[36] The “difference” is in the digestibility, and in guarding against excess: Overeating is, of itself, a positive guarantee of indigestion.[A] The advantages of the hard bread and “dry diet” are manifold: (1) thorough mastication—calling the muscles of the mouth into action, and while this tends to make the cheeks plump and full, the exercise affects the various glands, and aids in the secretion of the salivary fluids essential for the digestion of starch;[B] (2) it causes one to eat slowly, so that each mouthful entering the stomach; is not only thoroughly insalivated and thus prepared for stomach-digestion, but can be thoroughly manipulated in the stomach and impregnated completely with the gastric juice: this must be deemed a very important feature, when we reflect that in very depraved states the digestive fluids are not as abundant nor as readily secreted as in health. (3) Chewing strengthens the gums and the teeth,—tends to preserve them and fit them for their legitimate work: decaying teeth are a source, as well as a symptom, of disease.
[A] In accordance with a universal law of nature,—“the conservation of energy,”—“gastric juice,” upon which digestion depends, “is secreted from the blood by the glands of the stomach, in proportion to the needs of the organism for food, and not in proportion to the amount of food swallowed.” There is, therefore, a normal dyspepsia for whatever of excess is taken. Moreover, in such cases, none of the food is well digested.
[B] Ptyalin, a vegetable matter contained in healthy saliva, has very peculiar properties: “if mixed with starch and kept at a moderate warm temperature, it turns that starch into grape-sugar. The importance of this operation becomes apparent when one reflects that starch is insoluble, and therefore, as such, useless as nutriment, while the sugar formed from it is highly soluble, and readily oxidizable.”—Huxley.
Note the special elements tending to insure success
in the case of self-treatment just given: The courage, prevalent good temper (so rarely found in these cases), and determination to win (equally rare), did much, very much, toward conquering her disease; but it is more than doubtful if these alone would have sufficed: her success in winning the family over to her radical views, or, at least, in gaining their entire co-operation, was a marked feature looking toward a final victory. None of them ventured to discourage her,—all joined heartily in the work. Had she sat at an ordinary table, one crowded with “good things”; and had her friends persisted in entreating her to eat this, that, and the other thing, it is probable that her good resolutions would have failed, sooner or later,—her life paying the forfeit. And this leads me to mention a most important feature of what has come to be known as the “Salisbury Treatment”: “Meals are to be taken at regular intervals, and the patient should eat either alone or with those who are using the same diet, and not sit down at a table where others are indulging in all kinds of food. He should take a good draught—one or two cupfuls—of warm water an hour before each meal; a sponge-bath two or three mornings,[37] and a comfortable full bath once a week. For the latter use a little pure Castile soap, but rinse thoroughly. Air-baths and sun-baths are also of great importance. (See ‘Air-baths,’)
Flannel worn next the skin [I should say, that the year round, cotton underwear is far better], and the clothing frequently changed and aired. As much open-air exercise as can be borne without fatigue, or thorough rubbing and pounding of the body [or squeezing of the muscles of the entire body, with a firm grasp of the attendant’s hand] morning and evening for those too weak to take exercise.”
[37] If desirable, this bath may be taken later in the day; but it should never occur within one hour before, nor until at least three hours after any meal. The temperature of the water should be agreeable with sensitive patients, but gradually lowered from day to day, until cool water becomes agreeable.
It is the prevalent belief that hot food is desirable especially for feeble persons, inclined to chilliness; but while smoking-hot dishes produce a temporary feeling of warmth and comfort, this is usually succeeded by a “reaction,” producing a still greater degree of chilliness: the congestion excited by the presence of the hot food or drink, soon subsides, leaving the stomach anæmic, delaying digestion, perhaps preventing it altogether. Cool food, properly masticated, acquires in the mouth a normal temperature, and thus enters the stomach without producing the unnatural stimulation which arises from the ingestion of hot food, and which is likely, in the case of feeble persons, to cause, secondarily, most mischievous effects. A single mistake of this sort may excite congestion of the lungs, and undo the good work of weeks of right living. This can not seem incredible, in view of the fact that a single excessive meal often excites an attack of congestion of the lungs in the case of robust persons. True, in these instances the disorder is usually attributed to “a sudden cold,” whether the victim can or can not recall any exposure, but the fact is as I have stated. I have had many
instances like the following: A business man, accustomed to an outdoor life, rises in the morning after a good night’s sleep, feeling as well as usual; eats a hearty breakfast, dons his overcoat, walks briskly to his place of business, and entering the hot, close office, perhaps within thirty minutes from the time of rising from the breakfast-table, he finds himself so hoarse that he can hardly make himself understood, and feels a pressure at the lungs indicating a great degree of congestion. There is but one way to explain this: a predisposition; a hot meal, rapidly eaten; active exercise taken immediately thereafter, and while the stomach is engorged with food—what more is needed? The wonder is, not that this man is suddenly made sick, but, rather, that he is not oftener so.
The consumptive will often derive great benefit from a full stomach-bath daily, consisting of about a pint of tepid water rapidly swallowed, on rising or an hour before breakfast. This will not create nausea or excite vomiting, unless there is occasion for these symptoms, arising from the presence of undigested food; but it will prove healing, prevent thirst and the necessity for drinking with, or directly after, meals—although, whenever there is thirst, the patient should drink pure cool water, moderately, but to his satisfaction, finally. It is better, however, as a rule, to drink regularly, an hour or so before each meal, such an amount as suffices to prevent thirst, while not causing a feeling of discomfort soon after drinking. A little practice, with careful observation, will soon enable the patient to judge how much to take.