Section Iii--the Obstacles to Hygiene

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

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

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

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

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

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

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

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

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

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