Chapter 3 POISONS

Section I-Constipation

If the human body be likened to a steam-engine, its wastes correspond to the ashes.

Retention of Body Wastes

The injury which comes from the retention of the body's waste products is of the greatest importance. The intestinal contents become dangerous by being too long retained, as putrefying fecal matter contains poisons which are harmful to the body. Abnormal conditions of the intestines are largely responsible for the common headache malady, and for a generally lowered resistance, resulting in colds and even more serious ailments. Constipation is extremely prevalent, partly because our diet usually lacks bulk or other needed constituents, but partly also because we fail to eliminate regularly, thoroughly, and often.

Constipation, long continued, is by no means a trifling matter. It represents a constant and cumulative tax which often ends in very serious consequences.

Water-Drinking

Free water-drinking when the stomach is empty, especially before breakfast, is beneficial in constipation. Free water-drinking at meals may prove constipating. Excess of water should be avoided by the very feeble or those suffering from heart trouble or dropsy.

Laxative Foods

The best regulators of the bowels are foods. Foods should possess sufficient bulk to promote the action of the intestines and should contain a due amount of laxative elements. Foods which are especially laxative are prunes, figs, most fruits except bananas, fruit juices, all fresh vegetables, especially greens of all sorts, wheat, bran, and the whole grain cereals. Oils and fats are also laxative but can not be used in sufficiently large quantities to produce very laxative effects without producing loss of appetite. Foods which have the opposite tendency are rice, boiled milk, fine wheat-flour in bread, corn-starch, white of egg.

Bran and Agar-Agar

The use of wheat-bran in cereals, in bread, and even in vegetables is a preventive of constipation, as is also the use of agar-agar, a Japanese seaweed product. This is not digested and absorbed, but acts as a water-carrier and a sweep to the intestinal tract. It should be taken without admixture with laxative drugs.

Mineral Oils

Paraffin oil is especially good as an intestinal lubricant to assist the food to slip through the intestinal tube at the proper rate of progress, provided the oil is first freed, by long-continued shaking with water, from certain dangerous impurities. Many refined preparations are on the market for use in constipation. Underweight people should not use these oils unless properly prescribed by a physician.

Avoiding Drugs

It is advisable, in general, to avoid cathartics except under medical supervision, since certain drugs are often very harmful when their use is long continued and the longer they are used the more dependent on them the user becomes. Laxative drugs, even mineral waters, should never be used habitually.

Enemas

The occasional, but not habitual, use of an enema (with warm water followed always by a second enema of cool water, to prevent relaxation) is a temporary expedient.

Massage of the Colon

Massage of the abdomen, deep and thorough, with a creeping movement of the ends of the fingers on the left side of the abdomen from above downward, also promotes the process of defecation.

The normal man and woman should find no difficulty in having complete movements regularly two or three times a day by merely living a reasonable life, being careful especially to avoid overfatigue, to include sufficient bulk in the food, to take regular exercise, including, in particular, breathing exercises, and to maintain an erect carriage.

Low Seated Water Closets

High-seated water closets, so often found in institutions, hotels and private houses, often favor constipation, as they do not permit of the proper physiological attitude in defecation. They prevent the individual from exercising abdominal pressure so essential for this function. Such seats should be made much lower than they are, or the feet should rest on a foot stool, in order to attain the proper attitude for thorough emptying of the intestine.

Number of Defecations

Observations on the manlike apes show that they defecate three or four times a day. Few of the human family have such ideal movements. Millions are conscious of some shortcoming in this regard, and doubtless millions more suffer from some shortcomings of which they are not conscious. Many believe they have free movements when actually they are suffering from a sluggishness in the rectum and other parts of the lower intestine. A rectal examination often reveals unsuspected fecal residues.

Establishing Proper Habits

The natural instinct to defecate, like many other natural instincts, is usually deadened by failure to exercise it. Civilized life makes it inconvenient to follow this instinct as promptly as, for instance, a horse does. The impulse to go to stool, if neglected even five minutes, may disappear. There are few health measures more simple and effective than restoring the normal sensitiveness of this important impulse. It may require a few weeks of special care, during which cold water enemas at night, following evacuation by paraffin oil injection, may be needed. It would be an excellent rule to visit the closet immediately after the noon and evening meals, as faithfully as most people do after the morning meal, until the reflex is trained to act at those, the most natural, times for its action.

Before leaving the subject of intestinal poisoning, we may here again mention the importance of avoiding the poisoning which comes from too much protein. This poisoning is probably due largely to the decomposition of protein in the colon.

Use of Sour Milk

One proposed method for reducing this decomposition of protein is through the use of sour milk. Lactic acid, the acid of sour milk, constitutes a medium in which putrefactive germs do not thrive. Hence, if sufficient sour-milk germs can be kept in the intestines to constantly manufacture lactic acid, putrefaction will be reduced. But, as Professor Rettger and others have shown, the mere swallowing of a little sour milk or of sour-milk tablets is seldom sufficient. The "good germs" swallowed die of starvation before they do much good. To keep them alive and enable them to multiply, we must feed them. The free use of milk and of milk sugar, a little raw starch, or partially cooked cereal such as Scotch brose (oatmeal cooked only ten minutes) will feed the germs.

Evidences of Injury

The odor and character of the stools are indicative of the extent to which our diet is injuring us. The odor is less offensive if the diet is low in protein and thoroughly masticated.

Section II-Posture

One of the simplest and most effective methods of avoiding self-poisoning is by maintaining an erect posture. In an erect posture the abdominal muscles tend to remain taut and to afford proper support or pressure to the abdomen, including the great splanchnic circulation of large blood-vessels. In an habitual slouching posture, the blood of the abdomen tends to stagnate in the liver and the splanchnic circulation, causing a feeling of despondency and mental confusion, headache, coldness of the hands and feet, and chronic fatigue or neurasthenia, and often constipation.

A slouching attitude is often the result of disease or lack of vitality; but it is also a cause.

The "Consumptive Stoop"

There is some reason to believe that "the consumptive stoop" leads to tuberculosis partly through the lowering of resistance resulting from the poisoning produced by a chronically relaxed abdomen.

Many persons who have suffered for years from the above-named symptoms have been relieved of them after a few weeks of correct posture, sometimes reenforced by the artificial pressure of an abdominal supporter and by special exercises to strengthen the abdominal muscles.

Lying face downward with a pillow under the abdomen presses the blood out of the congested splanchnic circulation.

Breathing and Posture

Breathing exercises are also very useful for correcting the chronic evils of bad posture. Exercises taken when lying on the back, by raising the legs or head, strengthen the abdominal muscles. Slow, deep breathing, through the nose, while lying on the back, with a weight on the abdomen, such as a bag of sand-2 to 4 lbs.-is beneficial.

Standing and Walking

In walking, the most common error is to slump, with the shoulders rounded, the stomach thrust out, the head thrust forward, chin up, and the arms hanging in front of the body. To those who walk or stand in this fashion, let it be known that this is the "habitus enteroptoticus," or asthenic droop. It is characteristic of those with weak muscular and nervous systems.

To set the shoulders back and square them evenly, to keep the chest high and well arched forward, the stomach in and the neck perpendicular, like a column, and the chin in, are simple fundamental measures that most people know and many people disregard.

One should have a sense of the firmness or tautness of the abdominal muscles and not of flabby relaxation. When one changes a slouching posture into an erect posture, there is a sense of having reversed the way the body hangs, as it were, on the spinal column.

Whether sitting, standing, or walking, these principles, that involve a correct and pleasing carriage and a healthful relation of the organs and structures of the body, should be observed by both men and women.

This perfect physical poise which places the muscles, organs, circulation, and even the brain and nervous system in harmonious relationship, adjusted for the best achievement, is well expressed in sculpture dating back to 500–600 B. C., when the Spartans attained supremacy in Greece. This same poise and symmetry is shown in modern sculpture of fine types of manhood and womanhood.

The Feet

It is not enough to have an erect carriage and a well-poised head. We must also have well-directed feet. It is pitiable to think how the work of a fine head may be spoiled by misdirected feet. Weak foot, and its final stage, flat foot, are more common among women than they are among men, because it is not a purely local condition in the arch of the foot, as so many suppose, but primarily due to a general weakened condition of the leg muscles that support the arch. The more vigorous exercise of boys as compared to that of girls protects them in some degree from this malady.

Toeing Straightforward

Weak feet are gradually converted into flat feet by faulty standing and walking posture and lack of leg exercise. Toeing out, whether walking or standing, so commonly noted among girls and women, places a great strain upon the arches of the foot. The correction of this fault by persistent toeing in, Indian fashion, and daily exercise of the leg muscles (rising on the toes twenty to forty times night and morning), will do much to prevent flat foot.

Chairs

Not only in standing, but in sitting, erect posture has been found to be a much more important factor in the maintenance of good health than is generally supposed. A rocker, or any other chair which tilts, is restful to the abdominal circulation, if the lower back is properly supported. Bad posture is common among sedentary people. The ordinary chair invites it. Every chair should be modeled like most modern automobile seats, on a curve to fit the back. Almost any chair can be corrected by placing a cushion so as to support the hollow of the back of the sitter. The responsibility for correct posture rests, however, on the individual and not on the chair.

Sitting

In sitting at a desk or table, when reading or working, the common fault is to adopt a sprawling attitude, with the shoulders hunched up, the elbows stretched outward, the body too far away from the desk or table, and the weight resting on the buttocks. Very often the desk or table is too high and the arms can not rest easily upon it, thus causing a continuous strain on the structures around the shoulder-joints.

To correct this fault, use if possible a chair with a back that curves forward. Sit well back in the chair, but close to the desk, so that the fleshy inner part of the forearms may rest easily upon its surface without pushing up the shoulders.

When it is necessary to lean over a desk, acquire the habit of inclining the body forward by bending at the hips and not by distorting the chest.

The arms should hang easily from the shoulder and the elbows should not rest upon the table. The shoulders should be evenly square, as in the correct standing posture. In right-handed people, the light should fall over the left shoulder or directly from above. The body should rest upon the full length of the thighs, not solely on the buttocks, and the feet (not legs) be crossed and resting lightly on the ground on their outer edges. In other words, the position should be freed from strain, especially strain of special groups of muscles.

Pains, erroneously ascribed to rheumatism or sciatica, are often due to faulty posture. Writer's cramp and many other needless miseries are caused by neglect to develop proper postural habits in working or reading.

Posture in Children

In children faulty posture may mar the future of the individual by causing spinal curvature and physical deformities that interfere with physical and mental efficiency throughout life, and often lower the resistance to disease. Deep breathing through the nose and "setting up" exercises are of incalculable importance in such cases.

The various types of faulty posture are so numerous that they can not be listed here. Having once grasped the meaning of correct posture, however, we can form a standard for ourselves, and any departure from this standard should be looked upon as a menace to health. As in the case of eye-strain, flat foot, work, worry, and drink, much depends on the original physical and mental endowment of the individual as to how much harm results from faulty posture. But always some harm results.

Teaching Correct Posture

The teaching of proper standing, proper walking and proper sitting should be a part of all school discipline as it is at military schools, especially as there is the temptation to crouch over the school-desk-which is usually the source of the first deviation from natural posture. An infant before it goes to school usually has a beautiful, erect carriage, with the head resting squarely on the shoulders.

Posture and Character

An erect posture is attractive from an esthetic point of view, and for that reason is sure again to become fashionable with women, after a due reaction from the present slouching vagary. It is also closely associated with self-respect. We know that any physical expression of an emotion tends reflexly to produce that emotion. Therefore, not only does self-respect naturally tend to brace a man's shoulders and straighten his spine, but, conversely, the assumption of such a braced-up attitude tends to "brace up" the man's mind also. Tramps and other persons who have lost their self-respect almost invariably slouch, while an erect carriage usually accompanies those feeling their respectability. We jokingly refer to those whose self-respect verges on conceit as "chesty," while we compliment one who is not so extreme by saying, "He is no slouch."

Between the slouch and slink of the derelict and the pompous strut of the pharisee, or the swagger of the bully or the dandy, there is the golden mean in posture, which stands for self-respect and self-confidence, combined with courtesy and consideration for others.

Section III-Poisons from Without

The poisons which hitherto have been mentioned are those developed within the body, especially in the intestine. It is not alone important to keep down the total amount of poisons produced within the body. It is equally important to exclude the entrance of any additional poisons from outside.

Habit-forming Drugs and Patent Medicines

Among the poisons which must be kept out of the body should be mentioned habit-forming drugs, such as opium, morphine, cocain, heroin, chloral, acetanilid, alcohol, caffein, and nicotin. The best rule for those who wish to attain the highest physical and mental efficiency is total abstinence from all substances which contain poisons, including spirits, wine, beer, tobacco, many much-advertised patent drinks served at soda-water fountains, most patent medicines, and even coffee and tea. Many so-called patent or proprietary medicines contain habit-forming drugs, especially morphine, coal-tar preparations, caffein, and alcohol, and depend largely for their sale upon the effects of these harmful substances. Harmful preservatives and adulterants in foods, such as saccharin, should also be avoided.

Reducing the Habit

For some persons the inevitable mode of improvement will be by substituting the milder drugs for the stronger-beer for spirits, weak tea for beer. The exact extent to which the milder poisons are injurious has not yet been scientifically settled. Tea, for instance, if very weak and used moderately, is, presumably, not injurious to any marked degree to healthy persons. The trouble is, however, that sensitive people do not keep moderate. In fact, the natural tendency of drug-craving is in the opposite direction, from weak drugs to strong ones, as from beer to spirits. In actual fact, it is much easier to abstain than to be moderate. It should also be noted that the lax spirit in which many people make an exception to the rules of health in favor of some mild indulgence is very likely to lead to the making of many other exceptions until they are, without knowing it, carrying a heavy load made up of scores of little items of harmful indulgence. Moreover, experiments at the Pasteur Institute have shown that the long-continued use of very minute doses of poison ultimately produces appreciable harm. Each person must decide for himself how far he chooses to depart from previous habits or common customs for the sake of physical efficiency. The object here is to state exactly what, in our present state of knowledge, is believed to be the truth.

Those with feeble digestions or unstable nervous systems are especially harmed by these poisons. A family history of nervously inclined people calls for rigid care in such matters.

Alcohol

Scientific experiments have resulted in the interesting discovery that the alleged "strength" obtained from beer, ales, and all intoxicating beverages is a delusion and a snare. The poison simply gives a temporary feeling of greater strength through paralysis of the sense of fatigue. But the strength does not exist. On the contrary, the user of alcohol in excess is weaker after taking it. Special classes of workmen have been tested as to their efficiency under liquor in small amounts and without it entirely, and it was invariably found that the liquor was a handicap, but that, also invariably, the workmen thought they could work harder by its aid! Alcohol numbs the sense of fatigue and so deceives the user. It is not a stimulant but a narcotic. The habit of taking a cocktail before meals is doubly harmful, because it is often taken on an empty stomach and because it poisons the system more quickly than when mixed with food and retained in the intestines.

Alcohol and Infectious Diseases

It is well known that people who indulge in alcohol show less resistance to infectious diseases than abstemious individuals. The paralysis of the white blood-corpuscles is one of the strong arguments against the use of alcohol. The experience of life insurance companies in England and America has clearly shown that even the "moderate" use of alcoholic beverages shortens human life. (See "Alcohol" in Supplementary Notes.)

Dr. Stockard has also shown in mice, on which he has experimented, that the effect of alcohol on the germ-plasm is distinctly injurious. It is a fair inference that the use of alcohol by parents tends to damage their offspring.

Tobacco

The evils of tobacco have not been so much studied and are not so well understood as those of alcohol. But every athletic trainer observes that the use of tobacco lessens physical fitness. The ordinary smoker is unconscious of this and often denies it. He sometimes says, "I'll stop smoking when I find it hurting me; it doesn't hurt me now." The delusive impression that one is well may continue long after something has been lost from the fitness of the body, just as the teeth do not ache until the decay has gone far enough to reach the nerve.

At Yale and at Amherst it has been found, by actual measurement, that students not using tobacco during the college course had gained over the users of tobacco in weight, height, growth of chest, and lung capacity.

Prof. Pack, of the University of Utah, finds that tobacco-using athletes are distinctly inferior to those who abstain. Prof. Lombard, of the University of Michigan, finds that tobacco lessens the power of the voluntary muscles, presumably because of the depressing effect on the central nervous system. There is also much experimental evidence to show that tobacco in animals induces arterial changes. The present well-marked upward trend of mortality from diseases of the arteries offers a good reason for heeding such evidence and taking the safe side in every controversy regarding it. (See "Tobacco" in Supplementary Notes.)

Germs

The poisons so far mentioned are limited to the amounts taken. Infections with germs, however, bring in poisons, the quantities of which tend to increase with the multiplication of the germs. It is, therefore, especially important to avoid infections. We should not depend altogether on the protection of our health officers. We must guard our own individual bodies.

Colds and La Grippe Germs

Infections enter the body through the skin or mucous lining. The common cold is believed to enter by the nose. We may avoid exposure to infection from grippe and common colds by keeping away from congested public places when there is an epidemic of grippe or colds, or when we are ourselves fatigued or for any reason likely to catch cold.

The infections of common colds are always to be found in the nasal passages and become active when the individual is subject to fatigue or indigestion or both. The liability of catching cold is greater when the mucous lining is injured. Nasal douches are injurious and impair the protective ability of the mucous membrane. They should be used only on prescription. A very gentle, warm spray of weak salt and water may be used when the nose is filled with soot and dust. The fingers should be kept from the nose. Handkerchiefs should be frequently changed, or small squares of gauze used and subsequently burned.

Tuberculosis Germs

The germ of tuberculosis is probably conveyed oftenest through the sputum of consumptives, when this sputum has been allowed to dry, has become pulverized and is breathed into the system. All sputum should be burned. It is well to avoid rooms occupied by consumptives who are not careful with their sputum.

Mosquito-borne Malaria and Yellow Fever

Suitable wire netting will guard us from malaria and yellow fever, the infections brought by mosquitoes and flies. The mosquito often carries malaria, and in the tropics carries yellow fever and other diseases. As some one has said: "A yard of screen in the window is better than a yard of crape on the door." The greatest triumph in connection with the building of the Panama Canal was not the engineering but the reduction in the death-rate among the workers, which, on account of these insect-borne diseases, had previously prevented the successful execution of the undertaking.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 "tox?mia," 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.

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.

Keeping the Mouth Aseptic

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.

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.

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.

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.

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.

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.

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.

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.

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.

Alkaline Dentifrice

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.

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.

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.

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.

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.

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.

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.

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