How to Live - Rules for Healthful Living Based on Modern Science
by Irving Fisher and Eugene Fisk
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Not only is it desirable to screen from mosquitoes, but to put oil on any body of water where they breed. Even a small puddle can breed millions of mosquitoes. No empty tin cans should be allowed to collect about the kitchen door; they gather rain-water and soon breed mosquitoes.

[Sidenote: Typhoid-free Water]

We take in many disease germs through food or drink. Every year 300,000 people in the United States enlist under the typhoid banner. To elude the typhoid-germ we need first of all pure water. But when one is in doubt as to the purity of water, it is advisable to boil water in order to destroy possible typhoid germs and other dangerous germs and impurities. Where hygienic water has been used a very large proportion of the deaths from typhoid has been eliminated. Where this is not feasible, it is desirable to use chlorinated lime (ordinary bleaching powder) in the drinking water (one part to 200,000—shake up and leave several minutes). If water of doubtful quality has to be drunk, it should be at the middle or end of a meal when the healthy stomach contains plenty of gastric juice, which to a limited extent has the power to kill germs.

It is safer to keep out of swimming tanks that are not filtered or refilled constantly, or chemically purified as by chlorinated lime.

[Sidenote: Typhoid-free Milk]

Another measure for avoiding typhoid is to pasteurize milk. Food that is liable to contain typhoid or other dangerous germs, such as raw oysters, and milk from typhoid-infected localities, should be avoided.

[Sidenote: The "Typhoid-fly"]

In protecting the food against all kinds of impurities which injure the body, we must remember that the carrier of typhoid fever, the common house-fly, deposits typhoid germs on the food, through which the germ is taken into the system. The most effective method of fighting flies is by preventing their breeding. Their favorite places for this are horse-manure, but they will breed in almost any mass of fermenting organic material. Manure piles and stables should be screened, and the manure removed at least once in seven days. Garbage-pails should be kept tightly covered. Fly-paper and fly-traps should be used. Houses should be screened, and, in particular in the pantry, the food itself should be screened. Flies are usually thirsty in the morning. By exposing a saucer of one per cent. of formalin solution, the flies will be tempted to drink this morning cocktail and pay the death-penalty.

A fly-trap has been invented by Professor Clifton F. Hodge, of the University of Oregon, Eugene, Ore., which any one is free to construct and which, if used universally about stables early in the season, would greatly help toward banishing the fly altogether.

Flies occasionally gain entrance to the house in spite of the most careful screening. The fumes of burning Pyrethrum powder (Persian insect powder), used in the proportion of 2 lbs. per 1,000 cubic feet of air space, will either kill or stupefy flies and mosquitoes, so that they may be swept up and effectually destroyed. It may be distributed in pots and pans, and ignited after sprinkling with alcohol.

[Sidenote: Other Vermin]

Ticks should also be carefully exterminated, as they are sometimes responsible for such diseases as Rocky Mountain spotted fever, African tick fever, and other infections. The bedbug is also by no means the harmless creature which it is generally regarded. To its credit are placed such maladies as relapsing fever. The flea has been responsible for such terrible diseases as the plague. It often operates by means of rats as its carrier to the human being. The louse is one of the direst offenders in the insect line, as it must take the responsibility not only for many cases of typhoid fever, but for the dread plague of typhus, which is ravaging the European armies.

[Sidenote: Hookworm]

Hookworm disease is to be avoided by not treading barefoot on ground polluted by victims of the disease, by preventing soil-pollution through the proper disposal of human excrement, and by screening all water-closets.

[Sidenote: Cleanliness]

Cleanliness is important for avoiding infections, and bathing is important for cleanliness. The hands, the face, and finger-nails should be kept clean, especially before meals. Any cut or crack in the skin or mucous membrane may let in germs when the spot is dirty or is touched by dirty hands. This is why surgeons are so scrupulously clean. Super-cleanliness probably also explains the extraordinarily low mortality of Jewish rabbis as a class.

The need of cleanliness is particularly great for those who work in factories, mines, and other places where dirt is likely to be carried to the mouth by the hands. Probably many diseases get a foothold in this way without the victim realizing in the least that they were due to his carelessness and lack of cleanliness.

Here, as elsewhere, esthetics and health go hand in hand. A person who does not bathe daily is pretty certain to carry on his skin some perspiration which, while he may be unaware of it, gives forth an offensive odor.

[Sidenote: Perspiration]

Cleanliness is promoted by perspiring prior to bathing. Every one knows the exhilaration which follows a healthy perspiration. Of course, the most beneficial method of securing perspiration is the method applied to the trotting horse—vigorous exercise. In fact, one of the benefits of exercise is perspiration. When a person can not or will not take exercise, perspiration can be induced by hot baths. Such extreme measures ought not, however, to be taken too often. How often will depend on the corpulence and other circumstances of each individual. Sweating may be overdone, and should never be pushed to the extent of exhaustion. The function of the skin in removing wastes from the body is much less important than formerly supposed. The advice of a physician is desirable. It should be remembered that all of us perspire insensibly as well as visibly.

[Sidenote: Sex Infection]

Some of the most serious and widespread although usually unmentioned infections are those from the venereal diseases, with a whole train of terrible consequences, such as blindness, joint-diseases with heart-complications, peritonitis, paralysis, and insanity. They are to be avoided by living a life hygienic and clean, not only in body but in mind and heart. From even the narrowest interpretation of hygiene, a decent life is necessary for the maintenance of health. This is a special subject on which most people are extremely ignorant. It is seldom realized, for instance, that all prostitutes are diseased. This was found to be the case in an investigation in Glasgow.

Dr. Rosenau says: "Every boy and girl, before reaching the age of puberty should have a knowledge of sex, and every man and woman before the marriageable age should be informed on the subject of reproduction and the dangers of venereal diseases. Superficial information is not true education. On the other hand, it is a mistake to dwell unduly upon the subject, for in many instances the imagination and passion of youth are inflamed by simply calling attention to the subject."

The Life Extension Institute can furnish special pamphlets covering this important topic.

The loss of citizens to the State from the sterilizing influence of gonorrhea upon the productive energy of the family, and the blighting destructive effect of syphilis upon the offspring offer extremely serious problems for preventive work.

Section IV—Teeth and Gums

There is one source of poisoning and infection so universal as to need special mention. This is infection through the mouth. Considered from the standpoint of efficiency, the modern mouth is out of adjustment with modern conditions—or, perhaps we should say, modern conditions are out of adjustment with it. Notwithstanding the numerous bacteria that flourish within its portals, mouth secretions and the mucous membranes do not seem to have the protecting power which is often manifest in other regions of the body and which protects an animal in a state of nature. Wild animals are not subject to caries or dental decay, as are man and domesticated animals.

[Sidenote: Mouth-dangers]

There are two forms of mouth-danger that should be clearly differentiated. Dental caries, or decay, is at first largely a chemical process and affects the tooth proper. Pyorrhea, or Riggs's disease, affects the tissues surrounding the root of the tooth, and is accompanied with infection by pus bacteria, and possibly also by animal parasites, termed endameba. Scrupulous cleanliness of the mouth largely prevents both of these maladies.

[Sidenote: Dental Decay]

In caries, or dental decay, plaques or films of mucin from the saliva form on the tooth-surfaces and enclose bacteria and particles of carbohydrate food, which undergo fermentation with the formation of lactic acid, which dissolves the lime salts on the surface of the teeth, leaving only the organic matter. This organic matter is then attacked by bacteria. Putrefaction sets in, and you have a cavity. This cavity is, of course, a menace, as it harbors various forms of bacteria, which may infect the general system through the root canals, or the digestive system by being swallowed with the food, and also gives rise to abscesses at the root-tips.

[Sidenote: Pyorrhea]

Pyorrhea is an infection of the gums or tooth-sockets. It begins beneath the edges of the gums that have been injured and especially where there has been an accumulation of tartar or lime-deposit. As the infection progresses and destroys the membranes that attach the root of the tooth to the socket, a pocket is formed around the root, and the tooth becomes loosened. It is said that this disease is responsible for far more loss of teeth than is decay.

[Sidenote: Systemic Injuries from Mouth Infection]

But this is not the only evil. In the pocket pus is continually being formed and discharged into the mouth and swallowed. Also, as the teeth rise and fall in their diseased sockets in ordinary chewing, bacteria are forced into the circulation and may be carried to distant parts, where they work harm according to their nature, selecting tissues for their operation in which they can best thrive.

[Sidenote: Focal Infection]

It was formerly supposed that the ill effects from such conditions as dental abscess and other pus foci were wholly due to the toxins or poisonous products thrown into the blood-stream by the bacteria at the focus. It is now known, however, that the bacteria migrate into outside tissues through the blood- and lymph-streams. In joint affections, they clog and obstruct the small blood-vessels, interfering with the nutrition of the joint-tissues, causing deformity and enlargement, as in arthritis deformans, as well as in acute inflammation, such as rheumatic fever. Indeed, this condition of subinfection, or "focal infection," is coming to be recognized as a far more important cause of disease than the time-honored autointoxication, a term which has been greatly abused and misused.

[Sidenote: Autointoxication]

The term "autointoxication" should properly be restricted to conditions where poison arises from changes in the tissues or in the activities of cells or organs, whereby substances are released into the circulation in quantities harmful to the organism; in other words, where the secretions of the body are altered, either in character or quantity, to such a degree as to cause injurious effects, such as overactivity or underactivity of the thyroid gland, or suprarenal gland.

The poison from undigested food, or from decomposing intestinal contents, should be termed "intestinal intoxication," or "toxaemia," rather than "autointoxication," or "self-poisoning," as it is actually due to infection from outside sources. Intestinal toxemia is, no doubt, a fairly frequent cause of illness, but it has lately been shown that stagnant bowels may cause true infection by micro-organisms that penetrate the tissues, and that many conditions ascribed to intestinal stagnation and the resultant chemical poisoning may actually be due to focal infection, or subinfection, arising in other regions.

The light that has lately been thrown on chronic sources of focal infection has cleared up many of the mysteries surrounding the causation of certain obscure affections—chronic rheumatism, arthritis deformans, certain forms of anemia, goitre, chronic heart and kidney troubles, diabetes, ulcer of the stomach, duodenum, etc., and other forms of chronic disease, especially those that have proved resistant to known methods of treatment.

[Sidenote: Lowered Resistance]

There are many cases where the so-called focus has apparently become established because of general bodily neglect and a general lowering of resistance, in which the focus, even though it be the mouth, has participated, and permitted the successful activities of germs or parasites. After the focus has been established, however, it is often an important and may be a deciding factor in keeping up the general diseased condition of the body.

This principle of focal infection, well established as it is, should not be accepted too literally, or given too wide an application, but no one can question the importance of preventing the bacterial hosts of the mouth from getting into the system, or the importance of getting them out, if we have unwarily permitted them to enter.

All the ills that flesh is heir to are not caused by mouth-infection, but enough of them are to more than justify a vigorous and world-wide campaign for the better care of the teeth and for a thorough search for mouth-infection in every case of obscure disease.

[Sidenote: Keeping the Mouth Aseptic]

[Sidenote: Over-dentistried Teeth]

Gum infection is not always due to conscious neglect. Some people do not know how to properly cleanse the teeth. Others have tissues of low resistance, and need to give extra care to tooth- and gum-cleansing under the closest dental supervision. Others have spent large sums for dental work that has filled the mouth with crowns and bridges difficult to keep aseptic or surgically clean. There are various means which the individual can use to prevent or cure these dental evils.

[Sidenote: General Hygiene]

First, the importance of thorough attention to general personal hygiene, in order that a general resistance to mouth-infection may be built up, can not be overemphasized.

[Sidenote: Vigorous Use of Jaws]

The cultivation of normal eating habits with respect to the vigorous use of the jaws by thorough mastication, and the eating of hard, resistant, crusty foods every day is the next desirable means of tooth and gum hygiene.

[Sidenote: Cleansing]

A leading dentist expresses the hope that some day the human animal, like other animals, will, through a correct diet, be able to get along without the aid of the tooth-brush; but he adds that, in the meantime, we need to advocate more tooth-, gum- and tongue-cleaning rather than less. They should be cleaned night and morning and after each meal if possible by rapid rotary brushing. Strong pressure is not advisable. Rapidity of movement is the important point. This stimulates the circulation and increases the resistance of the gums and cleanses the teeth at the gum margins from the accumulations of tartar which are at first soft and easily removable by a brush.

[Sidenote: Kind of Brush]

A brush should be used with bristles that are stiff and of different lengths, so that the innermost crevices of the teeth may be reached. If the gums are sensitive, a moderately stiff brush can be used until the gums can bear the more vigorous treatment.

[Sidenote: Tongue Brushing]

The tongue should also be carefully cleansed with the tooth-brush. By taking care not to hit the roof of the mouth, gagging is avoided.

[Sidenote: Tooth-Powders and -Pastes]

Tooth-powders and -pastes may be used, but should not be the main reliance. Perhaps once a day for their use is often enough. Some powders, if used too freely, are liable to unduly thin the enamel of the teeth.

[Sidenote: Dental Floss]

The use of dental floss silk between the teeth, provided care is taken not to press it against the gums, is also helpful.

[Sidenote: Emetin]

A number of investigators have reported the presence of an animal parasite, the endameba buccalis, in all cases of pyorrhea, and it is thought that this parasite may be one of the principal causes of this disease. Emetin, the active principle of ipecac, which has been successfully used in amebic dysentery, is now employed in the treatment of this trouble. Such a remedy should only be used in connection with thorough surgical treatment and dental prophylaxis. It is claimed that in the early stages of pyorrhea a mouth-wash composed of two drops of fluid extract of ipecac to a half-glass of water is very serviceable, and as at that stage a mouth-wash is entirely harmless, it should be tried, especially as it is now claimed that some degree of pyorrhea or of endamebic infection is almost universally present.

[Sidenote: Alkaline Dentifrice]

[Sidenote: Food Acids]

For an alkaline dentifrice, there is nothing better than lime-water, made from coarse, unslaked lime. Alkaline washes are very superficial in their action, however, while fruit acids curdle and thus render removable the mucin plaques and prevent the formation of tartar. They also cleanse the tongue and membranes of the mouth generally, which may be important sources of infection. These acids are found in grape-juice, orange-juice, apples, and vinegar. Such mechanical cleansing is particularly important before retiring, as it is usually during the night that the most damage is wrought.

[Sidenote: Erosion]

The advice of the dentist should be sought as to the condition of the teeth, especially as to whether there is any erosion or destruction of enamel, before using either acid or alkaline washes exclusively.

[Sidenote: Periodic Examination]

Periodic examinations and cleanings by the dentist are the only safe measures. If the dentist has facilities for giving preventive treatment by specially cleaning the teeth, he should be visited every other month. If such a program is adopted, it will generally be found unnecessary to visit him for any other purpose.

[Sidenote: Saving Teeth]

Some dentists and physicians have until lately given too much attention to the saving of teeth, without fully realizing the dangers of infection from the mechanical devices employed. The teeth should not be extracted on mere suspicion and without proper effort to save them, but it is far more important to save a heart or a kidney or a set of joints than it is to save a tooth. This is not to say that all bridge- and crown-work is improper, but that such work should only be of a character that will permit of surgical cleanliness in the mouth, and that such teeth should always be examined by the X-Ray, when there is evidence of systemic disease in order to be sure that the roots and sockets are not infected.

[Sidenote: Irregularities of Teeth]

In early life the jaws should be carefully examined by both dentist and doctor in order to determine whether or not the proper development is taking place. If upper and lower teeth fail to fit well together, extra strain is placed upon certain teeth and the sockets are liable to injury and infection. Faulty development can often be corrected and deformities that interfere with proper mastication and place a strain on certain teeth can thus be avoided.

[Sidenote: The Temporary Teeth]

The temporary teeth should not be allowed to be removed by decay. Thorough dental and home care should prevent this. If cavities form, they should be filled under proper precautions and the teeth should be saved until the last minute, unless they are causing infection.

[Sidenote: Teeth and Infectious Diseases]

Amazingly good results from teeth-hygiene have been shown in a Boston asylum, which cares for over 300 children. Before the introduction of a dental clinic into this asylum, infectious diseases—diphtheria, mumps, scarlet fever, pneumonia, measles, whooping cough, tonsillitis, chicken-pox, croup, etc.—had been occurring for four years at the rate of over 80 cases per year, but for three years after the dental clinic was established the average was only 3 per year.



Section I—Work, Play, Rest and Sleep

In order to live a hygienic life it is not only necessary, as shown in the foregoing three chapters, to supply the body with wholesome substances and to exclude unwholesome substances, but it is also necessary that the body should at times act, and at other times be inactive. There are two great forms of activity, work and play; and two great forms of inactivity, rest and sleep. All four of these are needed in the healthy life and in due relation to each other.

[Sidenote: The Daily Rhythm]

The whole personality should be utilized and energized in a daily rhythm. When, as too often happens, the equilibrium and mutual proportions of the various wholesome elements in a well-rounded life have been lost, the balance should be restored if possible the next day. If a physician has had his sleep broken, he should aim to make it up at the earliest opportunity. If the afternoon exercise has had to be omitted, an extra amount should be taken as soon as possible. Some people find that while it is difficult to live a complete life every single day, it is quite within their power to give every element its due proportion in each week, taken as a whole. To go a step farther, when the balance has not been kept even in a week as a whole, the next week should be modified to compensate. But it is ideal to make the day, not the week, the unit. It is almost as absurd to relegate all our exercise to Saturday afternoon as to do all our eating on Sunday.

[Sidenote: Adjusting the Proportion of Work and Play]

It is distinctly unhealthful either to overdo or to underdo work, play, rest, or sleep. "Moderation in all things" is a rule that is particularly important in this realm. Not all people are in need of exercise, nor are all in need of rest; but almost every one needs to change his proportion between the two. To-day many people are suffering from too much or too little work. For instance, the increase in diseases of the heart is often due to nervous overstrain combined with either too much or too little physical exertion.

The remedy for the evils of idleness is obviously to find some useful work which will inspire real interest and enthusiasm. There are few things more necessary to a normal healthy life than to have purposeful work. A great dream or ambition in life often obviates personal ailments and nullifies their potency. Work, when done with zest, is a wonderful tonic. Exertion of any kind is usually pleasurable at first, and becomes drudgery only when too far protracted.

[Sidenote: Need of Work]

Normal work is one of the greatest blessings of life, but too many miss the joy of it, some because their work has gone to the extreme of drudgery and others because it has shrunk into nothingness and futility. Sometimes people become ill because their personality, hungry for work, is given nothing but introspection to feed upon. This is the self-imposed curse of the idle rich.

[Sidenote: Prevention of Overstrain]

Methods of preventing or correcting overstrain vary greatly, according to the kinds of overstrain. In general, overstrain of any kind tends to overfatigue. Overstrain is to be avoided, therefore, by paying heed to Nature's fatigue-signals as soon as they appear. A very moderate degree of fatigue is perhaps normal, but anything that approaches exhaustion should be avoided with the utmost care.

[Sidenote: Working Hours]

Working hours should be so arranged as to enable the worker to fully recuperate overnight, partly from sleep and partly from the recreation enjoyed in leisure between work and sleep.

[Sidenote: Variety of Work]

Variety of work is especially needed in modern times, when specialization tends to lead men to extremes. Changes in work which prevent a sense of monotony will greatly increase the power to work. A clerk will do more work, and do it more effectively, if he is occasionally allowed something else to do than to foot up columns.

[Sidenote: Monotony and Interruption]

If the monotonous strain of performing numerical additions is interrupted a few times daily, the adding faculty of the brain is given much needed rest. Many men in the higher rank of workers complain of the many interruptions which they suffer, but if they would welcome these interruptions instead of allowing themselves to be irritated by them, each interruption would serve the purpose of a vacation. It is in this way that some of the greatest workers, like Gladstone, have been enabled to accomplish so much.

The strain of modern life is sometimes special rather than general. Often the strain comes on some one muscle or organ. Modern industry is so constituted that the individual strains one part of the body while other parts are in need of exercise.

[Sidenote: Eye-strain]

One of the organs which is most commonly strained in modern life is the eye. In its modern use, the eye is constantly focusing at a short distance. To look at the horizon is a rest. The reflex evils from eye-strain are great and numerous and are often incorrectly ascribed to entirely different causes. Headaches, nausea, and dizziness are especially frequent results of eye-strain. Probably some of the breakdowns in middle life are due primarily to the reflex effect of eye-strain.

Eye-strain is to be prevented by scientifically adapted spectacles, by care to secure the right kind of illumination, and in some cases by systematically resting the eyes. Reading on moving trains or looking for a long time at moving pictures may overstrain the eye. One should be especially careful not to read in a waning light or, on the other hand, to read in the glare of the sun. If one works facing a window, it is advisable to wear an eye-shade; otherwise there is a struggle between the tendency of the bright light to close the pupil and the tendency of the work requirement to keep it open.

To offset the evils of a sedentary life, it is advisable to spend one hour daily, or at least 15 minutes, in some kind of vigorous physical exercises.

[Sidenote: Mechanical Home Exerciser]

The rowing-machine is probably the most beneficial form of mechanical home exercise that is likely to be followed faithfully. Simple stretching in bed when one wakes up is helpful, especially if combined with breathing exercises.

[Sidenote: Stimulating Heart and Lungs]

The most beneficial exercise, as a rule, is that which stimulates the heart and lungs, such as running, rapid walking, hill-climbing and swimming. These should, of course, be graduated in intensity with varying age and varying degrees of vitality.

[Sidenote: Exercise after Meals]

Gentle muscular activity after meals promotes normal digestion and should be practised for a quarter or half an hour after each meal, but violent exercises immediately after meals should be avoided, as a large amount of blood is then engaged by the digestive system.

[Sidenote: Outdoor Exercise in Winter]

A very important fact for the average man to take into consideration is that, whereas he naturally gets considerable out-of-door exercise in summer, he allows it to lapse in the winter. Such a decided change in the amount of exercise is dangerous and should be avoided by taking regular gymnasium exercise. Even though a gymnasium is not elaborately equipped, use can be made of such games as hand-ball, volley-ball and other available games.

[Sidenote: Enthusiasm in Exercise]

Systematic exercise is important and beneficial, even when the individual finds it uninteresting. The idea, which is now spread abroad, that exercise in which one is not emotionally interested is of no benefit, is quite incorrect. A gentleman who had this opinion was challenged to test it and speedily changed his mind. For an entire winter he faithfully attended a gymnasium, though it was an unceasing bore to him. To his surprise, he found that he had never spent a winter in such good health.

But, although exercise when self-imposed is wholesome, exercise to which one is naturally attracted is more so. Golf, horse-back riding, tennis, usually inspire enthusiasm, and enthusiasm itself is healthful. Walking may also do so, if the walk has an object, as in mountain-climbing, when often the artistic feelings may be enlisted in the sport. Working out an ideal stroke in rowing, perfecting one's game in polo or other sports, are other examples.

[Sidenote: The Greek Ideal]

[Sidenote: Injuries from College Athletics]

The Greeks lifted their sports to a higher level than ours by surrounding them with imagination and making them a training in esthetics as well as in physical excellence. The American idea is too closely connected with the mere wish to win and the performance of mere "stunts" and not enough with the idea of beauty of physique and control of the body. There is accumulating considerable evidence that college athletics often seriously injure those who engage in them, although they were originated and encouraged for precisely the opposite effect. The value of exercise consists not in developing large muscles nor in accomplishing athletic feats, but in attaining physical poise, symmetry of form, and the harmonious adjustment of the various parts of the body, as well as in furthering the proper activity of cell-tissues and organs and the elimination of waste products.

Even those whose work is largely muscular, unless it involves most of the muscular system, may do well to exercise the unused muscles—although Nature herself produces to some extent the necessary compensation by what is known as the "law of synergic movement," by which unused muscles profit by the exercise of those which are used.

[Sidenote: Exercise of the Mind, Will and Emotions]

Not only the functions of the body but those of the mind require exercise—exercise in thinking, feeling, and willing. A person who does not read or think loses some of his ability to read or think. The physical worker, for instance, often allows his mind to become dull and sodden. The accountant adds up figures all day and has no chance to exercise his judgment or other mental faculties. In the same way a person who does not exercise his artistic, poetic, or affectional side will suffer its atrophy. The plaint of Darwin that he had allowed his taste for music and poetry to atrophy could to-day be made by many intellectual specialists. Good music is especially healthful.

The exercise of the will is of first importance. Many young people to-day are brought up so well protected that they have lost the power to decide for themselves. Will is exercised every time a decision is made. One of the advantages of all games is that they require decision by the players. A game like baseball calls out the exercise of almost every power. It requires the mind to play, the emotions to enjoy, the will to decide, the muscles to act, and all in mutual coordination.

[Sidenote: The Avocation]

Since the work of most people is likely to produce some unhygienic element which can not be avoided, a compensation should be sought in an avocation or "hobby," to be practised out of regular working hours. The avocation should be far removed from the nature of the regular work. Often the avocation can serve a productive purpose. Gladstone and Horace Greeley sawed wood or chopped down trees for recreation. A well-known engineer divided his recreation between writing stories and painting pictures.

[Sidenote: Enjoy Recreation]

But one should beware of turning his play itself into work. Some people read Shakespeare to "improve their mind," and make as hard work of it as though they were studying geometry. We should enjoy our recreations for their own sake, or else they are not recreations. All work and no play make not only dull boys but dull men and women.

[Sidenote: Pleasures of Walking]

In some form, every one can secure recreation. If one can not play golf, or polo, or tennis, or swim, or climb the Alps, at least he can walk, and, if he tries, he can do so in good company on interesting highways and byways.

[Sidenote: Games]

Recreations in which more persons than one take part are far superior in this respect to those of a solitary nature. They require a give and take, a matching of wits, a feeling of rivalry, and at the same time, companionship.

Plays and moving pictures of the right character and free from morbid suggestions, if enjoyed in moderation, are hygienic. Comedy is generally more wholesome than tragedy. Laughter lengthens life; tears do not.

The proper kind of reading is often a most beneficial type of recreation.

[Sidenote: Morbid Literature]

It is best for the average individual to avoid literature that deals with the morbid and pathological, that depicts and analyzes abnormal psychological conditions. Such studies are better left for alienists. Literature of mawkish sentimentality should also be avoided. Within the range of sound literature there is a wide choice of abundant material affording healthful mental suggestions.

[Sidenote: Dancing]

Dancing combines wholesome exercise, social enjoyment, and the acquirement of skill and grace, but it is seldom of much hygienic value because it is frequently overdone, and often involves bad air and loss of sleep. In one large plant where the employes were examined by the Life Extension Institute, the management regarded the harmful effect of dancing as their chief obstacle to efficiency. Many of the large force of girls and women were accustomed to dance until late in the night, bringing on a condition of chronic fatigue.

[Sidenote: Card-playing]

Card-playing and similar games afford wholesome mental recreation for some persons. However, they, too, are liable to be associated with late hours, and other disadvantages even when they do not degenerate into gambling. Card-playing, dancing, and many other popular forms of amusement often border on dissipation.

[Sidenote: Suicidal Amusement]

Amusements which weaken and degrade are not hygienic. Many who need amusement make the fatal mistake of getting it in suicidal ways, in the saloons, dives, and the low dance-halls.

Play is simply a half way stage between work and rest. In a hygienic life there must be a certain amount of actual rest. Every bodily power requires rest after exertion. The heart rests between beats. The muscles require relaxation after every contraction. The man who is always tense in muscle and nerve is wearing himself out.

[Sidenote: Relaxation]

The power to relax, when fatigue requires it, is one of the most important safeguards one can possess. Lying down when tired is a good rule. A very hard-working college president when asked about the secret of his working-power and length of life replied, "My secret is that I never ran when I could walk, never walked when I could stand, never stood when I could sit, and never sat when I could lie down."

[Sidenote: A Rule for the Lazy]

Such rules as these are valuable, of course, only when the requirements of one's occupation tend toward ceaseless activity. For idle and lazy people the rule should be reversed—never to lie down when one could sit, never to sit when one could stand, never to stand when one could walk, and never to walk when one could run! A complete life must have all in due proportion. Relaxation is only a short vacation, as it were, between two activities.

[Sidenote: Bathing and Swimming]

Bathing and swimming supply, in their numerous forms, examples of both healthful activity and relaxation. A cold spray or shower, alternated with hot, affords excellent gymnastics for the skin. A very hot bath, lasting only a minute, or even a hot foot-bath, is restful in cases of general fatigue. The most restful of all is a neutral, that is, tepid, bath of about the body-heat (beginning at 97 or 98 degrees and not allowed to drop more than 5 degrees and continued as long as convenient).

[Sidenote: How to Induce Sleep]

The wonderful nervous relaxation induced by neutral baths is an excellent substitute for sleep in case of sleeplessness, and often induces sleep as well. Neutral baths are now used not only in cases of insomnia and extreme nervous irritability, but also in cases of acute mania. When sleep occurs in a neutral bath, it is particularly restful. A physician who often sleeps in the bath tub expresses this fact by saying that "he sleeps faster" there than in bed.

Sleep may also be induced by monotonous sound, or lack of sound, or the monotonous holding of the attention. Keeping awake is due to continued change and interruption or arrest of the attention.

Exercise taken in the afternoon will often promote sleep at night in those who find sleep difficult. Slow, deep, rhythmic breathing is useful when wakeful, partly as a substitute for sleep, partly as an inducer of sleep.

Sleep is Nature's great rejuvenator, and the health-seeker should avail himself of it to the full. Our sleep should not only be sufficient in duration but also in intensity, and should be regular.

[Sidenote: Hours of Sleep]

The number of hours of sleep generally needed varies with circumstances. The average is seven to nine. In general one should sleep when sleepy and not try to sleep more. Growing children require more sleep than grown-ups. Parents often foolishly sacrifice their children's sleep by compelling them to rise early for farm "chores," or in order to sell papers, or for other "useful" purposes.

[Sidenote: Eating before Retiring]

One's best sleep is with the stomach empty. It is true that food puts one to sleep at first, by diverting blood from the head; but it disturbs sleep later. Water, unless it induces bladder-action during the night, or even fruit, may be taken without injury before retiring. If one goes to bed with an empty stomach, he can often get along well with six or seven hours' sleep, but if he goes to bed soon after a hearty meal, he usually needs from eight to ten hours' sleep.

[Sidenote: Place of Sleep]

It has already been pointed out that sleeping outdoors is more restful than sleeping indoors.

[Sidenote: Pillows]

A pillow is not a necessity if one sleeps lying prone with one arm extended above the head and the leg opposite drawn up. This sleeping attitude can easily be reversed to the opposite side. It has one advantage over pillow-sleeping, that of not tending to round shoulders. This prone position is often used now for infants, but is seldom enjoyed by adults.

[Sidenote: Type of Bed]

A modern "hard" bed is far preferable to the old-fashioned soft (and hot) feather bed.

[Sidenote: Character of Thoughts]

The character of sleep depends largely on the mental attitude on going to bed. One should get into the habit of absolutely dropping work and cares at bed-time. If then one suggests to himself the pleasantest thought which memory or imagination can conjure up, his sleep is likely to be far more peaceful and restful than if he takes his worries to bed, to keep him awake until sleep comes in spite of them, and to continue to plague him in his dreams. If one is worried, it is a good plan to read something diverting, but not exciting, just before retiring.

Section II—Serenity and Poise

As we have seen, not only the body but the mind needs its due activity and rest. As to the mind, the important question is the quality of the activity rather than the quantity. If we are to be really healthy, our mental attitude must be healthy. A healthy mental attitude implies many elements, but they are all roughly summed up in the word "serenity." Probably no other one hygienic requirement is of greater importance than this. Moreover, the attitude of "healthymindedness" should be striven for not only in order to produce health, but as an end in itself, for which, in fact, even health itself is properly sought. In short the health of the body and the health of the mind act and react on each other.

[Sidenote: Influence of the Health on the Character]

We may generally keep serene through following the other measures already described. Discontent is undoubtedly very often the consequence of wrong conditions in the body, and though melancholy, worry, peevishness, fear generally appear as arising from outward conditions, there are usually real physical sources, existing within the body itself. These are at times most difficult of recognition. A person who is physically ill is likely to be ill-satisfied with everything, without suspecting the fundamental cause of the discontent. When the apparent "cause" is removed, the discontent remains none the less, and fastens itself on the next thing that comes along.

[Sidenote: The "Cause"]

Although some little event such as the mistake of a tradesman or a cross word of a friend may seemingly "cause" a disagreeable reaction in a man if he is ill (whether he knows he is or not), the same "cause" does not necessarily produce that same reaction at all times. When he is in a healthy mood, the "cause" may be entirely inadequate to bring about the same result.

[Sidenote: Approach of Menstrual Period]

The near approach to the menstrual period in women is often accompanied by mental depression and physical fatigue which it is almost impossible for the sufferer to recognize at the time as caused by anything but "real" or outside misfortunes.

[Sidenote: Hidden Causes]

Other physical conditions act in the same way. The hidden cause may be constipation, eye-strain, or the effects of alcohol or other drugs, a sedentary life, a bad posture, or weak abdominal muscles; and the proper remedy may be an enema, a pair of glasses, a vigorous swim, deep breathing exercises or an abdominal supporter, an erect carriage or a general change of daily habits. A young man returning from a surveying trip in the mountains of Colorado in which an ideal hygienic out-of-door life was lived, said, "I never saw so good-natured a crowd of rough men. Nothing ever seemed to make them angry. They were too full of exultant health."

[Sidenote: Mental Rewards from Health]

Health for the body awakens mental capacities where they exist. Failure in mental work can often be traced to failure in physical health; and the restoration of bodily health is often essential to success in the tasks of the mind. This is especially true of the artistic professions, where the kind of product is dependent so largely upon the state of the emotions, upon exhilaration and enthusiasm. A noted sculptor who, a number of years ago, was "down and out" in the artistic world, after a period of years "came back" with a masterpiece, having adopted a more hygienic life.

Epictetus taught that no one could be the highest type of philosopher unless in exuberant health. Expressions of Emerson's and Walt Whitman's show how much their spiritual exaltation was bound up with their health conditions and ideals. "Give me health and a day," said Emerson, "and I will make the pomp of emperors ridiculous."

[Sidenote: Influence of the Mind on Health]

But what most concerns us in this section is that the mind has an important influence over the condition of the body. A Kansas poultryman, who owns a hen which he claims to value at $10,000 because of her qualities as a breeder, a few years ago knew a great deal more about how to maintain the health of his poultry than he did about how to maintain his own health. Long and bitter experience had taught him that he obtained freedom from sickness among hens only by being very careful to feed them on a special diet; to give them drinking water at regular intervals—warmed in winter; to supply them with well ventilated and cleanly houses, and so on. But, after all this, he found there was one condition, which, if unfulfilled, still precluded the realization of maximum possibilities. "A discontented hen won't lay eggs," was the startling discovery. "When I see a man go into the yard and 'holler' loudly at the hens, and wave his arms, making them scatter, frightened, in all directions, I say to that man: 'You call at the office and get your pay and go.' But when I see a man go into the yard, and call gently to the hens, so that they all gather around him and coo and cluck and eat out of his hand, I raise that man's pay."

[Sidenote: Physical Manifestations]

It can not be too much emphasized that mental perturbation affects the body in many ways. Shame fills our cheeks with blood. Fear drives the blood away. Excitement quickens the heart-beat. Grief brings tears, the reaction of glands about the eyes, and sighs, the disturbances of regular breathing. A great shock to the mind may cause fainting, the rush of blood from the head into the abdomen. Worry will interfere with digestion and sleep. The X-ray has detected the arrest of the peristaltic movement of the stomach and intestines because of a strong emotion. Some peculiarly constituted people, who take their work and obligations with a kind of seriousness that amounts almost to fear, can not eat anything of consequence until their day's work is ended. The digestive processes seem to be at a standstill until then. A curious fact is that strong emotion may lead to a great increase in the sugar in the blood, sometimes enough to cause its appearance in the urine as though the person had diabetes. One man expresses this by saying, "bitterness of soul banishes sweetness even from the body."

[Sidenote: The Demands on the Mind]

It is doubtless on account of such influences of the mind on the body that some persons who have attempted to improve their health by what they call "thoroughly masticating" their food—but who have interpreted this phrase as having a purely mechanical meaning—have wondered why they were not benefited when they forcibly held their food in their mouths until they performed a certain number of chews, while in fact they were making a bore of eating and were forgetting to taste and enjoy. The mind and the emotions refuse to be ignored in this way, and exact due penalty from the body when they are not satisfied. To attain the desired results from any hygienic measure, it is apparently necessary, in some degree at least, to satisfy the mind along with the body.

[Sidenote: Hypochondriacs]

There is in fact a danger to which some people are especially subject—the danger of becoming hypochondriacs from paying too much attention to physical hygiene. Such a person becomes fearful lest he is not doing exactly the right thing. He looks suspiciously at every article of food and fears that it will disagree. He fears that he has strained his heart; he worries over the loss of an hour's sleep; he chafes because his employer has not given him a vacation at the right time or of the right length. The hypochondriac thus neutralizes practically all the benefit of other hygienic measures by disregarding this special measure of keeping serene. It might, in many cases, be better to disregard some rules of hygiene than to worry over them.

[Sidenote: "Mind-cure"]

On this theory the devotees of mind-cure cults have derided every hygienic measure but one—their "mind-cure." They sometimes succeed in the "real cure of imaginary ailments," and the "imaginary cure of real ailments." In the latter case, the mental contentment lasts only until the real ailment becomes too aggressive to be ignored. But it is a great mistake to stake everything on the simple resource of mental equanimity. In some cases it is criminal, as for instance to refuse surgery for cancer, or outdoor living for tuberculosis.

In its proper place, "mind-cure" is an essential part of individual hygiene. In order to get the benefit of the other rules, there must be no worrying or watching of symptoms. After the regimen of exercise, baths, diet, etc., has been selected, it must be followed as a matter of course, with confidence that it will help, and with patience as to the rate of improvement which will follow.

[Sidenote: Worry]

It would seem that incessant, even if mild, worry is more exhausting than occasional fits of intense anger or fright or overexcitement, just as we waste more water from a spigot left slightly open all the time than from one which is alternately closed and wide open. Worry, if unceasing, will often drain away the largest store of nervous energy. Worry seems, as it were, to short-circuit nerve currents in the brain, which normally form a long circuit through the body. One man, with this simile before him, has found he can stop worrying almost at will, avoid the supposed continuous short circuit and save up his nervous energy until it is needed.

[Sidenote: Rejoice at Things as They Are]

We must rejoice at things as they are; they might be worse! If we should count up we should be surprised to find how seldom the things we fear or worry about really happen. It is a true proverb that "half the trouble never comes."

[Sidenote: Serenity an Art]

Each must learn for himself how best to avoid anger, fear, worry, excitement, hate, envy, jealousy, grief, and all depressing or abnormal mental states. To do so is an art which must be practised, like skating or bicycle-riding. It can not be imparted merely by reading about it.

[Sidenote: "One Day at a Time"]

When, as unfortunately is often the case, the difficulty of maintaining one's serenity seems insuperable, the battle can often be won by "living one day at a time." Almost any one in ordinary conditions of adversity has it within his or her power, for merely one day or at any rate one hour, or one minute, to eliminate the fear, worry, anger, or other unwholesome emotions clamoring to take possession. At the expiration of say the hour, or minute, the same power can be exercised for the next ensuing period, and so on until one is caught napping, after which he must pick himself up and patiently try again.

[Sidenote: The Hurry Habit]

In modern life, which has been gradually speeded to the breaking-point, many people are suffering from a constant oppressive sense of hurry. Most people have "so much to do," that they can not do it. This fact is of much annoyance and at the same time spurs them on in the vain endeavor to catch up. When once it is realized that the sense of hurry actually reduces the effective speed of work—in other words, that "the more haste, the less speed"—the situation has been reached in which the individual can teach himself some practical philosophy.

[Sidenote: Religion and Philosophy]

An immense help in the field of mental hygiene is to be obtained from religion and philosophy, although this is not the place to advocate any particular form of either, and from the standpoint of hygiene, it does not greatly matter! One may get his chief help from the Bible, from faith-healing cults, from writers like Emerson, from Tagore and other Orientals, or from Marcus Aurelius and Epictetus.

[Sidenote: "Religion of Healthymindedness"]

Professor William James commends the adoption of a "religion of healthymindedness" in which we renounce all wrong or diseased mental states, cultivating only the healthy ones, such as courage, patience, optimism, and reverence.

[Sidenote: The Habit of Happiness]

When the mind turns from shadow to sunshine, the body will tend also to assume the radiance of health. Stevenson said that there is no duty we so much underrate as the duty of being happy. The habit of being happy enables one to be freed, or largely freed, from the domination of outward conditions. Though the trait is apparently totally lacking in some, while existing to a high degree in others, experience has shown that conscious cultivation will develop it to an appreciable degree, even in very stubborn cases. As in little Pollyanna's "Glad Game," it is possible to find something to be glad about in every situation in life.

[Sidenote: Control of Attention]

The secret of equanimity consists not so much in repressing the fear or worry, as in dropping or ignoring it—that is, diverting and controlling the attention. It does no good to carry a mental burden. "Forget it!" The main art of mental hygiene consists in the control of attention. Perhaps the worst defect in the Occidental philosophy of life is the failure to learn this control. The Oriental is superior in such self-training. The exceptional man in Western civilization who learns this control can do the most work and carry the most responsibility. On much the same principle as the Indians used when their young men were trained to endure pain self-inflicted, we might well devote a few minutes each day to the difficult task of changing at will our attention from the thing which is engrossing it to anything else we choose; or, what is more difficult still, to blank nothingness. When we have sufficiently strengthened this power, we can turn off the current of our thoughts as we turn off the lights and lie down to sleep in peace, as a trained sailor does in a storm.

[Sidenote: Making Up One's Mind]

If a person's work is drudgery but has to be endured, the making up of the mind to endure it cheerfully, the relinquishment of the doubtful but fascinating pleasure of dwelling upon one's misery, is found to largely obviate the burden. It is the making up of the mind which presents the difficulty. The truth is that we instinctively shrink from making, without reservation, important decisions as to our future course of conduct. We balk even at really committing ourselves not to worry. A man who, when he complained of his lot, was advised to "grin and bear it," replied that he'd have to bear it, but he'd be hanged if he'd grin!

[Sidenote: Intensity of Desires]

The decision which is perhaps the hardest to make and, at the same time, the most important from the standpoint of health and working-power, is the decision not to care too much about the objects we are seeking to achieve. We need not subscribe to the Nirvana philosophy. A certain intensity of desire is normal, but modern life tends to a morbid frenzied intensity. Most of us need, in the interest of mental health or sanity, to moderate our desires. A business man who had set his heart on fulfilling a large responsibility nearly wrecked his health from worry over the outcome. His wise physician prescribed that, before sitting down to his desk each day, he should spend five minutes repeating and impressing on his mind the words, "I don't give a hang! I don't give a hang!" The truth is many people fail because of over-anxiety lest they fail. Some invalids die from an exaggerated desire not to die.

[Sidenote: Ruling Ourselves]

A helpful precept, when one is failing in some crucial undertaking from his very over-anxiety to succeed, is to replace the ambition to succeed by a determination to pass the crisis unruffled, whether one succeeds or fails, "He that ruleth himself is greater than he that taketh a city," and incidentally if we rule ourselves we are far more likely than otherwise to take the city, if that be possible at all.

An ideal course of conduct implies a constant readiness, after all has been done which can be done, to renounce one's feverish desires and accept whatever higher powers decree, even if it be death. This is one of the supreme aims of every great philosophy or religion. Job (13:15) said, "Though He slay me, yet will I put my trust in Him," and Christ exclaimed, "If it be possible let this cup pass from me; nevertheless, not as I will, but as Thou wilt."



Section I—The Fifteen Rules of Hygiene

The aids to health discussed in the preceding chapters may be summarized in specific formulas classified under the four heads, Air, Food, Poisons, and Activity, corresponding to the four chapters, and under fifteen sub-heads, corresponding to the fifteen sections.

I. AIR. 1. Ventilate every room you occupy. 2. Wear light, loose and porous clothes. 3. Seek out-of-door occupations and recreations. 4. Sleep out, if you can. 5. Breathe deeply.

II. FOOD. 6. Avoid overeating and overweight. 7. Eat sparingly of meats and eggs. 8. Eat some hard, some bulky, some raw foods. 9. Eat slowly.

III. POISONS. 10. Evacuate thoroughly, regularly and frequently. 11. Stand, sit and walk erect. 12. Do not allow poisons and infections to enter the body. 13. Keep the teeth, gums and tongue clean.

IV. ACTIVITY. 14. Work, play, rest and sleep in moderation. 15. Keep serene.

The application of these rules to one's daily life must be varied with each individual. The most practical method is for the individual to begin the improvement he would seek by constructing a typical day's program in which time is provided for, say, breathing and other exercises in bed, bath, toilet, walk to business, meals, amusement, etc., with special notes and memoranda as to the particular faults of omission and commission to be corrected. One might also, as Benjamin Franklin records in his autobiography, keep a daily record for a week as to how nearly the program is lived up to. By dint of such and other stimuli, the transition in habits can be made, after which the "rules" cease to be rules, as carrying any sense of restriction, and become automatic like putting on or taking off one's clothes.

Section II—The Unity of Hygiene

[Sidenote: The Rules Interrelated]

The above rules embody our preachment on individual hygiene. We have stated them as fifteen separate kinds of procedure. In actual life, however, our acts can not be so separated. The neglect or observance of one rule carries with it, to some extent, the neglect or observance of other rules. For instance, one can not take muscular exercise without, to some extent, taking breathing exercises. Swimming serves as a means of cleanliness, of skin gymnastics, of general exercise and of amusement. A game of tennis implies the practise, to some extent, of at least five of the fifteen rules.

The human body is a "harp of a thousand strings," which are intended to harmonize. If one of them is out of tune, it is likely to cause discord throughout, while to tune up one helps the harmony of all.

[Sidenote: Medical Specialists]

Any one ailment has a far-reaching effect throughout the system. It is because of this far-reaching effect that the "one idea" specialist in medicine has so often thought his particular specialty to be the one and only gateway to all therapeutics and hygiene. The oculist is liable to look at all ailments as related to the eyes; the dentist as related to the teeth; the mental hygienist as related to wrong attitudes of mind. If we examine their claims, we find that they are usually right in their affirmations, though wrong in their denials. It is their affirmations in which we are here interested. They find that the ailments within their own special province extend in unsuspected ways, and to a surprising degree into seemingly remote fields; and that to remedy the special defect which they can treat, will often go a long way toward remedying numerous other ailments.

[Sidenote: Remote Effects of Ailments]

It has already been noted that eye-strain leads to an astonishing number of serious nervous affections, and that corrective eyeglasses will often work wonders for remedying those ailments and improving the general health. There may be other unhygienic conditions equally responsible for these symptoms, and the correction of which may produce equally wonderful improvement. Vertigo may be due to eye-strain, or it may be due to wrong posture or to pressure of wax on the ear-drum. Diabetes may be aggravated by too much sugar, by infected tooth-sockets, or by too much worry. Tuberculosis may be due jointly to indoor-living, lack of exercise, wrong diet, wrong posture, sexual excess, alcohol, nerve-strain, and numerous other preconditions, besides infection with the tubercle bacillus. The social evil can be fought not only directly by attack on prostitution, and by appeals to self-control and moral ideals, but also indirectly by diminishing the consumption of alcohol and other drugs, for alcohol not only produces abnormal sexual desire but reduces the strength of will by which that desire is repressed. Forel asserts that the social evil can not be controlled until the use of alcohol as a beverage is abolished.

[Sidenote: Popular Delusions]

It is not uncommon for people to attribute their ailments to the less important rather than the more important cause, and so fail to get the best benefits of hygiene. Many people bemoan the fact that they sat in a draft and "therefore" caught cold, when what they most needed was not to keep out of drafts but to keep in such condition that drafts would do them good, not harm. Benjamin Franklin, a century ago, believed, what we now know to be true, "that people who live in the forest, in open barns, or with open windows, do not catch cold, and that the disease called 'a cold' is generally caused by impure air, lack of exercise, or overeating."

[Sidenote: So-called "Overwork"]

Most people who are "overworked" are, more properly speaking, simply the victims of bad air, bad diet, poisons, or worry. They believe that because they are tired it must be work which is hurting them. The man who breaks down in middle life commonly imagines that he has ruined his health by overwork. The college girl thinks she has ruined her health by study. All these "overworked" people prove their case by showing that they improve in health when given a vacation. This simply shows that a bad condition can often be remedied by improving the general health in any way whatever, even if the primary source of the difficulty is not reached. They are undoubtedly working beyond their working capacity; but their working capacity is only a fraction of what it would be if they took exercise, were not constipated, did not eat too much, abjured alcohol, or ceased to worry continually. If they lived hygienically in these respects, the work which was a drag might be an inspiration. A physician of wide experience says that every day men come to him broken down in health, invariably telling him that they have overworked; and yet upon questioning them he finds that none of them works as hard as he. Their breakdown was due to the terrible load of unphysiological habits which they had been carrying—a load so great that scarcely any work could be carried in addition.

[Sidenote: An All-round Regime]

Other examples might be given of ascribing ailments and disabilities to the less important instead of the more important causes. The error is almost always made of resting the blame on only one cause. In consequence most health-seekers make the mistake of making only one correction in their daily regime of life. One will cease alcohol drinking, another will give up tobacco smoking, another will give up coffee; a third will cease using all "red meats," another turns vegetarian, another adopts a raw food diet; another takes up outdoor sleeping; another adopts a daily game of golf; another embraces a mental healing cult; another takes up mastication. But great and permanent results require the adoption of an all-round, well-balanced regime.

Section III—The Obstacles to Hygiene

[Sidenote: Effort of the Will]

It is not enough that the individual should know how to live. Knowledge is of no avail without practise. Mr. Moody, the evangelist, once said of religious conversion, "Merely to know is not to be converted. I once boarded a train going in the wrong direction. Some one told me my mistake. I then had knowledge, but I did not have 'conversion' until I acted on that knowledge—seized my traveling-bag, got off that train, and boarded one going in the opposite direction." Many people are on the wrong train in hygiene, as in religion, and know it. They are traveling fast to that kind of perdition which in the end unhygienic living always brings. In fact, a great many people practise unhygienic habits more through indifference than through ignorance. Most people have acquired, by imitation of their neighbors, a great number of unhygienic habits and have continued in these habits for so many years, that they can not get rid of them, except through a great effort of will. This effort they are usually unable or unwilling to put forth unless very strong incentives are brought to bear. Often—in fact, if the truth were known, usually—they wait until ill health supplies the incentive. The man who is most receptive on the subject of health conservation, is, in the majority of cases, the man who has just had some ominous warning of coming ill health; although there is now a small but increasing number who do not wait so long, men who pride themselves on keeping "in the pink of condition." These are the men who are rewarded for their efforts by enjoying the highest reaches of working-power.

[Sidenote: Cost of Good Health]

The ordinary man, in ordinary good health, does not want or thinks he does not want to live hygienically. He sees all sorts of imaginary objections to adopting a hygienic life, and closes his eyes to its real and great advantages. One of the objections often trumped up is that the practise of hygiene costs too much—that it can only be a luxury of the rich. It is quite true that here, as elsewhere in human life, wealth confers great advantages. The death-rate among the rich is always less than that among the poor. And yet the rich have unhygienic temptations of their own, while the poor, on their part, are far from living up to their opportunities.

[Sidenote: Missionaries]

There are really only two material disadvantages from which the poor suffer in their opportunities to live a healthy life: One is unhygienic housing, both at home and at work; the other is unhygienic toil. It must be admitted that millions of unfortunates are unable individually to remedy these two disadvantages in their lot in life. Yet they can, even in these two respects, accomplish much if they take an intelligent interest in hygiene. The graduates of tuberculosis sanatoria are largely among the poor and they are doing much good missionary work in securing better ventilation, both in the home and in the workroom. They find this possible partly by insisting on more open windows in home and workshops, partly by changing their home to one better equipped with windows or situated in the suburbs instead of in the city, partly by changing their occupations, partly by getting the cooperation of their employer or simply by cooperating with him when he is ready to do his part. The workman can also accomplish something through the Trades Unions, especially in regard to hours of work. Employers will increasingly cooperate in this movement, as they come to realize that the securing of efficiency in their workmen is to their interest, and that monotony, long hours, and other unhygienic elements which are now, through sheer carelessness, often imposed on their workmen, bring back in the end big financial losses on themselves.

Except for the evils mentioned—those of housing and working conditions—there are few people so poor that they can not buy the means of living a healthy life. In fact, hygiene is one of the few precious gifts which can be had almost for the asking. Most people can sleep out-of-doors, if they will—if in no other way than by the so-called indoor window-tent—or can take deep-breathing exercises without cost. It costs nothing to stand, sit, and walk erect, to evacuate thoroughly, regularly, and frequently. It costs less than nothing to avoid overeating and overweight, and to be totally abstinent from alcohol and tobacco.

[Sidenote: Cost of Food]

Almost all can allow enough time for meals to eat slowly. Coarse and raw foods are always to be had and are usually cheaper than the conventional soft, concentrated cooked foods. In fact, meat, eggs, and like foods are among the most expensive and the least desirable. If we compare the cost of flour and of the other cheapest food materials, with the cost of oysters, one of the dearest, we find that the latter is fifty times as expensive as the former for the same food value. This takes no account, of course, of the expenses involved in cooking either of them. It has been proved by actual experience that one can live in the best of health on food costing as low as ten cents a day, exclusive of the labor of preparing, cooking and serving. Mrs. Richards, in her "Cost of Food," says that this is possible anywhere in America within fifty miles of a railroad. The only real objection to living on this minimum expense is the lack of variety. The following is a brief list of foods in ascending order of cost per 100 calories of food value, the cheapest being at the beginning and the dearest at the end: glucose, corn-meal, wheat-flour, oatmeal, cane-sugar, salt pork, rice, wheat bread, oleomargarine, beans, peas, potatoes, butter, milk, cheese, beef-stew, ham, mutton-chops, beef, eggs, and oysters. If the foods in this list be looked up in the table given in the SUPPLEMENTARY NOTES for their protein, fat, and carbohydrate contents, it will be seen that a well-balanced ration is possible without the use of expensive foods. In fact, among the cheap foods are some consisting mostly of protein, some consisting mostly of fat, and some consisting mostly of carbohydrate. For instance, cheap sources of protein are skim milk, beans, cheese, and peanuts. Cheap sources of fat are oleomargarine and cottonseed-oil. Cheap sources of carbohydrate, i.e., starch and sugar, are bread, bananas, potatoes, glucose, and even ordinary sugar. If a diet, selected for cheapness, is not at first well balanced, a judicious admixture of one or more of the foods just mentioned, will restore equilibrium. A cheap bulky food is cabbage.

[Sidenote: Repaid Cost]

Most of the rules of hygiene cost nothing to observe. But even when hygiene is costly at first, the cost is usually repaid in the end many times over. To ventilate a house in winter always costs a certain additional expenditure for coal, but it is better to pay the coal bill than the doctor's bills. To sleep out-of-doors costs some extra blankets, bedding, clothing, and roll curtains, but these not only save the cost of heating an indoor sleeping-room, but save also the cost of ill-health. There is no better economy than to keep one's working-power. To lose it means to lose its earnings and to have, in addition, the heavy expenses of medical attendance, medicines, and nursing, and often to lose life itself with its potential earnings of every sort. In short, an unhygienic life, for the sake of economy, is "penny-wise and pound-foolish."

[Sidenote: "I Have No Time"]

Many busy men object to hygiene because, they say, they have no time for it. They imagine that to devote an hour each day to exercise or relaxation is a waste of time and that they are really economizing their time by working that hour instead. We are here referring, not to those who can not control their working-time, but to those who deliberately choose to work when hygiene would require them to play. It is often those who fix their own working-hours, rather than those whose working-hours are fixed for them, who overwork the most. If these could know the suffering which sooner or later follows inevitably as the consequence of this mistaken policy, they would not pursue it for a single day. A slight loss of working-power comes immediately. A careful observer of mental workers found that an hour invested in exercise in the afternoon often pays for itself within a day, by rendering possible more rapid work. He also found an improvement in the quality of his work. The razor-edge of the mind needs daily honing through physical exercise. The same principle applies to all work. It is just as necessary to stop, at intervals, our physical and mental machinery for oiling and repairs, as to stop the machinery of a factory.

[Sidenote: "Too Much Trouble"]

Another objection is that the practise of hygiene is "too much trouble." It is undoubtedly true, that no one who has unhygienic habits can overcome them without a certain amount of "trouble." The people who get the best results are those who are never deterred by trouble so long as the trouble is worth while. For those who have not the necessary enthusiasm or self-control to break their unwholesome habits by sheer will power, the best advice is to so arrange their lives as to make the practise of hygiene inevitable. One physician in Chicago deliberately got rid of his automobile and other means of locomotion in order to force himself to walk to all his patients, and so secure enough physical exercise. Another man in New York City, with the same object in view, selected the location for his dwelling so that there was no rapid transportation available to take him to his office, making the walking back and forth a necessity from which he could not escape.

[Sidenote: Simplicity of Hygienic Living]

The only difficulty lies in overcoming the inertia of acquired habits. After one has changed his habits, it is just as easy to live rightly as to live wrongly. The rules of hygiene are not restrictive, but liberating. They may seem at first restrictive, for they prohibit many things which we have been in the habit of doing; but they are really liberating, for the things we were doing were unrealized restrictions on our own power to work, to be useful, or even to enjoy life. The "rules" of hygiene are thus simply the means of emancipating us from our real limitations. These so-called rules, when tried, will prove to be not artificial but natural, not difficult but easy, not complicated but simple. They are almost as simple as the direction to bathe in the river Jordan. It is, in fact, their very simplicity and availability to which is largely due their deplorable neglect and the failure to realize the wonderful benefits following their careful and continued observance.

[Sidenote: The Evil of Romancing]

Not only a healthy mental attitude toward life, but a healthy mental attitude toward one's own unhygienic habits is essential. It is a very common thing for a man to romance over his shortcomings, or his unhealthy physical conditions, to make humor of them to his friends. Very often the first step toward a better physical condition is a change in this mental attitude.

Section IV—The Possibilities of Hygiene

[Sidenote: The Preventability of Disease and Death]

Certain it is that more people would practise hygiene if they could be made to realize in some vivid way how much they needed it. Few persons, even when they read and accept the statistics on the subject, really have a picture of the imperative need of hygiene as an integral part of every human life. It is not brought home to them how widespread is illness, how numerous are preventable deaths, how many are the tendencies toward individual and racial deterioration.

The report of the Roosevelt Conservation Commission on National Vitality, indicates that annually there are in the United States over 600,000 deaths which might be prevented if existing knowledge of hygiene were properly applied; that at least half of the 3,000,000 and more sick-beds constantly kept filled in the United States are unnecessary; that the financial loss from earnings cut off by preventable disease and premature death amounts to over $1,500,000,000 annually; and that over 15 years are lost to the average life through the lack of application of knowledge which already exists but which simply has not yet been disseminated and applied.

[Sidenote: Impairments Unsuspected]

The health examinations of the Life Extension Institute have revealed unsuspected ailments in persons who considered themselves well, and to an extent which has astonished even those who have long been familiar with these subjects. Among large groups of clerks and employes of banks and commercial houses in New York City with an average age of 27 and all supposedly picked men and women, only 1 per cent. were found free of impairment or of habits of living inviting impairment. Of those with important physical impairments, 89 per cent. were, prior to the examination, unaware of impairment; 16 per cent. of the total number examined were affected with organic heart trouble, 42 per cent. with arterial changes, ranging from slight thickening to advanced arteriosclerosis, 26 per cent. with high or low blood pressure, 40 per cent. had sugar, casts, or albumin in the urine, 24 per cent. had a combination of urinary and other serious impairment, 47 per cent. had decayed teeth or infected gums, 31 per cent. had faulty vision uncorrected.

Among industrial groups, not exposed to any special occupational hazard or poisoning, the figures were as follows: With an average age of 33, none were found to be free of impairment or habits of living inviting impairment. Of those with important physical impairments, 89 per cent. were, prior to the examination, unaware of impairment; 3 per cent. of the total number examined were affected with organic heart trouble; 53 per cent. with arterial changes, ranging from slight thickening to advanced arteriosclerosis; 23 per cent. with high or low blood pressure; 45 per cent. had sugar, albumin or casts in their urine; 26 per cent. had a combination of urinary and other serious impairment; 69 per cent. had decayed teeth or infected gums; 41 per cent. had faulty vision uncorrected.

[Sidenote: Minor Ailments]

There are few persons in America to-day who reach the age of forty sound and normal in every part of the body, especially if we include among abnormalities the minor ailments. The extent to which minor ills are prevalent among those who pass for "well" people is not generally appreciated. Once we penetrate beneath conventional acquaintance we almost invariably learn of some functional trouble, such as impairment of heart, circulation, liver, kidneys, stomach; or gallstones, constipation, diarrhea; or insomnia, neurasthenia, neuritis, neuralgia, sick-headache; or tonsillitis, bronchitis, hay fever, catarrh, grippe, colds, sore throat; or rupture, enlarged glands, skin eruptions; or rheumatism, lumbago, gout, obesity; or decayed teeth, baldness, deafness, eye ailments, spinal curvature, flat foot, lameness; or sundry other "troubles."

These ailments, though regarded as "minor," should be recognized promptly and accepted as the signal that the person is moving in the wrong direction. There is no need for alarm provided this warning is heeded. Otherwise disaster is almost certain sooner or later to follow. The laws of physiology are just as inexorable as the laws of physics. There is no compromising with Nature. No man can disobey the laws of health to which he has been bred by Nature without paying for it—any more than a man can sign a check against his bank account without reducing the amount. He may not be immediately bankrupt, and until he exhausts his account he may not experience any inconvenience from his great extravagance, but Nature keeps her balances very accurately, and in the end all claims must be paid.

[Sidenote: The Personal Equation]

It is true, of course, that some persons have greater resistance than others. If we had a convenient barometer by which to measure daily the state of our vitality, we might register the effect of every unhygienic act. But it is so seldom that endurance is accurately measured that few people appreciate the enormous differences in people and the variations of the same person at different times. These differences and variations have a range of many hundred per cent. Some people can not walk upstairs or run across the street without being out of breath, while others will climb the Matterhorn without overstrain. The fact that certain people have lived to the century-mark in spite of unhygienic living is sometimes cited to prove that hygiene is ineffective. One might as well cite the fact that certain trees are not blown down in a gale or are not quickly destroyed by insect-pests to prove that gales have no tendency to blow down or insects to destroy trees.

[Sidenote: Over-confidence]

The truth is that a person who has so much vitality as to lead him to defy the laws of health and to boast that he pays no price no matter how he lives, is likely to be the very man to exhaust his account of health prematurely. There was, a few years ago, a famous American, possessed of prodigious bodily vigor. He ought to have lived a century. Unfortunately he had this "insolence of health." He was warned several times against overwork, lack of sleep, and abuse of his digestion. But he merely smiled and claimed that such warnings were for others, not for him. He met an untimely end, due as his physicians believed and as he himself acknowledged, when too late, to his abuse of the great powers with which Nature had endowed him and to the neglect of personal hygiene.

[Sidenote: Possible Health Attainment]

Conversely, an observance of the laws of hygiene affords wonderful results in producing vitality and endurance. Insurance companies are discovering that even weak and sick people, will, if they take good care of themselves, outlive those with robust constitutions who abuse them.

To those unfamiliar with the subject in its larger aspects, the possibilities seem almost beyond belief. As an example of the wonderful gains which can be secured by obeying the laws of hygiene may be cited the case of a young man who a few years ago was scarcely able to drag himself into the sun in Colorado, where he was endeavoring to rid himself of tuberculosis. He not only succeeded, but subsequently, by dint of following substantially all of the rules of hygiene here laid down, became an athlete and capable of running twenty-five miles for sheer love of sport and apparently without the overstrain experienced by "Marathon" runners. Kant and Humboldt are cases typical in different fields of achievement of many of the world's most vital men who have actually made over their constitutions from weakness to strength. Cornaro says that it was the neglect of hygienic laws which made him all but a dead man at thirty-seven, and that the thoroughgoing reform of his habits which he then effected made him a centenarian. His rules, drawn up four hundred years ago and described in his interesting work "The Temperate Life," are, so far as they are explained, almost identical with those given in this book. It is difficult to assign a limit to the good which can be accomplished by practising these rules and so minimizing the poisons which usually narrow and shorten our lives.

[Sidenote: Immortal Animal Cells]

So far as science can reveal, there seems to be no principle limiting life. There are many good and bad reasons why men die, but no underlying necessary reason why they must die. The brilliant Carrel has kept tissue cells of animals alive outside of the body for the past three years. These cells are multiplying and growing, apparently unchanged by time, to all appearances immortal so long as they are periodically washed of poison and nourished in a proper medium. If we could at intervals thoroughly wash man free of his poisons and nourish him, there seems to be no reason why he should not live indefinitely.

Section V—Hygiene and Civilization

In view of the vast extent of human misery from ill health, the question naturally arises, How does it happen that the world is burdened with so colossal a load? Is it no more than is biologically normal? Is it true that in other organisms, animals and plants, ill health is the rule rather than the exception? Are all races of men subject to the same heavy load?

[Sidenote: Natural Adjustments Upset]

These questions have not yet received sufficient attention. The answer seems to be that man is suffering from his own mistakes made unconsciously and in ignorance. He has upset the equilibrium which Nature had established among the various powers and activities of his body, and between himself and the outside world. Man has done mischief for his own body similar to what he has done for the natural resources on which he lives. In Professor Shaler's epoch-making little book, "Man and the Earth," he shows, for instance, that the little layer of soil on the surface of the earth from which plants and animals derive their nutriment was, before the advent of man, replenished quite as fast as it was washed away, but that after man had put his plow into it and had taken off the protective mat of vegetation, he unconsciously despoiled the accumulation of ages. "In a plowed field, an hour's torrential rain may wash off to the sea more than would pass off in a thousand years in the slow process of erosion which the natural state of the earth permits." He also shows that the constant croppings of the soil rob it of nitrogen, phosphorus, and other elements faster than Nature restores them. The problem of conservation is to reestablish the balance which has been lost through the depredations of man, for instance, to lessen soil-wash by terracing, and to restore to the soil the lost elements by supplying nitrates and phosphates and by other methods of scientific farming.

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