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The Commoner.
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The Conservation of Rural Health
By G. E. Condra, director of tho Nebraska
conservation and soil survey, member Nebraska
rural llfo commission and chairman of committeo
on rural sanitation and health, Lincoln, Neb.
This paper Is a health message for people in
the country and small towns. It is based on in
formation gathered by persons who have had
opportunity to study rural conditions in Ne
braska, visiting thousands of homes in different
parts of tho state. Among those who have con
tributed are: State food inspectors, commis
sioners of public health, city health commission
ers, several physicians with country practice,
many farmers and rural teachers, and tho dean
of tho medical collogo of the University of Ne
braska. As a result of these observations and
experience therewith, certain specific things
that should prove helpful in improving rural life
are herein recited. They are given without bias
and should be so considered.
The striking thing in the development of
public hoalth in the United StateB, and appar
ently so in Nebraska, is that the country is not
keeping pace with the city.
It is evident, also, that the country presumes
too much on its healthful conditions, and fails
to develop, certain advantages which it has over
the .city. Lot it bo understood that Nebraskans
have better than average health, a fact worthy of
praise, but that our pride should not servo to
prevent the best possible, conservation of Jife.
It should not be -our. purpose, therefore, toJead
other states, but to become as healthy as pos
sible, knowing that human health .and life are
the state's greatest resources. Let, the ideal be
tho development of the largest possible number
of healthy persons capable of .rendering efficient
service, physically, andotherwJse,..and fit to -bear,
tho new generation. Viewed in the light of.con
servation, bad health is not a resource but the
opposite; good health, the normal condition, is
always at a premium.
Most attention first given to conservation was
to the physical resources, then to the betterment
of strains and breeds of crops and farm animals.
This bore fruit in many lessons concerning life
which are now known to apply in some measure
to the conservation of people. Today more than
usual consideration Is manifest for the develop
ment of public health and ability to work.
Health is promoted by many popular and scien
tific organizations. State departments deal
directly or indirectly with the conservation of
most vital resources, including man. The federal
government itf about to establish a department
of public health. The new turn in conservation
is in order and timely, for reliable authority
places the number of dangerously sick persons
in the United States at about 3,000,000 and the
annual deaths at about 1,500,000, of which
more than 600,000 are by disease nearly wholly
preventable. The economic loss from negligence
resulting in such a death rate represents a vast
sum. Good authority has placed the national
,0BBAt. rom Dreventable sickness, preventable
death, and the necessary care demanded there
with at about two billion dollars a year. It is
plainly evident that too many people are sick
in, the United States, causing such an expense
and requiring so much time in the way of care
and medical treatment.
The way to check a part of this loss of time
and life is being found. Students of the subject
say that sickness is reduced, the death rate de
creased, and the average length of life prolonged
about in proportion as individuals and the pub
lic practice the principles of personal hygiene
and sanitation. So, it appears that the great
need of this time is a niore definite and reliable
knowledge of the cause and prevention of
disease.
CAUSE OF DISEASE
Only a short time back in history law-giving
religious ceremony, and healing were practiced
by ono and the same individual. Then practi
cally nothing was known of the cause, and con
sequently very little of the prevention and
treatment of disease. During the past century
and the past twenty-five years especially, scien
tists have given much time to the investigation
of diseases as produced by natural causes. The
microscope made it possible to study tho minute
forms of life and determine their relations to
higher life. Such investigation gave a new con
ception of many diseases, in whioh the cause is
found to be in the lower forms of life, such as
bacteria and minute animal parasites, that gain
access to the body and feed upon it when and
where conditions are favorable. Not all bac
teria are of the disease-producng kind; in fact
many of them do a beneficial work, especially
in the field of agriculture. Most diseases that
spread from person to person are said to bo con
tagious because they are catching. Society finds
it necessary to guard against the spread of such
by tho uso of disinfectants, in which the germs
are killed, and by quarantine, in which the sick
are isolated for a safe period of time.
Though there are many disease-producing
organising, not all of them have been studied Jn
detail. Certain ones are known to cause specific
diseases such as cholera, yellow fever, scarlet
fever, diphtheria, measles, chicken-pox, whooping-cough,
tonsilitis, mumps, syphilis, tubercu
losis, etc. Put in a simple way, it may be said
that our bodies represent the soil or ground and
tho germs the seed, which, if it finds a suitable
place to grow and multiply in the body, does so,
thereby causing a particular kind of disease.
The following, if done, would assist in reduc
ing the amount of sickness and death by con
tagious diseases:
1. Cleaning up the farmstead and thus
destroying filth tho home of -specific germs.
2. Preventing the spread of germs from host
to host.
3. Increasing the resistance of the body to
germ .infection through proper attention to diet
and elimination.
. A. -knowledge of contagious disease is giving
rise' to 'public sanitation which is Tapidly gain
ing prominence in tho various civilized coun-
tries, r The United States succeeded with its
wars in Cuba and the "Philippines, and With the
Panama canal chiefly because of sanitation.
Yellow fev6r and malaria' especially 'were
.stamped-out-by the use of scientific "Jcnowledge.-fNo.one-will
deny the wisdom ofjleaning up Cuba'
andtho Philippinesrbut 'why -not apply-sanitary
knowledge of such "importance to our ownv situa
tion in the Interior of the United States, especi
ally in the rural districts? It would make the
people healthier, and prolong their lives from
ten to fifteen years.
It is important to know how disease gets into
our bodies, or, in other words, how it is trans
mitted. MEANS OF TRANSMISSION
Transmission or spread of disease-producing
organisms is mainly through air, 'water, food,
and by insects. The fly and mosquito play a
large part in spreading tuberculosis, typhoid,
and malaria. In some diseases transmission is
mainly by contact of persons; to be more exact,
by the contact of parts of their bodies. Some
diseases are transmitted more in one way than
another; consequently they are known as air
borne, water-borne, or food-borne diseases, etc.
Knowing this, one should guard against infec
tion from tho different sources.
It should be more generally understood that
a person suffering from a contagious disease,
such as. tuberculosis, typhoid, or syphilis, may
become a menace to society unless the necessary
safeguards are observed. He is unclean, and
therefore a probable source of danger.
SANITARY WATER
Drinking water of the farmstead should bo
guarded with extreme care, for it may become
the leading medium through which disease is
carried to the body. Attention is paid to the
kind of water supplied to farm animals, for a
good quality is necessary to produce hoalth and
a rapid growth. Some farmers argue against
pond water and polluted stream water for stock
Much of this is well-founded, for It is good busi
ness. Be that as it may, we are sure that farm
ers should consider the water problem as heaving
great Importance as a factor in human health
As a rule, the domestic water supplies of Ne
braska are obtained from wells. It is purer
than that from streams, lakes, and most other
sources. Furthermore, the well water supply
of our state is one of the best to bo found in any
country. Notwithstanding this fact, there is
need for improvement at many places. A con
siderable number of wells are located on either
alkali or hard-water formations whereas near
by, and sometimes on tho same farm, supplies
could be secured of better quality. It is tho
duty, therefore, of tho farmer to seek out the
best possible supply of water, getting that which
is most ideal from the standpoint of health
The leading thing to guard against In most wells
is organic pollution from slops, garbage, barn
yards and privies. A hotter knowledge of the
nature and source of well water would serve to
show tho cause of such pollution. Briefly stated
the rain water, except which runs off, soaks into
VOLUME 12, NUMBER 52
the ground and percolates downward to the
water table. Below this the subsoil is com
pletely saturated, and the water moves slowly in
the direction of the lower land, where it may
come to the surface in the form of seepage or
springs. During its percolation and slow under
flow in the ground, the water gathers up niore
or less organic matter, including germs of
disease, if they are present, and may carry them
to the well. The well is an artificial opening
In the ground extending down to and below tho
water table. The more water used therefrom
tho greater the movement to it by underflow.
The following statements are intended to be of
uso in making well water more sanitary:
1. The privy or cesspool should not be
placed too close to the well. The distance can
not be definitely given because of differences in
the texture and structure of the ground. In
many places privies and wells are not more than
twenty-five to fifty feet apart. Such situations
should be regarded as positively dangerous un
less the well is deep and the subsoil very close
textured. The only safe practice is, to widely
separate the well or sources of-water from the
place in -which is placed the most dangerous of
matter, namely, the excreta" of tho human body.
The deeper the -well the less the danger from
this source, as a rule.
2. Wells should be placed on higher ground
than farm buildings, lots, and privies, especi
ally, if possible. This gives surface drainage
away from the well and not to it. A hotter rule
than .this, since many farm homes are on valley
and .upland plains, Is to locate the well up-valley
oroip-plain from the house, lots .and privy. In
this way the underflow, extending with the
general slope of the land, comes to the. well be
fore being, polluted. To meet this condition,
most wells in the state should be -west or north
west of .the, house -and outbuildings. This is
because the general slope and drainage, both
x surface '.and underground, is- eastward or south
eastward. Tho water, if polluted 'while passing
under the outbuildings and lots, has ample time
to purify before reaching the next farmstead on
the plain. Often the general unqualified statement
Is made that wells should be placed on higher
ground than the rest of the improvements of
the farmstead. Such a rule would not hold good
at all points on valley sides, as along tho Re
publican and Niobrara valleys, where such a
location would not prove feasible because of a
lack of water at some places.
3. Open wells should be cleaned frequently
for the purpose of removing any dangerous mat
ter that may have fallen into them or blown into
them. Closed wells are safer than open wells.
4. The ground should be graded up around
the well to carry the surface drainage away from
It. Furthermore, the opening should be tightly
covered to prevent the intake of excreta from
birds, chickens, etc. This will also guard against
the entry of mice, rats, frogs, and rabbits, and
the unsanitary effects resulting therefrom.
5. In most parts of the state the water is
in sand beds called first, second, and third
water, etc., and separated by tliin clay "layers.
Tho first water at places is more alkalied than
the second or third water. It is also apt to con
tain more organic pollution, being on that ac
count less desirable for drinking .purposes. It
is recommended, therefore, that tho second,
third, or lower water be used when available.
It is positively known from many examina
tions that too little care is given to the conser
vation of healthful water supplies. In many in
stances farmers are using water from wells in
which are remains of dead animals. In some
cases the hair from these being brought to the
surface by pumping or in the bucket is appar
ently not sufficient evidence to indicate the pos
sible presence of an animal in the well.
Chickens and geese on some farms have access
to the covering of the well in which the, boards
lie loosely. Many wells are not graded, thus
receiving a portion of the surface drainage 'from
yards and lots, as the case may be. In a few
places this drainage is from manure piles on
which have been thrown human excreta, making
a dangerous situation.
Disease is also spread by careless methods of
using drinking water supplied from sanitary
sources. Germs of the sick are carried to new
hosts by drinking in common from buckets, dip
pers, cups, etc. Most communities have patients
suffering from tuberculosis, and the contact of
their lips with the cup or other vessel is apt to
leave germs thereon. The next person using
the cup may receive the germs into his body.
A knowledge of hygiene and sanitation should
bo sufficient to cause us to refuse to accept this
risk or chance .of becoming injected. The "old
oaken bucket" from which tramps and all others
could drink to their mutual danger has no virtu
