Francis Lieber.

Library of universal knowledge. A reprint of the last (1880) Edinburgh and London edition of Chambers' encyclopaedia, with copious additions by American editors (Volume 13) online

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or being repeatedly washed in the same water; to water for cooking being repeatedly
used; to imperfect cleansing of houses and streets; to the sewers becoming clogged, and
the air thus rendered impure. The natural result is as in the case of a deficiency of
pure air a depressed condition of the general health, with a tendency to skin-diseases,
ophthalmia, etc. ; while the imperfect cleansing of the sewers favors the spread of typhoid
fever and of choleraic diarrhea. We are indebted more perhaps to Mr. Simon's valuable

A general bath requires about 50 gallons; a shower-bath at least 6 gallons; and a hip-bath from
12 to IS gallons.

t The water of the Pelho and other rivers in the north of China is so impure and has so offv
stve a smell during winter, that the Chinese never drink it except as tea. when it seems to love nil its
bad effects. It is only by using their " brick -tea'' to purify the water of the steppes, that the Tailors
render the water drinkable.



Sanitary.

reports than to any other source for the knowledge that a continually increasing class of
cases is found to be connected with the use of impure water, the principal noxious
ingredients being animal organic matter, especially when of fecal origin; vegetable
orgaai : mailers, when derived from marshes; and some salts, except when in very small
quantifies, as sulphates of lime and magnesia, chlorides of calcium mid magnesium,
nitrates and niiritcs of ammonia, etc. The alimentary mucous membrane is especially
liable, he supposes, to be affected by impure water. Thus, dyspepsia, with such symp-
toms as pinial loss of appetite, uneasiness or pain in the pit of the stomach, nausea and.
constipation, with occasional diarrhea, may be caused by water containing certain quan-
tities (probably about eight grains each per gallon) of sulphate of lime, chloride of cal-
cium, and the magnesian salts. Diarrhea may be caused by the use of many of the
great North American rivers, the Ganges, etc., Avhere much clay is held in suspension.
Water contaminated with sewage, and containing suspended animal and especially
fecal matter, is a common cause OL an outbreak of this affection and even of choleraic
symptoms. Dissolved animal organic matters doubtless have a similar effect, but it is
difficult to dis'.inguMi between the actions of these and of suspended organic matters.
Among other impurities known t ) occasion diarrhea are fetid gases (sulphureted hydro-
gen), an excess of dissolved mineral matters and nitrate of lime; and on most persons,
brackish water acts similarly. The effects which the selenitic well-waters of Paris exert
on strangers are \\ellknown. There is abundant evidence to show that impure water
is one of the principal causes of dysentery. The records of our army surgeons abound in
illustrative cases. The deleterious effect of the impure water of Calcutta in inducing
dysenterv has been forcibly pointed out by Dr. Chevers in the Indian Annals for 1864.

In addition to the diseases affecting the alimentary mucous membrane of the intes-
tines, there are certain specific diseases which result from the use of impure water, as
malarious fevers of various forms, from the use of the water of marshes; ti/phoid fevtr,
from water contaminated with sewage matters, or the special typhoid poison; clwlera,
from water into which cholera-evacuations have imde their way; and possibly yellow f ever.
(The relation of impure water to typhoid fever and cholera will bo more fully noticed in
a later part of this article.) To the use of water unfit for drinking purposes are also
ascribed epidemic boils from the presence of sulpimreted hydrogen; disease of the bones,
as exostosis. from an excess of carbonate and sulphate of lime; calculi (on, we think,
Insufficient evidence); goiter,, from water derived from limestone and magnesian rocks;
and ento/.oa of various kinds. Dr. Parkes sums up the department of his Manual which
treats of water in a hygienic point of view with the following practical conclusions:
" (1) An endemic of diarrhea in a community is almo. t always owing cither to impure air,
impure water, or bad food. If it affects a number of persons suddenly, it i; probably
owing to one of the two last causes; and if it extends over many families, almost cer-
tainly to water. (2) Diarrhea or dysentery constantly affecting a community, cr return-
ing periodically at certain times of the year, is far more likely to be produced by bad
water than by any other cause. (3) A very sudden and localized outbreak of either
typhoid fever or cholera is almost certainly owing to the introduction of the poison by
water; and the same fact holds good in cases of malarious fever. (4) The presence of
lumbrici, guinea-worm, or buthriocepJialiis latus, should always excite suspicion of the
drinking and bathing water." Op. cit., p. 63.

After the two most important factors in relation to health, viz., air and water, SOIL
and CLIMATE occupy a secondary, although by no means unimportant place. As their
practical bearing is less direct and universal, we will dismiss them briefly. Soil may
affect health (1) by its conformation and elevation. Thus, among hills, the healthy spots
are inclosed valleys, where the air must stagnate, and ravines. On plains, the moct
dangerous spots are at the foot of hills which store up water, unless a ravine cuts off the
drainage. (2) Vegetation exerts an important influence. If we regard vegetation as
divisible into herbage, brushwood, and trees, it may be laid down as a general rule, that
herbage is always healthy, and in the tropics, is of great importance in cooling the ground,
both by obstructing the sun's rays and by aiding evaporation; that brushwood is almost
always bad, but that its removal may cause a temporary increase of malarious disease, on
account of the disturbance of the soil; and that trees should seldom be removed, unless
they decidedly interfere with the movement of the air, for in cold countries they shelter
from cold winds in hot, they cool the ground and in both they may afford protection
from malarious currents. The present condition of St. Thomas in the West Indies,
which is now one of the most pestilent sites we are acquainted with, is mainly due to the
insane destruction of its trees. The island of Mauritius, which has lately been visited by
one of the most universal and destructive forms of fever ever recorded, has similarly
suffered from the same cause. (3) The mechanical structure of the soil is of hygienic
importance in various points of view. Thus, heat is very differently absorbed by differ-
ent soils under the same conditions of exposure. Assuming that the sand with a little
lime has the maximum power of retaining heat, and that its capacity be represented by
100. tlien the capacity of clay will range from 76.9 to 66.7; while that of chalk will bo
61.8, and that of humus as low as 49. Hence we see the comparative coldness of the
latter soils as compared with sand. The capacities of these soils for absorbing and retain-
ing moisture are in the reverse order.

As a general rule, there seems to be the following connection between the geological



Sanitary.

characters of a site and its probable healthiness. Granitic, metamorpliic, and trap rocks
are usually healthy; there is generally a slope, so that water runs off readily, the air
is dry, vegetation is moderate, and drinking-water generally good. They are, however,
supposed "to be unhealthy when they have become disintegrated, as at Hong-Kong, iuto a
dark-colored soil. Clay-slate rocks are regarded as healthy, for very similar rea-
sons; water, however, is often scarce. Of the varieties of Innti'tintc rocks, the hard
ooiite is the best, and the magnesian (which, if possible, should always be rejected
us a site) the worst. Chalk, when unmixed with clay, forms a very healthy soil;
but if it be mixed with clay, it loses its permeability, and is often damp and
i old. The air is pure, and the water, though hard, is clear, sparkling, and pleasant.
The sftiidxfoufs, if permeable, are healthy; but if, from an admixture or underlying of
<-lay, they lose this property, they are often damp. The water must be carefully exam-
ined.. The hard millstone grits are very healthy. Gravels of any depth are hcaljhy, except
water rises through them. Dr. Parkes considers gravel-hillocks as the healthiest of all
Kites, and the water as being very pure, day, dense marl*, and al;>n-;<il x<,i -,v must be
regarded with suspicion. Such soils, and especially the deltas of rivers, should, if pos-
t-ible, he avoided as sites, and if they must be chosen, thorough subsoil draining, caret ul
purification of the water, and elevation of the houses far abo\e the soil, are the measures
to be adopted. According to Dr. Forbes Watson, nearly one-third of the whole surface
of India is covered by alluvial soil.

CLIMATE. The most important climatic conditions connected with the air arc tem~
perature, humidity, and movement, wciy/tt, and composition of the air. Under the head of
temperature we might enter into the general subject of acclimation; we must, however,
conhne ourselves to the remark, that Europeans from temperate climates seem to flour-
ish in countries not much hotter than their own, as in some parts of Australia and New
Zealand, although it is vet too soon to decide whether the general vigor of the race will
improve or dimmish. In countries with a yearly mean of 20" Fahr. higher th;.n their
Lome climate, as in many parts of India, the race seems to dwindle, aiul gives indica-
tions of dying out. The endemic diseases of Europeans in the tropics are liver-disease
and dysentery, but it is uncertain hov far other influences may be at work besides heat
in the production of these diseases. Rapid changes of temperature r.rc always danger-
ous, 'llie sudden check to the free action of the skm caused by a cold wind* is sure to
give riso to catarrh, iuflamir.atious. and neuralgia. The registrar-general's returns show
thi^t when the temperature in London falls from 45 to 27, the weekly morU.lity is
increased by 400, bronchitis being the disease which maiuly causes tl.u increase an
affection which usually does not prove fatal in more iliau about 40 cases weekly. The
fatal influence of extreme cold in depressing the nervous system, and giving rise to a
(sleep from which there is no awakening, is noticed in the article COLD. According to
their humidity, climates arc also divided into moixt and dry. The most agreeable amount
of moisture to most persons is when the relative humidity* is bet ween 70 and 80 per cent.
In chronic lung diseases, a still moister air is most pleasant, and serves to allay cough.
The morbid effects of undue moisture are always associated with rise of temperature. Aa
u general rule, warmth and great humidity are less oppressive than cold and great
humidity. There seems to be close relation between the spreading and the checking of
certain epidemic diseases and the relative moisture of the atmosphere. The malarious
diseases are most intense when the moisture isexcessive; while plague and small-pox art:
checked by a very dry atmosphere. Yellow fever seems unaffected by this atmospherio
condition. That the humidity of a, climate, irrespective of other climatic relations, \s
not injurious to life, may be inferred from a comparison between the climates of Eng-
land and Ireland. The number of persons over 100 years of age is, in proportion to the
population, five times as great in Ireland as in England, and the greatest longevity has
been observed in Con naught, the wettest of the provinces.! Sec Mapother, op. cit., p.
134. u

>:The irorement of the air is another climatic condition of importance, but it must be
considered in connection with heat and moisture. A cold wind abstracts the bodily heat
in proportion to its velocity; while a hot wind, if dry, increases evaporation, and may
thus partly neutralize its own heating power. Variations in atmospheric pressure are of
great importance in relation to health. "In ascending mountains," says Dr. Parkes.
" there is rarefaction, i.e., lessened pressure of air, lowered temperature, and lessened
moisture above 4,000 ft. ; greater movement of the air; increased amount of light ; greater
sun-radiation, if clouds are absent; and the air is freer from germs of infusoria. Owing
to the rarefaction of the air and watery vapor, there is greater diathermancy of the air;
the soil is rapidly heated, but radiates also fast, hence very great coolnc.-s of the ground
and of the air close to it at night." Op. cit., p. 418. The physiological effects of lessened
pressure begin to be perceptible at somewhat less than 3.000 ft, at which altitude the
mercury falls 3 inches. The pulse is quickened by 15 or 20 beats, and the breathing by
10 or 15 inspirations per minute; there is increased evaporation from the skin and lungs,

*B T ' relative humidity we express comparative moisture, complete saturation being assumed to he
100. It is determined by dividing the weight of v^por actually existing in the air (or the absolute
humidity), by the weight of vapor which would have been present if the air had been saturated.

t The average annual relative humidity of Ireland is 88, but on many clays it attains as high a point
&B94.



121



Sanitary.



while the urinary secretion is probably diminished. At an elevation of 0,000 or 7,000
ft., as 111 the Swiss Alps, the effect of the mountain air shows itself in a marked improve-
ment in digtistion, sanguification, and in nervous and muscular vigor. At great heights
there is swc.ling of the superficial vessels, ami occasional bleeding of the nose and lungs;
and a sensation of weight is felt in the limbs from the lesr-eued pressure on the joints. A
residence for .-nine time in a mountain-air is of great value in all ana mic nifeclions, from
whatever caiue they may arise. Neuralgia, gout, and rheumatism are all benefited by
high alpine positions (see Weber On the Climate nf the Sieitts Alps, 1804); and scrofula and
consumption a e almost absent in the true alpine regions, while patients affected with .
these diseases, If brought to such a climate, rapidly improve. On ihe other hand, pneu-
monia, pleurisy, and acute bronchitis are more common in high regions than lower down.
The disease formerly known as "mountain asthma" seems, Irom Weber's observations,
to be common pulmonary emphysema combined with or followed by chronic bronchitis.

FOOD is a suojvct which has been already considered in the articles DIKT and FOOD
AXD DiUMv. Thu'c are, however, certain points connected with it which obviously fall
within the domain of hygiene; as, for example, (1) the quantity of the different kinds of
food required for persons of different sexes and ages, and under varying conditions of
life and climate; (2) the determination of the best articles of lood "in lach class, and
whether they are in u proper state for use. The first of these subjects is to a consider-
able degree discussed in the article DIET. The latest and probably the most accurate
statements on this subject are those of Pcttenkofer and Voit (quoted in Parkes's Sanitary
Report of the Army for 1865); a strong average man requires, according to these physiol-
ogists, 5.22 07.. of dry nitrogenous matters, 3.G3 oz. of fat, and 13.3oz. of carbohydrates.
They also find that when the food is sufficient, the daily excretion of carbon from the
lungs is 8.92 oz. or 3,902 grains. We may add that an average man, at moderate work,
takes in 24 hours from -j-'^th to ^ e th of his own weight in solid and liquid food viz.,
from 34 to 46 oz. of so-called solids, as bread, meat, etc. : and from 50 to 80 oz. of water.
The ratio of the solid to the liquid food is generally 1 to 2, but may be 1 to G. Great
bodily exercise requires a greater increase of "the solid than of ihe liquid food.

It may be interesting to many readers to know the amount and nature of the daily
diet of an English soldier* ou. home service and the railway navvy: %



Soldier.
Meat


Oz.

12


Navvy.
Meat


Oz.
13.7


Bread


24


1 Jread


.... 285


Potatoes


10


Potatoes


7


Other vegetables


8




057


Coffee ..


033


Gutter


57


Tea


0.10


Cheese


1.7


Salt


i!5


Beer


37


Sugar


1.33


Coffee


.. . . 05


MiJk...


. 3.23


Cocoa . . .


. 1.1



Deputy-inspect or-gencrals O'Flaherty and Taylor, and assistant-surgeon Spurwny,
published, in 1867, important articles on the diet of soldiers in the 7th volume of the
Statistical, Sanitary, a nd Medical Reports for the year 1865, from which it would appear
that, inter alia, an addition to the fatty food would be expedient. For information on
the Dietary <>f Workhouses and Prisons, we must refer to Dr. E. Smith's admirable report
on the former subject, and to Dr. Lankcster's paper, "On Prison and Workhouse Diet-
aries," read before the health department of the social science congress at Belfast an
abstract, of which may be found in the British Medical Journal for Nov. 2, 1867. The
whole subject of prison dietaries requires revision. While in some favored institutions
the prisoners live in comparative luxury, in others the dietary scale is far too scanty.
The Irish prisons are especially faulty i'n this respect; the daily expense of the food per
head'seldom reaching fourpence, and in some jails being only twopence! At Waterford
jail no food is allowed from 3 P.M. to 8 A.M., and in the Irish jails generally a pint of
skim milk constitutes the whole animal diet. It is understood that a commission has
teen issued to report upon this subject. The proper arrangement of diet for the sick is
a matter of great difficulty. In hospitals fixed scales must, as a matter of convenience,
be adopted; but almost every special case requires a modification. For further informa-
tion on special diets the reader is referred to Moleschott's Phyniologie. dcr Kahrungfmittel
(1860); to Dr. Dobell's useful Manual of Diet and Regimen; and to Dr. Smith's Practical
Dietary for Families, Schools, and the Laboring Classes.

The diseases connected with food are so various that we can only notice the most
important. Passing over those which arise from excess of food generally, or of one of
its classes, with the remark, that a prolonged excess of albuminates gives rise to conges-
tion and enlargement of the liver, and a general state of plethora, while excess of starchy
matters may possibly affect the muscular fibers of the heart and voluntary muscles, and
certainly often renders the urine saccharine, we proceed to notice the diseases produced
by fhe deficiency of food. The history of epidemic fevers in all ages and countries
shows the close relation between famine and fever. The lrih famine of 1847-49 is now
a matter of history. In those three years, no less than 579,721 cases were treated in the

* We learn from Fronde's History of England that in the reign of Edward VI. the English soldier'g
rations during war were, meat, 2 Ibs. ; bread, 1 Ib. ; light French wine, 1 pint.



Sanitary.

hospital? alone. Fleeing in despair, emigrants carried the germs of disease -with them;
cud llu so-called skip-fever which followed desiroyed its thousands. Its malignity was
most appalling. In one vessel 329 out of 849 passengers caught the fever, and 117 died;
find the mortality in Liverpool, induced by the contagion of the fever-stricken Irish
who landed there, suddenly became the highest ever recorded in any modern town the
death-rate being raised to 70 per 1000. During the last three years." l^Oo-GT. the death-
rate of this town was 86, 43, and 80. Dr. Mapotlier is of opinion that the introduction
of the potato as an almost sole article of diet has been productive of much harm, in con-
sequence of the deficiency of that root in nitrogenous matters and in salts of lime and
magnesia.* To this source he traces indigestion, consumption, scrofula, rickets, oph-
thalmia, and chronic rheumatism. The deprivation of starchy food, on the other hand,
can be borne for a long time if fat be given; but the simultaneous deprivations of fat
and starch soon induces illness, though albuminates be supplied.

With regard to salt meat, it must be recollected that the brine, if it has been used
several times, occasionally becomes poisonous. The evidence as to the power of dis-
eased meat when eaten to excite disease, is if we except the cases in which entozoa are
present very unsatisfactory. We have the evidence of sir Samuel Baker and others
that certain African tribes eat without injury meat swarming with maggots. In this
country, the flesh of healthy animals, when decomposing, is sometimes eaten with
impunity, and sometimes occasions severe gastric intestinal disorders. There is reason,
however, to belic-ve that if slightly tainted meat, poultry, or river fish be washed in very
dilute solution of Condy's fluid, previous to being cooked, all danger is removed. The
occasional occurrence of a poison in sausages and even in pork pies is well known,
although its nature is not clearly understood. The fresh flesh of diseased animals assur-
edly causes injurious effects in many cases, but not in all. In the early stage of acuto
inflammatory disease, the meat is not altered, and may be eaten with impunity. Whether
tlie epidemic pleuro-pneumonia of cattle renders their flesh unfit for use, is an open
question. (See Mapotber, op. tit., pp. 217-224, who decidedly condemns its use, and
Parkes, dp. cit., pp. 161-166, who quotes conflicting evidence.) The discrepancy of
evidence is equally great regarding anthrax and malignant pustule. The deatli of sheep
from splenic apoplexy or braxy, and from, small-pox, renders their flesh unlit for food;
while the flesh of cattle destroyed by foot-and-mouth disease and by typhoid fever has
been largely used in France without injury. The detection of the adulterations of the
ordinary articles of food is a very important duty in relation to hygiene; on this subject
we must refer to Hass-ilFs great work, and to our article FOOD.

The object of CLOTHING is to preserve the proper heat of the body by protecting it
both from cold and heat, and thus to prevent the injurious action of sudden changes of
temperature upon the skin. The most important materials of clothing are cotton, linen,
wool, silk, leather, and india-rubber. Cotton, as a material of dress, wears well, does
not readily absorb water, and conducts heat much less rapidly than linen, but much,
more rapidly than wool. From the hardness of its fibers, its surface is slightly rough,
and occasionally irritates a very delicate skin. Its main advantages are cheapness and
durability. In merino it is mixed with wool in various proportions, and this admixture
is far preferable to unmixed cotton. Linen is finer in its fibers than cotton, and hence
is smoother. It possesses high conducting and bad radiating powers, so that it feels
cold to the skin; moreover, it attracts moisture much more than cotton. For these rea-
sons, cottons and thin woolens, are much preferred to linen garments in warm climates.
Si'k forms an excellent underclothing, but from its expense, it can never come into gen-
eral use. Wool is superior both to cotton and linen in being a bad conductor of heat,
and a great absorber of water, which penetrates into the fibers and distends them (hydro-
scopic water), and also lies between them (water of interposition). " This property of
hydroscopically absorbing water is," as Dr. Parkes observes, "a most important one.
During perspiration, the evaporation from the surface of the body is necessary to reduce
the heat which is generated by exercise. When the exercise is finished, the evaporation
still goes on, and to such an extent as to chill the frame. When dry woolen clothing is
put on after exertion, the vapor from the surface of the body is condensed on the wool,
and gives out again the large amount of heat which had become latent when the water
was vaporized. Therefore, a woolen covering, from this cause alone, at once feela
warm when used during sweating. In the case of cotton and linen, the perspiration
passes through them, and evaporates from the external surface without condensation;
the loss of heat then continues. These facts make it plain why dry woolen clothes are
so useful after exertion. In addition to this, the texture of wool is warmer, from its
bad conducting power, and it is less easily penetrated by cold winds." Op. cit., p. 853.
Leatlier is used not only for shoes, boots, and leggins, but, in cold, windy countries, for

* Potatoes contain 74 per cent, of water, 1.5 of albuminates. 0.1 of fat, 23.4 of starch, cellulose, etc*



Online LibraryFrancis LieberLibrary of universal knowledge. A reprint of the last (1880) Edinburgh and London edition of Chambers' encyclopaedia, with copious additions by American editors (Volume 13) → online text (page 28 of 203)