Rural Hygiene

CHAPTER XXI. Hygiene and Law

HYGIENE AND LAW

Principle of laws of hygiene. Self-interest, the real basis of law. Quality of water. Regulations governing foods. Basis of pure food laws. Protection of milk. Laws governing quarantine 410-425

LIST OF FIGURES

FIG. PAGE 1. Map of New York State 5 2. Bad conditions about a dwelling 28 3. Grading that turns water away from the house 42 4. Modes of laying out drains 46 5. Exterior wall-drains 50 6. Interior cellar-drains 51 7. Wall modes of making air-space 53 8. Water-tight wall 54 9. Rough-backed wall 56 10. Even-backed wall 56 11. Modes of making water-proof cellar walls 57 12. Water-proofing of cellar walls 58 13. Cellar-wall forms 65 14. Letting in fresh air 78 15. Ventilating device 79 16. Ventilating device 80 17. Ventilation by means of coal stove 82 18. Coal-stove ventilation 83 19. Coal-stove ventilation 84 20. Outlets into walls 86 21. Cow-barn ventilation 88 22. How a pump works 105 23. Air-lift pump 106 24. Diagram of a spring 109 25. Water finding its way from a hillside 110 26. The sinking of wells 110 27. Mode of sinking a well 114 28. A well that will catch surface water 115 29. A well properly protected 116 30. A properly protected well 117 31. Well-drilling apparatus 118 32. Sinking a well by means of a water-jet 120 33. An enclosed spring 122 34. A spring extension 123 35. A reservoir for home use 126 36. Stream draining a privy 129 37. Contamination of a creamery from the water supply 148 38. A protected spring-chamber 157 39. Concrete core in a dam 159 40. Section of a flood dam 161 41. Section of a flood dam 162 42. A joint in tile pipe 167 43. Windmill and water tank 170 44. Installation of a ram 172 45. Means of securing fall for hydraulic ram 174 46. A hot-air engine 176 47. A gas engine 179 48. Pump operated by belt 180 49. Duplex pump operated directly by steam 180 50. Raising water by means of compressed air 182 51. Wooden tank 183 52. Iron tank 185 53. Hand pump applied to air-tank 186 54. Engine applied to air-tank 187 55. Windmill connection with tank 188 56. Construction of a wooden tank 193 57. Hot-water attachment to the kitchen stove 195 58. Enameled iron sink 197 59. Enameled iron laundry tubs 198 60. Leveling the drain 200 61. Water-supply installation 202 62. A trap 204 63. Washout water-closet 205 64. Washdown water-closet 205 65. Syphonic closet 205 66. Syphon-jet closet 206 67. Sewage beds 217 68. Plan of sewage beds 220 69. Plan of subsurface irrigation field 224 70. Section of "Miller" syphon 226 71. Plan and section of a septic tank 227 72. Section of a septic tank with syphon chamber 229 73. Plan of sewage disposal for a single house 231 74. School girl with adenoids 289 75. Outdoor sleeping porch for tuberculous patients 343 76. Mortality from pulmonary tuberculosis 344 77. Spring infected by polluted ditch 356

RURAL HYGIENE

CHAPTER I. _vital Statistics of Rural Life_

VITAL STATISTICS OF RURAL LIFE

It is commonly supposed that good health is the invariable accompaniment of country life; that children who are brought up in the country are always rosy-cheeked, chubby, and, except for occasional colds, free from disease; that adults, both men and women, are strong to labor, like the oxen of the Psalmist, and that grandfathers and grandmothers are so common and so able-bodied that in practically every farmhouse the daily chores are assigned to these aged exponents of strong constitutions and healthy lives. If, however, we are honest in our observations, or have lived on a farm in our younger days, or have kept our eyes open when visiting in the country, we will remember, one by one, certain facts which will persistently suggest that, after all, life on the farm may not be such a spring of health as we have been led to believe. We will remember the frequency of funerals, especially in the winter, and the few families in which all the children have reached maturity. We will remember the worn-out bodies of men and women, bent and aged while yet in middle life.

It is worth while, then, at the beginning, to find out, if we can, just what are the conditions of health in rural communities, in order to justify any book dealing with rural hygiene; for it is plain that if health conditions are already perfect, or nearly so, no book dealing with improved methods of living is needed, and the wisdom of the grandparents may be depended on to continue such methods into the next generation.

Death-rate.

The usual method of measuring the health conditions of any community, such as a city, town, county, state, or country, is to compute the general death-rate, as it is called; that is, the number of deaths occurring per 1000 population. For example, in 1908, with its estimated population of 8,546,356, there occurred in New York State 138,441 deaths, or 16.2 deaths for every 1000 population. Sixteen and two-tenths is, then, the general death-rate for the state for that year. This method of determining the health of a community is crude and should not be too strictly relied upon for proving the healthfulness implied. The rate is at best only an average, and takes no account of anything but death, one death being a greater calamity, apparently, than a dozen persons incapacitated from disease. Then, too, this death-rate is greatly affected by peculiarities of the community in age, sex, nationality, and occupation, and by local conditions of climate, altitude, and soil. The effect of these local conditions can best be explained after a consideration of the general death-rate and its definite values in different places.

In the United States, as a whole, or, more exactly, in that part of the United States which keeps such records of deaths as to be reliable (about one half), the annual average death-rate for the five-year period 1901-1905 was 16.3, and this may be compared with the death-rate in other countries shown in the following table for the same period:--

TABLE I. DEATH-RATES IN VARIOUS COUNTRIES

Australia 11.7 Austria 24.2 Belgium 17.0 Denmark 14.8 England 16.0 France 19.6 Germany 19.9 Italy 21.9 Japan 20.9 Netherlands 16.0 New York State 17.1 Norway 14.5 Spain 26.1 Sweden 15.5 United States 16.3

Ideal death-rates.

There are special reasons why the Australian death-rate should be low, but, neglecting this one country entirely, it will be seen that Norway, Denmark, and Sweden have rates of 14.5, 14.8, and 15.5, respectively; rates which may be considered as good as any country can attain at the present time. But the United States, as a whole, has about one more death per 1000 than these countries, and New York State two more per 1000 population. This means that in New York State there are 16,000 more deaths each year than if the population were living in Sweden under Swedish conditions and laws. Or, expressed in another way, it means that in Sweden one out of every sixty-five persons dies each year, and in New York one out of every fifty-eight persons.

The rate in New York State is high because the state contains a large number of cities, and concentration of population generally implies all kinds of bad and unsanitary conditions. As a rule, a higher death-rate may be expected in a densely populated community than in a sparsely settled one, and we should therefore expect a rural community to show a lower death-rate than a city or urban community. It is not a fair estimate of the health of any rural locality, such as a county where no large cities exist, to compare its death-rate with the average of the state, or with the average rate of some other county which contains a large city. This fact is plainly brought out by the statistics in Table II, from the several sanitary districts into which the state of New York is divided, as shown on the map, Fig. 1:--

TABLE II. SHOWING VARYING DEATH-RATES IN DIFFERENT PARTS OF NEW YORK STATE

====================================================== | DEATH RATE IN SANITARY DISTRICTS --------------------------- | 1901-5 | 1906 | 1907 ------------------------------------------------------ New York State | 17.1 | 17.1 | 17.5 Maritime | 19.0 | 18.2 | 18.4 Hudson Valley | 17.2 | 17.0 | 18.2 Mohawk Valley | 15.5 | 16.3 | 16.6 West Central | 15.0 | 15.6 | 16.6 Lake Ontario and Western | 14.9 | 15.5 | 15.9 East Central | 14.9 | 15.4 | 15.9 Southern Tier | 14.4 | 14.7 | 15.6 Adirondack and Northern | 13.9 | 15.1 | 15.3 ======================================================

Death-rates in New York State.

MAP OF THE STATE OF NEW YORK SHOWING THE SANITARY DISTRICTS]

The Maritime District includes the four counties of New York City and comprises about half the population of the state. Its population is almost entirely quartered under distinctly urban conditions, in some parts with a congestion not equaled in any other city of the country. It would naturally, therefore, have a high death-rate, and that it is no higher than it is makes it a matter for congratulation. And yet the rate in New York City is higher than in the other principal large cities of the world. For example, the rates for the five-year period 1900-1904 in Berlin averaged 18.3, in Paris 18.2, and in London 16.9, New York being 19.4 for the corresponding period. The excess in New York is due in part to local conditions and in part to a less active oversight in matters of public health. Similarly, the Hudson Valley District, which embraces the large cities along the Hudson, has a higher death-rate than the state average, whereas the other six districts have low rates, chiefly because of the large proportion of agricultural land and small towns. The last district should be noted particularly, since its rate is remarkably low and its number of cities very small, compared with the area included. The conclusion may be properly drawn, therefore, that statistics confirm the general impression that life in the country is healthier than life in the city.

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