Popular Science Monthly/Volume 23/June 1883/The Remedies of Nature II
By FELIX L. OSWALD, M. D.
CARBONIC acid, the lung-poisoning residuum of respiration and combustion, is heavier than the atmospheric air, and accumulates in low places—in wells, in cellars, in deep, narrow valleys, etc.—and often mingles with the malarious exhalations of low, swampy plains. On very high mountains, on the other hand, the air becomes too rarefied to be breathed with impunity. It accelerates the respiratory process, as the amount of air inhaled at one inspiration does not contain oxygen enough to supply the wants of the organism at the ordinary rate of breathing, and is therefore especially distressing to diseased (wasted) lungs, whose functions are already abnormally quickened, and can not be further stimulated without overstraining their mechanism.
In the temperate zone, the purest and at the same time most respirable air is found at an elevation of about four thousand feet above the level of the sea, an altitude corresponding to the midway terraces of the European Alps and the average summit-regions of our Southern Alleghanies. The broad table-lands of the Cumberland Range are several hundred feet above the dust- and mosquito level. Between the thirty-fourth and thirty-sixth degrees of north latitude the elevated plateaus have the further advantage that their climate equalizes the contrasts of the season: it mitigates the summer more than it aggravates the winter. Southerly winds predominate, and melt the snow with the same breezes that cool the midsummer weeks, for in the dog days the Mexican table-lands are considerably cooler than our Northern prairie States. In the Alps of North Carolina, Tennessee, and Northern Georgia land and labor are so cheap that even people of moderate means can build a sanitarium of their own. It has been often observed that the moral effect of a residence at a place where consumptives congregate is not favorable to the cure of the disease; and, moreover, a private establishment lessens the danger of contagion. The cheapness of living may be inferred from the fact that at the Chalybeate Springs of Benton, Tennessee, where board-rates vary from fifty to seventy-five cents a day, the visitors from the surrounding country towns, nevertheless, prefer to board on the co-operative plan: the proprietor of a kitchen-garden furnishes vegetables, a stock-farmer fresh meat, the owner of a carriage free transportation, and every family has a little cottage of its own. Summer-guests who come to drink mountain air can build their cabins wherever they find a convenient plateau, and contract with the next farmer for all the comestibles they may need in addition to their canned provisions. They can cook at their own fireplace. A log-house can be made as airy as any tent, and is out and out more comfortable. A rough-hewed porch-roof, projecting like the veranda of a Swiss chalet, will keep the cabin both dry and airy; square holes in the center of each wall can serve as windows in fine weather, and during a storm can be shut with a sliding-board. Between May and November the winds in the Southern Alleghanies come from the south or southwest, nine days out of ten, and, in order to get the full benefit of the pure air, the house should face one of the thousand promontories of the southwestern slope that rises in terraces from the "Piedmont counties" of North Carolina and Northern Georgia, with a free horizon toward the plains of the Gulf-coast. Have the door on the south side, and keep it wide open all night, as well as the windows or louvers in the opposite wall. If the windows do not reach to the ground, spread your bedclothes upon a hurdle-bedstead rather than on the floor, in order to enjoy every afflatus of the night-breeze. Night and day one can thus breathe mountain airs that have not been tainted by the touch of earthly things since they left the pine-forests of the Mexican Sierras. Every inspiration is a draught from the fountain-head of the atmospheric stream.
There is no need of living on oiled sardines where the brooks are full of speckled trout. Those who must break the commandment of Brahma (and the highland air confers certain immunities), may devour their humble relatives in the form of wild-turkeys, quails, and opossums; but the products of the vegetable kingdom are cheap, and diversified enough to make up a tolerable menu. Sweet-potatoes at twelve cents a peck, string-beans fifteen, green peas twenty-five; strawberries ten cents a quart, roasting-ears a cent a piece, brown beans actually a bushel for one dollar—Dalton (Georgia) market-prices. "Semi-annual" comestibles in proportion: eggs eight cents a dozen, butter twenty cents a pound in mid-winter, and ten cents in summer. Milk is a drug in the market; a good milch-cow can be hired for a dollar a month, a cow-boy for two dollars and his board. Whortleberries are sold at five cents a quart, but the pleasure of picking them is worth a great deal more. The lamest and weakest can join in that sport, for the shrub attains a height of three feet, and thus saves one the trouble of stooping.
About an hour after breakfast the colony (or family) should muster for out-door exercise. The choice between the various opportunities for entertaining work is the only difficulty, for Nature has provided them in embarrassing profusion. Expert bee-hunters can find four or five hive-trees in a single day. The chestnut-forests of the upper ridges are full of squirrels, and with a dog, a sack, and a good axe, it is not difficult to catch one alive, and turn it over to the quartermaster of the pet-department. Climbing trees is an exercise that brings into action nearly every muscle of the human body, and, like the mal de monte, the shudder that seizes the traveler at the brink of Alpine precipices, the dizziness that takes away the breath, returns it with interest and is a mechanical asthma-cure. Entomologists may combine the gratification of their mania with useful exercise by rolling logs in quest of big-horn beetles. Log-rolling and tumbling rocks from the tops of projecting cliffs is the spice of life in the engineering enterprises which a campful of male North Americans are sure to set afloat—as enlarging the entrance of a cave, constructing a graded trail to the next spring, to the next wagon-road, or to a favorite lookout point. Enterprises of that sort involve a good deal of grubbing and chopping, but also many interesting discoveries—geological specimens, an unknown chrysalis, new varieties of ferns and mosses. As the work progresses it becomes a pastime rather than a task, and novices feel inclined to agree with engineer Spangenberg, that "with a little management a first-class railroad can be built to any point of the continent earth." There is no cliff that can not be circumvented or terraced. With a slight curve in the road an apparent obstacle can be utilized as a bulwark. In fallen trees the removal of a few side branches develops revolving faculties. A pickaxe makes a whole wilderness plastic.
The summer air of the highlands makes out-door life a luxury, but the chief advantage of the plan is this: The stimulus of a pleasant pastime enables a man to beguile himself into about ten times as much exercise as he could stand in the Turner-hall. The visitors of a hygienic gymnasium take their turn at the horizontal bar as they would swallow the drugs of a public dispensary: they know that it is a lesser evil, they know that the road to Styx is the alternative, they intend to come every day, but the intolerable tedium of the crank-work exercise soon shakes that resolution. The motive for exertion is too abstract; it lacks the charm of progressiveness and the stimulus of a proximate, tangible, and visible purpose. The sham competition of a regiment of invalids under the command of a turn-master does not much sweeten the bitter broth; it is still crank-work, minus the club of the jailer, and nine out of ten hygienic gymnasts will soon find or make a pretext for discontinuing their visits. How many out of a hundred pupils of a young ladies' seminary would dream of performing their "callisthenics" at home? They would as soon walk on all fours, or ride on a dry clothes-line. But arrange a May-day picnic in the mountains, and they will beat a kid in climbing up the steepest rocks, and swing on wild grape-vines for hours together.
It is likewise certain that fatigues can be far better borne if the body is not encumbered with a surplus of calorific clothes. A pair of linen trousers, a flannel hunting-shirt, and a loose necktie, make the most hygienic summer dress. In the afternoon remove the necktie and roll up the shirt-sleeves: it can do no harm to imbibe fresh air by all available means, and let the cutaneous lungs share in the luxury. Nor is there any excuse for the wide-spread fallacy that it is dangerous, even in the most sweltering nights, to remove the bed-blankets. Kick them into the farthest corner if they become too warm, and sleep in your shirt and drawers, or under a linen bed-sheet. Half-naked lazzaroni sleep the year round on the stone terrace of the Museo Borbonico and outlive the asthmatic burghers in their sweat-box dormitories. The body effects part of its breathing through the pores. Painting a man with yellow ochre and copal-varnish would kill him as surely as hanging him by the neck. The confined air between the skin of the body and a stratum of heavy blankets gets gradually surcharged with carbonic acid—in warm weather even to the verge of the saturation point. The perspiration is thus forced back upon the body; and the lungs—perhaps already weakened by disease—have to do double work.
Hunters may find it hard to return in time for dinner, and need a rallying-signal. One p. m. is a good time for a general shouting match. Wake the echoes of the old mountains; the spirits of the departed Cherokees are tolerant—offer a premium for the loudest and ghastliest war-whoop, and depend upon it that no pulmonary disaster will spoil the triumph of the victor. Blood-vessels are not ruptured in that way, but by sudden movements or abrupt ejaculations, when terror or a similar emotion has driven the blood back upon the heart. But, while the mind is at ease, and the lungs not strained by a desperate exertion of the pectoral muscles, I would defy a consumptive to yell himself into a hæmorrhage. A vocal effort does not injure the respiratory organs; on the contrary, it strengthens them. Statistics show that lecturing and preaching savants outlive their graphic colleagues. In Carrollton, near New Orleans, I knew a hectic old Mexican banana-vender who was so short of breath that he had often to clutch the legs of his chair in his dire struggles for life-air, and who told me that every few days or so he had to hitch up his market-wagon, and bawl out his wares at the top of his voice, and for hours together—in order to ease his lungs. of speaking in a whisper, consumptives should envy cattle-drivers, whose business gives them a plausible pretext for yelling.
The prejudice against after-dinner speeches is founded upon a more valid reason. Rest, mental and physical, is really a prime condition of a thorough digestion. Invalids, especially, need a liberal siesta, and a two hours' nap in the shade of a shelving rock can do no harm. Long, sultry afternoons, though, are unknown in the highlands, and before 3 p. m. the air will again be cool enough for any kind of outdoor sport. If the spring needs cleaning out, a wheelbarrow full of flat rocks from the next creek will turn it into a deep, limpid brunnen, where a pail can be filled at a single dip. On sunny days butterfly hunters may bag their game on every mountain-meadow. Grasshoppers can be flushed by the dozen, and make the best bait for brook trout. The rock-benches at the water's edge would invite to a prolonged session if other pastimes were not too tempting and numerous. There are raspberries and muscadines in the brake; farther up the woods are strewed with chestnuts, and the collector soon learns to find the little dells where they accumulate, like nuggets in the cavities of a California gold-creek.
It is astonishing how work of that sort makes the hours vanish, together with many evils which tedium is apt to aggravate: languor, spleen, and dull headache. But more wonderful yet is its effect on the disorders of the respiratory organs. Under anything like favorable circumstances the lungs are, indeed, the most curable part of the human body. With every inspiration the balm of pure air can be brought into contact with the thousand times thousand air-cells of the respiratory apparatus, and, as we breathe about twenty times per minute, the panacea can be applied twenty-seven thousand times in twenty-four hours. Every day six hundred and eighty cubic feet of gaseous food circulates through the lungs of a full-grown man, carrying nourishment and restoratives to every fiber and enabling it to rid itself of its morbid excretions. The rapidity of the remedial process has more than once forced upon me the thought, "What persistent outrages against the health laws of Nature must it have required to make the lungs the seat of a chronic disease!" The mountain-cure remedies assist Nature only in an indirect way, but before the end of the first week the breathing power of the asthmatic lungs will revive as seeing and hearing awaken after a trance. The respiration is still short and quick, but becomes less and less laborious; the patient need not gasp for air; bis lungs have resumed business, and attend to all the details of its functions till it becomes entirely automatic.
Expectoration becomes less frequent; the source of the affection seems to retreat upward, the sputa come from the upper air-passages, and without the preliminaries of a worrying cough. Their quantity gradually diminishes, and the relief is permanent, while cough-medicines loosen the phlegm only by increasing its quantum, and discharging it with a tide of artificial mucus.
The night-sweats, too, soon disappear, for they can be cured on the slmilia similibus principle of the homœopathists—by day-sweats. Put on a flannel shirt, get an old axe and try your luck with a good sized bee-tree, or with the old log that obstructs the trail. Keep a tin cup about you, and assist Nature by frequent trips to the spring. No matter if you have to change your flannel shirts four times a day; depend upon it that you will not need them at night. The hectic fever abates; the cause has been removed. The sweats as well as the fever are induced by a pulmonary inflammation that increases the temperature of the body, but can be relieved by giving it a chance to eliminate the morbid matter. The four or five quarts of water that were excreted in the process of perspiration have circulated through every pore of the respiratory organs and depurated them more effectively in a single day than the repeated doses of a cough-exciting nostrum could do in a week. After the return from the mountains to the city (not before November, if possible) the occasional recurrence of the trouble will generally be limited to the rainy weeks of the first month, for the antipyretic influence of cold, clear weather rivals that of the perspiration-cure.
The danger of a hæmorrhage is generally passed when the cessation of purulent expectorations proves that the disease has become non-progressive, and that the ulcers begin to cicatrize. Hemoptysis, r blood-vomiting, is the only symptom of their disease which is liable to shake the characteristic hopefulness of consumptives. It generally frightens them considerably; they are apt to protest against out-door proceedings, and speak with bated breath, under the (erroneous) impression that a vocal effort has somehow induced the trouble. It can do no harm to humor that disposition; but keep the patient on his legs—lying down flat on the back after a heavy hæmorrhage is almost sure to bring on a relapse before the end of twenty-four hours. For the first three or four hours walk slowly up and down, try to keep up a deep and calm respiration, and, if possible, take the first nap in a sitting posture—propped up with cushions and pillows. At the end of forty-eight hours the danger is past, and out-door exercise may be gradually resumed.
For stubborn dyspnœa (want of breath) there is a somewhat heroic but almost infallible palliative, though I own that the rationale of its efficacy is somewhat undefined—artificial insomnia. Read or write as long as that will keep you awake; after midnight walk up and down the room for fear of falling asleep in the chair, and toward morning, when drowsiness becomes irresistible, go to bed for a few hours, and that they will be passed in peaceful sleep can generally be inferred from the circumstance that by that time the dyspnœa has disappeared. After the second night's vigils the trouble is not apt to recur for a month or so. But, unless the distress is utterly unbearable, or the necessity for prompt recuperation very urgent, it is, on the whole, better to eschew palliatives and rely on the only permanent asthma-cure—the gradual but normal invigoration of the whole system.
In chronic catarrh—a frequent concomitant of a tubercular diathesis—the obstruction of the nasal ducts by accumulated mucus yields in a day or two to any exercise that brings into play the muscles of the neck, shoulders, and chest, such as shouldering a good-sized log, walking bolt-upright with two large pails full of water, or a loaded wheelbarrow. A very simple household remedy is a palliative to the same effect: hot water applied to the palms of the hands and the soles of the feet. It affords immediate though often only temporary relief; for the diathermal influence of the hot-water treatment, as it were, dries up, and thus temporarily reduces the mucous accumulations, while the preferable exercise-cure more gradually but permanently removes the cause of the trouble.
The stitch-like pain in the chest is apt to recur with every catarrh, and forms, indeed, only an incidental concomitant of tubercular consumption. It is a pleuritic affection, and is often entirely wanting in cases that end with death by tubercular cachexia. The Calmuck Tartars, who defile the air of their family tents with tobacco-smoke and suffer the usual consequences, cure pleuritic inflammation by a simple method of inunction: viz., by fomenting the nape and chest with hot mutton-tallow. When loss of appetite indicates a derangement of the digestive organs, ointments may be used as a temporary substitute for a demulcent diet.
Dropsical swellings, chronic diarrhœa, with frequent chills, prove that the disease has reached the colliquative or hopeless stage of its development. But, even under such circumstances, the mountain-cure, in the form of moderate exercise in the pure air of a highland sanitarium, will confer at least the negative benefit of saving the patient from the horrors preceding the last act of a hospital-tragedy—it will insure an anæsthetic conclusion of the disease; the vital strength will ebb away in a painless deliquium.
But while the vital forces still keep the foe at bay, i. e., before the symptoms of the decline have assumed the chronic form, before the process of digestion becomes utterly deranged, before the impoverishment of the blood results in dropsy and a livid discoloration of the lips, while the patient has intervals of sound sleep and sound appetite, and strength enough left to walk a couple of miles—there is more than an even chance that the disease can be permanently cured. One memento only of its ravages will remain—the acceleration of the breathing-process whenever the convalescent engages in active exercise. But even that inconvenience can be diminished by a system of training that will gradually inure the lungs to the strain of the ordinary movements and exertions of daily life: namely, by walking up-hill (or upstairs) with a load of daily increasing weight. After two months or so it will take two scuttles full of coal to produce the panting and gasping which used to result from a small pailful of water, and the mere weight of the body will seem barely sufficient to indicate the difference between a rough mountain-trail and a graded pike-road.
A few years ago an emaciated Canadian miner came South for his health, and located a small placer-claim on the plateau of the "Fort Mountain," in Murray County, Georgia. The mountain is a mile high, and the up-trip with a few dozen eggs from the next valley farm obliged the miner to stop every few minutes to keep his chest from bursting, but before the end of the year he was able to make the same trip, without a stop, with a bushel-bag full of corn-meal. The waste from the corrosions of the tubercle-virus can perhaps never be repaired, but the healthy tissue of the remaining portion of the lung is susceptible both of expansion and invigoration. The lungs expand and contract with the chest. If three sisters marry on the same day—the first a ferryman, and learns to row a boat; the second a tailor, and takes to tight-lacing; the third a grocer, and tends his shop—an autopsy would show that in twenty years after their separation the ferrywoman's lungs have grown fifty per cent larger than the shopkeeper's, and fully twice as large as the dressmaker's.
But few consumptives ever outgrow the sensitiveness of their lungs, and must beware of contagion, avoid crowded meetings and lectures, and rather offend Mrs. Grundy than prolong their visits to a catarrh-infected house. Thoroughly healed though reduced lungs (reduced often to two thirds of their original size) will perform their functions in a sufficient manner for a long series of years. With the above-named precautions and a nutritive but strictly non-stimulating diet, there is no reason why a convalescent from pulmonary scrofula in its most unmistakable form should not enjoy an out-door festival in honor of his eightieth birthday. It is well known that in the deliquium of pulmonary consumption, in the stage of violent haemorrhages and dropsical swellings, the confidence of the patient often gives way to gloomy forebodings—the harbingers of the long night that never fails to cast its shadows before. But this despondency is not more significant than the hopefulness that precedes it. For I believe that instinct is right in both cases, and that in the first stages of its development consumption is really the most curable of all chronic diseases. Chateaubriand, Heinrich Voss, Count Stolberg, Alfieri, Francis Deak, and Dr. Zimmermann, were descended from consumptive parents, but redeemed their constitutions by traveling and out-door exercise, and attained to a more than average longevity. Goethe, in his younger years, was subject to hectic fevers, with frequent hæmorrhages, but recovered and died as an octogenarian.
A tendency to emaciation, the most characteristic symptom of tuberculosis, generally continues to counteract the normal effects of a liberal diet, even combined with continence and a tranquil mode of life; but the limitation of that tendency is a sufficient guarantee that the disease has become non-progressive. But there is a still surer criterion: consumptives are generally remarkably fair and smooth skinned. The reason is, that the dross of the cachectic system gravitates toward the diseased lungs. An East-Indian surgeon found that small-pox can be localized by rubbing the chest with croton-oil, and thus concentrating the eruption. Pulmonary consumption is a kind of centralized scrofula. Two hundred years ago, when the cutaneous form of the disease was more frequent, surgery was often invoked to remove ulcers that threatened to disfigure the patient or destroy his eyesight. The approved method was to produce an artificial and larger sore, where it could not do so much harm, on the arm, below the chin, or on the nape of the neck. The larger sore attracted the morbific matter; and thus healed the smaller one. For cognate reasons, a scrofulous affection of the respiratory organs acts, as it were, as a cosmetic. Pimples disappear; boils head at once, and without suppuration; intemperance, surfeits, a congenital taint of scrofula, do not affect the color of the face; and (excepting the effect of gross dietetic abuses, which ultimately react on the lungs) the cutaneous excretion of such impurities is therefore not an unfavorable symptom. For their reappearance on the surface of the body proves that the respiratory organs have ceased to attract the cachectic humors of the system; in other words, that the tubercle-sores have cicatrized, and the lung-destroying virus has been eradicated.