A Handbook of Health - Woods Hutchinson (whitelam books txt) 📗
- Author: Woods Hutchinson
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Statistics for the population of the old City of New York. The chart shows a decrease from 95 out of every 1,000 in 1891-92 to 48 out of every 1,000 in 1909. This is due very largely to the careful methods of prevention enforced by the Board of Health, especially the inspection of milk.
Any child who has sneezing, running at the nose or eyes, sore throat, or cough, especially with headache or backache, a flushed face and feverishness, ought to be kept at home from school and placed in a well-ventilated, well-lighted room by himself for a day or two, until it can be seen whether he has one of these children's diseases, or only a common cold. If it turns out to be measles, scarlet fever, or whooping cough, he should then be kept entirely away from other children in a separate room, or, where that is impossible, in a special hospital or ward for the purpose; he should be kept in bed and given such remedies as the doctor may advise. Then no one else will catch the disease from him; and within from two to five weeks, he will be well again. The most important thing is not to let him get up and begin to run about, or expose himself, too soon; five times as many deaths are caused by taking cold, or becoming over-tired, or by injudicious eating, during recovery after measles, scarlet fever, and whooping cough, as by the disease itself. This one caution will serve two purposes; for, as a sick child's breath, and the scales from his skin, and what he coughs out from his mouth and nose are full of germs, and will give the disease to other children from two to four weeks after the fever has left him, he ought to be kept by himself—"in quarantine," as we say—for this length of time, which is just about the period needed to protect him from the dangers of relapse or taking cold. Boards of Health fix this period of quarantine by law and put a colored placard on the house to warn others of the danger of infection.
Note that, after the quarantining of measles in 1896, the death-rate dropped at once. Statistics for the old City of New York.
Colds and Sore Throats. A milder and even more common kind of infection is that known as common colds. These, as shown by their name, were once supposed to be due to exposure to cold air, or drafts, or to becoming wet or chilled. But, while a few of them are so caused, at least eight, and probably nine, out of ten are due to germs caught from somebody else. They are never caught in the open air and very seldom in cold, pure fresh air of any sort, but almost always in the hot, foul, stuffy, twice-breathed air of bedrooms, schoolrooms, churches, theatres, halls, sleeping cars, etc. The colds, for instance, that you catch when traveling, are usually due not to drafts or damp sheets, but to the crop of cold germs left behind by the last victim.
You have probably known of colds that have run through a family or a school or a shop. It is well worth trying to keep away from the infection of colds, because not only is their coughing and sore throat and hoarseness and running at the nose very disagreeable and uncomfortable, but they may cause almost as many different kinds of serious troubles in heart, kidneys, and nervous system as any of the other infections. In fact, they probably cause more than any other, because they are at least ten times as common and frequent. For instance, many cases of rheumatism, or rheumatic fever, come after attacks in the nose and throat, which cannot be distinguished from a common cold or ordinary tonsilitis. Indeed, it is more than probable that one of the ten or a dozen different germs that may get into your nose or throat and give you a cold, is the germ that causes rheumatism. At all events, it would be fairly safe to say, "No colds, no rheumatism."
Whenever you have a cold, keep away from everybody that you possibly can and stay at home from school or business for a day or two. You will do no good to yourself or others, working in that condition; and you may infect a dozen others. If you find anyone in your class or room or shop, sneezing or coughing or running at the nose, report him to your teacher or foreman; and if he won't send him home, keep away from him as much as possible.
Diphtheria. Another common and serious disease, until quite recently very fatal, is diphtheria. This is caused by getting into your mouth or nose the germs from another case of the disease. This disease also is most likely to occur in childhood, though it may attack a person of any age, and is always serious. It may be prevented from spreading by keeping children who have it shut up in rooms, or wards, by themselves and keeping all other children away from them, or from their nurses or those who have anything to do with them. Up to about thirty years ago, it was one of the deadliest and most terrible diseases that we had anything to do with. We knew absolutely nothing that would cure it, or even check its course; and nearly half of the children attacked by it died.
About that time, however, two scientists, Klebs and Loeffler, discovered that, by taking some of the membrane, or tough growth that forms in the throat in this disease, and by rubbing it over a plate of gelatin jelly, they could grow on that gelatin a particular kind of germ. This germ, or bacillus, they then put into the throats of guinea pigs, and found that it would give them diphtheria.
This is the way disease germs are discovered, or, as we say, identified; but of course this did not give at once any remedy for the disease. Scientists soon found, however, that, if a very small number of these bacilli were put into a guinea pig's throat, it would have diphtheria, but in a very mild form. If, when it had recovered, it was again infected, it would stand a much larger dose of the bacilli without harm. This made them suspect that some substance had been formed in the guinea-pig's blood that killed the bacillus or worked against its toxin, or poison; and soon, to their delight, they succeeded in finding this substance, which they called antitoxin (meaning "against poison"). Then came the idea that if they could only get enough of this antitoxin, and inject it into the blood of a child who had diphtheria, it might cure the disease. A guinea pig is such a tiny animal that the amount of antitoxin which it could form would be far too small to cure a man, or even a child. So larger animals were taken; and it was finally found that the largest and strongest of our domestic animals, the horse, would, if the diphtheria germs were injected into its blood, make such large amounts of antitoxin that merely by drawing a quart or two of the blood—and closing up the vein again—enough antitoxin could be got to cure fifty or a hundred children of diphtheria. This treatment has not the slightest harmful effect upon the horse. The pain of injecting is only like sticking a pin through the skin, while the pain of bleeding is no greater than cutting your finger. There are now at our great manufacturing laboratories whole stables full of horses, for the production of this wonderful remedy.
Statistics from the City of New York. Antitoxin was used largely from 1893-95, during which time there was a steady decrease (from 60% to 30%) in the death-rate. After the Board of Health took up the matter, furnishing antitoxin without cost, the death-rate continued to decrease to less than 10% of the total number of cases, in 1909.
With this remedy, our entire feeling toward diphtheria is changed. Instead of dreading it above all things, we know now, from hundreds of thousands of cures, that, if a case is seen on the first day of the disease, and this antitoxin injected with a hypodermic needle, it is almost certain that the patient will recover; not more than two or three cases out of a hundred will fail. If the case is seen and treated on the second day, all but four or five out of a hundred will recover; and if on the third day, all but ten. In fact, the average death rate of diphtheria has been cut down now from forty-five per cent to about six per cent.
We now have antitoxins, or vaccines, for blood-poisoning; for typhoid fever; for one of the forms of rheumatism; for boils; for the terrible cerebro-spinal meningitis, or "spotted fever"; and for tetanus, or lock-jaw. And every year there are one or two other diseases added to the list of those that have been conquered in this way.
None of these vaccines is so powerful, or so certain in its effects, as the diphtheria antitoxin. But they are very helpful already; and some of them, particularly the typhoid vaccine, are of great value in preventing the attack of the disease, as small doses of it given to persons who have been exposed to the infection, or are obliged to drink infected water, as in traveling or in war, very greatly lessen their chances of catching the disease.
Vaccination, the Great Cure for Smallpox. Another valuable means of preventing disease by means of its germs is by putting very small doses of the germs into a patient's body, so that they will give him a very mild attack of the disease, and cause the production in his blood of such large amounts of antitoxin that he will no longer be liable to an attack of the violent, or dangerous, form of the disease. Vaccines, for this purpose, usually consist either of a very small number of the disease germs, or of a group of them, which have been made to grow upon a very poor soil or have been chilled or heated so as to destroy their vitality or kill them outright. When these dead, or half-dead, bacilli are injected into the system, they stir up the body to produce promptly large amounts of its antitoxin. In some cases the reaction is so prompt and so vigorous that the antitoxin is produced almost without any discomfort, or disturbance, and the patient scarcely knows anything about it. In others there will be a slight degree of feverishness, with perhaps a little headache, and a few days, or hours, of discomfort. When this has passed, then the individual is protected against that disease for a period varying from a few months to as long as seven or eight years, or even for life.
The best-known and oldest illustration of the use of these vaccines is that of smallpox. A little more than a hundred years ago, an English country doctor by the name of Jenner
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