CHAPTER VII. Miscellaneous

MISCELLANEOUS

CHAPTER VII

MISCELLANEOUS

MALNUTRITION

This condition may result from a lack of the proper amount of food and from unhygienic conditions. However, it is often found among the children who should be properly nourished, who have the very best of care and the most wholesome food. There is no definite standard by which to determine a case of malnutrition. The extreme cases are obvious, but a child may be simply underweight and still not be classed as a case of malnutrition. Up to eleven or twelve years of age a child is not usually considered properly nourished if he is 10% below the normal standard of weight for his age and height. If the food supply is insufficient in quantity or quality, if there are bad habits of eating, such as bolting the food, insufficient mastication, and irregular hours of eating, these should all receive proper attention. If, on the other hand, the supply of food is sufficient in quantity and quality, if all habits of eating are normal and there is malnutrition, it is because the food is either not properly digested or not properly assimilated, or both, and the child should receive prompt attention at the hands of a competent chiropractor.

Symptoms

The symptoms of malnutrition are very obvious and need no special mention here. Such children are usually irritable and fretful. They are of a nervous disposition and very active. They are usually very bright mentally and often excel in their school work. Children suffering with malnutrition are very susceptible to different incoördinations and may be sick a great deal.

Major Adjustment

In these cases, if the child is provided with food having sufficient nourishment, most excellent results will be obtained from chiropractic adjustments. A very careful analysis must be made in order to determine all the facts in the case for the major differs in different individuals. In some cases the major will be C.P. and K.P., in others S.P., K.P. and a lumbar, while in some cases Li.P. and Sp.P. may be involved.

INANITION

This is the term applied to the condition resulting from the lack of food assimilation, It affects principally young infants. It is characterized by a persistent loss of weight with more or less severe symptoms which may appear rather suddenly.

Symptoms

The infant’s pulse is weak and rapid and the temperature may be high. There is scanty urine, cold extremities and great muscular relaxation. The face presents a peculiar bluish gray color. There may be cyanosis. There is rapid irregular respiration. In the more severe cases there may be stupor, while in others the child is very restless and fretful. Pupils are contracted and the fontanel is sunken. The progress of the incoördination may be rapid and in very young infants death may occur quite suddenly. Breast feeding is very essential in these cases.

Major Adjustment

Inanition is really malnutrition in the young infant due to a lack of assimilation of nutrition. The major adjustment is C.P. or S.P. and K.P. In some cases Li.P. may be involved, while in others Spl.P. may enter into the combination.

MARASMUS

This condition is also called infantile atrophy and simple wasting. It is not very common and is usually found in institutions for infants. It affects infants who are unusually weak. It is said to result largely from improper food and feeding and also it is influenced by the surroundings. In these cases the methods of feeding and the character of food should be carefully investigated. If these are found satisfactory it will then be obvious that the food is not being properly digested. This calls for a careful analysis and adjusting of the child. In these cases the food can not be assimilated because it is not properly digested. There is a progressive and persistent loss in weight. The body temperature becomes subnormal, the lung expansion imperfect, emaciation very marked, the skin deeply wrinkled and the face and arms take on a very old appearance. The eyes appear very large, the temples and fontanels are sunken, and the abdomen becomes very prominent. The child is very susceptible to all forms of incoördinations and because of the extreme weakness may succumb quickly to any acute dis-ease. In some cases after the emaciation has become very marked there may be an unusual and sudden gain in weight due to a general edema. This condition may increase until all the tissues of the body become extremely water-logged. The large cavities, however, are very seldom affected. Infants under seven or eight months of age are likely to be affected by this edema.

Major Adjustment

These cases call for a combination major which consists of S.P. and K.P. and an Up.L.P. Excellent results will be attained in these cases if adjustments are given early enough in the stage of the incoördination. The patient is never too weak to be adjusted.

SCURVY

Scurvy is a condition resulting from faulty nutrition. It is characterized by a swelling of the joints, sometimes pseudoparalysis of the lower extremities and a spongy condition of the gums which have a tendency to bleed. There may be cachexia and anemia. This condition is supposed to result from a continuous diet lacking in the vitamin C.

Symptoms

Usually the first symptoms to appear are tenderness of the legs. This will be observed from the fact that the child cries when his legs are moved. Eventually this tenderness localizes about the knees and ankles and it is accompanied with swelling of these parts. The gums then become swollen and show a marked tendency to bleed. This swelling may produce pain sufficient to interfere with the child taking food. The child loses weight, becomes very fretful, and has a slight fever. There is a characteristic posture in which the hips are rotated outward, while there is a semi-flexion of the thighs and legs. The child will usually lie very quietly because any movement produces pain, especially in the legs. There is marked sub-periosteal hemorrhages which may be so great that the limbs will become twice their normal size. In severe cases epiphyseal separation is not uncommon. Scurvy is very often associated with rickets. However, it is affirmed that they are two separate conditions and not just different forms of the same condition.

Major Adjustment

This incoördination requires a combination major which will be found at C.P. or S.P. and K.P.

RICKETS

Rickets is also called rachitis and known by some as Barlow’s dis-ease. It is listed as a dis-ease of nutrition, although the most important anatomical changes which take place are those affecting the bones. This dis-ease is found among people of all classes. There is no race that is immune, yet some nationalities seem to suffer more frequently and severely than others. Negroes and Italians seem to be especially susceptible when placed in northern climates and congested quarters in northern cities. In general practice rickets is considered a rather uncommon incoördination, although in congested cities it will be found quite prevalent.

Symptoms

The first symptoms to appear are nocturnal restlessness and profuse sweating about the head during sleep. The restlessness is usually quite marked; the patient rolls and tosses a great deal, and almost constantly moves the head back and forth on the pillow. Because of the profuse sweating the child becomes very susceptible to colds, bronchitis and bronchial pneumonia. A case of rickets is rather easily recognized by the large head, the pigeon breast, beaded ribs, the deformities of the extremities, the swelling of the epiphyses of the wrists and ankles, and the prominent abdomen.

Deformities of the Head

Deformity of the head appears very early in the dis-ease and is due to the thickening of the cranial bones, producing the typical square head of rickets. This square head is known as caput quadratum. Numerous soft spots are formed in the cranial bones which when pressed upon give one the impression that he is feeling parchment. This is known as cranial tabies. The fontanels and sutures are very late in closing, sometimes as late as the third or fourth year. The large rachitic head must not be mistaken for hydrocephalus.

Deformities of the Thorax

The chest is deformed in such a way that the transverse diameter is decreased and the antero-posterior diameter is increased. This produces the typical pigeon breast. Such deformity is caused from the softening of the thoracic bones. Beading of the ribs is characteristic and is known as the rachitic rosary. These nodules are formed at the junction line of the costal cartilages and the ribs. While these nodules are always present, they are not always visible. The rachitic gurgle, which is a transverse depression extending from one side of the chest to the other and is about two inches broad, is also present.

Deformities of the Spine

The most characteristic deformity of the spine in rickets is a kyphosis usually involving the lower dorsal and the entire lumbar region, although lateral curvatures may appear. In a well defined case of rickets every bone in the body may be abnormally involved. The deformity of the spine results from a softening of the bones which give way under the weight of the trunk.

Deformities of the Extremities

A case of rickets usually presents characteristic curvatures of the bones. The long bones are, as a rule, involved symmetrically. Green stick fractures very often occur. In practically all cases of this dis-ease there is an arrested longitudinal growth in the bones. Because of this the height will often be very much less than that of the normal child. There is marked enlargement of the epiphyses at the wrists and ankles. The slight curvatures in the bones of the arms will be exaggerated when the child begins to creep and the curvatures in the legs will be increased when the child begins to stand and walk.

Deformities of the Abdomen

Due to the general motor minus condition of the abdominal muscles there is developed a condition known as pot belly. This enlargement is often exaggerated by intestinal indigestion and constipation. This constipation results from the motor minus condition which interferes with the vermicular movement of the intestinal tract.

Equation

The function that is primarily involved in rickets is nutrition, but this results in other functions being implicated. There is expansion minus especially in the development of the osseous tissue. The equation is N— with X—.

Major Adjustment

Most excellent results are obtained in rickets. It is very essential that the adjustments be given at the beginning before the deformities become marked. In the more chronic cases the incoördination will be checked by the adjustments and the patient will recover, but it will be obvious that the marked deformities such as genu varum, genu valgrum, enlargement of the wrist and deformities of the head can not be corrected in the chronic cases. The adjustment is At. or Ax., S.P. and K.P.

NEUROTIC CHILDREN

Neurotic symptoms may appear very early in infancy. They may be first noticed when the child is startled by sudden sounds or unusual sights. Ordinarily the infant, only a few weeks of age, will pay little or no attention to its surroundings. The neurotic infant, however, may be startled or badly frightened by its environment. Such infants are found to apparently fix their attention upon objects as early as the third or fourth week. If its attention is thus centered upon a person who should make a quick, unexpected move, the child often becomes terrified. In other cases the symptoms may manifest themselves in a muscular spasm, such as mild opisthotonos, and other conditions suggesting cerebral incoördination. In early infancy vomiting and diarrhea may be brought on by excitement. The vomiting takes place without nausea and may be excited either by food or water. This must be carefully distinguished from the spitting up of milk so characteristic in infancy. This is a perfectly normal process and seems to be Innate’s method of adaptation when the child has taken too much milk into the stomach. Vomiting in neurotic infants may even become so severe that it results in a loss of weight. The diarrhea occurs with no more apparent cause than the vomiting. If the stools are not too frequent the food will be well digested but the diarrhea may become so severe that the food passes through the intestinal tract undigested. This diarrhea may be very obstinate and then it results in serious malnutrition. As the child grows older the characteristic symptoms of infancy become less marked but the child continues to be extremely nervous, irritable and cross. This nervousness may be exaggerated by the surroundings. Such children usually have poor appetite and suffer from constipation. They are almost always poorly nourished and anemic. The pulse is usually more or less rapid and is generally affected by excitement. Such children are quite restless during sleep.

Neurotic children are often precocious but lack in concentration due to their restlessness. Headache is a very common symptom. There is a marked tendency toward habit, spasm and chorea.

Family

These conditions are classified in the spasms family.

Equation

The equation is not so well defined since the condition of nervousness is adaptative. Therefore the equation for the nervousness is I.A. If other symptoms appear the equation would depend upon the function involved.

Major Adjustment

It is maintained by most authorities that this nervousness is inherited, but it has been demonstrated clinically by Chiropractic that results are readily obtained by chiropractic adjustments. It is reasonable to assume that there are environmental conditions which might produce nervousness even in the small infant, but it is also recognized that if the child is normal he soon becomes accustomed to the peculiarities of the environment and pays little or no attention to them. Subluxations in the cervical region, usually atlas or axis, are found in these children. These subluxations may produce sufficient cord pressure to cause such symptoms as usually manifest themselves in malnutrition as so-called nervous indigestion and other symptoms which would indicate constitutional disorders. A very careful analysis reveals that the nervousness in some of these cases is adaptative to some other incoördination. If the nervousness is direct the major adjustment will be Up.C. with a possible combination of C.P. and K.P. If the nervousness is adaptative, then a very careful analysis must be made to determine the incoördination to which it is adaptative. The major then will be determined by the location and the family involved.

CONVULSIONS

A convulsion is a violent involuntary contraction of muscles which ordinarily contract only under direction of the will. It may be either clonic or tonic. A clonic convulsion consists of a spasm of the muscles with alternating contractions and relaxations while the tonic spasm consists in constant rigidity of the muscles involved. The contractions may be confined to certain muscles or sets of muscles as, for example, the muscles of the face, the trunk or the extremities. In some cases the muscles of the entire body are involved.

During the first eighteen months of life the child is more susceptible to convulsions than at a later age, although the condition is rather common during childhood. Convulsions accompany many incoördinations and are considered adaptative to some other condition. Therefore the first thing to consider in a case of this kind is the primary condition or the incoördination to which the convulsion is adaptative.

The more common conditions with which convulsions are associated are: Incoördinations involving the nervous system, such as cerebra-spinal conditions; rachitis; and organic and functional disorders. Any condition which produces an irritation of the nervous system may result in a convulsion of more or less violence. For this reason children are often subject to convulsions during dentition and disorders resulting in slight temperature. Cerebral tumors, abscesses of the brain, hydrocephalus and meningitis are examples of cerebral conditions in which convulsions are commonly found.

Subluxations in the upper cervical region are often produced at the time of birth which cause cord pressure, making the child susceptible to all conditions that would irritate the nervous system.

There may be K.P. subluxations interfering with the process of elimination resulting in an accumulation of poison within the body, or there may be other subluxations resulting in the production of toxines within the body and these will produce an irritation of the nervous system resulting in convulsions. Disturbances in digestion, affections of the respiratory tract, a sudden rise of temperature and incoördinations involving the gastro-intestinal tract are often responsible for convulsions. Convulsions are quite frequent at the onset of acute dis-eases such as whooping-cough, measles and mumps. They are often associated with enlargement of the thymus gland.

During the convulsion there may be loss of consciousness with tonic and clonic spasms in various degrees of severity. The urine may be voided and the bowels evacuated. In the very young infant a single attack may prove fatal, although this is rather unusual. When death occurs in this way it is most often due to asphyxia, or when the convulsions recur in rapid succession death will result from exhaustion.

The clinical picture is quite typical. Usually there is pallor of the face which may be followed quickly with a twitching of the facial muscles, and sometimes those of the hands and feet. In most cases the attack comes on without warning; the eyes become fixed and rolled backward; the twitching usually begins in the face and very soon the entire body is involved. The face is distorted by muscular contractions, the head is drawn backward and the neck is thrown forward; there may be frothing at the mouth. The pulse is irregular and weak, the respiration is shallow and feeble while there is cold perspiration of the forehead and it may also be on the body. The thumbs are turned into the palms and the hands are tightly closed. There is rhythmical convulsive movements consisting of alternating flexion and extension.

The attack usually lasts from a few minutes to half an hour and sometimes longer. The patient is left in a more or less state of exhaustion and the attack may be followed by stupor and coma. Very often convulsions in children over two years of age indicate the onset of some acute condition such as pneumonia or scarlet fever. However, convulsions may mean very little with small children that are extremely nervous. During the first few days of life they may be the result of temporary circulatory disturbances in the brain from prolonged pressure in difficult labor.

Family

All cases of convulsions are in the spasms family no matter with what other conditions they are associated. If there are other complications, and there usually are, the family for the complications will depend upon the functions involved.

Major Adjustment

When a chiropractor is called to see a child that is having convulsions he should make a very careful inquiry into the history of the case and try to find the associated incoördination. This is done for the purpose of determining the combination to be used. The major for location will be atlas or axis, while the combination will depend upon the associated condition. This may be K.P. or it may be S.P. or any other combination which would include the subluxation for condition.

Excellent results are obtained in cases of convulsions. The adjustment should be given as soon as possible. In many cases an adjustment of the atlas or axis will bring the child to consciousness and prevent a recurrence of the attack. The convulsion may be caused by an atlas subluxation with no accompanying condition. This is known as a direct convulsion and will respond very quickly to an adjustment.

NOCTURNAL ENURESIS

As early as the tenth or twelfth month of age the child may be trained to make known his desire to empty the bladder. However, with some children this may not be accomplished until two and a half years of age. If by the third year of age the child is unable to retain the urine for a normal length of time, it is evidence of some abnormality and should receive Chiropractic attention. The child is afflicted with what is known as enuresis, which may take place during the day or night, or both. If it occurs during the day, it is called diurnal; while if it takes place during the night, it is known as nocturnal. It is more likely to take place during the night, since it may be possible for the child to control the bladder during waking hours.

We are most concerned with the nocturnal enuresis, because this form causes the child more discomfort and it is more difficult to control than the diurnal.

We recognize nocturnal enuresis as an adaptative condition. That is, the emptying of the bladder is a perfectly natural process and will always take place under certain conditions. For example, if the sphincter muscle relaxes, the urine will be voided. In this event, we are not concerned in the voiding of the urine, but in the cause for the relaxation of muscle which prevented the bladder from retaining the urine. There are a number of conditions to which nocturnal enuresis is adaptative. The following are the most common:

Incoördinations involving the nervous system.

Highly acid urine.

Excessive quantity of urine.

Abnormalities and incoördinations of the bladder.

Irritation of the genital organs.

Incoördinations of the Nervous System

The incoördinations of the nervous system in which there may be nocturnal enuresis are those commonly found in extremely neurotic children, and children who are under-nourished and anemic. Chorea, neurasthenia and hysteria are examples of conditions in which nocturnal enuresis is very common. Nervous children are easily disturbed during sleep and are prone to dream, at such times the innate interpretation of the vibrations produced by the urine in the bladder reaches the educated mind and there is not sufficient reasoning of the conscious mind to enable the child to realize where he is or to prevent the following of the natural desire to urinate.

The inability of the child to control the bladder during acute illness must not be mistaken for habitual nocturnal enuresis; for this will be only temporary, and will disappear when the child recovers from the acute attack.

Highly Acid Urine

In some cases, the urine being highly acid, produces vibrations in the bladder which results in Innate Intelligence causing the sphincter muscle to relax, which results in the voiding of the urine. This is an adaptative action on the part of Innate to prevent the acidity of the urine from setting up an irritation in the bladder. If the urine remained in the bladder it would damage the tissues and call for an expenditure of energy for reparation; this is all prevented by getting the urine out of the bladder as soon as possible. The hyperacidity of the urine is the result of the lack of the expression of mental impulses in the body and should receive immediate attention, that the cause of the incoördination may be removed. When this is accomplished the nocturnal enuresis will cease.

Excessive Quantity of Urine

In some incoördinations there is abnormal thirst which results in the child drinking more water than is required for the normal bodily processes. The natural channel through which this excessive amount of water is excreted is through the kidneys. This results in the bladder being filled often, which necessitates the frequent passing of urine. The child might be able to control the bladder during waking hours and make his wants known; but in sleep, as the bladder becomes full, Innate would relax the sphincter muscle, which would allow the urine to escape in order to relieve the pressure. To overcome the nocturnal enuresis in a case of this kind, it is necessary to adjust for the cause of the excessive thirst; and when this is corrected, the bed wetting will cease.

Incoördinations of the Bladder

Abnormal conditions of the bladder will cause difficulty in retaining the urine for a normal length of time. An inflammation of the bladder is greatly exaggerated by the presence of urine, therefore an irritation would be set up which would result in a desire to empty the bladder. This would invariably result in nocturnal enuresis. An interference with the transmission of motor mental impulses to the sphincter muscle would be another cause for bed wetting. In this case, it would be impossible to retain the urine after a certain amount had passed into the bladder. This would result in enuresis, since there would be nothing to prevent the urine from passing freely from the bladder.

Irritation of the Genital Organs

In some cases there is an irritation of the genital organs resulting in the production of vibrations which, when the child is asleep, results in enuresis. This irritation may be produced by an adherent prepuce. Balanitis and phimosis are also quite common conditions. There may be an irritation of the rectum produced by pin-worms. Vaginal irritation may be the result of vulvovaginitis, or due to adherent clitoris.

Correction of the Condition

It is asserted by some that nocturnal enuresis in many cases is due largely to habit. We see no more reason for considering this condition a habit than for considering any other abnormal condition a habit. It is the result of interference with the transmission of mental impulses, and it is the duty of the chiropractor to find the condition to which nocturnal enuresis is adaptative and correct the cause of that condition.

Some parents have the idea that bed wetting is a habit, and the child should be punished in an effort to break him of the habit. This, however, is the wrong attitude and no good will be accomplished in this manner. Punishment will only tend to make the child nervous and the condition worse.

This condition yields so easily to Chiropractic adjustments that there is no reason for allowing a child to continue without relief from this most annoying condition. We have never seen a case that did not respond to adjustments after the proper analysis was obtained.

In analyzing a care of nocturnal enuresis it must not be taken for granted that the major is K.P., or even a lumbar. For this may not be true. A most thorough analysis should be made to determine the exact condition of the child. If the nervous system is involved, there will likely be found an atlas or axis subluxation. We have seen many cases that had been adjusted persistently at K.P. and a lumbar, but with no results, while an adjustment of the axis would get almost immediate results. This does not mean that every stubborn case will respond to an axis adjustment.

Scanty and highly colored urine, which has a tendency to scale and irritate the skin, usually indicates highly acid urine. In this case a careful analysis must be made to determine the cause of the acidity. The palpation will reveal a subluxation and most likely a hot box at C.P. and K.P. In many cases the child will be anemic, and in a general rundown condition; in this case the combination will be S.P. and K.P.; the combination may also include a lumbar.

In the cases involving the bladder, the major will be a lumbar vertebra. The combination will be determined by the local condition, which may necessitate the use of K.P. When there is an irritation of the genital organs or adjacent structures, the major will include a lower lumbar vertebra and may or may not require a K.P., the combination depending upon the character of the local condition.

From the foregoing it will be observed that the major for nocturnal enuresis varies, depending upon the condition to which it is adaptative. The major may include At., Ax., C.P., K.P., lumbar, or any combination of these or other subluxations. When the impingements are found, and the causative subluxations adjusted, complete results will be obtained—in every case.

OPHTHALMIA

This is an incoördination characterized by inflammation of the conjunctiva. It is also called purulent conjunctivitis. Medically these cases are supposed to be produced by gonorrhea, although in many of the milder forms the gonococcus is not present. This is evidence that the cause is not the gonococcus but that the germs, when present, are there because of the pathological condition of the tissues.

Symptoms

The eyelids are swollen, there is a copious, purulent discharge, and there may be ulceration of the eyelids.

Major Adjustment

The major for this condition is a combination major which includes a middle or upper cervical for the location and kidney place for elimination.

TETANUS IN INFANTS

This is a condition which is occasionally found in young infants and is the result of an infection usually of the umbilical wound. It is most prevalent where conditions are unsanitary. Tetanus is characterized by a tonic spasm of the muscles. It may affect all the muscles of the body or it may be limited to the muscles of the jaw, producing what is known as trismus or lockjaw.

Symptoms

The first symptom to appear may be the spasm in the masseter muscle which interferes with nursing the child. The muscle of the face and jaws appear firm and hot and the lips slightly protrude. Intervals will occur when the muscles will be completely relaxed. At first these paroxysms appear at intervals, between which the relaxation is complete; but later they become more frequent and the relaxations less marked until there is more or less of a continuous rigidity. This contraction grows more exaggerated until the entire body becomes rigid. The jaws become set and may be separated only slightly, if at all. There is a peculiar characteristic facial expression due to the contraction of the facial muscles. Swallowing becomes very difficult. There is a weak, rapid pulse. In the mild cases there is only a slight temperature, but in the more severe cases the temperature may become extremely high. The cry becomes weak and whining. The incoördination is of short duration. The child soon dies from exhaustion or from suffocation due to the rigidity of the respiratory muscles or it may be due to a spasm of the larynx. While tetanus is not a very common incoördination, the mortality is very high. Authorities place the fatality as high as 90% and even 95%.

Equation and Family

The equation is excretion minus (E-). The family is poison and contractures.

Major Adjustment

If these cases are adjusted at an early stage excellent results will be obtained. There is a combination major at At.P., C.P., and K.P.

PEMPHIGUS NEONATORUM

This is a rather unusual condition seldom found in general practice. It usually occurs as epidemics in institutions where large numbers of children are cared for. Outside of such institutions it is more common among children in unhygienic surroundings. It is characterized by an eruption of blebs containing a serous fluid.

Symptoms

These blebs appear about the third or fourth day and may be found upon any part of the body, but usually upon the exposed parts. They remain for a time and then rupture or dry up. There is no suppuration. As the blebs enlarge they sometimes coalesce, covering quite a large area. The epidermis is loosened by a serous exudate which occurs directly beneath it and separates it from the true skin. The case produces a very striking picture having the appearance of being extensively burned. After the blebs have ruptured the epidermis hangs in shreds, leaving a very bright red surface beneath. In this way there may be large areas of the body almost completely denuded of the epidermis. There may be a very slight temperature and slight restlessness. There is great depression and marked weakness. The symptoms at first appear rather slowly, later the dis-ease progresses very rapidly, death often occurring in from twenty-four to forty-eight hours. Pemphigus neonatorum should be distinguished from congenital syphilis. The liver and spleen are usually very greatly enlarged in syphilitic cases and there are usually other characteristic symptoms present, such as changes in the nails, mucous membrane and other parts.

Equation and Family

The general equation is excretion minus (E-). The condition is in the poison and fever families.

Major Adjustment

The major adjustment is C.P. and K.P.

INDEX

A PAGE

Abdomen, circumference of, 294 Enlargement of, 295 Normal, 295

Abscesses of brain, 382

Absolute humidity, 56

Absorption, 17

Absorption of gases, 52

Acid, carbolic, 213

Action, adaptative, 22, 187

Active occupations, 196

Acute catarrhal bronchitis, 340 Equation, 342 Family, 342 Major adjustment, 342 Symptoms, 341

Acute catarrhal laryngitis, 334 Major adjustment, 336

Acute dis-ease, 171

Acute intestinal indigestion, 359 Major adjustment, 360

Acute nasal catarrh, 327 Equation, 328 Family, 328 Major adjustment, 328 Symptoms, 327

Adaptation, 48, 50, 52, 54, 96, 188

Adaptation to environment, 20

Adaptive action, 22, 187

Adaptability of body, 186

Adenoid growths, 330, 349

Adjusting infants, 321

Adjustments during dentition, 303

Adulteration of food, 248

Aerated water, 110

Aerating, 129

Aerial envelope, 68

Aim and function of hygiene and sanitation, 15

Air, 44 Alveolar, 45 Cells, 48 Cold damp, 60 Cold dry, 57 Complemental, 65 Constituents of, 44 Emboli, 53 Foul, 68 Fresh, 66 Humidity of, 55 Impurities in, 67 Increased pressure, 51 Normal pressure, 50 Oxygenated, 51 Pressure at sea level, 54 Pressure increased, 51 Pressure, normal, 50 Pressure, reduced, 50 Rarefied, 51 Residual, 45, 66 Sources of impurities in, 67 Space, 34 Space per capita, 70 Supplemental, 65 Temperature of, 55 Tidal, 65 Warm dry, 61 Warm moist, 59

Airing a room, 70

Albuminoids, 267

Algæ, 127

Alveolar air, 45

Ammonia, 44, 49

Analyzing infants, 307 History of case, 307 Objective symptoms, 307 Zones involved, 312

Anemia, 376

Animals as source of communication, 22

Animal foods, 237

Animal life, 45

Anorexia, 341, 360

Anterior fontanels, 293

Anthrax, 207, 212

Antibiosis, 175

Antibodies, 176

Antigens, 176

Antineurotic vitamin, 241

Antiseptic, 207

Apathy, 341

Aphonia, 334 Acute catarrhal laryngitis, 334

Appetite, 232

Argon, 44, 46

Arsenic poisoning, 167

Arteriosclerosis in lead poisoning, 166

Artificial foundation beds, 33

Artificial lighting, 99, 162

Artificial methods of water purification, 128

Artificial reservoir, 116

Artificially high temperatures, 163

Artificially fed babies, 286

Asbestos, 34

Asepsis, 208

Aspect, importance of, 29

Assimilation, food, 374

Asthma, 348 Equation, 349 Family, 349 Major adjustment, 349 Symptoms, 348

Atmosphere, 44

Atmospheric pressure, 50

Atrophy, infantile, 375

Autolytic enzymes, 267

Average weight of boys, 287

Aquasphere, 44

Aqueducts, 106

Aqueous humor, 96

Baby, the, 277 Bottle-fed, 353 Breast-fed, 353 Food, 277

Bacilli, 173, 196

Bacteria, 196

Balanced rations, 236

Barlow’s dis-ease, 376

Barns and Barnyards, 259

Basement, 32, 33

Basement of school building, 141

Bassinet, 283

Bath tub, 37

Beaded ribs, 377

Bed, 222

Bed pan, 223

Bedrooms, 30

Bed wetting, 386

Bedding, 222

Beginners, age of, 148

Bends, 53

Beriberi, 241

Blackboards, 145

Bladder, 384

Bladder, control of, 284

Bladder worms, 270

Blast furnace workers, 163

Blebs, 390

Body heat, 81

Bodily temperature, 58

Boiling, 211

Boracic acid, 261

Borax, 261

Botulism, 246, 248

Bottle-fed babies, 278, 291, 353

Bottling milk, 260

Bowels, 284

Bow-legs, 281

Brain, development of, 279

Brass, 166

Breast feeding, 278, 353, 374

Breathing, 48

Brick, 36

Bronchi, foreign bodies in, 338 Symptoms, 339

Bronchial croup, 343 Major adjustment, 343

Bronchitis, acute catarrhal, 340

Bronchitis, chronic, 342

Bronchitis, fibrinous, 343

Bronchopneumonia, 344

Building construction, 32

Building site, 28

Buildings, character of, 161

Butter, 262

Cachexia, 376

Caisson dis-ease, 53

Caisson workers, 52, 163

Calisthenics, 150

Calorific mental impulses, 80

Capillary attraction, 31

Caput quadratum, 377

Carbolic acid, 213

Carbon dioxide, 44, 45, 47, 67, 108

Carbohydrates, 239

Care in milking, 258

Care of cows, 258

Care of food animals, 269

Care of sick room, 220

Carpopedal spasms, 333

Carriers, 200

Casein, 238, 255

Casing, 125

Casts, fibrinous, 343

Catarrh, acute nasal, 327

Catarrh, chronic nasal, 329

Cause of dis-ease, 21

Central heating, 88

Cerebral incoördination, 379

Cerebral tumors, 382

Cesspools, 125

Channels of entry, 201 Digestive tract, 201 Genito-urinary tract, 201 Respiratory tract, 201 Skin, 201

Character of buildings, 161

Character of cry, 309

Charts, 146

Chemical agents, 210

Chemical composition of foods, 238

Chemical purification, 131

Chemically pure water, 108, 109

Cheese, 263

Chicken pox, 173

Child exercise from handling, 281

Child’s cry, 313

Children, effects of labor upon, 158

Chiropractic hygiene, 19

Chiropractor, 192

Choice of occupation, 157

Chorea, 385

Cholera infantum, 360 Major adjustment, 361

Chronic bronchitis, 342 Major adjustment, 343 Symptoms, 342

Chronic dis-ease, 171

Chronic gastritis, 354 Major adjustment, 355

Chronic intestinal indigestion, 361

Chronic laryngitis, 336 Major adjustment, 336 Symptoms, 336

Chronic nasal catarrh, 329 Equation, 330 Family, 330 Major adjustment, 331 Symptoms, 330

Chyle, 17

Chyme, 17

Circumference of abdomen, 294

Cisterns, 113

Classification of dis-ease, 171

Classification of foods, 237

Cleanliness, 15

Cleanliness, external, 15

Cleanliness, internal, 15

Cloak rooms, 146

Clonic convulsion, 381

Cocci, 173

Cold damp air, 60

Cold dry air, 57

Cold in head, 327

Colic, 362, 368 Major adjustment, 363

Colicky pain, 359

Combustion, 79, 81

Commensal, 175

Communicable dis-ease, cause of, 226

Communicability, 175

Communication, source of, 22, 198

Competitive games, 281

Complemental air, 65

Composition of water, 107

Composition of meat, 267

Compression, air, 52

Condensation, 126

Condensed milk, 261

Condiments, 239

Condition of eyes, 308

Conduction, 86

Conductivity of atmosphere, 58

Congestion, 346

Constipation, 366, 358 Major adjustment, 367

Constituents of air, 44

Constitutional dis-ease, 170

Construction, fireproof, 36

Contact infection, 199

Contagious, 173, 202

Contractures, 279

Convection, 88

Convection through water, 89

Conveyance, media of, 198

Convulsions, 279, 381 Clonic, 381 Family, 383 Major adjustment, 384 Tonic, 381

Copper, 166

Corpuscles, 50

Corridors, 141

Coryza, 327

Cows, care of, 258

Cows’ milk, 278

Creeks, 114

Creoline, 213

Cresoles, 213

Croup, 332

Croup, bronchial, 343

Crude sewage, 133

Crying, 280

Crying, incessant, 314

Crystalline lens, 96

Curiosity of child, 280

Cutting teeth, 299

Cyanosis, 374, 308

Cyclic vomiting, 365

Dairy barn, unsanitary, 259

Dampness, 29, 32

Damp site, 29

Deciduous or milk teeth, 299

Decomposing food between teeth, 302

Decompression, air, 52

Decreased air pressure, 50

Deep sleep, 279

Deep wells, 123

Deformities of the thorax, 295

Degree of infection, 172

Dental caries, 302

Dentition, 299

Dentition, incoördinations during, 300

Dentition, symptoms exaggerated by, 300

Deodorant, 209

Desk, school, 144

Distinction between sanitation and hygiene, 14

Development, 285

Development of brain, 279

Diameter of chest, 294

Diaper, changing, 283

Diaphragm, 280, 340

Diarrhea during dentition, 300

Definitions, 171

Digestion, gastric, 357

Digestive organs, 278

Digestive tract, 353

Dilution, 127

Diphtheric germs, 197

Direct infection, 199

Direct lighting, 101

Direct radiation, 87

Dis-ease acute, 171, 226

Dis-ease, cause of, 21

Dis-ease, constitutional, 171

Dis-ease, germs do not cause, 191

Dis-ease the cause of germs, 189

Disinfection, 207, 210

Disposal of excreta, 223

Distillation of water, 109

Distilled water, 129

Divers, 51, 163

Diver’s palsy, 53

Diving bells, 52

Diving suits, 52

Domestic water supply, 118

Drafts, 282

Drainage, 32

Draw sheet, 222

Drinking fountains, 146

Dry heat, 211

Dry man, 247

Dry milk, 262

Dustless chalk, 145

Dusty trades, classification of, 165

Dyspnea, 334, 335, 343

Ear drums, 52

Echinococcus, 271

Edema of glottis, 339 Equation, 339 Major adjustment, 339 Symptoms, 339

Educated mind, 220

Educated mind, function of, 219-220

Effects of dust, 164

Effect of labor upon children, 158

Effect of posture, 159

Electric discharges, 49

Elimination of water from body, 111

Endemic, 177

Energy, expenditure of, 61

Environment, 381

Environment, importance of, 218

Environment, necessity of quiet, 279

Enzymes, autolytic, 267

Epidemic, 177

Epistaxis, 331 Equation, 331 Family, 332 Major adjustment, 332

Equation, epistaxes, 331

Equilibrium, 50, 296

Eruption, 301

Evaporation, 31, 58, 126

Evolution of lighting systems, 99

Exercise, 277, 280

Exercise, outdoor, 281

Excessive quantity of urine, 386

Exhaustion, muscular, 282

Exhaustion theory, 184

Expenditure of energy, 61

Expired air, 65

Exposure, 172

Exposure, stage of, 172

External cleanliness, 15

Eye, 96 Adaptation to light, 96 Aqueous humor, 96 Crystalline lens, 96 Fovea centralis, 96 Iris, 96 Macula lutea, 96 Protection, 284 Retina, 96 Vitreous humor, 96

Eyelids during sleep, 290

Facial expression, 308

Fans, plenum, 73

Fat soluble A, 240, 256

Fatigue, 59, 160

Fatigue, muscular, 161

Fats, 239, 255

Feces, 223

Feeding, 277

Fermentation, 31

Fibers, taut, 171

Fibrinous bronchitis, 343

Fibrinous casts, 343

Filter beds, 130

Filtration, 129

Filtration, mechanical, 128, 131

Fire escapes, 36, 37

Fire extinguishers, 36

Fireplace, 84, 85

Fireproofing, 36

Fire protection, 36

Fire-resisting, 36

Fixtures of bathroom, 37

Floors, 32, 33

Floors, construction of, 34

Floors, sanitary requirements, 33

Fluctuation of ground water, 30

Flushing tanks, 39

Fomites, 178

Fontanels, 293, 377

Fontanels, in cretinism, 293

Fontanels, in hydrocephalus, 293

Fontanels, in rachitis, 293

Food, adulteration of, 248

Foods, animal, 237

Food animals, 269

Food animals, care of, 269

Food assimilation, 374

Food, 231, 233 Balanced rations, 236 Carbohydrates, 239 Casein, 238 Chemical composition of, 238 Condiments, 239 Fats, 239 Function of, 238 Infection, 245, 246 Intoxication, 245, 248 Meat, unfit for, 269 Milk, 240 Necessity for, 231 Physical properties of, 338 Poisons, 245 Proteins, 238 Roughage, 237 Value of meat, 268 Vitamins, 237, 240

Foot tub, 37

Footings, foundation, 33

Forces, adaptative, 217

Foreign bodies in bronchi, 338 Symptoms, 339

Foreign bodies in larynx, 338 Symptoms, 339

Foreign bodies in the nose, 329

Foreign ingredients in water, 108

Formaldehyde, 208, 209, 210, 261

Formation, limestone, 123

Foul air, 68

Fouling of seal, 39

Foundation, 32 Footings, 33 Preparation of, 33

Fovea centralis, 96

Fresh air, 66

Fumigation, 209, 210

Function of foods, 238

Function of hygiene and sanitation, 15

Function of school life, 147

Functional activity, 186

Furnace heating, 88

Furniture of playroom, 282

Furniture of sleeping room, 282

Games, competitive, 281 Systematic, 281

Garbage cans, 135

Gaseous disinfectants, 210

Gastric digestion, 357

Gastritis, 353 Catarrhal, 353 Chronic, 354 Corrosive, 353 Major adjustment, 353 Membranous, 353 Symptoms, 353 Ulcerative, 353

Gelatinoids, 267

Genital organs, irritation of, 387

Genito-urinary, 202

Germ, a scavenger, 189

Germ medium, milk a, 257

Germ theory, origin of, 195

Germicide, 208

Germs, 23, 196, 197

Germs, cause of dis-ease, 189 Diphtheria, 197 Do not cause dis-ease, 191 Non-pathogenic, 174 Pathogenic, 174

Glass blowers, 163

Glossitis, 356 Equation, 356 Family, 356 Major adjustment, 356

Glottis, edema of, 339

God of medicine, 13

Goddess of health, 13

Gonococcus, 389

Gray hepatization, 346

Green plants, 47

Grimace, 308

Ground air, 30

Ground water, 30, 113, 118, 121

Growth and development, 285

Growth, evidence of health, 285

Gums, 376

Hard water, 110

Heat, 80

Heat exhaustion, 68

Heat loss, 58

Heat, molecular theory of, 79

Heat stroke, 59

Heating, 79 Central, 88 Combustion, 79 Conduction, 86 Convection, 88 Fireplace, 84 Hot air, 88 Hot water, 89 Local, 84, 85 Methods of, 83 Normal heat, 80 Of schoolroom, 144 Proper temperature, 82, 83 Radiators, 89 Radiation, 84 Steam, 91 Stove, 86 System, requirements of, 83 Three methods of, 83

Head, 292

Health, meat danger to, 270

Hearing, 290

Height of child, 289 Table showing average, 287

Helium, 44, 46

Hemoglobin, 46, 48

Hepatization, 340 Gray, 346 Red, 346

Highly acid urine, 386

History of public water supply, 106

Host, 175

Hot air, 88

Hot box, 314, 347

Hot water, 89

House dampness, 34

House plumbing, 37

House sewer, 39

Humidity, 55, 58, 61, 62 Absolute, 56 Relative, 56

Hunger, 232

Hunger cry, 313

Hydatid, 271

Hydrogen, 44

Hydrogen peroxide, 44, 49

Hydrocephalus, 382

Hygeia, 13

Hygiene, 19, 301 Chiropractic, 19 Defined, 13 Housing, 28 Layman’s, 19 Medical, 19 Personal, 13 Public, 14 Sanitation, aim and function of, 15 Three viewpoints on, 19

Hygienic measures, 329 In so-called communicable dis-eases, 224

Hyperacidity of urine, 386

Hypertrophic stenosis, 357

Hysteria, 385

Ice coils, 73

Ice, manufactured, 127

Icterus, 369 Equation, 370 Family, 370 Major adjustment, 370 Pathological, 369 Physiological, 369 Symptoms, 369

Ignition proof, 36

Ill effects of damp houses, 35

Immunity, 181, 191, 192 Acquired, 183 Adaptability of body in, 186 Artificial, 183 Defined, 181 Exhaustion theory, 184, 189 Mechanism of, 188 Natural, 182 Retention theory, 184 Various theories of, 185

Impounding reservoirs, 116

Impervious strata, 119

Impurities in air, 30, 67

Inanition, 235, 236 Major adjustments, 374 Symptoms, 374

Incandescent electric light, 100

Incessant crying, 314

Incineration of refuse, 134

Incoördinations of bladder, 386 Of infants, zones involved, 312 Of larynx, 332 Of lungs, 340

Increased air pressure, 51

Increased rate of breathing, 50

Incubation, stage of, 172

Indigestion, 357 Acute intestinal, 359 Chronic intestinal, 361

Indirect infection, 199, 200 Method of lighting, 102 Radiation, 87

Industrial dusts, 164

Industrial establishments, 161

Industrial hygiene, 156 Definition, 156 Dust, classification of, 164, 165 Place of work, 159 Poisons, 158, 165, 166, 167, 168 Work places, 162

Infant, thorax of, 340

Infantile atrophy, 375

Infants, adjusting, 321

Infection, 23, 172, 199, 200

Infection, channels of, 199 Degree of, 172 Direct, 199 Indirect, 200 Mode of, 199 Period of, 172 Source of, 23, 198

Infectious, 173, 202

Inflammable, 36

Inorganic detritus, 67

Inorganic salts, 239

Insecticide, 208

Inspiration of air, 48

Instrumental birth, 308

Intellectual adaptation, 50

Intellectual adaptation in immunity, 181

Intercepting sewers, 39

Interference with transmission, 61

Internal cleanliness, 15

Internal resistance, 54

Intussusception, 367 Major adjustment, 369 Stools in, 368 Symptoms, 368

Invasion, period of, 172

Iris, 96

Irritability, during dentition, 300

Irritation of genital organs, 387

Jaundice, 308

Kidneys, 60

Klebs-Loeffler bacilli, 335

Krypton, 44, 46

Labor, effect upon children, 158

Lactalbumin, 255

Lactoglobulin, 255

Lactose, 256

Lakes, 114, 115

Languor, 59

Larvæ, of tænia saginata, 270

Laryngeal obstruction, 335

Laryngismus stridulus, 333

Laryngitis, acute catarrhal, 334 Chronic, 336 Tubercular, 337

Larynx, foreign bodies in, 338 Symptoms, 339

Larynx, incoördination of, 332

Lavatory, 37

Layman’s hygiene, 19

Lead colic, 166

Lead palsy, 166

Lead poisoning, 166

Lighting, 95 Artificial, 99, 162 Direct, 101 Incandescent electric light, 100 of schoolroom, 142 Psychological effect of, 100 Systems of, 101, 102 Physiological effect of, 100 Schoolroom, 142 Value of sunlight, 98 Window area, 98, 99

Limestone formation, 121, 123

Limestone regions, 119

Lips, tactile sensibility of, 290

Liquid disinfectants, 210

Living rooms, 30

Lobar pneumonia, 344 Symptoms of, 346

Local heating, 84

Location of work, 164

Lockjaw, 389

Loss of light, 98

Loss of seal, 38

Loss of weight, 287

Lungs, 45

Lysol, 213

Macula lutea, 96

Main sewer, 37

Malnutrition, 373 Major adjustment, 374 Symptoms, 373

Man, as source of communication, 22

Manufactured ice, 127

Manure, 259

Marasmus, 375 Major adjustment, 375

Matron, 147

Measles, 173

Measly beef, 270

Meat, 267, 268 Care of food animals, 269 Composition of, 267 Danger to health, 270 Food value of, 268 Source of, 268 Unfit for food, 269

Mechanical devices to aid walking, 296

Mechanical filtration, 128, 131

Mechanical ventilation, 72, 164

Mechanism of immunity, 188

Meconium, 366

Media of conveyance, 198

Medical hygiene, 19

Meningitis, 382

Mental impulses, 186

Mercurial poisoning, 167

Mercury, 166

Mercury, use of, 167

Metallic cough, croup, 332

Methods of sewage disposal, 132

Methods of water purification, 126

Miasmatic, 203

Microcephalus, 293

Milk, 240, 261 As a food, 254 Condensed, 261 Dry, 262 Germ medium, 257 Pasteurization, 261 Products, preparation of, 261 Proper temperature, 260 Sanitary measures in production, 257 Sugar, 256

Milk teeth, appearance of, 299

Mineral wool, 34

Mode of infection, 199

Model site, 28

Modes of transfer, 199

Moisture in houses, 35

Molecular theory, 79

Morbific agents, 173

Mosquitoes, 32

Mouldings in school room, 142

Mountain climbers, 163

Mouth breathing, 330

Mucopurulent discharge, 328

Muddy water, 110

Municipal swimming pools, 132

Muscular exhaustion, 282

Muscular fatigue, 282

Nail point two, 323

Nasal catarrh, 327 Acute, 327 Adjustment, 328 Chronic, 329 Equation, 328 Family, 328

Natural birth, 308

Natural immunity, 182

Natural light in buildings, 98

Natural means of disinfection, 210

Natural means of ventilation, 69

Natural methods of water purification, 126

Necessity for food, 231

Necessity for water in body, 109

Need for conserving energy, 220

Neon, 44, 46

Nerve tracing, 316

Nervous mechanism, 279

Nervousness, 280

Neurotic children, 379, 385 Equation, 380 Family, 380 Major adjustment, 381

Nocturnal enuresis, 384,387 Correction of condition, 387 Excessive quantity of urine in, 386 Highly acid urine in, 386 Incoördinations of bladder in, 386 Incoördination of nervous system, 385 Irritation of genital organs in, 387

Nocturnal restlessness, 377

Non-nitrogenous food, 238

Non-pathogenic germs, 174

Normal air pressure, 50, 163

Normal bodily temperature, 81

Normal bowel movement, 284

Normal heat, 80

Normal stool, 366

Nose bleed, 331

Nourishment, 277

Nitric acid, 49

Nitrogen, 44, 46

Nitrogenous foods, 238

Nude baby, 280

Nurseries, 282

Nursery furniture of, 282 Temperature of, 283 Ventilation of, 282

Obligate saprophytes, 176

Obstetrician, 277

Occipito-frontal measurements, 292

Occupation, 157 Active, 160 Choice of, 157 Effect of posture, 159 Effect upon children, 158 Effect upon health, 156 Fatigue, 160 Personal factors in, 157 Place of work, 159 Sedentary, 160

Odor of urine, 18

Oleomargarine, 262

Ophthalmia, 389 Major adjustment, 389 Symptoms, 389

Opisthotonos, 379

Origin of germ theory, 195

Outdoor exercise, 281

Outside airing, 284

Overwork, 160

Oxidation, 46

Oxidizing agent, 49

Oxygen, 44

Oxygenated air, 51

Ozone, 44, 49

Pain, colicky, 359

Palatability of water, 108

Pallor, 308

Palpating the infant, 314

Palpation of cervical vertebrae, 316

Palpation of sacrum, 316, 317

Pandemic, 178

Papillomatous, 337

Parasites, 175

Partitions, 37

Pasteurization of milk, 261

Pathogenic action, 174

Pathogenic germs, 174

Peculiarities of child considered, 149

Pemphigus neonatorum, 390 Equation, 391 Family, 391 Major adjustment, 391 Symptoms, 391

Period of infection, 172

Period of invasion, 172

Periodical vomiting, 365

Permanent hardness of water, 111

Permanent teeth, table of, 301

Personal factors in occupation, 157

Perspiration, 18, 60

Personal hygiene, 13

Petrosphere, 44

Phosphorus, 166

Phosphorus poisoning, 168

Physical agents of disinfection, 210

Physical properties of food, 238

Pigeon breast, 377

Pillow of the infant, 283

Pinched expression, 308

Pisiform bone, 322

Place of work, 159

Plant foods, 237

Play, 281

Play periods necessary, 148

Playroom, 282

Plenum system, 69, 72, 73, 164

Pneumonia, 343 Equation, 347 Family, 347 Major adjustment, 347 Symptoms, 345

Poison, 233 Cycle, 22

Poisoning, Arsenic, 167 Chromium, 168 Industrial, 158 Lead, 166 Mercurial, 167 Phosphorus, 168

Poisonous gas, 49

Pollution of well water, 119

Ponds, 114

Pools, Swimming, 132

Portland cement, 37

Position of infant for adjustments, 321

Posture, 149, 159

Pott’s dis-ease, 295

Preface, 7

Preparation of foundation, 33

Preparation of milk and milk products, 261

Prevention of siphonage, 39

Prism glass, 142

Privy vault, 132

Process of respiration, 48

Production of milk in sanitary measures, 257

Prophylactic measures in lead poisoning, 166

Prophylaxis, 152

Proteins, 238, 255

Psychological effects of light, 100

Ptomaines, 270

Public hygiene, 14

Pulmonary tuberculosis, 342

Pulse rate, 311 Disturbances in, 311 Table of, 311

Purification, chemical, 131 Sewage, 133

Purified milk, 261

Pylorospasm, 357

Pylorus, stenosis of, 357

Rachitic girdle, 378

Rachitic rosary, 378

Radiation, 79, 84 Direct, 87 Indirect, 87

Radiator, 89, 90

Rain water, 113, 114

Rales, 341, 345

Rarefied air, 51

Rate of respiration, 65

Recess, 150

Recirculated air, 68

Recoil, 321

Red blood cells, 45

Red hepatization, 346

Reduced air pressure, 50

Refuse disposal, 132, 134

Regulation of breathing, 48

Reinforced concrete, 36 Floors, 34

Relative humidity, 56, 61, 62

Removal of sewage, 132

Requirements of ventilating systems, 67

Reserve energy, 187

Reservoirs, impounding, 116

Residual air, 45, 66

Respiration, 44, 65, 309, 310, 383

Respiratory system, 48, 327

Restlessness during dentition, 300

Retching, 365

Retention theory, 184

Retina, 96

Retropharyngeal abscess, 328

Rhinopharyngitis, 327

Rickets, 295, 376 Deformities of abdomen in, 378 Deformities of extremities in, 378 Deformities of head in, 377 Deformities of spine in, 378 Deformities of thorax in, 377 Equation, 379 Major adjustments, 379 Symptoms, 377

Rivers, 114

Roof, 34

Room, proper temperature of, 83

Roughage, 237

Rudimentary spinous processes, 317

Sacral adjustments, 323, 324

Sand filter, 128, 129, 130

Sandstone rock, 123

Sanitary art, 14

Sanitary environment, 20 Measures in production of milk, 257 Requirements of floors, 33 Science, 14

Sanitation and hygiene, distinction between, 14

Sanitation, sick room hygiene, 217

Sapremia, 177

Saprophytes, 176

Sarcolactic, 267

Scavengers, 226

School building, 140 Basement, 141 Blackboards, 145 Charts, 146 Cloakrooms, 146 Corridors, 141 Heating, 144 Lighting of, 142 School desks, 144 School room, size of, 141 Stairways, 140 Toilets, 147 Ventilation of, 143 Water supply, 146 Window area, 142 Window shades, 143

School hygiene, age of beginner, 148 Peculiarities of child, 149 Personal factors, 147 Play periods, 148 Recess, 150 School dis-eases, 151

School desks, 144

School dis-eases, 151

School hygiene, 140

School life, functions of, 147

School room, size of, 141

Science, Sanitary, 14

Screens, 221

Scurvy, 376 Major adjustment, 376 Symptoms, 376

Sea level, 54

Seal, 37

Secretions, 50

Sedentary occupations, 160

Sedimentation, 115, 128

Self purification of water, 127

Semi-indirect lighting, 101

Septic method of sewage purification, 133

Septicemia, 177

Serous circulation, 61

Sewage, crude, 133

Sewage disposal, 132

Sewage pollution, 116

Sewage purification, septic method, 133

Sewage, removal of, 132

Sewage system of body, 16

Sewerage system, 39

Sewer air, 39

Sewer gas, 39

Shallow wells, 123

Shape of head, 294

Shingles, 34

Sick room, 217 Bed and bedding of, 222 Bed pan, 223 Care of, 220 Disposal of excreta, 223 Draw sheet, 222 Sponge bath, 224 Ventilation of, 221

Sight, 289

Siphonage, 38

Site, building, 28

Site of school building, 140

Slate and tile roofs, 34

Sleep, 278

Sleeping rooms or nurseries, 282

Slow sand filter, 130

Smallpox, 173

Smell, 291

Sneezing, 327

Snow water, 113

Soft water, 110

Soil, 30

Soiled linen, 222

Soup stock, 268

Sources of communication, 22

Source of food, 237

Source of infection, 23

Source of impurities in air, 67

Source of impurities in water, 118

Spasmodic laryngitis, 332

Special senses, 289

Speech, age at which developed, 291

Sphincter muscle, 386

Spinograph, 317

Spirilli, 173

Sponge bath, 224

Sporadic, 178

Spring water, 118

Sputum, 223

Stable, 259

Stage of exposure, 172

Stagnant water, 32, 116, 259

Stairways, 37, 140

Starvation, 234

States of aggregation of water, 108

Steam, 115, 212

Steam heating, 91

Steel floor beams, 37

Stegomyia calopus, 114

Stenosis, 334

Stenosis hypertrophic of the pylorus, 357 Equation, 358 Family, 358 Major adjustment, 359 Symptoms, 357

Sterile milk, 260

Sterilization, 207, 212

Stomatitis, 355 Equation, 356 Family, 356 Major adjustment, 356

Stone, 36

Stool, 37 In intussusception, 368 Normal, 366

Stooped shoulders, 160

Storm sewers, 39

Stove, 86

Strabismus, 308

Street sewer, 39

Stridulus, laryngismus, 333

Stupor, 374

Subsoil water, 113, 118, 121

Suction fans, 73

Sulphur dioxide, 209

Sulphuric acid, 49

Sunlight, 98, 128

Supplemental air, 65

Supply, water, 146

Suppurative nephritis, 339

Surface water, 113, 114, 117

Sutures, 292

Sweat glands, 58

Swimming pools, 132

Symbiosis, 175

System, respiratory, 327

Systematic games, 281

Systems of heating, 83

Systems of lighting, 101

Table of heights, 288

Table of weight, 288

Tactile sensibility, 290

Tænia saginata, larva of, 270

Tapeworm, 270

Taste, 291

Taut fibers, 171

Technique, 323

Teeth, 301

Teeth, hygiene of, 301

Temperature, 62 Artificially high, 163 Bodily, 58 Of buildings, 82 Of playroom, 282

Tempering coils, 75

Temporary hardness of water, 110

Temporary strabismus, 290

Terra-cotta, 34, 36

Tetanus, 207, 212

Tetanus in infants, 389 Equation, 390 Family, 390 Major adjustment, 390 Symptoms, 389

Theories of immunity, 182

Thorax, shape of, 294 Deformities of, 295 Infants, 340

Three viewpoints on hygiene, 19

Thymus gland, 382

Tidal air, 65

Tile, 31, 34

Toilets, 147

Tongue, tactile sensibility of, 290

Tonic spasm, 381, 389

Toothache, 302

Top cover, 222

Touch, 290

Toxemia, 177

Transfer, modes of, 199

Trap, 37, 38, 39

Trichinosis, 270

Trismus, 389

Tubercular laryngitis, 337

Tubercular ridge, 317

Tuberculosis, 166

Tumors, cerebral, 382

Turbid water, 110

Tympanites, 359, 368

Typhoid fever, 173

Under drains, 39

Underground water, 121

Unsanitary dairy barn, 259

Urine, 223 Excessive quantity of, 386 Highly acid, 386 Odor of, 18

Vacuum, 69, 164

Vacuum system, 73

Value of sunlight, 98

Various theories of immunity, 185

Vent pipe, 39

Ventilating system, 67

Ventilation, 66 Air space per capita, 70 Breathing zone, 72 Defined, 65 Means of, 69 Mechanical, 72 Natural means of, 69 Of hall and stairways, 30 Of playroom, 282 Plenum, system of, 69, 73 Schoolroom, 143 Sick room, 221 Sleeping room, 282 Tempering coils, 75 Vacuum, system of, 69, 73 Washing the air, 73 Water curtain, 75

Ventilators, 282

Vertical currents, 117

Visual analysis, 309

Vital resistance, 187

Vitamin, 240, 256

Vitamin antineurotic, 241

Vitiated air, 70, 143

Vitiation, 67

Vitreous humor, 96

Volume of air inspired, expired, 65

Vomiting, 363 Cyclic, 365 Major adjustment, 365 Obstructive, 364 Periodical, 365 Recurrent, 365 Symptoms, 365

Walls, 33 In school room, 142 Methods of construction, 33

Walking, 295

Warm dry air, 61

Warm moist air, 59

Washing the air, 73

Water, 105, 106, 108 Amount needed per day, 111 Artificial reservoirs, 116 Chemical purification of, 131 Chemically pure, 108, 109 Cisterns, 113 Composition of, 107 Condensation, 126 Distillation of, 109 Distilled, 129 Elimination from body, 111 Evaporation, 126 Fall mixing of, 117 Filtration, 129 Foreign ingredients in, 108 General considerations, 106 Ground, 113, 120 Hard, 110 Impounding reservoir, 116 Lakes, 115 Muddy, 110 Necessity for, in body, 109 Needed for all purposes, 111 Palatability of, 108 Proper supply of, 106 Purification of, 126 Rain, 113 Sedimentation, 128 Self-purification of, 126 Snow, 113 Soft, 110 Sources of impurities, 118 Spring, 118 Stagnation of, 116 States of aggregation, 108 Streams, 115 Subsoil, 113, 118, 121 Surface, 113, 114, 117 Taste of, 110 Turbid, 110 Underground, 120 Universal solvent, 109 Well, 118

Water curtain, 75

Water-logged, 33-36

Water meters, 113

Waterproof course in walls, 35

Water-soluble B, 240, 256

Water-soluble C, 240, 256

Water supply, 112, 113, 146

Water vapor, 55

Water waste, 113

Weight, gain in, 286

Weight, how considered, 286

Weight, loss of, 287

Weight of boys at birth, 285

Weight of girls at birth, 285

Weight, table showing average, 287

Wells, 123

Wet clothing, 146

Window area, 98, 99

Window hopper, 70

Window shades, 99, 143

Window ventilation, 69

Wood shingles, 34

Work, place of, 159

Work places, 162

Writer’s cramps, 161

Xenon, 44, 46

Zinc, 166

Transcriber’s Notes

pg 53 Changed: These may form in the labryinth of the ear to: These may form in the labyrinth of the ear

pg 101 Changed: which will permit some of the light days to penetrate to: which will permit some of the light rays to penetrate

pg 132 Changed: running sores, conjunctivitis, or veneral diseases to: running sores, conjunctivitis, or venereal diseases

pg 171 Changed: while enviromental dis-eases are attributed to: while environmental dis-eases are attributed

pg 187 Changed: so as to increase the processs of adaptation to: so as to increase the process of adaptation

pg 234 Changed: There is an engorgment of the liver to: There is an engorgement of the liver

pg 249 Changed: 4—Fradulent labeling of food to: 4—Fraudulent labeling of food

pg 323 Changed: extreme case must be exercised to: extreme care must be exercised

pg 342 Changed: may tend to influence and exxagerate to: may tend to influence and exaggerate

pg 365 Changed: similar to migrane in adults to: similar to migraine in adults

pg 383 Changed: There is rythmical convulsive movements to: There is rhythmical convulsive movements