Chapter III: CONSUMPTION——(Continued) (1)

The country boor says he must have meat to make muscle; and all
the while his vegetarian team is twitching him and his plow
along the furrow. Where does he suppose they get their muscles?--
THOREAU.

Stupidly ignorant, or unmindful, of the fact that there are, in this country and Europe, hundreds of thousands of people of all ages, sexes and social positions, who live year in and year out mainly, and a large proportion strictly, on the vegetarian diet, and live in health, not only, but found perfect health by abandoning the common mixed diet and coming nearer to first principles——notwithstanding all this, still the farce goes on among the scientists of “proving” by chemical analyses, pretty theories and specious arguments, that man “can not subsist in health on a vegetarian diet.”[17]

[Footnote 17: Jules Virey estimates that four-tenths of the human race subsist exclusively on a vegetable diet, and that seven-tenths are practically (though not on principle) vegetarians. Virchow estimates the total number at eighty-five per cent.——OSWALD.]

“The matter is this: in a cold climate we can not thrive without a modicum of fat, but that fat need not come from slaughtered animals. In a colder country than England, the East-Russian peasant, remarkable for his robust health and longevity, subsists on cabbage-soup, rye-bread, and vegetable oils. In a colder country than England, the Gothenburg shepherds live chiefly on milk, barley bread, and esculent roots. The strongest men of the three manliest races of the present world are non-carnivorous: the Turanian mountaineers of Daghestan and Lesghia, the Mandingo tribes of Senegambia, and the Schleswig-Holstein _Bauern_, who furnish the heaviest cuirassiers for the Prussian army and the ablest seamen for the Hamburg navy. Nor is it true that flesh is an indispensable, or even the best, brain-food. Pythagoras, Plato, Seneca, Paracelsus, Spinoza, Peter Bayle, and Shelley were vegetarians; so were Franklin and Lord Byron in their best years. Newton, while engaged in writing his ‘Principia’ and ‘Quadrature of Curves,’ abstained entirely from animal food, which he had found by experience to be unpropitious to severe mental application. The ablest modern physiologists incline to the same opinion. ‘I use animal food because I have not the opportunity to choose my diet,’ says Professor Welch, of Yale; ‘but, whenever I have abstained from it, I have found my health mentally, morally, and physically better.’”——(“Physical Education.”)

With regard to the muscular vigor of vegetarians: if they have not become noted as “winners of rowing, walking, or boxing matches,” it is chiefly because they are rarely sporting men; besides, they are as yet in this country——although their numbers are quite rapidly increasing——in a very small minority; but, of late, since this objection has been so frequently raised, vegetarians have entered the lists, notably in England, in bicycle races, and have distanced their meat-eating rivals in long races, showing greater staying powers.

Says the London _Lancet_: “In the summer of 1872, it became necessary to shift the rails on upwards of 500 miles of permanent way on the Great Western line, from the broad to the narrow gauge, and there was only a fortnight to do it in. The work to be got through was enormous. About 3,000 men were employed, and they worked double time, sometimes from four in the morning till nine at night. Not a soul was sick, sorry, or drunk, and the work was accomplished on time. What was the extraordinary support of this wonderful spurt of muscular strength and energy? Weak oatmeal gruel. There was no beer, spirits, or alcoholic drink in any form. Here,” continues the _Lancet_, “is a very old and well-known agent, cheap enough, and easily procured, capable of imparting ‘staying power’ better, probably, than anything else, which is not employed to anything like the extent it might be with advantage.”

The principal part of the ration allowed in the above case was one and one-half pounds of oatmeal. In view of the immense labor performed by these men on that quantity of this cereal, can it be wondered at that the sedentary dyspeptic who essays to “diet” on three full meals of such food comes to grief? For him a single moderate meal of grain food, with fruit, would be a generous ration.

To very many the term “vegetarian” seems almost to imply one who is restricted to a diet of turnips and water. But Epicurus, the god of gluttons, was himself a vegetarian, for while he regarded pleasure as the _summum bonum_, and placed the pleasures of the table first, still, he knew that a simple fare was most conducive to health and comfort in this life. As to variety: “with five kinds of cereals, three legumina, eight species of esculent roots, ten or twelve nutritive herbs, thirty to forty varieties of tree fruits, besides berries and nuts, a vegetarian might emulate the Duc de Polignac, who refused to eat the same dish more than once per season.”

In view of the constant violations of natural law as to quality, quantity and frequency of meals, I would say that it is from the nature of the case impossible for people living in the prevailing manner to avoid digestive disorders;[18] in practice I find _none_ altogether exempt from them, except the very small class of abstemious vegetarians referred to——an individual or a family, or two, in each community——all others are more or less dyspeptic, and _dyspepsia_ is _incipient consumption_. Thousands of dyspeptics are oblivious as to the true nature of their disorder, simply because the most marked symptoms in their cases, _now_, are affections of the throat and lungs. The popular ignorance in this direction amply accounts for the appalling fact that respiratory diseases destroy the lives of about one-third, and consumption alone one-fifth of all who die in this country. When dyspepsia has blossomed into consumption, unless the primary disease——that of the stomach and intestines——is removed——an impossibility except by a radical change from the evil dietetic habits that have caused it——nature is powerless to heal the lungs, because (1) the inflammation is being perpetually propagated, and (2) the entire nutritive system is becoming more and more hopelessly diseased.

[Footnote 18: “I think I shall not be far wrong if I say that there are few subjects more important to the well-being of man than the selection and preparation of his food. Our forefathers in their wisdom have provided, by ample and generously endowed organizations, for the dissemination of moral precepts in relation to human conduct, and for the constant supply of sustenance to meet the cravings of religious emotions common to all sorts and conditions of men. In these provisions no student of human nature can fail to recognize the spirit of wisdom and a lofty purpose. But it is not a sign of ancestral wisdom that so little thought has been bestowed on the teaching of what we should eat and drink; that the relations, not only between food and a healthy population, but between food and virtue, between the process of digestion and the state of mind which results from it, have occupied a subordinate place in the practical arrangements of life. No doubt there has long been some practical acknowledgment, on the part of a few educated persons, of the simple fact that a man’s temper, and consequently many of his actions, depends on such an alternative as whether he habitually digests his food well or ill; whether the meals which he eats are properly converted into healthy material, suitable for the ceaseless work of building up both muscle and brain; or whether unhealthy products constantly pollute the course of nutritive supply. But the truth of that fact has never been generally admitted to an extent at all comparable with its exceeding importance. It produces no practical result on the habits of men in the least degree commensurate with the pregnant import it contains. For it is certain that an adequate recognition of the value of proper food to the individual in maintaining a high standard of health, in prolonging healthy life (the prolongation of unhealthy life being small gain either to the individual or to the community), and thus largely promoting cheerful temper, prevalent good-nature, and improved moral tone, would require almost a revolution in the habits of a large part of the community.

“The general outlines of a man’s mental character and physical tendencies are doubtless largely determined by the impress of race and family. That is, the scheme of the building, its characteristics and dimensions, are inherited; but to a very large extent the materials and filling in of the framework depend upon his food and training. By the latter term may be understood all that relates to mental and moral and even to physical education, in part already assumed to be fairly provided for, and therefore not further to be considered here. No matter, then, how consummate the scheme of the architect, nor how vast the design, more or less of failure to rear the edifice results when the materials are ill chosen or wholly unworthy to be used. Many other sources of failure there may be which it is no part of my business to note; but the influence of food is not only itself cardinal in rank, but, by priority of action, gives rise to other and secondary agencies.

“The slightest sketch of the commonest types of human life will suffice to illustrate this truth.

“To commence, I fear it must be admitted that the majority of infants are reared on imperfect milk by weak or ill-fed mothers. And thus it follows that the signs of disease, of feeble vitality, or of fretful disposition, may be observed at a very early age, and are apparent in symptoms of indigestion or in the cravings of want manifested by the ‘peevish’ and sleepless infant. In circumstances where there is no want of abundant nutriment, over-feeding or complicated forms of food, suitable only for older persons, produce for this infant troubles which are no less grave than those of the former. In the next stage of life, among the poor the child takes his place at the parents’ table, where lack of means, as well as of knowledge, deprives him of food more suitable than the rough fare of the adult.... On the whole, perhaps he is not much worse off than the child of the well-to-do, who becomes a pet, and is already familiarized with complex and too solid forms of food and stimulating drinks which custom and self-indulgence have placed on the daily table. And soon afterward commence in consequence——and entirely in consequence, a fact it is impossible too much to emphasize——the ‘sick-headaches’ and ‘bilious attacks,’ which pursue their victim through half a lifetime, to be exchanged for gout or worse at or before the grand climacteric. And so common are these evils that they are regarded by people in general as a necessary appanage of ‘poor humanity.’ No notion can be more erroneous, since it is absolutely true that the complaints referred to are self-engendered, form no necessary part of our physical nature, and for their existence are dependent almost entirely on our habits in relation to food and drink. I except, of course, those cases in which hereditary tendencies are so strong as to produce these evils, despite some care on the part of the unfortunate victim of an ancestor’s self-indulgence. Equally, however, on the part of that little-to-be-revered progenitor was ill-chosen food, or more probably excess in quantity, the cause of disease, and not the physical nature of man.

“The next stage of boyhood transfers the child just spoken of to a public school, where too often inappropriate diet, at the most critical period of growth, has to be supplemented from other sources. It is almost unnecessary to say that chief among these are the pastry-cook and the vender of portable provisions, for much of which latter that skin-stuffed compound of unknown origin, an uncertified sausage, may be accepted as the type.

“After this period arise the temptations to drink, among the youth of all classes, whether at beer-house, tavern, or club. For it is often taught in the bosom of the family, by the father’s example and by the mother’s precept, that wine, beer, and spirits are useful, nay, necessary to health, and that they augment the strength. And the lessons thus inculcated and too well learned were but steps which led to wider experience in the pursuit of health and strength by larger use of the same means. Under such circumstances it often happens, as the youth grows up, that a flagging appetite or a failing digestion habitually demands a dram before or between meals, and that these are regarded rather as occasions to indulge in variety of liquor than as repasts for nourishing the body. It is not surprising, with such training, that the true object of both eating and drinking is entirely lost sight of. The gratification of acquired tastes usurps the function of that zest which healthy appetite produces; and the intention that food should be adapted to the physical needs of the body and the healthy action of the mind is forgotten altogether. So it often comes to pass that at middle age, when man finds himself in the full current of life’s occupations, struggling for pre-eminence with his fellows, indigestion has become persistent in some of its numerous forms, shortens his ‘staying power,’ or spoils his judgment or temper. And, besides all this, few causes are more potent than an incompetent stomach to engender habits of selfishness and egotism. A constant care to provide little personal wants of various kinds, thus rendered necessary, cultivates these sentiments, and they influence the man’s whole character in consequence.”

“But it is necessary to say at this point, and I desire to say it emphatically, that the subject of food need not, even with the views just enunciated, be treated in an ascetic spirit. It is to be considered in relation to a principle, in which we may certainly believe, that aliments most adapted to develop the individual, sound in body and mind, shall not only be most acceptable but that they may be selected and prepared so as to afford scope for the exercise of a refined taste, and produce a fair degree of that pleasure naturally associated with the function of the palate, and derived from a study of the table. For it is certain that nine-tenths of the gormandism which is practiced——for the most part a matter of faith without knowledge——is no more a source of gratification to the eater’s gustatory sense than it is of digestible sustenance to his body.”——“FOOD AND FEEDING,” by Sir Henry Thompson.]

The stomach, more especially after long years of abusive treatment, is one of the least sensitive organs. “If it had nerves as sensitive as our finger-tips, our attention would be so much taken up with the ordinary digestion of food that we could not properly attend to our work or studies.” At first, in infancy, it is more sensitive, and any excess of food is thrown off, but ere many months the disorder grows worse and deeper-seated, and in the course of years stomachs become so diseased as to give no sign, except when unusually outraged. It may have sores without knowing it. Dr. Beaumont saw sores in St. Martin’s stomach after the latter had drunk liquor, but they occasioned no pain. “Cold sores,” chapped lips, parched or pimpled tongue or mouth, furred tongue, etc., etc., are but signs of serious disease of the stomach and intestines, and, consequently, of the entire organism.

I have classed as one of the most natural and effective measures for the preservation of health or the cure of disease, _rest_; for diseased organs, rest[19] and light tasks; for the healthy person who desires to keep well, I have said, “rest when tired.” Unfortunately many people, and more especially consumptives, never know when they are tired, but work habitually, until they are exhausted. With the latter, this is usually set down to willfulness or lack of judgment. “She won’t listen to reason,” says the anxious husband. “She is always overdoing,” says another. Jockeys, describing horses thus affected, call them “pullers”: it is the same disease——indigestion. Reason being dethroned by the poisoned circulation in the brain, Nature, through muscular action, essays to excrete the toxic elements. This is _stimulation_ (see “Coffee.”)

[Footnote 19: The various excretory organs, as the bowels, kidneys, liver, as well as the digestive apparatus, are relieved by fasting, or diminishing the food ration.]

It is the stimulus imparted by the thrice daily ingestion of so many unnatural and indigestible articles that compose the mixed diet, which prevents so many from resting when they are tired. With others, however, the effect is quite the reverse: some are always complaining of a “tired feeling.” There is a genuine lack of vital force occasioned by lack of nourishment. When this feeling is experienced on rising, it is usually, almost invariably, at least in part, the effect of close sleeping-rooms. Many persons,——some who are fat, and called healthy, others, perhaps, lean,——are called “lazy” who are positively weak, too weak to work without great effort such as lookers-on know nothing about, although most people may have had similar feelings occasionally——the “after-dinner laziness.” This special form of disease has previously been spoken of. (See p. 34).

Nutrition is the grand factor in the prevention or cure of disease. It may be said, truly enough, that the blood-_aerating_ capacity remains throughout equal, often superior, to the blood-_making_ capacity; and consumption may be appropriately described as _dyspeptic starvation_. (See “Saline Starvation.”) In those instances where the capital stock (of vitality) is exhausted the victims of this disease must die; but thousands of cases pronounced after a long course of medication and stimulation, hopeless, have been restored by a simple diet and an out-door life. Even hygienic institutes have failed to apply this principle in its entirety when brought face to face with cases that demanded “heroic treatment;” influenced in some measure, possibly, by the popular distrust of their methods, especially the deep prejudice against a restricted diet——now, however, rapidly disappearing——they have hitherto erred continually on the side of excess. Nevertheless, they restore to health, or greatly benefit, ninety per cent. of the broken down invalids who come to them, usually, as a last resort.

I desire here to note particularly the change now going on in the minds of the most eminent and practical physicians in this and European countries, concerning the use of beef-tea. It is found by chemical analysis to be almost identical with “chamber-lye”——the favorite prescription of our grandmothers——and although more agreeable to the taste than urine, even when the latter is drowned in treacle, it is, in my opinion, always injurious, especially in sickness, when, of course, the excretory system is already taxed to the utmost. Most people, even in health, have more than they can well do to excrete their own, once, without swallowing any portion of the waste of animals!

Says Dr. Brunton:

“We find only too frequently that both doctors and patients think that the strength is sure to be kept up if a sufficient quantity of beef-tea can only be got down; but I think it a question whether beef-tea may not very frequently (?) be actually injurious, and whether the products of muscular waste which constitute the chief portion of beef-tea, beef-essence, or even the beef itself, may not, under certain circumstances, be actually poisonous.”

“In many cases of nervous depression we find a feeling of weakness and prostration coming on during digestion, and becoming so very marked about the second hour after a meal has been taken, and at the very time when absorption is going on, that we can hardly do otherwise than ascribe it to actual poisoning by digestive products absorbed into the circulation. From the observation of a number of cases, I came to the conclusion that the languor and faintness of which many patients complained, and which occurred about eleven and four o’clock, was due to actual poisoning by the products of digestion of breakfast and lunch; but at the time when I arrived at this conclusion I had no experimental data to show that the products of digestion were actually poisonous in themselves; and only within the last few months have I seen the conclusions to which I had arrived by clinical observation, confirmed by experiments made in the laboratory. Such experiments have been made by Professor Albertoni, of Genoa, and by Dr. Schmidt-Mühlheim, in Professor Ludwig’s laboratory at Leipsic.”

“Professor Albertoni and Dr. Schmidt-Mühlheim independently made the discovery that peptones prevented the coagulation of the blood in dogs, and the latter, under Ludwig’s direction, has also investigated their action upon the circulation. He finds that, when injected into a vein, they greatly depress the circulation, so that the blood-pressure falls very considerably; and when the quantity injected is large, they produce a soporose condition, complete arrest of the secretion by the kidneys,[20] convulsions, and death. From these experiments it is evident that the normal products of digestion are poisons of no inconsiderable power, and that if they reach the general circulation in large quantities they may produce very alarming, if not dangerous symptoms.”

[Footnote 20: See “Bright’s Disease.”]

“Instead of trying to keep up the strength, as it is termed, by loading the stomach with food, the exhausted brain-worker should rather lean toward abstinence from food, and especially toward abstinence from alcoholic liquors.[21] The feeling of muscular weakness and lassitude, which I have already had occasion to mention as frequently coming on about two hours after meals, is not uncommonly met with in persons belonging to the upper classes who are well fed and have little exercise. It is perhaps seen in its most marked form in young women or girls who have left school, and who, having no definite occupation in life, are indisposed to any exercise, either bodily or mental. I am led to look upon this condition as one of poisoning, both on account of the time of its occurrence, during the absorption of digestive products, and by reason of the peculiar symptoms——viz., a curious weight in the legs and arms, the patient describing them as feeling like lumps of lead. These symptoms so much resemble the effect which would be produced by a poison like curare, that one could hardly help attributing them to the action of a depressant or paralyzer of motor nerves or centers. The recent researches of Ludwig and Schmidt-Mühlheim render it exceedingly probable that peptones are the poisonous agents in these cases; and an observation which I have made seems to confirm this conclusion, for I found that the weakness and languor were less after meals consisting of farinaceous food only. My observations, however, are not sufficiently extensive to absolutely convince me that they are entirely absent after meals of this sort, so that possibly the poisoning by peptones, although one cause of the languor, is not to be looked upon as the only cause.”[22]

[Footnote 21: See chapter on Coffee.]

[Footnote 22: “Indigestion as a Cause of Nervous Depression.” By T. Lauder Brunton. M.D., F.R.S., in _Practitioner_.]

I am able to vouch for a number of cases of consumption, and marasmus, in which, under tonic treatment and frequent meals, the patients were steadily declining, but which yielded, finally, to the influence of the one-meal-a-day system: comparative rest of the diseased alimentary organs, and consequent improvement in the digestive and assimilative functions proved the needed “stimulant.” The Boston _Journal of Chemistry_, of February, 1882, gives the history of a well-authenticated case, of an old man of 70 years, who had been declining with pulmonary consumption for three years, and who was pronounced incurable, who was made convalescent by a voluntary and absolute fast of 43 days——taking water freely, however, during the time——and, following this with the “bread and fruit” diet, was restored to health.

Let us contrast this method of _restoring_ the nutritive organs with that of “curing” them by medication:

J. Milner Fothergill, M.D., truly says (in the _Practitioner_), that “it is more important to study the tongue than to go over the chest with a stethoscope, and that attention to the stomach and bowels is just as essential as the treatment of night sweats. When the tongue is covered with thick fur it is nearly or quite useless to give iron or cod-liver oil; for the tongue is the indicator of the state of the intestinal canal, and absorption through the thick layer of dead epithelial cells is impossible.” And then Dr. Fothergill gives us his method of _rasping off the coating_, so to say, with “a compound calomel and colocynthe pill every second night, and a mixture of nitro-hydrochloric or phosphoric acid, with infusion of cinchona three times a day until the tongue clears.” I would suggest that _nitro-glycerine_ would act more speedily and reduce the suffering to a minimum! The point, however, to dwell upon,——and it is one worthy of the deepest consideration,——is that the state of the alimentary canal, so aptly described by the authority quoted, and which forbids the absorption of iron and oil, also prohibits the absorption of wholesome substances. Not only this; the secretion of the digestive fluids (even supposing for the moment that these fluids are present in normal amount and quality in the circulation, which is, of course, far from the truth in this as in most disorders) is in great degree prevented by this same physical obstruction, the “thick layer of dead epithelial cells;” and, moreover, the secretion of fecal matters by the glands of the colon is, in like manner and degree, prevented. (See chapter on “Constipation.”)

What have we, then, in summing up, as the effect of this conservative effort of nature to “iron-sheathe and copper-fasten” this most abused alimentary tract, if I may thus characterize the coat which has resulted from the maltreatment of the digestive organs, and but for which the individual would, we may reasonably suppose, have died long ago from some plethoric disease? First: the digestive fluids, being scant and scantily secreted, it results that (2) only a small quantity at best, of the most wholesome food, can be by them digested, and (3) absorption from the small intestines is equally difficult, even supposing that the appropriate “small quantity” of food possible to be digested has not been exceeded, which, in ordinary practice, is anything but a supposable case. Excess is the invariable rule, and therefore (4) the undigested and fermenting food substances, excepting a portion which is absorbed in this poisonous condition, make their sluggish course along the intestines, collect in great masses in the lower bowel, and, finally, (a) either by aid of purgative medicines, or the ordinary stimulating drinks indulged in, (b) the irritating effects of these abnormal accumulations themselves, or (c) by means of injections, the lower bowel is more or less frequently emptied. These extraordinary evacuations are often described by the patient or friends as “exhausting.” That such excreta is not composed of true fecal matters, we may reasonably conclude from the fact that (1) digestion and assimilation are but poorly performed, and but a very small proportion, therefore, of the quantity swallowed (often enough consumptives continue large eaters, gauged by any standard, and, relatively speaking, this is invariably the rule with them)——but a small proportion, I repeat, is absorbed into the circulation, and, therefore, undigested food must form the chief share of the so-called fecal matters, and (2) owing to the heavy fur-coat, lining the colon, the secretion of waste matters from the blood is, as just stated, well nigh prohibited.

Hence it results that under the ordinary treatment the consumptive patient is hurried out of the world by a relative, and, often enough, by an actual, exaggeration of the very practices which originated his disorder. Referring once more to Dr. Fothergill’s, which is, to be sure, the regular drug plan: having scoured off the fur, so to say, with drastic purgatives, which have, possibly, cut a little too deep; or when, from whatever cause, instead of the furred coat, “the tongue is raw, bare, and denuded of epithelium, the patient should,” he says, “take a mixture of _bismuth_ with an _alkali_ and use a milk diet. Seltzer water and milk will often agree when the milk alone is found to be too heavy and constipating.” Here we have a case analogous to that of the robust gourmand whose dinner of a dozen courses is carried on and out by the aid of his “dinner pill,” or the free use of filthy mineral waters: A cup or two of cow’s milk (which, at best, is only a natural aliment for the calf, and which is too often drawn from a creature herself suffering from tuberculosis), is, to the depraved consumptive, even more “heavy and constipating” than the grossest diet indulged in ordinarily, to supposably healthy Christians, not to speak of such occasions as church festivals or society “breakfasts.” One secret of the difficulty which besets the hygienist in his efforts to prevail upon a consumptive patient to persist in a course of “natural medication,” after having once fairly entered upon it, lies in this: There is naturally a letting down, at first, from the stimulated condition, and this is often discouraging; the craving for the customary stimulants is almost as unappeasable as that of the rum-dyspeptic; and what makes the matter worse with the consumptive than with the drunkard, everybody who approaches the former seeks to tempt the appetite: or, in any event, the sight, smell, and hearing of the “good things” renders abstinence from such most difficult; and then, again, after leaving off many objectionable articles of food and drink, and having abstained from them for a few months, we will say, the transient resumption, always imminent, of the use of forbidden fruit operates with renewed force, and the patient finds himself, as he thinks, “gaining a little,” and he is thus encouraged to fall back, more or less gradually, into all his old practices. Coffee, for example,——which originally proved constipating, after its first (laxative) effects ceased,——having been abstained from for some months, is now found to “agree” with and even “help” the patient, who, beginning with a single small cup at breakfast, works up finally to two at each meal; and, altogether, things go on swimmingly for a time. Again, after a period of abstinence from flesh-food, pastry, spices, etc.——to guard against which nature has put the fur-coat upon the intestines, or, perhaps, it should be said that the wear and tear occasioned by all unwholesome articles introduced into the stomach, have produced an effect somewhat analogous to the thickened cuticle resulting from the constant chafing of an ill-fitting shoe, for example,——as the intestinal tract begins to acquire something of its normal condition, there is a point when the resumption of a “generous” diet, in which the aforesaid substances figure largely, will seem to give the patient a fresh impulse healthward: they once more, perhaps, produce the laxative effects simulating that most desirable state of the bowels called “regular.” And so on to the end of the chapter, the patient, friends, and perhaps the medical adviser, are misled as to the real state of affairs, until, finally, the end approaches, and the patient who was “improving so nicely” grows worse, and, after a period of intense suffering, which weans him from all desire to live, and reconciles his friends to the change, dies. “He catched cold, it settled on his lungs, and in his weak state”——etc., etc.

Speaking in round terms, the consumptive’s digestive ability is about on a par, usually, indeed, inferior to his muscular powers; and it is as irrational to expect him to digest and assimilate several meals a day, as to expect him to saw several cords of wood in the same length of time. Both are alike impossible. The fact that the food disappears, or that there is a craving for it, even, or, again, that it “seems to agree with the stomach,” does not change the case. A little food of the simplest sort may be assimilated, a little muscular exercise may be taken, and both prove curative. In common practice, however, the alimentary system is taxed to its own exhaustion and the impairment of the entire organism, while the voluntary muscular system deteriorates by reason of _non-use_ as well as from the general lack of nutrition.

A very grave error, however, is sometimes made——of taking too much exercise; that is, of beginning the change too abruptly. Whatever the state of one’s general health, he can only do with advantage _about_ what he has _habitually done_. If he has all along lived a very active life and is in his usual health, he can take a good deal of exercise without harm, even with advantage; if, on the other hand, his life is sedentary, but little can be taken——beyond the current amount——without doing more harm than good. In either case, however, there may be a gradual increase of muscular exercise, and for many of the latter class this would prove life conserving, (if persisted in as a habit of life), but spasmodic efforts at building up a muscular system will always fail; nature does nothing in that fashion. The rule should be to exercise a little short of fatigue, and it should be increased little by little each day, “until the labor of working accommodates itself to easy habits.” This rule would leave for some consumptive patients, at first, only the passive exercise of having their muscles pressed by their attendant’s hand, or a gentle walk for a short distance, and so on.

“Combined with a hectic flush of the face, night-sweats, or general emaciation, shortness of breath leaves no doubt that the person thus affected is in the first stage of pulmonary consumption. If the patient were my son, I should remove the windows of his bedroom, and make him pass his days in the open air——as a cow-boy or berry-gatherer, if he could do no better. In case the disease had reached its _deliquium_ period, the stage of violent bowel-complaints, dropsical swellings, and utter prostration,[23] it would be better to let the sufferer die in peace; but, as long as he were able to digest a frugal meal and walk two miles on level ground, I should begin the outdoor cure at any time of the year, and stake my own life on the result. I should provide him with clothing enough to defy the vicissitudes of the seasons, and keep him outdoors in all kinds of weather——walking, riding, or sitting; he would be safe: the fresh air would prevent the _progress_ of the disease. But _improve_ he could not without exercise. Increased exercise is the price of increased vigor. Running and walking steel the leg-sinews. In order to strengthen his wrist-joints a man must handle heavy weights. Almost any bodily exercise——but especially swinging, wood-chopping, carrying weights, and walking up-hill——increases the action of the lungs, and thus gradually their functional vigor. Gymnastics that expand the chest facilitate the action of the respiratory organs, and have the collateral advantage of strengthening the sinews, and invigorating the system in general, by accelerating every function of the vital process. The exponents of the movement-cure give a long list of athletic evolutions, warranted to widen out the chest as infallibly as French-horn practice expands the cheeks. But the trouble with such machine-exercises is that they are almost sure to be discontinued as soon as they have relieved a momentary distress, and, as Dr. Pitcher remarks in his ‘Memoirs of the Osage Indians,’ the symptoms of consumption (caused by smoking and confinement in winter quarters) disappear during their annual buffalo-hunt, but reappear upon their return to the indolent life of the wigwam. The problem is to make outdoor exercise pleasant enough to be permanently preferable to the _far niente_ whose sweets seem especially tempting to consumptives. This purpose accomplished, the steady progress of convalescence is generally insured, for the differences of climate, latitude, and altitude, of age and previous habits, almost disappear before the advantages of an habitual outdoor life over the healthiest indoor occupations.”——(“Physical Education.”)

[Footnote 23: The fasting consumptive referred to on page 62 had already approached this condition.——AUTHOR.]

I would not be understood, by any means, as advising every consumptive patient, or every one who supposes himself to be suffering from this disease, to immediately and without advice stop eating; but this much I do say: in all cases of progressive emaciation, that is to say, where the organs of digestion and assimilation have become so impaired that the body is not nourished, but is steadily declining, the attending physician should _consider_ the question of temporary rest for the alimentary organs, so far as the ingestion of food is concerned. The presence even of a craving appetite should be treated as a morbid symptom, and should weigh in favor of abstinence. It should also be borne in mind that the earlier this remedy is applied the smaller will be the “dose” indicated, and the more speedy and complete the relief. Had Mr. Connolly, for example——whose cure by fasting I have already alluded to——at any time during his first few months of “pressure at the lungs, with cough and expectoration,” fasted for a week or ten days,[24] perhaps, under the care of a physician sufficiently intelligent to judge of his needs in this direction, and had he thereafter lived on the plain diet which he now finds so complete, he would in all probability have escaped the illness which followed, and would have enjoyed uninterrupted health to the present day. Again, if he had changed his manner of living five years earlier——from three “mixed” meals[25] of stimulating food, as flesh and the irritating condiments invariably associated with animal food; pastry, white flour, and stimulating drinks, as tea and coffee——to two meals composed of the cereals, vegetables and fruits, prepared in the simplest and plainest manner, there would have been no call for a fast. I have the means of knowing of over five thousand families in this country alone who have made this change for preventive and curative purposes, and with the happiest results. I would say that any person who finds his appetite failing or fitful——sometimes poor, sometimes craving——and who has reason to fear the decline of his nutritive powers, will do well to make a radical change in his habits of living; and the sooner the better. The most pernicious custom of which I have any knowledge, yet one almost universal in the care of the sick, is that of “tempting the appetite,” concocting fancy or especially toothsome dishes, when nature is saying in the plainest manner that feeding has already been overdone. Such preparations are a severe tax upon even robust persons——they are fatal to consumptives. It is infinitely worse than bribing an exhausted laborer, who can scarcely move a muscle, to rouse himself to fresh tasks. He will do more and better work by reason of present and absolute rest; and the same is true of the sick stomach: there will be a relish for the coarsest article of diet——aye, it will be delicious——and digestion will wait on appetite, when the nutritive organs shall have been restored by sufficient rest. The experiments of Tanner at New York, Griscomb at Chicago, and now of Terrence Connolly (the consumptive faster) at Newton, N. J., have, I believe, demonstrated the fact that, in health or in sickness, in all cases of abstinence from all food, saving only water and pure air, of whatever disease the subject may die, it will not be for want of food, _so long as there remains any considerable amount of flesh[26] on his bones_. By the light of these experiences we shall do well, too, to study more closely the functions of the lymphatic system: human flesh, by absorption, constitutes a most appropriate diet in certain conditions of disease (see article on rheumatism). The absorption and excretion of diseased tissues is, under some circumstances, the only work that nature can with safety undertake, and in these cases no building up can be accomplished until a solid foundation is reached and the _debris_ removed; and _not then unless, while this good work is going on, the nutritive organs are given an opportunity to virtually renew themselves_.

[Footnote 24: It is evident that such a fast, _then_, would have proved, so far as the danger of starvation is concerned, a mere bagatelle, since three years later, as we have seen,——years of decline and emaciation,——he endured, and, with advantage, a fast of over six weeks.]

[Footnote 25: A return to his old diet now would probably make short work of this subject, and should I hear of his early death, my first inquiry would relate to this point.]

[Footnote 26: The amount “consumed” in the case of Mr. Connolly from day to day, was very slight indeed, scarcely more than before he left off eating; that is, it was observed that his emaciation was no more rapid during the fast than immediately prior thereto; before the fast his food was not being digested nor assimilated, and he was taking purgatives continually for torpid bowels.]

Dr. Tanner, in his forty days’ fast, lost about fifty pounds in weight. Mr. Griscomb lost a little more than that in his fast of forty-five days; and although moving about, taking more exercise every day than many sedentary people, and attending to a large correspondence, etc., was still able to say to the audience assembled to see him break his fast: “Ladies and gentlemen, you see now a man who has swallowed no food, except water, for forty-five days, and yet I can assure you that I am neither faint nor hungry; but I shall soon convince you that I have an excellent appetite,” and, so saying, he proceeded to partake of a very moderate dinner, and in moderate fashion. It is commonly supposed that these are uncommon men: they are uncommon only in possessing a knowledge as to the power of the living organism to withstand abstinence from food, and in having the courage of their opinions. And yet, when discussing the advantages of the two-meal system, uninformed people talk about “getting faint if they go so long” without nourishment! They speak from the three-meal-fish-flesh-fowl and pickle stand-point; accustomed to applying a hot poultice to a gnawing, sick stomach every few hours, they do get faint if the time runs over a single hour.

These various fasts, with the lessons to be drawn from them, must prove, finally, of inestimable value to science in the treatment of disease, where it may be desirable to rest all the viscera, or any portion thereof, concerned in digestion,[27] or to “close the bowels” for certain surgical operations, without resorting to injurious medication, and also——a very important consideration——in cases of enforced abstinence, as in time of famine or shipwreck, to prevent death from fright and discouragement, which have heretofore killed scores where actual starvation has one.

[Footnote 27: An eminent Maine statesman has recently died, who might have recovered and lived for years, but for the mistaken theory that food is a daily need under all circumstances: To constantly feed an irritated stomach is like kicking a man when he is down. And yet this is being done with fatal effect constantly all over the world. In certain cases, and especially with aged patients, this system is as surely fatal as strychnine, if less speedy. There are many besides myself who believe that President Garfield died from fatty degeneration, chronic dyspepsia, and constant feeding during his illness, rather than from the effects of the bullet. True enough, he might have lived on for years in his disordered physical condition but for the wound; still, on the other hand, it is equally probable that he might have lived, and that his sickness would have restored him to health even, but for the constant tampering with his stomach, which needed rest as much as the great and good man himself. No rest for the stomach, no rest for the man, is an axiom which I would submit to my brother practitioners, as one worthy of all acceptation. It is being constantly proved right before their own eyes, and yet very few have learned the lesson it teaches.]

As illustrating the influence of an out-door life, with partial or transient fasting, I will cite

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.