after the clothing has been
removed, in an effort to locate the seat of the pain. However, this
is not so very important because first, in most of these cases it is
practically impossible to determine the location of pain, and second,
because a very careful palpation of the child will always reveal the
causative subluxation. In making the analysis the chiropractor should
give himself plenty of time to make a thorough palpation. He should
not be in too great a hurry to adjust the child merely because of
his anxiety to relieve the crying. He must not allow the incessant
crying of the child to work upon his nerve and destroy his efficiency
in caring for the patient. In these cases the subluxation may be
located in any part of the spine, although it is less often found
in the cervical region. If there is a subluxation in the cervical
region, great enough to produce this constant crying, there is very
likely to be cerebral symptoms. In these cases the subluxations are
usually quite exaggerated and very often the hot box becomes the
determining factor.

In a case recently an infant three weeks old had been crying
constantly for several hours. The clothing had been removed and
the child very carefully bathed and powdered; then instead of the
clothing being replaced the child was wrapped in a blanket. Still the
crying persisted. A very careful observation of the patient gave no
information whatsoever as to the possible location of the cause for
the crying. There was nothing that would quiet the child. He finally
grew so exhausted that the cry became little more than a whimper,
beads of perspiration standing out over the entire body. There were
no signs of colic or tympanites. A careful palpation revealed the
sixth dorsal very badly subluxated and a slight subluxation of the
first lumbar. These were adjusted and the child stopped crying almost
instantly and in less than ten minutes was sleeping normally. There
was no return of the abnormal crying and the child had no further
adjustments.

We have many such cases on record, but the citation of this one is
sufficient to illustrate the results that are obtained in such cases.


Palpating the Infant

In palpating an infant the first thing to look for is the hot box. It
may be possible to locate it very easily and if this is so it then
becomes necessary only to list the direction in which the vertebra
is subluxated. In looking for the hot box it is necessary to use
care so as not to be misled by the difference in the temperature
of the back due to some article of clothing being in contact with
the back and raising the temperature in that region. Notice that
there has not been some woolen garment, such as the band, pressing
against the spine. To eliminate the possibility of thus being misled
the entire back should be exposed to the atmosphere a sufficient
length of time to allow the back to become influenced alike to the
temperature of the air. The majority of incoördinations of infancy
are acute, therefore the hot box is present. After the hot box is
located then a very careful palpation should be made to determine the
direction in which the vertebra is subluxated. It is not sufficient
to consider that because the patient is an infant all that is
necessary is to list the vertebra straight posterior and adjust it
accordingly. Laterality, superiority and inferiority are quite as
essential, and the chiropractor should not be satisfied until he has
convinced himself on the question of these directions. If there is no
laterality, superiority or inferiority then the adjustment should be
given straight toward the anterior.

In palpating an infant it is usually best to place the child on the
knees of an adult in the position for an adjustment. The child will
be almost constantly on the move. It will therefore be necessary for
the chiropractor to adapt himself to this constant moving. The child
should be placed in as many different positions as possible to make
the palpation. He may be held up over the shoulder of the mother or
nurse; first on one side, then on the other, this giving opportunity
to palpate with both hands and make comparisons.

No effort should be made to force the child to be still. It is a
good policy to hold the palpating fingers on the spine and let the
child wiggle and squirm all he wants to, moving the spine beneath the
palpating fingers of the chiropractor. In this way a comparison may
be made of what is felt under the fingers while the child is moving.

It is quite difficult to nerve trace an infant in any measure of
accuracy because the infant can not coöperate to any degree of
satisfaction. In some, however, nerve tracing may be used to a
certain extent by producing slight pressure and noticing whether or
not the child flinches.

It is very much more difficult to palpate the cervical vertebrae of
an infant than it is those of the dorsal and lumbar regions. The same
technique and tactics are used, however. It is sometimes an advantage
to place the child on the mother’s lap in such a way that the head
will be unsupported by the lap. One hand should support the child’s
forehead, while the other hand palpates or it may be necessary to
place the infant in some other position. The chiropractor should be
sufficiently resourceful to find a way to get an accurate palpation
of the cervical region. Here, again, he will meet with the difficulty
of keeping the child still. This makes it necessary that he be very
alert and at the instant it is possible to feel the vertebra to be
ready to make his comparisons quickly and decide the direction in
which it is subluxated.

The cervical vertebrae of an infant are very hard to feel, but if
one of the segments is subluxated sufficiently to cause pressure on
a nerve that segment will be easier to feel because it is out of the
median line; especially will it be easier to feel if it is subluxated
posteriorly. Every possible means must be used to make an accurate
palpation. If there is a subluxation in the cervical region there
will very likely be symptoms which will indicate it. Subluxations are
not as commonly found in the cervical region as in the other regions
of the spine.

In making an analysis of the infant the importance of the sacrum must
not be overlooked. It will be remembered that the segments of the
child’s sacrum are separated with cartilage and are subject to being
subluxated. These segments coalesce later in adolescence and form the
sacrum into one solid bone. Therefore it is highly important that the
subluxations that may exist between the segments be adjusted before
this process takes place.

The tubercular ridge formed by the rudimentary spinous process in the
median line of the posterior surface of the sacrum is of very little
value in palpating the segments of the sacrum. It is best to palpate
the articular crest on each side of the tubercular ridge. In this way
it is possible to determine if one segment is more prominent on one
side than on the other. This should be done very carefully and if a
subluxation is found it should be adjusted on the side that is most
prominent. The contact is on the articular ridge and the thumb may be
used for nail point the same as in the dorsal region; or if the child
is large enough nail point one may be used.

Whenever possible a spinograph should be made of the child. This may
not always be possible with the small child and with the very young
infant it may be very difficult. In many acute incoördinations it is
impracticable to try to get a spinograph, not because the spinograph
would not be of value, but because it is difficult to get to the
office to take it. In the chronic cases a spinograph should by all
means be taken. Every possible means should be used to verify the
palpation.




CHAPTER IV

ADJUSTING INFANTS




CHAPTER IV

ADJUSTING INFANTS


The recoil is used in adjusting a child the same as in adjusting an
adult. The young infant can be placed upon the knees of the mother
or nurse instead of being placed on an adjusting table. The ordinary
adjusting table will be too large for the real small infant. Care
must be used that the child is placed in the correct position for the
adjustment and that the neck and head are properly supported. Placing
the child on a pillow on the lap of an adult is not satisfactory
because the pillow is too soft and makes it more difficult to move
the vertebrae. If the child is adjusted on the mother’s lap care must
be exercised that the mother’s skirt is not drawn tightly for it is
best to leave the infant’s abdomen unsupported or at least not to
have too solid a support.

When the mother holds the babe on her lap there is a tendency for her
to raise her heel off the floor so as to make the knee supporting
the child’s head higher than the other. When the adjustment is given
the knee will not be sufficiently solid to support the child and the
vertebra will not move. For this reason the chiropractor must see
that the mother’s heels are both placed squarely on the floor. It is
a good plan after the contact has been taken and the chiropractor is
ready to give the adjustment to ask if both heels are on the floor.
Nine times out of ten one heel will be lifted and the toe will be
supporting the weight of the child.

In adjusting small infants in the dorsal and lumbar regions the side
of the thumb may be used for nail point. In getting the contact one
should palpate in the usual manner, find the vertebra that is to be
adjusted, remove all fingers except the pointer finger, turn the hand
so the finger is parallel with the child’s spine, then instead of
placing the pisiform bone of the nail hand, place the side of the
thumb in exactly the same manner as if it was nail point one. This
being done, remove the pointer finger. Then instead of placing the
hammer hand on the nail hand as in using the pisiform bone for nail
point, grasp the thumb that is being used for nail point between the
thumb and finger of the hammer hand and press the tissues tightly
to make the side of the nail thumb firm. The thrust is given with a
recoil just the same as in the usual manner.

It is best not to use too much force until it is determined just
the amount required to move the vertebra. One will be surprised,
however, at the amount of force required to move the vertebrae of a
very small infant. It should be remembered that the vertebrae must
move if we expect to get results. It must also be remembered that
the child is small and that it is necessary to adapt the amount of
force used to the size of the patient. It is not possible to injure a
child with a chiropractic adjustment, but it is possible to apply an
awkward force, supposed to be a corrective force, in such a way that
subluxations may be produced.

This method will be used only with the smallest infants. When the
child is a few months old the pisiform bone may be used in exactly
the same manner as with the adult. The only difference is that the
amount of force will be suited to the size of the patient. In case
a straight posterior subluxation and a double transverse adjustment
is given on a single vertebra the adjuster may use his two fingers,
the first and second, to get contact on the transverse processes. The
nail hand is then placed across the two fingers and the adjustment is
given with the recoil. It will require very little force to move a
vertebra of an infant on the transverse processes.

Care must be exercised that the neck is properly supported when an
adjustment in the cervical region is given. It is best to place the
child on an infant’s adjusting table whenever possible. When this
is impracticable the child may be placed on the lap of an adult the
same as for an adjustment in the other regions of the spine. If the
head is allowed to remain unsupported as is so often the case when
larger babies are adjusted in this manner, there is danger of moving
something that should not be moved when the adjustment is made.
Therefore that part of the neck directly beneath the vertebra to
be adjusted must be placed solidly on the mother’s knee. The same
technique is used with older patients in that the face is turned in
the direction of the laterality of the subluxation to be adjusted.

With the small infant it may be difficult or even impossible to
get nail point two in position to adjust, especially in the middle
cervical region. In this event the side of the first finger may be
used to an advantage. This will be used, however, only with the
smallest infants. In using nail point two it will be an advantage
to get the contact near the distal end of the fifth metacarpal bone
instead of at the center as in using nail point two on an adult. In
adjusting the atlas and axis it is very easy to get the contact with
nail point two in the usual manner.

The cervical vertebrae of the infant are very small and extreme care
must be exercised in adjusting. Sufficient force must be used to move
the vertebra.

The importance of proper attention to adjusting the segments of the
sacrum of the infant and small child can not be overestimated. During
childhood the child is subject to many falls and jars which are
likely to be centered upon the sacrum. These segments being separated
by cartilage are relatively easily subluxated. If they become
subluxated in youth incoördinations may develop, which in later life
will result in various degrees of discomfort or even defects which
will become permanent and for which nothing can be done. There are
many conditions in adult life which are without doubt the result of
pressure upon sacral nerve and this pressure can not be released
because of the inability to move the subluxated segments after they
become coalesced.

Many deformities and incoördinations in these zones could be averted
by proper attention to the segments of the sacrum during childhood.
When parents realize the importance of this they will take their
children to their chiropractor periodically to have the sacrum as
well as the rest of the spinal column palpated. Then the subluxations
that have been produced will be taken care of before they become
chronic and more difficult to correct.

A careful palpation of the segments of the sacrum should be made. The
most common subluxation is a rotation resulting in that segment being
more prominent on one side than on the other. When a segment is found
to be posterior on one side the adjuster should stand on the opposite
side and palpate in the usual manner finding the tubercle of the
segment subluxated, measuring to a point midway between the tubercle
and the ilium with the second finger of the palpating hand. This
finger should then be replaced with the second finger of the opposite
hand and the pisiform bone of the palpating hand should be used for
nail point. If the patient is a very small infant do not change nail
hands but use the thumb of the usual nail hand and adjust the same as
adjusting a dorsal or lumbar vertebra when using the thumb for nail
point.




CHAPTER V

RESPIRATORY SYSTEM




CHAPTER V

RESPIRATORY SYSTEM


Children and infants are subject to the same general class of
dis-eases as are adults and there are no dis-eases which are
particularly peculiar to childhood. The incoördinations are not
peculiar but rather the children as patients are peculiar. The
incoördinations of the child’s respiratory system are practically the
same as those affecting the respiratory system of the adult but there
are certain peculiarities of the patient that should be considered.
Our work will be principally the consideration of these peculiarities
rather than the incoördinations themselves. It is not our thought to
produce a work on symptomatology.


ACUTE NASAL CATARRH

This is also called coryza, cold in the head and acute
rhinopharyngitis. It is a very common condition in infants and small
children and one that is readily recognized and easily handled
chiropractically. It is very essential that we be able to distinguish
between a simple acute nasal catarrh and the coryza which accompanies
such conditions as measles, influenza, and nasal diphtheria. If in
these conditions there is profuse discharge tinged with blood for two
or three weeks, nasal diphtheria should be suspected, even though
there are no other very serious symptoms. With a very young infant a
persistent acute nasal catarrh may indicate syphilis. In such a case,
a careful watch should be kept for more positive symptoms.


Symptoms

The onset may be more or less sudden with sneezing and a slight
fever. There is a profuse discharge from the nose in severe cases
which at first is seromucous and later becomes mucopurulent. The
mucous membrane is red and swollen. The equation for the mucous
membrane is calorific plus and N.C.R. for the mucopurulent discharge.
In severe cases there may be a temperature of 103° F. to 105° F. with
marked constitutional disturbances. In the mild cases the symptoms
will be less severe and many times very transient.

Results are obtained very quickly with acute nasal catarrh or coryza
and when the adjustment is given at the beginning of the symptoms
there will be no complications. However, if the condition is allowed
to run until it has gained momentum, longer time will be required for
results and there may be distressing complications. If the condition
is not corrected at once the throat may become involved and even the
bronchi, which may develop into bronchopneumonia. Retropharyngeal
abscesses may also develop. Nasal catarrh may continue until it
becomes chronic.


Equation

Primarily the equation in nasal catarrh is M-. In the capillaries
of the mucous membrane lining the nasal passages this results in
hyperemia of the blood vessels and exudation. This results in C+ in
the mucous membrane. The exudation which at first is a colorless
fluid soon becomes mucopurulent from the C+ so the equation for the
exudation becomes N.C.R.


Family

The family for the C+ condition in the mucous membrane is fever
family, while the N.C.R. condition is in the degenerations family.
The products of the degeneration may produce symptoms in the poison
family.


Adjustment

The major adjustment for acute nasal catarrh is M.C.P. and K.P.

Conditions of this kind are sometimes aggravated by the care which
the child receives at the hands of a careless mother. She may keep
the child too warm or not warm enough. Often a child is dressed so
warmly that the least exertion will cause profuse perspiration.
Then the child “takes cold” because of the inability of Innate
Intelligence to bring about an intellectual adaptation in so short a
time. An infant may be and should be kept very warm, but as the child
grows older he should be allowed sufficient freedom, especially in
the summer time, to permit of exercise and yet not become too warm.

The hygienic measures to be used are attention to the sleeping rooms,
which should be properly ventilated, always having plenty of air at
night, and the house temperature during the day. This should be from
65°F to 68°F.


FOREIGN BODIES LODGED IN THE NOSE

Children often in their play will place such foreign bodies as peas,
beans, buttons, beads and other small objects in their noses. These
set up a mechanical irritation and produce swelling of the mucous
membrane and often pain. If the object remains for any length of
time there is likely to be a profuse discharge of a mucopurulent
character. If there is such a discharge from only one, nostril
special attention should be given to determine the presence of any
foreign body and if there be one the child should be taken to a
surgeon at once. If the discharge continues following the removal it
will be due to a subluxation at M.C.P., which is interfering with
the transmission of mental impulses preventing normal adaptation and
reparation taking place. This should be adjusted. However, if there
are no subluxations the injury which was done by the mechanical
obstruction will be repaired in a short time.


CHRONIC NASAL CATARRH

Chronic nasal catarrh, also called chronic rhinitis, is a chronic
inflammation of the mucous membrane lining the nasal passages and
pharynx. There may be structural changes take place resulting in
injury to the organs of smell, taste, hearing, speech and respiration.


Symptoms

The mucous membrane becomes congested and swollen. There is a
constant mucous or mucopurulent discharge from the nose. The air
passages may be partially or completely closed. If the child is old
enough the nose may be easily freed from this discharge by blowing.
If the child is not old enough to do this great inconvenience and
discomfort will be experienced. The upper lip may become irritated,
swollen and permanently enlarged and prominent from the constant
blowing and wiping the nose. The excretion produces a constant
irritation. There is a marked tendency on the part of the child to
constantly pick at the nose; this tends to increase the irritation
both of the nose and the upper lip. Usually there are adenoid
growths, which will produce mouth breathing and may interfere
with the function of hearing. A very marked characteristic is the
inclination for the child to continually snuffle.

If the condition is allowed to remain for a long time without
adjustments, ulcerations may occur on the mucous membrane; the
discharge from this will be very offensive. In the atrophic form
ozena is very common. Ozena is a very fetid discharge from the nasal
cavity associated with ulcerations which may involve the bones of the
nose.


Equation

The equation is the same as the acute form with the exception that
the N.C.R. condition becomes more prominent.


Family

Same as the acute form except that the degenerations family takes
precedence over the other families involved.


Major Adjustment

The adjustment is the acute condition—M.C.P. and K.P. A greater
length of time will be required, however, than in the acute stage,
but the prognosis is always good. In caring for a child in this
condition the parents and attendants should exercise care that there
is no unnecessary irritation of the nose and local parts. The nose
should be kept clean and as soft a handkerchief as possible used in
wiping the nose. During the process of retracing discharge from the
nose will pass through practically the same stages as during the
progress from the acute stage. The process is just reversed. The
scabs that form in the nose now begin to soften and the discharge
continues to change until it becomes as it was in the beginning of
the acute stage in a thin watery discharge. Finally the discharge
ceases entirely and the child is well.


EPISTAXIS

Nose bleed does not often occur in infants but is quite common during
childhood. It is the result of interference with the transmission of
motor mental impulses to the muscular walls of the capillaries of the
nose. Epistaxis may result from a fall or blow on the nose. It occurs
as an early symptom of different incoördinations such as typhoid
fever and measles; as a matter of fact, it occurs in the hemorrhagic
form of all eruptive fevers, in some cases of diphtheria, and in
dis-eases of the heart and blood vessels.

Epistaxis is often considered of little consequence, but it may be
a very serious condition and even result in death. It is especially
serious when occurring in infants.


Equation

The equation for epistaxis is M. There is a relaxation of the
muscular walls of the capillaries resulting in the hemorrhage.


Family

Epistaxis is in the prolapsis family due to the relaxation of the
muscular fibers in the walls of the capillaries.


Adjustment

The adjustment for epistaxis is M.C.P., and in most cases this is
fourth cervical. In some cases the results come instantly. The
prognosis is always good when the proper adjustment is given.


INCOÖRDINATIONS OF THE LARYNX


CROUP

Croup is an inflammation of the larynx characterized by a more
or less severe spasm of the laryngeal muscles. This spasmodic
contraction distinguishes it from similar affections in adults. The
spasm produced is very often more marked and results in more severe
symptoms than does the inflammation. This incoördination is also
called spasmodic laryngitis and catarrhal croup.


Symptoms

In spasmodic laryngitis or croup there is a slight catarrhal
inflammation of the mucous membrane lining the larynx and a marked
spasm of the larynx. There may be a slight discharge from the nose
and slight hoarseness. The attacks usually come on at night with a
hollow, metallic cough. About this time there is difficult breathing
and the cough becomes more severe and of a teasing nature, the
child making every possible effort to keep from coughing. The voice
becomes husky but is seldom lost. There is rapid pulse and a slight
temperature seldom over 101° F. The attack lasts three or four hours,
after which the child will fall asleep. The dyspnea is aggravated
and the spasm increased by excitement. During the day the child
will appear well except for the slight cough and hoarseness, but
the second night the attack will return with about the same degree
of severity as that of the first night. Usually the attack may not
return the third night or if it does it will be less severe.

Spasmodic laryngitis should not be confused with laryngismus
stridulus, membraneous croup or with acute catarrhal laryngitis.
According to Holt and Howland laryngismus stridulus occurs only in
infants, and there is not only stridulous breathing, but also periods
of complete arrest of respiration.


Major Adjustment

Lower cervical and S.P. is the combination major to use in this
incoördination. Under adjustments results are often obtained
immediately with no recurrence of the attack the following night.

In chronic cases enlarged tonsils and adenoid growths may be found.
This, however, will not change the adjustment or the combination,
but will increase the amount of time required to completely correct
the condition so far as the chronicity is concerned. It will not
interfere with the relief from acute attacks.


LARYNGISMUS STRIDULUS

This incoördination, according to Holt and Howland, occurs only in
infancy. It is characterized by muscular spasms in the larynx with
marked dyspnea.


Symptoms

There may be complete arrest of respiration for short periods,
during which there will also be a marked lack of oxygenation of the
blood. There may be recurrence of these attacks several times a
day, and unless adjustments are given may last for weeks. There may
be general convulsions and carpopedal spasms which are spasmodic
contractions of the joints of the hands and feet. During the periods
of arrested breathing the face becomes cyanosed. This terminates with
a slight cough or a high-pitched crowing sound produced by the sudden
inspiration of air. Because of this it is sometimes called “child
crowing.” It is also known as thymic asthma and spasms of the glottis.

       *       *       *       *       *

=Major Adjustment=

The combination major is lower cervical and stomach place. Under
adjustments results are obtained in a very short time, in many cases
almost instantly.


ACUTE CATARRHAL LARYNGITIS

This incoördination is found in children from one to five years of
age. It may be severe and even cause death. It may be a secondary
condition following measles, scarlet fever, influenza and other
like incoördinations; however, it may result directly and not be
associated with any other condition. It is often aggravated by
inhaling steam, gases or irritating dusts.

There is congestion and inflammation of the mucous membrane lining
the larynx; there is swelling and dryness of the membrane followed by
an exudate which may become profuse. If the swelling is exaggerated
there will be stenosis of the larynx. The vocal cords become swollen
and produce aphonia.


Symptoms

The symptoms are hoarseness, dry metallic cough, which may become
very severe and teasing. The onset is sudden with a marked tendency
to cough, especially during the night. The voice often is entirely
lost and the larynx becomes sore and painful. There is dyspnea and
the respirations are short and shallow.

In some cases which develop more slowly there will be coryza for a
day or two preceding the severe attack, or the laryngeal symptoms
may precede the acute symptoms. The onset, however, may be very rapid
and the most severe symptoms be present within a very few hours after
the manifestation of the first symptom. In the well developed, case
the cough is dry, metallic, barking and stridulus. The inspiration
is labored. The dyspnea is severe, occurring in paroxysms during the
night. There is temperature, rapid pulse and increased respiration.
If the inflammation extends down into the bronchi it will result in
bronchopneumonia. Laryngeal obstruction may occur often and prove
very severe.

It is sometimes very difficult and in some cases impossible to
distinguish acute catarrhal laryngitis from membranous laryngitis or
laryngeal diphtheria. This is not so important to the chiropractor,
for if adjustments are given soon enough results will be obtained
before positive diagnostic symptoms have time to develop. However,
it is well to be thoroughly informed on the difference in the
symptoms since the chiropractor is sometimes not called in until the
condition is well under way. At the onset the two conditions are
very much alike, which is very reasonable to the chiropractor, since
the only difference is in degree of severity, due to a different
combination, and a difference in degree of the functions involved
resulting from the same combination o£ subluxations. In the catarrhal
condition the temperature is usually greater than in the membranous
form. The dyspnea in catarrhal laryngitis is usually paroxysmal; it
is less exaggerated during the day but worse at night, while the
membranous type is constant and rapidly becomes more exaggerated.
The dyspnea occurs on both inspiration and expiration, while in the
catarrhal form it occurs only on inspiration. If the culture shows
Klebs-Loeffler bacilli it is considered laryngeal diphtheria.


Major Adjustment

As has been stated, the chiropractor gives the same adjustment
whether it is membranous or catarrhal. The major combination is L.C.
and S.P. with K.P. Excellent results are obtained from adjustments in
these cases. When the first symptoms are manifest adjustments should
be given immediately in order to get the best results. The usual
difficulty in such cases is that the parents consider the condition
only a cold and of little importance. Therefore, they neglect taking
the child to a chiropractor until great momentum has developed.
Such cases necessitate a greater amount of time before results are
obtained.


CHRONIC LARYNGITIS

This form is simply a prolongation of the acute form, but may be
associated with adenoid growths of the pharynx, with tuberculosis of
the larynx, with syphilis or with new growths in the larynx.


Symptoms

The symptoms are similar to those in the acute stage except they are
not so severe.

It is not uncommon to find adenoid growths in the pharynx of the
very young infant. There is a superficial inflammation of the mucous
membrane producing a local calorific plus. This is the result of
interference with transmission of mental impulses to these tissues
and when this interference is removed Innate Intelligence will
function normally and the growths will disappear.


Major Adjustment

The adjustment is the same as in the case of acute laryngitis. The
results will be slower in the chronic case than in the acute case,
but in the course of time the child will be entirely relieved of
the condition without the aid of surgery. If the proper adjustment
is given during the acute attack the condition will never reach the
chronic state.

A chronic laryngitis is often accompanied by papillomatous growths
which occur very early in life, in most cases during the first year.
This condition occurs more often in boys than in girls. The size and
location of the growths determine the severity of the symptoms. There
is paroxysmal cough, dyspnea, loss of voice, and hoarseness. The
symptoms usually develop so slowly that they do not attract attention
until the growth has attained quite a size. Holt states that the
prognosis is usually serious from a surgical standpoint because
there is danger of bronchopneumonia following the operation. It is
also stated that operations have been largely given up because of
the tendency of the papilloma to return in increasing numbers. These
tumors are the result of the interference with transmission of mental
impulses to the tissues, preventing the normal personification of
Innate Intelligence in the production of function. Under adjustments
which results in the restoration of the normal transmission excellent
results are obtained. In the course of time under adjustments the
growths will disappear and with them all the symptoms of the chronic
laryngitis. Adjustments should be given just as soon as the growths
are suspected and kept up until the symptoms have disappeared.


TUBERCULAR LARYNGITIS

Tubercular laryngitis is seldom found in infants and is rare even in
later childhood. Usually pulmonary tuberculosis develops later; by
some it is considered to be always associated with it. There is cough
and hoarseness with aphonia, expectoration of mucopurulent or in some
instances bloody character. Microscopic examination of the sputum
reveals the tubercle bacilli. Results are obtained under adjustments,
providing a sufficient amount of time is allowed to permit Innate
to overcome the momentum and rebuild the structures that have been
destroyed.


FOREIGN BODIES IN LARYNX AND BRONCHI

Children are likely to acquire the habit of putting small objects,
such as buttons, small playthings, and even pins, into their mouths.
If the child becomes frightened, tries to cough, laugh or cry that
which is held in the mouth at the time is likely to be drawn into the
larynx and may lodge there, especially if it is sharp or has rough
edges. If, however, it is a smooth object, such as a button or bean,
it is more likely to pass into the bronchi, usually the right one.

When the foreign body enters the larynx there will be violent
coughing which may result in the expulsion of the object. If it is
not immediately expelled but becomes impacted in the larynx there
will be marked dyspnea and even death from suffocation.

When the foreign body passes the larynx it will lodge, usually, in
one of the bronchi or at the bifurcation of the trachea. If this
occurs there will be localized pain over the region of the foreign
body. There is a cough and may be spitting of blood. The irritation
will result in a local inflammation; this may result in the formation
of an abscess which may prove serious. In some cases following
such conditions there is prolonged illness resembling pulmonary
tuberculosis during which there may be sufficient relaxation in
the muscular walls of the bronchi to permit the foreign body being
expelled during a paroxysm of coughing. This has occurred in many
cases. Following the expulsion of the foreign body the patient
recovers very rapidly. In some cases there are repeated attacks of
pneumonia. The health of the child becomes greatly impaired and thus
he becomes easily susceptible to the acute attacks which may prove
too much for the adaptability of the body.


Symptoms

The symptoms of a foreign body in the larynx are characteristic and
consists in the very sudden appearance of the attacks and also in
the severity of the symptoms. There will be a history of something
having been in the child’s mouth, or the possibility of the child
having placed some object in his mouth. A metallic body can always be
located by means of the X-ray.

Ordinarily these cases do not come within the scope of Chiropractic.
There might be a subluxation which would prevent adaptation from
taking place, and if so, an adjustment might result in a relaxation
of the muscles to such an extent that the foreign body could be
expelled by coughing. These cases are traumatic and should be taken
to a competent surgeon at once.


EDEMA OF THE GLOTTIS

This is a dropsical condition of the glottis and is very rare in
infancy or early childhood. Usually there will be other symptoms
indicating abnormality of the kidneys.


Symptoms

If the edema is great enough there will be attacks of suffocation
because of the interference with inspiration. There is very little if
any interference with expiration. There may be hoarseness, painful
and difficult swallowing and a cough. The symptoms may come on
suddenly and develop very rapidly and soon result fatally.


Equation and Major Adjustment

The equation for the local condition is secretion plus (T+). If the
condition is involved with nephritis the equation for the nephritis
is calorific plus (C+) in the kidneys with N.C.R. in suppurative
nephritis, which results in excretion minus (E-). The major
adjustment is K.P. with S.P. and local L.C.


INCOÖRDINATIONS OF THE LUNGS


GENERAL CONSIDERATIONS

The thorax of the infant is shaped somewhat different from that of
the adult, being more cylindrical, the antero-posterior being nearly
the same as the transverse diameter. The transverse diameter begins
to increase about the third year and this continues until puberty
when the typical conical or dome-shaped thorax is attained.

In the infant and young child the walls of the thorax are exceedingly
yielding and elastic. This is because the greater portion is made up
of cartilaginous tissue before the completed ossification of the bony
structures has taken place.

The thoracic muscles are imperfectly developed. This makes the
thoracic walls very thin. In well nourished infants the walls are
made thicker by the abundance of fat which is found deposited on
them. The diaphragm is very high in the infant and this greatly
decreases the capacity of the thorax as well as does the frequent
distention of the stomach and intestinal tract because of the
accumulation of gas. The trachea and bronchi of the infant are
comparatively larger than in the adult, the air cells are much
smaller, and for this reason a slight acute congestion will
interfere almost as much with their function as will hepatization.
This necessitates immediate action in all conditions which involve
the respiratory tract, and especially those which affect the lungs
or bronchi. In all such cases results are obtained very quickly
under adjustments. In the child there is a greater tendency for the
inflammation to spread in the lung tissue than in an adult.


ACUTE CATARRHAL BRONCHITIS

There is probably no one acute incoördination affecting infants and
children that is so common as acute catarrhal bronchitis, commonly
called cold in the chest. During the cold months, and especially in
the late winter and early spring, there are a great many cases. The
chiropractor who is careful in handling these incoördinations will
find no class of cases that will give more satisfactory results. The
analyzing must be done very carefully and the vertebrae must be moved
from the very beginning because if results are not obtained quickly
the inflammation will spread to the air vesicles very rapidly. When
this occurs there is danger of serious complications.


Symptoms

In the more mild form of bronchitis the symptoms develop rather
gradually and the first noticed may be a coryza or nasal catarrh.
As the bronchi become involved there will be a slight rise in the
temperature, noticeably increased respiration, and a slight cough.
There may be restlessness, anorexia and vomiting, usually caused by
swallowing the mucous that is coughed up.

Rales are heard over the entire chest. These appear very early
and may remain for some little time after all other symptoms have
disappeared. It is very common to hear coarse rales with a very
slight cold in the young infant.

If the condition is permitted to go for some little time without
adjustments the symptoms become more severe. The cough becomes more
serious, there is dyspnea, increased fever and a moderate degree of
prostration which increases as time goes on. During inspiration the
nostrils will be noticeably dilated. In most cases there is great
difficulty in nursing. In the later stages there is usually great
prostration. The cry becomes feeble and the cough weak, there is
rapid superficial respiration and feeble pulse. The facial expression
is dull and there may be stupor and apathy. The attacks may come on
very suddenly and terminate fatally in a very short time. Therefore
it is necessary for action from the adjustments to be obtained as
quickly as possible.


Equation and Family

The subluxation at lower cervical or upper dorsal region interferes
with the transmission of mental impulses to the bronchi. The function
primarily involved is motor which results in a relaxation of the
muscular walls of the capillaries. This produces hyperemia and
congestion from which there is an exudate of mucous. At first it is
clear, but with normal heat applied to this exudate it soon becomes
mucopurulent. This gives calorific plus, therefore the equation for
the mucous membrane lining the bronchi is calorific plus (C+) with
N.C.R. for the mucopurulent discharge. The equation for the general
fever is C+. The family is fever and degenerations.

The major adjustment for acute catarrhal bronchitis is L.C. or Up.D.
with K.P. In some cases CP. will be included in the combination.


CHRONIC BRONCHITIS

It can readily be seen that chronic bronchitis would not often be
found with the very young infant. In early childhood it is more often
found and frequently follows the acute attack or is the sequel of
measles, influenza or whooping-cough. Unhygienic surroundings may
tend to influence and exaggerate the condition.


Symptoms

There is little or no fever, although the cough is bad; there is
very little if any dyspnea. The condition becomes worse during cold
weather, and the patient is usually subject to attacks of acute
bronchitis. There may be no constitutional symptoms and the general
health of the patient may not be greatly affected.

If there is a light rise in the bodily temperature regularly in
the evening, with loss of weight and slight anemia, pulmonary
tuberculosis should be suspected.


Major Adjustment

The adjustment for chronic bronchitis is the same as that for acute
bronchitis, Up.D. and K.P. If the child receives adjustments during
the acute attack the chronic condition will not develop.

A child suffering with chronic bronchitis should be given adjustments
immediately and the results will be most satisfactory, complete
recovery resulting in a very short time.


BRONCHIAL CROUP (Fibrinous Bronchitis)

This incoördination is relatively rare in small children, except in
diphtheria, when it appears as a contamination into the bronchi from
the larynx and trachea. It may be acute or chronic and affects all
ages from infancy to puberty. The characteristics are severe dyspnea
and the coughing up of fibrinous casts from the large bronchi after
which there is a marked improvement. As the exudate collects again
the symptoms reappear. In the chronic form there is dyspnea and
expectoration of fibrinous casts.


Major Adjustment

The adjustment for fibrinous bronchitis is the same as that for
other forms of bronchitis. The prognosis is excellent, providing
adjustments are given in time to enable Innate to overcome the
momentum. Results are obtained in a very short time.


PNEUMONIA

Aside from digestive disturbances, the most common incoördinations
affecting infants are those involving the lungs, and especially as a
sequel following the so-called infectious dis-eases. The different
types of pneumonia are named according to the area of the lungs
involved and the nature of the changes affecting them. The two
general divisions are bronchopneumonia and lobar pneumonia. These two
principal groups are divided into several subdivisions according to
the particular pathology and stage of development. It is not of vital
importance to the chiropractor to know just what part of the lungs or
bronchi is involved or the nature of the pathology. He must, however,
be sufficiently familiar with symptoms to correctly determine the
zone in which the incoördination is located. In bronchopneumonia the
entire bronchial wall of the small bronchi is affected, while in
lobar pneumonia the bronchitis is usually very superficial and the
terminal bronchi and alveoli are filled with a fibrant exudate. An
entire lobe may be involved or the inflammation may involve only part
of a lobe. Very often the two varieties, bronchopneumonia and lobar
pneumonia will be present in the same case, one variety affecting
one part of the lung, while the other variety will affect another
part of the lung. In children by far the larger percentage of cases
of pneumonia is of the bronchopneumonia type; however, as has been
stated, the type of pneumonia is of little importance, but the
location of the zone or zones is of vital importance.

Bronchopneumonia occurs most often during the winter months, being
more prevalent in late winter or early spring. One or both lungs
may be involved, but the most common seat of the inflammation is
the lower left lobe, or if in front only, the right apex. The local
subluxation producing this condition will be found to be the second
or third dorsal vertebra, which is producing the pressure upon the
nerves and interfering with the transmission of mental impulses.
As a result there is a relaxation of the muscular fibers of the
blood vessels which results in a distention of these vessels in the
affected area. The seat of the catarrhal inflammation is in the
mucous membrane of the large and small bronchi.


Symptoms

The most frequent type of bronchopneumonia among infants is the
acute congestive type. Its duration may be only one or two days.
The symptoms develop very rapidly and produce a great shock to the
nervous system because of the suddenness and severity of the attack.
There is a sudden rise of temperature and prostration is very great
from the beginning. There is cyanosis and rapid respiration. There
may be no cough. There may be little or no pain felt in the chest.
During respiration the expansion of the affected side will be less
than that of the unaffected side. However, this must not be confused
with the natural tendency found in extremely young infants; when a
child is placed in certain positions the expansion of one lung will
be greater than that of the other. In the severe cases there is
profound stupor and other cerebral symptoms, such as dullness, apathy
and there may be convulsions. The progress of the incoördination is
very rapid, due to the sudden engorgement of the lungs, which in the
infant produces symptoms almost the same as those of consolidation in
older children or in adults. This is due to the air vesicles being
extremely small. These cases should be adjusted as soon as there is
a manifestation of symptoms, otherwise the momentum of the dis-ease
may, because of its rapid progress, become so great that it will be
impossible for Innate to overcome. When the medium and small sized
bronchi only are affected, it is known as capillary bronchitis. The
symptoms will be very much the same as in the type just mentioned,
with the exception that in this type there is always a more or less
severe cough. Prostration is not so great and the symptoms do not
develop so rapidly. There is very rapid respiration with dyspnea and
rales over the entire chest. There are symptoms which will indicate
consolidation. While bronchopneumonia may come on very abruptly, yet
it is not uncommon for the symptoms of bronchitis to merge gradually
into those of pneumonia. From a chiropractic standpoint it would
make little difference to the chiropractor whether the condition was
called bronchitis or bronchopneumonia, for if adjustments are given
at the beginning results will be obtained before a diagnostician
would be able to make a positive diagnosis.

Children with pneumonia should not be permitted to lie in one
position for any length of time. A constant change in the position
is essential to prevent the accumulation of the exudate in a
localized area. The child may be more easily cared for and made
more comfortable by being held in the arms of an adult. This will
permit frequent changing of the child’s position with very little
disturbance to the child. In all cases of pneumonia plenty of
fresh air is essential, but if there is any bronchitis, care must
be exercised that the air is not too cold. In cases involving
hepatization there is no danger of having the air too cold.


Symptoms of Lobar Pneumonia

Lobar pneumonia is not so frequent in infants as is bronchopneumonia
although it does occur occasionally in early infancy. The previous
health of the child seems to make little difference, since it often
occurs in the strong and robust children. As a matter of fact, the
strong child is more likely to contract this form of pneumonia.

There are three stages in lobar pneumonia. There is: first, the
congestion; second, the red hepatization, in which the lung becomes
filled with a fibrant exudate containing red blood corpuscles;
the third stage, that of gray hepatization, wherein the exudate
undergoes a decomposition. These stages are of little importance to
the chiropractor, except to indicate the degree of momentum attained
by the incoördination. The first symptoms usually consist in loss
of appetite, general weakness and headache. There is restlessness,
excessive thirst, dry skin and a high temperature. There is rapid
pulse and the respirations are from forty to fifty per minute.
During the night the child is restless and slightly delirious.
Occasionally there are convulsions, but this is very rare.


Equation and Family

The chiropractor is concerned chiefly in the location of the
incoördination and the family involved. In order to determine
the family it is first necessary to know the functions that are
abnormally involved. From the symptoms given we observe readily
that all cases of pneumonia, of whatever type, will be in the fever
family, but it is quite obvious that this is not the only family
involved. From the symptoms manifest we recognize that there is
hyperemia and exudate, that this exudate undergoes degeneration
and thus becomes of a toxic nature. The fever, or C+ condition,
is exaggerated by the presence of this poison being retained in
the body. This gives us an overlapping of the poison and the fever
families.


Major Adjustment

The major for the poison family is K.P.; for the fever family C.P.,
the local being Lu.P.; therefore, the combination major is lung
place, center place, and kidney place. In making an analysis of the
infant with pneumonia it is of the utmost importance to select the
specific vertebra in these different regions. Although the patient
will have quite a temperature, in many cases a hot box may be
detected in the spine. In endeavoring to find a hot box in the spine
of an infant the back of the patient should be exposed for sufficient
length of time to eliminate the possibility of the temperature being
greater at one point than at another because of clothing that may
have been heavier at one point than at another.

The vertebra causing the impingement at lung place may be either
second or third dorsal. This should be determined by very careful
palpation and by the presence of the hot box. We cannot emphasize
too greatly the necessity for very careful palpation, since in the
child nerve tracing can very seldom be used. In severe cases it may
be necessary to adjust as often as once every six hours. With careful
conscientious work on the part of the chiropractor, there should
be very little danger in losing a patient, even in the most severe
cases, and if the adjustments are given in the early stages of the
dis-ease, the more marked symptoms will not develop, results will be
shown in a very few hours and the child will recover in a short time.


ASTHMA

The type of asthma found among adults very seldom affects infants.
The most common form is associated with mild attacks of bronchitis
and is of a catarrhal nature. The attacks are very likely to
accompany or be associated with different incoördinations involving
the bronchi. In some cases the attacks seem to be exaggerated by
certain kinds of food which the child eats. It is thought by some
that attacks are brought on by the indigestion of some foreign
protein. These proteins are very numerous and it is very difficult
to determine the particular food in which the offending protein is
found. In some patients an attack of asthma may be brought on by the
eating of eggs. From a chiropractic standpoint we do not consider
that the cause of asthma is in the food which the child eats,
although there might be an interference with transmission which would
impede the normal processes of digestion, this would result in the
production of a poison which might produce certain symptoms. This,
however, does not change the fact that when the subluxations are
properly adjusted the incoördinations will disappear, regardless of
the kind of food that the patient eats.


Symptoms

The acute attack of asthma is accompanied with slight fever and
acute catarrhal symptoms. Later the typical asthmatic symptoms
appear in which there is a constriction of the bronchi due to spasms
of the unstriped muscular fibers. There is hyperemia in the mucous
membrane and a slight exudate. Usually the tonsils are enlarged and
there are adenoid growths. There is more or less severe dyspnea,
moderate cyanosis and, in severe cases, prostration. The peculiarity
in respiration consists in a short inhalation with slow, labored
exhalation. Dyspnea may be so severe that it is impossible for the
child to breathe lying down. There is an almost constant dry teasing
cough. Many infants suffering from asthma are inclined to be rachitic.


Equation

The functions involved are motor and calorific; C+ for the heat in
the mucous membrane lining the bronchi and M+ for the contraction,
muscular contraction in the bronchi, with T+ for the accumulation of
the mucin.


Family

This condition involves two families, the fever and spasms family.


Major Adjustment

Asthma is caused by a subluxation in the lower cervical or the upper
dorsal region, producing pressure upon the nerves which transmit
mental impulses to the pharynx and bronchi, interfering primarily
with the motor function. The major adjustment is lower cervical or
upper dorsal in combination with kidney place.




CHAPTER VI

DIGESTIVE TRACT




CHAPTER VI

DIGESTIVE TRACT


GASTRITIS

Incoördinations of the stomach alone are less frequent in infancy
than are those of the intestines. Usually the stomach and intestines
are involved at the same time and it becomes impossible to
differentiate the two. The greater part of digestion during infancy
takes place in the intestinal tract, the stomach acting more as
a receptacle for the milk from which food passes slowly into the
intestinal tract to be properly digested. In an infant one month old
the stomach will be empty one and one-half hours after nursing; in
bottle-fed babies it will take a little longer. From two to eight
months of age the time is about two hours for breast-fed babies and
from two and a half to three hours for those taking cow’s milk.


Symptoms

The symptoms of gastritis come on very suddenly with pain and
tenderness in the epigastric region, and with a high temperature
which after the onset decreases. There is thirst, loss of appetite,
and vomiting. The vomited matter is usually sour and may be streaked
with blood. If there is an excessive amount of blood it indicates
ulcers. This is rather unusual, however, in small children. Vomiting
is excited by anything taken into the stomach. The thirst is intense,
although the water will be vomited as soon as taken. The tongue is
heavily coated and the breath is foul. If these symptoms continue
intestinal symptoms will soon develop.

The different kinds of gastritis are given as: catarrhal, ulcerative,
membranous and corrosive; but the symptoms are all very much the
same and from a chiropractic standpoint a knowledge of the particular
pathology would be of no value as the adjustment would be the same.
In these cases the difference, or rather specific diagnosis, cannot
be made, medically, until after the autopsy. In the ulcerative type
the condition is more prolonged and there is a greater tendency to
hemorrhage which results in a greater amount of blood in the material
vomited. Corrosive gastritis is the result of a corrosive poison
being taken into the stomach, such as carbolic acid.


Major Adjustment

From a chiropractic standpoint it is immaterial what form of
gastritis the child may be suffering from with the exception of the
corrosive type which may require the administration of an antidote.
In this event the condition passes out of the realm of Chiropractic
the same as any other traumatic condition. The adjustment in all
cases of gastritis the same as in any other incoördination of the
stomach is S.P. If there are symptoms which indicate that the poison
family is involved the combination would include K.P.

If adjustments are given at the onset results will be obtained almost
instantly. The temperature will soon be reduced, the pain will
be relieved and in a remarkably short time the symptoms will all
disappear.


CHRONIC GASTRITIS

There are no characteristic peculiarities associated with gastritis
when it becomes chronic. There is no advantage in differentiating
the chronic from the acute. The symptoms are somewhat less severe,
and run a longer course. There is vomiting following meals. Between
meals there will be a regurgitation of the food. This form of
indigestion is not common among infants but may be found with older
children. The most prominent symptom is that of malnutrition. There
is restlessness at night, loss of appetite, constant loss of weight
and anemia.


Major Adjustment

The adjustment in the case of chronic gastritis is the same as in the
acute attacks. Stomach place is the condition of the stomach with
kidney place for the elimination of the waste products which result
from the lack of digestion. The kidney place adjustment is also to
correct any abnormality in the serous circulation resulting from
faulty digestion.


STOMATITIS

Dr. James N. Firth, in his “Chiropractic Symptomatology,” states
that “There are five forms of stomatitis, viz.: simple, ulcerative,
follicular, thrush and gangrenous.” It is not our thought to cover
this subject in detail as he has done, but only to point out that
which is characteristic of stomatitis in infants and small children.
In this incoördination the mucous membrane lining the mouth becomes
inflamed and swollen. The mouth is hot and the lips dry. The child
is fretful and even though hungry refuses to nurse or will cry while
trying to nurse. There is quite an increase in the secretion of
saliva.

Stomatitis in infants often accompanies the acute febrile dis-eases
or may appear alone. There will be more or less indigestion with
possibly some diarrhea. If the condition remains for a great length
of time the child becomes emaciated from the lack of food ingestion.

It is not necessary for us to take up the different forms of
stomatitis since the adjustment is the same in all cases. Upon the
first indication of stomatitis or the slightest symptom of sore
mouth, the infant should receive prompt attention. Strict hygienic
measures should be used, especially if the child is being bottle fed.


Equation

In stomatitis the equation is C+ for the simple form; for the
suppurative form it is N.C.R.


Family

Simple stomatitis is classified in the fever family. The other forms
involve the poison and degeneration families.


Major Adjustment

The adjustment for simple stomatitis is S.P. in combination with
M.C.P. If there is any suppuration involving the poison and
degenerations family the major will include K.P.


GLOSSITIS

Glossitis is not very common among infants. It is an inflammatory
condition of the tongue with hyperemia and swelling. There is
usually a slight temperature and the swelling may involve the mucous
membrane of the mouth. The tongue may be so greatly swollen that it
becomes very difficult for the child to take food. Glossitis is often
associated with stomatitis or any involvement of the mucous membrane
of the mouth.


Equation

The equation for glossitis is C+ with T+ for the hyperemia. If there
is suppuration it is N.C.R.


Family

This condition is in the fever family overlapping the degenerations
family in case of suppuration.


Major Adjustment

The major adjustment for glossitis is S.P. and in cases involving
suppuration K.P.


STENOSIS OF THE PYLORUS

There are two types of stenosis of the pylorus in infancy. One
is a stenosis due to a muscular spasm of the pylorus called a
pylorospasm. The other is a stenosis due to a hypertrophy of the
pylorus known as hypertrophic stenosis of the pylorus. It is possible
for both conditions to be present at the same time. The stenosis
may be congenital and is usually called stenosis of infancy. It is
considered a serious condition and the mortality is very high.

This incoördination is characterized by constipation, persistent
wasting, projectile vomiting, and a marked visible tumor.


Symptoms

The symptoms begin to appear during the first or second week of life.
Up to this time the child may have been gaining and showing all signs
of perfect health. Vomiting is usually the first symptom to appear
and this may be at irregular times but without apparent cause. It
soon becomes very forcible and later projectile. The symptoms of
indigestion are absent; there is no eructations of gas; the breath
is sweet and the appetite is good. There is no evidence of pain and
there is no fever, yet the child steadily wastes and loses in weight.

The contests of the stomach are sometimes expelled with such force
that the food will be thrown a distance of two or three feet. The
food sometimes comes through the nose. The vomiting takes place
immediately after feeding and sometimes while the child is nursing.
The fact that the child will nurse after vomiting and sometimes
will leave the breast only while the food contents of the stomach
are being ejected shows that the vomiting is not the result of
indigestion; the fact that the food is all expelled at one time and
not regurgitated at intervals is further proof. The food seldom
remains in the stomach long enough for gastric digestion to take
place, therefore the vomited food is not digested but it is just
about in the same stage as it was when taken into the stomach. In
some cases, however, the vomiting may not take place immediately; in
some cases the food may even be retained for two or three feedings,
although this is unusual.

The constipation is very obstinate from the fact that the food is
vomited and does not pass into the intestinal tract. In the severe
cases the stools resemble meconium. There is very little fecal matter
in the stool. In the severe cases there is persistent loss of weight
which may amount to two or three ounces per day. The constipation is
very marked and the urine is scanty.

In the mild cases the symptoms are all less marked. The vomiting may
be only occasional, the loss of weight is not so great, fecal matter
is passed in the stools and there may even be a gain in weight at
times.

Due to the character of the vomiting which is projectile the symptoms
are sometimes mistaken for cerebral symptoms. The scanty urine
and the vomiting confuse the condition with renal dis-ease. It is
not difficult to distinguish stenosis of the pylorus from gastric
indigestion. The latter rarely develops suddenly, but is very common
in infants. The vomiting usually occurs shortly after feeding.


Equation

If the condition is the result of hypertrophy of the pylorus the
equation is X+. If it is a case of pylorospasm the equation would be
M+. The equation for the loss of weight and wasting is N-.


Family

The family of the hypertrophic condition of the pylorus would be
tumor family while the pylorospasm would come in the spasms family.


Major Adjustment

The adjustment for this condition would be stomach place in
combination with kidney place. The adjustment results in a relaxation
of the muscular fibers of the pylorus and permits the food to pass
from the stomach. In case of hypertrophic stenosis of the pylorus
there is not only a relaxation of the muscular fibers, but Innate
Intelligence removes the hypertrophy and thus enables the food to
pass from the stomach. Excellent results are obtained in these cases.
Care should be exercised in making the analysis and the adjustments
should be given as early in the progress of the condition as possible.


ACUTE INTESTINAL INDIGESTION

This is quite a common incoördination and is very much more prevalent
in hot weather. It is found often in very young infants, but more
often in children during their second summer. There are many forms
and degrees of acute intestinal indigestion among infants and
small children. The attacks come on usually very abruptly and may
be severe from the beginning. The most outstanding feature of the
incoördination is the characteristic diarrhea. In the mild form
the symptoms develop suddenly with marked gastric disturbances. At
the beginning there is colicky pain and tympanites. There is great
restlessness and typical symptoms of colic. The diarrhea appears in
a very short time. The color of the stool is at first yellow, then
it becomes a yellowish green and finally a grass green. It will
usually contain undigested foods. The odor is very foul, grass green,
and very much thinner than normal. This mild form may develop into
the more severe type or the more severe form may develop suddenly
from the very beginning. The temperature rises rapidly. The skin is
hot and dry. At the beginning the child is very restless and cries
a great deal, but later he lies in a stupor, the eyes are sunken,
pulse is weak and there is all the appearance of an attack of serious
illness. There may be anorexia. There is usually great thirst and
nausea and vomiting. In a few hours there is marked diarrhea. The
stools are yellow and of a thin consistency with a very offensive
odor. There is usually much gas expelled. There may be as many as
four or five stools an hour. This incoördination is responsible for a
great many deaths among children. They respond, however, very quickly
to chiropractic adjustments.


Major Adjustment

The subluxation responsible for intestinal indigestion will be found
in the lumbar region, usually upper lumbar. It may be necessary to
include kidney place for the elimination of the products of the
indigestion. This condition is in the fever family overlapping the
poison family.


CHOLERA INFANTUM

When the severe type of intestinal indigestion is accompanied with
gastric disturbances and severe vomiting, it is known as cholera
infantum. In this form the temperature rises rapidly and the symptoms
develop quickly and become very severe in a remarkably short time.
The vomiting is very severe and usually appears simultaneously with
the diarrhea. After the stomach has been emptied of food the vomitus
becomes serum and mucous. The contents of the small intestines may
regurgitate into the stomach and be vomited up. Vomiting may be
induced by taking water into the stomach. The stools are frequent,
are of a pale green, yellow or brownish color at the beginning, but
later become almost entirely serous. In the severe cases the bowels
may be evacuated every few minutes. This type differs from that
previously described in that the stools are practically odorless.
In rare cases, however, they may be exceedingly offensive. There is
probably no other incoördination during childhood in which there is
such a rapid loss of weight. The picture which the patient presents
is characteristic. There is great weakness and prostration from the
very beginning. The fontanel is depressed and in some cases there
may even be an overlapping of the cranial bones. The features become
sharp, the eyes are deeply sunken and the angle of the mouth is
drawn down. The nose is pinched, the skin over the forehead is tense
and dry, the temples are sunken. There is pallor, stupor, marked
relaxation of the lips and there will be convulsions and collapse.
Statistics show that under medical treatment fully three-fourths of
the cases die.


Major Adjustment

Most excellent results are obtained in these cases under chiropractic
adjustments. In the severe attacks it will be found necessary to
adjust the child as often as once every six hours. The subluxations
will be found at stomach place and kidney place and middle lumbar.
Some very severe cases have come under our personal observation and
in the cases that we have handled personally the results have been
100%. Such cases must be analyzed very carefully, and must have the
very best care in every way.


CHRONIC INTESTINAL INDIGESTION

Chronic intestinal indigestion is a very common incoördination
affecting children. It is more likely to be found among children
who are artificially fed. Intestinal indigestion is responsible for
a great variety of symptoms that are sometimes considered separate
dis-eases.


Symptoms

Children suffering with intestinal indigestion usually present
symptoms of malnutrition. They are anemic, the extremities being
usually very small. The most striking feature of such a case will
be the extremely large abdomen. The colon is usually dilated as
are also the small intestines. There is marked tympanites, which
usually increases during the daytime but diminishes during the
night. This is one of the principal symptoms which differentiate
intestinal indigestion from tubercular peritonitis. Such children
are easily fatigued, have a very sallow complexion with dark rings
under the eyes. They are usually very much below the average weight
and are very cross and irritable. They do not sleep well, often
grinding their teeth and crying out in their sleep. There is usually
alternating constipation and diarrhea, the odor of the stools being
very offensive. In extreme cases there may be convulsions and other
cerebral symptoms. There is seldom any fever.


Major Adjustment

The local major subluxation will be found in the lumbar region with
the combination at kidney place. Kidney place is used only when there
has been an accumulation of products of indigestion which makes it
necessary to increase elimination to take care of these products. In
many of these cases the liver is involved and therefore will call for
liver place in combination with kidney place and the local lumbar.
These cases will respond very readily to chiropractic adjustments.


COLIC

Colic is a common incoördination of infancy and is very prevalent
during the first three months. Colic is a symptom rather than a
dis-ease and usually indicates intestinal indigestion or some
inflammatory condition of the intestines. It is characterized by
sharp paroxysmal pains in the intestines. A child who is subject to
colic will usually be suffering also from constipation. The crying of
a colicky child is characteristic, being very violent and paroxysmal,
which presently subsides only to be followed with another attack.
During these spells the lower extremities will be drawn up and the
abdomen will be tense from the accumulation of gas. In mild cases
the child will not cry out but will be fretful. This may be wrongly
construed to be the result of hunger. When the attacks of colic come
on the child will show a desire to nurse and will take the breast as
though very hungry. This may be followed by relief from the pain, but
this relief is only temporary and when the pain returns it is usually
more severe. There is probably no incoördination of childhood that is
quite so trying to a chiropractor as an acute attack of colic, due to
the violent crying of the child and the eager desire on the part of
the chiropractor and the attendants to relieve the pain. It is often
quite hard to obtain a correct analysis in such cases because of the
difficulty experienced in getting the child into a proper position
for palpation. In making the palpation the chiropractor should take
plenty of time and should never endeavor to force the child to be
still, rather he should adapt himself to the constant moving about of
the infant.


Major Adjustment

The major varies somewhat in these cases so far as a specific
vertebra is concerned, but the local will always be found in the
lumbar region, usually the first or second lumbar vertebra. Kidney
place should be used as a combination.


VOMITING

During nursing the infant swallows quite a little air and not
infrequently this is the cause of vomiting immediately following
feeding. It is not uncommon for an infant to vomit without effort
after overfilling the stomach. This is a natural thing among healthy
children and needs no attention from a corrective standpoint. In such
cases the milk is but little changed.

In gastric indigestion and gastritis vomiting is always present, but
in these cases it does not take place until some time after feeding,
perhaps several hours. In gastritis the vomiting is more constant.
In the more severe cases there will be not only the partially
digested food but also bile and mucus and sometimes traces of blood.

Obstructive vomiting is sometimes found among infants and may be
due to intestinal obstruction or to an obstruction of the pyloris.
The obstruction may be congenital or it may develop after birth.
Obstruction of the pyloris may be the result of hypertrophic
stenosis. In this condition the child vomits immediately following
feeding and with great force. This is thoroughly described in the
article on Hypertrophic Stenosis of the Pylorus. If the obstruction
is in the intestinal tract it may be the result of a congenital
malformation or due to intussusception. The vomiting is forceful and
the vomitus may contain fecal matter.

Vomiting is often associated with peritonitis and appendicitis. In
these conditions there is distention of the abdomen with abdominal
pains which may be localized. There may also be a slight temperature.
Vomiting is purely adaptative on the part of Innate Intelligence. The
food cannot be digested and carried through the digestive tract so
Innate realizes that the best thing to do is to free the body from it
in the quickest manner.

Vomiting often precedes such incoördinations as pneumonia, scarlet
fever and malaria and may precede any of the febrile dis-eases.
Vomiting may be produced by the accumulation and absorption of
toxines in the body.

Infants suffering with nervous disorders such as acute meningitis,
tumors of the brain and other central conditions will often have
cerebral vomiting. In this event the vomiting is spontaneous and
does not necessarily occur at feeding time. Other cerebral symptoms
present will aid in determining the analysis.

Vomiting may be produced by the presence of worms that come up
into the throat from the stomach and intestinal tract. Hunger may
occasionally bring on an attack of vomiting. This is more common in
older children than in infants.


RECURRENT VOMITING

This is also known as cyclic vomiting and periodical vomiting.
It is characterized by recurrent attacks which may be weeks or
months apart. They come on without any apparent cause and from the
descriptions and explanations given in medical science very little
can be done medically to control the vomiting which at the end of
two or three days will cease spontaneously. The attacks recur at
different intervals, usually less often, gradually decreasing until
they cease altogether when the patient is about the age of ten or
twelve years.


Symptoms

There is loss of appetite and malaise. The pulse becomes rapid and
in some cases there is slight temperature. There is usually headache
and excessive thirst. During the attack of vomiting there is extreme
retching and great distress. The symptoms are similar to migraine
in adults. This condition must be differentiated from tubercular
meningitis in which there is vomiting without apparent cause. The
course of the symptoms will soon enable a positive differentiation.
In acute indigestion there is vomiting, but the history of the case
reveals the fact that the attack was brought on by undigested food.
It is very easy to distinguish this type of vomiting from that of
appendicitis, since in appendicitis there is marked tenderness at
McBurney’s point, also pain and the characteristic rigidity and
muscular contraction. In intussusception the symptoms are usually
more severe and there is blood and mucus in the stool.


Major Adjustment

Since there seems to be no particular indication of indigestion or
impaired functions, and no pathological changes, it is evident that
the function involved is that of motor. But regardless of the primary
function that is interfered with a subluxation will be found at S. P.
and in most cases there will be a hot box during the acute attack.
The vertebra most commonly subluxated is the sixth dorsal. In most
cases there is no combination and results will be obtained in a very
short time by adjusting nothing but the S.P. subluxation. In the
severe cases it may be necessary to adjust as often as once every six
hours until the vomiting ceases. Ordinarily the vomiting will cease
in a short time and in most cases marked improvement will be noted
after the first adjustment.

Vomiting occurs in gastric indigestion, intussusception, meningitis,
peritonitis, pyloric stenosis, uremic poisoning, and in many other
acute incoördinations.


CONSTIPATION

The first bowel movement after birth is known as meconium and is a
dark brownish-green color, and of a semi-solid consistency. During
the first two or three days the bowels move from four to six times
daily. On the third day the character of the stools begin to change
and by the fourth day the feces has become normal.

The normal stool of a normal nursing infant is about the color of
the yolk of an egg, and may be slightly green. The average amount is
about two ounces daily. The stools should never be watery, but of
a butter-like consistency. During the first few weeks the infant’s
bowels will move on an average of four times daily. After about six
weeks the average will be two a day. The stool changes in character
as soon as the child is placed upon a mixed diet. It then becomes
more like that of an adult but remains softer.

Constipation is one of the most common incoördinations of infancy and
childhood. There are many factors to be considered and many things
that contribute to the condition. In older children habit plays no
small part in aggravating constipation. For this reason the child
should be very carefully trained early in life to obey the first call
on Nature in this respect.

Normally the infant should have two bowel movements a day, although
some have more while others may have only one. Frequent movements
do not, however, mean that the child is not constipated or costive.
With two or three dry hard stools per day the child would be costive.
Constipation is the result of a lack of motor function in the
muscular walls of the intestines while costiveness is the result of a
lack of secretion due to interference with transmission of secretory
mental impulses. The two conditions are often associated. When there
is a lack of motor function in the muscular walls the fecal matter
will not be forced out of the intestinal tract fast enough and much
of the moisture will be absorbed, thus leaving the fecal matter dry
and hard. This is not a true costiveness and should not be mistaken
for such.

In costiveness there may be colicky pains which may be increased,
and may at times be quite severe, when the hard dry fecal matter is
passed. The general health of the child may be seemingly normal. In
severe cases hemorrhoids and even hernia may be developed from the
constant straining.


Major Adjustment

These cases are simple and respond readily to chiropractic
adjustments. The combination varies somewhat in different cases. In
constipation the major will be a lumbar vertebra. In costiveness,
where secretions are involved, the combination will include a Li.P.
and K. P. In some cases excellent results are obtained by adjusting
ninth dorsal.


INTUSSUSCEPTION

Intussusception is a condition wherein there is a telescoping of the
intestines in which one portion passes into the adjacent portion and
produces an obstruction.

This condition occurs most often in early infancy, although not very
commonly. The most frequent site is at the ileocecal valve. It may,
however, occur at any point in the intestinal tract. When it occurs
in the small intestine it is known as enteric intussusception; in the
colon as colic; and at the ileocecal valve as ilecocecal.

Intussusception may be chronic or acute. In the chronic cases there
may be adhesions which will make it very difficult for Innate to
accomplish a reduction.


Symptoms

The onset is usually accompanied with paroxysmals of pains and
vomiting. The pains may be very severe and the vomiting projectile.
The pain may be mistaken for that of ordinary colic, but it is much
more severe and may continue through the entire attack.

The vomiting is persistent, especially at the onset, and occurs
as soon as food enters the stomach. In older children it may be
stercoraceous after the third or fourth day. It never occurs,
however, in infancy. The vomiting is the result of the intestinal
obstruction and is adaptative on the part of Innate Intelligence. It
is quite obvious that it is better not to have food in the stomach
than it is to have it and not be able to complete the process of
intestinal digestion.

The character of the stools is of importance. At first the bowel
movements may be diarrheal and later there will be no fecal matter,
but the stool will contain nothing but blood and mucus. A paroxysm
of colicky pain may be followed by a mucous and bloody stool several
times daily. At the onset the abdominal walls are soft and relaxed,
or may even be retracted. Tympanites may occur about the second or
third day.

The symptoms in the acute cases are those of shock. There is an
extremely anxious look on the face which is pallid, cold extremities,
subnormal temperature and cold perspiration. There is restlessness
and in many cases convulsions. Later there will be stupor. A sudden
rise in temperature indicates a turn for the worse and may mean death
in a short time. In the chronic cases there is marked inanition which
progresses very rapidly.


Major Adjustment

The subluxation interfering with the transmission of mental impulses
causing intussusception will be found in the lumbar region, the
specific vertebra depending upon the location of the intussusception,
whether in the upper or lower intestinal tract. Most excellent
results have been obtained in these cases, and there should be
no hesitancy in adjusting. The function involved is motor, which
prevents a coördinate action of the muscular walls of the intestines.
As soon as this action becomes normal Innate Intelligence will
correct the condition and all symptoms will subside.


ICTERUS

Icterus is a rather common incoördination of infancy. It is
characterized by yellowish discoloration of the skin produced by the
accumulation of bile pigment. This is the result of an occlusion
usually of the common bile duct, which prevents the bile from passing
into the duodenum. There are two forms: the physiological and the
pathological. In the physiological there is an inflammation in the
mucous membrane lining the common bile duct. This causes a decrease
in the size of the lumen, which obstructs the flow of bile. In the
pathological there may be a complete obstruction due to malformation
or there may be a congenital absence of the bile duct. While the
common bile duct is the most common seat of the pathological type,
yet the hepatic and cystic ducts may also be involved.


Symptoms

The most prominent symptoms is the discoloration of the skin. In the
severe obstructive jaundice the stools are white, the urine dark
brown and bile-stained and the liver and spleen often enlarged. There
may be severe convulsions. In the more common and less exaggerated
cases the foregoing symptoms are present but in a milder form. There
is typical jaundiced discoloration which in some cases will appear
soon after birth. This will continue for a few days and may become
quite marked. The stools will be colorless, while the urine will be
highly colored.


Equation and Family

The equation is secretion plus (T+) and excretion minus (E-) for the
accumulation of the bile. The family is the poison family. In case of
temperature it overlaps the fever family.


Major Adjustment

The chiropractor must not conclude that the case is one of congenital
malformation or absence of the bile duct merely because of the
extreme discoloration of the infant. Cases have come under our
observation in which the symptoms would all indicate that the case
was hopeless, but under chiropractic adjustments they have recovered.
It must be recognized, of course, that if there is a congenital
absence of the bile duct the case is hopeless, but since there is no
way of determining whether it is a mere obstruction or congenital
absence, the case should by no means be considered hopeless. Every
effort should be made to locate and adjust the subluxation. The
subluxation will be found at liver place which must be adjusted in
combination with kidney place. Kidney place is required for the
elimination of the accumulated bile. These cases will respond very
quickly and satisfactorily under chiropractic adjustments.




CHAPTER VII

MISCELLANEOUS




CHAPTER VII

MISCELLANEOUS


MALNUTRITION

This condition may result from a lack of the proper amount of food
and from unhygienic conditions. However, it is often found among the
children who should be properly nourished, who have the very best
of care and the most wholesome food. There is no definite standard
by which to determine a case of malnutrition. The extreme cases are
obvious, but a child may be simply underweight and still not be
classed as a case of malnutrition. Up to eleven or twelve years of
age a child is not usually considered properly nourished if he is 10%
below the normal standard of weight for his age and height. If the
food supply is insufficient in quantity or quality, if there are bad
habits of eating, such as bolting the food, insufficient mastication,
and irregular hours of eating, these should all receive proper
attention. If, on the other hand, the supply of food is sufficient in
quantity and quality, if all habits of eating are normal and there is
malnutrition, it is because the food is either not properly digested
or not properly assimilated, or both, and the child should receive
prompt attention at the hands of a competent chiropractor.


Symptoms

The symptoms of malnutrition are very obvious and need no special
mention here. Such children are usually irritable and fretful. They
are of a nervous disposition and very active. They are usually very
bright mentally and often excel in their school work. Children
suffering with malnutrition are very susceptible to different
incoördinations and may be sick a great deal.


Major Adjustment

In these cases, if the child is provided with food having sufficient
nourishment, most excellent results will be obtained from
chiropractic adjustments. A very careful analysis must be made in
order to determine all the facts in the case for the major differs in
different individuals. In some cases the major will be C.P. and K.P.,
in others S.P., K.P. and a lumbar, while in some cases Li.P. and
Sp.P. may be involved.


INANITION

This is the term applied to the condition resulting from the lack
of food assimilation, It affects principally young infants. It is
characterized by a persistent loss of weight with more or less severe
symptoms which may appear rather suddenly.


Symptoms

The infant’s pulse is weak and rapid and the temperature may be
high. There is scanty urine, cold extremities and great muscular
relaxation. The face presents a peculiar bluish gray color. There may
be cyanosis. There is rapid irregular respiration. In the more severe
cases there may be stupor, while in others the child is very restless
and fretful. Pupils are contracted and the fontanel is sunken. The
progress of the incoördination may be rapid and in very young infants
death may occur quite suddenly. Breast feeding is very essential in
these cases.


Major Adjustment

Inanition is really malnutrition in the young infant due to a lack of
assimilation of nutrition. The major adjustment is C.P. or S.P. and
K.P. In some cases Li.P. may be involved, while in others Spl.P. may
enter into the combination.


MARASMUS

This condition is also called infantile atrophy and simple wasting.
It is not very common and is usually found in institutions for
infants. It affects infants who are unusually weak. It is said
to result largely from improper food and feeding and also it is
influenced by the surroundings. In these cases the methods of
feeding and the character of food should be carefully investigated.
If these are found satisfactory it will then be obvious that the
food is not being properly digested. This calls for a careful
analysis and adjusting of the child. In these cases the food can
not be assimilated because it is not properly digested. There is
a progressive and persistent loss in weight. The body temperature
becomes subnormal, the lung expansion imperfect, emaciation very
marked, the skin deeply wrinkled and the face and arms take on a
very old appearance. The eyes appear very large, the temples and
fontanels are sunken, and the abdomen becomes very prominent. The
child is very susceptible to all forms of incoördinations and because
of the extreme weakness may succumb quickly to any acute dis-ease.
In some cases after the emaciation has become very marked there may
be an unusual and sudden gain in weight due to a general edema. This
condition may increase until all the tissues of the body become
extremely water-logged. The large cavities, however, are very seldom
affected. Infants under seven or eight months of age are likely to be
affected by this edema.


Major Adjustment

These cases call for a combination major which consists of S.P. and
K.P. and an Up.L.P. Excellent results will be attained in these
cases if adjustments are given early enough in the stage of the
incoördination. The patient is never too weak to be adjusted.


SCURVY

Scurvy is a condition resulting from faulty nutrition. It is
characterized by a swelling of the joints, sometimes pseudoparalysis
of the lower extremities and a spongy condition of the gums which
have a tendency to bleed. There may be cachexia and anemia. This
condition is supposed to result from a continuous diet lacking in the
vitamin C.


Symptoms

Usually the first symptoms to appear are tenderness of the legs.
This will be observed from the fact that the child cries when his
legs are moved. Eventually this tenderness localizes about the knees
and ankles and it is accompanied with swelling of these parts. The
gums then become swollen and show a marked tendency to bleed. This
swelling may produce pain sufficient to interfere with the child
taking food. The child loses weight, becomes very fretful, and has
a slight fever. There is a characteristic posture in which the hips
are rotated outward, while there is a semi-flexion of the thighs and
legs. The child will usually lie very quietly because any movement
produces pain, especially in the legs. There is marked sub-periosteal
hemorrhages which may be so great that the limbs will become twice
their normal size. In severe cases epiphyseal separation is not
uncommon. Scurvy is very often associated with rickets. However,
it is affirmed that they are two separate conditions and not just
different forms of the same condition.


Major Adjustment

This incoördination requires a combination major which will be found
at C.P. or S.P. and K.P.


RICKETS

Rickets is also called rachitis and known by some as Barlow’s
dis-ease. It is listed as a dis-ease of nutrition, although the most
important anatomical changes which take place are those affecting
the bones. This dis-ease is found among people of all classes. There
is no race that is immune, yet some nationalities seem to suffer
more frequently and severely than others. Negroes and Italians seem
to be especially susceptible when placed in northern climates and
congested quarters in northern cities. In general practice rickets is
considered a rather uncommon incoördination, although in congested
cities it will be found quite prevalent.


Symptoms

The first symptoms to appear are nocturnal restlessness and profuse
sweating about the head during sleep. The restlessness is usually
quite marked; the patient rolls and tosses a great deal, and almost
constantly moves the head back and forth on the pillow. Because of
the profuse sweating the child becomes very susceptible to colds,
bronchitis and bronchial pneumonia. A case of rickets is rather
easily recognized by the large head, the pigeon breast, beaded ribs,
the deformities of the extremities, the swelling of the epiphyses of
the wrists and ankles, and the prominent abdomen.


Deformities of the Head

Deformity of the head appears very early in the dis-ease and is
due to the thickening of the cranial bones, producing the typical
square head of rickets. This square head is known as caput quadratum.
Numerous soft spots are formed in the cranial bones which when
pressed upon give one the impression that he is feeling parchment.
This is known as cranial tabies. The fontanels and sutures are very
late in closing, sometimes as late as the third or fourth year. The
large rachitic head must not be mistaken for hydrocephalus.


Deformities of the Thorax

The chest is deformed in such a way that the transverse diameter
is decreased and the antero-posterior diameter is increased.
This produces the typical pigeon breast. Such deformity is caused
from the softening of the thoracic bones. Beading of the ribs is
characteristic and is known as the rachitic rosary. These nodules are
formed at the junction line of the costal cartilages and the ribs.
While these nodules are always present, they are not always visible.
The rachitic gurgle, which is a transverse depression extending from
one side of the chest to the other and is about two inches broad, is
also present.


Deformities of the Spine

The most characteristic deformity of the spine in rickets is a
kyphosis usually involving the lower dorsal and the entire lumbar
region, although lateral curvatures may appear. In a well defined
case of rickets every bone in the body may be abnormally involved.
The deformity of the spine results from a softening of the bones
which give way under the weight of the trunk.


Deformities of the Extremities

A case of rickets usually presents characteristic curvatures of the
bones. The long bones are, as a rule, involved symmetrically. Green
stick fractures very often occur. In practically all cases of this
dis-ease there is an arrested longitudinal growth in the bones.
Because of this the height will often be very much less than that of
the normal child. There is marked enlargement of the epiphyses at the
wrists and ankles. The slight curvatures in the bones of the arms
will be exaggerated when the child begins to creep and the curvatures
in the legs will be increased when the child begins to stand and walk.


Deformities of the Abdomen

Due to the general motor minus condition of the abdominal muscles
there is developed a condition known as pot belly. This enlargement
is often exaggerated by intestinal indigestion and constipation. This
constipation results from the motor minus condition which interferes
with the vermicular movement of the intestinal tract.


Equation

The function that is primarily involved in rickets is nutrition, but
this results in other functions being implicated. There is expansion
minus especially in the development of the osseous tissue. The
equation is N— with X—.


Major Adjustment

Most excellent results are obtained in rickets. It is very essential
that the adjustments be given at the beginning before the deformities
become marked. In the more chronic cases the incoördination will
be checked by the adjustments and the patient will recover, but it
will be obvious that the marked deformities such as genu varum, genu
valgrum, enlargement of the wrist and deformities of the head can not
be corrected in the chronic cases. The adjustment is At. or Ax., S.P.
and K.P.


NEUROTIC CHILDREN

Neurotic symptoms may appear very early in infancy. They may be
first noticed when the child is startled by sudden sounds or unusual
sights. Ordinarily the infant, only a few weeks of age, will pay
little or no attention to its surroundings. The neurotic infant,
however, may be startled or badly frightened by its environment. Such
infants are found to apparently fix their attention upon objects as
early as the third or fourth week. If its attention is thus centered
upon a person who should make a quick, unexpected move, the child
often becomes terrified. In other cases the symptoms may manifest
themselves in a muscular spasm, such as mild opisthotonos, and other
conditions suggesting cerebral incoördination. In early infancy
vomiting and diarrhea may be brought on by excitement. The vomiting
takes place without nausea and may be excited either by food or
water. This must be carefully distinguished from the spitting up of
milk so characteristic in infancy. This is a perfectly normal process
and seems to be Innate’s method of adaptation when the child has
taken too much milk into the stomach. Vomiting in neurotic infants
may even become so severe that it results in a loss of weight. The
diarrhea occurs with no more apparent cause than the vomiting. If
the stools are not too frequent the food will be well digested but
the diarrhea may become so severe that the food passes through the
intestinal tract undigested. This diarrhea may be very obstinate and
then it results in serious malnutrition. As the child grows older
the characteristic symptoms of infancy become less marked but the
child continues to be extremely nervous, irritable and cross. This
nervousness may be exaggerated by the surroundings. Such children
usually have poor appetite and suffer from constipation. They are
almost always poorly nourished and anemic. The pulse is usually more
or less rapid and is generally affected by excitement. Such children
are quite restless during sleep.

Neurotic children are often precocious but lack in concentration due
to their restlessness. Headache is a very common symptom. There is a
marked tendency toward habit, spasm and chorea.


Family

These conditions are classified in the spasms family.


Equation

The equation is not so well defined since the condition of
nervousness is adaptative. Therefore the equation for the nervousness
is I.A. If other symptoms appear the equation would depend upon the
function involved.


Major Adjustment

It is maintained by most authorities that this nervousness is
inherited, but it has been demonstrated clinically by Chiropractic
that results are readily obtained by chiropractic adjustments. It is
reasonable to assume that there are environmental conditions which
might produce nervousness even in the small infant, but it is also
recognized that if the child is normal he soon becomes accustomed to
the peculiarities of the environment and pays little or no attention
to them. Subluxations in the cervical region, usually atlas or
axis, are found in these children. These subluxations may produce
sufficient cord pressure to cause such symptoms as usually manifest
themselves in malnutrition as so-called nervous indigestion and
other symptoms which would indicate constitutional disorders. A very
careful analysis reveals that the nervousness in some of these cases
is adaptative to some other incoördination. If the nervousness is
direct the major adjustment will be Up.C. with a possible combination
of C.P. and K.P. If the nervousness is adaptative, then a very
careful analysis must be made to determine the incoördination to
which it is adaptative. The major then will be determined by the
location and the family involved.


CONVULSIONS

A convulsion is a violent involuntary contraction of muscles which
ordinarily contract only under direction of the will. It may be
either clonic or tonic. A clonic convulsion consists of a spasm of
the muscles with alternating contractions and relaxations while the
tonic spasm consists in constant rigidity of the muscles involved.
The contractions may be confined to certain muscles or sets of
muscles as, for example, the muscles of the face, the trunk or
the extremities. In some cases the muscles of the entire body are
involved.

During the first eighteen months of life the child is more
susceptible to convulsions than at a later age, although the
condition is rather common during childhood. Convulsions accompany
many incoördinations and are considered adaptative to some other
condition. Therefore the first thing to consider in a case of this
kind is the primary condition or the incoördination to which the
convulsion is adaptative.

The more common conditions with which convulsions are associated are:
Incoördinations involving the nervous system, such as cerebra-spinal
conditions; rachitis; and organic and functional disorders. Any
condition which produces an irritation of the nervous system may
result in a convulsion of more or less violence. For this reason
children are often subject to convulsions during dentition and
disorders resulting in slight temperature. Cerebral tumors, abscesses
of the brain, hydrocephalus and meningitis are examples of cerebral
conditions in which convulsions are commonly found.

Subluxations in the upper cervical region are often produced at the
time of birth which cause cord pressure, making the child susceptible
to all conditions that would irritate the nervous system.

There may be K.P. subluxations interfering with the process of
elimination resulting in an accumulation of poison within the body,
or there may be other subluxations resulting in the production of
toxines within the body and these will produce an irritation of the
nervous system resulting in convulsions. Disturbances in digestion,
affections of the respiratory tract, a sudden rise of temperature
and incoördinations involving the gastro-intestinal tract are often
responsible for convulsions. Convulsions are quite frequent at the
onset of acute dis-eases such as whooping-cough, measles and mumps.
They are often associated with enlargement of the thymus gland.

During the convulsion there may be loss of consciousness with tonic
and clonic spasms in various degrees of severity. The urine may
be voided and the bowels evacuated. In the very young infant a
single attack may prove fatal, although this is rather unusual. When
death occurs in this way it is most often due to asphyxia, or when
the convulsions recur in rapid succession death will result from
exhaustion.

The clinical picture is quite typical. Usually there is pallor of
the face which may be followed quickly with a twitching of the
facial muscles, and sometimes those of the hands and feet. In most
cases the attack comes on without warning; the eyes become fixed and
rolled backward; the twitching usually begins in the face and very
soon the entire body is involved. The face is distorted by muscular
contractions, the head is drawn backward and the neck is thrown
forward; there may be frothing at the mouth. The pulse is irregular
and weak, the respiration is shallow and feeble while there is cold
perspiration of the forehead and it may also be on the body. The
thumbs are turned into the palms and the hands are tightly closed.
There is rhythmical convulsive movements consisting of alternating
flexion and extension.

The attack usually lasts from a few minutes to half an hour and
sometimes longer. The patient is left in a more or less state of
exhaustion and the attack may be followed by stupor and coma. Very
often convulsions in children over two years of age indicate the
onset of some acute condition such as pneumonia or scarlet fever.
However, convulsions may mean very little with small children that
are extremely nervous. During the first few days of life they may be
the result of temporary circulatory disturbances in the brain from
prolonged pressure in difficult labor.


Family

All cases of convulsions are in the spasms family no matter
with what other conditions they are associated. If there are
other complications, and there usually are, the family for the
complications will depend upon the functions involved.


Major Adjustment

When a chiropractor is called to see a child that is having
convulsions he should make a very careful inquiry into the history
of the case and try to find the associated incoördination. This is
done for the purpose of determining the combination to be used. The
major for location will be atlas or axis, while the combination will
depend upon the associated condition. This may be K.P. or it may be
S.P. or any other combination which would include the subluxation for
condition.

Excellent results are obtained in cases of convulsions. The
adjustment should be given as soon as possible. In many cases an
adjustment of the atlas or axis will bring the child to consciousness
and prevent a recurrence of the attack. The convulsion may be caused
by an atlas subluxation with no accompanying condition. This is known
as a direct convulsion and will respond very quickly to an adjustment.


NOCTURNAL ENURESIS

As early as the tenth or twelfth month of age the child may be
trained to make known his desire to empty the bladder. However, with
some children this may not be accomplished until two and a half years
of age. If by the third year of age the child is unable to retain the
urine for a normal length of time, it is evidence of some abnormality
and should receive Chiropractic attention. The child is afflicted
with what is known as enuresis, which may take place during the day
or night, or both. If it occurs during the day, it is called diurnal;
while if it takes place during the night, it is known as nocturnal.
It is more likely to take place during the night, since it may be
possible for the child to control the bladder during waking hours.

We are most concerned with the nocturnal enuresis, because this form
causes the child more discomfort and it is more difficult to control
than the diurnal.

We recognize nocturnal enuresis as an adaptative condition. That
is, the emptying of the bladder is a perfectly natural process and
will always take place under certain conditions. For example, if the
sphincter muscle relaxes, the urine will be voided. In this event, we
are not concerned in the voiding of the urine, but in the cause for
the relaxation of muscle which prevented the bladder from retaining
the urine. There are a number of conditions to which nocturnal
enuresis is adaptative. The following are the most common:

Incoördinations involving the nervous system.

Highly acid urine.

Excessive quantity of urine.

Abnormalities and incoördinations of the bladder.

Irritation of the genital organs.


Incoördinations of the Nervous System

The incoördinations of the nervous system in which there may be
nocturnal enuresis are those commonly found in extremely neurotic
children, and children who are under-nourished and anemic. Chorea,
neurasthenia and hysteria are examples of conditions in which
nocturnal enuresis is very common. Nervous children are easily
disturbed during sleep and are prone to dream, at such times the
innate interpretation of the vibrations produced by the urine in
the bladder reaches the educated mind and there is not sufficient
reasoning of the conscious mind to enable the child to realize where
he is or to prevent the following of the natural desire to urinate.

The inability of the child to control the bladder during acute
illness must not be mistaken for habitual nocturnal enuresis; for
this will be only temporary, and will disappear when the child
recovers from the acute attack.


Highly Acid Urine

In some cases, the urine being highly acid, produces vibrations
in the bladder which results in Innate Intelligence causing the
sphincter muscle to relax, which results in the voiding of the urine.
This is an adaptative action on the part of Innate to prevent the
acidity of the urine from setting up an irritation in the bladder.
If the urine remained in the bladder it would damage the tissues
and call for an expenditure of energy for reparation; this is
all prevented by getting the urine out of the bladder as soon as
possible. The hyperacidity of the urine is the result of the lack
of the expression of mental impulses in the body and should receive
immediate attention, that the cause of the incoördination may be
removed. When this is accomplished the nocturnal enuresis will cease.


Excessive Quantity of Urine

In some incoördinations there is abnormal thirst which results in
the child drinking more water than is required for the normal bodily
processes. The natural channel through which this excessive amount of
water is excreted is through the kidneys. This results in the bladder
being filled often, which necessitates the frequent passing of urine.
The child might be able to control the bladder during waking hours
and make his wants known; but in sleep, as the bladder becomes full,
Innate would relax the sphincter muscle, which would allow the urine
to escape in order to relieve the pressure. To overcome the nocturnal
enuresis in a case of this kind, it is necessary to adjust for the
cause of the excessive thirst; and when this is corrected, the bed
wetting will cease.


Incoördinations of the Bladder

Abnormal conditions of the bladder will cause difficulty in retaining
the urine for a normal length of time. An inflammation of the bladder
is greatly exaggerated by the presence of urine, therefore an
irritation would be set up which would result in a desire to empty
the bladder. This would invariably result in nocturnal enuresis. An
interference with the transmission of motor mental impulses to the
sphincter muscle would be another cause for bed wetting. In this
case, it would be impossible to retain the urine after a certain
amount had passed into the bladder. This would result in enuresis,
since there would be nothing to prevent the urine from passing freely
from the bladder.


Irritation of the Genital Organs

In some cases there is an irritation of the genital organs resulting
in the production of vibrations which, when the child is asleep,
results in enuresis. This irritation may be produced by an adherent
prepuce. Balanitis and phimosis are also quite common conditions.
There may be an irritation of the rectum produced by pin-worms.
Vaginal irritation may be the result of vulvovaginitis, or due to
adherent clitoris.


Correction of the Condition

It is asserted by some that nocturnal enuresis in many cases is
due largely to habit. We see no more reason for considering this
condition a habit than for considering any other abnormal condition
a habit. It is the result of interference with the transmission of
mental impulses, and it is the duty of the chiropractor to find the
condition to which nocturnal enuresis is adaptative and correct the
cause of that condition.

Some parents have the idea that bed wetting is a habit, and the child
should be punished in an effort to break him of the habit. This,
however, is the wrong attitude and no good will be accomplished in
this manner. Punishment will only tend to make the child nervous and
the condition worse.

This condition yields so easily to Chiropractic adjustments that
there is no reason for allowing a child to continue without relief
from this most annoying condition. We have never seen a case that did
not respond to adjustments after the proper analysis was obtained.

In analyzing a care of nocturnal enuresis it must not be taken for
granted that the major is K.P., or even a lumbar. For this may not be
true. A most thorough analysis should be made to determine the exact
condition of the child. If the nervous system is involved, there will
likely be found an atlas or axis subluxation. We have seen many cases
that had been adjusted persistently at K.P. and a lumbar, but with no
results, while an adjustment of the axis would get almost immediate
results. This does not mean that every stubborn case will respond to
an axis adjustment.

Scanty and highly colored urine, which has a tendency to scale and
irritate the skin, usually indicates highly acid urine. In this
case a careful analysis must be made to determine the cause of the
acidity. The palpation will reveal a subluxation and most likely a
hot box at C.P. and K.P. In many cases the child will be anemic, and
in a general rundown condition; in this case the combination will be
S.P. and K.P.; the combination may also include a lumbar.

In the cases involving the bladder, the major will be a lumbar
vertebra. The combination will be determined by the local condition,
which may necessitate the use of K.P. When there is an irritation of
the genital organs or adjacent structures, the major will include
a lower lumbar vertebra and may or may not require a K.P., the
combination depending upon the character of the local condition.

From the foregoing it will be observed that the major for nocturnal
enuresis varies, depending upon the condition to which it is
adaptative. The major may include At., Ax., C.P., K.P., lumbar, or
any combination of these or other subluxations. When the impingements
are found, and the causative subluxations adjusted, complete results
will be obtained—in every case.


OPHTHALMIA

This is an incoördination characterized by inflammation of the
conjunctiva. It is also called purulent conjunctivitis. Medically
these cases are supposed to be produced by gonorrhea, although in
many of the milder forms the gonococcus is not present. This is
evidence that the cause is not the gonococcus but that the germs,
when present, are there because of the pathological condition of the
tissues.


Symptoms

The eyelids are swollen, there is a copious, purulent discharge, and
there may be ulceration of the eyelids.


Major Adjustment

The major for this condition is a combination major which includes
a middle or upper cervical for the location and kidney place for
elimination.


TETANUS IN INFANTS

This is a condition which is occasionally found in young infants
and is the result of an infection usually of the umbilical wound.
It is most prevalent where conditions are unsanitary. Tetanus is
characterized by a tonic spasm of the muscles. It may affect all the
muscles of the body or it may be limited to the muscles of the jaw,
producing what is known as trismus or lockjaw.


Symptoms

The first symptom to appear may be the spasm in the masseter muscle
which interferes with nursing the child. The muscle of the face and
jaws appear firm and hot and the lips slightly protrude. Intervals
will occur when the muscles will be completely relaxed. At first
these paroxysms appear at intervals, between which the relaxation is
complete; but later they become more frequent and the relaxations
less marked until there is more or less of a continuous rigidity.
This contraction grows more exaggerated until the entire body becomes
rigid. The jaws become set and may be separated only slightly, if at
all. There is a peculiar characteristic facial expression due to the
contraction of the facial muscles. Swallowing becomes very difficult.
There is a weak, rapid pulse. In the mild cases there is only a
slight temperature, but in the more severe cases the temperature
may become extremely high. The cry becomes weak and whining. The
incoördination is of short duration. The child soon dies from
exhaustion or from suffocation due to the rigidity of the respiratory
muscles or it may be due to a spasm of the larynx. While tetanus
is not a very common incoördination, the mortality is very high.
Authorities place the fatality as high as 90% and even 95%.


Equation and Family

The equation is excretion minus (E-). The family is poison and
contractures.


Major Adjustment

If these cases are adjusted at an early stage excellent results will
be obtained. There is a combination major at At.P., C.P., and K.P.


PEMPHIGUS NEONATORUM

This is a rather unusual condition seldom found in general practice.
It usually occurs as epidemics in institutions where large numbers
of children are cared for. Outside of such institutions it is more
common among children in unhygienic surroundings. It is characterized
by an eruption of blebs containing a serous fluid.


Symptoms

These blebs appear about the third or fourth day and may be found
upon any part of the body, but usually upon the exposed parts.
They remain for a time and then rupture or dry up. There is no
suppuration. As the blebs enlarge they sometimes coalesce, covering
quite a large area. The epidermis is loosened by a serous exudate
which occurs directly beneath it and separates it from the true skin.
The case produces a very striking picture having the appearance of
being extensively burned. After the blebs have ruptured the epidermis
hangs in shreds, leaving a very bright red surface beneath. In
this way there may be large areas of the body almost completely
denuded of the epidermis. There may be a very slight temperature and
slight restlessness. There is great depression and marked weakness.
The symptoms at first appear rather slowly, later the dis-ease
progresses very rapidly, death often occurring in from twenty-four
to forty-eight hours. Pemphigus neonatorum should be distinguished
from congenital syphilis. The liver and spleen are usually very
greatly enlarged in syphilitic cases and there are usually other
characteristic symptoms present, such as changes in the nails, mucous
membrane and other parts.


Equation and Family

The general equation is excretion minus (E-). The condition is in the
poison and fever families.


Major Adjustment

The major adjustment is C.P. and K.P.




INDEX


  A
                                PAGE

  Abdomen, circumference of, 294
    Enlargement of, 295
    Normal, 295

  Abscesses of brain, 382

  Absolute humidity, 56

  Absorption, 17

  Absorption of gases, 52

  Acid, carbolic, 213

  Action, adaptative, 22, 187

  Active occupations, 196

  Acute catarrhal bronchitis, 340
    Equation, 342
    Family, 342
    Major adjustment, 342
    Symptoms, 341

  Acute catarrhal laryngitis, 334
    Major adjustment, 336

  Acute dis-ease, 171

  Acute intestinal indigestion, 359
    Major adjustment, 360

  Acute nasal catarrh, 327
    Equation, 328
    Family, 328
    Major adjustment, 328
    Symptoms, 327

  Adaptation, 48, 50, 52, 54, 96, 188

  Adaptation to environment, 20

  Adaptive action, 22, 187

  Adaptability of body, 186

  Adenoid growths, 330, 349

  Adjusting infants, 321

  Adjustments during dentition, 303

  Adulteration of food, 248

  Aerated water, 110

  Aerating, 129

  Aerial envelope, 68

  Aim and function of hygiene and sanitation, 15

  Air, 44
    Alveolar, 45
    Cells, 48
    Cold damp, 60
    Cold dry, 57
    Complemental, 65
    Constituents of, 44
    Emboli, 53
    Foul, 68
    Fresh, 66
    Humidity of, 55
    Impurities in, 67
    Increased pressure, 51
    Normal pressure, 50
    Oxygenated, 51
    Pressure at sea level, 54
    Pressure increased, 51
    Pressure, normal, 50
    Pressure, reduced, 50
    Rarefied, 51
    Residual, 45, 66
    Sources of impurities in, 67
    Space, 34
    Space per capita, 70
    Supplemental, 65
    Temperature of, 55
    Tidal, 65
    Warm dry, 61
    Warm moist, 59

  Airing a room, 70

  Albuminoids, 267

  Algæ, 127

  Alveolar air, 45

  Ammonia, 44, 49

  Analyzing infants, 307
    History of case, 307
    Objective symptoms, 307
    Zones involved, 312

  Anemia, 376

  Animals as source of communication, 22

  Animal foods, 237

  Animal life, 45

  Anorexia, 341, 360

  Anterior fontanels, 293

  Anthrax, 207, 212

  Antibiosis, 175

  Antibodies, 176

  Antigens, 176

  Antineurotic vitamin, 241

  Antiseptic, 207

  Apathy, 341

  Aphonia, 334
    Acute catarrhal laryngitis, 334

  Appetite, 232

  Argon, 44, 46

  Arsenic poisoning, 167

  Arteriosclerosis in lead poisoning, 166

  Artificial foundation beds, 33

  Artificial lighting, 99, 162

  Artificial methods of water purification, 128

  Artificial reservoir, 116

  Artificially high temperatures, 163

  Artificially fed babies, 286

  Asbestos, 34

  Asepsis, 208

  Aspect, importance of, 29

  Assimilation, food, 374

  Asthma, 348
    Equation, 349
    Family, 349
    Major adjustment, 349
    Symptoms, 348

  Atmosphere, 44

  Atmospheric pressure, 50

  Atrophy, infantile, 375

  Autolytic enzymes, 267

  Average weight of boys, 287

  Aquasphere, 44

  Aqueducts, 106

  Aqueous humor, 96


  B

  Baby, the, 277
    Bottle-fed, 353
    Breast-fed, 353
    Food, 277

  Bacilli, 173, 196

  Bacteria, 196

  Balanced rations, 236

  Barlow’s dis-ease, 376

  Barns and Barnyards, 259

  Basement, 32, 33

  Basement of school building, 141

  Bassinet, 283

  Bath tub, 37

  Beaded ribs, 377

  Bed, 222

  Bed pan, 223

  Bedrooms, 30

  Bed wetting, 386

  Bedding, 222

  Beginners, age of, 148

  Bends, 53

  Beriberi, 241

  Blackboards, 145

  Bladder, 384

  Bladder, control of, 284

  Bladder worms, 270

  Blast furnace workers, 163

  Blebs, 390

  Body heat, 81

  Bodily temperature, 58

  Boiling, 211

  Boracic acid, 261

  Borax, 261

  Botulism, 246, 248

  Bottle-fed babies, 278, 291, 353

  Bottling milk, 260

  Bowels, 284

  Bow-legs, 281

  Brain, development of, 279

  Brass, 166

  Breast feeding, 278, 353, 374

  Breathing, 48

  Brick, 36

  Bronchi, foreign bodies in, 338
    Symptoms, 339

  Bronchial croup, 343
    Major adjustment, 343

  Bronchitis, acute catarrhal, 340

  Bronchitis, chronic, 342

  Bronchitis, fibrinous, 343

  Bronchopneumonia, 344

  Building construction, 32

  Building site, 28

  Buildings, character of, 161

  Butter, 262


  C

  Cachexia, 376

  Caisson dis-ease, 53

  Caisson workers, 52, 163

  Calisthenics, 150

  Calorific mental impulses, 80

  Capillary attraction, 31

  Caput quadratum, 377

  Carbolic acid, 213

  Carbon dioxide, 44, 45, 47, 67, 108

  Carbohydrates, 239

  Care in milking, 258

  Care of cows, 258

  Care of food animals, 269

  Care of sick room, 220

  Carpopedal spasms, 333

  Carriers, 200

  Casein, 238, 255

  Casing, 125

  Casts, fibrinous, 343

  Catarrh, acute nasal, 327

  Catarrh, chronic nasal, 329

  Cause of dis-ease, 21

  Central heating, 88

  Cerebral incoördination, 379

  Cerebral tumors, 382

  Cesspools, 125

  Channels of entry, 201
    Digestive tract, 201
    Genito-urinary tract, 201
    Respiratory tract, 201
    Skin, 201

  Character of buildings, 161

  Character of cry, 309

  Charts, 146

  Chemical agents, 210

  Chemical composition of foods, 238

  Chemical purification, 131

  Chemically pure water, 108, 109

  Cheese, 263

  Chicken pox, 173

  Child exercise from handling, 281

  Child’s cry, 313

  Children, effects of labor upon, 158

  Chiropractic hygiene, 19

  Chiropractor, 192

  Choice of occupation, 157

  Chorea, 385

  Cholera infantum, 360
    Major adjustment, 361

  Chronic bronchitis, 342
    Major adjustment, 343
    Symptoms, 342

  Chronic dis-ease, 171

  Chronic gastritis, 354
    Major adjustment, 355

  Chronic intestinal indigestion, 361

  Chronic laryngitis, 336
    Major adjustment, 336
    Symptoms, 336

  Chronic nasal catarrh, 329
    Equation, 330
    Family, 330
    Major adjustment, 331
    Symptoms, 330

  Chyle, 17

  Chyme, 17

  Circumference of abdomen, 294

  Cisterns, 113

  Classification of dis-ease, 171

  Classification of foods, 237

  Cleanliness, 15

  Cleanliness, external, 15

  Cleanliness, internal, 15

  Cloak rooms, 146

  Clonic convulsion, 381

  Cocci, 173

  Cold damp air, 60

  Cold dry air, 57

  Cold in head, 327

  Colic, 362, 368
    Major adjustment, 363

  Colicky pain, 359

  Combustion, 79, 81

  Commensal, 175

  Communicable dis-ease, cause of, 226

  Communicability, 175

  Communication, source of, 22, 198

  Competitive games, 281

  Complemental air, 65

  Composition of water, 107

  Composition of meat, 267

  Compression, air, 52

  Condensation, 126

  Condensed milk, 261

  Condiments, 239

  Condition of eyes, 308

  Conduction, 86

  Conductivity of atmosphere, 58

  Congestion, 346

  Constipation, 366, 358
    Major adjustment, 367

  Constituents of air, 44

  Constitutional dis-ease, 170

  Construction, fireproof, 36

  Contact infection, 199

  Contagious, 173, 202

  Contractures, 279

  Convection, 88

  Convection through water, 89

  Conveyance, media of, 198

  Convulsions, 279, 381
    Clonic, 381
    Family, 383
    Major adjustment, 384
    Tonic, 381

  Copper, 166

  Corpuscles, 50

  Corridors, 141

  Coryza, 327

  Cows, care of, 258

  Cows’ milk, 278

  Creeks, 114

  Creoline, 213

  Cresoles, 213

  Croup, 332

  Croup, bronchial, 343

  Crude sewage, 133

  Crying, 280

  Crying, incessant, 314

  Crystalline lens, 96

  Curiosity of child, 280

  Cutting teeth, 299

  Cyanosis, 374, 308

  Cyclic vomiting, 365


  D

  Dairy barn, unsanitary, 259

  Dampness, 29, 32

  Damp site, 29

  Deciduous or milk teeth, 299

  Decomposing food between teeth, 302

  Decompression, air, 52

  Decreased air pressure, 50

  Deep sleep, 279

  Deep wells, 123

  Deformities of the thorax, 295

  Degree of infection, 172

  Dental caries, 302

  Dentition, 299

  Dentition, incoördinations during, 300

  Dentition, symptoms exaggerated by, 300

  Deodorant, 209

  Desk, school, 144

  Distinction between sanitation and hygiene, 14

  Development, 285

  Development of brain, 279

  Diameter of chest, 294

  Diaper, changing, 283

  Diaphragm, 280, 340

  Diarrhea during dentition, 300

  Definitions, 171

  Digestion, gastric, 357

  Digestive organs, 278

  Digestive tract, 353

  Dilution, 127

  Diphtheric germs, 197

  Direct infection, 199

  Direct lighting, 101

  Direct radiation, 87

  Dis-ease acute, 171, 226

  Dis-ease, cause of, 21

  Dis-ease, constitutional, 171

  Dis-ease, germs do not cause, 191

  Dis-ease the cause of germs, 189

  Disinfection, 207, 210

  Disposal of excreta, 223

  Distillation of water, 109

  Distilled water, 129

  Divers, 51, 163

  Diver’s palsy, 53

  Diving bells, 52

  Diving suits, 52

  Domestic water supply, 118

  Drafts, 282

  Drainage, 32

  Draw sheet, 222

  Drinking fountains, 146

  Dry heat, 211

  Dry man, 247

  Dry milk, 262

  Dustless chalk, 145

  Dusty trades, classification of, 165

  Dyspnea, 334, 335, 343


  E

  Ear drums, 52

  Echinococcus, 271

  Edema of glottis, 339
    Equation, 339
    Major adjustment, 339
    Symptoms, 339

  Educated mind, 220

  Educated mind, function of, 219-220

  Effects of dust, 164

  Effect of labor upon children, 158

  Effect of posture, 159

  Electric discharges, 49

  Elimination of water from body, 111

  Endemic, 177

  Energy, expenditure of, 61

  Environment, 381

  Environment, importance of, 218

  Environment, necessity of quiet, 279

  Enzymes, autolytic, 267

  Epidemic, 177

  Epistaxis, 331
    Equation, 331
    Family, 332
    Major adjustment, 332

  Equation, epistaxes, 331

  Equilibrium, 50, 296

  Eruption, 301

  Evaporation, 31, 58, 126

  Evolution of lighting systems, 99

  Exercise, 277, 280

  Exercise, outdoor, 281

  Excessive quantity of urine, 386

  Exhaustion, muscular, 282

  Exhaustion theory, 184

  Expenditure of energy, 61

  Expired air, 65

  Exposure, 172

  Exposure, stage of, 172

  External cleanliness, 15

  Eye, 96
    Adaptation to light, 96
    Aqueous humor, 96
    Crystalline lens, 96
    Fovea centralis, 96
    Iris, 96
    Macula lutea, 96
    Protection, 284
    Retina, 96
    Vitreous humor, 96

  Eyelids during sleep, 290


  F

  Facial expression, 308

  Fans, plenum, 73

  Fat soluble A, 240, 256

  Fatigue, 59, 160

  Fatigue, muscular, 161

  Fats, 239, 255

  Feces, 223

  Feeding, 277

  Fermentation, 31

  Fibers, taut, 171

  Fibrinous bronchitis, 343

  Fibrinous casts, 343

  Filter beds, 130

  Filtration, 129

  Filtration, mechanical, 128, 131

  Fire escapes, 36, 37

  Fire extinguishers, 36

  Fireplace, 84, 85

  Fireproofing, 36

  Fire protection, 36

  Fire-resisting, 36

  Fixtures of bathroom, 37

  Floors, 32, 33

  Floors, construction of, 34

  Floors, sanitary requirements, 33

  Fluctuation of ground water, 30

  Flushing tanks, 39

  Fomites, 178

  Fontanels, 293, 377

  Fontanels, in cretinism, 293

  Fontanels, in hydrocephalus, 293

  Fontanels, in rachitis, 293

  Food, adulteration of, 248

  Foods, animal, 237

  Food animals, 269

  Food animals, care of, 269

  Food assimilation, 374

  Food, 231, 233
    Balanced rations, 236
    Carbohydrates, 239
    Casein, 238
    Chemical composition of, 238
    Condiments, 239
    Fats, 239
    Function of, 238
    Infection, 245, 246
    Intoxication, 245, 248
    Meat, unfit for, 269
    Milk, 240
    Necessity for, 231
    Physical properties of, 338
    Poisons, 245
    Proteins, 238
    Roughage, 237
    Value of meat, 268
    Vitamins, 237, 240

  Foot tub, 37

  Footings, foundation, 33

  Forces, adaptative, 217

  Foreign bodies in bronchi, 338
    Symptoms, 339

  Foreign bodies in larynx, 338
    Symptoms, 339

  Foreign bodies in the nose, 329

  Foreign ingredients in water, 108

  Formaldehyde, 208, 209, 210, 261

  Formation, limestone, 123

  Foul air, 68

  Fouling of seal, 39

  Foundation, 32
    Footings, 33
    Preparation of, 33

  Fovea centralis, 96

  Fresh air, 66

  Fumigation, 209, 210

  Function of foods, 238

  Function of hygiene and sanitation, 15

  Function of school life, 147

  Functional activity, 186

  Furnace heating, 88

  Furniture of playroom, 282

  Furniture of sleeping room, 282


  G

  Games, competitive, 281
    Systematic, 281

  Garbage cans, 135

  Gaseous disinfectants, 210

  Gastric digestion, 357

  Gastritis, 353
    Catarrhal, 353
    Chronic, 354
    Corrosive, 353
    Major adjustment, 353
    Membranous, 353
    Symptoms, 353
    Ulcerative, 353

  Gelatinoids, 267

  Genital organs, irritation of, 387

  Genito-urinary, 202

  Germ, a scavenger, 189

  Germ medium, milk a, 257

  Germ theory, origin of, 195

  Germicide, 208

  Germs, 23, 196, 197

  Germs, cause of dis-ease, 189
    Diphtheria, 197
    Do not cause dis-ease, 191
    Non-pathogenic, 174
    Pathogenic, 174

  Glass blowers, 163

  Glossitis, 356
    Equation, 356
    Family, 356
    Major adjustment, 356

  Glottis, edema of, 339

  God of medicine, 13

  Goddess of health, 13

  Gonococcus, 389

  Gray hepatization, 346

  Green plants, 47

  Grimace, 308

  Ground air, 30

  Ground water, 30, 113, 118, 121

  Growth and development, 285

  Growth, evidence of health, 285

  Gums, 376


  H

  Hard water, 110

  Heat, 80

  Heat exhaustion, 68

  Heat loss, 58

  Heat, molecular theory of, 79

  Heat stroke, 59

  Heating, 79
    Central, 88
    Combustion, 79
    Conduction, 86
    Convection, 88
    Fireplace, 84
    Hot air, 88
    Hot water, 89
    Local, 84, 85
    Methods of, 83
    Normal heat, 80
    Of schoolroom, 144
    Proper temperature, 82, 83
    Radiators, 89
    Radiation, 84
    Steam, 91
    Stove, 86
    System, requirements of, 83
    Three methods of, 83

  Head, 292

  Health, meat danger to, 270

  Hearing, 290

  Height of child, 289
    Table showing average, 287

  Helium, 44, 46

  Hemoglobin, 46, 48

  Hepatization, 340
    Gray, 346
    Red, 346

  Highly acid urine, 386

  History of public water supply, 106

  Host, 175

  Hot air, 88

  Hot box, 314, 347

  Hot water, 89

  House dampness, 34

  House plumbing, 37

  House sewer, 39

  Humidity, 55, 58, 61, 62
    Absolute, 56
    Relative, 56

  Hunger, 232

  Hunger cry, 313

  Hydatid, 271

  Hydrogen, 44

  Hydrogen peroxide, 44, 49

  Hydrocephalus, 382

  Hygeia, 13

  Hygiene, 19, 301
    Chiropractic, 19
    Defined, 13
    Housing, 28
    Layman’s, 19
    Medical, 19
    Personal, 13
    Public, 14
    Sanitation, aim and function of, 15
    Three viewpoints on, 19

  Hygienic measures, 329
    In so-called communicable dis-eases, 224

  Hyperacidity of urine, 386

  Hypertrophic stenosis, 357

  Hysteria, 385


  I

  Ice coils, 73

  Ice, manufactured, 127

  Icterus, 369
    Equation, 370
    Family, 370
    Major adjustment, 370
    Pathological, 369
    Physiological, 369
    Symptoms, 369

  Ignition proof, 36

  Ill effects of damp houses, 35

  Immunity, 181, 191, 192
    Acquired, 183
    Adaptability of body in, 186
    Artificial, 183
    Defined, 181
    Exhaustion theory, 184, 189
    Mechanism of, 188
    Natural, 182
    Retention theory, 184
    Various theories of, 185

  Impounding reservoirs, 116

  Impervious strata, 119

  Impurities in air, 30, 67

  Inanition, 235, 236
    Major adjustments, 374
    Symptoms, 374

  Incandescent electric light, 100

  Incessant crying, 314

  Incineration of refuse, 134

  Incoördinations of bladder, 386
    Of infants, zones involved, 312
    Of larynx, 332
    Of lungs, 340

  Increased air pressure, 51

  Increased rate of breathing, 50

  Incubation, stage of, 172

  Indigestion, 357
    Acute intestinal, 359
    Chronic intestinal, 361

  Indirect infection, 199, 200
    Method of lighting, 102
    Radiation, 87

  Industrial dusts, 164

  Industrial establishments, 161

  Industrial hygiene, 156
    Definition, 156
    Dust, classification of, 164, 165
    Place of work, 159
    Poisons, 158, 165, 166, 167, 168
    Work places, 162

  Infant, thorax of, 340

  Infantile atrophy, 375

  Infants, adjusting, 321

  Infection, 23, 172, 199, 200

  Infection, channels of, 199
    Degree of, 172
    Direct, 199
    Indirect, 200
    Mode of, 199
    Period of, 172
    Source of, 23, 198

  Infectious, 173, 202

  Inflammable, 36

  Inorganic detritus, 67

  Inorganic salts, 239

  Insecticide, 208

  Inspiration of air, 48

  Instrumental birth, 308

  Intellectual adaptation, 50

  Intellectual adaptation in immunity, 181

  Intercepting sewers, 39

  Interference with transmission, 61

  Internal cleanliness, 15

  Internal resistance, 54

  Intussusception, 367
    Major adjustment, 369
    Stools in, 368
    Symptoms, 368

  Invasion, period of, 172

  Iris, 96

  Irritability, during dentition, 300

  Irritation of genital organs, 387


  J

  Jaundice, 308


  K

  Kidneys, 60

  Klebs-Loeffler bacilli, 335

  Krypton, 44, 46


  L

  Labor, effect upon children, 158

  Lactalbumin, 255

  Lactoglobulin, 255

  Lactose, 256

  Lakes, 114, 115

  Languor, 59

  Larvæ, of tænia saginata, 270

  Laryngeal obstruction, 335

  Laryngismus stridulus, 333

  Laryngitis, acute catarrhal, 334
    Chronic, 336
    Tubercular, 337

  Larynx, foreign bodies in, 338
    Symptoms, 339

  Larynx, incoördination of, 332

  Lavatory, 37

  Layman’s hygiene, 19

  Lead colic, 166

  Lead palsy, 166

  Lead poisoning, 166

  Lighting, 95
    Artificial, 99, 162
    Direct, 101
    Incandescent electric light, 100
    of schoolroom, 142
    Psychological effect of, 100
    Systems of, 101, 102
    Physiological effect of, 100
    Schoolroom, 142
    Value of sunlight, 98
    Window area, 98, 99

  Limestone formation, 121, 123

  Limestone regions, 119

  Lips, tactile sensibility of, 290

  Liquid disinfectants, 210

  Living rooms, 30

  Lobar pneumonia, 344
    Symptoms of, 346

  Local heating, 84

  Location of work, 164

  Lockjaw, 389

  Loss of light, 98

  Loss of seal, 38

  Loss of weight, 287

  Lungs, 45

  Lysol, 213


  M

  Macula lutea, 96

  Main sewer, 37

  Malnutrition, 373
    Major adjustment, 374
    Symptoms, 373

  Man, as source of communication, 22

  Manufactured ice, 127

  Manure, 259

  Marasmus, 375
    Major adjustment, 375

  Matron, 147

  Measles, 173

  Measly beef, 270

  Meat, 267, 268
    Care of food animals, 269
    Composition of, 267
    Danger to health, 270
    Food value of, 268
    Source of, 268
    Unfit for food, 269

  Mechanical devices to aid walking, 296

  Mechanical filtration, 128, 131

  Mechanical ventilation, 72, 164

  Mechanism of immunity, 188

  Meconium, 366

  Media of conveyance, 198

  Medical hygiene, 19

  Meningitis, 382

  Mental impulses, 186

  Mercurial poisoning, 167

  Mercury, 166

  Mercury, use of, 167

  Metallic cough, croup, 332

  Methods of sewage disposal, 132

  Methods of water purification, 126

  Miasmatic, 203

  Microcephalus, 293

  Milk, 240, 261
    As a food, 254
    Condensed, 261
    Dry, 262
    Germ medium, 257
    Pasteurization, 261
    Products, preparation of, 261
    Proper temperature, 260
    Sanitary measures in production, 257
    Sugar, 256

  Milk teeth, appearance of, 299

  Mineral wool, 34

  Mode of infection, 199

  Model site, 28

  Modes of transfer, 199

  Moisture in houses, 35

  Molecular theory, 79

  Morbific agents, 173

  Mosquitoes, 32

  Mouldings in school room, 142

  Mountain climbers, 163

  Mouth breathing, 330

  Mucopurulent discharge, 328

  Muddy water, 110

  Municipal swimming pools, 132

  Muscular exhaustion, 282

  Muscular fatigue, 282


  N

  Nail point two, 323

  Nasal catarrh, 327
    Acute, 327
    Adjustment, 328
    Chronic, 329
    Equation, 328
    Family, 328

  Natural birth, 308

  Natural immunity, 182

  Natural light in buildings, 98

  Natural means of disinfection, 210

  Natural means of ventilation, 69

  Natural methods of water purification, 126

  Necessity for food, 231

  Necessity for water in body, 109

  Need for conserving energy, 220

  Neon, 44, 46

  Nerve tracing, 316

  Nervous mechanism, 279

  Nervousness, 280

  Neurotic children, 379, 385
    Equation, 380
    Family, 380
    Major adjustment, 381

  Nocturnal enuresis, 384,387
    Correction of condition, 387
    Excessive quantity of urine in, 386
    Highly acid urine in, 386
    Incoördinations of bladder in, 386
    Incoördination of nervous system, 385
    Irritation of genital organs in, 387

  Nocturnal restlessness, 377

  Non-nitrogenous food, 238

  Non-pathogenic germs, 174

  Normal air pressure, 50, 163

  Normal bodily temperature, 81

  Normal bowel movement, 284

  Normal heat, 80

  Normal stool, 366

  Nose bleed, 331

  Nourishment, 277

  Nitric acid, 49

  Nitrogen, 44, 46

  Nitrogenous foods, 238

  Nude baby, 280

  Nurseries, 282

  Nursery furniture of, 282
    Temperature of, 283
    Ventilation of, 282


  O

  Obligate saprophytes, 176

  Obstetrician, 277

  Occipito-frontal measurements, 292

  Occupation, 157
    Active, 160
    Choice of, 157
    Effect of posture, 159
    Effect upon children, 158
    Effect upon health, 156
    Fatigue, 160
    Personal factors in, 157
    Place of work, 159
    Sedentary, 160

  Odor of urine, 18

  Oleomargarine, 262

  Ophthalmia, 389
    Major adjustment, 389
    Symptoms, 389

  Opisthotonos, 379

  Origin of germ theory, 195

  Outdoor exercise, 281

  Outside airing, 284

  Overwork, 160

  Oxidation, 46

  Oxidizing agent, 49

  Oxygen, 44

  Oxygenated air, 51

  Ozone, 44, 49


  P

  Pain, colicky, 359

  Palatability of water, 108

  Pallor, 308

  Palpating the infant, 314

  Palpation of cervical vertebrae, 316

  Palpation of sacrum, 316, 317

  Pandemic, 178

  Papillomatous, 337

  Parasites, 175

  Partitions, 37

  Pasteurization of milk, 261

  Pathogenic action, 174

  Pathogenic germs, 174

  Peculiarities of child considered, 149

  Pemphigus neonatorum, 390
    Equation, 391
    Family, 391
    Major adjustment, 391
    Symptoms, 391

  Period of infection, 172

  Period of invasion, 172

  Periodical vomiting, 365

  Permanent hardness of water, 111

  Permanent teeth, table of, 301

  Personal factors in occupation, 157

  Perspiration, 18, 60

  Personal hygiene, 13

  Petrosphere, 44

  Phosphorus, 166

  Phosphorus poisoning, 168

  Physical agents of disinfection, 210

  Physical properties of food, 238

  Pigeon breast, 377

  Pillow of the infant, 283

  Pinched expression, 308

  Pisiform bone, 322

  Place of work, 159

  Plant foods, 237

  Play, 281

  Play periods necessary, 148

  Playroom, 282

  Plenum system, 69, 72, 73, 164

  Pneumonia, 343
    Equation, 347
    Family, 347
    Major adjustment, 347
    Symptoms, 345

  Poison, 233
    Cycle, 22

  Poisoning, Arsenic, 167
    Chromium, 168
    Industrial, 158
    Lead, 166
    Mercurial, 167
    Phosphorus, 168

  Poisonous gas, 49

  Pollution of well water, 119

  Ponds, 114

  Pools, Swimming, 132

  Portland cement, 37

  Position of infant for adjustments, 321

  Posture, 149, 159

  Pott’s dis-ease, 295

  Preface, 7

  Preparation of foundation, 33

  Preparation of milk and milk products, 261

  Prevention of siphonage, 39

  Prism glass, 142

  Privy vault, 132

  Process of respiration, 48

  Production of milk in sanitary measures, 257

  Prophylactic measures in lead poisoning, 166

  Prophylaxis, 152

  Proteins, 238, 255

  Psychological effects of light, 100

  Ptomaines, 270

  Public hygiene, 14

  Pulmonary tuberculosis, 342

  Pulse rate, 311
    Disturbances in, 311
    Table of, 311

  Purification, chemical, 131
    Sewage, 133

  Purified milk, 261

  Pylorospasm, 357

  Pylorus, stenosis of, 357


  R

  Rachitic girdle, 378

  Rachitic rosary, 378

  Radiation, 79, 84
    Direct, 87
    Indirect, 87

  Radiator, 89, 90

  Rain water, 113, 114

  Rales, 341, 345

  Rarefied air, 51

  Rate of respiration, 65

  Recess, 150

  Recirculated air, 68

  Recoil, 321

  Red blood cells, 45

  Red hepatization, 346

  Reduced air pressure, 50

  Refuse disposal, 132, 134

  Regulation of breathing, 48

  Reinforced concrete, 36
    Floors, 34

  Relative humidity, 56, 61, 62

  Removal of sewage, 132

  Requirements of ventilating systems, 67

  Reserve energy, 187

  Reservoirs, impounding, 116

  Residual air, 45, 66

  Respiration, 44, 65, 309, 310, 383

  Respiratory system, 48, 327

  Restlessness during dentition, 300

  Retching, 365

  Retention theory, 184

  Retina, 96

  Retropharyngeal abscess, 328

  Rhinopharyngitis, 327

  Rickets, 295, 376
    Deformities of abdomen in, 378
    Deformities of extremities in, 378
    Deformities of head in, 377
    Deformities of spine in, 378
    Deformities of thorax in, 377
    Equation, 379
    Major adjustments, 379
    Symptoms, 377

  Rivers, 114

  Roof, 34

  Room, proper temperature of, 83

  Roughage, 237

  Rudimentary spinous processes, 317


  S

  Sacral adjustments, 323, 324

  Sand filter, 128, 129, 130

  Sandstone rock, 123

  Sanitary art, 14

  Sanitary environment, 20
    Measures in production of milk, 257
    Requirements of floors, 33
    Science, 14

  Sanitation and hygiene, distinction between, 14

  Sanitation, sick room hygiene, 217

  Sapremia, 177

  Saprophytes, 176

  Sarcolactic, 267

  Scavengers, 226

  School building, 140
    Basement, 141
    Blackboards, 145
    Charts, 146
    Cloakrooms, 146
    Corridors, 141
    Heating, 144
    Lighting of, 142
    School desks, 144
    School room, size of, 141
    Stairways, 140
    Toilets, 147
    Ventilation of, 143
    Water supply, 146
    Window area, 142
    Window shades, 143

  School hygiene, age of beginner, 148
    Peculiarities of child, 149
    Personal factors, 147
    Play periods, 148
    Recess, 150
    School dis-eases, 151

  School desks, 144

  School dis-eases, 151

  School hygiene, 140

  School life, functions of, 147

  School room, size of, 141

  Science, Sanitary, 14

  Screens, 221

  Scurvy, 376
    Major adjustment, 376
    Symptoms, 376

  Sea level, 54

  Seal, 37

  Secretions, 50

  Sedentary occupations, 160

  Sedimentation, 115, 128

  Self purification of water, 127

  Semi-indirect lighting, 101

  Septic method of sewage purification, 133

  Septicemia, 177

  Serous circulation, 61

  Sewage, crude, 133

  Sewage disposal, 132

  Sewage pollution, 116

  Sewage purification, septic method, 133

  Sewage, removal of, 132

  Sewage system of body, 16

  Sewerage system, 39

  Sewer air, 39

  Sewer gas, 39

  Shallow wells, 123

  Shape of head, 294

  Shingles, 34

  Sick room, 217
    Bed and bedding of, 222
    Bed pan, 223
    Care of, 220
    Disposal of excreta, 223
    Draw sheet, 222
    Sponge bath, 224
    Ventilation of, 221

  Sight, 289

  Siphonage, 38

  Site, building, 28

  Site of school building, 140

  Slate and tile roofs, 34

  Sleep, 278

  Sleeping rooms or nurseries, 282

  Slow sand filter, 130

  Smallpox, 173

  Smell, 291

  Sneezing, 327

  Snow water, 113

  Soft water, 110

  Soil, 30

  Soiled linen, 222

  Soup stock, 268

  Sources of communication, 22

  Source of food, 237

  Source of infection, 23

  Source of impurities in air, 67

  Source of impurities in water, 118

  Spasmodic laryngitis, 332

  Special senses, 289

  Speech, age at which developed, 291

  Sphincter muscle, 386

  Spinograph, 317

  Spirilli, 173

  Sponge bath, 224

  Sporadic, 178

  Spring water, 118

  Sputum, 223

  Stable, 259

  Stage of exposure, 172

  Stagnant water, 32, 116, 259

  Stairways, 37, 140

  Starvation, 234

  States of aggregation of water, 108

  Steam, 115, 212

  Steam heating, 91

  Steel floor beams, 37

  Stegomyia calopus, 114

  Stenosis, 334

  Stenosis hypertrophic of the pylorus, 357
    Equation, 358
    Family, 358
    Major adjustment, 359
    Symptoms, 357

  Sterile milk, 260

  Sterilization, 207, 212

  Stomatitis, 355
    Equation, 356
    Family, 356
    Major adjustment, 356

  Stone, 36

  Stool, 37
    In intussusception, 368
    Normal, 366

  Stooped shoulders, 160

  Storm sewers, 39

  Stove, 86

  Strabismus, 308

  Street sewer, 39

  Stridulus, laryngismus, 333

  Stupor, 374

  Subsoil water, 113, 118, 121

  Suction fans, 73

  Sulphur dioxide, 209

  Sulphuric acid, 49

  Sunlight, 98, 128

  Supplemental air, 65

  Supply, water, 146

  Suppurative nephritis, 339

  Surface water, 113, 114, 117

  Sutures, 292

  Sweat glands, 58

  Swimming pools, 132

  Symbiosis, 175

  System, respiratory, 327

  Systematic games, 281

  Systems of heating, 83

  Systems of lighting, 101


  T

  Table of heights, 288

  Table of weight, 288

  Tactile sensibility, 290

  Tænia saginata, larva of, 270

  Tapeworm, 270

  Taste, 291

  Taut fibers, 171

  Technique, 323

  Teeth, 301

  Teeth, hygiene of, 301

  Temperature, 62
    Artificially high, 163
    Bodily, 58
    Of buildings, 82
    Of playroom, 282

  Tempering coils, 75

  Temporary hardness of water, 110

  Temporary strabismus, 290

  Terra-cotta, 34, 36

  Tetanus, 207, 212

  Tetanus in infants, 389
    Equation, 390
    Family, 390
    Major adjustment, 390
    Symptoms, 389

  Theories of immunity, 182

  Thorax, shape of, 294
    Deformities of, 295
    Infants, 340

  Three viewpoints on hygiene, 19

  Thymus gland, 382

  Tidal air, 65

  Tile, 31, 34

  Toilets, 147

  Tongue, tactile sensibility of, 290

  Tonic spasm, 381, 389

  Toothache, 302

  Top cover, 222

  Touch, 290

  Toxemia, 177

  Transfer, modes of, 199

  Trap, 37, 38, 39

  Trichinosis, 270

  Trismus, 389

  Tubercular laryngitis, 337

  Tubercular ridge, 317

  Tuberculosis, 166

  Tumors, cerebral, 382

  Turbid water, 110

  Tympanites, 359, 368

  Typhoid fever, 173


  U

  Under drains, 39

  Underground water, 121

  Unsanitary dairy barn, 259

  Urine, 223
    Excessive quantity of, 386
    Highly acid, 386
    Odor of, 18


  V

  Vacuum, 69, 164

  Vacuum system, 73

  Value of sunlight, 98

  Various theories of immunity, 185

  Vent pipe, 39

  Ventilating system, 67

  Ventilation, 66
    Air space per capita, 70
    Breathing zone, 72
    Defined, 65
    Means of, 69
    Mechanical, 72
    Natural means of, 69
    Of hall and stairways, 30
    Of playroom, 282
    Plenum, system of, 69, 73
    Schoolroom, 143
    Sick room, 221
    Sleeping room, 282
    Tempering coils, 75
    Vacuum, system of, 69, 73
    Washing the air, 73
    Water curtain, 75

  Ventilators, 282

  Vertical currents, 117

  Visual analysis, 309

  Vital resistance, 187

  Vitamin, 240, 256

  Vitamin antineurotic, 241

  Vitiated air, 70, 143

  Vitiation, 67

  Vitreous humor, 96

  Volume of air inspired, expired, 65

  Vomiting, 363
    Cyclic, 365
    Major adjustment, 365
    Obstructive, 364
    Periodical, 365
    Recurrent, 365
    Symptoms, 365


  W

  Walls, 33
    In school room, 142
    Methods of construction, 33

  Walking, 295

  Warm dry air, 61

  Warm moist air, 59

  Washing the air, 73

  Water, 105, 106, 108
    Amount needed per day, 111
    Artificial reservoirs, 116
    Chemical purification of, 131
    Chemically pure, 108, 109
    Cisterns, 113
    Composition of, 107
    Condensation, 126
    Distillation of, 109
    Distilled, 129
    Elimination from body, 111
    Evaporation, 126
    Fall mixing of, 117
    Filtration, 129
    Foreign ingredients in, 108
    General considerations, 106
    Ground, 113, 120
    Hard, 110
    Impounding reservoir, 116
    Lakes, 115
    Muddy, 110
    Necessity for, in body, 109
    Needed for all purposes, 111
    Palatability of, 108
    Proper supply of, 106
    Purification of, 126
    Rain, 113
    Sedimentation, 128
    Self-purification of, 126
    Snow, 113
    Soft, 110
    Sources of impurities, 118
    Spring, 118
    Stagnation of, 116
    States of aggregation, 108
    Streams, 115
    Subsoil, 113, 118, 121
    Surface, 113, 114, 117
    Taste of, 110
    Turbid, 110
    Underground, 120
    Universal solvent, 109
    Well, 118

  Water curtain, 75

  Water-logged, 33-36

  Water meters, 113

  Waterproof course in walls, 35

  Water-soluble B, 240, 256

  Water-soluble C, 240, 256

  Water supply, 112, 113, 146

  Water vapor, 55

  Water waste, 113

  Weight, gain in, 286

  Weight, how considered, 286

  Weight, loss of, 287

  Weight of boys at birth, 285

  Weight of girls at birth, 285

  Weight, table showing average, 287

  Wells, 123

  Wet clothing, 146

  Window area, 98, 99

  Window hopper, 70

  Window shades, 99, 143

  Window ventilation, 69

  Wood shingles, 34

  Work, place of, 159

  Work places, 162

  Writer’s cramps, 161


  X

  Xenon, 44, 46


  Z

  Zinc, 166




  Transcriber’s Notes

  pg 53 Changed: These may form in the labryinth of the ear
             to: These may form in the labyrinth of the ear

  pg 101 Changed: which will permit some of the light days to penetrate
              to: which will permit some of the light rays to penetrate

  pg 132 Changed: running sores, conjunctivitis, or veneral diseases
              to: running sores, conjunctivitis, or venereal diseases

  pg 171 Changed: while enviromental dis-eases are attributed
              to: while environmental dis-eases are attributed

  pg 187 Changed: so as to increase the processs of adaptation
              to: so as to increase the process of adaptation

  pg 234 Changed: There is an engorgment of the liver
              to: There is an engorgement of the liver

  pg 249 Changed: 4—Fradulent labeling of food
              to: 4—Fraudulent labeling of food

  pg 323 Changed: extreme case must be exercised
              to: extreme care must be exercised

  pg 342 Changed: may tend to influence and exxagerate
              to: may tend to influence and exaggerate

  pg 365 Changed: similar to migrane in adults
              to: similar to migraine in adults

  pg 383 Changed: There is rythmical convulsive movements
              to: There is rhythmical convulsive movements