As a tonic and invigorator, the cold or cool bath (shower or tub), in the morning on arising can be highly recommended. It promotes skin activity, is a stimulant to the bowels and kidneys and to the general circulation, besides being cleansing. We find today that the morning bath has become such a necessity to the average American that all new hotels are fitted with private baths, and old hotels, in order to get patronage, are arranging as many baths connected with sleeping rooms as is possible. Our generation assuredly is a ruddy, clean-bodied one. What the actual results of this out-door life and frequent bathing will be for the race remains to be seen, but one can not but feel that it must build up a stronger, more resistant race of people, who not only enjoy better health than did their forefathers, but enjoy it longer.
Not every one can stand a cold bath. It is folly to urge it on one to whom it is distasteful, or on one who does not feel the comfortable glow that should naturally result. For the well, or those with a tendency to arteriosclerosis, or those in whose families there have been several members who had early arteriosclerosis, such proceedings as recommended could not be improved upon. However, for the person who has well recognized sclerosis, only warm baths should be advised, and these not daily. The water should be at a temperature of 90-95° F. Care should be taken that persons sent to spas be cautioned against hot baths. It is not inconceivable that the increased force of the heart beat that accompanies a hot bath might be sufficient to rupture a small cranial vessel. Hence, Turkish and Russian baths should be most unqualifiedly condemned. As a matter of fact, persons vary so in their habits with regard to bathing that what might suit one person would do another much harm.
Personal Habits
The personal habits of the individual, more than any other factor, determine whether or not arteriosclerosis sets in early in his life. The man or woman who is moderate in eating and drinking, sees that the kidneys are kept in good condition, and attends strictly to regularity of the bowels, lays a good basis for the measure of health which is so essential for happiness. It has been shown that sclerosis of the splanchnic vessels may be due to constant irritation of toxic products elaborated in digesting constantly enormous meals. In obstinate constipation, many poisons, the nature of which we do not know, are absorbed and circulate in the blood. We have not sufficient data to prove that constipation favors the production of arteriosclerosis, but our impression has been that it does favor it. Constipation can often be relieved by a glass of water before breakfast, a regular time to go to stool, and abdominal massage or exercises. Some maintain that it is a bad habit only, and can be readily overcome. Whatever is done, avoid leading the patient into the drug habit, for the last state of the patient will be worse than the first. Habits of sleep are not of such great importance. Most persons get enough sleep except when under severe mental strain. Most adults need from seven to eight hours' sleep, although some can do all their work and keep in prime health on five or six hours' sleep.
Tobacco has been accused of causing many ills and has been thereby much maligned. We can not see that the use of tobacco in any form in moderation is harmful to most men. Undoubtedly the blood pressure is raised when mild tobacco poisoning occurs, and individual peculiarities of reaction to the weed are multitudinous. But to condemn offhand its use is the height of folly. There is no reason why the arteriosclerotic who has always used tobacco in moderation, should not continue to use it, whether he smoke cigarettes, cigars, or pipe. His supply should be decreased, but there is no sense in depriving a man of one of the solaces of life, unless, as is sometimes the case, abstinence is easier for the patient than moderation.
As for alcohol, opinions differ widely.[19] Some see in alcohol one of the most frequent causes of arteriosclerosis; others do not believe that the part played by alcohol is a serious one, only in conjunction with other poisonous substances is it dangerous. Probably unreasoning fanaticism has had much to do with the wholesale condemnation of alcoholic beverages. The general effect of alcohol is to lower the blood pressure by causing marked dilatation of all the vessels of the skin. True, the alcohol circulates in the blood, and is broken up in the liver, and this organ would seem to bear the brunt of the harm done. Alcoholic drinks in moderation, I do not believe have any deleterious effect on health. On the contrary, I believe that they may in some cases assist digestion and assimilation. Indiscriminate indulgence is to be condemned, as is overindulgence in exercise or eating. What may be moderate for A, might be excessive for B. Every man is then the arbiter of his own fortune and within his own limits can indulge moderately (a relative term after all) without fear of doing himself harm. In advanced arteriosclerosis it is necessary to decrease the supply of alcohol just as it is necessary to cut down the food supply. This must rest entirely on the judgment of the physician, who must not act arbitrarily, but must have his reasons for every one of his orders.
Dietetic Treatment
Most persons eat too much. We not only satisfy our hunger, but we satisfy our palates, and, instead of putting substantial foodstuffs into our stomachs, we frequently take unto ourselves concoctions that defy description.
Foodstuffs are composed of one or all of three classes: (1) proteins, (2) fats, (3) carbohydrates. As examples of the first are beef and white of egg; of the second, the oils, butter, lard; of the third, sugar, potato, beet, corn, etc.
The physiologists and chemists have shown us that both endogenous and exogenous uric acid in excess will cause a rise of blood pressure, but the bodies most concerned in the production of elevated blood pressure are the purin bodies, those organic compounds which are formed from proteins and represent chemically a step in the oxidation of part of the protein molecule to uric acid. Red meat contains more of the substances producing purin bodies than any other one common foodstuff, and for this reason the excessive meat eater is, ceteris paribus, more apt to develop arteriosclerosis comparatively early in life.