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they have tuberculosis, in two-thirds of the cases it will make a little reddening and swelling like a very mild vaccination. But in order to get any good from this, cases must be brought to a doctor, early, without waiting for a bad cough, or for night sweats.

Signs of Consumption. The signs that ought to make us suspicious of a possible beginning of tuberculosis are first, loss of weight without apparent cause; fever, or flushing of the cheeks, with or without headache, every afternoon or evening; and a tendency to become easily tired and exhausted without unusual exertion. Whenever these three signs are present, without some clear cause, such as a cold, or unusual overwork or strain, especially if they be accompanied by a rapid pulse and a tendency to get out of breath readily in running upstairs, they should make us suspect tuberculosis; and if they keep up, it is advisable to go at once and have the lungs thoroughly examined. Nine cases out of ten, seen at this stage, are curable—many of them in a few months.

AN OUTDOOR CLASSROOM FOR TUBERCULOUS CHILDREN
AN OUTDOOR CLASSROOM FOR TUBERCULOUS CHILDREN

The roof and the side awnings are the only obstructions to the outer air.

Even if we should not have the disease, if we have these symptoms we need to have our health improved; and a course of life in the open air, good feeding, and rest, which would cure us if we had tuberculosis, will build us up and prevent us from developing it.

PNEUMONIA

Its Cause and Prevention. The other great disease of the lungs is pneumonia, formerly known as inflammation of the lungs. This is rapid and sudden, instead of slow and chronic like tuberculosis, but kills almost as many people; and unfortunately, unlike tuberculosis, is not decreasing. In fact in some of our large cities, it is rapidly increasing. Although we know it is due to a germ, we don't yet know exactly how that germ is conveyed from one victim to another. One thing, however, of great practical importance we do know, and that is that pneumonia is a disease of overcrowding and foul air, like tuberculosis; that it occurs most frequently at that time of the year—late winter and early spring—when people have been longest crowded together in houses and tenements; and that it falls most severely upon those who are weakened by overcrowding, under-feeding, or the excessive use of alcohol. How strikingly this is true may be seen from the fact that, while the death-rate of the disease among the rich and those in comfortable circumstances, who are well-fed and live in good houses, is only about five per cent,—that is, one in twenty,—among the poor, especially in the crowded districts of our large cities, the death-rate rises to twenty per cent, or one in five; while among the tramp and roustabout classes, who have used alcohol freely, and among chronic alcoholics, it reaches forty per cent. The same steps should be taken to prevent its spread as in tuberculosis—destroying the sputum, keeping the patient by himself, and thoroughly ventilating and airing all rooms. As the disease runs a very rapid course, usually lasting only from one to three weeks, this is a comparatively easy thing to do.

Though pneumonia is commonly believed to be due to exposure to cold or wet, like colds, it has very little to do with these. You will not catch pneumonia after breaking through the ice or getting lost in the snow, unless you already have the germs of the disease in your mouth and throat, and your constitution has already been run down by bad air, under-feeding, overwork, or dissipation. Arctic explorers, for instance, never catch pneumonia in the Frozen North.

CHAPTER XV THE SKIN OUR WONDERFUL COAT

What the Skin Is. The skin is the most wonderful and one of the most important structures in the body. We are prone to think lightly of it because it lies on the surface, and to speak of it as a mere coating, or covering—a sort of body husk; but it is very much more than this. Not only is it waterproof against wet, a fur overcoat against cold, and a water jacket against heat, all in one, but it is also a very important member of the "look-out department," being the principal organ of one of our senses, that of touch.

The eyes in the beginning were simply little colored patches of the skin, sunk into the head for the purpose of specializing on the light-rays. The smelling areas of the nose also were pieces of the skin, as were also the ears. Not only so, but—although it is a little hard for you to understand how this could have happened—the whole brain and nervous system is made up of folds of the skin tucked in from the surface of the back; so that we can say that the skin, with the organs that belong to it and have grown from it—the eyes, nose, ears, brain, and nerves—forms the most wonderful part of the body. Everything that we know of the world outside of us is told us by the skin and the look-out organs that have grown out of it. The skin is not only the surface part and coating of the body, far superior to any six different kinds of clothing which have yet been invented, but it is related to, and assists in, the work of nearly half the organs in the body. Not only all that we learn by touch and pressure, but everything that we know of heat and cold, of moisture and dryness, and most of pain, comes to us through our skin, through the little bulbs on the ends of the nerve twigs in it. It also helps the lungs to breathe, the kidneys to purify the blood, and the heart to control the flow of blood through the body.

A healthy skin is of very great importance; and part of this health we can secure directly, by washing and bathing, scrubbing and kneading and rubbing, because the skin lies right on the surface, where we can readily get at it. But, on the other hand, no amount of attention from the outside alone will keep it healthy. All the organs inside the body must be kept healthy if the skin is to be kept in good condition. Although the external washing and cleaning are very important, the greater part of the work of developing a healthy skin and a good complexion must be done from the inside.

The Two Layers which Make Up the Skin. Like our "internal skin," the mucous membrane, which lines our stomach and bowels, the skin is made up of two layers—a deeper, or basement, sheet, woven out of tough strands of fibrous stuff (derma); and a surface layer (epidermis) composed of cells lying side by side like the bricks in a pavement, or the tiles on a floor, and hence called "pavement" (epithelial) cells. These pavement cells are fastened on the basement membrane much as the kernels of corn grow on a cob; only, instead of there being but one layer, as on a cob of corn, there are a dozen or fifteen of them, one above the other, each one dovetailing into the row below it, as the corn kernels do into the surface of the cob. As they grow up toward the surface from the bottom, they become flatter and flatter, and drier, until the outer surface layer becomes thin, fine, dry, slightly greasy scales, like fish-scales, of about the thickness of the very finest and driest bran.

THE LAYERS OF THE SKIN
THE LAYERS OF THE SKIN

E, epidermis; C, capillaries; D, dermis; F, fat globules and connecting fibres.

We are continually Shedding our Skin. One way in which the skin keeps itself so wonderfully clean and fresh is by continually shedding from its surface showers of these fine, dry, scaly cells, which drop, or are rubbed off, as they dry. This is the reason why no mark, not even a stain or dye, upon the skin, will stay there long; for no matter how deeply it may have soaked into the layers of the pavement-cells, every cell touched by it will ultimately grow up to the surface, dry up, and fall off, carrying the stain with it.

If you want to make a mark on the skin that will be permanent, you have to prick the colors into it so deeply that they will go through the basement layer and reach cells which will not grow toward the surface. This "pricking-in" operation is known as tattooing; and it is as foolish as it is painful, for blood-poisoning and other diseases may be carried into the system in the process.

Perhaps you will wonder why, if you are shedding these scales from all over your surface every day, you don't see them. This is simply because they are so exceedingly small, thin, and delicate, that you cannot see them unless you get a large number of them together; and when you are changing your clothing, bathing, etc., they are rubbed off and float away. If a part of the body has been shut in—as when a broken arm, for instance, is in a cast, which cannot be changed for several weeks—when finally you take off the bandage, you will find inside it spoonfuls—I had almost said handfuls—of fine scales, which have been shed from the skin and held in by the wrappings.

THE GLANDS IN THE SKIN

Sweat Glands. Like all the pavement (epithelial) surfaces of the body, inside and out, the skin has the power of making glands by dipping down little pouches or pockets into the layers below. In the skin, these little gland-pockets are of two kinds, the sweat glands and the hair glands.

The sweat glands are tiny tubes which go twisting down through the different pavement layers, through the basement layer, and right into the coat of fat, which lies just under the skin. The tube of the sweat gland soaks, or picks, out of the blood some of the waste-stuff—just as the kidney tube does in the kidney,—together with a good deal of water and a small amount of delicate oil, and pours them out on the surface of the body in the form of the "sweat," or perspiration.

As you will remember, when the muscles work hard and pour more waste into the blood, then the heart pumps larger amounts of blood out into the skin; and this causes it to redden. The sweat glands work harder to purify this extra blood, and they pour out the waste and oil and water on the surface. As soon as this water gets upon our hot skin, it begins to evaporate and cool us off, as well as to carry off some of the waste in the form of gas. The trace of oil in the perspiration helps to lubricate the skin and keep it soft; but when too much of it is poured out we have that greasy feeling, which we have all felt after perspiring freely.

From all this cooling and breathing and blood-purifying work going on upon the surface of our skin, you can easily see why it is so important that all our clothing should be loose and porous and that next the skin easily washed; else it will very soon become clogged up and greasy, and shut off the breathing and blood-purifying work of the skin and make it dirty and unhealthy. This continual mist of water, rising and bubbling up through our skin like springs out of a hillside, is another of nature's wonderful ways of cleansing the skin and of preventing any kind of dirt from permanently sticking to or lodging in it. Remember, you do not need to dig below the surface when

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