SOME OTHER SYMPTOMS.
Nasal catarrh; the radical suppression of this discharge is likely to be followed by serious if not fatal kidney disease.[49] (To remove the former by removing its cause, thus rendering the discharge unnecessary, is quite another thing). Hence the danger of using so-called catarrh remedies, or of adopting any specific local treatment: they are either inert or injurious.
[49] As illustrating this point I will mention the case of M. K., of Troy, N. Y.,—a case of successful (?) self-treatment for catarrh. This patient had for a dozen or more years suffered with nasal catarrh, and had tried most of the advertised “specifics” without avail; in fact, the disorder steadily increased. At last, the twice daily snuffing of slightly soapy water, for some weeks, “cured” him, as he said; but simultaneously with the suppression of the catarrhal discharge there resulted (without, however, any thought of connecting the two events, in the mind of the patient) an excessive flow of urine, extreme thirst, etc., etc.; in short, true diabetes. In this case great relief was experienced from an exclusive diet of skim-milk for five months, the patient swallowing nothing else for that length of time, except two tablespoonfuls, daily, of wheat-bran thoroughly chewed, “for the bowels.” At the end of the five months the patient weighed 210 lbs. This he realized as excessive, and my attention being directed to the case at this point, the patient at my suggestion adopted the bread and fruit diet—discontinuing the skim-milk and bran—and gradually reducing his weight by moderate diet and increased exercise, went on to a complete recovery.
Erysipelatous inflammation of the dropsical limbs; “vomiting may happen at any stage, even the earliest; it is often incontrollable.” Head symptoms, which occur in the more prolonged forms of the complaint, are usually of a convulsive kind, whereas, in acute cases, coma is apt to set in without any such prelude. Epileptic seizures may be preceded by pain in the head, drowsiness, or peculiarity of manner, or may occur without any premonitory sign.
Says Dr. Dickinson: “The gouty habit, from whatever circumstance it arise, is one of the more obvious and immediate conditions to which granular disease of the kidneys can be traced.” ... “The disease is a frequent result of gout; this is by far the most important fact in its etiology. It is one of the results of the gouty diathesis (see Rheumatism), and may precede or follow the external manifestations.... It is scarcely necessary to insist ... that the gouty condition comes first.” The fact is that there is a process of degeneration going on throughout the entire structure of the man, even to the last tissue, and the symptoms are all indicative of this; and this is more or less strictly true of all disorders. The naming and classifying of “diseases” is calculated to mystify and mislead: sickness is the proper term for describing them all; self-abuse, in the broadest sense of the word, is the cause of them; and obedience to law, the only means of prevention or cure.
I hold that the gouty, the rheumatic, the strumous, the “colds,” and all other diatheses, are practically
unimportant distinctions. The technical difference is, of course, well understood and admitted. In any event, it is certain that the course of living best suited to prevent one, is also best adapted to prevent or remove all. For all practical purposes, however, they may be classed together; and whoever desires, either for themselves or their children, exemption from, or the alleviation of, suffering, have only to adopt a pure mode of living in order to escape, or emerge from, the disease diathesis.
NOTE.—The limits of this work forbid an extended consideration of the influence of this or that occupation in promoting this disease; nor is it, in my estimation, essential. The trades must go on, regardless of their influence upon health. There must, for example, be painters, plumbers, compositors, tin-workers, etc., even though the absorption of lead does tend to produce the gouty condition and, so, a predisposition to renal disease. A sufficient degree of care in other directions would enable this class to outlive the more favored ones who neglect the laws of life.
See note 2 in Appendix, p. [276].
CHAPTER VI.
INSOMNIA—INSANITY.
Sleeplessness is often referred to as a cause of insanity, but it would be much nearer the truth to say that insanity causes sleeplessness. Dr. Rush says: “A dream is a transient paroxysm of delirium, and delirium a perpetual dream.” Not every dreamer becomes insane, in the common understanding of the term, nor every person who is distressed by wakefulness; nor do all those persons who dream dreams of a strange, droll, startling, heart-rending, exhausting character, become inmates of lunatic asylums, although all such are fit subjects for a rigid hygiene; and not a few out of this large number of bad dreamers—who are likewise afflicted with insomnia—but could with advantage place themselves under the charge of an expert in diseases of the brain, or even in an asylum, if either the former, or the physicians in charge of the latter, were in all regards thoroughly equipped for their work—a rare circumstance indeed. Normal sleep is dreamless; in default of this total oblivion, sleep is only partial—it is not perfect nervous repose. No person who suffers severely from indigestion but is also troubled with much dreaming, and, more or
less, with wakefulness; and no person who has these last-named symptoms but can safely set them down; at least in great measure, to digestive disorder; and as, almost invariably, removable by improved habits.
Some very wise men have stated as their belief, that no man living is really of sound mind, any more than of sound body, in the strictest application of the term; all have their crazy aspects—their “weak spots,” as we say; and the anxious, brooding man, who fears the loss of his reason, may take courage from the thought that his symptoms are only a little worse than his neighbor’s, and only demand of him to diminish his dyspepsia if he would become normally insane! To attack insomnia as a disease instead of a symptom, is sure to result in discomfiture in the great majority of cases, and is in every instance unsound in principle. Once established, this condition of wakefulness tends to perpetuate itself; but this would be otherwise with an absolutely natural regimen. A man is wakeful at night because under his present physical condition he ought to be—just as in diarrhœa, the looseness is doing its work of cure. So with all symptoms. Pain has its office, and this is coming to be better understood; is already well known to thoughtful, well-informed people; and the wakefulness of which so many complain, and which, in some cases, is of the most distressing, painful character, is as truly normal, considering the present physical state of the sufferer’s brain, as is pain following a cut. As an aid in the removal of this symptom, next to a radical reform in one’s living habits, which is the only possible
cure for the disease, the above reasoning is one of the most effectual.
When a man is wounded severely his anxiety is not increased by the pain; it causes no additional alarm, because he knows that it is entirely natural; let him know that sleeplessness is an analogue of pain, and he will, or may, bear it philosophically, and thus tend to its removal. He has a poverty-stricken mind, indeed, who can not, under such circumstances, pass an hour, or several of them, in comparative comfort, knowing that sleep will come in good time. But, thinking all the while that it is sleep only that he needs, his sleeplessness distresses him, causes him to be more and more alarmed, and, consequently, has the effect to postpone the oblivion so devoutly prayed for, but so little earned. To deserve sleep is to have it. Let the insomniac read the concluding article of this volume, and by the light of it review the hints on diet, air, exercise, etc., in the body of the article on consumption, so as to know what he has to do to become a good man, physiologically; and go to bed at about the same hour every night, if possible, or at any rate when he does lie down to sleep it should be after a quiet hour or half-hour devoted to peaceful and thought-steadying occupations, never exciting mental exercise, whether amusing or instructive; and when he draws the blankets about him, let it be with a sublime indifference as to whether he shall or shall not go to sleep promptly. “As to the subduing of the senses, the attempt to shut out external impressions by deafening the ears, closing the eyes, and lowering the sensibilities generally, is
in itself a frequently recognizable and always possible cause of persistent wakefulness. The effort to compose the mind (after lying down) and subdue the activity of the senses is made by the higher mental faculty, a part or function of the organism which, of all others, needs to be itself restful in order that the physico-mental being may sleep. It is, therefore, obvious that an endeavor to go to sleep is a mistake.”[50]
[50] J. Mortimore Granville, M.D., in Good Words.
Rather let me, when staring out into the darkness,—for to attempt to shut out the sense of sight by closing the eyes is always to render the inner-mental sense increasingly acute: “the field of sight is soon crowded with grotesque and rapidly changing images—a phantasmagoria, the worrying effect of which is only a too familiar experience of the sleep waiter,” and all the mental senses are in like manner stimulated, and their acuteness intensified, by the endeavor to lower the sensibility of the sense organs; and, worst of all, to narcotize them with drugs or sleeping-draughts is irrational and its effects injurious, and if long continued, fatal;—rather, I repeat, having ears to hear, let me hear, and eyes to see, see; and a brain, let me think. Let the brain, the ears, and the eyes “forget their cunning,” only when the eyelids droop in sleep because I am sleepy. Meantime, not self-abasingly, but calmly and dispassionately, would I philosophize thus: Well, I am in for it again! I would like to sleep promptly, soundly, and long; why do I not? I suspect that I am not running this physico-mental machine even in a fairly physiological manner; I cause
it to run at an abnormal rate during the day, and keep up intense mental excitement through stimulation of one sort or another, prolonging excessive mental activity too far on toward the night; and because of this, and the lack of a fair degree of muscular exercise, I only half breathe; of my fifteen or sixteen inspirations per minute, not one distends the air cells of my lungs to half their capacity. [Thus it transpires that the organism suffers in two ways, viz.: (1) the circulation is not sufficiently oxygenated for its general purposes; and (2) the waste matters are not “pumped out” of the substance of the brain,[51] as effectually as need be]. My coffee was strong and nice this morning; it stimulated me very satisfactorily throughout the day; and, what I had not bargained for, I am still feeling the spur (see article on Coffee). That new brand of cigars is exquisitely flavored; but, upon the whole, a perfect night’s sleep would be far more exquisite; at least, just now I am in the mood to think so. I sneered at that food-reformer who told me he was never a good sleeper until his present simple, natural habits made him so; but now, just at this
moment, it seems as if it would be a good trade to exchange some of my favorite dishes for coarse food and balmy sleep! Oh, if I only could get “balmy” that way every night! I “got the best” of —— yesterday morning on those —— stocks, and spent an hour, bent over my desk, figuring to see how I could get hold of some more at that price, before its holders had time to ascertain its real value. I will tell the widow —— in the morning, what it is worth, instead of trying to buy hers under-price as I contemplated doing. And so I would con over and look through myself and my habits, feeling sure that my eyelids would droop, and sleep would come before I should have completed the work of reform; and I am sure that every sufferer will find that a real reform—a permanent reform—will unfailingly lead on to health, and so to sweet and satisfactory sleep.
[51] “As stimulation of the brain causes dilatation of its vessels, and increases the flow of blood through them, mental action of itself not only attracts more blood to the brain, but provides to some extent for the removal of waste products. Hence sleeplessness is normal for a clogged brain. The movements induced by the cardiac pulsations are not so extensive as those caused by the respiratory movements or by muscular exertion, and therefore, when the brain is overworked and the respiratory and muscular movements are restricted, the cerebral nutrition will be diminished by the imperfect removal of waste from its substance. But if, in addition to this, the cerebral cells and fibers are actually poisoned by the circulation within the vessels which supply them, of noxious substances due to imperfect digestion or assimilation, matters will become very much worse.”—T. L. Brunton, M.D., F.R.S. (ibid.)
“Let no sleepless person be discouraged. Maintain hope under all circumstances. Remember that there are many worse cases of suffering than your own in the world, although to you it seems impossible. Keep up your general health by all sanitary means possible; walk much in the open air, if you can walk; ride, if you can not walk. Above all measures, keep the functions of the skin in prime condition; cleanliness is antagonistic to sleeplessness. Dry friction over the body by the use of the hand, or better by the use of the French hair mitten, twice a day, we have found of great service. The air-bath should not be neglected. A few minutes after the employment of friction over the body, walk about without clothing in a cool room,
and if possible let the sun strike upon the body. Do not remain uncovered too long, so as to become chilled. Keep the digestion good; eat only such forms of food as suit the digestive organs. Surround yourself with cheerful company if possible, read such books as do not tax or weary the mind, and life will cease to be a burden, even if you do not sleep as others do. Avoid above all things constant dosing; throw into the ditch, or into the sea, all nostrums that may fall into your hand.”
Comparatively few, even of the so-called hopelessly insane, but might in the early stages of their disease be completely restored; and at any period, so long as there is great vital force, or what would commonly pass for robust physical health, no case need be set down as hopeless. But while the present system of treatment prevails (it is not worthy the appellation of “system,”) the present small proportion of “cures” will continue to be the rule. The inmates are confined more or less closely, often in imperfectly ventilated apartments, deprived of the exercise in the open air they so much need, to the lack of which in their own homes is, in part, attributable their present condition; they are fed generously, even to plethora; and this, through the fault of the ignorance of their attending physicians, although, if these were wise enough to know when and how their patients needed “dieting,” the friends of these sufferers would never submit to anything bordering upon a strictly abstemious diet in their treatment. In visiting lunatic asylums in this and other countries, I have been struck with the
appearance of groups of patients—the similarity of their physique, as compared with the men and women seen on our streets every day—fat or lean, seldom medium—all exhibiting clearly the physical characteristics of disease, as emaciation, obesity, lack of, or ravenous, appetite, usually the latter. Meal-time comes every five or six hours, and if the appetite is good, all are permitted to eat very much in excess of their needs; they are urged to eat when they desire to fast; and food is forced into their stomachs if they are inclined to abstain for any length of time. It is not uncommon to find patients who upon entering an asylum begin to fatten, though already in an abnormal condition in this regard, their symptoms becoming more and more discouraging as their weight increases, although neither physician nor friends connect the two facts in any way. The latter feel thankful that “poor dear J—— gets enough to eat!” In this connection I introduce an incident of recent occurrence, not as indicating that a compulsory fast for an extended period should be resorted to generally, nor my own belief that it is a specific for all mind-troubles, by any means, but as a fact of great significance which all interested in this question may well pause a moment to contemplate.
[Dispatch from Philadelphia to the New York Herald].
TANNER’S RECORD BEATEN.
AN INSANE ASYLUM PATIENT ABSTAINS FROM FOOD
FOR FORTY-ONE DAYS.
One of the most extraordinary cases of an insane man attempting to restore his reason by voluntary
starvation was discovered recently at the —— County Insane Asylum. The case presents an interesting study for medical men generally. ——, aged forty years, a well-known resident of ——, who has been confined in the institution for the last two years, has abstained absolutely from all food except water, for the space of forty-one days. From the forty-second day of his fast until the fifty-first day he drank one pint of milk daily, and from then began eating strawberries and milk. This diet was maintained for three weeks, and was then succeeded by oatmeal gruel and milk. The case is a matter of careful record at the institution and under circumstances that prevented deception. Therefore, there is not the slightest doubt as to the extraordinary performance having been genuine. Mr. ——, when he first came to the asylum, was very violent at times, but, like many insane persons, he was a ravenous eater. His insanity is supposed to be hereditary. Occasionally he has had lucid intervals, and during these brief periods he frequently expressed the belief that there existed some method by which the insane might have their affliction alleviated if not entirely done away with. To Mrs. ——, the matron of the asylum, he took a great fancy, and, while averse to having anything to do with any other of the officials, he confided in her thoroughly and often expressed the wish that his mind might be restored to him and that he could be released. “For forty-one days,” said Mrs. ——, “nothing passed his lips but water, and tepid water at that. Of this fact I am thoroughly positive, knowing
as I do the continuous efforts made every day to induce him to eat. When he began the fast he had been living on the same diet as the rest of the patients. He came to me and said, seemingly in a perfectly rational manner, that he was anxious to be cured, and that he thought abstinence from food for a time might benefit him. Mr. —— said he did not intend to carry his experiment to extremes, but that the moment he felt it would be proper for him to break the fast he would do so. On the second day —— again refused to eat, and did not go out of his room. On the third day he drank a small cupful of water. At the end of the seventh day he had drank about six pints of water, and the natural functions of the body had then ceased. All of the attendants were instructed to use every possible means to induce the man to partake of nourishment, and a man was with him constantly through the day.”
“Could he not have obtained food at night?” was asked.
“It would have been impossible,” replied Mrs. ——. “All the rooms are locked, and none of the patients have access to other parts of the building after sundown. We would have been only too glad had he taken food. About the 20th day he began to get thin and haggard-looking about the face, and seemed to be feeble. He said that his head felt better, and that he did not intend to eat anything as long as he felt so well. On the 35th day he became so weak that he had to go to bed, and remained there until he broke the fast. I had told him that whenever
he wanted to eat to send me word, no matter what hour of the night or day it happened to be, and I would see that he was provided with anything he might fancy. On the afternoon of the 41st day since Mr. —— had ceased eating,” continued Mrs. ——, “he sent up word by an attendant that he should like to have a cup of coffee.[52] I hastened to comply with the request at once, and had a cup of very strong Java prepared. Mr. —— drank it, and followed it up an hour later with a cup of nice, rich milk. He stuck to the milk for a week, I think, and then added strawberries. This low diet was kept up, oh, for a long time, probably a month, then he gradually began eating oatmeal mush and gruel, which has been maintained up to to-day.”
[52] One of the worst moves be could have made; but it is significant that this was his last attempt to return to his coffee habit. In his renewed state it proved no longer enticing!
“And you are perfectly positive, Mrs. ——, that Mr. —— fasted absolutely, with the exception of water, for forty-one days?”
“Perfectly satisfied,” replied Mrs. ——; “in fact, I know it. There can be no possible doubt, inasmuch as the attendants were only too anxious to force the man to eat.”
“Do you think the fast has made any change in Mr. ——’s condition?”
“Well,” replied Mrs. ——, “he will probably be discharged as cured at the next meeting of the board of freeholders in August.”[53]
[53] It is a matter of regret to me that this book goes to press before I can ascertain the final result. Judging from the above account, however, I should expect a thoroughly successful ending, unless it should transpire that, true to their instincts, the attendants prevailed upon the patient to abandon the simple regimen, which he adopted after the fast, and resume the ordinary stimulating diet; in which case I should confidently expect a complete relapse.
As a hint regarding the effect of a stimulating and excessive diet upon persons of unsound mind, I subjoin a brief note taken during the trial of the most celebrated lunatic of modern times: “Guiteau’s appetite is quite as remarkable as his insolence. He has breakfast served in his room at the court-house about nine o’clock, and usually consumes at this meal a pound of steak, nine buckwheat cakes, three roasted potatoes, and five cups of coffee. Then, at half-past twelve, he gorges himself on roast beef and mutton.”
A certain class of wakeful patients are benefited by the practice of eating shortly before bedtime, when this right has been earned by sufficient restriction during the day. To make this the fourth, or even the third meal, however, is almost certain to increase the difficulty at last. The victim of sleepless nights often finds himself quite overcome with drowsiness after his midday meal. If then he could throw himself upon the bed he would have no time to “count,” or even think of such a device for putting himself to sleep. He was wide awake before lunch, and but for the habit of taking it, could have finished the day better without than with this out-of-season sleeping potion. Let him take the hint, eat his second and last meal, a sufficient one of plain food, in the evening after fully rested, and, thus equipped, go to bed directly, or after an hour or two of agreeable, but non-taxing, social converse. He must avoid every form of artificial stimulation—tea, coffee, wine, beer, tobacco. To breathe the atmosphere of an office, hotel, or smoking-car, for any considerable period, is no better, may be worse, than a moderate indulgence at first-hand in the open air.
CHAPTER VII.
RHEUMATISM, FATTY DEGENERATION, ETC.
Casey A. Wood. M.D., Professor of Chemistry in the Medical Department of Bishop’s College, Montreal, in an article entitled “Starvation in the Treatment of Acute Articular Rheumatism” (Canada Medical Record), gives the history of seven cases where the patients were speedily restored to health by simply abstaining from food from four to eight days, and he says he could have given the history of forty more from his own practice, but thought these would suffice. In no instance did he find it necessary to extend the fast beyond ten days. His patients were allowed to drink freely of cold water, or lemonade in moderate quantities, if they preferred, and simple sponging with tepid water was resorted to when indicated by feverishness of the surface. In no case did this treatment fail. No medicine was administered. The cases reported “included men and women of different ages, temperaments, occupations, and social positions.” He further says: “From the quick and almost invariably good results to be obtained by simple abstinence from food, I am inclined to the idea that rheumatism is, after all, only a phase of
indigestion, and that, by giving complete and continued rest to all the viscera that take any part in the process of digestion, the disease, is attacked in ipsa radice.” In chronic rheumatism he obtained less positive results, but did not venture to try fasts of longer duration. Dr. Wood concludes by saying that “this treatment, obviating as it does, almost entirely, the danger of cardiac complications, will be found to realize all that has been claimed for it—a simple, reliable remedy for a disease that has long baffled the physician’s skill; and the frequency with which rheumatism occurs will give every one a chance of trying its efficacy.” As elsewhere remarked, nearly all patients continue eating regularly, until food becomes actually disagreeable, even loathsome, often; and, after this, every effort is exhausted to produce some toothsome compound to “tempt the appetite.” Furthermore, and often worst of all, after the entire failure of this programme, the patient can, and usually does, take to gruel or some sort of “extract,” which he can drink by holding his breath. All this tends to aggravate the acute symptoms, and to fasten the disease in a chronic form upon the rheumatic patient, or to insure rheumatic fever; and the same principle holds in nearly all acute disorders, it is well to remember. So inveterate is this mania for eating, even when to continue is like turning coals upon the dead ashes and clinkers of an expired fire, that, in ordinary practice, it is well-nigh impossible to induce any class of patients to abstain from food at the beginning of an attack, or to give the fasting cure a fair trial at
any stage of the disease. The term frequently applied—“starvation cure”—is both misleading and disheartening to the patient: in fact, he is both starved and poisoned by eating when the hope of digestion and assimilation is prohibited, as is, in great measure, the case in all acute attacks, and more especially when there is nausea or lack of appetite; and he can only escape from the danger by abstaining temporarily. Dr. Wood’s prestige in the natural treatment of acute rheumatism was obtained in hospital practice, where it is comparatively easy to “control the symptoms” by withholding the cause, or, in other words, where the physician—providing the nurse is honest—can regulate the diet of his patients, absolutely. After such experience, it was less difficult for Dr. Wood to introduce this remedy among the most intelligent of his patients in private practice; for he could recommend it as in no sense an experiment, but as a remedy of positive advantage and, in fact, indispensable, if the best results were to be effected. My own experience, so far as it goes, has been similar to that of Dr. Wood. Moreover, in chronic cases—cases of long standing—the best results may be hoped for—in fact the best possible results have invariably followed—from an abstemious (frugivorous) diet, together with simple bathing, as special symptoms may indicate,—and an improved general regimen, as to fresh air, exercise (inaugurated gradually), beginning, perhaps, with passive exercise, as rubbing, etc., by the attendant. A chronic disease usually implies chronic provocation: Nature has simply commuted
the extreme penalty of the law; or, it may be likened to the reprieve of a convict under sentence of death, with an assurance of full liberty upon complete reform.
Among the disorders radically and safely removed by fasting, is