THE CASE OF MR. VICKERS.
Joseph Vickers, born and raised in England, but now of Biddeford, Me., whose home is near my own, and the man himself well known to me, was very “low with consumption” at one time, when in his twenty-second year. His disease was attributed, and without doubt justly, to a severe chill resulting from wading the river on one of his hunting bouts, and being compelled to dry his clothes on his back—a feat he had previously performed repeatedly, except that on this occasion, being very much fatigued, and night coming on, instead of continuing vigorous exercise while his clothes were drying, he “went into camp” and “shivered throughout the night in his soaked garments.” Declining very rapidly, with every symptom of pulmonary consumption, his case
was considered hopeless by his friends. Medicine seeming to him useless, he gave up taking it, and his physician consequently gave him no encouragement or hope of recovery. His digestion was very imperfect—as he put it, “Nothing I ate seemed to do me any good”—and to the disgust of his parents and friends he often refused to eat anything for an entire day. Able to be up and dressed a good portion of the time, he would spend as much of the day outdoors as possible, and at night “never slept without a window open in the bed-room.” Gaining a little strength, and being “badgered,” as he says, “all the time, when at home, about eating,” and being very fond of hunting, and not sleeping well, he would rise very early, take his gun and, as he expressed it, would “crawl off to the woods,” and sit or lie down until rested, and then “travel a bit and rest again,” and so spend the entire day, taking no lunch, and eating nothing, drinking from a brook or a spring when thirsty, returning at night, often as late as seven or eight o’clock, when he would eat a little coarse food after resting, and then go to bed. “A couple of weeks” of this sort of life sufficed to bring him home at night with an “appetite for a side of sole-leather,” and he would eat a hearty supper—always of the plainest food—and soon go to bed. From this point his recovery was as rapid as his decline had been. His diet has always been of the plainest sort, mostly vegetable (a large proportion of coarse bread and fruit),—“My drink is always cold water, and I let the rest of the family eat all the fancy stuff,” he remarked. Mr.
Vickers,—who is a devout Christian man, and his story corroborated in every feature by others as reliable,—is now sixty-six years old, though he appears like a robust, well-preserved man of fifty.
Excepting under very aggravated conditions, as for example, the case of Mr. Vickers, given above, rarely does any creature ever begin to have consumption with a sound stomach, liver, and intestines. Nor can the digestive organs become diseased, ordinarily, so long as the diet and general regimen are even approximately correct. If we thought more of what would “tickle” the stomach and intestines than the palate, simply, we would banish most of our disorders; pure air, active exercise, a clear conscience, and the cultivation of a spirit of cheerfulness, kindliness, and contentment, would send the balance a-flying. Upon the importance of cheerfulness, a recent writer, a physician with a large practice, and a man of keen perceptions, says: “One of the most important directions of all is personal and subjective. Cultivate with the utmost force possible the habit of cheerfulness. No words can put this out with the strength and weight which I should be glad to give to it. Its value is utterly beyond estimation. The difference between meeting the common, or uncommon, trials of life with cheerfulness or with despondency, and perhaps complaint and grumbling, is often just the difference between life and death.”
The appetite for “sweets”—candy, syrup, sugar, and fancy dishes deluged with sweet sauces—encouraged to an abnormal degree from infancy, and
the gratification of this appetite throughout life are prolific aids in establishing the phthisical diathesis. There is a natural appetite for sweet fruits and this demand may be safely met by such forms of food, but never by the unbalancing artificial sweets, or proximate principles of food, as cane or beet sugar and the “bon-bons” formed from them.
Victor Hugo,—that grand man who gave us “Les Miserables,”—in the first volume of the series, puts this bit of physiological wisdom into the mouth of the witty libertine, Tholomyés, who uses it, to be sure, in a double sense, which I need not here explain: “Now, listen attentively!” says this oracle of the “four.” “Sugar is a salt. Every salt is desiccating. Sugar is the most desiccating of all salts. It sucks up the liquids from the blood through the veins; thence comes the coagulation, then the solidification of the blood; thence the tubercles in the lungs; thence death. And this is why diabetes borders on consumption.” I commend the above thought to consumptives, and to the parents of fat children—the consumptives of the future. Every grain of artificial sugar swallowed, constitutes a tax upon the system—upon the lungs and kidneys, more particularly—a tax upon the individual’s vitality.
Among the prolific causes of consumption in after life, is that of the involuntary cramming and fattening of infancy, followed up during childhood and youth by a somewhat less excessive gluttony, which is taught inferentially by the conversation and example of the elders, as by constantly dwelling upon the
delights of the palate, arranging entertainments which are feasts of the body, rather than of the mind, in advance of which all classes discuss with excess of interest the palatal pleasures of the coming “good time,” and at which all unite, if not in gorging themselves, at least in feeding themselves for pleasure to the disregard of the true requirements of their bodies for nutriment.
As a result of all this, sedentary persons become, like stall-fed oxen, degenerated with fat; and this, as just remarked about children, is a predisposing cause of consumption. A very large proportion of consumptives, most of them, in fact, are first thus diseased; and when any person is round and plump, or even fairly covered, so to say, and is yet lacking in muscular power—“easily tired”—it is prima facie evidence that the muscular system is degenerated in the manner described; and if the muscles, then the vital organs within, also. Thus we observe that grossness is by no means essential to fatty degeneration, although all obese persons are, of course, thus affected.
The salary of a fireman (“coal heaver”) depends upon his intelligence in the matter of fuelling up his engine with a view to its “health,” power and longevity; that of the cook or caterer, upon his ingenuity in devising means to accomplish the reverse of all this in the case of the human engine placed at his mercy.
“A well-spread board” should be described as one at which the youngest child (whose teeth are cut) may
exercise his will without let or hindrance until, at the first indication of dallying, or “loafing,” over his food, it is evident that he has had enough; and at which the consumptive may eat without being tempted to overindulge, but, paying heed to the first intimation of satiety, rise from the table with the assurance of having performed an agreeable duty, in that he has eaten in quantity and quality, what he can digest and assimilate. The consumptive starves, not for want of food, but for want of digestion and assimilation. It is impossible to emphasize this fact too strongly.
The Scientific American of June 3, 1882, in an article entitled “Tubercle Parasite,”[28] considering Dr.
Koch’s theory, says: “According to Dr. Salisbury, this disease (consumption) is one arising from ‘continued unhealthy alimentation, and must be treated by removing the cause. This cause is fermenting food and the products of this fermentation, viz.: alcoholic yeast and alcohol, vinegar yeast and acetic acid, carbonic acid gas, embolism, and interference with nutrition. Consumption of the bowels can be produced at any time in the human subject in from fifteen to thirty days, and consumption of the lungs inside of ninety days, by special, exclusive, and continued
feeding upon the diet that produces them—that is, food containing starch and sugar in alcoholic and acetic acid fermentation.’” Dr. Salisbury had found this embryonic form of the vinegar yeast in the blood, sputa, and excretions of persons suffering with consumption. In the blood the plant forms masses by itself, grows inside the white corpuscles, causes the fibrin filaments of the blood to be larger in size and stronger, the red corpuscles to be ropy, sticky, adhesive, making small clots or “thrombi,” which become “emboli” or plugs, and block up the capillaries and blood-vessels. The growth of the vinegar yeast in its embryonal stage, combined with the mechanical interference with nutrition, causes abnormal growths in the substance of organs, called tubercle; and the concurrent inflammatory results, in addition to the chemical action of the vinegar or acetic acid, causes the death and breaking down of the organs invaded—the lungs, for example. That this is not opinion only is shown by the fact that over 246 swine were, at his instance, destroyed by feeding on farinaceous food in a state of alcoholic and vinegar fermentation, the vinegar yeast traced in the blood, found in the excretions, and 104 of the dead swine were subjected to post-mortem examinations and their lungs found broken down and diseased as in ordinary consumption. The same experiment was tried on a number of men, “all healthy, and with no vegetations in the blood. They were given plenty of exercise in the open air,” but within three months these men had consumption of the
lungs. “Certainly,” says the Scientific American, “we think the evidence submitted shows that Dr. Salisbury has come nearer to the real intimate nature of consumption than Dr. Koch or any one we know. There is a simplicity, directness, breadth, and positiveness rarely seen in the treatment of a medical subject. Indeed, it is doubtful if there have been experiments so conclusive and extensive before or since.” It must be evident to even the crudest thinker that this fermenting process must ultimately produce the same effects when begun in the stomach, and described as indigestion; and no more efficient means of initiating this process can be imagined than that of swallowing indigestible substances—the most wholesome food-substances may be prepared in such a manner as to render them indigestible—or eating in excess of the needs of the organism, and therefore of the capacity for digestion. Thousands upon thousands of so-called healthy people are in this way approaching the point of decline, more or less slowly, but surely, utterly unconscious of their danger, simply because in their ignorance they can not recognize the premonitory symptoms, of which chronic constipation, for example, is one, and a very grave one. (See article on this subject.)
[28] Microscopic examination reveals the presence of a multiplicity of fatty crystals throughout the substance of the lungs of persons who have died of consumption. At a recent meeting of the New Orleans Pathological Society, its President, Dr. H. D. Schmidt, whose researches have been extended and minute, made an important microscopical demonstration to disprove Prof. Koch’s so-called discovery as to the bacilli of tuberculosis. Prof. Schmidt claimed to demonstrate that the so-called bacilli, thought by Dr. Koch to be the cause of consumption, were simply fatty crystals. Connecting with this the fact that Prof. Koch really found certain minute living organisms which he propagated artificially for several generations, it becomes evident to my mind (1) that the “bacillus” is simply a natural scavenger enveloped in the diseased tissue—the fatty crystal, or the tubercle—and (2) that its office is really, under the circumstances, conservative to life. Nor is this conclusion disproved by the alleged fact that the inoculation with the bacilli, of supposably healthy animals, produced the disorder: In the first place, the little domestic pets, such as were thus operated upon, are always, owing to their artificial surroundings, predisposed to the disease in question, frequently falling victims to it without the aid of inoculation, and (3) this being the case, their inoculation with a liberal reinforcement of greedy vermin,—or, supposing that, as yet, none were generated, their premature introduction,—would naturally tend to a speedy and fatal termination. It makes no difference to a dead man whether his lungs were devoured by bacilli, or simply broken down from fatty degeneration; but to the living, it is a matter of the utmost importance to learn the true condition of things in the premises. The idea of being eaten alive by myriads of little vermin from which there is supposably no escape, is enough to strike terror to the mind of a patient; but let him know that his disease is of such a nature that (with the aid of the bacilli, perhaps,) a radical change in his manner of living affords great assurance for the hope of its entire eradication, and he has at once an all-sufficient motive for reform.
Dr. J. Milner Fothergill, in a letter to the Philadelphia Medical Times, referring to Koch’s theory of the origin of tuberculosis, remarks, half jocosely: “Talk of the bitterness of death! It is nothing to the shadowy danger which overhangs us of a tubercle-bacillus getting into one’s pulmonary alveoli in an unguarded moment, and when one’s ‘resistive power’ happens to be impaired. Shadowy in the sense of invisible, not unreal! Is this what is meant by ‘the doom of a great city’? Is the bacillus a relative of the poison-germ which slew Sennacherib’s host in a night? We do not yet know the little creature intimately enough to say. But, really, the horrors which the mind conjures up of the dangers of the bacillus in the future are demoralizing. Suppose, now, that some change of the human constitution should favor the bacillus, just as the potato-field did the Colorado beetle, who had been happily quiet in his dietary of the leaves of the deadly nightshade, but who went on the war-path when the leaves of the other members of the Solanaceæ came within his reach. The imagination fails to conceive what may be the fate of man,—to be slain by a foe more remorseless than any of the plagues of Egypt. Suppose, now, that the bacillus took such a new departure, and got ahead of our ‘resistive power.’ Why, man would be swept off the face of the earth! What an ignominious end, too! Man, in the plenitude of his power over the forces of nature, slain by an insignificant little bacillus!”
After all, excess in diet is, usually, only another term for lack of fresh air and exercise, without which no one can become, or continue, robust. While it is true that to command health and muscular vigor one must be well fed, still no amount of food alone can make the right arm like that of a blacksmith. But
we can make the muscles grow on ample exercise and—food enough; always, however, considering a constant supply of oxygen as an essential element in the ration. The muscular system wastes—with many is never even tolerably developed—the powers wane, because of sedentary habits. “Inaction contravenes the supreme design of the human constitution, and is therefore adverse to its health.”—Huxley. The lungs begin to take on disease, often, because the individual does nothing to make him breathe deep; exercise is not frequent and vigorous[29] enough to cause frequent deep inspirations; the remote air-cells are in many instances seldom, and with corset-wearers never, inflated, and, consequently, the tendency is to grow together, so to say, or, rather, to fester and slough off, as useless appendages. To form the habit of taking long breaths in the open air, occasionally, throughout the day, would do much to maintain the integrity of lung-tissue, aerate the blood and prevent or cure consumption; but, after all, Nature designs that creatures who inhabit this earth shall be “fit” for something besides drawing their own breath.[30] To be “fit to survive” one must be of use in the world; hence there must be employment that taxes the mental, moral, and physical forces sufficiently to stimulate their growth and development. This, and nothing short of this, is health, in the complete sense
of the term. Robust health, if one would secure it, demands that one should be much in the open air and exposed, often, to a low temperature while taking a great deal of vigorous exercise. To be long-lived, on the other hand, requires rather that the diet be restricted to correspond with abstinence from labor and cold, some degree of exercise in the open air, however, being essential. The robust often wear out faster than the brain workers, whose lives are rather on the quiet order. Worry kills ten where work kills one.
[29] In a badly vitiated atmosphere inaction is the only palliative; muscular exercise causes a demand for an increased supply of oxygen, and increases the amount of carbonic acid to be eliminated, neither of which conditions can be met except by means of pure air.
[30] See note 1 in Appendix, p. [275].
The best illustration of the natural means of preventing, or curing, consumption—in fact, of promoting and maintaining health, under any circumstances—I have ever seen, is given in the following true story of