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A Plea for a Simpler Life
Chapter III

I have as yet only attempted to lay a foundation for my plea for a simpler life,’ the main object of this book. I have tried to show that when disease comes upon us, the means ordinarily used to restore us to health other than those which nature herself employs are mostly at best doubtful and uncertain, often injurious, and varying at different times, and I may add in different countries.

I have pointed out that in a large proportion of cases what we call disease is the means adopted by nature for the cure, or, I may add, for the checking of some evil lurking in the system, which, if allowed to go on, might lead to permanent impairment of some of the important organs of the body or of their functions, or even to loss of life. If this is true, the inference is clear that something has occurred, either suddenly, or since a longer or shorter period, which has led to the necessary interference on the part of nature.

To point out what this something is, in the whole domain of medicine, is a very large order indeed ; and here there is room for the highest knowledge and skill that professional men are ever likely to attain to, and where these will always have their work and their reward.

My object is a much humbler one, and is mainly to point out that the means commonly adopted at the present day for the cure of a large part of the diseases which are commonly met with in our ordinary practice are precisely those which are themselves, when used improperly, the main causes of these same diseases. I allude, of course, to food and stimulants, and these assisted by drugs to do their evil work unobserved.

Food is essentially, as has often been pointed out, of two kinds. The one is that which, by slow combustion in the body, and mainly in the lungs, goes to the production of heat. This is used up mostly in sustaining the heat of the body, but it is also, by some subtle chemical or other change which we do not know, converted into force, in the forms of muscular, nervous, and mental energy, and perhaps of electricity. This, which may be called the working food, is mostly carbonaceous, and includes all matters which burn in the fire, as sugar, starch, oily matters, and alcohol, which all burn readily and leave no residue. The other kind of food is what goes mainly to form and to keep up the body, and to supply its waste; the essential element in its composition is nitrogen. It will not burn in the fire, but is slowly consumed, leaving only a small quantity of mineral matter in the form of ash.

This also assists in a minor degree in keeping up the heat of the body and in the production of energy, by a slow oxygenation in its passage through the body, which it leaves mostly through the kidneys. It is represented chiefly by animal flesh of all sorts. Other substances used as food are combinations of these two, and of these bread and milk are the most important; but it includes all cereals, and the pea or lentil tribe, which are astonishingly rich in nitrogen. Vegetables belong mostly to the carbonaceous group, but vary much in composition, as also do fruits, which often contain little but water, with more or less sugar or some acid peculiar to the fruit itself. All foods contain some saline matters, varying much both in quantity and kind, but some of them absolutely necessary to the health or full development of the human body.

The above is a very elementary and imperfect history of the two forms of ordinary food, but it is enough for my present purpose.

Of stimulants I need only mention alcohol, wine, and beer, and these very shortly. That they are not necessary for life th<-re can be no doubt whatever. Nature does not provide them; they are artificial products ; and how long man existed and progressed without them we do not know. In large regions they are not used or are not to be had. and these regions lie in all parts of the world—hot, cold, and temperate. The evils arising from them we all see and deplore, and any benefits they confer either in health or disease we have seen to be very doubtful. Fashion changes in regard to them much as with drugs. Formerly it was wine, then brandy, and now Scotch or Irish whisky. In India some thirty years ago the run was upon strong Burton beer. Now comparatively little of this is exported, and its place is taker, by lighter beers from this country and a much lighter country beer, or by light claret, and brandy and water or whisky and water.

I will now consider in a general way how errors in food affect the healthy and induce disease; or, in other words, render interference necessary in order to prevent some greater evils.

If a healthy person takes too much carbonaceous food, the error sooner or later shows itself. For a time the excess is set aside in the form of fat; and the discomforts from this, or still more frequently the change In the figure, attract attention, and, if the case be wisely treated, relief is got from less food and more exercise. Or the secretion in the liver of bile—which contains so large an amount of carbon that it burns in the fire—is unduly increased, the blood gets carbonised, langour and discomfort come on, appetite fails, and a chill, followed by irritation of the stomach, ends in a bilious attack. This, with the enforced starvation, it may be for several days, clears off the superabundant carbon, and leaves the sufferer in a healthy condition.

The case is very different when the excess has been in animal food. This may go on for many years, even for what may be considered a fair lifetime ; and. if the individual is of a sound constitution, and under favourable circumstances, he may dispose of twice or thrice the quantity of flesh food that is required by his system, and still retain his health to all appearance unimpaired. The kidneys, which eliminate with some little help from the skin ail effete animal matters, will do double or three times their necessary work for an indefinite period: and if life be cut short by accident, the case may be quoted as one of a remarkably healthy life, and the credit of this may be given to the full mode of living. But if not cut short by accident, ar.d if there be no weak organ which may break down earlier, sooner or later, but long before what should be the natural span of a healthy life, ugly signs of disease unexpectedly manifest themselves, and the till now strong and healthy man is told that his case is hopeless ar.d beyond the means of possible cure. Naturally the overworked kidneys are the first to give out, and failure on their part may prove fatal; or the blood gets loaded with animal matters of which they fail to relieve it, and these are deposited in various organs in some in the form of fibrin, which by and by hardens, and destroys more or less their substance and their functions. A very common form of evil arising in this way is what is called general paralysis; I never heard of this in my student days, and not till long after. No doubt cases occurred before and were known by a different name, but they were few, and their number has increased enormously during the last thirty years. The symptoms and pathological changes vary infinitely, according to the part of the nerve centres affected, and the stage of the disease. I cannot recall a case which was not that of a previously healthy individual, and who lived fully.

What I wish mainly to draw attention to as to those two errors of excess is, that in the first nature interferes soon and sharply, and no permanent mischief is left; and in the other, excellent health may be enjoyed for very many years, while all the time changes are going on which give no sign till the case is hopeless.

In the great majority of cases of errors of food in quantity, the excess is of both kinds, carbonaceous and nitrogenous J and no doubt there are very few healthy people who can afford it who do not usually exceed. Appetite seems to call us to enjoy it, and a ‘ healthy appetite ' is applauded by all, while a ‘poor appetite’ meets with general reprobation, and any one who ‘picks’ is looked on as a poor creature. If appetite threatens to fail there are plenty of ‘ pick-me-ups ’ to have recourse to; and if any discomfort is felt after a meal there are plenty of pills ready at hand to relieve it. Then as ‘preventior is better than cure’—a wise saying if properly used—the pill is taken before or with the meal, and ail goes merrily, for a time. The blood-vessels of the stomach and the stomach itself get enlarged, and demand a larger supply of food to give satiety, a tonic is now needed and a stronger pill, then a stronger tonic, which by the bye seldom does any good; but sooner or later dyspepsia comes on—if no more serious ailment,—with its innumerable miseries; for the nerves of the stomach when irritated seem to take a pleasure in worrying all the other nerves of the body. Innumerable ‘remedies’ are now available— pepsins, peptones, alkalies, acids, etc., all with the view of assisting digestion. Dyspepsia is a mine of wealth to the doctor and the chemist, not forgetting the proprietors of patent medicines whose ‘infallible cures’ are legion. The invalid may suffer for the rest of his life, and, as his spirits and temper are often none of the best, his misery is often shared by all who are about him. The ablest men in science, art, and literature seem to suffer most. It may be that their condition is only better known, from their lives being made public; but in reading biographies I have often been saddened by occasional hints of sufferings brought on undoubtedly by resisting natural laws, a resistance kept up till the very last days of life. The worst case of this I ever came across was that of a well-known public man, not so many years ago. whose case was watched by many as given in regular medical bulletins published in the daily papers. I pointed out, just a month after they began to appear, how the reports alternated in this way. For a few days they were despondent, as the patient was lower and could take no food. Then (after the abstinence) he improved, and satisfaction was expressed that the appetite had returned and that he could eat; very soon appetite failed, and he was weaker. This went on for some four months, the strength however gradually failing. At length the case got hopeless and was acknowledged to be so. but still the attempt at feeding went on, and on the very last day of life food was pressed on the unwilling sufferer, even though it was immediately rejected. Here unfortunately the case is ended, and no other method can be tried. There is but one chance. If nature had been allowed to have her way, had the abundant material stored up in the body been left to do its own work, and little or nothing been added but a supply of plain water, the best diluent and eliminator, and with it, if considered necessary and if agreeable to the patient, more or less force-giving heat—the only real stimulant—I cannot but think that the result would have been very different. I am not orthodox enough (blasphemous enough?) to believe that these sufferings are all sent by Providence. An old man who has lived a natural life, and has reached his full time, has an infinitely better chance of passing away without suffering, and without regret. I have seen both.

In such badly treated cases—in my opinion —as the above, I cannot blame either the medical men or the friends of the sick. It is the bad system which guides the former, and anxiety to leave nothing undone that could benefit the loved one which influences the latter. It is only a little want of knowledge which unwittingly leads to so much suffering and death.

To what degree this want of knowledge extends amongst the profession the following will tell. I was asked by a young friend to meet the headmaster and other teachers of a large educational establishment which shall be nameless. There were many boarders, who were treated generally and fed in the way followed in the leading English schools of the day. My friend, who was one of the teachers, had himself suffered when a boy from intense headache, and had got benefit from my advice: and he knew well the evils which resulted to youths from too high feeding. I dined with the party; we had a friendly enough discussion, but I could not alter their opinion in the slightest degree. A year later I had occasion to see the headmaster again. After our business was finished he said to me, ‘ You will remember our talk, just a year ago, about the general mode of treating our boys, and especially about their food.’ 'Perfectly,’ I answered, ‘and precious little I made of you.’ ‘That I allow,’ he said; ‘but I know now that you are right, and I very much wish you could help us, but in the meantime we are helpless. It is the system known to the parents and expected of us. If, for instance, the boys do not get the best butcher meat, and as much as they wish every day, they can write to their parents; they would write to the directors; and, in short, we must go on as we have done.’ I said that I was much pleased to hear that he now agreed with me, and I hoped something better might come of it; but that I should like very much to know what had made him change his views so completely, and in so short a time. He told me it was a very simple matter indeed. He had an older brother, an English clergyman, who for many years had suffered from rheumatic gout, and who went annually to one of the favourite baths in France or in Germany. He returned always somewhat improved in health, but he lost it all and more by the next season, and latterly he had been going fast downhill, and it looked as if he would soon not be able to go at all. Last year, since we had our conversation, he went to Germany, and he met at last an honest doctor, who. when he was leaving, said to him : ‘ What :s the use of your coming here, or elsewhere, once a year to get washed out, and then going home and living in a way which absolutely destroys all the benefit and brings back all your ailments?’ But what struck me most,’ the headmaster added, ‘was that he put my brother upon precisely the food you recommended for our boys, and that he has kept well since, and has had no occasion to return to Germany.’ It was this that converted him.

What I wish to notice specially here is, that the advice as to diet which the German doctor gave the clergyman was perfectly new to him. He had consulted medical men both in this country and abroad, but had got no warning from any of them. He at once saw the common sense of the advice, and was only too glad to follow it. Many, I know, would not have done so even had they been warned.

For many years after giving up ordering drugs I sent patients to Germany for a course of baths, and saw great benefit in some cases where a more rational diet was adopted for the future. But too many others used the benefit they got only to enable them to exceed again with some comfort for a time; and in some the end certainly came sooner in consequence. I have a hope that a few who read this may be induced to follow the example of the old clergyman, and get the same benefit that he did.

I am quite aware that in most work which treat of such diseases as mentioned above, one cause of them always given is too rich living; but I am not aware that I ever saw it given as the essential cause, and in practice it seems to be overlooked both by patient and doctor. The fear of ‘letting the system run down’ seems to neutralise every other consideration.

The evil principles as to diet which prevail in this country are, I fear, at least as dominant in the colonies and across the Atlantic. 1 have had some experience as to both, but can only afford room for the following.

Four years ago I was crossing from New York to Glasgow. One day, on entering the smoking-room, I found a hot discussion going on as to the advantages or otherwise of tobacco. One elderly gentleman who had injured himself by its abuse was insisting that its effects were always bad, and that its use should not be allowed. I was appealed to as a medical man to decide between the parties. This I managed to do to the apparent satisfaction of both. I pointed out that tobacco is a natural product; that it has come to be used in all parts of the globe where it can be got; and that this fact alone surely indicated that it must have some quality which fitted it for man’s use. Though no regular smoker myself, I had often found, when anxious or worried and worn out, that a very mild cigar had soothed me, and enabled me to take a more hopeful view of what was troubling me. Of course I noticed the evils of excess, but added that every good thing is liable to abuse, and, as I always do when I have the opportunity, I spoke of the abuse of fresh food as doing perhaps more harm than all other evil habits together. This was a new doctrine to all, and we went into it pretty fully. By and by a youngish gentleman who had said nothing started up and, in a somewhat excited manner, said that I had exactly described his case ; that this was the turning-point of his life ; and that he would at once change his mode of living. I had noticed his pallid, ‘seedy’ look, and as he sat at a table near me I could not help seeing that he regularly, after a few days’ sea-sickness, took for a little man, as he was, an enormous quantity of beef and mutton. He afterwards told me his history. He had been in his father’s business, an important one, in one of the largest Canadian cities. So long as he could take it easily, and had plenty of out-of-door exercise, especially in hunting, he enjoyed the best of health. By and by he became a partner of the firm ; he was kept much more closely to the office and could get very little exercise. Soon his health failed, and he became utterly unfit for business. Four doctors, he said, had treated him with no good result, and he was sent off for a three months’ holiday. I asked him why he took so much animal food. He said he felt so weak that he thought the more he could take the better, and he had never been warned against it. One of the medical men, he remembered, had said he was taking more food than was good for him under his circumstances ; but he understood that the circumstances ought to be changed and not the food. My observations in the smoking-room were, in fact, a revelation to him. He at once altered his diet both in quantity and quality, and after a week, when the voyage ended, he already felt much better, and there was some slight appearance of colour in his face. I heard from him a month later, when he wrote that he was very much better; that his strength was returning, and that he could now walk five miles with ease; and he thanked me warmly for having ' taught him how to live.’ He visited me before returning home, and he certainly looked a very different man. Later I had a letter from him, in which he states: ‘I am pleased to say that I am feeling splendid, and am holding fast to your method of living. In fact, I have not tasted butcher’s meat half a dozen times since my return home, which is six months ago.’

Another of the party who heard the conversation in the smoking-room—a Scotch clergyman—also adopted a different mode of living, and, as he told me, with great advantage to himself and family. To him also the doctrine was a new one. How many there must be who ‘perish for lack of knowledge! ’

So much for the evils arising from abuse of food, especially of animal food; I have no doubt I will be told that all that I have here brought forward has been preached and published limes without number, not only by vegetarians, homeopaths, etc., but also by members of the profession. This is no doubt true, and it is well that it is so. I am pleased to know that I am not the only black sheep in the fold; and I trust their number will increase, and that they will put themselves in evidence more and more. I have no wish to monopolise the fighting, and will be glad to pass it on to younger hands.

Much is to be hoped from the work of medical scientists, among whom there are many eminent workers and searchers after truth. I am not sure that practical medicine has as yet been much assisted by their labours. A genuine medical fact is about the most difficult fact to establish, so that it may be usefully and safely acted on. It has to deal with such complexities of chemical and physiological and vital changes within the body acting and reacting on each other, and these affected by temperament, heredity, idiosyncrasies, and external surroundings, that a final and reliable determination is always difficult and often impossible. Medicine as a fixed science does not as yet exist.

But the work of medical scientists in many different lines, if it has not as yet done much to help forward the practical treatment of disease, has at least shown the uselessness (or worse) ol some medicines or methods hitherto in repute. One of the most interesting of these is seen in the recent investigations of Dr. A. Haig, which go to prove the effects of uric acid in the blood in destroying its coloured globules, and thus inducing anaemia, for which good ‘ red meat ’ has hitherto been considered the fittest cure. In experimenting or. himself to try to ascertain the action on the blood of uric acid taken into the stomach, he took a certain quantity of beef-tea as an equivalent for a certain number of grains of the acid. He shows also that iron is useless so long as it is given with red meat, and he thus accounts for its failure in many cases. I long ago came to the same conclusions, but could not give the same scientific reason. Perhaps the most white-faced family I ever saw was one of six, in South America, who had at least two full meals daily of beef and mutton. The only exception was the baby, which was still at the breast and which was a fine rosy child. The parents were Scotch. They lived in the country, in a fine airy house, and about the last thing one would expect to see there was anaemia in any form.

In the British Medical Journal, 31st March 1894, is a review of the last work on Skin Diseases by Dr. H. Tenneson of the Hospital St. Louis, Paris. Dr. Tenneson’s views on eczema are specially noticed, and they are virtually those which I have held for forty years. As to medicines in this disease, he says that several are injurious, none are useful. As to food he says: ‘Many people, because they have a good appetite, think they have a good stomach; and manufacture daily in their overloaded digestive tracts toxic substances, which, after they are absorbed, excite abnormal effects both on the skin and all the other organs of the body.’ His rule therefore as to food is simply restricting the quantity, particularly at the mid-day meal. His local treatment is allowing or provoking the oozing as long as possible, and he finds that the soothing ointments used owe their value solely to the lard with which they are made. I have constantly pointed out to my patients that eczema is a natural relief to the system, as it throws out safely on the skin some of the excess of plastic matter in the blood, which it cannot dispose of in the natural way through the kidneys. The next safest exit for this material is by the mucous surface of the throat and larynx and bronchia; and the amount excreted from them in cases of chronic bronchitis, which are so common in gouty and rheumatic subjects, is sometimes very great. The phlegm coughed up is not mere watery fluid, but is more or less pure animal matter, as may be seen by putting it into spirit, when, like white of egg. it gets solid. Unfortunately both these skin and mucous exudations are treated as diseases per se, and are checked if possible. Surely it is better to allow the excess of material to escape from the blood in this way (if we do not cut down the excess of food which produces it) than to force the blood to relieve itself by depositing it in deeper and more important organs, as the liver, the nerve centres, or the heart. As the product of these exudations is purely nitrogenous, I would blame excess of flesh food as their cause ; and as Dr. Tenneson says that it is the mid-day meal which specially requires reduction, and as this is in France the chief flesh meal of the day, we may be practically at one. But nature clearly throws off the excessive plastic matter from the blood clean and unchanged, and I do not see the necessity for the previous formation of toxic matters from the intestines, at least not in the cases we have been considering.

There is much, therefore, to be hoped from the progress of science. But its influence on practical medicine has been long in coming, and unfortunately hitherto one scientist has but too often only overthrown the conclusions of another. Is not this after all the ordinary way by which truth is reached?

The evils of food excess are much aggravated if at the same time alcohol is taken, even in very moderate quantity. This follows from what we now know from the researches of Sir B. W. Richardson, fie was. I believe, the first to prove that the presence of alcohol in the body hinders all the chemical actions going on there, exactly as it stops or modifies fermentation in a barrel of wine or beer. In both it retards oxygenation, and lowers the heat. Hence its use in cases of fever, or where it is given in extreme cases when the temperature threatens to rise to a dangerous height. In cases where very little food is habitually taken, it may do little harm, as it lessens the waste of the body, and to a small extent acts as a true food. A Highlander frequently takes as much whisky as would render most persons useless, but living as he often does on a very small amount of oatmeal or potatoes and a little milk, he may do a good day's work if not too severe, and he may live to a long life. I was told by one of the first financiers in Scotland, that such a life about the age of sixty is a much better one on which to buy an annuity, than that of a well-fed Yorkshire teetotaler of the same age. Had the drinking Highlander been also well fed, or had the well-fed Yorkshire-man indulged in alcohol in any form, neither of the two was likely ever to have reached the age of sixty; but after sixty the average life of the Highlander was appreciably longer than that of the Yorkshireman, and therefore more valuable for the financier’s purpose.

What is heterodox in me was much gratified, now many years ago, by the somewhat unprofessional appearance in the Titties of a letter from the first of our surgeons in his own line, Sir Henry Thompson. I have not a copy of the letter, but it took a strong hold on my memory and was to the following effect. He wrote, that after a large practice for twenty years among rich and poor, he felt constrained to publish as his strong conviction, that the main cause of the terrible sufferings he had to treat was the glass or two of wine which so many of his patients had been in the habit of taking daily. This was no new idea to me, only it told me that these very moderate drinkers were also well fed. a matter which, for the time. Sir Henry seems to have overlooked. Some years later he published an excellent book on diet. In the second volume he gave menus for dinners, which were admirably adapted to assist a weakened stomach to digest with comfort what is generally considered as a fair amount of food, and which it could not do if the food was presented to it, in a more gross, or to speak politely, in a less scientific form. But still later by some years Sir Henry published a paper in one of the monthly magazines, with almost every line of which I could cordially agree. He pointed out in a very graphic manner the evils that arise from too much food, and that it is our teeth, and later in life our artificial teeth, that cause us so much misery, and bring so many to an untimely grave. I have been very much indebted to this paper, and have often fallen back on it when put on the defensive. I wish we had such another from one of the first class London physicians. At one time I had hopes of it. but the eminent doctor I allude to got in Punch as the ‘starving physician,’ a name I have long been rather proud of. Perhaps this had nothing to do with it, but to the end of his life I have known nothing to throw any doubt on his thorough orthodoxy. A ‘starving doctor’ would not, I fear, have as yet a very long career as a fashionable and popular physician in London.

If the evils of high living are bad for the adult, they are still worse for the young, and not only from a physical but from a moral standpoint. For the growing youth until he reaches his full development a larger proportion of nitrogenous food is required, and this nature provides in milk, the most perfect food that exists, and which supplies all that is wanted for the sustenance and growth of a healthy body, flesh and bone. I have only met with one case where the child, on leaving its mother, could not take; cow's milk or any other; but I have known some and heard of others who lived on milk for years, in one case for thirty years, and enjoyed the best of health. After weaning. cereals in various forms, eggs, and soups from chickens and young animals should be, along with milk, the ordinary food for some years, when a moderate allowance of flesh from the same young animals or from fish may be added. The only error I should like to notice, in the early steps of a child’s life, arises from the dislike of most to give water. A child when feverish from any cause, as a chill, teething, etc., has often a desire for fluid, which it manages easily to express in its own way. But in a vast majority of cases, according to my experience, unless this is much changed during the last fifteen years, the only drink allowed is the ordinary food, possibly in some cases somewhat more diluted. This the stomach by and by rejects, and the case from this cause alone may get serious. An extreme case will illustrate my meaning. I was called to see a child about eighteen months to two years of age. It had been left in the charge of two elderly aunts, the parents being missionaries in India. I found the child in a very precarious condition. Nothing would remain on its stomach; its extremities were cold and shrivelled, the stomach hot and distended. The eye had a peculiar, glistening, eager look, which at once told me it wanted something. I asked if they had given any water. Mistaking my meaning, and perhaps fearing a reprimand they said no, but immediately added that they had given a very little, but they had boiled it first. I asked for a jug of cold water and a tumbler. I shall never forget the eagerness with which the child eyed the water, and grasped the tumbler. To the bewilderment of the aunts it drank the whole to the last drop. It all returned in a few minutes, considerably heated. Another tumbler was given, and another and another. These were returned after somewhat lengthening periods, but the fifth remained. Already the heat of the stomach was gone, the extremities were warmer and beginning to fill up. The eager glistening look was changed into a calm placid one. the fever disappeared as if by magic, and the child was soon in a quiet and natural sleep. The cure, in fact, was complete. The aunts said it was a miracle, but I told them it was only a case of common sense. I have rarely felt such well-justified anger, and I fear I did not try to conceal it.

As this is the only occasion I will have to allude to the earliest period of life, I will shortly notice the mischief which may arise from beginning to give aperient medicine. The first milk of all animals has an aperient tendency, and this is sufficient. Sir James Simpson used to say that if nature had required anything more it would have been provided. But in my day nurses considered it as part of their duty to give castor oil very soon after the infant was born, and in Hints to Mothers by first-class accoucheurs it was laid down as a rule that the bowels must be moved once a day; in one well-known little volume it was twice a day. The worst case I ever saw of a large mass collected in the bowel was in a child who got medicine daily, the result being always a liquid motion. I very rarely gave any medicine at all, and on one occasion I was very unexpectedly pulled up when I did so. An excellent nurse had come to a family I looked after from a doctor’s family, where the children were dosed in the orthodox fashion. She took very badly with the new system, and the mother told me several times of the trouble she had in preventing her from doing what she honestly believed to be part of her duty. Time passed, and one day I was asked to see one oi the children. To gratify the nurse, I fear, and to show her that I was not absolutely incorrigible, I said she might give a small dose of castor oil. But I had miscalculated the power of observation of the nurse and her common sense. She told me next morning that the child was all right, but that she had not given the oil.

The terrible evils that are seen in later life from the unnecessary use of medicine in infancy must be my excuse for giving the two cases which follow. I could give many others.

Owing to the death of the family adviser I was asked to see a girl of some ten or twelve years of age, the niece of a very old medical friend in Edinburgh. She had been treated in true orthodox fashion, but it had been found necessary to give her stronger and stronger physic, till now she was daily getting pills of the strongest kind, and such as are only used by strong men. Her health was suffering, and her education was interfered with. With very much trouble, by using milder means and fitting diet, after two years she got rid of all medicine, and a year or two later she went to school in London. She kept quite well for three months, when influenza broke out in the school, which unfortunately she did not escape. The doctor, one of the first in London, of course began her cure with a dose of medicine. This started again the evil habit which with such difficulty she had got rid of; and after three months more she returned with her box of strong pills in much the same state as when I first saw her. I now failed to cure her. This happened fully twenty-five years ago. She has had wretched health ever since, and has tried many doctors and cures in this country and abroad. The only time that she has been in a natural condition, her uncle told me, was after an attack of typhoid fever, which she caught on the Continent. I do not blame the London physician. Every one would have done the same.

Much about the same time I saw a child of about three years of age under precisely similar circumstances, but already suffering to a much greater degree. She had to get strong medicine every day, and she suffered tortures from its effects. 1 tried milder measures' with no result; she was going down rapidly, and she was evidently dying. I gave up all physic, and told the nurse to use mechanical means only for her relief. She found that this was impossible ; the poor thing was locally so tender that even touching her risked bringing on a fit. The only thing to be done was to leave her entirely to nature. At once she began to improve. The bowels moved naturally every twelve or fourteen days. The suffering then was great, but not more so than was the daily suffering previously, and she had time to recover in the intervals. She soon recovered her health. After some years the intervals gradually shortened, and the last time I heard of her she was natural in every way and enjoyed the best of health.

Let us return to errors in food, and first, as to their effect on the healthy and from a physical point of view.

Space will not allow me to consider the evils of too little food. In a country like ours this is frequently bad food, and got and eaten with more or less irregularity as to time. This naturally can be best studied in infirmaries and hospitals for the sick, where rest and warmth may be often helped by a moderate supply of good food, and possibly sometimes even of stimulants. But these cases of real debility from want differ prodigiously from cases we meet with elsewhere, where debility, perhaps much greater and requiring very different treatment, arises from an entirely opposite cause, viz. failure of the digestive organs, from long overwork in disposing of more food than it was possible to make a right use of. In these cases a long period of clearing out is needed before the organs can be usefully employed for again building up the system 'n a wholesome manner. This may be done quickly by a fever or other acute illness, which, if it does not kill the patient, very soon burns off the offending matters, although, as we see in cases of influenza, the benefit may be lost by a foolish system of feeding and stimulating, both during and still more after the illness. If this rapid method of cure is not available, it may be reached much more slowly by failure of appetite coming on. or perhaps some of the more acute forms of dyspepsia. If these are allowed to effect their work of elimination by a more or less protracted process of starvation, all may come right. But if the lowering of the system—letting it get ‘under par' is the favourite phrase—is looked upon as the evil, and if the object aimed at is to get the stomach to .do more and better work by the help of some of the innumerable ‘ remedies ' of the present day, some temporary relief may be got, but a real permanent cure. I believe, never. This, in my experience, is one, perhaps the chief, cause of those chronic illnesses which are, and very properly, considered as the opprobria of the profession.

Is it possible that the love of modern physicians for good feeding and stimulants may have some connection with the source whence they get most or all their teaching and their experience? Teachers, the favourite ones, are often clever young men, well up in science, but who have never had any outside experience; and in England at least such youths start at once as full-blown consultants, by virtue of their degree alone. I am old-fashioned enough to think that apprenticeship under a good master is not a bad introduction to general practice, and that eminence gained as a general practitioner is a good preparation for a consulting physician. I could give some strange illustrations of this, but I forbear.

In my young days, in the Twenties and Thirties, the food of the working-man, and also of most of the upper classes, was simple and good. It consisted mostly of milk, eggs, fish, oatmeal, potatoes, and a few other vegetables. There was no baker nor butcher in the parish, and there was no doctor within five miles, and as his fee was £1 he was rarely wanted; the clergyman was the ordinary medical adviser. On one occasion typhus fever broke out in a fishing village. There were twenty cases: only one of these could afford :o get a regular doctor, and his was the only case which proved fatal. The others were, I suppose, left very much to nature. Yeast was the only ' remedy that was given, and it got the credit of pulling them through. The sanitary state of the houses was worse than now, and croup and a peculiar local form of ague were no doubt due to a want of drainage of the fields. But with the good food which I have just mentioned there was not much general sickness. It supplied all the wants of the body in a perfect manner, and gave no great temptation to excess. By and by times changed, and white bread and flesh came into general use. Along with these luxuries came the doctor, although owing to railway facilities he is r.o longer located in the district. From what I find on occasional visits I am not at all sure that the general health is improved; indeed, I doubt it very much. One fact at least is certain that the doctor is much more required than formerly. The improved sanitary conditions alone should have led to a healthier state of the community. Is it wicked in me to suggest that perhaps the changes from the simpler to a fuller mode of living may have helped to neutralise those undoubted advantages?

A very large element of the diet both of young and old nowadays is white bread and butcher’s meat. I have often pointed out that both are very insufficient foods, especially for the growing child and youth. In the oat, which is now too costly for the poor, and which requires cooking at home, the phosphates essential for the growth of the bony skeleton pervade the whole grain. In wheat it is mostly confined to the outer skin, and as this is entirely removed for the sake of appearance, there is little or nothing in the white loaf of bony matter. It is the same with flesh. The animal makes a perfect body from despised vegetable matter pure and simple, but the phosphates go to form the skeleton, and in the muscle, which we eat. they are conspicuous by- their absence. The want is most imperfectly made up by chemical phosphates, which have come much into use in recent years, and which, no doubt, have helped the purses of the chemists who manufacture them, and of the doctor who very properly, under the circumstances, prescribes them. Had nature been allowed her way, neither chemist or doctor would have been needed.

In youth, as I have already said, a due supply of nitrogenous food is required to build up the body, in addition to what is wanted to supply what is lost by its ordinary waste. The waste varies considerably with the amount of exercise or work. A certain amount of exercise is needed in order to keep the system in a perfect condition of health, and if less work is done than usual less food should be taken. This, however, is a rule which is very often overlooked, although it appears so simple.

I have occasionally been consulted by gentlemen in apparent good health, but who complained of being quite ‘ out of sorts,’ and who said they never felt really well except when hunting or shooting or taking strong exercise of some sort. On asking them, they told me they went on taking the same amount of food whether they were active or idle; and on more close inquiry I found their diet was a very full one at all times. They, of course, most of them, took medicine, but they did not find that sufficient. It had not occurred to them to reduce their diet, and they wanted some prescription to help them. I always pointed out the risks they were running, and simply recommended a more rational diet. To assist them I advised them to take their food more slowly, and assured them that they would find that less would satisfy them: and this if carried out will often enable a mar. to reduce his food by one-half, and will add very much to his comfort and health.

I have frequently had Mr. Brassey's experience cast up to me. He got excellent work from his English navvies; but on extending his contracts to the Continent, he found that the poorly-fed natives could not do the same work till he got them to use the same food. This was triumphantly put to me. as a sure proof that a man is a better man when he is well-fed. ‘ Undoubtedly,’ I replied ; ‘ the man is a better man for Mr. Brassey, but what about the man himself? A navvy is wore out by the time he is forty, and a navvy at forty-five is scarcely known.' This fact I had full forty years ago from a Dunfermline doctor, a large part of whose practice was among navvies. This was ar. argument new to my opponents, but it was always sufficient.

In more advanced life, and in old age, a simple and restricted diet is even more necessary than before. The natural loss of teeth gives a good hint that the more solid articles of food should be withdrawn. Artificial teeth are of obvious use in other ways, but 'x is here that Sir H. Thompson’s saying about the grave being dug by the teeth mainly comes in. The digestive organs get weak with the rest of the body, and the comparative rest which age entails lessens the demand for food, both for the production of motive and other force, and for replacing the waste of the body ; and the heat of the body can be partly kept up by external warmth. Stimulants do even more mischief. than formerly. It is a common remark that cold weather kills old people, and it is a true one. But I was far more afraid of this when the friends insisted on giving the old a regular allowance of wine, in the belief that this would help to keep them alive. The fallacy of this is apparent. The glass of wine may give a fillip for the moment, but it only lasts at the most for half an hour. No fact has been better proved than this. To be of any use it should therefore be repeated twice every hour. This is of course absurd. After the little excitement is over there is naturally a slight reaction, and this is the time, when the system is really ‘ below par,’ that the cold produces its fatal action.

But, apart from cold, there is a very common idea—and this is shared in by the profession—that old people who may have taken no stimulant hitherto require it, or, at least, are better for it as they get old and frail. There can be no greater mistake. I always recommended my elderly friends, even those who had been accustomed to take alcohol in some form all their days, to stop it, whether at once or gradually it did not much matter, and I have never seen L.ny harm result. On the contrary, the effect has been always good and has been acknowledged to be so both by the patient and by friends. The desire, if any, soon passes off, as does that, sooner or later, which has been brought on by any other bad habit.

I have seen such undoubted prolongation of life, both in middle and in what is usually held as old age, by changing to a simpler mode of living from one very much the reverse, that I came to the conclusion that with fair play from the commencement the ordinary life of man should reach one hundred years. This would only apply to those born with a sound constitution. From the errors of our parents, and perhaps of theirs, many are born into the world under very unfavourable circumstances, and it might require proper living for some generations to restore a family to a natural condition of health. To expect that this may ever happen is, I fear, quite Utopian; and nature usually cuts the knot in a more speedy fashion by extinguishing the family altogether. I was pleased to notice recently that Sir B. W. Richardson, working on other lines, viz. by comparing the period of full development of animals with their average length of life, and this with the same data in mar., has come to the conclusion that the natural life of man is one hundred and five years. If this be true there must be a terrible fault somewhere, as the estimate exceeds the reality by more than one-half. Instinct seems to do for animals what reason, assisted for hindered?) by the resources of civilisation, does not do for man. There is no proof that in the early ages of mankind life was longer than now, or that it is so now among tribes living in a state of nature. If life is to be prolonged, therefore, man must work out his own salvation, and perhaps it is true here also that perfection cometh through suffering.

In my more orthodox days I used to point out that our antediluvian ancestors who lived such long lives were vegetarians. I also pointed out as a proof that animal diet gives a desire for strong drink, that the first thing we read of Noah, after permission was given to eat flesh, was that he was drunk. The critics have deprived me of these arguments.


On the subject of the moral effects of high living, especially on the young, I do not enter; it does not come within the scope of this work. But it is notorious that the morals of the country have not improved during the last half-century; and this may be taken along with the Scriptural statement that ‘ Strong meat belongeth to them that are of full age.’ To keep to the physical side of the question, we have also Paul’s apt and terse statement: ‘ They that strive for the mastery are temperate in all things.’ A very old friend, well known as the best shot' of his day, gave me the credit of his son being the first champion of England. This was from my having got him, at any rate when shooting, to carry out this ‘temperance in all things.’ Two other volunteer friends, who were fortunate in competitions, also ascribed their success to their having followed my recommendations. This was long ago : but I am told that it is now well known that high living is fatal to good shooting.

In the pleas I have advanced for a simple life so far as food is concerned 1 have purposely abstained from giving any taxed rules. Much must be left to oneself, or to those in authority. A long experience bears me out in this. A mistake made and felt tells more than any argument. In some cases strict rules must be given by a medical adviser when he knows that a general rule will not be attended to. But, on the whole, they are better omitted, especially in cases of disease, when the state of the patient may vary from hour to hour. What I would mainly urge is that, when any amount of food can be had, the risk of taking too much is much greater than the risk of taking too little. If this were only known and acted on the change would be very great and very salutary. Another simple rule is to eat slowly. This acts beneficially in two ways. It mixes the food better with the saliva, thus promoting digestion; and it satiates the appetite sooner, so that less food is taken.

Less food should be taken or none at all when one is worried or anxious, or when engaged in any severe mental work. There is in these conditions little or no nervous energy to spare for the stomach. I came long ago in the course of reading on three celebrated men who, when engaged in working out some great problem in science or war, took actually no food till the strain was over. They were Sir Isaac Newton, Napoleon, and the Duke of Wellington. The latter was always a careful eater. The late General Crockett, who was with him in the Peninsula, told me that, often when a long menu was presented to him, he would run his finger down it till he came to the pudding, which he would order and dine upon. In a recent American work on Edison, I find that he follows the bame rule as the other great men, and sometimes enforces it on his assistants by locking them with himself into a room or workshop till the job (some difficult one) is completed. I had the pleasure once in Edinburgh of dining with the late Sir Erskine May. Our host was an English clergyman pretty far gone in phthisis, whom I had difficulty in getting to reduce the full diet which he had been ordered in the South. Sir Erskine had just finished a long session in the House of Commons, where he was perhaps the busiest man. He seemed to be in the best of health, and he looked more like a healthy English farmer than an over-worked clerk of Parliament. I could not help asking him how he kept his health so well with such an amount of anxious work, and with such long hours. He told me that his rule was. while the House was sitting, to take a chop in the middle of the day, and only a cup of tea at night. He added that Lord Palmerston followed the same plan, though on an occasion he could enjoy a very full dinner. Our host stared, and I had less difficulty with him as to food afterwards; the plain narration had more influence than a thousand arguments.

If, when in good health, we took only the food necessary for our comfort and for our work and no more, instead of working the stomach to the utmost, and helping it when it dags by dainties, as well as by drugs and stimulants, we would have much more pleasure from our meals, and a much longer continuance of strength and health. We would also escape many of the ills that life is said to be heir to; or, should some disease perchance come upon us, if we could eliminate from the old system of cure a large amount of the depletion, and from the new a still larger amount of the feeding and physicking, we would come nearer to nature’s mode ol preventing and curing diseases; we would find that prevention would be far the larger element of the two. and that the need for the other would be wellnigh extinguished.

But the physician need not as yet have much fear for his craft. The Archbishop of Cambrai put into the mouth of his wise Nestor that the time will surely come when we will be ashamed to be sick, the causes being our own indiscretions and ignorance. That was two hundred years ago. and as yet there is no sign of the prophecy being nearer its fulfilment. Changes for good come very slowly, and with much back falling and opposition. The way to life is narrow, the other way is broad: and few walk in the one. and many in the other. Whatever our beliefs regarding a future life, we might be more careful of the present which we most certainly possess, and more readily adopt the simpler ways which lead to its being both longer and happier; we might seek truth and follow after righteousness for their own sake, and with no thought of reward, and no fear of punishment; and lastly, we might use the increased means which the simpler life would afford us to show a more helpful sympathy with the fallen, who, often from no fault of their own, but from their birth and surroundings, are doomed to a life of degradation, misery, vice, and crime.

I offer no apology for the free use I have made of the personal pronoun in these pages. Had I not done this, I could not have said what I wished to say; and so I will take for my ‘ finis ’ the hopeful motto of my family, of which I have for fifteen years been the oldest member—


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