PREVENTIVE MEDICINE.

PART II.

PURE AIR AS A CONDITION OF HEALTH.

THE VITAL NECESSITY OF AIR.

Value of Pure Air.—There are some things in nature of which we take but little cognizance, probably from the fact of their apparent simplicity. Pure air, pure water, pure food are essential and fundamental to good health and health to happiness, so we see that our very lives depend upon the exercise of principles which we neglect to study and understand, possibly on account of other and manifold duties. But nature's laws are invariable, and the time comes when dire results follow a disregard of first principles. Any one will admit that pure, unadulterated food is necessary to health. Food is converted into blood, which having circulated through the body is unfit for further use until purified.

Air a Blood Purifier.—It is through the medium of the air, with its life-giving oxygen, that the blood is purified. It therefore follows, logically, that air and pure air is necessary to health and, other things being equal, the health will be imperfect in proportion to the impurity of the air we breathe. It should be our aim to learn much of so important a condition of health in order that we might, so far as is possible, avoid disease.

Necessity of Pure Air.—Not only is pure air of value to preserve a state of health, it is an absolute necessity. It is true that some persons with strong wills and capacious lungs can perform the feat of holding the breath, but if they endeavor to prolong the experiment from a minute and a half to two minutes the need of breathing becomes so intense that control over the muscles of the chest is lost and a deep inspiration must be drawn in spite of resolutions to the contrary. If the access of fresh air to the lungs is absolutely prevented by external force death speedily takes place, the fatal result occurring in from five to fifteen minutes. This latter condition is present in hanging and drowning and in some forms of croup in children. Four minutes is the limit of time a person can be deprived of oxygen and live.

Fatal Results from Impure Air.—No better illustration of the fatal effects of impure air upon the human system can be brought forward than the lamentable history of the Black Hole of Calcutta, a prison in India, the horrors of which have rendered it memorable even in that land of ferocious cruelty. According to the account of a survivor, 146 persons were shut up on a sultry night in June in a prison eighteen feet square, furnished with only two small windows, both strongly barred with iron. The thirst and oppression of breathing felt by the unhappy prisoners soon became intense, and the scanty supply of water brought in compliance with their entreaties only made the confusion more terrible, and caused several to be trampled to death. This scene of misery proved entertaining to the brutal guards outside, who supplied them with water that they might have the satisfaction of seeing them fight for it, as they phrased it, and held up lights to the bars in order that they might lose no part of the inhuman diversion.

Frantic Pleas for Air.—Before eleven o'clock most of the gentlemen, who formed about one-third of the whole, were dead, and "air! air!" became the general cry. Renewed insults were devised for the purpose of provoking the guards to shoot them, and every man had eager hopes of meeting the first bullet. About two o'clock in the morning the survivors crowded so much to the windows that many of them died standing, unable to fall on account of the throng. About six in the morning an order came for their release; but at that time, out of the 146 who went into the dungeon ten hours before, only 23 remained alive, and all these miserable survivors were in a highly feverish condition, several dying from putrid or typhus fever soon afterward.

We Breathe Out Poison.—Such, then, are the frightful consequences of overcrowding together a large number of human beings, and thus depriving them of fresh air in such a way that they are exposed to the poisons of their own contamination, comprising carbonic acid and the secretions from the lungs and skin. Wholesale poisonings by very impure air of this kind are fortunately seldom met with, but the gradual injury to health and destruction of life-force, produced by breathing an atmosphere slightly contaminated with noxious ingredients, are exceedingly common, and probably give rise to or aggravate a large part of the diseases to which our flesh is heir.

QUALITIES OF PURE AIR.

Composition.—In speaking of pure air we refer to a standard condition of air. The air is a mechanical mixture of elements. As ordinarily met with at the surface of our earth, pure air, when analyzed, is found to be composed of seventy-nine parts of nitrogen and twenty-one parts of oxygen to every one hundred parts of air. It contains also a considerable quantity of watery vapor, a trace of ammonia, and from three to six parts in ten thousand of that deleterious gas carbonic acid. Oxygen is the active element. If a candle be held in oxygen it would burn more brightly than in ordinary air, and so our own lives, if lived in an atmosphere of oxygen, would be more quickly spent. Our tissues would be quickly used up. Nitrogen, which forms so large a proportion, acts simply as a diluent; of itself it cannot support life, and a lighted candle held in nitrogen gas is quickly extinguished. Carbonic acid gas, or, as it is called, carbon dioxide, is normal to the extent of .04 per cent., and though it is useless to animals, it is quite as necessary to plant life as is oxygen to us.

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Localities of Pure Air.—As air is rendered impure by respiration, the purest air is found in those localities farthest removed from human habitation, i. e., on the mountain tops and upon the ocean. When there is a tendency to disease or during recovery from a disease residence in the mountains or at the seashore is of distinct benefit.

In order to understand how it is that the breathing in and out of the air of a room in time vitiates it, it will be necessary to explain some points of the anatomy and physiology of the respiratory tract—and the act of respiration.

RESPIRATORY TRACT.

Anatomy.—The respiratory tract is made up of the lungs and the air passages leading to them. The air passages comprise the larynx or voice box, the trachea or windpipe and the bronchial tubes—two in number—which are branches of the trachea.

The Larynx.—The larynx is situated at the upper part of the trachea and presents in front the prominence known as Adam's Apple.

The Trachea.—The trachea or windpipe is four and a half inches long, and extends from the larynx to about the middle of the breast-bone or sterum, where it divides into the two bronchial tubes.

The Lungs.—The lungs, two in number, are situated in the cavity of the thorax or chest, one on either side of the heart. The lungs are made up of lobes, and the lobes are made up of still smaller divisions called lobules or little lobes. These latter are quite small, one one-hundred and twentieth of an inch in diameter, and they represent the ultimate divisions of the bronchial tubes, which have ramified and subdivided like the branches of a tree. Surrounding each lung and lining the cavity of the chest is the pleura, an inflammation of which constitutes the disease known as pleurisy.

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Physiology.—The larynx, trachea and bronchial tubes admit the air to the lungs. The larynx, in addition to this function, is the organ of voice, being supplied with the vocal cords. Voice is produced by the outgoing air setting these cords into vibration. The air cells, of which the lungs are composed, are the meeting places of the air and the blood for the purpose of the exchange of oxygen and carbonic acid.

Heart Functions.—The heart, which is a thick, strong muscular bag, pumps the blood through the lungs as it goes round and round through the circulation, at the rate of about sixteen hundred pints of the vital fluid every hour. These sixteen hundred pints of blood, by being spread out in the fine network of delicate tubes in the walls of the air-cells, get rid of nearly sixty pints of carbonic acid, and absorb rather more than sixty pints of oxygen in that length of time. Upon this gaining of fresh oxygen and getting rid of stale carbonic acid unceasingly, our very lives depend, for, as demonstrated in hanging and drowning, if this interchange of the gases in the blood is interrupted for even the space of a few minutes death is the effect.

Unceasing Heart Pumping.—Whilst life continues, night and day, our hearts must go on pumping dark, purple, venous blood into the lungs, to be there purified and changed into red arterial blood by losing its carbonic acid and gaining fresh oxygen, which is carried to every part of our bodies, as has been just explained, conveying everywhere its own new and vigorous life. Night and day, too, quite as unceasingly, must the lungs do their part, by pumping in fresh air to furnish this requisite supply of revivifying oxygen; and, what is almost equally important, they must pump out the air which has been partly deprived of its oxygen, and has received in its place the worn-out and now deleterious substances got rid of by venous blood. This constitutes the pulmonary circulation in distinction to the circulation of the blood through various parts of the body for purposes of its nutrition which constitutes the systemic circulation.

PURE AIR AS A CONDITION OF HEALTH.

HUMAN INTERNAL ORGANS.

THE LUNGS.

Upper Left-Hand Plate.—This handsome plate shows, at the top, the windpipe (trachea), entering the lungs. It divides into two branches, one for each lung, and each branch subdivides, so as to carry air to every part of the lung.

Lobes.—The plate shows the two great parts of the lungs, right and left lobes. These are filled with the air cells. Notice in the lobes the immense number of veins which form the circulatory system of the lungs.

Heart.—The heart is seen in its true position, to the right of the centre.

Pulmonary Vein.—To the left of the centre is seen the great pulmonary vein, carrying the lung-blood to the left auricle of the heart.

Pleura.—The pleura membrane is seen surrounding the entire lungs and walling them in.

THE LIVER.

Upper Right-Hand Plate.—The liver is the largest gland In the body. Situate on the right side, and partly covers the stomach.

Lobes.—The plate shows its two lobes on upper surface and five on under surface.

Vessels.—The entire circulatory system is shown—portal vein, hepatic artery, hepatic duct, lymphatic and smaller veins. To the left, in pear-shape, is the gall bladder.

THE HEART.

Lower Left-Hand Plate.—The plate shows the cone-shaped heart, situate in the chest, between the lungs, its apex toward the left. Though supplying blood to the whole body, it yet has its own circulation, as seen by its veins.

Cavities.—It has four cavities, an auricle and ventricle on each side. The right auricle receives the veinous blood and pumps it into the right ventricle. The right ventricle throws its blood into the left auricle. The left ventricle pumps it into the aorta and thence through the body. The upper section of the plate shows the aorta and the great pulmonary vein.

THE STOMACH.

Lower Right-Hand Plate.—The plate shows the stomach when one is in a reclining position.

Veins.—The numerous veins show how well it is nourished.

Liver.—To the left is the liver. Above it is the opening through which food passes from the gullet (esophagus). At the opposite end is the pyloric gate, through which the partly digested food passes into the duodenum (twelve-inch bowel).

Muscles.—Around the stomach, in brown and white, are seen the powerful abdominal muscles. The white represents streaks of fatty matter. The stomach is usually about twelve inches long and four inches in diameter.

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Respiration.—The lungs, which contain the air, are not active in the act of respiration. The chest cavity enlarges by the contraction of the diaphragm and the elevation of the ribs and sternum, so that the chest is enlarged in its vertical, its transverse and its antero-posterior dimensions. With this enlargement the pressure from without is greater than the pressure from within, and the air rushes in, thereby distending the air vesicles. In expiration the chest-cavity diminishes in the diameters in which it has been increased, and, as a result, the air in the lungs is subjected to pressure, and consequently rushes out. The air that passes in and out with each respiration is called tidal air, and is equal to twenty cubic inches of air. But, after an ordinary inhalation, it is possible, by the exercise of a little effort, to breathe in still more air, to the extent of one hundred cubic inches. This is called the complemental air. After an ordinary expiration it is still possible to breathe out air to the extent of one hundred cubic inches. This is called the supplemental or reserve air.

Residual Air.—After all efforts to expell air from the lungs there still remains about one hundred cubic inches, called the residual air, from the fact that it resides in the lungs. But we must not get the idea that this residual air is unchanged, for it is ever being purified.

Frequency of Breathing.—The respirations vary from fourteen to eighteen per minute. They are greater during infancy and childhood. it is then during respiration that the fresh air, laden with oxygen, is carried to the blood to give to the blood its oxygen and to receive in its place carbonic acid. But the air does not meet the blood directly. On the outer side of the air cells we have the air, while distributed on its inner side we have the small blood-vessels or capillaries which have carried the blood to the lungs. So that separating the air from the blood we have, first, the walls of the air cells, and second, the walls of the capillaries. But these two are so thin and delicate that the exchange can readily take place through them.

IMPURE AIR.

The Impurities of the Air.—The light of modern research has enabled as to know much of atmospheric conditions conducive to disease and health, the latter particularly engaging our attention at this time. The impurities of the air are, first, suspended substances and, second, gaseous substances. The suspended substances are particles of almost every known substance, the most important being sand, dust, soot, pollen, microorganisms of all kinds, particles of food and clothing. The gaseous impurities are carbonic acid, whenever it exceeds .05 per cent.; carbon monoxide; sulphur dioxide; sulphuric, hydrochloric and nitric acids; hydrogen, sulphide, ammonia and its compounds, and organic vapors from decomposing animal and vegetable matters.

Action of Impurities of the Air.—The solid impurities act by clogging up the air vesicles, thereby interfering with their function. They may of themselves be causes of disease, as in the case of micro-organisms. The gaseous impurities act, first, by virtue of their own toxic or poisonous properties and, second, by the fact that they take the place of the necessary element, oxygen. Carbonic acid is normal to the extent of .04 per cent. As before mentioned, air that we inhale contains twenty-one parts of oxygen and seventy-nine parts of nitrogen to every one hundred parts of air. On the other hand, expired air contains sixteen parts of oxygen, five parts of carbonic acid and seventy-nine parts of nitrogen. If, now, we should be placed in a room where the air is unchanged the air inlialed contains a greater percentage than .04 per cent., and is consequently impure.

Carbonic Acid.—Carbonic acid is the most common impurity of air, and, with its associated organic matters from human or animal breathing, pollutes the atmosphere of closed or badly-ventilated apartments in the manner already described. Acute poisoning from contaminated air, such as took place in the Black Hole of Calcutta, is very uncommon, because people who are long shut up in over-crowded rooms always feel such an overpowering need of fresh air that they can be prevented only by main force from hurrying away from the danger to which they are exposed. Nature warns them so emphatically and imperatively to seek a purer atmosphere that they become ready to sacrifice everything to obey her commands.

Symptoms of Air Poisoning.—The early symptoms of oppression from breathing impure air are too well known to require any lengthened description, although the direct connection of many uncomfortable sensations experienced in crowded rooms, with the aerial contamination, is not so generally understood and appreciated. Among the primary indications of physical injury to the blood from inhaling vitiated or "second-hand" air, are a disposition to draw long, full breaths, as a result of the stifled or almost suffocated feeling which early makes itself apparent. This is accompanied, or soon followed, by flushing of the face, throbbing of the temples, headache and sickness at the stomach, which may even proceed so far as faintness or an actual fainting-fit, as we often see in delicate ladies accidentally wedged in crowded lecture-rooms, concert-halls or theatres.

Chronic Effects of Air Poisoning.—The chronic effects of long-continued breathing an air which is but moderately polluted are seen in a general deterioration of the strength, appetite and digestion, a pallid dyspeptic appearance, from want of renewal of the blood.

Bacteria in the Air.—Bacteriology has explained the cause of many diseases. The air is everywhere laden with them. They enter our bodies through the respiratory and digestive tracts. If our vitality or resistance is sufficient to withstand their invasion we remain in a state of health; but, when the vitality is lowered for any reason, the bacteria invade the system and disease results. The bacteria present in the atmosphere are not, as a rule, actively disease producing. Those that do produce disease are found particularly where the discharges of diseased animals have been allowed to collect and dry. These excretions become pulverized and are subsequently carried about in the air we breathe. The dried expectoration of cases of tuberculosis, of influenza, and occasionally of pneumonia, produce these diseases in this manner. The boards of health in various parts of the country are fast coming to the conclusion that expectoration upon the sidewalks, in the street cars, in public halls, and so forth, is a menace to the public well-being. In hospitals patients suffering with tuberculous disease are obliged to expectorate in special cups or pasteboard boxes, which are kept covered and subsequently destroyed. Similar measures might be adopted in private practice.

EVIL EFFECTS OF EXPOSURE TO DRAUGHTS.

Cold Air.—Cold air, and especially cold, moist air, is so often a factor in the production of disease that the consideration of this constantly impending danger to health and its hygienic treatment by the means of suitable clothing is very important.

Clothing.—Contrary to the popular notion, clothing gives no heat in itself, but only saves the heat of our bodies from escaping into the surrounding air, and it does this just in proportion as it is a bad conductor of heat. The rate at which our raiment carries off the bodily heat varies from that of a thin linen coat, for example, which conveys it away rapidly, to that of a thick fur cloak, through which the loss of heat into the surrounding air is very gradual. Upon this difference in conducting power for heat the relative value of different articles of dress depends.

Why Clothing Comforts.—Much of the comfort that clothes afford is due to the fact that they give what is called an "artificial surface" to our bodies, on which the cold air can act without our feeling it so much. It is the absence of this artificial surface on the bare hands and face which makes the fingers, forehead and ears ache so with the cold, sometimes in wintry weather, and the reason that people's toes, after a while, often ache in the same way, is that the foot-coverings frequently become chilled through, so that they no longer do their duty as protectors against loss of heat.

Hardening Process.—The process of "hardening oneself" consists in rendering the skin so used to changes from a warm to a cold air, that its blood-vessels and nerves are comparatively little affected by the contracting influence of the cold. "Making oneself tender," on the contrary, is establishing the habit of staying, in warm air, and venturing out only when well wrapped up, to such an extent that any accidental exposure to even moderately cold blasts has a powerful, or even dangerous, effect. Hardening the skin against the weather is just like hardening the eyes to a bright light, or the ears to loud noises. All three may occasionally prove valuable accomplishments after they are acquired, but a certain per cent. of the people who try to be thus accomplished will lose their lives, or their eyes, or their ears, in the process. No doubt thousands of young girls have died of consumption caught in the attempt to harden themselves to going with bare arms and bare necks, in the costume absurdly called "full dress" by fashionable society.

Dangers to be Avoided.—In every effort to harden oneself against the influence of changes of the air, and likewise in the practice of that accomplishment after it is acquired, any saving of clothes is often more than compensated for by a waste of extra food used up in maintaining the animal heat, through the process of burning up the fatty and starchy articles of our diet. Besides this, a great and frequently an unnecessary strain is imposed upon the digestive organs, in preparing this extra supply of nutriment, and the nervous system is also severely taxed in regard to both the digestive and the heat-regulating operation, so that study or other mental efforts may be seriously interfered with. Hence the hardening process should only be applied to our bodies in the most carefully considered way, by people who are, at the time the experiment is tried, in good health, and those especially who are free from any tendency, inherited or otherwise, to disease.

When to Venture Out of Doors.—As a substitute for hardening oneself by exposure to all sorts of atmospheric changes, without carefully regulated protection, attention to the weather indications, or "probabilities," as published every day in the newspapers, has of late years become of great importance from a hygienic point of view. In fact, the study of sanitary meteorology, as this branch of the science might be called, for the purpose of determining what hygienic precautions in regard to clothing, ought to be instituted against hot, moist, or cold air, what days or what hours convalescent patients, and especially children, may venture out of doors, when is the best time for invalids to bear removal, and at what periods neuralgic and rheumatic patients must exercise particular care against exposure, has a highly practical, and sometimes an almost incalculable value.

Providing Against Weather.—Any one, by consulting the daily "indications" in the public prints, can provide against the weather correctly about eight times out of ten, but in order to avoid most of the remaining 20 per cent. of blunders, it is only necessary to combine the knowledge obtained from the signal office predictions with that derived from observations upon an aneroid or mercurial barometer, as described in the following pages.

WEATHER, OBSERVATIONS.

Signal Service Bureau.—From the time the great Dr. Johnson uttered his famous sarcasm upon observers of the weather, to wit, "A certain set of men pass their lives in watching the changes of the weather, and die at a good old age with the conviction that the weather is changeable," little has been accomplished in rendering us more truly weather-wise, until the splendid results attained by our own Signal Service bureau gave a new impetus to the study of meteorology.

Value of Weather Observations.—Few can dispute that not only the hygienists of America, but also those of the Old World, are under great obligations to our National Government, which, taking timely advantage of opportunities never before presented in the history of mankind, has utilized them with marvelous success.

Weather Reports.—These opportunities consist, of course, in the circumstances, first, that in our American Union there is a larger compact portion of the earth's surface inhabited by civilized man, now under the same jurisdiction, and controlled by one central authority, than in any antecedent epoch; and second, that by the most extended system of telegraphic communication ever organized, it has been possible, during the last decade, for the first time in the history of the world, to obtain instantaneous and simultaneous weather reports from an area of the earth's surface occupying the whole breadth of our continent, stretching from the thirtieth almost to the fiftieth parallel of latitude, and comprising more than three millions of square miles.

Methods of Observing Weather.—Over this vast section of country signal stations have been established, under the direction of the Weather Bureau, at least wherever practicable, and to such extent as the yearly appropriation would permit. At these stations three observations are taken daily, at the same moment, the hours selected being 7 o'clock A. M., 3 P. M. and 11 P. M., Washington time.

Weather Maps.—By this plan the changes from hour to hour and day to day, as well as the effects which are produced by these alterations, are noted, and after these records are forwarded to the central office, they are reproduced in a permanent form upon the daily weather map, which is transmitted as far as practicable over the country. Hence these daily maps may justly be entitled "the geography of our atmosphere." Without examining them, we can no more secure an accurate conception of the general state of the weather than we could gain a correct idea of the real arrangement of seas, continents and islands, as represented upon geographical maps, by walking a few miles along the coast, or climbing over a range of mountains.

Storms.—By means of the extensive series of observations, carried on through several years by the United States Signal Office, it has been discovered that storms occur in areas of low barometer, rounded or oval in form, and two or three hundred miles in diameter, which travel across our country, from west to east, exactly opposite to the apparent movement of the sun in the heavens. The storm therefore is an immense ring or oval of wind, cloud and rain, which speeds across the country about as rapidly as a fast express train, that is, from about 300 to 600 miles in twenty-four hours.

Direction of Storms.—Such storms usually come to us from the Pacific coast, and by having telegraphic messages sent to Washington from several of the western stations on the Pacific Railroad, announcing at what time the storm reached each one respectively, the observers of the signal office can, of course, tell Just how fast that particular tempest is advancing, and calculate when it is due in Washington, exactly as the railroad officials can tell, if they are informed by telegraph, precisely what time their train will arrive from the west. Evidently, after being thus notified, it is an easy matter for the Washington authorities to send word to the people in the neighborhood to get ready to meet the rain in one instance, or their friends at the depot in the other.

Storm Paths.—The path of an area of low barometer across the continent has been aptly compared to the track of an immense water-cart, the centre of which is, as a general rule, the line of most violent storm. The average rate of motion for such a storm-centre is 350 miles a day, although it may vary from 100 to 1200 miles in twenty-four hours. The winds commonly blow from all quarters towards the area of low barometer, the many apparent exceptions being caused by mountain-ranges, valleys, and so forth, turning aside the currents of air.

Barometric Effects.—From this it follows that, when the area of low barometer is running on a line of high latitude, the winds felt in places on its southern margin will be from the south, and vice versa. That is to say, if at any time an area of low barometer is passing through New York and New England, the winds in Philadelphia will, in a general way, be towards it and from the south; while, on the contrary, at any time when a similar area is traveling through Virginia and Maryland, the winds in Philadelphia will be from the north, and usually cooler. The exceptions to the rule of north winds being cooler and south winds warmer, are obviously due to large volumes of cold air or of warm air, respectively, having previously been blown to the north or south of a particular position.

Direction of Barometric Areas.—Although the general direction of the areas of low barometer seems to be round the earth towards the rising sun, their course is sometimes very irregular, as is demonstrated by the daily weather maps, which occasionally exhibit them traveling almost due north for three or four days, during which excursion they may pass over a distance of a thousand or fifteen hundred miles, before they resume their usual easterly tendency. The storm, as before remarked, is where the area of low barometer is, and as this almost always approaches us from the west or southwest, most of our storms really come from that direction. Hence there is seldom or never a true northeast storm, much as we hear people talk about "northeasters;" and a northeast wind, with rain, results from an area of low barometer situated southwest of us, and, as a rule, traveling eastward on a parallel of latitude one or two hundred miles south of our position.

Uses of the Barometer.—The use of the barometer is especially seen in determining, by its steady and gradual rise, that the edge of an oval of low barometric pressure has passed over a particular place. It also indicates, by its gradual fall, the oncoming of an area of low barometer, although when, as frequently happens, a storm lags behind this area a little, rain and wind may be most severe with a rising barometer. The indications afforded by barometric observations must therefore be specially studied for each particular place, and judiciously combined with the daily report of probabilities from the Weather Bureau, in order to gain the greatest advantage in sanitary meteorology.

INFLUENCE OF WINDS ON HEALTH.

Variety of Influences.—Wind or air in movement exercises upon human health an influence which depends partly upon its rapidity, partly upon the properties which it may have acquired from the land and water over which it has passed, and lastly upon its variations. Its influence from these various causes may be either accidental or temporary, or durable and more profound. Thus, the effect of a cold or damp wind upon an individual who is in a free perspiration, as a consequence of active exercise just engaged in, may be to produce a cold, a sore throat, a bronchitis, or an attack of rheumatism, according to the predisposition or weak point of the person. Hence, as already insisted upon, every man ought to study out carefully his own special aptitudes, under the agency of certain exciting causes, to the development of particular diseases. This is indisputably the part of wisdom, because it is far easier to avoid these exciting causes, which may so readily bring into action the dangerous maladies to which we are predisposed, if we are well informed concerning the exact defect in our armor against their power.

Deleterious Influences.—A wind, if charged with injurious substances, such as the pestilential effluvia of marshes, for example, may carry with it the causes of serious alterations in the health. Some such winds produce, in countries where they blow, diseases terrible both on account of their severity and their persistence, and which cease only with the wind which has brought them. Difference in the rapidity of the movement of the air gives rise to great variations in its effects. A moderate agitation of the air, such, for instance, as a wind moving ten miles per hour, is decidedly favorable to the proper performance of the functions of the skin, to the energetic exercise of the muscular system, and to the maintenance of an agreeable temperature. Nothing, for example, can be pleasanter, nor in their way more healthful, during the exhausting heats of summer, than the sea breezes of maritime coasts.

Sea Breezes.—When cool air is in rapid motion, however, and just in proportion to that activity, a great and speedy abstraction of heat from the surface of our bodies is perceptible. Air which in repose gave merely the sensation of agreeable freshness, becomes cold when in movement, and cold air under a similar change of circumstances becomes frigid.

Hygienic Effects of Air in Motion.—Physiologists have calculated that, with dry air in rapid motion, the loss of moisture from the surface of the skin is ten times as great as when the air is still and moist. This fact explains the necessity of avoiding, as far as possible, exposure of the body, particularly when perspiring, to air in rapid motion, because the dangers of chill are thereby greatly increased. On the other hand, a very dry wind rapidly parches the skin, checks its secretions, which are so important to the maintenance of health, and produces a general feeling of discomfort. The exaggerated condition of this prejudicial influence is seen in persons exposed to the celebrated sirocco of the Great Desert of Sahara. The influence of winds depends not only upon their humidity and their rapidity, but also upon the nature of the countries which they traverse. The wind which crosses the icy peaks of snow-clad mountain-ranges carries with it for a long distance the cold with which it is charged. The town of Nice, such a favorite resort for consumptives in the south of Europe, would have an almost perfect climate were it not for the fierce and frigid wind called the mistral, which occasionally visits it, blowing from the summits of the Alps down the valley of the Rhone.

Effects of Cold Air.—Cold encountered without forewarning may be the cause of disease. Too often it is a predisposing cause of disease. Cold air may of itself cause disease, as is seen in frost bite, or it may produce its results by simply making the system more vulnerable. To illustrate—it was formerly thought that cold was the cause of pneumonia. We now know that pneumonia, like many other diseases, is due to a germ. Many healthy persons have the germ of pneumonia in the secretions of the mouth. If the vitality or power of resistance is good no evil effects follow. Should the same individual be "run down" for any reason and the added influence of cold be present the germs are no longer resisted and pneumonia results.

Benefits of Winds.—But no cloud is without its silver lining, and if we but look for it, it may be found. If we examine the subject more closely we see that winds are responsible for conditions of health, that upon winds or air in motion depends the whole subject of ventilation to be discussed later. It is by the motion of the air that respiration is possible. Impure air is diluted by pure air, and then rendered purer.

OZONE.

Among the invisible ingredients of air sometimes found in considerable quantity, but not always present in any appreciable amount, is ozone.

Origin of Ozone.—Ozone is made up of three atoms of oxygen, whereas free oxygen is made of but two atoms. It is therefore concentrated oxygen, and by the loss of one of its atoms it is converted into free oxygen of two atoms.

Importance of Ozone.—As yet, the researches of medical chemists only enable us to state that the test of Shoenbein indicates that ozone is more abundant in pure than in impure air; in greater quantity at the seashore than in the interior, and in mountain air than in that of plains; absent in the centre of large towns, yet present in their suburbs; deficient in the air of a hospital ward, yet plentiful in the atmosphere outside.

Ozone in Pine Woods.—Dr. Nicholson, of Michigan, found in a long series of observations that ozone was more abundant in a pine forest than m the open country during the summer, but less abundant during the winter; less abundant in coal-pits and over swamps than in the open country, and less abundant generally in the night than in the day.

Property of Turpentine.—The results of these investigations in regard to the air of pine woods are in accord with the statements of Dr. Schreiber, of Vienna, who declares that the turpentine exhaled from pine forests possesses to a very high degree the property of converting the Oxygen of the air into ozone, and this fact perhaps explains why a continued residence among the balsamic odors of the pines has long been credited with a favorable influence in cases of consumption. The test for the presence of ozone in the air, consisting of paper which has been soaked in starch and iodide of potassium, or iodide of calcium, is not reliable.

VENTILATION.

Importance of Ventilation.—Having reviewed the serious derangements to health that impure air might occasion, it behooves us to consider some preventive measures to ward off disease. The great remedy against impure air is, of course, proper ventilation.

System of Ventilation.—In arranging any system of ventilation, we may assume that the greatest amount of carbonic acid (and its associated organic material from the breath) which may be allowed in an inhabited room, without injurious results, is six-tenths of a gallon in every 1000 gallons of air, as already mentioned. The first question then is, how much fresh air must he supplied every hour for each person in a room, in order that this proportion of impurity may not be exceeded?

Quantity of Air for a Room.—By experiment and calculation it is found that, in order to keep up this admitted standard of purity, it is requisite that 3000 cubic feet of perfectly pure air should flow into a room hourly for every grown person occupying it. Of course, an equal bulk of more or less vitiated air must escape to give place to the pure air, and this bulk, which must be poured in and likewise emptied out hourly, for each individual, would be equal to the contents of an apartment thirty feet long, ten feet wide, and ten feet high.

When Increase of Air is Needed.—Such a quantity, large as it seems, must sometimes be considerably increased, in order to maintain the requisite standard of purity. For example, when lights are used, and no provision is made for carrying away the products of combustion, much additional pure air is needed. An ordinary gas-burner consumes the oxygen of about twenty-five cubic feet of air hourly, and produces nearly as much carbonic acid as ten men would do in the same space of time. Sick people, especially those with diseases of the lungs, and those affected with low or putrid fevers, should have a larger quantity of pure air; and it has been found that, unless 3500 or 4000 cubic feet are supplied hourly for each patient, hospital wards, for instance, are more or less haunted by offensive odors.

Size of Apartments.—The size of apartments for human habitation should be directly dependent, within certain limits, upon the perfection of the ventilating and warming apparatus, because, if the room is small, it is only by securing a proper delivery of warm air that the occupants can receive their allotted 3000 cubic feet per head per hour, without suffering from dangerous or unpleasant draughts. For instance, in a room containing but 100 cubic feet, the air must be changed thirty times hourly, or every two minutes, in order to maintain the atmosphere at its standard purity. This would involve the necessity of such rapid currents of air flowing through the narrow space that it would be almost uninhabitable.

Objection to Small Rooms.—Besides, when the room is small, it is not possible to diffuse equally the air which enters it, because, between the inlet and the outlet, a direct current is apt to be established, so that a good deal of the fresh air passes right through, without being of any use in reducing the amount of impurity.

The Sleeping-Room.—The best authorities assert that, with ordinary means of ventilation, the space for every grown person should be not less than 1000 cubic feet, and that in this space the entire air should be changed three times each hour. According to this rule, a sleeping-room of ten feet wide, ten feet high, and twenty feet long, might be allotted to two people; and four persons, but no more, should sit, eat or sleep in a room twenty feet square and ten feet high, provided it was well ventilated in the ordinary way.

Frequency of Air Changes.—If the best ventilating apparatus is employed, and the air is warmed to the temperature of about 65 degrees Fahrenheit, the air in a room may be changed six times hourly without causing annoyance, so that, under such exceptional conditions, an apartment of less than half the size above mentioned, or twelve feet wide, fourteen feet long and ten feet high, would answer for four people.

Death Rate in Small Lodgings.—The dimensions given above are, unfortunately, very much larger than are generally provided in our dwelling-houses, and in the crowded lodgings of the poorer classes the allowance of space for each person often falls as low as 250 or even 200 cubic feet. Under the latter circumstances, the increased sick-rate and death-rate, and the general aspect of what a celebrated French physician graphically describes as "physiological destitution," bear witness to the disastrous effects of breathing impure air in confined apartments.

Natural Ventilation.—A certain amount of natural ventilation, as distinguished from artificial ventilation, effected by contrivances especially arranged for that purpose, goes on all the time through the many crevices, holes and pores of our dwellings, although this supply of air is, as a rule, but a small part of what is necessary for our health. It contributes, however, to the change which does progress, whilst we sit quietly within our four walls without feeling the least draught.

Relative Weight of Airs.—Since air, like other gases, expands or contracts according as it is heated or cooled, warm air is, of course, lighter than cold air, and tends to escape at the upper part of a room, whilst its place is supplied by cold air, which flows in through every aperture in the lower portion. The familiar experiment of opening a door leading to a cold entry an inch or two, and then holding a lighted candle first near the bottom and then at the top of the crack, shows very clearly, by the way the flame is blown inward in the first instance, and outward in the second, how strong are the currents of air in these two positions.

Effects of Second-Hand Air.—Many persons, especially ladies, are so sensitive to the effects of second-hand air in a room, that they can tell in a very few minutes, by the sensations in the head and lungs, whether an agreeable amount of ventilation has been provided, by leaving the door a little way open, or whether it has been shut tight.

Effects of Differing Temperatures.—The rapidity with which the necessary interchange of air goes on through the crevices of our doors and windows depends very much upon the difference between the inside and outside temperature. This important fact is well illustrated by the following observations of Pettenkofer. He found that, in a room ten feet high, ten feet wide and twenty-six feet long, containing 2600 cubic feet, when the difference in temperature within and without was 34 degrees, the contents of the apartment changed once in an hour, through the ordinary crevices of the doors and windows. In the same room, with the same difference in temperature, but with a roaring hot fire in the stove, the change in the air increased about one-fourth. When, however, in the same room the thermometer stood at 71 degrees, whilst outside it registered 64 degrees, leaving a difference of only 7 degrees, ventilation went on only at the rate of 780 feet per hour, and even opening a window, the aperture of which equalled eight square feet, only increased the ventilation about one-half, or to 1060 cubic feet. This experiment was very instructive, showing, as it does, that a difference in temperature of 34 degrees, with carefully shut doors, windows and crevices, has as great an influence in securing a pure atmosphere as much larger and quite unobstructed communications with the outer air, when this latter is of nearly the same temperature as that inside.

Getting Rid of Foul Air.—The quickest way of getting rid of foul air in a room is by cross ventilation, or "perflation," as it is sometimes called. This is obtained by opening windows on opposite sides of the apartment when a moderate breeze is blowing; but it is a method which cannot be relied upon, because, if the outside air is stagnant, no ventilation is secured; whilst, on the other hand, if there is a strong wind, the violent current of air produced might be unendurable.

SLEEPING APARTMENTS.

Ventilating.—In all rooms which are occupied most of the day, and in all sleeping rooms, proper ventilation should be secured by artificial apparatus specially designed for the purpose, as will be described in the section of this book upon Sanitary Architecture. In old houses, until proper alterations can be made, the exit of foul air ought to be provided for by lowering the windows at the top, and the entrance of fresh air permitted by raising them at the bottom.

Preventing Unwholesome Draughts.—Unwholesome draughts may be prevented in the latter instance by the simple device of fastening a board across the window-frame on the inside, in such a way as to direct the incoming current of air upward toward the ceiling of the room. Dr. Keen's arrangement, which is still simpler and equally efficient, is to fasten with tacks or pins a piece of cloth, or even strong paper, across the lower ten or twelve inches of the window-frame, and then raise the lower sash more or less, according to the weather. The convenience of this contrivance is increased if the cloth, instead of being permanetly fastened to the window-frame, is held in its place by loops of tape, which allow of its easy removal as occasion requires.

Dangers of Neglected Ventilation.—If we but stop a moment to consider we cannot fail to see the necessity of properly ventilating the sleeping apartments. We are oftentimes surprised at the neglect of these all-important matters by intelligent people. If the air of any room becomes impure during the day we are at liberty to remove to another, and our sense of smell or perhaps a headache indicates when such a change is desirable. But during the night the senses are at rest and the individual must breath again and again the foul air of an unventilated room.

Consumption and Air.—Speaking on the subject of patients suffering with tuberculosis or consumption under treatment, Tyson states the more nearly the temperature of the sleeping-room approaches that of the outdoors the more likely is the patient to improve. The same truth holds in cases of health.

Remove Plants at Night.—plants should not be kept in a sleeping apartment. During the night they do not give off oxygen, hence their presence is not needed. It is only under the influence of sunlight that the carbonic acid of the air is changed to carbon, which becomes a part of the plant, and oxygen which supports animal life.

CONTAMINATION OF AIR BY SEWER-GASES.

Dangers from Cess-Pool Germs.—A second great danger of impure air arises from its pollution by emanations from sewers and cess-pools, which frequently contain the germs of typhoid fever, diphtheria and perhaps other complaints, as will be more fully explained under the head of Contagion as a Cause of Disease. Dr. Letheby found that sewage-water excluded from the air and containing 128 grains of organic matter to the gallon, gave off over a cubic inch of foul-smelling gases per hour for a period of nine weeks.

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Poisons in Sewer-Gas.—Of course, the danger to persons who inhale sewer-air, or "sewer-gas," as it is often called, depends very much upon, whether it is loaded with disease-poisons as well as with foul odors, and the instances adduced by well-meaning but ignorant persons, for the purpose of showing that the emanations from sewers have proved harmless, are chiefly cases in which ill-smelling gases happened to be unmixed with the poisons of disease.

Proof of Sewer-Gas Poisons.—It would be just as well to argue that because hundreds of ships cross the Atlantic in safety every year, therefore no shipwrecks ever occur, as to contend that, because many people breathe sewer-gas with impunity, therefore it is never injurious to human health. That some sewer-gas is highly deleterious in its nature is proved by the following stubborn facts; and since we have as yet no tests for determining accurately the degree to which any particular sewer is infected with the germs of disease, our safest plan is to cut off all connection between the air of our houses and that of those dangerous channels for filth and disease-poisons.

Illustrations.—Although this subject will be considered more fully in another section, protection against the disease-poisons which enter our systems with air polluted from sewers is so important that two illustrations are here presented, showing what very often occurs. In the left-hand figure above is indicated how the untrapped outlet-pipe of a sink or stationary washstand may conduct the poisonous emanations from an adjoining water-closet, or from the sewer below, directly into a bedroom or other inhabited apartment. On the right is seen how the overflow-pipe of a trapped stationary washstand may be the avenue of dangerous or fatal poisoning by sewer-gas, as in some of the instances next mentioned:

Diptheria from Sewer-Gas.—Dr. William N. Thursfield, of Birmingham, England, reports in 1878 tracing an isolated case of diphtheria to temporary exposure to sewer-gas in a house on a short line of sewer which he knew to be specifically contaminated by diphtheria. This sewer, when opened and examined by a surveyor, produced in him a severe diphtheritic attack.

Typhoid from Sewer-Gas.—Dr. William V. Keating, of Philadelphia, in 1879, details at length four cases of typhoid fever attributed to sewer-gas from untrapped drain-pipes, and refers to cases of measles, scarlet fever and diphtheria in two other families apparently from the same cause.

Dr. C. W. Chamberlin, of Hartford, relates a remarkable case of fatal erysipelas in 1880, seemingly due to sewer-gas from a waste-pipe carelessly left open beneath the bed of the patient.

Vomiting from Sewer-Gas.—Dr. George Wilson quotes the account of twenty out of twenty-two boys of Glapham, England, who were attacked, and two of them died, with violent vomiting, purging and fever within three hours after standing over a choked-up drain, watching the workmen cleaning it out.

Other Examples of Gas Poisons.—Nor are these isolated instances, for the medical journals of America and Europe record numerous similar examples of dangerous or fatal effects from disease-poisons in sewer-air when inhaled by human beings.

Avoiding Sewer Poisons.—In view of this great body of evidence, showing the direct conveyance of disease by air from sewers, it behooves us all to avoid the access of such noxious effluvia into our houses, or into any inhabited place whence they can penetrate into the lungs, which are the usual avenue of entrance into human systems.

Remedies for Gas Poisons.—Such a desirable object is probably best accomplished by mercury seal-traps, which form complete metallic bars to the entrance of foul air and disease-germs. When these improved mechanical appliances cannot be obtained, ball-traps or ventilated U and S traps, if faithfully disinfected at short intervals with a strong copperas solution, 8 ounces to the gallon of water, or with chloride of lime or solution of carbolic acid, 4 ounces of Calvert's No. 8 to the gallon of water, afford safeguards which should be far more generally employed.

DUST IN THE AIR AS A CAUSE OF DISEASE.

Solid Particles.—Dust of various kinds floating in the air, and often occurring in such minute particles that it can only be recognized in a bright sunshine, or by the aid of a beam of electric light, as Professor Tyndall has shown, is a far more potent cause of disease than is generally supposed.

Danger of Saliva-Loaded Dust.—Although affections of the stomach and bowels are often induced by the introduction of particles of injurious dust swallowed with the saliva, diseases of the lungs are chiefly to be dreaded when air loaded with substances which are mechanically or chemically noxious find their way to the delicate mucous membrane which lines the recesses of our pulmonary organs. Bronchitis, catarrh and acute or chronic pneumonia, the latter often running on into one form of consumption, are especially to be guarded against in persons who are liable to be forced to inhale dust of various kinds.

Unhealthy Trades.—The effects of dust are chiefly dependent for their severity on the large amount of the offending material, and the angular, rough and hard character of its particles. A large number of the unhealthy trades are insalubrious especially from this cause. Thus, for example, it is stated by Mr. Simon that, excepting in one locality, 300,000 miners break down in England prematurely from bronchitis and pneumonia caused by the atmosphere in which they live. The one exception is most important, because it occurs among the colliers of Durham end Northumberland, where the mines are well ventilated.

Coal Dust and Consumption.—The sharply-angular fragments of coal which may be seen under a microscope to constitute coal-dust, mechanically irritate the lungs of those who inhale them, and often give rise to the kind of consumption which is so peculiar that it is called miners' consumption or miners' phthisis. This malady alone cuts short the days of an immense number of laborers among coal-dust, and after death their pulmonary organs are found filled with sharp particles of coal, which being inhaled with the breath, become imbedded in the substance of the lung, and then acting like a vast quantity of tiny splinters in the flesh, give rise to innumerable minute boils or abscesses, by which the breathing apparatus is actually riddled with holes, and so much of it destroyed that the poor sufferers die for want of lung-substance enough to supply properly their blood with air.

Saw-Grinders' Consumption.—The fine particles of steel and of sand thrown off in grinding saws and other tools, give rise to saw-grinders' consumption, particularly when dry-grinding is resorted to, and unless the dust is carried away from the workmen.

Particles of Deadly Dust.—In manufacturing these various steel and iron implements, the rough articles are firmly pressed against grindstones, which are revolving sometimes at the rate of three thousand times in a minute. Practically it is found that the degree of danger to the workmen thus employed depends partly upon the amount of dust inhaled, partly upon the character of the particles composing this dust, and partly upon the constrained attitude which the workmen are frequently compelled to assume.

What Dust Most Dangerous.—The grinding of needles and forks is the most dangerous, because it must be done upon dry grindstones, in order to reduce the chance of the fabricated utensil becoming rusty. Scissors, razors and table-knives can be ground partly upon wet grindstones, so that the men employed in such work run less risk of injury from it, whilst the coarser implements generally are now, as a rule, finished upon wet stones entirely, so that still less danger is incurred.

Grinders' Asthma.—The grinders' consumption, called also the grinders' asthma from the difficulty of breathing, which is one of the prominent symptoms, comes on very gradually, and often lasts four or five years before it proves fatal. At first there is only a little dry cough, with scanty expectoration; later on the mucus, which is coughed up, begins to be reddish from a minute quantity of blood mingled with it; and, although there is no fever, and the strength and appetite remain good, an examination of the chest with the stethoscope reveals serious trouble in one or both lungs.

How Recovery is Possible.—Still, recovery is not only possible, but probable, at this stage of the complaint, if the workman can be persuaded to abandon his occupation; but if he persists in exposing himself to the perils incurred by breathing these dangerous dusts into the lungs, the pulmonary structure soon begins to ulcerate away, and painful, lingering death by consumption follows.

Average Life of Grinders.—Until recent improvements in regard to grinding, the fatality of these particles of dust, when inhaled into the lungs, was very great. According to Dr. Holland, the average age at death of twelve workmen at the trade of needle-grinding was only thirty years and eight months, and other authorities give the duration of life as from thirty-one to thirty-five years.

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Nailers' Consumption.—In Wheeling, West Virginia, the dust of nail-factories is so injurious that "nailers' consumption" is very common, and certain life insurance companies refuse to insure any operative in the grinding department of the works.

Use of the Magnetic Plate.—In factories where steel-grinding goes on to a very great extent, the use of a large magnetic plate, for drawing to itself the metallic particles, is very useful; but, of course, it has no power to purify the air from any injurious dust, except that made up of iron or steel, and perhaps on this account it has never been popular among the workmen.

The Mouth Filter.—One might suppose that it would not be difficult to devise a mouth-filter or mask to be worn over the face, and exclude the dust, whilst allowing the purified air to enter the lungs. Practically it is found, however, very difficult to construct a piece of apparatus of this kind which will keep out the dust, and yet remain unobstructed by the moisture of the breath, which condenses upon the material of which the filter is made.

Use of the Face Mask.—Dr. Richardson, of London, has arranged a very ingenious mask for this purpose, which is fitted with a breathing tube, around the inside of which feathers are rolled in such a position that when the air is drawn through the tube they will rise up and filter it, and during the reverse process of expiration, they will be flattened down against the sides of the tube by the current of air, and leave an open channel for it to be breathed out. By this plan it would seem that lightness, dryness, good filtration and self-cleansing of the filtering material would be secured; but, strange to say, it has not been approved by those who wear it. The workmen complain that it causes closeness of the air and looks unsightly, but it certainly merits a more extended trial before being abandoned.

Use of the Mechanical Fan.—Another very efficient method is to draw away the dust in the strong current of air created by a powerful mechanical fan. A single fan may be made to extract the dust from several grindingstones, care being taken to have the opening in the boxes which surround the stones and in which the draught is set up underneath, so as to extract both the heavier and lighter particles. This plan adds materially to the expense of manufacture, and is therefore not very popular among the mill-owners, but it so greatly diminishes the dangers to the workmen, when properly adapted, that its employment should be enforced by law, in order to protect the health of the operatives.

Danger from Wet-Grinding.—Although the introduction of wet-grinding for the coarser tools vastly decreases the chance of mechanical injury to the lungs from floating particles in the air, the artisans are often kept covered with the muddy water which is constantly being whirled off from the stones. Being thus exposed to the combined evil influence of cold and wet, they are especially subject to acute bronchitis, pneumonia and rheumatism, which may, however, be in part prevented if the men wear water-proof clothing whilst they are at work.

Pottery Dust.—In the pottery trade there is often a large amount of dust made up of mineral particles, which are very irritating to the lungs of the operatives employed. The same may be said of the artisans who work at the trade of glass-making, the most dangerous department being that of grinding and polishing the cut-glass. Of these men more than one-third are said to die of consumption, and their average age at death is variously estimated at from thirty to forty-two years.

Flax Dust.—In flax factories a very irritating dust is produced in the processes of hackling, carding and tow-spinning, and Dr. Greenhow states that, of 107 operatives examined indiscriminately, no less than seventy-nine were suffering from bronchial irritation, and in nineteen of these cases there had occurred that serious symptom of consumption, bleeding from the lungs.

Cotton Dust.—In the carding-rooms of cotton, flax and silk-spinners there is also a large amount of dust and loose vegetable fibres, which frequently set up dangerous irritation in the lungs of the workmen, who breathe the air thus loaded with injurious impurities.

Match-Makers' Diseases.—The makers of matches, who are exposed to the fumes of phosphorus, suffer from a form of ulceration of the jawbone, if there happens to be any uncovered portion upon which the poisonous vapor can act, as for instance, around the root of a diseased tooth. The manufacture of many chemical products is exceedingly dangerous to health, and requires special precautions to reduce its evil influence as far as possible.

Danger of Metal Fumes.—In some trades and under certain circumstances the fumes of metals or particles of metallic compounds pass into the air, and render it very injurious to health for those who happen to breathe it. Brass-founders are affected with bronchitis and asthma, as in other trades where dust is inhaled by the workmen, but in addition they suffer from a disease called brass-ague or brass-founders' ague. It appears to be the result of inhaling the metallic fumes, perhaps of the oxide of zinc.

Symptoms of Fume Poison.—The symptoms are tightness and oppression of the chest, with uncomfortable nervous sensations, followed by shivering, an indistinct hot stage, and lastly profuse sweating. The attacks, unlike those of genuine ague, are not periodical. Coppersmiths are apt to be affected in a similar way by the fumes arising from the partly vaporized metal or from the solder. Tin-plate workers likewise suffer occasionally from the fumes of the soldering.

Plumbers' Poison.—Plumbers are liable to inhale the volatilized oxide of lead which rises during the process of casting or in soldering; nausea and a feeling of oppression about the chest are the first symptoms, and afterwards colic and palsy, especially of the wrists.

White-Lead Poison.—Workmen in white-lead manufactories often suffer in the same way from inhalation of fine powder of white lead, chiefly from the beds in which oxidation goes on and in the process of packing the product. And the same may be said of house painters to some extent, although lead poisoning is more apt to occur in them from swallowing the lead compound in consequence of want of cleanliness while taking food.

Tobacco Dust.—Operatives in tobacco factories sometimes suffer from irritation of the throat, nose and eyes by the tobacco dust, and there are some people who cannot become accustomed to an atmosphere of the weed. The greatest irritant effect seems to be produced in the manufacture of snuff, but with the large majority of operatives, if proper care and ventilation is secured, no serious effects result after the first few weeks or months.

Mercury Poison.—Workers in mercury, artisans who silver mirrors and those who handle the amalgam of mercury and gold used for gilding silver articles in some cases are very apt to be affected with a peculiar disease called mercurialismus. This complaint appears to be the result of the poisonous action of mercury upon the mouth, the teeth, the bones, and so forth.

Arsenical Poison.—Workmen who handle compounds of the poison metal arsenic in the manufacture of wall paper, and women engaged in artificial flower-making where arsenical colors are employed, very generally suffer from the effects of arsenical poisoning in consequence of inhaling the dust of this poisonous metal.

Wall-Paper Poisons.—Perhaps the most common kind of poisoning from a metallic dust inhaled with the air is that developed in persons who spend much time in rooms decorated with arsenical wall papers. In some instances, these brilliant yet treacherous decorations, which may be either green, purple or brown in color, have been found to contain as many as thirty-seven grains of the arsenical compound to the square foot, and numerous well-authenticated cases of serious injury to health from inhalation of the atmosphere of rooms in which this arsenical dust was constantly floating are on record. Whenever a person who occupies a room papered with green or purple hangings begins without any obvious cause to suffer from headache, nausea, inflammation of the eyelids, dry cough, muscular tremors and impaired nervous power, the cause should at once be sought for upon the walls of the apartment, and if the usual chemical tests show the presence of arsenic in a little of the paper which has been scraped off, both the patient and the paper should be promptly removed,


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