Popular Science Monthly/Volume 23/August 1883/The Remedies of Nature IV
By FELIX L. OSWALD, M. D.
LIFE is a sun-child; and nearly all species of plants and animals attain the highest forms of their development in the neighborhood of the equator. Palm-trees are tropical grasses. The python-boa is a fully developed black-snake; the tiger an undiminished wild-cat. With every degree of a higher latitude, Nature issues the representatives of her arch-types in reduced editions—reduced in beauty and longevity, as well as in size and strength.
The human animal, however, seems to form an exception to that general rule. For the last two thousand years, nine out of ten international wars ended with the victory of northern nations over their southern neighbors. The hegemony of commerce and superior civilization moves farther and farther north. Our oracles have been transferred from Delphi to Berlin, to Edinburgh and Boston. The Muses and Graces are wearing fur cloaks. Has the sun of the south lost its stimulating power? The truth seems to be, that cold air is an antidote. The antiseptic effect of a cold climate enables us to indulge with comparative impunity in numerous vices which our southern neighbors have paid with the loss of their moral and physical health. It has been ascertained that alcoholic stimulants, instead of increasing actually decrease the temperature of the system, and that cold weather constitutes no valid excuse for the use of intoxicating drinks, but it is equally certain that a low temperature promotes recovery from the effects of intoxication. Many hyperboreans eat flesh as a stimulant rather than as a medium of calefaction; tea-drinkers contract a morbid craving for boiling-hot beverages. But climatic influences increase the activity of their digestive organs to a degree that enables Nature to compromise the violation of her laws. Gluttons and topers die in the south and survive in the north, not because a warm climate per se is incompatible with the normal vigor of the human system, but because a cold winter counteracts the effects of gluttony and intemperance in much the same way as rum counteracts the effects of a snakebite, or mercury the virus of the lues veneris. Frost is a counter-poison. Protracted impunity tempts sinners to believe in the innocence of their habits. During the two centuries when the Cæsars vied in the gratuitous purveyance of bread, oil, and circus-games, the Roman citizens had no special reason to admit the turpitude of idleness. Under the protection of the Holy Inquisition dunces were secure enough against the competition of genius to consider ignorance as a virtue. Thus the prophylactic influence of a frigid climate has made the propriety of many of our daily sins so axiomatic that the neglect of their practice excites a sort of virtuous indignation. A German proverb, traced to the table-talk of an eminent reformer, denounces the demerits of the man who fails to worship music, women, and—wine. To many minds closed bedroom-windows and three warm meals a day are essential conditions of true respectability. Even in the dog-days, the impropriety of Scotch knee-breeches would be thought worthy of a harsher name. When financial embarrassments obliged the later Caesars to abolish the free-lunch system, the astonishment of the cives Romanus was only equaled by his wrath at the injustice of the innovation; and with a similar mixture of indignation and surprise thousands of exiles from the regions of prophylactic frost denounce the malignity of a climate that fails to protect them from the logical consequences of their sins against nature. In summer weeks, when the Creoles pass the night on their flat house-roofs, with a mattress and a linen bed-sheet, and regret at the necessity of adding a mosquito-cap, the foreign resident insists on sleeping in a flannel undershirt, under woolen blankets, and the impression that his life depends on keeping his doors and windows hermetically closed. During the noontide glare, when the youngsters of the native patricians run about in white muslin inexpressibles, and their plebeian comrades in a still less expressible and certainly unspeakably sensible costume, the children of the north have to mourn their exile in black broadcloth, woolen stockings, boots or air-tight gaiters, tight-fitting collars, neckties, and waistcoats, besides the unavoidable flannel undershirt. And, worse than that, the ex-hyperborean not only continues to gorge himself with an amount of calorific food that would more than suffice for the climatic exigencies of his own latitude, but persists in eating that excessive amount in the specially indigestible form of fried and broiled meat, served smoking hot with greasy sauces, after a prelude of sudorific doses of hot soups or narcotic drinks. In a cold climate the pathological results of overfeeding are chiefly limited to the evils of mal-nutrition, i. e., the difficulty of eliminating the cachectic elements of a mass of accumulated and fermenting ingesta. But in a warm climate that result is complicated by the further difficulty of maintaining the normal temperature of the system. For the organic functions of the animal body require a uniform degree of warmth as a condition of their healthy performance, and in the human body the normal average of that temperature has been found to be about 98° Fahr. A variation of only two degrees denotes an abnormal depression or acceleration of functional activity, a difference of five degrees indicates a serious disease. In the polar regions, where a rousing stove-fire often fails to thaw the rime-frost on the stove-pipe, the organism of the human body contrives to maintain its blood-heat within half a degree of the normal average, i. e., sometimes at a temperature of 150° above that of the external air. In the tropics the same marvelous organism becomes a refrigerating apparatus, and lowers its temperature as much as thirty degrees below that of the outer atmosphere, which in British India, for instance, has been seen at 132° above zero, or a hundred degrees above the freezing-point.
In these thermal regulations, Nature has, however, to rely on the co-operation of instinct or reason; and a mariner who would wear the same dress on a north-pole expedition and a trip to Suez could hardly hope to escape the consequences of his imprudence. But even if the Arctic explorer should not only forget his furs, but intentionally chill his blood by sitz-baths on an ice-floe, and promenades in the costume of the Nereids, his chances of continued health could hardly be worse than those of the British merchant who practices in the tropics the calorific artifices of his native land, and aggravates the blood-seething effects of a West Indian summer by superfluous clothes and worse than superfluous beefsteaks and sudorific drinks. The blood of the sitz-bathing mariner would congeal; the blood of the beef-eating merchant does ferment. With all diversity of opinion as to the proximate cause of climatic fevers, there is no doubt that the febrile blood-changes indicate the agency of a catalytic, or fermentative process. In yellow fever the temperature of the body rises to 105°, and after death often to 112°; the progress of decomposition separates the serum from the red blood-globules (whence the chlorotic hue of the skin), and the bodies of the victims need immediate interment on account of the rapidity with which putrefaction begins, or rather completes, its work. The clinical study of the disease in such towns as Vera Cruz and New Orleans has preserved the record of many curious cases of molecular life after somatic death. Dr. Bennett Dowler ("New York Journal of Medicine," 1846) mentions the case of an Irishman whose arms, after the cessation of respiration, rose and fell with a rhythmical motion, and of a Kentuckian whose flexor muscles, four hours after death, reacted against the slightest mechanical stimulation. The symptoms of ordinary "chills and fevers" can be temporarily suppressed by antiseptic drugs—quinine, arsenic, strychnine, ferro-cyanide of iron—in fact, by all chemicals that would arrest a process of decomposition. Hence also the prophylactic effect of alcohol ("tonic bitters") and of Nature's great antiseptic, frost. That marsh-miasma is only an adjuvant cause of endemic fevers can be abundantly demonstrated by the comparative study of the typographical and climatic conditions of the chief fever-centers, as well as by many unmistakable analogies of "climatic fevers" and certain enteric diseases which can be traced to purely subjective causes. The swampiest districts of Central and South America—the Peninsula of Yucatan, Tehuantepec, the Brazilian province of Entre-Rios, the Orinoco Valley, the "Gran Chaco," or monster-swamp, between Bolivia and Paraguay—enjoy an almost perfect immunity from pyrexial diseases, while Vera Cruz and Pernambuco with their zone of barren sand-hills, or La Guayra, Havana, and Rio Janeiro, with their mountainous vicinity, are subject to yearly visits of the plague. During our last two epidemics the vast Arkansas river-swamps, and the coast-fens of Georgia, Florida, and Texas, escaped, while Vicksburg and Memphis, on their dry bluffs, and Chattanooga, at an elevation of six hundred feet above sea-level, suffered more in proportion to their populations than any place this side of Vera Cruz. During every fever-epidemic the focus of the disease seems to be some commercial city of the tropics or sub-tropics, a town uniting torrid summer climate with the presence of a large number of northern foreigners.
In all fevers ascribed to a malarial origin the success of the conventional mode of treatment depends chiefly upon the efficacy of chemical antiseptics which temporarily suppress or palliate the symptoms of the disease, but (aside from the deleterious after-effects of such drugs) the disease itself can be cured only by the removal of the cause. That cause is the inability of the vital powers to withstand the influence of moist heat from within and without. The proper method of cure, therefore, consists in diminishing the thermal product of that complex cause, either by flight to a colder climate, or by adopting a less calorific regimen. The latter expedient is the cheaper, and generally the shorter and safer one; and in no other disease is the remedy more clearly indicated by the promptings of instinct. The premonitory stage of yellow fever is characterized by an intense longing for refrigeration: fresh air, cold water, cooling fruits or fruit extracts. The fever-dreams of an ague-patient are crowded with visions of tree-shade and mountain-brooks. Even "chills" are often accompanied by a burning thirst; and during the cold stage of an intermittent fever the temperature of the system is actually higher than during the sweating stage; according to Dr. Francis Home, respectively 104° and 99°.
In the first place, remove the patient to the airiest available room in the house. The art of house-cooling seems to have been lost with the ancient civilization of Southern Europe. There is not a room in the narrowest alley of the Naples Jew quarter where open windows and ten cents' worth of ice would fail to lower the temperature from twenty to thirty degrees below that of the outer atmosphere. Create a draught, and if possible a cross-draught, without fear that the admission of air from a sun-blistered courtyard, for instance, would make the room equally uncomfortable; the thermal contrast itself will create an air-current, and that draught will be cooler to the feeling than stagnant air of an actually lower temperature. The shade of a leafy tree is never more grateful than when the surrounding fields tremble under the rays of a vertical sun. The evaporation of ice water, or even of common cistern-water, will greatly aid the good work. Pour it into flat basins, tubs, etc., and place them in the center of the room, or get a wheelbarrow full of unglazed bricks, that can be procured at any pottery, put them close together on the floor and sprinkle them from time to time with cold water. The water will soak into the porous mass and evaporate more rapidly than from an impervious surface. A bundle of bathing-sponges or a sheaf of bulrushes, suspended from the ceiling and sprinkled from time to time, will serve the same purpose; and, where ice is cheap, a dog's-day sirocco can be easily reduced to an April breeze.
But the best time to begin the refrigeration-cure is an hour after sunset. On this continent alone, the night-air superstition costs annually the lives of about fifteen thousand human beings; for at least one half of the thirty thousand North Americans who succumb every year to yellow fever, ague, and congestive chills, could have saved themselves by opening their bedroom-windows. In the jungles of our Southern Gulf-coast thousands of hunters and lumbermen breathe with impunity the air of the very swamps to whose neighborhood the city-dweller ascribes the summer epidemics. Their febrifuge is the cooling night wind, for here, as in the dyspeptic shopkeeper cities and consumptive factory-towns, each night labors to undo the mischief of each day, The flat-boat men who often contract the ague during a week's delay in a Southern inland port, need no quinine by the time they reach New Orleans, a week or two of chill night-camps on the open river having cured them as effectually as the first November frosts cure the chlorotic city-dweller.
For direct refrigeration a sponge-bath is more effective as well as less disagreeable than a wet-pack; though an air-bath, before an open window (under cover of night) is preferable to both, if the strength of the patient is reduced by a protracted ague or injudicious medication. In obstinately sultry weather an ice-pack will afford almost immediate relief—a pailful of crushed ice, stuffed into linen bags and wrapped for a few minutes around the neck and arms, or around the wrists of a bedridden patient.
"Stuff a cold and starve a fever" was, in regard to fevers, at least, not a bad plan, when "stuffing" implied a monster dose of beef and beer. But the want of appetite which characterizes all febrile affections is properly defined as only an abhorrence of calorific food—flesh, hot soups, and greasy made-dishes. The mere sight of such comestibles is enough to aggravate the sick-headache that precedes yellow fever and follows an ague-fit, and, when the idea of food has become closely associated with visions of smoking grease, the voice of instinct is apt to be in favor of total abstinence. But that protest is always accompanied by a passionate craving for cooling drinks, which easily connives at an admixture of solid nourishment, after a refrigerating diet has once been tasted in the form of cooling fruits. Cold sweet milk, whipped eggs with a drop of lemon-flavor, a sherbet of ice-water, sugar, and orange-juice, offered to the rebellious stomach of a fever patient, are not only tolerated, but absorbed with an almost conscious satisfaction. Fruits, however, rank first among the dietetic febrifuges of Nature, especially tropical fruits. "Under the exhaustion of a blazing sun," says Sir Emerson Tennent, "no more exquisite physical enjoyment can be imagined than the chill and fragrant flesh of the pineapple, or the abundant juice of the mango, which, when freshly pulled, feels almost as cool as ice-water. . . . It would almost seem as if plants possessed a power of producing cold, analogous to that exhibited by animals in producing heat. Dr. Hooker, when in the valley of the Ganges, found the fresh, milky juice of the mudar (calotropis) to be but 72°, while the damp sand in the bed of the river where it grew was from 90° to 104°."
With a biscuit or two, a sliced pineapple, two or three bananas or a couple of oranges, will make a sufficient meal; and in very warm weather bananas alone would do for a couple of days, for the nutritive value of saccharine fruit is generally underestimated; our next relatives, whose digestive organs are a close copy of our own, are exclusively frugivorous, and withal the most active and indefatigable creatures of their size. With cold, sweetened orangeade alone, the physicians of the Spanish-American hospitals often support their comatose patients for days together.
These remedies should be applied in the very beginning of the disease. As soon as the yawning and stretching languor of a bilious remittent announces the approach of an ague-fit, the patient should prepare for refrigeration by sponge-baths, air-baths, and rest, in a shady, well-ventilated room. The thirst that announces the needs of the internal organism should be freely indulged with fresh spring water (or the next best thing, filtered and ice-cooled cistern-water). I would not prevent a fever-stricken child from drinking five quarts of water in as many half-hours, if its system craves it, for, besides its refrigerating influence, fresh water fulfills an important expurgative purpose, and helps to eliminate the catalytic germs of the tainted blood. During the shivering stage of a fever there would not seem to be much need of artificial refrigeration; but I have noticed that a fit of "chills" is far more supportable if the craving for a warm cover is justified by an external cause. In a sultry room a woolen blanket is apt to turn a shaking fit into the ugliest symptoms of the hot and headachy stage, while in a cold room the shivering patient (covered up, but with his head exposed to a cooling draught) soon finds relief in a quiet slumber. The ancient Romans cured their fever-patients in subterranean grottoes, and where the means of refrigeration are as cheap as in the New Orleans ice-factory I would keep the yellow-fever ward of a hospital at a maximum temperature of 55°, and at night, if possible, below 50. Wet-packs and a frequent change of posture greatly alleviate the throbbing pains in the loins, where the pyrexial process of a yellow-fever paroxysm seems to center its activity. These pains are often accompanied by a stupor-like oppression of the brain and are grievously aggravated by a stagnant atmosphere.
In the tent-camp of Medellin, to where the French authorities had removed the fever-stricken paupers of Vera Cruz, I noticed that comatose symptoms occurred only in a small minority of cases, while their worst forms were frequently observed in all the city hospitals, except the excellently ventilated infirmary of the Catholic orphan asylum. In common ague, fresh air alone, and without the aid of fruit and ice (which can not be readily procured in some inland districts of our Southern States) will modify the paroxysms sufficiently to reduce them to debilitating rather than distressing—symptoms tremors, followed by perspiration, and a cerebral excitation somewhat resembling the first effects of certain intoxicants.
During the hot stage of an intermittent, delirium can be obviated by keeping the patient in a half-sitting posture, and cooling his temples from time to time with a wet towel, or, in extreme cases, with the above-mentioned ice-pack. After a profuse perspiration the pulse will gradually become normal, and the feverish brain pass into a sort of twilight state between slumber and more or less fantastic daydreams, but without obstreperous symptoms and without oppressive headaches.
All this, however, on condition that the bark of Cinchona calisaya is left severely alone. I have seen quinine-drunk patients break away from their nurses and rush out into the street like Indian amuck-runners, or sit moaning on their beds, freed from the febrile diathesis, but afflicted with ear-aches that pierce the head like twinges of neuralgia, and often impair the hearing for months together. Quinine sticks to the system like mercury, and I doubt if there is such a thing as perfect recovery from the effects of its protracted use. Strychnine, bitter-orange peel, Valeriana, arsenic, and snake-root, are equally objectionable, and often produce after-effects that are ascribed to other causes, or to a lingering nervousness induced by the fever itself. Besides, the removal of the cause is the only radical fever-cure; chemical antiseptics merely palliate the symptoms, as a cloth mantle would smother a fire, till it gets strong enough to break out through cloth and all. Frost kills out flies where arsenic fails. By the refrigeration cure the zymotic disease-germs are, as it were, frozen out: the blood heat of the system is reduced below the temperature which is a condition of their development. The quinine-treatment is an attempt to poison them. For a time that attempt may prove successful, but the patient becomes a slave to his drug, and, till frost sets in, one of the most nauseous of all medicines has to be applied from week to week, and generally in increasing doses. But, if the febrile diathesis has been subdued by a refrigerating diet, the most ordinary precautions suffice to keep the disease in abeyance. The cause has been removed. I will venture the prediction that the zymotic agency of climatic fevers, as of tuberculosis, will be traced to the development of a living organism, and I suspect that Nature's effort to eliminate the tainted humors constitutes the critical symptoms of the affection, while the periodicity of the disease is due to the periodical redevelopment of the parasites from their ova or vital rudiments. In the vomit of cruor that precedes the crisis of yellow fever, the system seems to make an attempt to eradicate the evil by a direct extrusion of the tainted particles of the blood (the fibrine and red corpuscles), at the risk of exhausting the vital pabulum by the impoverishment of the humors. The success of that heroic remedy ends the trouble: yellow fever hardly ever attacks the same person more than once. Ague, on the contrary, recurs with the return of every favorable opportunity; nay, persons who have suffered most from remittent fevers are especially liable to relapses, and, if the disease is allowed to continue, its result is the same impoverishment of the blood (chlorosis and jaundice) which the paroxysm of yellow fever effects in a few hours. It is not safe to count upon an early frost, or immediate relief by a change of climate (in midsummer, especially, when the weather is often as warm at the borders of the Arctic Circle as fifty degrees farther south). And the persistent neglect of dietetic precautions under reliance on the prophylactic effect of a weekly dose of quinine would be strictly analogous to an attempt to legalize the sins of Don Juan by saturating the system with mercury.
In yellow fever large doses of quinine directly increase the chief danger of the disease by arresting the excretion of uric acid, which, passing into the circulation, has been recognized as a main cause of the convulsions and coma which so often inaugurate the hopeless stage of the deliquium.
During the delirious paroxysms of climatic fevers, ice-water may be administered like medicine, by spoonfuls, but solid food should never be forced upon the patient. When coolness, sweetness, and fruity flavors can not make a dish acceptable to the appetite, its obtrusion upon the stomach would do more harm than good, and it is a great mistake to suppose that even total abstinence could in such cases aggravate the danger of the disease. At San Nazaro, near Brescia, the Austrian hospital-town after the battle of Solferino, a wounded Hungarian sergeant, whose three tent-comrades had died of typhus syncopalis ("spotted fever"), cured himself of the same disease by an absolute fast of eight days, not including the two days of his transport from the battle-field, when he had taken a cup of coffee and a mouthful of bread. In malignant cases of yellow fever the revulsions of the bowels often invert the digestive process for days together; chyle, as well as the nutritive elements of the blood, are forced back upon the stomach and disgorged in that eruption of cruor commonly called the "black-vomit"; and the ingestion of food would, under such circumstances, only aggravate the gastric distress.
With the power of assimilation, the appetite for solid nourishment gradually returns; but this re-establishment of the digestive process is greatly retarded by the obtrusion of a distasteful diet, especially animal food and all greasy made-dishes. The peculiar dietetic whims of fever-patients, their sudden cravings for a special kind of food, drink, or condiment, can with certain exceptions (or the revival of an alcohol passion) be indulged without danger, and generally indicate a favorable turn of the crisis. "Ya se va á volver; pide chilé"—"He'll soon be all right; he's asking for chile" (red pepper or pepper-sauce)—is a standing form of congratulation among the Spanish-American friends of a yellow-fever convalescent. But even with chile they would hesitate to tempt him with garbanzas or guisado, well knowing that the mere smell of greasy viands is often enough to bring on a relapse of the vomit. Disagreeable smells of any kind are, in fact, a potent adjuvant, if not independent cause, of a febrile diathesis. "A manufacture of artificial manure," says Professor Grainger, "formerly existed immediately opposite Christchurch workhouse, Spitalfields, which building was occupied by about four hundred children with a few adult paupers. Whenever the works were actively carried on, particularly when the wind blew in the direction of the house, there were produced numerous cases of fever, of an intractable and typhoid form. . . . The proprietor at last was compelled to close his establishment, and the children returned to their ordinary health. Five months afterward, the works were recommenced; in a day or two subsequently, the wind blowing from the manufactory, a most powerful stench pervaded the building. In the night following forty-five of the boys, whose dormitories faced the manufactory, were again seized with severe diarrhœa, while the girls, whose dormitories were in a more distant part, and faced in another direction, escaped. The manufactory having been again suppressed, there was no subsequent return of the diarrhœa" ("Report on the Hygienic Condition of the Metropolis," p. 36).
The Turkish custom-house officers fumigate their quarantine-buildings with a powerful but agreeably aromatic kind of incense-powder, which seems to serve all the purposes of disinfection, and could in many cases be substituted for the carbolic-acid libations that fill our hospitals with their scandalous odors. To the stomach of a fever patient, however, the smell of boiling fat is still more offensive, and kitchen-fumes should be carefully excluded from the sick-room.
If these precautions are adopted in time, a common remittent generally terminates with the third fit, and yellow fever takes the form of a "walking case," as the Memphis physicians call that mild type of the disease which limits its symptoms to a few shivering fits, and a night's headache, and seems, in fact, to be nothing but a modified sort of a summer ague. Every pyrexial affection is essentially an enteric disorder, a bowel-complaint, and dietetic management alone will generally insure a favorable issue of the disease. The Spanish cigar-peddlers and Spanish and Italian fruit-venders of New Orleans inhabit the vilest alleys of the "French quarter," but their frugality has saved them again and again, when their flesh-eating neighbors died by hundreds. I have known vegetarians to survive in tenements where the rooms above, below, and around them were filled with fever stricken families—decimated from week to week, dreading removal to the hospital like a sentence of death, but sticking to their flesh-pots and alcoholic "tonics." How fruit, the chief febrifuge of nature, came ever to be suspected of being the cause of pyrexial disorders, would be utterly inexplicable without the analogies of the post hoc ergo propter hoc fallacy—our liability to mistake a coincidence for a causal connection. In cold weather the hyperborean biped retreats to his unventilated den and contracts a catarrh, which he ascribes, not to its true cause, foul air, but to cold air, having noticed that winter and pulmonary affections are annual concomitants. Fruits, like countless other products of nature, are most abundant when they are most needed, and have for ages preserved the health of our tropical ancestors; but their carnivorous descendant ascribes his affliction, not to his daily beefsteaks, but to the occasional peaches and watermelons of which he happened to partake about the time the fever took hold of him. At the end of the year, when fruits become scarce, fevers too disappear, and the proof seems complete. Inductive logic: but the precipitate follower of Viscount Verulam fails to explain the fact that in the swampiest and hottest districts of the Eastern Continent fevers and fruits exclude each other like science and superstition, and the still stranger fact that hundreds of Northlanders who scrupulously abstain from fruit are nevertheless victimized whenever they brave the sun of the lower latitudes. In cholera the fruit-delusion may have derived a color of plausibility from the circumstance that persons who have for months subsisted upon beef and farinaceous food are liable to an attack of diarrhoea after their first experiments with a more digestible diet. For analogous reasons a long incarceration makes a prisoner unable to bear the fresh air and clear light of the outer world. The Creoles use pepper enough with their meat to dispense with other antiseptics, and yet eat fruit with every meal as the French serve a dessert of cakes and raisins—"pour la bonne bouche." A dime's worth per day for every man, woman, and child, of such fruits as oranges, melons, or "Chickasaw plums," that can be bought in almost every Southern town, would soon ruin the business of the quinine-manufacturers and reduce the trade of the "bitters" distillers to customers who like to drink whisky under some more respectable name.
The Spaniards divide all articles of diet into comidas frias and comidas calientes; but their definition of calorific food does not quite coincide with Liebig's theory. According to the nitrogenous and non-nitrogenous system, starch, sugar, gums, are "respiratory" food, and as exclusively heat-making as fat, while the experience-taught South American would unhesitatingly class starchy potatoes and starchy corn-bread with the comidas frias, the "cooling comestibles"; and flesh, eggs, and rich cheese with the heat-producers. Cold milk would be assigned to the former class, and, together with unleavened and "unshortened" bread, fruit, or fruit-jelly, constitute the dietetic specifics for convalescents from climatic fevers. Subacid fruits are, on the whole, more cooling than purely saccharine ones (figs, for instance); but bananas, though sweetish rather than acid, are, par excellence, an anti-fever food, being refreshing, palatable, and nutritive, as well as exceedingly digestible. Oranges, biscuits, and cold water, during the critical stage of the disease—milk, bread, and bananas, after the crisis is past—ought to be the standard regimen in our semi-tropical seaport towns; inland and farther north substituting pears or baked apples, and perhaps sweet-potatoes, for bananas, and watermelons for oranges. A frugal diet has the further advantage of obviating the tendency to fretfulness and splenetic humors which results from the use of animal food in indigestible quantities, i. e., in hot weather from a very moderate quantum. In midsummer, persons of a "nervous temper" could often cure their disposition by a change of diet. Mental energy exercises a remarkable influence on the idiopathic symptoms of climatic fevers. Pluck is a febrifuge. Men of exceptional will-force, or under the stimulus of an exceptional enthusiasm, contrive to hold the foe at bay; they keep on their legs till their work is done, even though the presence of a febrile diathesis continues to manifest itself by indirect symptoms. During the carnival of chaos following the end of our civil war and preceding the collapse of the Mexican "Empire," the Sheriff of Cameron County, Texas, undertook to escort a Mexican prisoner across the Rio Grande, in order to save him from a mob who unjustly but obstinately accused him of complicity in the "Cortina riot." It was a ticklish job, but the sheriff, though prostrated by a malignant ague and almost blind from the use of quinine, declined to intrust his protégé to a deputy, and preferred to rely on luck and his reputation as a "dead shot." Like most pistol virtuosos he was able to fire off-hand, and was confident that no shakiness would interfere with the accuracy of his aim, but was rather uneasy on account of his impaired eyesight. But on the morning of the critical day his fever left him, together with all sequelæ and concomitant symptoms, and he returned, with the conviction that the expedition had saved his own life as well as that of his prisoner.
Even scientific enthusiasm may exercise a similar prophylactic effect, and has supported more than one African explorer and East Indian officer whom no quinine could have saved from the combined influence of solar and animal heat. The trouble is, that the effect is so apt to subside with the cause: heroes and explorers who survive a summer campaign in the wilderness die upon the return to their comfortable winter quarters. The fate of Sir Stamford Raffles is a melancholy instance: A naturalist, a patriot, and a zealous philanthropist, his triple enthusiasm carried him safely through the swampiest regions of the Sunda Archipelago, and, as long as his expedition required his personal presence, Fortune seemed to favor him in every enterprise; but, upon his return to his palatial residence at Bencoolen, he and all his household were prostrated by the jungle-fever, and, at the end of a life perhaps unequaled for successful activity, he found himself bankrupt, childless, and hopeless. At a time when beef or pork steaks and a bottle of porter were the essentials of a Christian breakfast, a vegetarian official of the East India Company might have defied ill-luck to outweigh the advantage of permanent good health where good health obtained the highest premium. Even now, by their obstinate adherence to their native diet, the British residents of the East Indies are almost decimated every year, especially where the zymotic tendency of that diet is aggravated by the effect of foul air.
For on the other hand it is equally sure that strict attention to ventilation and a liberal use of cold air and sponge-baths will palliate the effects of many dietetic sins. The patient has either to adapt his diet to the temperature of the South, or adapt his temperature to the diet of the North. Experience has taught the Creoles to take things coolly. With all their excitable temperament, they avoid violent outbursts of passion; they do not overwork themselves; they preserve the even tenor of their way, even if they are behind time and know that their dinner is getting cold. And, above all, they indulge in liberal siestas. Hard work in the hot sun, with a stomach full of greasy viands, obliges the vital force to resist the triple fire of a furnace heated by the sun-rays, by exercise, and by calorific food. Brain-work, too, is apt, in hot weather, to exert an undue strain on the vital energies, and to complicate the difficulties of the digestive apparatus. Cold air is a peptic stimulant, but even in the North a man can not labor with his brain without impeding the labors of his stomach; but, in the languid atmosphere of a southern marsh-land, that impediment becomes an absolute prevention, and the brain-worker who eats for the purpose of nourishing his organism had better save his food for supper than oblige his stomach to carry it for half a day in an undigested condition. For during that half day putrescent decomposition anticipates the work of gastric disintegration; the ingesta ferment, catalytic humors pass into the circulation and prepare the way for the reception and development of zymotic germs from without. The hygienic alternative is, therefore, a long siesta, or a considerable postponement of the dinner-hour. South of Cape Hatteras, Nature exacts an account for every superfluous act that tends to raise the temperature of the system by a single degree. Keep cool becomes the first commandment of her sanitary code. He who scrupulously avoids anger, enthusiasm, and other calorific passions, who performs the principal part of the day's work in the cool of the morning, and eats his principal meal in the cool of the evening, who rests during the hottest hour of the afternoon, and takes active exercise only in the swimming-school, may indulge in the dietetic prerogatives of the higher latitudes; Nature will condone his beefsteaks, pork-fritters, and some of his cocktails; his mince-pies will not rise and bear witness against him. But the happier biped who can waive those prerogatives will free his stomach from the necessity of digesting winter food in a summer climate, and, in return, will enjoy the freedom of the land, the privilege to work, play, eat, rest, laugh, or get mad, at any time he pleases. He has reconciled himself to Nature, and shares the natural rights of the creatures who have not forfeited their earthly paradise; for the artificial comforts of the North are, after all, only more or less imperfect imitations of the gratuitous luxuries which our forefathers enjoyed in their tropical garden home.