Science of Dress/Chapter IV
CHAPTER IV.
COLD, AND THE HARM IT DOES.
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FROM what has already been said on the subject of animal heat it has become evident that any undue abstraction of it from the body must be followed by evil consequences.
Cold is simply the absence of heat, and when the body is surrounded by substances at a low temperature, heat is abstracted from its surface, and a certain painful and familiar sensation is imparted through the nerves of the skin.
The action of cold on the surface of the body is very complex. In the first place it prevents the flow of blood to the skin by causing contraction of the muscular fibre, which lessens the calibre of the small arteries of the skin, and so impedes the flow in the capillaries. It also produces reflex nervous action, which causes the little arteries to contract still more violently, until the circulation in the skin of the part is stopped entirely. That is what happens when on a very cold day your finger is, as you call it, "dead," and it is the first stage of frost-bite in which the part actually dies and comes away. Now when the blood does not circulate near the skin, the action of the skin as an excretory organ is stopped, and its work of getting rid of waste matters from the blood is thrown upon the other excretory organs, the lungs and the kidneys; these become overworked, and disease results. Besides this, when the blood cannot pass near the surface of the body, it has to go somewhere else, and the consequence is that the internal organs get too great a supply, and are thus rendered very liable to become inflamed.
Thus many diseases are directly occasioned by cold; but, even apart from these, general debility may be induced by it, owing to insufficient nutrition, for animal heat is derived from part of the food consumed, and consequently, if much heat is abstracted from the body by a low external temperature, much of the food matter has to go to supply heat instead of forming tissue, and the frame is practically starved, unless a corresponding amount of nutriment is supplied, which is not always possible, especially in those of feeble digestive powers.
The injury done by cold is most apparent in the case of children, who for obvious reasons suffer from it more than adults do.
The first danger a new-born infant has to encounter is from the external cold. It passes from a high and practically unvarying temperature into one much lower and exceedingly changeable. This danger is increased by the fact demonstrated by Milne Edwards, that the power of generating heat is at its minimum in all animals immediately after birth, increasing as the individual developes, and its strength and activity become greater. Moreover, the younger a child is, the more readily it parts with its heat, because the smaller it is, the larger is its surface relatively to its bulk, for the area of a body varies as the square of its dimensions, while its mass varies as their cube, and the surface of a human body is an evaporating—consequently a cooling one. The following example will make this point clearer. A cube one inch in the side has six square inches of surface to one cubic inch of bulk, while a cube ten inches in the side has 600 square inches of surface to 1000 cubic inches of bulk, so that the surface of the small cube is ten times greater in proportion to its contents than that of the large one. Now, supposing a child to be one-tenth of the size of its mother, besides its feebler powers of generating heat, it will have just ten times as much surface in proportion to its size by which to lose heat as that mother has.
The lungs in young infants are especially active, and are thus rendered more liable to become diseased than any other organ when increased work is thrown upon them by exposure to cold, and every year thousands of children fall victims to lung diseases, which are very much more common during childhood than at any other time of life, as you will see clearly from the fact that out of 379 fatal cases of pneumonia—that is, inflammation of the lungs—in London and some country districts, 228, or nearly two-thirds, were children under three years of age. But in order to give a fuller idea of the mischief done, let me quote the Registrar-General's statistics. From these we see that in one year alone (the year 1871) more than 18,000 infants under one year died in England and Wales from pneumonia and bronchitis. If that is not a massacre of innocents, I should like to know what is. And yet this mortality does not represent a hundredth part of the mischief done, for we have to take into consideration all those thousands who, although surviving these diseases and others, such as scarlet fever, measles, whooping-cough, mumps, and croup, the dangers of which are vastly increased by exposure to cold, have been permanently injured by them.
The evils of cold are clearly shown by the enormous death-rate of cold countries—a death-rate chiefly made up by infantile mortality. During the year 1883 the mortality from zymotic diseases was nearly twice as great in New York as in London, and the excess in the mortality from diseases of the respiratory organs and from consumption was very marked. The death-rate of children is proportionately high, for while in London the deaths of children under five years of age were 65.1 per thousand, in New York they amounted to no less than 90.3.
In Russia the mortality is frightful, 60 per cent, of those born, actually more than one-half, dying before they are five years old, and nearly two million children perishing there every year. In some parts of the Czar's dominions the average duration of life is only twenty-six years, and thus Russia shows the highest death-rate of any European country. Of eight million boys born, less than half attain the age of military service, which in Russia is twenty-five, and of these at least one million, that is, more than one-fourth, are found to be unfit for the army, owing to their shortness of stature and physical debility.
This last fact illustrates another point of great importance—namely, that those who survive exposure to cold are injured by it, either in growth or in development.
The subject of growth is inextricably interwoven with those of nutrition and heat. Spencer, in his great work on "Biology," states1[1] that growth is substantially equivalent to the absorbed nutriment, minus the nutriment used up in action. This is a short way of saying that growth is supplied by digested food, but only by the surplus of digested food which is left after replacing the worn-out tissues that are constantly being used up in the body, and the heat which is constantly passing away from it. Thus the more heat that is lost from the body, the more nutriment has to be confiscated for heat-giving purposes, and the less can be devoted to building up the body. Hence cold is an enemy to growth alike in the animal and vegetable world.
An interesting series of experiments bearing on this subject has been instituted by Mailing-Hansen, and the results of these experiments were made public by him at the International Medical Congress of 1884, held at Copenhagen. He finds that increase of warmth is accompanied by increase in the weight of children, decrease of warmth by decreased weight. He found a decrease of 2° in temperature to be accompanied by as much as a ninefold decrease in the weight of a child, while a rise of 3° was followed by a thirteenfold increase in weight.
Weight decreases in proportion as the temperature falls, for the same reason that growth is hindered by cold.
Since growth is so strongly influenced by cold, a knowledge of the normal growth-rate is invaluable to those who have the care of children, as deviations from that normal rate are a sure index to impaired nutrition and general health. In order to ascertain whether such deviations are going on, children should frequently be weighed and measured, for in the one word growth I include increase both in weight and in height.
All infants lose five or six ounces in weight during the first few days after birth; they, however, gain one pound by the end of the first month, and two pounds in the second, after which the increase is less rapid. In the first four or five months the weight at birth should be doubled, and trebled by the end of the first year. During this time the child should gain three inches in height in the first three months, two inches in the next quarter, and two or three inches in the last six months. At three years old the average child is three feet high, and weighs thirty-two pounds; at five years it weighs forty pounds; at eight years its height is four feet, weight fifty-six pounds; at twelve it is five feet high, and weighs from seventy-two to eighty pounds.
Dr. Squire's statistics on this point, which are averaged from a large number of observations, may be seen at a glance from the following table, which shows the height and weight of children from the fourth to the twelfth year :—
Height. Weight. Years. Ft. in. Stones. 4 3 0 over 2 5 3 5 2¾ 6 3 7 3 7 3 9 3½ 8 3 11 4 9 4 0 4½ 10 4 3 4½ 11 4 6 5 12 4 9 5½
At adolescence two stones should be added for every three or four inches in height. Thus, a person measuring five feet six should weigh eight stone; whereas, if measuring five feet eight, he or she ought to weigh nine stone.
In accordance with the rule that growth is hindered by ill-health, its increase is less rapid during the first dentition. Owing to various causes most children grow by fits and starts, adding perhaps three inches to their height in one quarter, and not an inch in the next half-year; but if girls do not increase their rate of growth during their eleventh and twelfth years, their healthy development a year or two later is hampered.
From all that I have said it is clear that every care should be taken to protect children, even more than adults, from cold.
Dwelling-rooms and school-rooms should be maintained at an even temperature of between 62° and 65° Fahrenheit, which should be regulated by a thermometer always kept well in view. How often may children be seen sitting up at lessons with fingers and noses red and blue with cold, or, on the other hand, confined in a room so hot and stuffy that it is painful to enter it! In this, as in everything else, the only right way is to avoid extremes, which can best be done by keeping an eye on the thermometer. Moreover, it must not be forgotten that the ventilation of rooms must not be sacrificed for the sake of warmth, for, vulgarly speaking, this is only "robbing Peter to pay Paul." If air cannot readily enter and leave the room, the atmosphere by the process of breathing, which I have described, becomes overcharged with carbonic acid gas and vapour of water, and loses its oxygen. The same portion of air cannot be breathed twice, so that if an animal is enclosed in a limited space it dies as soon as all the air contained in its prison has passed through its lungs. Hence bad ventilation is a serious evil.
The sufferings of children from cold are terribly increased by the barbarous way in which they are generally dressed.
From all that I have said, it ought to be very clear that children should be better protected from the cold—more warmly clad—than grown people. But what do we find when we look around us? Herbert Spencer said years ago, "What father, full grown though he is, losing heat less rapidly as he does, and having no physiological necessity but to supply the waste of each day—what father, we ask, would think it salutary to go about with bare legs, bare arms, and bare neck?" Yet this is exactly what most people allow their children to do, ignoring the fact that, even if colds and the more serious diseases I have mentioned are escaped, injury must result to growth or structure—for, owing to the insufficient clothing, much of the nourishment which ought to supply the development of the organism has to be expended in keeping up its temperature. Exposure means loss of heat, and loss of heat produces dwarfishness, as proved by the stunted and hideous figures of the dwellers in the Arctic and Antarctic regions, and by the dwarfed vegetation of cold countries.
It is therefore impossible too strongly to condemn this custom of exposing children's arms, legs, and necks; for every inch of their bodies which is so exposed is a means of abstracting heat, and a loophole for health to escape by. I have not the slightest doubt that if only the amount of trouble spent by mothers on personal adornment, and on ornamenting their children's clothes, was devoted to preventing the exposure of children to cold, the mortality from the diseases I have mentioned, and the cruel mischief done by them, would be reduced to almost nothing. "We have met with none competent to form a judgment on the matter who do not strongly condemn the exposure of children's limbs," says Herbert Spencer. Alas, then, to judge from the manner in which we see children generally dressed, how many millions must be incompetent to form a judgment on the matter!
People seem to imagine that they improve the appearance of children by exposing their necks and limbs. For my own part, I never can discover the beauty of the red, harsh, and often chapped and painful skin which results from the practice. The appearance natural to the skin of childhood is a creamy, satiny softness, beautiful alike to sight and touch, and it is therefore no less wrong artistically than hygienically to submit children to the evil influence of cold.
Dr. Inman has said that if you coddle an infant and take care of it, it will very likely grow to be a strong and healthy adult; but if you try and harden it by exposing it to cold, and not clothing it properly, &c., you must not be surprised if you "soon have to measure it for a long box." Whenever I read a sentimental poem about some sweet infant that has gone to a better world, or hear some mother with tears in her eyes declare that her little one "is an angel now," I say to myself, ten chances to one that child died, as thousands die every year, wholly from neglect of laws of health, which it is the bounden duty of every mother and nurse to know and obey, and of which 999 out of a thousand are absolutely ignorant. Often, when women are priding themselves on being the best of mothers, they are, in utter ignorance, actually murdering their children! But I have often been told, when remonstrating with mothers for exposing their children, "O, I don't believe in coddling; this sort of thing hardens them and makes them strong." This theory of hardening is a fallacy from beginning to end. From one point of view only can anything be said in its favour, and that is, that, allowing there are already too many people in the world, it will be an advantage to get rid of as many of the weakest of newcomers as possible. By adopting the "hardening" plan, the weak ones certainly go to the wall, though I think mothers, even while defending the theory, will hardly appreciate the advantage of this result; but then the survivors are just as certainly injured in health or in development.
Here I would mention also that there are two facts which the advocates of the "hardening" theory entirely ignore. Firstly, when they say, "Well, look at these children; their arms and legs and necks are bare, but they do not feel the cold a bit," or, "I never wrap up, but I do not feel the cold," they forget the principle which I shall presently2[2] take some pains to explain, that the senses, when their warnings are constantly neglected, cease, after a time, to give any. Nature has adapted itself to the objectionable circumstances, but this is no guarantee that no harm has been and is being done by them. Secondly, when these theorists point to A, B, or C, and say, "See what a fine fellow he is, yet he was never coddled," they forget that most important of all principles, that the fittest survive. A, B, or C may be a very fine fellow indeed, but he is only so because he is the happy possessor of a magnificent constitution, which he has inherited from his ancestors, and which enables him to do with impunity all sorts of things which would be fatal to a weaker individual. The "hardening" theorists only take account of their successes; their failures are quietly put away underground and forgotten, or perhaps remembered with a sigh and the remark that "God loved them, so He took them for His own."
The necessity for a thorough protection from cold is a pressing one, especially for children. The warmth of clothing, whether for children or adults, should be regulated by the thermometer, not by the season of the year; and in kind and quantity clothes should be "sufficient in the individual case to protect the body effectually from an abiding sensation of cold, however slight" as Andrew Combe wrote over forty years ago. In the case of infants, however, it is not always easy to know if they are sufficiently warm, since they cannot tell us of their sensations; but the best plan to adopt is to pass the warm hand over the surface of their bodies, and if it feels chilly, to supply increased warmth of clothing.
As the subject of clothing is most important in the case of young infants, it will be well to devote a whole chapter to its consideration.