There fell to my care a very much worn-out mother, who took to her bed with an attack of inflammatory rheumatism, with the joints so involved as to require the handling of a trained nurse. The agony was such that the hypodermic needle was required to make existence endurable, and it was used with the idea that the brain would be less injured by the remedy than by the agony with its inevitable loss of sleep. I know of no disease in which treatment has been more savage than in this. The remedies in common use at that time were mainly new and of supposed specific powers; but they were so violent, and proved to be so futile, that they have all been given up since by the majority of the profession. As the days went on the disease declined in spite of the enforced comfort through the needle; there were easier movements, a clearing of the skin from sallow to a tint of redness, and finally, after a month, the armchair could be used for a change. On the morning of the forty-sixth day there was revealed in the face the perfect color of health, and happiness marked every line of the expression. There was ability to walk through several rooms of her home. But it was not until the afternoon that the first My next marked case is a wonderful illustration of the self-feeding power of the brain to meet an emergency, and a revelation, also, of the possible limitations of the starvation period. This was the case of a frail, spare boy of four years, whose stomach was so disorganized by a drink of solution of caustic potash that not even a swallow of water could be retained. He died on the seventy-fifth day of his fast, with the mind clear to the last hour, and with apparently nothing of the body left but bones, ligaments, and a thin skin; and yet the brain had lost neither weight nor functional clearness. In another city a similar accident happened to a child of about the same age, in whom it took three months for the brain to exhaust entirely the available body-food. I will now enter upon a study of the brain and its powers along these lines, to be enlivened by illustrative evidence. What reason and physiology had I with me that I should use methods in the sick-room wherein the entire medical world was against me, and with severest condemnation? The head is the power-house of the human plant, with the brain the dynamo as the source of every possible human energy. We think, love, hate, admire, With this physiology, who in or out of the medical profession can fail to see clearly that the digestion of even an atom of food is a tax upon the strength of the brain for whatever of power needed by the stomach, the machine, for this purpose? Unless it can be proved that the stomach has powers not derived from the brain system, this will have to be admitted. How is the strength kept up in the light of this physiology? The universal belief is that it is kept up by the daily food. In proportion to the prostration of sickness, so are physicians anxious to conserve the energies by working the stomach to the limit of its powers. The impression that there must be something di If the well need food to keep up the strength, the sick need it all the more; this is the logic that has been displayed upon this question. Let us keep it clear in mind that, if the nerves going to the stomach are severed, paralysis will result as in the case of the arm, in order more definitely to conceive the stomach as a machine that requires power to run it even to a tiringout degree. This is strikingly illustrated by the exhausted feeling that invites the after-dinner nap for rest, which, however, does not rest overfilled stomachs, overfilled brains. The brain gets no rest while getting rid of food-masses with more of decomposition than of digestion. If food really has power to keep up the strength, there should not be so much strength lost by the general activities—indeed, it would seem that fatigue should be impossible. But the fact remains that from the first wink in the morning to the last at night there is a gradual decline of strength no matter how much food is taken, nor how ample the powers of digestion; and that there comes a time with all when they must go to bed, and not to the dining-room, to recover lost strength. The loss of a night of sleep is never made up by any kind of care in eating on the following day, and none are so stupid as not to know that rest is the only means to recover from the exhaustion of excessive physical activity. The brain is not only a self-feeding organ when necessary, but it is also a self-charging dynamo, regaining its exhausted energies entirely through rest and sleep. There is no movement so light, no thought or motion so trivial, that it does not cost brain power in its action—and this is true of even the slightest exercise of energy evolved in digestion. Why, then, do we eat? For two reasons, or perhaps three: we eat because we are hungry. We rarely fail to eat excessively to satisfy the sense of relish after the normal hunger sense has been dissipated; we may eat to satisfy relish as we eat ice cream, fruits, and the enticing extras that beguile us to put more food into the stomach after it is already overfilled for its working capacity. But our actual need of food, the best reason for taking it, is to make up for the wastes from the general activities; and this is a process in the order of Nature that actually tires the entire brain system, or, in the common phrase, the whole body, unless the stomach has powers not derived from the brain system. Now as we need not, cannot feed the brain in time of sickness, what can we feed? In all diseases in which there are a high pulse and temperature, pain or discomfort, aversion to food, a foul, dry mouth and tongue, thirst, etc., wasting of the body goes on, no matter what the feeding, until a clean, moist tongue and mouth and hunger mark the close of the disease, when food can be taken with relish and digested. This makes it Another very important, unquestioned fact is that disease in proportion to its severity means a loss of digestive conditions and of digestive power. Cheer is to digestion what the breeze is to the fire. It may well be conceived that there are electric nerve wires extending from the depths of the soul itself to each individual gland of the stomach, with the highest cheer or ecstacy to stimulate the highest functional activity, or the shock of bad news to paralyze. From cheer to despair, from the slightest sense of discomfort to the agony of lacerated nerves, digestive power goes down. Affected thus, digestive power wanes or increases, goes down or up, as mercury in a barometer from weather conditions. Digestive conditions in their maximum are revealed in the school-yard during recess, when Nature seems busy recovering lost time. How compares the ramble of a June morning, with the blue and sunshine all above, the matchless green of the trees, and all the air fragrant with the perfume of flowers and alive with music from the winged singer, in digestive conditions, with those in the rooms of the sick, where there is only distress felt in the body and seen in the faces of the friends? In time of health, if we eat when we are not hungry, or when very tired, or in any mental worriment, we find that we suffer a loss of vital power, of both Since vital power is centred in the brain, do we need to feed, can we feed, for other than brain reasons? This physiology admitted, there is no other conclusion possible than that feeding the sick is a tax on vital power when we need all that power to cure disease. With all this physiology behind me, for more than a score of years I have been going into the rooms of the sick to see the evolutions of health from disease, as I see the evolutions from the dead wastes of March to the affluence of June, and from the first I had the exceeding advantage of being able to study the natural history of disease, a history in which none of the symptoms were aggravated by digestive disturbances. As there was no wasting of vital power in the hopeless effort to save the body from wasting, I had a clear right to presume that my patients recovered more rapidly and with less suffering. With no perplexing study As to the danger of death from mere starvation, the following remarkable case reveals how remote it is in the ordinary history of acute diseases. The late Rev. Dr. Merchant, of Meadville, Pa., a short time before his death, which occurred some months ago, informed me that a brother entered the army during the War of the Rebellion with a weight of one hundred and fifty-nine pounds. He was sent home so wasted from ulceration of stomach and bowels that he actually spanned his thigh with thumb and finger. He lived ten days only, to astonish all by the clearness of his mind even on the last day of his life, when he could think on abstruse questions as he had never been known to do in health. At death his body weighed only sixty pounds. It was Dr. Merchant's opinion, from a history of the case, that no food was digested during the last four months of his life; but it is my opinion that it took a much longer time than this for the brain to absorb more than ninety pounds of the body. That life was shortened by the more rapid loss of the tissues from the disease is to be taken into account in estimating time in starvation. |