Chapter III: CONSUMPTION——(Continued) (2)

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.)

[Footnote 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.

[Footnote 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.]

[Footnote 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

HOW A YOUNG GIRL CURED HERSELF.

“Then you are surprised to learn that I came within six weeks of dying of consumption, thirty years ago, are you, doctor?” The questioner was a bright, healthy little woman of fifty who, in the course of a consultation about a consumptive niece, had expressed herself as having little hope of her recovery, “because she wouldn’t do as I did when I had the disease——and she isn’t nearly as sick as I was.” Straight as an arrow, active and merry, looking more like forty than fifty, Mrs. E. was the last person that any one would select as belonging to a “consumptive family,” or of having suffered with the disease, in her own person, and yet her mother died of it when this daughter was about 19, and the latter’s decline was attributed to inherited tendency and long confinement in the sick-room, during the last year of her mother’s life. “Yes, I have told Lettie how I cured myself after the doctors gave me up, but she will not undertake it——not now, at least——perhaps she may when she gets where I was. Do you want me to give you my recipe for the cure of consumption, Doctor? Tell you the whole story? Well, the way is simple, and the story a short one, and if it will help any one I shall be very glad. I needn’t tell you all about mother’s case——hers was the old-fashioned consumption; she was sick a good many years, but the last year she was almost helpless and would have no one but me to take care of her. Well, I bore up until she died, and then I gave out; I could not go to the grave——I was in bed during the funeral. I had not realized——none of the family had——how poorly I had become; but now it was plain enough. I kept my bed most of the time——could not get rested. I had been sick several weeks when my brother was brought home ill, was taken with typhoid fever, and there was no one to nurse him. I roused myself up and declared that I was able to do it; and I carried the point, in spite of all father could say. Well, he was sick nine weeks, but I gave up before he recovered. I carried him through the worst of it, however, before I took my bed; and then I was very sick indeed. For a while they thought I could live but a few weeks, but I rallied and got more comfortable. I raised a great deal, and for several months remained about the same, apparently; but the autumn came, and when we began to shut the house up I seemed to grow worse; my cough was still very bad, but I couldn’t ‘raise’ much, and I suffered terribly for breath. The doctor who had been attending me——the one who had tended mother——at last said he could do no more for me, and for some months we had no physician, and then father called a new one——a young doctor who was fitting himself for practice in our village. He came to see me, examined my lungs, and I fainted away in the effort. He went out——leaving no medicine——and had a talk with father. He said that he did not care to take the case; that there was no hope for me; my lungs were badly ulcerated, and I had but few weeks to live. ‘She can’t live over six weeks,[31] Mr. B., and she may die any day. I am young, just commencing practice, and it will injure me to have her die on my hands; and I can not help her.’ ‘At least,’ said father, ‘give her something to relieve her suffering.’ They did not know that I could hear them; but spring-time had come again, the day was quite warm, and I had asked to have the window raised at the head of my bed, and so it happened that I could hear all they said. I heard the doctor returning, and I resolved not to take any of his soothing drops; I had taken all I meant to. ‘Well,’ said I, ‘what have you come back for, doctor?’ ‘Your father wished me to prescribe for you,’ said he. ‘Never mind,’ I said, firmly, ‘I shall take nothing more. You say I have six weeks to live: I will spend them in getting rid of the medicines I have taken the past year,’ and he went away. Soon father came in, seeming much disappointed and grieved, and in answer to his questioning, I told him why I had determined to take no more medicine, and what I had resolved to do; and now I will tell you what I did, and how I came to do it. I had read in an old English almanac——not a medical one, like the ones strewn about everywhere now, but there was a good deal of useful information in it——a ‘Sure Cure for Consumption,’ and it was so different from what I had been doing, and appealed so strongly to my judgment, that I had been thinking that if I could only make a start there might be a chance for me; but the effort required was so great that I doubt if I should have had courage enough to undertake it but for my resentment, upon overhearing that conversation——to think that the doctors had given me nothing but medicine, and that I had been eating in such a way——without any appetite, except for some of the ‘rich’ things they were always making because I couldn’t relish anything else. The recipe explained that the disease was caused by lack of fresh air, outdoor exercise, and appropriate food; but I will only tell you what I did, and you will understand all about the reasons for it. First, I told father and the rest of the family that as I had but six weeks to live, they must let me have my own way in everything, and must do as I said. I could not move from the bed alone, but I had them carry me on a comforter out on the lawn and lay me down there. ‘How was _I_ to take exercise——when I could scarcely turn myself in bed?’ was the question. Well, I did turn myself on one side, and, with a stick, begun to dig a little in the ground. It looked then as though I should not do much damage to the nice sod father had taken so much pains to make; but I dug a little hole as large as my fist, and then rested. After a while I turned over on the other side and dug another little hole, filled it up, and rested again. It seemed good to rest and I felt a little better; for the outdoor air, and the exertion I had put forth, ‘loosened’ my cough a little, and I begun to ‘raise.’ At night they carried me back to bed. My bed-room windows had been wide open all day, and I wouldn’t have them shut now; but in answer to their fears about the night air and catching cold, I said, ‘Give me clothes enough, and I will risk the night air——I’m going to breathe pure air the next six weeks——if I live so long.’ They all felt terribly——they thought I was shortening my life, even then——but they yielded, finally, in everything, even to not asking me ‘if I couldn’t eat a little of this, or that, if they would make it for me?’ I had replied: ‘No, when I feel like eating a piece of Graham bread or a potato, without butter or salt, I will eat something——not before.’ This had occurred in the morning, and that very night I asked for a slice of bread and ate a little bit——as big as my two fingers, perhaps. I had them put a teaspoonful of cayenne pepper[32] in a dish and turn warm water on it——a quart——and let it stand overnight, and in the morning was sponged all over in that water——the dregs turned off. I had them bathe an arm and then dry it with a coarse towel, and rub me with it as hard as I could bear (not very hard, to be sure), then a leg, and so on.[33] It seemed to give the dead skin a little life; then they carried me out to my ‘work’ again! I felt like resting after the bath, but after a while I turned over and dug a larger hole than on the day before, filled it——partly with what I raised from my lungs, and such stuff as it was! I could take longer breaths, too; and after digging a minute or so I would _have_ to stop and take a long breath, and then go on again.[34] I was thirsty a good deal, and would drink water——all I wanted. I ate a piece of stale coarse bread and some fruit that morning after I was rested from my first digging, and then I kept on resting for some hours, after which I dug a little more. In the middle of the day, when the sun came down too hot, I had an old umbrella put over me and fastened. At night a little bit of bread and a small potato: I ate as much as I could relish, but not a mouthful more. In this way I kept on, day after day, and they began to see that I was gaining. Father, who could not believe the gain was real, but rather the temporary effect of my will, yet joked me about ruining the lawn: ‘I shall have to turf it all over again, Lucia,’ said he, even before I could dig a hole large enough in a day to bury a cat in, and he tried to laugh at his little joke. I remember that I did laugh, and came near strangling in a coughing fit in consequence, but that was a help; what I _needed_ was to cough and raise the stuff up——those old ulcers that the doctor said my lungs were covered with——and I found fresh air, flavored with a little exercise, a better ‘expectorant,’ as you doctors say, than those I had been taking. I began to feel hopeful——the novelty of the idea——digging for my life! I took a desperate view of it——six weeks to live——‘I’ll die fighting,’ I said to myself. It seemed almost droll——droll enough, at any rate, to interest my mind, and I would say funny things to the others to make them laugh, and this seemed to make them try to be cheerful and to cheer me on. The third day, I remember that I ate the same kind of a breakfast——just a little——and at night asked them to boil a beet! I would have only one vegetable at a time, lest I might be tempted to overeat and lose my appetite, and so spoil everything.[35] I was impressed with the idea of ‘earning my living’ at outdoor work——‘by the sweat of my brow’——and not to eat more than I earned by the exercise. I had renounced my coffee and tea; I ate no grease of any kind, nor meat——bread, fruit, and vegetables only——no salt or spices, pastry, pie, puddings, nor cake, nor ‘sweets’ of any sort, except the natural, _whole_ sweet furnished by nature, in the form of vegetables and sweet fruits. The prescription said that some people ate too much soft food,——bread and milk, puddings, and the like,——and that while such dishes were better than many others in common use, still they were not the best, especially for sick people with weak stomachs, but that dry (farinaceous) food was every way better; and so I ate bread, or unleavened biscuit, which, after a little practice, the girl could make very nice,——just the meal and water well mixed and moulded stiff and baked in a hot oven,——and I ate them very slowly, chewing each mouthful thoroughly. You can tell, perhaps, doctor, just why this should make a difference:[36] I only know that it seemed to agree with my stomach better. They bathed me every morning in the same way, only after a while they did not have to work so slowly and cautiously. I could exercise more and more, from day to day, and with less and less fatigue, and I laughed to myself that father’s joke would prove something more than a joke; I was bound to undo all his nice work; and I knew he wouldn’t care, so that I could get well. After a while I could raise myself up and sit erect, and dig a little, first on one side and then on the other; and by the time my ‘six weeks’ were up——and I told father so one day——I could dig a pretty good grave for myself, if they wanted to bury me; only, it wouldn’t be quite deep enough to hold me down——for I had actually raised myself to my feet, stood alone, and walked a few steps without help. On the eighth week I could walk about——would walk off a dozen steps, come back, sit down——perhaps lie down. The more I did, the more I could do——always taking care not to exhaust myself——and the more I could eat; but I took even more care not to overeat than not to overwork: I found that the real thing was to eat little enough——not to see how much I could eat——so that I could increase the amount regularly, rather than to lose my appetite and eat nothing some days, or eat without an appetite, and next day eat enormously, perhaps, as mother used to; I wouldn’t have them ‘fix up’ anything——I was afraid of being put back. I ate but twice a day, and sometimes my breakfast was nothing but fruit——two or three oranges or as many apples, or a huge slice of watermelon——this was food and drink, both. I wore the least possible weight of clothing——often removing my stockings as well as shoes, and going barefooted and bare-armed when the weather was very warm. I had lost all fear of taking cold, though I kept comfortable always——throwing off clothing when too warm, and putting it on, as any great change in the temperature made it necessary, but to the extent of my increasing strength I endeavored to keep warm by exerting my muscles. One day, after some months of self-treatment, and when it had become evident that I was really convalescent, I asked brother to call Dr. Osgood (the young doctor who refused to take my case). ‘Why, sis,’ said he, ‘you are not in earnest?’ ‘Yes, I am,’ said I, ‘I want to tell him how to cure consumption! You tell him I want to see him, but don’t say what for.’ He had been away somewhere, and had forgotten all about me, of course, but when brother spoke to him about me, he was astonished to find that I was alive. ‘It was amazing’ he said. ‘Yes, if there is any chance of saving(!) her I will call’——and he came. He expressed his pleasure at finding me so well, and I suppose he thought I had come to a point where I felt the need of his advice and a ‘tonic,’ perhaps; but I just made him listen to the story of my self-cure, and asked him if he couldn’t advise others to do the same way, and so do his patients more good. He was inclined to be vexed, at first, but finally he laughed and said: ‘Really, Miss B————, I have come here at your request, and you have prescribed for me, instead of I for you, and I thank you for it——will pay you for it, if you will name the price——but I could not practice in that way. Why, how many consumptives would act upon my advice, if it was of that character? How many, indeed, would have the second visit from me, or recommend me to others? They would even denounce me to their friends——to every one they saw, and I would have to go to digging in the ground myself, or leave for other parts. No, Miss B————, you learned the true secret, and you were “fit” to “survive” because you worked out your own salvation: you have taught me something——a valuable lesson, I may say, and one that I shall profit by as I have an opportunity; but we could never set up such a reform——one doctor, nor two, nor three, alone——the time is not ripe for it, physicians are not ripe for it, and it can only come, if it is ever to come, by just such independent action as your case represents.’ And so he went away, and I continued my ‘treatment.’ The next summer I had a little flower garden of my own, watered and tended it, and, a little later, helped about the kitchen-garden, besides taking care of my own room; and so I went on, gaining steadily, until, within two years, I was well——better than I had known myself since my romping days, and I have scarcely had a real sick day since——never a serious illness from that day to this, nearly thirty years.” “How do I keep well?” you ask. “Why, by pursuing the same principle that cured me——the same, in fact, that would have prevented my decline, in the first place. I never breathe ‘indoor’ air, winter nor summer, day nor night; I eat only the simplest food, and in moderation——yet I will, sometimes, eat a little more than I need——some meals or some days——and will have a little headache, or, perhaps, an old tooth will ache, or there may be a little disturbance in the stomach; but whatever it is, I eat more moderately——sometimes go without a meal; and if anything more serious than I have named presents itself——lack of appetite, or a bad feeling at the stomach, or a bad headache——I go all day without eating, and keep about my work, as usual, or take a walk outdoors, and this plan always works a cure. You see, I _dress_ right——loose garments, no corsets, no heavy skirts hanging to my waist or hips, no smothering flannels, except the lightest, and those only in the coldest weather; I keep busy about something most of the time; take a good deal of exercise; go out when I can, and bring outdoors in when I can’t go out——by having every part of my house well ventilated and as light and ‘sunshiny’ as need be (you see, doctor, I am not whimsically afraid of flies nor of fading the carpet); I think of my escape, of my good health, and this makes me cheerful. I feel sure of not getting sick——I have no anxiety on that score,——and I try to do what good I can, in my small way, and all this is as it should be——it is ‘healthy,’ and, all things being so, there is only one other chance to err, and that is in eating, and so when anything troubles me, I know what it is. So many people go wrong in all these things——dress bad, breathe bad air, feel languid in consequence and lie about doing nothing, indoors; eat worse food than I do, and eat more and oftener——no wonder they are always ailing, nor that so many die. But, Doctor, this will not cure my niece——our talking——and I don’t suppose I have taught you anything, as I did the young doctor, so many years ago; but if, as you say, you can tell the story for the benefit of others, I shall be very glad indeed to see it in print. You will send me a copy of the paper, won’t you? ‘A dozen copies?’ Well, all the better, I will send them to my friends; they will wonder how the ‘old story’ got into the papers.” And that is the way this history of a “Natural Cure” came to be printed.

[Footnote 31: It is, of course, idle to speculate as to whether Miss B. was within six weeks, or six months, of a fatal termination of her disease under the usual treatment. Her physician expressed his honest opinion, certainly; though had he been catechised closely, he would doubtless have modified it somewhat, as, by saying that while she was liable to be taken off at any time, still, she might linger along several months, or until severe cold weather in winter, the season usually so fatal to this class of patients,——not because it is impossible, or even difficult, to keep the sick-room at any desired temperature, but because this end is sought to be accomplished, largely, by shutting out “the breath of life,” and by retaining the vitiated air, to breathe which would “chill” the healthiest subject. “To retain foul air for the sake of its warmth is expensive economy.”]

[Footnote 32: It was, in the author’s opinion, the _bath_ rather than the _pepper_ which proved so beneficial.]

[Footnote 33: In practice, it will often prove that quick sponging, all over, and brisk drying, followed, perhaps, by thorough hand-rubbing, will be more useful than the “piece-meal” bath: with water at a comfortable temperature, and the work quickly and skillfully performed, while it might seem likely to occasion a severe shock to the patient, still, it is but one “shock” instead of many, and is really far less trying, with many patients, than the more prolonged process with its oft-repeated local shocks. If rightly managed, the reaction from the full bath makes it altogether the most agreeable. It is of vital importance, to secure this warm “reaction,” and if, in any instance, there is failure in this direction, the instant application of warming appliances——hot-water bottles to feet, warm flannel wraps, extra blankets, etc.——is imperatively demanded. Baths which are succeeded by chilliness are depleting, and if of common occurrence are destructive to life; far better not bathe at all.]

[Footnote 34: See note 6 in Appendix, p. 284.]

[Footnote 35: One element which aided immensely in this remarkable cure, was the absence of great variety in the food. Indigestion is _the_ enemy to be overcome; and he must be “killed dead.” _Variety_ is this enemy’s right-hand man——encouraging excess and the indulgence in questionable articles; and, above all, prohibiting the _adaptation_ of the digestive organs to any class of all the ailments thrust upon them. (See foot-note, p. 213.)]

[Footnote 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.]

[Footnote 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.]

[Footnote 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.”

[Footnote 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.

OPEN-MOUTH BREATHING.

I am not going to recommend the consumptive, nor any person, well or ill, to do all or much of his breathing through the mouth; on the contrary, I agree that the nostrils were designed to warm and filter the air, and that in general this is necessary. But there are times when the atmosphere does not require to be _filtered_ and when it had better not be _warmed_; and I wish to do away with all fear of danger from casual or occasional open-mouth breathing, especially in the _open air_, and in winter, or at any season when there is freedom from dust, and regardless of the weather, and the time of day or night. For “sore” or irritated throat and bronchi, or oppressed lungs, I have found persistent open-mouth breathing of pure cold air curative in its tendency; and have myself, upon occasion, gone out on a winter’s night, to walk and breathe in this manner by the hour. Consumptives are often subject to attacks of dyspnœa (difficult breathing), but rarely, if ever, do they come on out of doors; it is rather, when, having been vouchsafed a little pure respiratory food, the lungs are again forced to respire the hot, poisoned, make-believe air of the home, that the congestion takes place. And this may be set down as the only danger in the premises, viz.: the return from the fresh, pure and bracing atmosphere without, to the over-heated and under-ventilated living-rooms. The remedy, then, for an attack under such circumstances would be found in throwing open the doors and windows——keeping well wrapped or warm in bed——rather than in sealing the crevices and piling on fuel. Even _pneumonia_, most dreaded of “diseases,” in which the lungs are congested to engorgement, is now being successfully treated on this principle——the persistent open-mouth breathing of out-door air, if in the winter, or the same, drawn through an ice-packed refrigerator——(scrupulously clean and profusely ventilated), if the weather be warm; the patient, meanwhile, being _warm_ in bed, though never sweltered with wraps [the aim being to balance the temperature, by cooling the head, heating the feet, and exposing and sponging the feverish surface, as may be indicated], and supplied with a proper face-piece to which is attached a flexible tube, through which the cold air is passed direct to the lungs; this manner of breathing to be _constant_ and _uninterrupted_, hour after hour, and throughout the night, if necessary (_never_ remittent), until the temperature of the patient, as indicated by the thermometer placed under the arm, is reduced to about the normal point (98.2° F.), and the pressure at the lungs relieved. The philosophy of this treatment is as evident as is that of the playing of an engine upon the hottest part of a fire.

A WORD ABOUT THE BED.

The bed and its covering constitute the night-clothes, and for the bed-ridden patient day-clothes as well. Therefore, we can hardly place too much importance upon the bed and its appointments. And yet, in view of all that has been said relating to cleanliness and wholesomeness, in a general way, but few words are necessary to tell the story. The bed may be of straw, even, and still, if full, fresh, and well-made, be every way sufficient for comfort and health,——better, indeed, than a poor or long-used mattress of any sort;——a mattress of hair, cotton, or wool makes a complete bed. A feather bed is the worst of all. Whatever the bed may be, it should remain open and airing whenever the patient is out of it for any length of time; hence the bed-room should not be the sitting-room when avoidable. Patients confined to the bed altogether, should, if possible, have two——one for day the other for night use——each kept airing during all the time it is unoccupied, and, when practicable, placed in the open air and in the sunshine a portion of the day; the more the better. After the cotton or linen sheets, the covering (of as little weight as is consistent with comfort) should, in place of the common “comfortables,” consist of woolen blankets, which, being porous, are less “stifling” to the body (see foot-note, p. 171), and permit of being readily cleansed and dried; and they should be thus treated as often as once in three or four weeks, at least, and oftener if the thorough airing recommended is not given them. The “sick-room” should be the “healthiest” room in the house——bright, sunny, and made as “cheery” as possible. No “long-faces” should enter it; there should be no “croning about”——no constant “how-do-you-feel-to-days,” nor subdued looks or airs. Carry along a happy, cheery face and tone, or keep out of the sick-room altogether. Above all, no mind-pictures about eating, eating, eating——unless, the patient is past hope!

THE POSITION IN BED.

As well as when up and about, is a matter of importance to the sick or well. With the sick, the habit of “rounding up” to the disease is every way prejudicial. Consumptives are especially inclined to seek present ease to their ultimate hurt. It should be one of the aims, in “lung difficulties,” to increase the breadth of the chest in order to give more room for the expansion of the lungs; and this demands increased efforts to expand the lungs, and to push the shoulders back——gradually, very gradually, never to the extreme, but with steady persistence. No radical and immediate change must be looked for; none can be accomplished, in any direction, whether in the shape of the body, quality of lung tissue, or breathing power; but a gradual transformation may be inaugurated, and ensured by means of persistent effort, as the general health improves. It is best to lie, at least much of the time spent in bed, as nearly flat upon the back as possible, slightly inclining toward the side, or alternating between the two positions, with the head low; arms and legs “at ease,” the latter not drawn or “curled” up, but slightly relaxed. If the general regimen is strictly hygienic, the position as thus described will, so far from working any harm, prove of advantage——favoring free breathing, as well as the fullest rest of the body. Where there is shortness of breath and difficulty in breathing, the patient is inclined to cultivate the habit of narrowing the shoulders, and so bolstering himself in bed as to still further shorten the breath, thus temporarily easing the difficulty, but finally increasing the disease. He needs to courageously take the opposite course (never rashly, however), and meet the consequences, which are likely to be manifested in some increase of coughing and raising——the very things he needs to do, but which he is apt to shrink from as much as possible. In avoiding natural “expectorants,” the necessity for artificial ones seems to arise. In the one case he raises with some effort what, in his present state, may be described as the normal amount of mucus; in the other, expectoration is easier because there is more to raise. The former is curative; the latter tends to fatality.

Well knowing that sexual indulgence constitutes one of the most fruitful causes of this disease——of decline, in short, however exhibited——I will conclude by saying, that the consumptive should _never_ depart from the rule of strict continence. (See Appetite.) No language can exaggerate the importance of this injunction for a person who is even threatened with decline, if he means to eradicate his disease. The sexual and the nervous systems (including the brain) act and react upon one another, keeping both abnormally alert, and these upon the digestive and assimilative, through the sympathetic, altogether making a quadrangular fight well calculated to impair——to break down, indeed——the strongest constitution; while with the less vigorous (often the most lascivious; or, maybe, the victim of a libidinous but otherwise considerate companion) the case is hopeless, unless the true remedy is applied. The patient should sleep alone, if possible, not even the husband or wife sharing the bed——a rule which, from every point of view, is of importance to both the patient and the attendant.

* * * * *

NOTE.——The underlying principle of this work prohibits the idea
of a specific and exclusive treatment for this, that, and the
other _disease_ mentioned; for these are named simply in order
that we may make a beginning toward understanding the term
_sickness_: the entire volume, from preface to finis, is a
treatise on the origin of sickness, its prevention and cure. In
view of this, we can not leave the consumptive here, while the
dyspeptic, the rheumatic, or the _douloureux_-tic is invited to
a consideration of his peculiar symptoms,——for these, in large
measure, are mere accidents, since the rheumatic of to-day may
be the paralytic of to-morrow, and the dyspeptic of this year
the consumptive next, and so on. But all classes, and all who
wish to inform themselves as to what makes pain and sickness,
and what ends these symptoms, should study carefully the various
chapters, omitting none.