Popular Science Monthly/Volume 23/July 1883/The Remedies of Nature III

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THE REMEDIES OF NATURE.
By FELIX L. OSWALD, M. D.

DYSPEPSIA.

BEFORE our ancestors colonized the colder latitudes of this planet, the equatorial regions had for ages been inhabited by men or man-like four-handers. The influence of this long abode in the tropics still asserts itself in many peculiarities of our physical constitution. We are but half acclimatized. Wolves are weather-proof; bears and badgers have managed to inure themselves to the miasma of their winter dens: but the primates of the animal kingdom can neither endure cold nor breathe impure air with perfect impunity; and of most of our civilized fellow-men, as well as of savages and all the species of our four-handed relatives who have thus far been wintered in northern menageries, it may be said that the sensitiveness of their lungs contrasts strangely with the tough vigor of their digestive organs.

In proportion to his size, a rhesus baboon eats more than a wolf; between morning and night a ceboo monkey will devour his own weight in bananas, and, where the cravings of a naturally vigorous stomach are increased by the stimulus of a cold climate, it seems almost impossible to surfeit a savage with palatable food; his appetite is the faithful exponent of his peptic capacity, and before the fauces positively refuse to ingest there is little danger that the gastric apparatus will fail to digest. Manifold and enormous must have been our sins against the dietary code of Nature before we could succeed in making indigestion a chronic disease. Deviations from the chemical standards of her menu are insufficient to account for her wrath. With all their unmistakable structural evidences of a frugivorous purpose, our digestive organs have been permitted to adapt themselves, not only to a carnivorous and herbivorous diet and various innutritive substances, but to a considerable number of positive poisons. The Yakoots live on fish and seal-blubber. The Shoshones stick to bull-beef. The Naruaqua Hottentots (who can not plead the exigencies of a cold climate) subsist almost entirely on venison. Several tribes of Northern Brazil eat clay with comparative impunity. Our Saxon forefathers added beer to venison and beef, and when they took to in-door life the stomach protested only by proxy; an utterly wrong diet led, not to dyspepsia, but to scrofulous affections. Excess in moderately unwholesome viands has to be carried to a monstrous degree before the after-dinner torpor turns into a malignant disease; the stomach of a nomad seems to acquire a knack of assimilating a modicum of the ingesta and voiding the rest like so much innutritious stuff. Dr. Robert Moffat saw a Bushman eat twenty pounds of hippopotamus-liver and a bucketful of broiled marrow, besides handfuls of ground-nuts, parched corn, and hackberries—all within twenty-four hours. In the provincial capitals of Northern China, where banquets of forty courses are de rigueur, convivial mandarins learn to devour a quantum of comestibles that would torpify a boa-constrictor. Eating-matches of fourteen and fifteen hours did not prevent Vitellius from acquiring distinction as a wrestler.

Daily alcohol-fevers, combined with pepper and mustard inflammations, would ruin the stomach of an ostrich; but in favor of the unfeathered biped Nature accepts such vicarious atonements as gout and dropsy. Thousands of crapulous Bavarian beer-swillers, who are hardly able to walk, are still able to digest their food. In-door life and want of exercise then added their quota of provocatives; but, where the lungs would have rebelled after seven protests, the stomach forgave seventy-seven times. Mediæval prelates, squires, and aldermen tried in vain to exhaust the patience of the long-suffering organ.

But their descendants finally solved that problem. To the alcoholic stimulants of the ancients we have added tea, coffee, tobacco, absinthe, chloral, opium, and pungent spices. Every year increases the number of our elaborately unwholesome-made dishes, and decreases our devotion to the field-sports that helped our forefathers to digest their boar-steaks. We have no time to masticate our food; we bolt it, and grumble if we can not bolt it smoking hot. The competition of our domestic and public kitchens tempts us to eat three full meals a day, and two of them at a time when the exigencies of our business-routine leave us no leisure for digestion. At night, when the opportunity for that leisure arrives, we counteract the efforts of the digestive apparatus by hot stove-fires and stifling bedrooms. Since the beginning of the commercial-epicurean age of the nineteenth century the votaries of fashion have persistently vied in compelling their stomachs to dispose of the largest possible amount of the most indigestible food under the least favorable circumstances.

That persistence has at last exhausted the self-regulating resources of our digestive organs. But even after such provocations the stomach does not strike work without repeated warning's. The first omen of the wrath to come is the morning languor, the hollow-eyed lassitude which proves that the arduous labor of the assimilative organs has made the night the most fatiguing part of the twenty-four hours. The expression of the face becomes haggard and sallow. The tongue feels gritty, the palate parched, in spite of the restless activity of the salivary glands, which every now and then try to respond to the appeals of the distressed stomach. Gastric acidity betrays itself by many disagreeable symptoms; loss of appetite, however, marks a later stage of the malady. For years the infinite patience of Nature labors every night to undo the mischief of every day, and before noon the surfeited organs again report ready for duty. Habitual excess in eating and drinking sometimes begets an unnatural appetency that enables the glutton to indulge his penchant to the last, only with this difference, that the relish for special kinds of food has changed into a vague craving for repletion, just as the fondness for a special stimulant is apt to turn into a chronic poison-hunger. This craving after engorgement forms a distinctive symptom of plethoric dyspepsia, but even in the first stage of asthenic or nervous dyspepsia the hankering after food is not hunger proper, but a nervous uneasiness, suggesting the idea that a good meal would, somehow, supply the means of relief. The first full meal, however, entails penalties which the sufferer would gladly exchange for the less positive discomfort of the morning. Instinct fails to keep its promise, as a proof that Nature has been supplanted by a deceptive second-nature. Headache, heart-burn, eructations, humming in the ears, nausea, vertigo, and gastric spasms, make the after-dinner hour "the saddest of the sad twenty-four": a dull mist of discontent broods over the whole afternoon, and yields only to tea and lamp-light. The patient begins to fret under the weight of his afflictions, but still declines to remove the cause. To out-door exercise he objects, not on general principles, but on some special plea or other. He has to husband his strength. The raw March wind would turn his cough into a chronic catarrh. The warm weather would spoil his appetite and aggravate his vertigo. The truth is, that of the large quantum of comestibles ingested only a small modicum is digested, and that the system begins to weaken under the influence of indirect starvation. Business routine prevents the dyspeptic from changing his meal-times. He can not reduce the number of his meals; people have to conform to the arrangements of their boarding-house. The stomach needs something strengthening between breakfast and supper. The truth is, that the exertions of the digestive organs alternate with occasional reactions, entailing a nervous depression which can be (temporarily) relieved by the stimulus of a fresh engorgement. Business reasons may really prevent a reduction of working hours, and domestic duties a change of climate or of occupation. The daily engorgement in the mean while goes on as before.

Nature then resorts to more emphatic protests. Sleep comes in the form of a dull torpor that would make a nightmare a pleasant change of programme. The digestive laboratory seems to have lost the discretion of its automatic contrivances; the process of assimilation, in all its details, obtrudes itself upon the cognizance of the sensorium, and urges the co-operation of the voluntary muscles. Contortions and pressing manipulations have to force each morsel through the gastric apparatus; the lining of the stomach has become sentient, and shirks its work like a blistered palate. Special tidbits can be traced through the whole course of their abdominal adventures. Undigested green peas roll on like buckshot hot from the smelting-pan of a shot-tower. A grilled partridge crawls along like a reluctant crab, clawing and biting at each step. Nausea and headache strive to relieve themselves in spasmodic eructations. Vertigoes, like fainting-fits, eclipse the eyesight for minutes together. Constipation, often combined with a morbid appetite, suggests distressful speculations on the possible outcome of the accumulating ingesta. The overfed organism is under-nourished to a degree that reveals itself in the rapid emaciation of the patient. The general derangement of the nervous system reacts on the mental faculties, and impairs their efficacy even for the most ordinary business purposes, till the invalid at last realizes the necessity of reform. He tries to reduce the number of his meals; but the lengthened intervals drag as heavily as the toper's time between drinks. He hopes to appease his stomach by a change of diet, but finds that the resolution has come too late; the gastric mutiny has become indiscriminate, and protests as savagely against a Graham biscuit as against a broiled pork sausage. He tries pedestrianism, but finds the remedy worse than the evil. The enemy has cut off his means of retreat; the necessitous system has no strength to spare for such purposes as an effort of the motive organs. But nine out of ten dyspeptics resort to the drug-store. They get a bottle of "tonic bitters." They try Dr. Quack's "Dyspepsia Elixir." They try a "blue pill"—in the hope of rousing Nature, as it were, to a sense of her proper duty.

Now, what such "tonics" can really do for them is this: they goad the system into the transient and abnormal activity incident to the necessity of expelling a virulent poison. With the accomplishment of that purpose the exertion ceases, and the ensuing exhaustion is worse than the first by just as much as the poison-fever has robbed the system of a larger or smaller share of its little remaining strength. The stimulant has wasted the organic energy which it seemed to revive. "But," says the invalid, "if a repetition of the dose can relieve the second reaction, would the result not be preferable to the languor of the unstimulated system? Wouldn't it be the best plan to let me support my strength by sticking to my patent tonic?"

Yes, it would be very convenient, especially in times of scarcity, if a starving horse could be supported by the daily application of a patent spur. It would save both oats and oaths. Even a fastidious nag could not help acknowledging the pungency of the goad. But it so happens that spur-fed horses are somewhat short-lived, though at first the diet certainly seems to act like a charm. For a day or two the drug stimulates the activity of the digestive organs as well as of the mental faculties, but the subsequent prostration is so intolerable that the patient soon chooses the alternative of another poison-fever. Before long the pleasant phase of the febrile process becomes shorter and the reaction more severe; the jaded system is less able to respond to the goad, and, in order to make up for the difference, the dose of the stimulant has to be steadily increased. The invalid becomes a bondsman to the drug-store, and hugs the chain that drags him down to the slavery of a confirmed poison-habit.

Circumstances may differ. A dyspeptic who intends to make his own quietus within a month or two, and in the mean while has a certain amount of work to finish, would be justified in stimulating his working capacities by all means, in order to improve to the utmost whatever chances of mundane activity may remain to him. But he who intends to stay has to make up his mind that recovery can not be hoped for till he has not only discontinued his drug, but expiated the burden of sin which the stimulant outrage has added to the original cause of the disease. Nature has to overcome the effects both of malnutrition and of malpractice. The drug has complicated the disease.

In childhood chronic dyspepsia is nearly always the effect of chronic medication. Indigestion is not an hereditary complaint. A dietetic sin per excessum, a quantitative surfeit with sweetmeats and pastry, may derange the digestive process for a few hours or so, but the trouble passes by with the holiday. Lock up the short-cakes, administer a glass of cold water, and, my life for yours, that on Monday morning the little glutton will be ready to climb the steepest hill in the county. But stuff him with liver-pills, drench him with cough sirup and paregoric, and in a month or two he will not be able to satisfy the cravings of the inner boy without "assisting Nature" with a patent stimulant.

But is it fair to denounce a palliative when the radical remedies have lost their efficacy? What dietetic reform can avail a man to whom oatmeal-gruel has become a poison? How can he invigorate his system by exercise if he is hardly able to support himself on his legs? The asthenic stage of the disease can reach a degree when the mere suggestion of gymnastic enterprises is enough to produce a fit of nervous spasms. I have known of dyspeptics who would not have crossed a room to save a pet bird from the claws of a cat, and who would have joined an expedition to the north pole as soon as to the skating-ring. Theirs is a sad plight, for a rule that holds good of unnatural habits in general applies more especially to the chronic establishment of dietetic abuses, namely, that the further we have strayed from nature, the longer and wearier will be the road of reform. Before the invalid can restore the health and vigor of his system, he has to restore his capacity for exercise. The first object is to create a healthy demand for nourishment. Under normal circumstances that demand is proportioned to the amount of the organic expenditure. The nursing females of the mammalia require a larger amount of nourishing diet than the ordinary wants of the system would account for. During the age of rapid growth, children eat and digest as much as hard-working men. Diabetes, the first stage of consumption and other wasting diseases, is characterized by an exorbitant appetite. Every increase of muscular activity involves an augmented demand for nourishment; cæeteris paribus, the man who walks a mile from his shop to his home will digest his supper more easily than he who takes the street-car. The hotel-boarder who makes it a rule to walk up the four flights of stairs to his attic will sleep sounder, and awaken more refreshed, than he who uses the elevator.

But the far-gone dyspeptic who is incapable of an active effort has to begin with a passive method of natural stimulation—the refrigeration-cure, based on the tonic influence of cold air and cold water. Voracity increases with the distance from the equator. An Esquimau eats a quantum that would crapulate three Hottentots and six Hindoos. A cold winter curtails the profits of boarding-houses. Camping in the open air whets the appetite even without the aid of active exercise. A bracing temperature exacts a sort of automatic exercise: it accelerates the circulation, it promotes the oxidation of the blood, and indirectly stimulates the whole respiratory process.[1] The generation of animal caloric has to be increased to balance the depression of the external temperature. Hence the invigorating effect of mountain-air, of sea-bathing, and, in high latitudes, of sea-voyages. The first dose of the tonic can be applied in-doors: sponge and shower baths, or Franklin's air-baths—a few minutes' pause between undress and bed-time.

People who have got rid of the night-air superstition can almost defy dyspepsia by sleeping in a cross-draught, or, in cold weather, at least near a half-open window. Cold, fresh air is an invaluable aid to the assimilation of non-nitrogenous articles of food (fat meat, butter, etc.). Stifling bedrooms almost neutralize the effects of out-door exercise. Winter is, therefore, on the whole, the most auspicious time for beginning a dyspepsia-cure. In summer a highland sanitarium is the best place to start with, or, for coast-dwellers, a surfy sea-shore. Early rising, a cold bath before breakfast, frequent ablutions, deep draughts of cold water, flavored with Seltzer and sugar or a few drops of raspberry-sirup, an air-bath before going to bed, and wide-open bedroom-windows, will score an important point in favor of Nature—the return of a normal appetite, and with it of renewed strength and mental elasticity. If the after-dinner affliction should show no direct signs of abatement, the patient must bide his time, and, under no circumstances, resort to the drug-exorcism. Temporary blue-devils are far preferable to a persistent blue-pill Beelzebub. But aid Nature by all legitimate means. Masticate thoroughly every mouthful of solid food. Eschew spices. Avoid pickles, cheese, salt meat, sour-krout, and hot drinks. Take a light breakfast, a lighter lunch, postpone the principal meal till the day's work is done, and make the after-dinner hour as pleasant as possible. Court fresh air at all times of the day and the night, and, in the course of two or three weeks, the capacity for active exercise will return. That point gained, the problem of recovery is reduced to a question of perseverance. The distress of the first attempts suggests almost the expediency of an unconditional surrender, but, after a dozen morning promenades in the park, and as many dumb-bell soirées, the three chief remedies begin to work hand in hand—exercise, refrigeration, and temperance. Exercise spices nonstimulating food, fresh air promotes digestion, and restored digestion gives strength for more exercise.

There will be fluctuations in the progress of convalescence. The valor of it, the confidence in the possibility of complete expiation, will sometimes falter under the realizing sense of past sins. The very effectiveness of the remedies will demonstrate the almost unpardonable mistake of their long neglect. But the stomach is not implacable, and, in spite of a few fretful relapses, it will, on the whole, accept the terms of reconciliation and ratify the treaty from week to week, till

the convalescent has reached the maximum, and future average, of two hours per day of active out-door exercise. Languid promenades may require an extension of that time; wood-chopping will justify its reduction to an hour and a half. For rainy days there should be a covered wood-shed, or, better yet, an amateur carpenter-shop with a liberal supply of dull saws and thick boards. Asthenic invalids will derive great benefit from horseback-exercise, or even from a buckboard trip—with or without catch-ropes—the great desideratum in antibilious exercises being concussion, the sound shaking-up of the whole frame. Trapeze-evolutions, spring-board and dumb-bell practice rank, therefore, highest among the gymnastic specifics; wood-cutting and sawing among the more arduous kinds of manual labor; and trotting clown-hill among the various modes of pedestrian exercise. It is worth a dyspeptic's while to hire a sedan-chair to lug him to the top of an out-of the-way hill, and a boy to run him a race to the foot of it. After a week or so he will be able to dispense with the sedan. At the first symptoms of indigestion, book-keepers, entry-clerks, authors, and editors should at once get a telescope-desk. Literary occupations need not necessarily involve sedentary habits, though, as the alternative of a standing-desk, I should prefer a Turkish writing-tablet and a square yard of carpet-cloth to squat upon. But Schreber's telescope-desk enables the writer to sit and stand by turns, and has the further advantage of a sloping top that eases the wrist by resting the weight of the arm upon the elbow.

Cold-baths (always before dinner) may be limited to the summer season; but open bedroom-windows are de rigueur the year round. As long as the bedclothes keep the couch warm, the lungs can inhale cold air not only with impunity, but with the most unmistakable benefit to the digestive organs. The cold nights of the South African tablelands enable the Caffre to digest his barbecues of sorghum-beer and rhinoceros-steaks, and the neighborhood of a glacier makes many a Swiss highland hotel a stronghold of gluttony. In the dog-days it can do no harm, in a sequestered region, to take a river-side ramble at a time when only the moonlight watches on the meadows, for out-door exercise on an oppressively sultry day may defeat its object and bring on a fit of retching and nausea. Intensely cold air, on the other hand, is such a powerful tonic that, in midwinter, a ten minutes' trot along an icy pavement will often serve all the digestive purposes of that day, though the convalescent will be surer to have fulfilled all righteousness by adding half an hour's arm-work in the wood-shed. In midsummer dyspeptics sometimes deprecate exercise on the peculiar plea that a long-continued muscular effort acts as a reliable astringent, and the testimony of a veteran gymnasium-teacher of my acquaintance seems to confirm the physiological fact. But, in the first place, a transient constipation is no very serious matter, and, besides, the danger can generally be obviated by training early in the morning, or (about three hours after the last meal) in the cool of the evening.

Dietetic reforms should begin with the prescription of a strictly non-stimulating diet. A spoonful of mustard, a glass of small-beer or claret, may seem a mere trifle; but the trouble is that all stimulant habits are progressive: the pungent spices are apt to slide into pungent tobacco, and the claret into port, or something worse. Fresh apple-vinegar, with a fruity flavor, can perhaps not do much more harm than sweet cider, but salt is not quite above suspicion, and the safest plan is to stick to comestibles that can be eaten without it. Cream, for that and other reasons, is better than fat meat, a whortleberry-soup better than a gravy-soup, and a raspberry-pudding preferable to a blood-pudding. All fried and broiled viands, all pickles, all rancid cheese, butter, and sausages, all smoked meats, are suspicious. Catchup-vials harbor the bottled-up demon of indigestion. But, withal? the diet should not be insipid. Ultra-vegetarians denounce all kinds of fat. Ultra-Grahamites suspect all sorts of sweetmeats. "Let your cook distinctly understand," says one peptic philosopher, "that, on peril of her life, she is to set nothing savory before you." Many hygienic institutes feed their dyspeptics on stale bran-bread, water gruel, and watery vegetables. Man has a right to decline existence on such terms. Not the naturally palatable, but the unnaturally stimulating, qualities of a dish tempt the dyspeptic to eat to excess. For one man who surfeits himself with sweet grapes or pancakes, a thousand, at least, derange their digestion with strong cheese, or hot-peppered ragouts. Alcoholic stimulants kill hundreds every year; how many intemperate drinkers have ever killed themselves with fresh milk or lemonade? And can not fruits, flour, milk, eggs, sugar, and orange juice, furnish the ingredients of a very tolerable meal?—not to mention berries, tubers, and dozens of harmless vegetables that can be creamed and sugared into tidbits to rival the entrées of the Frères Provençaux in everything except virulence, alias pungency. It is better to improve the digestion than to spoil the appetite, for no man can thrive on a naturally distasteful diet. Nature intended us to be vegetarians; but I can not help thinking that the word is misleading by its popular association with the idea of kitchen-vegetables. Our next relatives in the animal kingdom do not live on pot-herbs, but on fruit. The victims of plethoric dyspepsia, the chronic gluttons who gorge for the sake of repletion, would stuff themselves with a potful of watery spinach as quick as with an eel-pie; and theirs is a rare, but indeed rather embarrassing predicament: they seem as unable to stop eating as to begin digesting. They are evermore esurient, though as cachectic as a starved Silesian weaver; I have seen gouty gluttons, to whom the sight of a restaurant-window was as tempting as a tavern sign to a toper. Certain drugs would abridge their penchant, but, with it, also, the last traces of a digestive function; and, instead of reducing their appetite, it is better to reduce its capacity for mischief, by limiting the number of their daily meals. For, after all, that capacity is circumscribed by the caliber of the stomach, and, if the quality of the food is unexceptionable, there is no serious danger of a man's eating more at one meal than his system, under otherwise favorable circumstances, can dispose of in the course of the next twenty-three hours. The apprehension in such cases as to the insufficiency of one meal a day is wholly gratuitous. For more than a thousand years the one meal system was the rule in two countries that could raise armies of men every one of whom would have made his fortune as a modern athlete—men who marched for days under a load of iron (besides clothes and provisions) that would stagger a modern porter. Even here, abstinence is easier than temperance; for twenty-three hours of each day it is far easier to abstain from food (though, of course, not from water) than to begin eating and stop in time. Not one glutton in a thousand will do it. Dio Lewis recommends a limited number of dishes—"never put more on the table than you intend to eat"; but the first mouthful reawakens the passion of Polyphemus, and for those who can not govern their appetite it is just about as easy to call for another dish as to reach for another plateful. But it is an excellent rule to prolong the pauses between the several dishes of a full meal, in order to give the stomach time to indicate the real wants of the system. "The ingestion of food," says Dr. Carpenter, "can not at once produce the effect of diminishing the feeling of hunger, though it will do so after a short time, so that, if we eat with undue rapidity, we may continue swallowing food long after we have taken as much as the wants of the body require."

The origin of the glutton-habit can often be traced to the mistaken liberality of a host who constantly urges the conviviality of his young guests, or even to the fatuous tenderness of nursing mothers, who so frequently think it their duty, as Dr. Page expresses it, to make a baby "guzzle till it is ready to die with fatty degeneration."

Begin with reducing the number of daily meals, and exercise, a change of climate and of habits will by-and-by help to subdue the baneful penchant. Occasional relapses can not be avoided; but the progressive relief from a number of the worst gastric afflictions will at last induce the veriest cormorant to stick to the one-meal plan.

The best time for that one meal is the end of the working-day—4 or 5 p. m.—when business-cares can be laid aside for the rest of the evening. Asthenic dyspeptics, too—all, at least, who are not completely masters of their own time—had better choose that hour for their principal meal. No other hygienic mistake, not even the stimulant-fallacy, has done so much to make ours a dyspeptic generation as the fatal habit of after-dinner head-work—severe mental labor in the study, the school-room, or the counting-house, at a time when the whole strength of the system is claimed by the digestion of a heavy meal. Not only that the progress of digestion is thus interrupted, not only that the body derives no strength from the inert mass of ingesta, but that mass, by undergoing a putrid instead of peptic decomposition, vitiates the humors of the system it was intended to nourish, irritates the sensitive membranes of the stomach, and gradually impairs the vigor of the whole digestive apparatus. Hence the gastric torments of poor overworked teachers, who (unlike happier servants of the public) can not shirk their work, and have to snatch their dinner during a brief interval of the hardest kind of mental drudgery. Hence the sallow complexion, the hollow eyes, and the weary gait of thousands of city clerks, scholars, lawyers, newspaper drudges, and even physicians. Housewives, after dinner, have generally the good sense to rest awhile, often a very good while, and thus manage to digest their food; for, that their immunity is not a prerogative of their sex is demonstrated by the chlorotic complexion of lady-teachers and boarding-school girls, who have only an hour's recess—physiologically no recess at all, if the school-bell rings right after dinner.

For those who have to drudge the whole afternoon, it would be better to postpone the principal meal to the very end of the day, and laugh at the supposed danger of "sleeping on a full stomach." For what do those who add a supper to an undigested dinner? only with this difference, that their stomachs are obliged to dispose of an acidulated mélange. Animals, in a state of nature, nearly always sleep or rest after a heavy meal; only the homo sapiens disregards the promptings of his instincts, and relies on a dyspepsia-pill.

In most cases, however, the matter could be compromised. Early rising and an unmuddled brain would enable almost any man to go home at 3 or 4 p. m., and counting-house clerks should consent to a reduction of their wages rather than forego the same privilege; at five, a full meal of milk, farinaceous preparations, and nutritive vegetables, followed by a dessert of fresh or cooked fruit; then a siesta of two full hours, music, conversation, or, faute de mieux, an entertaining book; then, the weather permitting, a ramble in the cool evening air, or light gymnastics; then rest in undress, an air-bath, and open bedroom-windows.

The general adoption of that plan would soon dissipate a strange and strangely prevalent fallacy: the supposed natural antagonism of the brain and the stomach—the alleged impossibility of combining studious habits with a sound digestion. Restricted to proper hours, head-work is as stimulating as any other kind of labor, and promotes digestion instead of hindering it. The nature-abiding habits of such men as Boileau, Linnæus, Cuvier, Goethe, and Humboldt, enabled them to reconcile the mental strain of their enormous literary activity with the enjoyment of almost uninterrupted health.

Dyspeptics, therefore, need not shirk brain-work, but, as they would shun the pills of a mercury-quack, they should beware of exasperating mental emotions. For it is a curious and not quite explained but incontestable fact that a short fit of anger is often enough not only to derange but to completely arrest the digestive process for a whole day. Close behind the stomach is a group of ganglia, the solar plexus, which sends out a large number of nerve-filaments that communicate with the brain, and thus suggest the physiological explanation of the curious phenomenon, though its final or teleological purpose is somewhat less apparent. Haller connects it with the fact that anger vitiates the saliva {teste, the virulent bite of enraged animals), and suggests that by a wise arrangement of Nature the suspension of the assimilative process may preserve the chyle from the contamination of malignant humors; and, in connection with the same subject, Camper mentions the circumstance that fear often acts as a sudden cathartic, perhaps for the purpose of easing the stomach, and thus preparing the body for emergencies—the necessity of flight, for instance. Speculations of that sort lead to a field of curious but rather recondite biological metaphysics; but the empirical fact remains, and partly suggests the rationale of another fact—namely, that pleasurable mental emotions act as a benignant digestive tonic. Hence, perhaps, the peptic beatitude of "jolly paunches," fellows who seem constitutionally unable to see the gloomy side of earthly concernments, and wax fat on the prescription of Democritus, "Ride, si sapis." The autocrat of the dinner-table should, therefore, peremptorily exclude all conversational topics of an irritating character, as well as all business talk. A remarkable influence on the action of the bowels can be exerted by mechanical laughter—I mean, the agitation of the diaphragm by means of a forcible and long-continued chuckle. Laurence Sterne mentions that he was able to keep up this factitious kind of laughter for minutes together, with or without the association of risible ideas. On solitary evenings that talent could be utilized as a physiological compensation for the absence of merry friends.

For the effects of mental worry, and nervousness (often the aftereffect of stimulating medication), the best remedy, next to out-door work, is a liberal allowance of sleep; and metropolitans who can not afford to join the summer exodus should at least remove their beds to a suburban cottage, far from the sleep-murdering noise of the business centers.

But neither long sleep nor short meals can save dyspeptics who will insist on swallowing their food smoking hot. The walls of the stomach are lined with a nerve-interwoven delicate membrane, which suffers from scalding fluids as much as any other tegumental tissues of the body, and by daily torrefactions becomes either callous or chronically inflamed, and in either case less fit for the performance of its important functions. Our forefathers served their viands steaming hot, but stuck at least to cool drinks, but hot French soups were soon followed by hot tea and hot coffee. The "second breakfast," as the Germans call the eleven-o'clock refreshment, used at least to consist of cold meats; but competing saloon-keepers have now introduced hot lunches, and in our larger cities there is no escape for dyspeptics; "the smoke of their torment ariseth for ever and ever."

The gastric irritability which forms a lingering after-effect of chronic dyspepsia can be better allayed by a vegetable diet than by the nutritive extracts which are supposed to aid the work of digestion. The bulk of innutritive admixtures somehow excites and maintains the vigor of the digestive organs; and the human organism can not thrive on concentrated nourishment, as for similar reasons the lungs can not be fed on pure oxygen. Water, either pure or in organic compounds, is likewise an effective sedative and depuratory; it aids the process of eliminating the indigestible or noxious elements of various articles of food, whose ingestion therefore excites thirst. But, without waiting for that urgent appeal, we should remember that the diet of our instinct-guided relatives contains about ninety per cent of water, and that a dearth of fruit should be compensated by artificial compounds, supplying the requisite amount of fluids in a palatable form. The remedial influence of many famous spas is due to the water as much as to its mineral admixtures. About fifty years ago, the Brooklyn hotels were crowded with visitors, attracted by the fame of a doctor who cured all manner of diseases with pure rain-water. The mystic motto of Thales, "Ariston men liydor" ("The best of all things is water"), might perhaps be explained from such facts. Our diet, in fact, is much too dry, and could be improved without resorting to lager-beer, which redeems its deleterious influence to some degree by helping the Germans to digest their pungent comestibles. Water, in some of its combinations, is also an effective aperient; in watermelons and whey, for instance; but still more in conjunction with a dish of legumina—peas, lentils, and beans. No constipation can long withstand the suasion of a daily dose of pea-soup, or baked beans, flavored with a modicum of brown butter, and glorified with a cup of cold spring-water; and, moreover, the aperient effect is not followed by an astringent reaction the cure, once effected, is permanent. Plethoric dyspepsia is almost invariably accompanied by close stools, and the drugs that have been swallowed to ease Nature for a day—would poison half the living creatures of the American Continent.

But rather forego the beans than eat them with pork. The interdict of the Hebrew lawgiver, I suspect, has something to do with the climate-proof health of his countrymen, for in warm weather fat pork is about as digestible as yellow soap. The Hungarian peasants are ravenously fond of it, and neither out-door life nor the vigor of their Turanian stomachs can save them from the consequences. Every summer, and sometimes three and four times a year, the digestive system of the rustic Magyar relieves itself by an expurgative process known as the tzömör, or pork-surfeit, a three clays' purgatory of heart-burns, nausea, and violent retching, accompanied by a burning thirst and an unspeakable loathing of all solid food. He who weathers the storm, says the traveler Kohl, feels like a new-made man, and reappears at the family table; but so does the pork-pot, and a few months after the respited sinner has another seizure, and groans, "O Jesus, Maria, meg tzömöretem—it's got me again!"

After the re-establishment of intestinal digestion, flatulence, vertigo, and that terror of constipated tea-drinkers, dull headache, become less and less frequent; the spell of the deliquium is broken, and the redevelopment of the wasted muscles proves that the system is no longer obliged to feed upon its own tissue. But these first symptoms of improvement should not encourage the patient to relax the rigor of the regimen before he is sure that the gastric inflammation has wholly subsided. As long as spasms and acrid eructations (water-brash) indicate the danger of a relapse, give the stomach all the rest you can. Never miss an opportunity that will make it easy to forego a meal or two. There are ways to make a fast-day a very trifling inconvenience, and its remedial value exceeds that of a round-trip to all the spas of the Eastern Continent. In my experiments on the operation of the fasting-cure, I have noticed the curious fact that for the first day or two the clamors of the stomach are restricted to certain hours, and can be induced to waive a disregarded claim. Convalescents who have already reduced the morning lunch to the standard of a Spartan breakfast, a "heathen fig and a thrice-accursed biscuit," can beguile the dinner-honr by diverting pastimes—a boat-trip, a fishing-excursion, a visit to the Zoo—and upon their return home will find that the craving for food has yielded to sleepiness, and the sweetness of the night's rest will be worth seven meals. It is during such periods of undisturbed rest that the work of repair makes its surest progress, and for the first three or four months it would be a good plan to imitate the example of the Ebonite heretics, who observed a weekly fast day in the Ugolino sense of the word. Water, of course, should never be stinted, and, after a long fast, will have an especially good chance to depurate the vacated passages of the abdominal labyrinth.

An advanced stage of alcoholism (which will be treated in a separate chapter) often results in that malignant form of chronic indigestion known as hepatic or bilious dyspepsia, a complete derangement of the digestive process, accompanied by headaches, which for months defy the influence of an hygienic regimen, and yield only to the heroic remedies of the pedestrian-cure. But, with that exception, ten weeks of strict temperance, fresh air, and moderate exercise, will generally suffice to appease the resentment of the outraged stomach. During the next twelve months the reconciled digestive apparatus helps to redress the impairments of other organs. For it is a generic peculiarity of dyspeptic affections that the symptomatic outlast the idiopathic disorders. After the action of the bowels has become perfectly-regular, after fat and sugar have ceased to cause heart-burn, the chronic lassitude—not pain exactly, but a nervous disinclination to active exercise—still lingers about the knee-joints; the flexor muscles of the upper arm still shirk their work; headaches that can not always be traced to dietetic backslidings recur at irregular intervals. The countenance is still sallow, the eyesight more or less impaired; even vertigo and murmurs in the ears occur, without their former gastric concomitants. But at the end of each month the progress in the direction of general health is unmistakable. Mountain excursions marvelously further the good work; but even the counting-house drudge need not doubt the reward of his perseverance, as long as he sticks to a plain diet, and such exercise as the opportunities of his leisure will offer on all but the busiest days. Unlike consumption (which can only be made non-progressive), dyspepsia can be thoroughly cured. As far as they are capable of repair, injuries to the respiratory organs heal quickly; gastric ailments with less ease but more completely.

Gymnastics, however, combined with cold-baths, air-baths, deep draughts of cold spring-water, dietetic aperients, temperance, abstinent forenoons, liberal siestas, cheerful evenings, and wide-open bedroom-windows, will speed the advent of the time when the after-dinner hour shall cease to be the "saddest of the sad twenty-four"—nay, when digestion, like all normal functions of the animal organism, shall be once more not only a painless but a pleasurable process.

 
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  1. "Why should sickness prevail during the warm, pleasant weather so much more frequently than during the cold? The reason appears to me very plain. The cold weather braces us up, gives us a sharp appetite, and we indulge freely in food which, while the cold weather continues, can be tolerated by the system." (Dr. C. E. Page.)