The Project Gutenberg EBook of Diphtheria, by Public Health Service
This eBook is for the use of anyone anywhere at no cost and with
almost no restrictions whatsoever. You may copy it, give it away or
re-use it under the terms of the Project Gutenberg License included
with this eBook or online at www.gutenberg.org
Title: Diphtheria
how to recognize the disease, how to keep from catching
it, how to treat those who do catch it
Author: Public Health Service
Release Date: May 1, 2011 [EBook #36006]
Language: English
*** START OF THIS PROJECT GUTENBERG EBOOK DIPHTHERIA ***
Produced by Bryan Ness, Dianna Adair and the Online
Distributed Proofreading Team at http://www.pgdp.net (This
file was produced from images generously made available
by The Internet Archive/American Libraries.)
Diphtheria
HOW TO RECOGNIZE THE DISEASE
HOW TO KEEP FROM CATCHING IT
HOW TO TREAT THOSE WHO DO CATCH IT
KEEP WELL SERIES No. 4
[Illustration: logo]
TREASURY DEPARTMENT
UNITED STATES PUBLIC HEALTH SERVICE
1919
GOVERNMENT PRINTING OFFICE
Diphtheria
After babyhood has passed, beware of diphtheria. Of all the deaths of
children 3 and 4 years of age, more than one-seventh are caused by
diphtheria.
Diphtheria is preventable and, when properly treated with antitoxin, is
curable. Most of the children who die from diphtheria really lose their
lives because of the ignorance and carelessness of their parents.
Diphtheria is a disease most often occurring in children and resembling
a sore throat or tonsillitis. It is caused by a small germ called the
diphtheria bacillus. The disease may resemble:
_A very mild sore throat_, the tonsils and back of the mouth being
redder than usual, and the person not feeling ill.
It may look like a _more severe sore throat_ or tonsillitis with a white
or grayish patch, called a membrane, on the tonsils. There may be only
one or a few small distinct patches, and the throat may feel somewhat
sore. The glands in the neck, below the tonsils, may be slightly
enlarged and may feel about the size of small peas. The patient may feel
rather ill.
Or the disease may be like a _very severe sore throat_, with small or
large gray or white patches. Not only the tonsils but also the uvula,
the small rounded end of the palate which hangs down between the
tonsils, may have on it white or gray patches. (If there is a membrane
on the uvula, the disease is almost certainly diphtheria.) With such a
throat the person feels very sick. Not only does the throat hurt, but
there are usually aches in the back of the neck and in the muscles
generally. The glands in the neck may be quite large and feel painful
when touched. The soreness in the throat may extend down the windpipe,
and membranes may form there. The patient is feverish and often is
delirious. The fever, however, is not necessarily high.
In some cases the membranes may form in the larynx (Adam's apple). When
this is the case the patient's voice sounds hoarse and croupy, and the
child may breathe with difficulty. In small children it is not uncommon,
if such cases remain untreated, for this membrane to choke the patient.
Therefore, in all cases of croup, send for a doctor immediately.
THROAT CULTURES.
In order to prevent the spread of diphtheria to others it is important
always to recognize the presence of the disease, even in mild cases. In
order to do this the doctor makes a culture from the throat and nose of
the suspected individual. He takes a piece of sterile cotton wrapped
around the end of a thin stick of wire and touches this to the throat
and tonsils, especially where there are patches or membranes. Then he
sends this swab to a laboratory, where cultures are planted from it. The
next day these cultures are examined with a microscope to see if
diphtheria bacilli, the germs which cause diphtheria, are present.
Since the diphtheria germs or bacilli grow on the lining of the throat
and air passages, they are easily thrown out from the mouth and nose of
the patient with particles of mucus or spit when the patient coughs,
spits, or sneezes. But even when the patient talks, especially when he
talks loudly, tiny droplets of mucus or spit are given off. These
droplets may have diphtheria bacilli on them. The same is true of
particles of food, no matter how small, falling from the patient's lips.
Eating utensils such as cups, glasses, forks, and spoons that have
touched the lips of the patient may likewise have saliva on them. When
the patient has diphtheria all these droplets of saliva and of mucus
may, and usually do, contain many diphtheria bacilli. Curiously, some
persons may have diphtheria bacilli in the nose and throat and yet
remain entirely well. Such persons are called "healthy carriers." They
are especially dangerous, because there is no outward sign which will
tell them or others that they are carrying deadly disease germs around.
All who attend the patient must be very careful not to get any of the
dangerous discharges from the patient's mouth or nose on the hands. In
fact, it is important for the attendant always to wash her hands
promptly after waiting on the patient. Besides this, care should be
taken that the germs are not carried to others by the use of eating
utensils, such as cups, glasses, spoons, forks, or plates. All of these
should be sterilized with _boiling_ water after each meal.
ANTITOXIN TREATMENT.
Depending on the way it is treated, diphtheria is one of the least
dangerous or one of the most dangerous diseases. It is one of the least
dangerous when promptly treated with antitoxin; it is one of the most
dangerous when the antitoxin treatment is not given, or is delayed or
insufficient. In the days before we had antitoxin one out of every three
children who had diphtheria died. Now, if antitoxin is used on the first
or second day of the disease ninety-eight out of every hundred children
recover. The sooner diphtheria is attended to the more certain is a
cure.
In severe cases suspected to be diphtheria the doctor always gives
diphtheria antitoxin at once. This is a wise thing to do, because the
disease goes on rapidly and a delay of 12 or 24 hours may be fatal.
Besides, no harm is done, even if the disease proves not to be
diphtheria. The antitoxin, although making some people uncomfortable for
a day or two, never does any real harm. Whenever antitoxin is given to a
person ill with diphtheria it should be given in _one dose, large enough
and early enough_.
TEMPORARY PROTECTION WITH ANTITOXIN.
Diphtheria is very contagious, and many people, especially children, can
catch it. For this reason, whenever a case of diphtheria is discovered,
the doctor injects the antitoxin not only into the patient, but also, as
a protective against the disease, into those who have come into contact
with the patient. This is spoken of as "immunizing" these individuals.
The immunizing dose is not so large as the curative dose given to the
patient, but it is usually sufficient to protect those exposed to
diphtheria for a month from the time of injection. At the end of that
time the protection disappears.
THE SCHICK TEST.
A few years ago a very simple test was discovered to tell whether a
person could or could not catch diphtheria. This is known as the Schick
test. It consists in injecting a few drops of a prepared diphtheria
toxin into the skin and then watching whether a characteristic red spot
appears where the injection was made. If such a spot does not appear
within two or three days it shows that the person can not catch
diphtheria.
LASTING PROTECTION BY DIPHTHERIA VACCINATION.
For those in whom the characteristic redness appears, and who are
therefore known to be liable to catch diphtheria, doctors now advise a
course of protective injections similar to those which have proven so
successful against typhoid fever. This protective treatment consists of
three small injections, a week apart. There is no sore, as there is in
smallpox vaccination, and the injections are harmless. The protection
lasts for years, and perhaps even for life.
Why not have the doctor make a Schick test on your child, and if this
shows the lack of protection against diphtheria have him give the three
protective injections?
PERSONAL AND BEDSIDE HYGIENE.
1. (_a_) All discharges from the nose and mouth should be gathered in
soft, clean cloths or rags or papers and destroyed by burning. (_b_) The
patient should cover the mouth and nose when coughing or sneezing, for a
cough or sneeze will throw droplets of mucus to a distance of 10 or 12
feet.
2. The attendant should wear a washable gown that completely covers her
clothing. It should be put on when entering the room of the patient and
taken off immediately on leaving it.
3. A basin of water, together with a cake of castile soap (or where
possible an antiseptic solution), should be placed in a convenient
place, so that the doctor and nurse attending the patient may wash their
hands whenever leaving the room, and even _before_ touching the door
handle.
4. All eating utensils that the patient uses should be washed in boiling
hot water separately from other dishes and used exclusively by the
patient.
5. All bedclothes and bedding should be boiled in soap and water, or
they should be exposed to the sunshine. _Direct sunshine kills disease
germs._
6. The person attending the patient should wear a double layer of gauze
or other soft thin cloth across the mouth and nose as a _face mask_
whenever near the patient so as to prevent the droplets containing the
germs coming from the patient's mouth from entering and lodging on the
lining of the mouth or throat of the attendant. _Always remember that
even though you may not get the disease if the germs lodge in your
throat they may grow there and you may carry the disease to another
person who may catch it._
7. There should be but one attendant wherever possible.
8. No visitors should be permitted in the sick room--not even during
convalescence.
9. The one who attends the sick should not prepare or handle the food of
others. Sometimes it is impossible to take this precaution, as very
often it is the mother who must take care of the patient, cook, and do
all the housework. In such cases the one attending the sick must _never
neglect_ whenever near the patient--
(1) To wear a face mask.
(2) To wear a washable gown (which is to be taken off on leaving
the room).
(3) To wash her hands when leaving the sick room.
_Every attendant on the sick should know how disease germs are carried
from the sick to the well. This knowledge should make her more careful,
and thus help to prevent the spread of the disease._
[Illustration: logo]
For other instructive Health Leaflets
write to the--
UNITED STATES
PUBLIC HEALTH SERVICE
WASHINGTON, D. C.
[Illustration: medical symbol]
* * * * *
End of the Project Gutenberg EBook of Diphtheria, by Public Health Service
*** END OF THIS PROJECT GUTENBERG EBOOK DIPHTHERIA ***
***** This file should be named 36006.txt or 36006.zip *****
This and all associated files of various formats will be found in:
http://www.gutenberg.org/3/6/0/0/36006/
Produced by Bryan Ness, Dianna Adair and the Online
Distributed Proofreading Team at http://www.pgdp.net (This
file was produced from images generously made available
by The Internet Archive/American Libraries.)
Updated editions will replace the previous one--the old editions
will be renamed.
Creating the works from public domain print editions means that no
one owns a United States copyright in these works, so the Foundation
(and you!) can copy and distribute it in the United States without
permission and without paying copyright royalties. Special rules,
set forth in the General Terms of Use part of this license, apply to
copying and distributing Project Gutenberg-tm electronic works to
protect the PROJECT GUTENBERG-tm concept and trademark. Project
Gutenberg is a registered trademark, and may not be used if you
charge for the eBooks, unless you receive specific permission. If you
do not charge anything for copies of this eBook, complying with the
rules is very easy. You may use this eBook for nearly any purpose
such as creation of derivative works, reports, performances and
research. They may be modified and printed and given away--you may do
practically ANYTHING with public domain eBooks. Redistribution is
subject to the trademark license, especially commercial
redistribution.
*** START: FULL LICENSE ***
THE FULL PROJECT GUTENBERG LICENSE
PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK
To protect the Project Gutenberg-tm mission of promoting the free
distribution of electronic works, by using or distributing this work
(or any other work associated in any way with the phrase "Project
Gutenberg"), you agree to comply with all the terms of the Full Project
Gutenberg-tm License (available with this file or online at
http://gutenberg.org/license).
Section 1. General Terms of Use and Redistributing Project Gutenberg-tm
electronic works
1.A. By reading or using any part of this Project Gutenberg-tm
electronic work, you indicate that you have read, understand, agree to
and accept all the terms of this license and intellectual property
(trademark/copyright) agreement. If you do not agree to abide by all
the terms of this agreement, you must cease using and return or destroy
all copies of Project Gutenberg-tm electronic works in your possession.
If you paid a fee for obtaining a copy of or access to a Project
Gutenberg-tm electronic work and you do not agree to be bound by the
terms of this agreement, you may obtain a refund from the person or
entity to whom you paid the fee as set forth in paragraph 1.E.8.
1.B. "Project Gutenberg" is a registered trademark. It may only be
used on or associated in any way with an electronic work by people who
agree to be bound by the terms of this agreement. There are a few
things that you can do with most Project Gutenberg-tm electronic works
even without complying with the full terms of this agreement. See
paragraph 1.C below. There are a lot of things you can do with Project
Gutenberg-tm electronic works if you follow the terms of this agreement
and help preserve free future access to Project Gutenberg-tm electronic
works. See paragraph 1.E below.
1.C. The Project Gutenberg Literary Archive Foundation ("the Foundation"
or PGLAF), owns a compilation copyright in the collection of Project
Gutenberg-tm electronic works. Nearly all the individual works in the
collection are in the public domain in the United States. If an
individual work is in the public domain in the United States and you are
located in the United States, we do not claim a right to prevent you from
copying, distributing, performing, displaying or creating derivative
works based on the work as long as all references to Project Gutenberg
are removed. Of course, we hope that you will support the Project
Gutenberg-tm mission of promoting free access to electronic works by
freely sharing Project Gutenberg-tm works in compliance with the terms of
this agreement for keeping the Project Gutenberg-tm name associated with
the work. You can easily comply with the terms of this agreement by
keeping this work in the same format with its attached full Project
Gutenberg-tm License when you share it without charge with others.
1.D. The copyright laws of the place where you are located also govern
what you can do with this work. Copyright laws in most countries are in
a constant state of change. If you are outside the United States, check
the laws of your country in addition to the terms of this agreement
before downloading, copying, displaying, performing, distributing or
creating derivative works based on this work or any other Project
Gutenberg-tm work. The Foundation makes no representations concerning
the copyright status of any work in any country outside the United
States.
1.E. Unless you have removed all references to Project Gutenberg:
1.E.1. The following sentence, with active links to, or other immediate
access to, the full Project Gutenberg-tm License must appear prominently
whenever any copy of a Project Gutenberg-tm work (any work on which the
phrase "Project Gutenberg" appears, or with which the phrase "Project
Gutenberg" is associated) is accessed, displayed, performed, viewed,
copied or distributed:
This eBook is for the use of anyone anywhere at no cost and with
almost no restrictions whatsoever. You may copy it, give it away or
re-use it under the terms of the Project Gutenberg License included
with this eBook or online at www.gutenberg.org
1.E.2. If an individual Project Gutenberg-tm electronic work is derived
from the public domain (does not contain a notice indicating that it is
posted with permission of the copyright holder), the work can be copied
and distributed to anyone in the United States without paying any fees
or charges. If you are redistributing or providing access to a work
with the phrase "Project Gutenberg" associated with or appearing on the
work, you must comply either with the requirements of paragraphs 1.E.1
through 1.E.7 or obtain permission for the use of the work and the
Project Gutenberg-tm trademark as set forth in paragraphs 1.E.8 or
1.E.9.
1.E.3. If an individual Project Gutenberg-tm electronic work is posted
with the permission of the copyright holder, your use and distribution
must comply with both paragraphs 1.E.1 through 1.E.7 and any additional
terms imposed by the copyright holder. Additional terms will be linked
to the Project Gutenberg-tm License for all works posted with the
permission of the copyright holder found at the beginning of this work.
1.E.4. Do not unlink or detach or remove the full Project Gutenberg-tm
License terms from this work, or any files containing a part of this
work or any other work associated with Project Gutenberg-tm.
1.E.5. Do not copy, display, perform, distribute or redistribute this
electronic work, or any part of this electronic work, without
prominently displaying the sentence set forth in paragraph 1.E.1 with
active links or immediate access to the full terms of the Project
Gutenberg-tm License.
1.E.6. You may convert to and distribute this work in any binary,
compressed, marked up, nonproprietary or proprietary form, including any
word processing or hypertext form. However, if you provide access to or
distribute copies of a Project Gutenberg-tm work in a format other than
"Plain Vanilla ASCII" or other format used in the official version
posted on the official Project Gutenberg-tm web site (www.gutenberg.org),
you must, at no additional cost, fee or expense to the user, provide a
copy, a means of exporting a copy, or a means of obtaining a copy upon
request, of the work in its original "Plain Vanilla ASCII" or other
form. Any alternate format must include the full Project Gutenberg-tm
License as specified in paragraph 1.E.1.
1.E.7. Do not charge a fee for access to, viewing, displaying,
performing, copying or distributing any Project Gutenberg-tm works
unless you comply with paragraph 1.E.8 or 1.E.9.
1.E.8. You may charge a reasonable fee for copies of or providing
access to or distributing Project Gutenberg-tm electronic works provided
that
- You pay a royalty fee of 20% of the gross profits you derive from
the use of Project Gutenberg-tm works calculated using the method
you already use to calculate your applicable taxes. The fee is
owed to the owner of the Project Gutenberg-tm trademark, but he
has agreed to donate royalties under this paragraph to the
Project Gutenberg Literary Archive Foundation. Royalty payments
must be paid within 60 days following each date on which you
prepare (or are legally required to prepare) your periodic tax
returns. Royalty payments should be clearly marked as such and
sent to the Project Gutenberg Literary Archive Foundation at the
address specified in Section 4, "Information about donations to
the Project Gutenberg Literary Archive Foundation."
- You provide a full refund of any money paid by a user who notifies
you in writing (or by e-mail) within 30 days of receipt that s/he
does not agree to the terms of the full Project Gutenberg-tm
License. You must require such a user to return or
destroy all copies of the works possessed in a physical medium
and discontinue all use of and all access to other copies of
Project Gutenberg-tm works.
- You provide, in accordance with paragraph 1.F.3, a full refund of any
money paid for a work or a replacement copy, if a defect in the
electronic work is discovered and reported to you within 90 days
of receipt of the work.
- You comply with all other terms of this agreement for free
distribution of Project Gutenberg-tm works.
1.E.9. If you wish to charge a fee or distribute a Project Gutenberg-tm
electronic work or group of works on different terms than are set
forth in this agreement, you must obtain permission in writing from
both the Project Gutenberg Literary Archive Foundation and Michael
Hart, the owner of the Project Gutenberg-tm trademark. Contact the
Foundation as set forth in Section 3 below.
1.F.
1.F.1. Project Gutenberg volunteers and employees expend considerable
effort to identify, do copyright research on, transcribe and proofread
public domain works in creating the Project Gutenberg-tm
collection. Despite these efforts, Project Gutenberg-tm electronic
works, and the medium on which they may be stored, may contain
"Defects," such as, but not limited to, incomplete, inaccurate or
corrupt data, transcription errors, a copyright or other intellectual
property infringement, a defective or damaged disk or other medium, a
computer virus, or computer codes that damage or cannot be read by
your equipment.
1.F.2. LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right
of Replacement or Refund" described in paragraph 1.F.3, the Project
Gutenberg Literary Archive Foundation, the owner of the Project
Gutenberg-tm trademark, and any other party distributing a Project
Gutenberg-tm electronic work under this agreement, disclaim all
liability to you for damages, costs and expenses, including legal
fees. YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
PROVIDED IN PARAGRAPH F3. YOU AGREE THAT THE FOUNDATION, THE
TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
DAMAGE.
1.F.3. LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
defect in this electronic work within 90 days of receiving it, you can
receive a refund of the money (if any) you paid for it by sending a
written explanation to the person you received the work from. If you
received the work on a physical medium, you must return the medium with
your written explanation. The person or entity that provided you with
the defective work may elect to provide a replacement copy in lieu of a
refund. If you received the work electronically, the person or entity
providing it to you may choose to give you a second opportunity to
receive the work electronically in lieu of a refund. If the second copy
is also defective, you may demand a refund in writing without further
opportunities to fix the problem.
1.F.4. Except for the limited right of replacement or refund set forth
in paragraph 1.F.3, this work is provided to you 'AS-IS' WITH NO OTHER
WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO
WARRANTIES OF MERCHANTIBILITY OR FITNESS FOR ANY PURPOSE.
1.F.5. Some states do not allow disclaimers of certain implied
warranties or the exclusion or limitation of certain types of damages.
If any disclaimer or limitation set forth in this agreement violates the
law of the state applicable to this agreement, the agreement shall be
interpreted to make the maximum disclaimer or limitation permitted by
the applicable state law. The invalidity or unenforceability of any
provision of this agreement shall not void the remaining provisions.
1.F.6. INDEMNITY - You agree to indemnify and hold the Foundation, the
trademark owner, any agent or employee of the Foundation, anyone
providing copies of Project Gutenberg-tm electronic works in accordance
with this agreement, and any volunteers associated with the production,
promotion and distribution of Project Gutenberg-tm electronic works,
harmless from all liability, costs and expenses, including legal fees,
that arise directly or indirectly from any of the following which you do
or cause to occur: (a) distribution of this or any Project Gutenberg-tm
work, (b) alteration, modification, or additions or deletions to any
Project Gutenberg-tm work, and (c) any Defect you cause.
Section 2. Information about the Mission of Project Gutenberg-tm
Project Gutenberg-tm is synonymous with the free distribution of
electronic works in formats readable by the widest variety of computers
including obsolete, old, middle-aged and new computers. It exists
because of the efforts of hundreds of volunteers and donations from
people in all walks of life.
Volunteers and financial support to provide volunteers with the
assistance they need, are critical to reaching Project Gutenberg-tm's
goals and ensuring that the Project Gutenberg-tm collection will
remain freely available for generations to come. In 2001, the Project
Gutenberg Literary Archive Foundation was created to provide a secure
and permanent future for Project Gutenberg-tm and future generations.
To learn more about the Project Gutenberg Literary Archive Foundation
and how your efforts and donations can help, see Sections 3 and 4
and the Foundation web page at http://www.pglaf.org.
Section 3. Information about the Project Gutenberg Literary Archive
Foundation
The Project Gutenberg Literary Archive Foundation is a non profit
501(c)(3) educational corporation organized under the laws of the
state of Mississippi and granted tax exempt status by the Internal
Revenue Service. The Foundation's EIN or federal tax identification
number is 64-6221541. Its 501(c)(3) letter is posted at
http://pglaf.org/fundraising. Contributions to the Project Gutenberg
Literary Archive Foundation are tax deductible to the full extent
permitted by U.S. federal laws and your state's laws.
The Foundation's principal office is located at 4557 Melan Dr. S.
Fairbanks, AK, 99712., but its volunteers and employees are scattered
throughout numerous locations. Its business office is located at
809 North 1500 West, Salt Lake City, UT 84116, (801) 596-1887, email
[email protected]. Email contact links and up to date contact
information can be found at the Foundation's web site and official
page at http://pglaf.org
For additional contact information:
Dr. Gregory B. Newby
Chief Executive and Director
[email protected]
Section 4. Information about Donations to the Project Gutenberg
Literary Archive Foundation
Project Gutenberg-tm depends upon and cannot survive without wide
spread public support and donations to carry out its mission of
increasing the number of public domain and licensed works that can be
freely distributed in machine readable form accessible by the widest
array of equipment including outdated equipment. Many small donations
($1 to $5,000) are particularly important to maintaining tax exempt
status with the IRS.
The Foundation is committed to complying with the laws regulating
charities and charitable donations in all 50 states of the United
States. Compliance requirements are not uniform and it takes a
considerable effort, much paperwork and many fees to meet and keep up
with these requirements. We do not solicit donations in locations
where we have not received written confirmation of compliance. To
SEND DONATIONS or determine the status of compliance for any
particular state visit http://pglaf.org
While we cannot and do not solicit contributions from states where we
have not met the solicitation requirements, we know of no prohibition
against accepting unsolicited donations from donors in such states who
approach us with offers to donate.
International donations are gratefully accepted, but we cannot make
any statements concerning tax treatment of donations received from
outside the United States. U.S. laws alone swamp our small staff.
Please check the Project Gutenberg Web pages for current donation
methods and addresses. Donations are accepted in a number of other
ways including checks, online payments and credit card donations.
To donate, please visit: http://pglaf.org/donate
Section 5. General Information About Project Gutenberg-tm electronic
works.
Professor Michael S. Hart is the originator of the Project Gutenberg-tm
concept of a library of electronic works that could be freely shared
with anyone. For thirty years, he produced and distributed Project
Gutenberg-tm eBooks with only a loose network of volunteer support.
Project Gutenberg-tm eBooks are often created from several printed
editions, all of which are confirmed as Public Domain in the U.S.
unless a copyright notice is included. Thus, we do not necessarily
keep eBooks in compliance with any particular paper edition.
Most people start at our Web site which has the main PG search facility:
http://www.gutenberg.org
This Web site includes information about Project Gutenberg-tm,
including how to make donations to the Project Gutenberg Literary
Archive Foundation, how to help produce our new eBooks, and how to
subscribe to our email newsletter to hear about new eBooks.
