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 digested to support the vitality of the system is a belief, a conviction that has always been too self-evident to suggest a doubt.

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 ill.u.s.trated 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-ma.s.ses 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 clearly evident that we cannot save the muscles and fat by feeding under these adverse conditions.

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 physical and mental energy. How, then, can food be a support to vital power when the brain is more gravely depressed by disease? Yet from the morning of medical history the question of how vital power is supported in time of sickness has never been considered, because there has never been any doubt as to the support coming from food. I a.s.sume this to be a fact, since all works on the practice of medicine of to-day enjoin the need to feed the sick to sustain their depressed energies--all this without a question as to whether there is not a possibility of adding indigestion to disease when food is enforced against Nature's fiat.

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 over what foods and what medicines to give, I could devote my entire attention to the study of symptoms as evidences of progress toward recovery or death; and in addition to all this there was the great satisfaction of being strictly in line with Nature as to when and what to eat.

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.

IV.

Feeding the sick! Who that rule in kitchens and feed the well do not realize with weariness of brain the demands of the stomach that at each meal there shall be some change in the bill of fare?

The chief reliance of physicians for the maintenance of strength while sick bodies are being cured is milk. As a food, milk was mainly destined for the calf, and not for man--certainly not after the coming of the molars. It is not a food that will start the saliva in case of hunger, as the odors from the frying-pan or from roasting fowl, yet because it plays such an important part as a complete food for some months in the life of the calf, and because it can be taken without especial aversion when the odors of the cooking-stove are an offence to the nostrils; it is given by the hour, day after day, and in some cases week after week; and there are physicians by the thousands who reinforce this inflexible bill of fare by the strongest alcoholics, whiskey being generally selected.

In this connection I shall say of alcoholics that they contain not an atom that can be converted into living atoms; they congest and irritate the stomach, and hence lessen digestive power; and benumb all the brain powers and faculties.

As a daily ration without change, this combination, strictly adhered to, would prostrate the energies of a giant, and he would find himself mustered out of all active service in less time than the hapless sick are often compelled to endure such feeding. Does Nature so conveniently reverse herself to meet an emergency that the sick can be built up and sustained by such feeding as would debilitate the well?

In the city where I live the physicians average well in learning, ability, character, and experience. Among them are the extremists in dosage: those with a hundred remedies for a hundred symptoms; others with such boluses as would writhe the face of an ox. There are some with extraordinary force of command in the rooms of the sick, who believe that whiskey is nourishing and that milk is liquid food; that doses go into human stomachs to travel the rounds of the circulation, and finally drop off at the right place for either patchwork or original work.

Whatever there is in drugs to cure disease, whatever in milk and the strongest alcoholics to sustain the strength, every protracted case has been made to reveal in their forceful hands. I have no reason to believe they exceeded authorized treatments. I have no reason to doubt that in all countries, in all lands, where there are educated physicians, the same appliances are in common use, appliances that will make the next short step from the lancet and bolus of a darker age the estimate of the time to come.

The treatments of the sick are always changing, while the process of cure remains the same. Only in the case of broken bones are we compelled to let Nature do all the curing, while we may take pride in some progress in the mechanical appliances.

As milk and stimulants are a common, authorized means to sustain the sick, and as they are poured into human stomachs with all the faith with which lancets were once forced into congested veins, their efficiency for good or evil must be studied by comparison.

Treatments must lessen both the severity and the duration of disease to be of permanent benefit. For a study by comparison, this opportunity came to me. There was a call to attend a case of typhoid fever in a young girl. In the same vicinity there had been under the care of one of my forceful brethren a woman in middle life, whose stomach was habitually rejecting all the milk and alcoholics poured into it, the doctor having a theory that good would result no matter how brief the time they were retained.

For a month my patient swallowed only the desired water and doses which did not corrode, a desire for food coming at the end of the month. The only day and night nurse was an overwrought mother, who got into bed with the same disease as soon as the daughter got out of it. There was another month of severer sickness, when without food and without the horror of dosage, as before, the call for food marked the close of the disease. My services ended here some days before the undertaker took charge of the doctor's case.

A girl in her later teens, with a mild, so-called malarial fever, fell into the same forceful care. There was a true history in this case of nearly two gallons of whiskey, and daily milk from the quart at first down to inability to take the least nourishment at last. Then there were more than a month of days when vital power sustained itself without the ways of violence, death occurring during the _nineteenth week_.

The ravenous brain had absorbed the lips to such thinness that the depressions between the teeth were clearly revealed. From the first dose to the last breath this was a case of dying, and the most persistent fight for life against immense odds I have ever become aware of in an acute case. In this case the stomach had become so seared by the alcoholic that digestion was impossible, as would have been the case in a body that was not sick.

Near this home there was a more delicate girl of about the same age taken with the same fever; but with mild dosage and no food--in Nature's care--hunger came at the close of the fourth week.

Later on in the same family there was a case of la grippe, in which for several years there had been chronic, ulcerative bronchitis that bid defiance to blisters and inhalations, the various specifics of another forceful predecessor, who also was a believer in large doses and full rations of alcoholized milk.

The coughing was so persistent, so continuous, that only the hypodermic needle met the need. To prevent the tearing of a raw surface in the bronchial tubes by the cough was as necessary as to apply splints to a broken bone. There was no food for six weeks, and Nature made most of her opportunity, not only to cure the acute disease, but also the chronic disease, which for nearly ten years since has remained cured.

I was summoned to Asheville, N. C., to see a young man in the last stage of consumption. I found him nearly a skeleton, though he had been eating six times daily for several months by the decree of a really learned physician. The belchings from gas were loud and frequent; the sputa by actual measure was about six ounces during every twenty-four hours.

A fast was ordered, and on the third day a ma.s.s of undigested food was thrown up. As soon as the stomach and bowels became empty there was comfort all along the line, and the cough was so diminished, that less than an ounce of sputa was raised in twenty-four hours.

After a week of fasting there came a natural desire for food, and thence on he enjoyed without distress of stomach all he wished to take. Thence on he lived with only the least discomfort, and with whispering lips he dictated to me his will, conveying large property. He could look with meaning when the power to whisper was gone, and life ended as the going out of a candle.

For months his sufferings had nearly all been due to food ma.s.ses in a state of decomposition. He saw clearly and mentioned often that his had been a case of starvation from overfeeding. Nature finally had to succ.u.mb because she was not also able to deal with a clearly avoidable disease, indigestion; but she kept up a brave fight until the body was nearly absorbed.

As soon as the stomach and bowels became empty the friends noticed that nervousness largely disappeared. His sleeps were much longer, because not broken by coughing as before; and as the brain was not taxed with food ma.s.ses there was an acc.u.mulation of power that was clearly revealed in the cheer of expression and a calmness as if heavenly rest had come at last.

A few years ago an attorney in this city had to endure a course of fever to which was added all the known barbarism of the times. Under enforced food and stimulants his mind at last became so weak that the dosings were forced down his throat. There were many weeks of life at lowest ebb before the man of torture (the doctor) was compelled to discontinue his evil work, and there were then months, extending to years, during which there appeared a colorless ghost of his former self on the streets--and this in spite of a wood-chopper's daily eatings, which were far in excess of power to digest.

At last he was brought to his couch with a mild fever complicated with a variety of other ailings. Not one of his friends who knew him intimately expected his recovery, as it was believed by them that there were chronic conditions that were beyond cure, and this because there had been death in manner, movements, and looks for months. And yet he had been able to take a stomach to his office every morning for many weeks filled with pancakes, sausage, fried potatoes, etc., only to shiver before the stove between his stomach-fillings.

To this possibly hopeless case I was called, and from that time he was to suffer only from the disease. For nearly three weeks no food was called for; and yet power so increased that he became able to dress himself; and on the morning before hunger finally called for food he came down from his bedroom with a son on his back who weighed not less than seventy-five pounds. Thence on, life, color, mind, muscle, rapidly came until there was such regeneration as to reveal a new body and a new soul.

Some years before this event an only son was taken sick with a mild fever. A young physician and friend of the patient was called whose faith in drugs, milk, and whiskey was boundless. He was fresh from his university, and therefore Nature had no part, through experience at the sick-bed, in the cure of disease. For many weeks these remedies of torture were vigorously and persistently enforced. But the time came when Nature would bear no longer. The father, a personal friend, came to see me simply to unburden himself, and as he was not able to give me the case I was unprofessional enough to advise that the attendance should go on, but that there should be a complete rest the physician should not know of. This was done, and in a few days there was a call for food, the first call in more than two months. Of course, there was a recovery, which was an exceeding victory for Nature against extraordinarily adverse conditions, but it required many months to restore the wrecked balance.

As I write this experience the following comes to me as a still stronger indictment against authorized medical method. A. B., when in the early maturity of his physical manhood, was stricken with a partial paralysis that sent him to his bed. It was simply the case of a wound of the brain requiring rest as the chief condition for cure. But milk, whiskey, and drugs were used with the greatest persistence, and after three months he became able to be about, no less feeble in mind than in body, and with teeth utterly ruined by the dosage. For fully five years he went about his home and along the streets as one in a dream. For ten years there was inability to attend to his ordinary business. Life came at last through the no-breakfast plan.

The most remarkable fight for life on the part of Nature against the adverse conditions of drugs, alcoholics, and milk I have ever known was in the following case: A spare woman, of perhaps forty years, came to her bed the victim of habitual bromidia and chloral, invited by severe headaches. The treatment of this case was as follows: whiskey every hour, milk every other hour; corrosive medication and powerful brain sedative every night, which would have paralyzed digestive energy for many days. There was not an hour during the twenty-four in which there was not dosing either to cure the disease or to sustain the system. The average quant.i.ty of whiskey was six ounces daily, and of milk nearly a quart. This treatment was borne for weeks, merging into months. There was no disease not caused by the treatments, and the battle went on until there was only the shadow of a woman left when Nature rebelled against further violence. A few days of peace were granted because hope had departed; but it took Nature more than a year to recover from the damage.

A man of iron and steel, in the early prime of life, was the victim of a severe injury. With the agony of lacerated nerves and the hypodermic needle to make the digestion of food impossible, milk and whiskey were poured into an unwilling stomach from the first, and both were used until neither could be retained; and then the lower bowel was extemporized into a stomach. For one hundred and forty-six days, from three to seven doses of morphine were put into the arm daily; and morphine dries both mouth and stomach and lessens all energies of the brain. The body itself was not sick; there was no hint of disease in it; yet there were drugs prescribed that cost dollars by the score, and there were alcoholics by the gallon. For months the pain, alcoholics, and morphine kept the mind in such a daze that there were only the imbecilic mutterings of a dreamer in trouble.