Copyright
Charles Field Mason.

A complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia online

. (page 25 of 38)
Online LibraryCharles Field MasonA complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia → online text (page 25 of 38)
Font size
QR-code for this ebook


added to alcoholic solutions, or vice versa, a precipitation of previ-
ously dissolved principles often ensues, and an unsightly or other-
wise undesirable mixture results. This is, however, not always the
case, for the substance, which is dissolved in the alcohol, may also be
soluble in water, or may be soluble in a mixture of alcohol and
water, and thus no change will occur.

4. Free acids unite with bases forming salts.

5. Strong acids and bases (such as inorganic acids, lead, mercury)
displace weaker acids and bases (such as organic acids, potassium,
lithium).



336 MATERIA MEDICA, THERAPEUTICS, PHARMACY

6. Salts in solution exchange acids or bases, if, by so doing, a
precipitate can be formed.

7. The occurrence of an apparent incompatibility, such as a pre-
cipitate in a solution, may be desirable, as in the cases of black and
yellow washes (made by adding calomel and corrosive sublimate
respectively to lime water) ; here this fact should be made known
by adding to the directions on the bottle that the mixture is to be
shaken before using.

8. Agents rich in Oxygen (oxidizing') when mixed in concentrated
form with readily oxidizable substances may cause explosions.
Hence Potassic Chlorate and Permanganate, strong Nitric, Nitro-
hydrochloric, and Chromic Acids (all powerful oxidizing agents)
should not be mixed with dry vegetable powders, Tannic Acid,
Sugars, Glycerin, Alcohol, tinctures, Ether, Sulphur, and Phos-
phorus.

9. A drug should never be prescribed with any of its tests or
antidotes.

TABLE OF MOST IMPORTANT MUTUALLY PRECIPITANT SOLUTIONS



.

EC "B 3 * 3 3 V

P. = precipitate * *S /S g Jg -g g g g g . *1

SB s * - 111 s^f

~ a -ii13 -i; " ? E^3-nSij>

<.2 3^5 2 =13 =13 sc 3 = 3 <.2 g S!'
- '-' - S*' S^

.OH

P.
P. P.





<< !


n


W I


H


C/2


in




P.


P.


P.


P.


P.


?.


Tannic Acid and Vegetable Astringents


P.


P.


P.


P.


P.




Solutions of Carbonates


P.


P.


P.


P.


P.


P.


Solutions of Sulphates and Sulphuric Acid






P.


P.


P.




Solutions of Phosphates and Phosphoric Acid. .


P.


P.


P.


P,


P.


P.


Solutions of Borax and Boric Acid


P.


P.


P.


P.


P.




Solutions of Chlorides and Hydrochloric Acid..






P.


P.






Solutions of Bromides and Hydrobromic Acid.






P.


P.






Solutions of Iodides, of Iodine, and Syrupus














Acid Hydriodici


P.




P.


P.






Solutions of Sulphides and Sulphurous Acid...


P.


P.


P.


P.


P.


P.


Arsenical Solutions


P.


P.


P.


P.


P.


P.


Albuminous Solutions




P.


P.


P.







PART VII

HYGIENE. POST AND CAMP SANITATION



CHAPTER I

WATER

The amount of water needed by the average man daily for drink-
ing purposes varies according to the amount of exercise he takes and
the temperature of the atmosphere; a fair average is three or four
pints in addition to that which he takes in food. On the march the
amount is limited by the capacity of the canteen to about one quart,
and this quantity should be very carefully husbanded.

The total daily allowance in the field is usually calculated at about
two gallons per man; four and one-half quarts for drinking and
cooking, two and one-half for washing, and one quart for wastage.

Waters are usually divided into two classes : surface waters and
ground waters. The former include rain, river, lake, and pond
waters, and the latter well and deep spring waters.

A water is said to be potable when it is fit to drink. A potable
water is an uncontaminated water ; no matter how clear, bright, and
sparkling a water may be, it is not potable if it is so situated that it
can be fouled by fecal matter, urine, or the drainage from manured
lands. There is a very common error that all spring water is pure ;
many springs, especially those which are not constantly flowing, draw
their water from surface sources.

Water from deep wells is usually safe ; from shallow wells suspi-
cious. Whether a well is to be considered a deep or shallow well
depends upon whether or not it passes through an impervious layer
of rock or clay so that surface drainage cannot get into it; if it
passes through such a layer it is a deep well ; if it does not it is a
shallow well.

Though rain water is originally pure, cistern water may be very
22 (337)



338 HYGIENE. POST AND CAMP SANITATION

impure; the impurities come from the washings of the roof from
which it is collected, from dust blown into it, and if it is an under-
ground cistern, there may be a crack through which surface drainage
may enter.

Hard water is water that will not lather well with soap ; the hard-
ness is due to lime salts and may be partially removed by boiling;
well water, especially deep well water, is usually hard.

Ice has tne same impurities as the water from which it is made ;
therefore natural ice is often impure. Ice made from distilled water
is usually very pure.

Water may be purified in three ways: by chemical treatment, by
boiling or distillation, and by filtration. The first two methods are
usually applied to limited supplies, while the last is applicable on a
large scale.

Chemical treatment: The simplest form of chemical treatment is
the use of alum, about a third of a gramme to the gallon, thoroughly
stirred in the water, which is then allowed to settle. The alum
causes a bulky precipitate, which in falling carries down with it most
of the suspended matter, including the bacteria.

Permanganate of potash is useful in quantities of one or two
grains to the gallon, or just enough to give the water a faint tinge.

Iodine may be used, three-quarters of a grain to a gallon, or tinc-
ture of iodine added to the water until it acquires a faint yellow
tinge. The taste and color of the iodinized water may be destroyed
by the addition of three-quarters of a grain each of hyposulphite of
soda and citric acid or tartaric acid.

Both iodine and permanganate act on the same principle as
chlorine.

Chlorinated lime is a very valuable water sterilizer; it is used
both for general water supplies and individually in the form of
tablets for soldiers on the march. Its destructive effect on bacteria
is due to the action of the oxygen set free when the chlorine com-
bines with the hydrogen of the water.

A very useful appliance for utilizing the bactericidal effect of
chlorine and water has recently been devised by Major Wm. J.
Lyster, Medical Corps, for use in the field. It consists of a canvas
bag of' specially woven flax, of sufficient capacity to supply a com-
pany of infantry at war strength with a canteen-full of water for
each officer and man. This bag at the opening is sewn over a gal-



WATER 339

vanized iron ring, hinged at one diameter, which permits the bag
to be folded. It is supported when in use by two pieces of hemp
rope, 3 feet 2 inches in length, spliced to the ring at points equi-
distant. The bag is fitted with five self-closing faucets just above
the bottom seam, spaced at equal intervals. This gives a container
that weighs about seven and one-half to eight pounds, that can be
folded up into a convenient and readily portable package not too
large or heavy to be carried over the infantry pack. Sufficient
chemical can be carried in sixty glass tubes to supply an infantry
company at war strength with five canteens of water a day per
capita for twelve days. Such a package of these tubes weighs ten
ounces and measures 6 x 3^ x 2% inches.

Under ordinary circumstances this bag, when filled with water,
will have its contents rendered safe in about five minutes. After
the bag has been filled with water, the calcium hypochlorite con-
tained in one tube, which is easily broken in the hands at the point
marked by a file, may be shaken directly onto the surface of the
water, or it may be added to a small amount of water in any ordi-
narily clean container and poured directly into the water in the bag ;
no stirring is necessary.

As the oxidation of organic matter in water through the agency
of hypochlorite proceeds best in clear water, it is desirable to remove
fine clay and other comparatively coarse matters before introducing
the hypochlorite. It is probable that in the field many surface
waters will carry suspended matter to an extent that may interfere
slightly with the hypochlorite process. To reduce this matter in
amount, a piece of Scotch outing flannel is used. This cloth, weigh-
ing one ounce, is fastened by tapes sewn to it to the ropes by which
the bag is suspended, so it almost covers the opening of the bag.
Through this cloth the water is poured in filling the bag. In the
hands of a medical officer or instructed non-commissioned officer of
the hospital corps, the starch iodine reaction gives exact information
as to whether sufficient hypochlorite is being used. As iodine and
starch are at hand in the field, we have a practical method of control.

Boiling and filtration are also applicable in the field. One min-
ute's active boiling is sufficient to destroy all the bacteria of water-
borne diseases; it does not, however, clear water nor remove dis-
solved organic matter.

As it removes the gases of water it becomes flat to the taste, and



340 HYGIENE. POST AND CAMP SANITATION

must be aerated before use, but this is easily accomplished by shak-
it up, or pouring from one vessel to another. To make the water
palatable it must also be cooled.

Distillation is an efficient process of sterilizing water, but if the
water is taken from a very polluted source offensive gases may pass




FIG. 222. Darnall Filter. Set up ready for use.

over in sufficient quantity to cause a disagreeable taste and perhaps
diarrhea.

Filtration is a process requiring constant care and supervision.
Individual or barrack filters, while they clear the water, are liable to
increase rather than diminish the number of bacteria. Unless such
filters are in perfect condition and frequently sterilzed the bacteria



WATER



341



grow into the substance of the filter, which finally becomes a culture
medium.

The Darnall Siphon filter, from which very satisfactory results
have been reported, combines precipitation with filtration, and pro-
vides for maintaining the bacterial efficiency of the filtering mate-
rials. The precipitant used is a combination of alum and soda
known as hydroxide powder.

The apparatus arranged ready for use is shown in Fig. 222.

Improvised filters intended only to clear muddy water are readily
prepared. The simplest form is that so common in tropical coun-
tries, a small hole being dug in the sand near the edge of a stream,
the water filtering through the intermediate sand or being caught on
its way to the stream.

Another simple method is to take two barrels of different sizes,
bore holes in the bottom of the larger and near the top of the




FIG. 223. Improvised Filter.



FIG. 224. Improvised Filter.



smaller, place the smaller barrel inside the larger, fill in the inter-
vening space with sand and sink both in the water (Fig. 223). Or
the larger barrel may be left intact, holes being bored in the bottom
of the smaller, and the water being poured in on the sand between
the barrels (Fig. 224). Sand used for such purposes should always
be washed and if possible sterilized before use, and this process
should be frequently repeated during use.

Impure water may cause disease in several ways. Hard water or
water containing mineral salts often causes diarrhea, constipation, or
indigestion in those unaccustomed to its use. Decomposing vegeta-
ble or animal matter in water or the presence of living algae may also
cause diarrhea and indigestion, but the great danger in the use of



342 HYGIENE. POST AND CAMP SANITATION

polluted water is the liability to swallow the germs of certain special
diseases, notably typhoid fever, cholera, and dysentery. Great
epidemics have been traced directly to the use of water fouled by
the discharges from patients afflicted with those diseases.

A great many intestinal parasites, round worms, pin worms, etc.,
are also carried by impure water.

Hospital corps men should know how to take samples of water for
analysis. For chemical analysis not less than three liters are neces-
sary; for bacteriological test about 200 cubic centimeters are re-
quired. Samples should be collected in perfectly clean glass bottles
stoppered with glass or clean new cork; if for bacteriological pur-
poses, the bottle must be sterilized. If taken from a tap, water
enough must be allowed to waste to empty the branch pipes; if from
a pump, the barrel must be emptied; if from a pond, the sample
must be taken from below the surface and at some distance from
shore.



CHAPTER II

AIR AND VENTILATION

As we have already seen, air is a mixture of oxygen, nitrogen,
carbonic acid, and watery vapor. Oxygen is the element that sup-
ports all animal life; it is being constantly withdrawn from the air
in the processes of respiration and combustion, and returned to it,
combined with carbon, as carbonic acid. Vegetable life takes up the
carbonic acid and decomposes it, retaining the carbon and returning
the free oxygen to the air, so that the equilibrium is maintained.

Watery vapor is a normal constituent of air, and the higher the
temperature of the air the more it is capable of holding; when it will
hold no more the air is said to be saturated. If air so saturated
meets with a cooler stratum the excess of moisture is precipitated as
rain or dew. Humidity refers to the amount of watery vapor in
air; relative humidity is the degree of approach to saturation at any
given temperature, while absolute humidity is the actual weight of
the moisture in a given quantity of air.

The impurities of air with which we have to deal in dwellings are
dust and bacteria, organic matter, and undue proportion of carbonic
acid. The organic matters are particles of epithelium and the vola-
tile products from the lungs and skin, from unclean mouths, noses,
and the intestinal tract; in hospitals there are also pus cells from
suppurating wounds, and the bacteria of infectious diseases. The
effects of overcrowding and vitiated air are well known ; immedi-
ately they are headache, dizziness, and loss of appetite ; when long
continued, there is loss of bodily vigor and diminished resistance to
disease.

Besides these indirect effects of vitiated air many diseases are
directly caused by the inhalation of bacteria from the air; among the
most important air-borne diseases are tuberculosis, pneumonia, ery-
sipelas, and possibly the eruptive fevers.

The pollution of air in dwellings is caused not only by the exhala-
tions from the human body, but also by the products of combustion in

(343)



344 HYGIENE. POST AND CAMP SANITATION

heating and lighting. It is estimated that an ordinary five-foot gas
burner when in use adds to the air of the apartment fully as much
carbonic acid, besides other impurities, as one man.

The process by which the vitiated air of dwellings is removed and
replaced or diluted by fresh air is known as ventilation.

For the maintenance of the human body in a fair degree of health
and vigor it has been found that about three thousand cubic feet of
fresh air per hour must be supplied each person. The size of the
air space which must be provided for each person depends upon the
possibility of supplying this amount of air without causing draughts ;
if the entering air is warm, draughts of course are not felt so much
as if it is cold.

As a matter of experience it has been found that even when
warmed the air of a room under the most favorable circumstances
can not be changed more than three or four times an hour without
causing a sensation of draught; so that the minimum cubic air space
per man should be at least one thousand feet, which with three
changes per hour will give the necessary three thousand cubic feet
of fresh air; in the tropics the minimum cubic air space should be
two thousand feet, with a floor space of not less than one hundred
square feet. In computing the cubic air space in a room we multiply
the length by the breadth and then by the height of the room, or by
twelve if the height is greater than twelve feet. The reason we do
not ordinarily count height above twelve feet is because above that
height there is very little movement of the air in the room unless
there are special arrangements for its change.

The floor space, therefore, should be not less than one-twelfth of
the cubic space.

In hospitals, owing to the additional impurities from the sick, four
thousand cubic feet of fresh air per man per hour should be allowed,
the floor space should not be less than one hundred square feet and
the cubic space not less than twelve hundred feet in temperate
climates, and 50 per cent more in the tropics.

The agencies concerned in ventilation are diffusion, and gravity or
weight. Diffusion is not of much value and can not be relied upon
alone; the important agent is gravity. Equal volumes of air of the
same temperature and under the same pressure have equal weights ;
now if one of the volumes is heated it expands and becomes lighter,
and being surrounded by heavier air, rises, or rather is forced up,



AIR AND VENTILATION



345



by the sinking of the heavier air, and thus currents are produced.
When the air in a room is heated by fire, lights, or even the human
body, it becomes ligher, and the heavier outside air forces itself in
through all the openings and crevices, at the same time forcing the
lighter air out, thus effecting a certain amount of ventilation.

Unequal temperatures in masses of air outside dwellings give rise
to winds, and winds aid ventilation in two ways : First, by pcrflation,
or blowing through a room when the windows are open, and second,
by aspiration when it blows across chimneys or flues.

Ventilation of a dwelling is said to be either natural or mechanical;
natural when we trust to the forces of nature, merely providing the




FIG. 225. Heating and Ventilation by Jacketed Stove.

necessary entrance and exit openings, together with heat if required ;
mechanical when the air is forced in or drawn out by fans or other
mechanical means.

In any system.it is necessary to remember that it requires two
openings to secure ventilation ; if only one opening is provided, the
incoming and outgoing currents interfere with each other and venti-
lation fails. This is well illustrated by the familiar experiment of
burning a candle inside of an unstoppered bottle; if the opening
into the btotle is divided into two parts by a partition, the candle
will burn, because the air currents pass up one side of the partition



346 HYGIENE. POST AND CAMP SANITATION



and down the other without interference; if the partition is removed
the light goes out.

Ventilation in summer or in hot climates is largely a matter of the
action of winds, because the temperature of inside and outside air is
practically the same, so that we merely leave doors and windows
open, and provide special openings in the ridge or .under the eaves
for the escape of the heated air in the upper parts of the building.
Or fans are provided to keep the air in motion ; and such devices as
the punkah or electric fans.

In winter the subject of ventilation is so intimately connected with
that of heating that it is well to consider the latter before going into
details of the arrangements for ventilation.

In the military service the methods for heating are practically con-
fined to stoves and furnaces in the older buildings, hot water in the
new hospitals, and steam in the new barracks.

Stoves are of very little value in assisting ventilation unless special
arrangements are made with that
end in view. This may be done
by partially surrounding the stove
from the floor to the level of the
top of the stove by a sheet-iron
jacket, and admitting fresh air
under the stove from an air-
shaft; if in addition to this the
stove pipe is made to heat an ex-
tracting shaft, opening preferably
at the floor level, ventilation may
be very materially assisted (Fig.
225). Heating stoves in use
should always have a pan of
water on them to maintain the
proper maisture of the air.

Furnaces are very valuable
ventilators; fresh air is brought
to the dome of the furnace by an
air shaft, heated, and delivered,
where required, through tin tubes.

In hot-water heating there are
two systems, low pressure and high pressure. In the low-pressure
system, which is that used in the army hospitals, a small, open tank




FIG. 226. Heating by Hot Water.
Low pressure.



AIR AND VENTILATION



347



is provided at the highest point of the system to allow for expansion
and the escape of gases. The circulation of the water is due to the
difference in weight of the columns of hot and cold water. The
water is heated in a boiler in the basement; from the top of the
boiler rises a main, with branches to all parts of the building; these
branches terminate in radiators, and from the bottom of each radi-
ator a branch return comes off, the branch returns uniting to form a
main return, which empties into the lower part of the boiler. As
the water in the boiler becomes heated it grows lighter, and the




FIG. 227. Heating by Steam. Low pressure.



heavier water in the returns falls and forces up the hot water, thus
effecting a circulation (Fig. 226).

In the high-pressure system the pipes are completely closed ; hence
there is some danger of explosion, but the water can be made hotter
and circulation is more rapid.

Steam heating is the same in principle as the low-pressure hot-
water heating, only steam is used instead of water, and the pipes
constitute a closed system (Fig. 227).

Radiators heated by either steam or hot water may be placed in the
room to be heated without any connection with the outside air ; this is
known as the direct system; or they may be placed in the basement
or some other room, enclosed in a sheet-iron box connected with a
fresh-air shaft, the warm air being then conducted to the room, the
indirect system; or the radiator may be placed in the room to be
heated and the fresh air brought directly in under and allowed to
pass up between the pipes so as to be warmed, the direct-indirect
system; the last is that commonly used in hospitals and barracks
(Fig. 228).



348 HYGIENE. POST AND CAMP SANITATION

When no special arrangements have been made for ventilation a
useful and simple device is to place a strip of board under the lower
sash, so that air can enter between the sashes and be directed upward




FIG. 228. Heating by Direct-Indirect Method.

(Fig. 80) ; or to pull down the upper sash and place a board sloping
down over the opening left above (Fig. 81) ; air will enter between
the sashes and escape above.

The best simple test of the efficiency of ventilation is to notice the
odor on coming into the room from the outside air; if it is stuffy
and close, ventilation is imperfect.



CHAPTER III

THE DISPOSAL OF WASTES

THE organic, dangerous wastes which it is necessary to dispose of
in such a manner as not to invite disease are night-soil (urine and
feces), slops and garbage; the first is by far the most dangerous,
containing, as it often does, the bacteria of disease. The arrange-
ments for the reception of the night-soil may be pits, pans, or water-
closets.

Pits are the most objectionable because they pollute the soil, may
infect the water supply, and permit the access of flies, which may
carry disease germs on their feet and bodies from the pits to the
kitchens and barracks and there infect the food and drink.

Perns, usually used in connection with dry earth to cover and deo-
dorize the feces, are little better than pits. They are open to the
same objections, except that soil pollution from accidental spilling is
not so marked; in addition they have to be emptied, thus affording
another opportunity for scattering infection and creating a nuisance.

Water-closets are best. They may discharge into cess-pools, or
into sewers. Cess-pools are excavations in the ground which may
or may not have a waterproof lining; if they do not have such a
lining they are known as leaching cess-pools. Cess-pools are objec-
tionable for the same reason as pits and pans.

Sewers are the pipes or channels which carry off the liquid wastes ;
the wastes themselves are known as sewage.

Waster-closets and all plumbing fixtures in dwellings empty
through short branches into a vertical iron pipe known as the soil
pipe, and this in the basement empties into a more or less horizontal



Online LibraryCharles Field MasonA complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia → online text (page 25 of 38)