“CONTROLLING THE SYMPTOMS,”
is like answering the cries and gesticulations of a drowning man with a knock on the head. If when
these intestinal disorders arise, or have become serious, their chief cause—over-feeding—be kept up, the next of nature’s remedies may be inflammation of stomach or bowels, or both, followed, perhaps, by dysentery, which is the most serious phase of constipation. These are very alarming symptoms, and demand entire abstinence from food until they are considerably abated; pure water should be given freely, and, when possible, exercise to some degree in the open air; tepid water injections, followed by gentle kneading of the bowels for a few minutes, occasionally, to promote the circulation in that region, thus favoring the cleansing and healing process. The appearance of a little fresh blood, even, following this treatment, should not excite alarm; on the contrary, it is, per se, a favorable symptom. This special phase of the subject is treated more at length in the author’s work entitled “How to Feed the Baby.”
A very common mistake with the laity, and often enough made by physicians in diagnosing this complaint, is that of considering a comfortable daily movement conclusive proof that the bowels are not constipated. Few people have tongues that are entirely clean, and a coating there indicates, unmistakably, a worse one of the stomach and intestines.[40] The daily—perhaps semi-daily—action is the result of purgation often, though they would scorn the idea of taking physic—the quantity or quality of their food being such as to cause a degree of indigestion and consequent irritation sufficient to produce purgative
effects. While this condition can be endured, all seems to be going along well. There is, to be sure, more or less of acidity, sour stomach, eructations of acrid matters (see the Salisbury theory in article on Consumption), flatulence, headache, neuralgic or rheumatic pains—more or less in number of the scores of ailments so common as to be considered almost normal—but not immediately any serious or alarming complaint. But, after a time, longer or shorter, according to the constitution of the individual, the movements become less satisfactory—irregular and not as profuse as common, and are passed with some difficulty, perhaps. Next to the mistake of resorting to drugs in these cases, is the quite common one of swallowing special kinds of food for the same purpose, and there, is some question as to which of the two evils is the least. An excessive quantity of rye mush, wheaten grits, or oat groats, with a generous dressing of butter, syrup, milk, or honey to wash it down in abnormal haste, will often purge the bowels like the most drastic poison. Active exercise in the open air, taken in conjunction with a proper diet, would prove curative; but in default of this the case goes from bad to worse, until in spite of all the efforts made, the constipation becomes more and more obstinate, various symptoms increasing in degree and new ones appearing, until there almost certainly follows a severe “attack” of some sort: whether this be typhoid, bilious, rheumatic, or scarlet fever, erysipelas, diphtheria, or what not, depends upon the age, surroundings, and diathesis of the patient.
[40] See chapter on Consumption.
All such attacks may be called Nature’s kill-or-cure remedies when, as a last resort, she is forced to adopt “heroic treatment”; but aid her in the Natural Cure and she is most kind.
Note.—Attention is called to the notes following Consumption, and Bright’s Disease.
CHAPTER V.
BRIGHT’S DISEASE (ALBUMINURIA).
In its later stages, this is one of the worst forms of disease. It is often said to be caused by “cold.” There can be no doubt but what a person whose kidneys are already badly diseased, and, consequently, his whole system depraved, may have a violent illness excited by extreme exposure to wet and cold. The same may be said in case of one reduced by any exhausting form of disease; but sound-bodied men, living hygienically, could never have this disease, whatever the degree of cold they might have to endure. On the contrary, this disease is not known among the residents of the polar regions; our own explorers among the ice-fields of the north do not have it, although exposed for long periods to a temperature at 40° to 60° F. below zero, and to changes of so extreme a character that our temperate climate affords no parallel to them. “In the accounts of Arctic expeditions, though the most intense cold was often endured, under circumstances of great fatigue, by men previously weakened by disease and hardship, this is not among the diseases from which they suffered. Dr. Kane’s men, though enduring extreme cold, exposed
on one occasion for seventy-two hours at a mean temperature of 41° below zero, suffered fearfully from frost-bite and scurvy, but not from any renal affection. Other travelers within the Arctic circle bear the same testimony, and I have been informed by those familiar with the cold districts of North America, that there renal dropsy is unknown.”[41] “The travelers in the frigid zone are exposed to far greater and more sudden transitions of temperature than are ever felt in our changeable but temperate climate. Capt. Parry states that his men often underwent a sudden change of 120°, in passing from the cabin of the vessel to the outer air, and yet none but the most trifling complaints resulted. Here we have all the circumstances from which experience would lead us to anticipate renal disease, viz.: great preceding depression, intense and protracted cold suddenly applied.... Extreme cold,” continues Dr. Dickinson (ibid.) “though it may stop cutaneous exhalation, probably does not allow the material that would cause renal inflammation to accumulate. Cold increases the action of oxygen and gives rise to increased combustion of the solids and fluids of the body. This condition, as I have emphasized elsewhere repeatedly, occasions a demand for a large amount of food daily, to supply the waste, and exalts the digestive powers correspondingly. The moral of all this, for those who, living in a temperate climate, would avoid these disorders—all physical disorders,
indeed—is that here the above conditions can not obtain to the extent of rendering possible the digestion and absorption of three full meals a day. Only under exceptional circumstances are two such meals ever thoroughly digested and assimilated—they can never be, unless needed; and this fact is not disproved simply because inexperts do not recognize the symptoms of indigestion which everywhere prevail among themselves. Some of the most incorrigible workers, with both brain and muscle, known to me, take but one meal a day,[42] and this because they found the change necessary in order to enable them to perform their arduous labors and preserve their health. Others similarly situated divide this meal into two halves—taking a small meal morning and night, or, better than the latter, a lunch in the morning, and at night, after ample rest, the principal meal. No person ever tried this plan and found any need of a change because of lack of nourishment.[43] I mention this last point to meet the stock objection of people who essay to escape from the logic of the position—the necessity for the modification of their own dietetic habits—behind the old dogma, ‘one’s meat is another’s poison.’ (See p. [43].) It is entirely probable that a robust man (a frail one would succumb to the exposure, with or without food) exposed for days together, and for the entire twenty-four
hours, to the extreme cold of winter, exercising vigorously meantime, could eat three full meals a day and escape digestive disorder. The habit of approximating as nearly as possible to this diet, in a temperate climate, or while the bodily warmth is maintained by artificial heat, originates the greater proportion of our ailments; while lack of exercise, and the folly of attempting to oxygenate this excessive quantity of food with air that is breathed over and over again—a process which one writer likens to eating one’s own fœces—amply accounts for the balance.
[41] “Treatise on Albuminuria,” by W. Howship Dickinson, M.D., F.R.C.P., etc., p. 54.
[42] See note on The One-Meal System.
[43] The fact is—and it can not be made too prominent—ninety-nine in the hundred, of all classes of people, eat in excess of their needs, and the “small eater,” eating without appetite, eats, relatively speaking, more excessively than the gross-feeder whose appetite never fails.
“By cold the respiratory function is exalted, and the excretion of urea is diminished. With the intense cold of the North Pole (and in the open air), the introduction of oxygen by the lungs is probably so great, and the oxidation in the body so active, that all material susceptible of such action becomes oxidized, as much of it as can be converted into carbonic acid passing out with the breath. The kidneys, therefore, are not liable, as in temperate climates, to be irritated by excrementitious matter, for the stress of excretion falls upon the lungs.” (Ibid.) The practical question then is, What can we do, in this particular climate, that shall tend to give us exemption from a disease that can not exist at the poles, where the cold is intense enough to require a man to eat all he can, nor at the tropics, when the heat is met with a diet of juicy fruits?[44] (See article on
Fruits.) Simply this, and nothing more; so regulate the diet as to forbid indigestion, or, in other words, eat according to our needs, as governed by work and weather; and all that has been said about the cause and prevention of “colds” (see C.) is applicable right here.
[44] Sojourners from the North, at the tropics, are exempt from disease so long as they live on the fruits of the soil; but a beef and brandy regimen makes short work with them.
Winter weather (inoperative, however, for those who spend their time in close, warm rooms), scant clothing, much exercise, fresh air—these conditions, so far as present, and to the extent of a man’s subjection to them, require a larger quantity of food than could be digested under opposite conditions, and tend to mitigate the effects of over-indulgence as to amount and quality. In our climate, however, not one person in ten thousand lives, even in the coldest weather, sufficiently under these influences to require the diet necessary at the poles, viz., three full meals of mixed food, largely composed of fat. Hence, the only palliatives a person can resort to, who adheres to the prevalent mode of living, as to diet, are those conditions that approach as nearly as possible to those obtaining in the frigid zone; but these conditions can not be, at least are not, enjoyed here, to a point rendering exemption from disease possible even for the most robust. But when we reflect upon the fact that our people are not, as a rule, robust (although this would be otherwise but for the unbalanced circumstances under consideration), that they live in warm rooms, wear heavy clothing even within doors, and don thick wraps on going out, work as little as possible (all tending
to the need of abstemiousness), and that in the face of all this they do not, at least to any appreciable extent, voluntarily restrict their appetites, but do, in fact, even in summer, imitate the blubber-eaters of the North, nearer than they do the fruit-eaters of the South; that Sabbath morning finds the New Englander, for example, gorging himself with pork and beans, hot brown bread dripping with butter, hot, strong coffee, etc.; Tuesday, roast-beef, with plenty of gravy; Wednesday—“boiled mutton, with caper sauce,” and so on to Saturday’s boiled dinner, of corned-beef, greasy cabbage, etc. (the diet of the poor differing chiefly in the quality, or price per pound), and this just the same during the warmest week in winter as during the coldest, and regardless of any of the possibly varying circumstances, as hard work out of doors, or light work, or none at all, within; and that this same folly runs into and becomes greater folly in the spring and summer even, except so far as nausea or lack of appetite cause an involuntary modification,—in view of all this we need not look altogether, nor indeed at all, to heredity to account for the wretched disorders to which we, as a people, are subject, and which prevail to an extent almost transforming our literary and art periodicals into indirect partnership-relations with the manufacturers of quack “remedies” for all forms of sickness; this class of advertisers pay too liberally to exclude their flaunting lies. I look almost in vain for even a religious journal that refuses to devote any portion of its space to medical advertisements. Do our religious
editors themselves believe in, and take, the “pills” they advertise?
Bright’s Disease is one that never attacks those who live on coarse food, live abstemiously, and drink water chiefly. It is rather a disease of “high livers.” But a man does not need a large income to ensure this affection: any one who can get all he wants to eat and drink, and who eats and drinks all he “wants” (even without indulgence in wine, or alcohol in any form, which is a prolific cause of this disorder), may safely reckon on some of the symptoms, if not upon the worst form of the disease; and whether it be the understood cause of his death or not, it will surely be a contributing cause. The possession of typically healthy kidneys is a rare circumstance in this climate. The excessive micturition so universal in infancy, occasioned by excess in diet, is the beginning of renal disease.
Dr. Bright immortalized his name by discovering the fact that, when a man’s last sickness is attended with a certain class of symptoms, as albumen in the urine, final suppression of the urine, and uremic poisoning, they are occasioned by a peculiar disease or degeneration of the kidney. From a practical stand-point we care nothing about the kind of change taking place in the kidney, but rather ask what kind of change in our habits will keep this, and all the organs of the body, in a healthy condition? The former study is all well enough for those who desire it, but if too much time is devoted to it, and to the relation of drugs thereto, by an individual, he may be, probably
will be, the very least fitted to advise an inquirer who desires to know what he can do to be saved from disease and the supposed necessity of taking medicine. Says Dr. Dickinson (ibid., chap. VI.): “There are few disorders which are more under the influence of medicine than is the catarrhal inflammation of the kidneys.” And the very next sentence is one worth pondering on by those who are accustomed to take medicine whenever they come to grief through ignorance or neglect of the laws of life: “Under some plans of treatment,” says this celebrated authority, in continuing, “plans which formerly were almost universally adopted, and still have their advocates, the disorder is one of heavy mortality. Under other circumstances the danger is so small, that if once the complaint be recognized, a recovery may be reckoned upon in a large proportion of cases. Without treatment of any kind there is reason to suppose that a large majority of the subjects of it would recover.” (The italics are my own.) From this it will be observed that it depends on one’s luck whether he shall fall into the hands of a practitioner who belongs to a class still adhering to the plan ensuring a “heavy mortality,” or of one whose modified form of treatment is less fatal; and upon his good sense, whether he shall come under the influence of either, or adopt the methods indicated herein, viz., the abandonment of disease-producing, and the adoption of ease-producing, habits, which would be an immense gain over the “no treatment” plan which, according to a rational interpretation of Dr. Dickinson’s language,
is the safest of the three referred to by him. From the three-hundred-page treatise before me, which is fresh from the mint (1881), and is a most valuable book for those who wish to study the pathology of the disease (Bright’s), but which is little calculated to aid any one healthward, except he be already pretty well informed in hygienic matters, I cull, in addition to the paragraphs already quoted, the following little nugget of pure gold: “We must avoid the use of any drugs which, under the name of stimulating diuretics, might exasperate the existing congestion; and we must enforce such diet as to reduce to a minimum that nitrogenous excess which finds its way out chiefly by the kidneys, and provides in many shapes effective means of irritation. Physiological repose is to be sought, not by debarring the gland of the harmless and necessary solvent, but by cutting off the materials of urea and uric acid.” How naturally, then, do we look for the continuing sentiments: “‘Spare diet and spring water clear’ may often be found sufficient though simple remedies. Of all diuretics water is the best.”[45] But how can we reconcile, with such counsel, the treatment that he himself commonly adopts?
[45] Ibid., p. 86. The italics are my own, and I am amazed to find that this best diuretic is rarely the one used, and never fairly tested by this authority, who seems almost to exhaust the materia medica in the treatment of even infants of tender age.
In one case noted by him, and in which, as he says, “the attack was slight,” and “the boy became convalescent,” but later, although under the doctor’s own eye
at the hospital, with “no evidence of his having taken cold,” he became worse, went on to a fatal termination, “the urine becoming loaded with albumen and abounding with fibrinous casts—convulsive attacks—death!” It seems to me easy enough, however, to reconcile the unfavorable turn and the fatal termination with the treatment he adopted, viz., digitalis instead of “the best diuretic” (water); “fluid diet,” consisting chiefly of beef-tea—a non-nutritive fluid whose solid constituents are mainly urea, kreatine, kreatinine, isoline, and decomposed hæmatine, exactly the animal constituents of the urine, except that there is but a trace of urea.[46]
[46] London Lancet.
As the little fellow grew worse, “a little brandy was given to counteract the depressing effect of the digitalis.” “On the 27th, the pulse had fallen to 52, and was not quite regular; the brandy was therefore increased to two ounces daily,” with digitalis every six hours; later, a “diuretic draught composed of scoparium, acetate of potash, and nitric ether; on the 29th, this diuretic mixture was changed by the addition of nitre and squills; on the 30th, as was anticipated, he was seized with eliptiform convulsions, a succession of which came on, accompanied with foaming and biting of the tongue, and caused his death in two hours and a half.”[47] The next case reported was that of a child eighteen months old, treated at the hospital by the same physician, and described:
“Dropsy—persistent diarrhœa—peritonitis—death.” “The child,” says the celebrated practitioner and author, “was frequently fed with pounded meat and milk; a little brandy was given, and opiates and astringents were prescribed to check the diarrhœa.” As he went on to his fate, he was made to swallow the following remedies: “opium, dilute sulphuric acid, tincture of the sesquioxide of iron, acetate of lead. The quantity of brandy was increased to three ounces daily. The child became paler and had a sunken look,” etc. “The child sunk a week after admission.” I make mention of these cases for the reason that up to this day the same horrible treatment is being practiced. Although these, and many even worse cases contained in this new work, transpired some years ago and were recorded in the first edition, still they remain in the new edition unaccompanied by any note of warning; and young or old medical students pore over and imitate the examples here set before them.
[47] The case of Thomas Vallance, 9 years old. Oh, wise physician: the fatal symptoms came along “as anticipated!”
I quote another paragraph from the treatise of Dr. Dickinson, which, if it has, as would seem evident, thrown little light about the doctor’s own pathway, as regards the appropriate treatment of the disorder, will prove instructive to some of my readers, and bear favorably upon my theory of disease. In the early pages (p. 29) of the treatise, Dr. Dickinson says: “It may be generally stated that this inflammatory disease arises from unnatural stimulation of the kidneys. The blood is charged with [food] material excessive in quantity or unnatural in quality,
which these glands take upon themselves to remove. Their own proper elements of secretion are poured upon them in sudden and excessive amount, or matter is thrown upon them which is foreign to their usual habit. As a consequence of overwork, or of work to which they are not adapted, they take on a turbulent and abnormal activity. They become congested, the tubes get choked up with epithelial growth, and the disease is established.”
Many of the symptoms in the following list are more or less frequently, some of them invariably, present in the case of supposably healthy infants, and are commonly considered as entirely normal. Fairly considered, however, they are the effects of excess in diet. To the greatest possible extent the superfluous water contained in their gross diet passes off by the kidneys, causing immediately a diseased condition of those organs from overwork; the cellular tissue becomes loaded and distended with the fatty matters, and also with much water, unrecognized as dropsy until it reaches immense proportions; what really amounts to purging is so universal as to be regarded as the normal state of an infant’s bowels, and this is, sooner or later, often very early, succeeded by the reaction termed constipation. The back-aching that results from all this is none the less terrible because the little sufferers can not talk and tell where the pain is; peevishness, general malaise, and crying, tell of suffering, not of (their) perversity. Among the