Weather not the cause of pneumonia.
One of the sources formerly believed to be largely responsible for pneumonia, that is, exposure to severe weather, is curiously negatived by the fact that children and old people are not those generally exposed to weather. Perhaps no fallacy in any disease has been more prevalent than that pneumonia is usually contracted by exposure to wet or to cold. It has, indeed, been noticed that the disease has been practically non-existent under conditions where it would be prevalent if exposure alone were the cause. For instance, in the Arctic zone, where the temperatures are very low and where no adequate provision against the rigors of a severe climate are possible, pneumonia is practically unknown. During Napoleon's retreat from Moscow, when thousands of soldiers died from physical exposure, from frost bite and starvation, where if exposure were the predisposing cause of pneumonia, it would have raged as an epidemic, it seldom appeared, proving this opinion.
Perhaps one reason why the disease has been supposed to result from exposure is the undoubted fact that it is chiefly prevalent in the winter and spring rather than in the summer. This argument is, however, modified by the fact that the majority of cases do not occur in January or February when the temperature is lowest, but in March, when the opening of spring is in sight. The reason for this is evident when we remember that the cause of the disease is a germ, generally present in the body and needing only a reduced vitality for its successful inroad on the human system. When, therefore, a person shuts himself up in an overheated house, without ventilation, takes insufficient exercise, and lives with an apparently determined effort to do everything possible to reduce his bodily vigor, then it is no wonder that the germ, almost in exultation, finds an opportunity for successful development.
Preventives in pneumonia.
Much as in tuberculosis, then, the best remedy and the best prevention for pneumonia is a careful attention to the needs of the body in order that it may preserve its normal vigor. Regular hours, sufficient sleep, and good food will, in most cases, keep the body in such a condition that pneumonia need not be dreaded, no matter what the exposure or what the temperature. Further than this, if the disease does once start and gain a foothold in the lungs, the best cure is, as with tuberculosis, a plentiful supply of oxygen or fresh air in order to remove the toxins formed by the disease and give the lung tissue an opportunity to recover.
Formerly medical men treated pneumonia by confining the patient in an overheated room in which steam was generated, with the idea that the lungs would be most helped by an atmosphere of moist heat. Now, a pneumonia patient is supplied with all the fresh air possible, the windows of the sick room, even in winter, being kept continually open, and every effort being made to give the patient fresh air even when every breath means a shooting pain, and apparently untold suffering. In some of the New York City hospitals, the ward for pneumonia patients is on the roof, and children and babies suffering with pneumonia are at once taken there, even with snow piled all around the tent in which they are kept. The nurses and physicians are obliged to don fur coats, and heavy blankets must be provided to keep the patients from freezing to death; but the pneumonia germ, under these conditions, is worsted almost as if by magic, and within a few hours after leaving the warm wards of the hospital the patients start on the road to recovery.
The remedy, then, for the 2000 cases of pneumonia which occur in New York State each year, is an improved regulation of the health conditions of the separate families throughout the state—a better hygienic regulation of the everyday life. Care must be taken to provide better ventilation in the houses, more fresh air in the sitting room and in the sleeping rooms, more outdoor life in the winter time, and more exercise by which the blood circulation will be kept active. Then more varied and more suitable food must be consumed, food which will be capable of absorption by the tissues and not clog the intestines and poison the system. More bathing, by which the pores of the skin can be relieved of the organic matter which otherwise clogs them and prevents their effective action in the removal of waste products, must be indulged in. With these three factors properly evaluated, with more fresh air, with better food, with ample bathing, pneumonia need not be dreaded, since then it would attack only those few whose constitutional vigor was impaired, and in the course of a generation or two the number of these would be so decidedly diminished that pneumonia would find no one susceptible.
Infection of pneumonia.
It must not be forgotten that a pneumonia patient is a source of infection quite as much as is a tuberculous patient, and the same precautions against infection should be followed. The nurse should be particularly careful not to infect herself. She should be careful to exercise enough self-control always to get daily exercise and fresh air and must, as a matter of self-protection, avoid overfatigue. The eating utensils, food refuse, and soiled clothing may all be infectious and must be sterilized by boiling as soon as removed from the sick room. The severe epidemics which have occurred from pneumonia have occurred in camps where sanitary conditions are grossly violated. Under such conditions pneumonia has become a most alarming epidemic, sometimes called the black death. In a single house, however, disinfection of the wastes of the patient and a proper care of the personal hygiene of the rest of the family will avoid the spread of the disease, and if the patient has sufficient vitality, sustained by good food and fresh air, he will recover without serious after affects.