As every one is aware, there are three causes for the circulation of the
blood.
(_a_) The contraction of the heart;
(_b_) Contraction of the voluntary muscles;
(_c_) The contraction of the diaphragm.
American women attempt to dispense with the last two; they neither take
exercise nor do they breathe with the diaphragm. The muscles act
precisely like the bulb of a Davidson syringe; when they contract the
blood is forced into the veins; when they relax a new supply flows in.
Dubois-Reymond determined by experiment that the minimum amount of
exercise, necessary to maintain the circulation, is equivalent to a walk
of five miles a day. American women do not average one-fifth of this
amount.
The diaphragm acts like the piston of a great pump, rising and falling
sixteen times a minute, and pumping the blood out of the abdominal and
pelvic cavities. Where its stroke is only one-half or one-third the
normal, the amount of blood raised must be correspondingly less. The
investigations of Dr. Thos. J. Mays, of Philadelphia, and of Dr. J. H.
Kellogg, of Battle Creek, Mich., have shown that women ought to breathe
precisely as men do. The thoracic type of respiration in women is
entirely artificial, and is not, as physiologists have claimed, a wise
provision of nature, having in view the restriction of the movements of
the diaphragm during pregnancy.
The second cause assigned for the ill-health of American women is lack
of specific exercise. All exercise is not of equal value; exercise of
the arms and legs, while of great value, is relatively far less
important than exercise of the trunk muscles, for the reason that the
circulation through the thoracic, abdominal, and pelvic cavities is
dependent upon exercise of the muscles surrounding these cavities. When
the trunk muscles are not freely and systematically exercised, the
circulation through the lungs and through the abdominal and pelvic
organs becomes feeble, and the functions of these organs are imperfectly
fulfilled.
We have now arrived at the point where we can trace, step by step, the
evolution of ill-health in the American woman. Her undeveloped body is
encased in corsets when she is fifteen years old. At school she learns a
great many things, but is not taught that in order to have good health
she must exercise the muscles of her body, and especially those of the
trunk, daily and systematically. After marriage she settles down to a
life of physical inactivity; she takes hardly any exercise, and even
this little is not taken systematically; she does not breathe with the
diaphragm; her circulation becomes feeble, her hands and feet are always
cold, the blood accumulates in her abdominal and pelvic cavities, the
functions of the abdominal and pelvic viscera are imperfectly carried
on; she becomes dyspeptic; her stomach is distended with gas; her liver
and intestines are torpid; the waste products of the system are not
carried off, but accumulate in the blood. The opinion is constantly
gaining ground that most of the functional nervous disturbances in women
are due to auto-intoxication.
By-and-by the pelvic organs begin to show signs of disease. When one
hears of the daily exploits of the abdominal surgeon, and learns that
there is hardly one woman out of five who has not some form of pelvic
disturbance, the conviction forces itself upon the mind that surely our
women must be grossly violating some fundamental law of health. We have
traced out the chain of physical causes which lead inevitably to a
stasis in the abdominal and pelvic circulation. As a further result of
this stasis there occurs a sagging of the abdominal and pelvic viscera,
and as the latter are underneath, they catch the worst of it.
Malpositions of the uterus are produced; the power of resistance of the
pelvic tissues to invasion by pathogenic microbes is lowered; the
tendency to plastic exudations is increased; the resolution of
inflammatory processes is very much retarded; and thus the foundation
for every variety of pelvic disease is laid.
The last cause assigned for ill-health in American women is
superstition—not religious, but pharmaceutical superstition. The sublime
faith with which an American woman will continue to swallow nauseous
drugs in the belief that they will restore her to health and keep her in
health, is only equalled by her faith in cosmetics. Drugs are wonderful
things in their place, but it is not possible by any combination of
drugs to replace the natural processes of health.
How are we to forestall this most serious of all our national evils, the
physical degeneracy of American women? This matter is far too widespread
and serious to be rectified by a little Anglomania, a little
calisthenics, a little athletic craze. There are far too many women who
lead lives that can only be characterized as parasitic; who have no
independent existence, but merely cling to life like a polyp to a rock.
They generate barely enough nervous energy to eat, drink, sleep, dress,
take a great deal of medicine, complain constantly, and finally drop out
of life without leaving the slightest vacuum.
The only way to meet this great evil is to introduce physical culture
into our schools and make it compulsory. Not until then will our women
realize the standard of feminine health as laid down by Walt Whitman:
They are not one jot less than I am,
They are tanned in the face by shining suns and blowing winds,
Their flesh has the old divine suppleness and strength,
They know how to swim, row, ride, wrestle, shoot, run, strike, retreat,
advance, resist, defend themselves,
They are ultimate in their own right—they are calm, clear,
well-possessed of themselves.
Louisville, Ky.
_POSSIBILITIES IN THE THERAPY OF NUX VOMICA._
(_Second Paper._)
By E. MACFARLAN, M. D.
Further clinical observations in the therapy of nux vomica have afforded
me an accumulation of evidence of its efficacy in certain and hitherto
untried affections of neurotic origin.
CASE I.—Was called, about one year ago, to Mrs. McG., age, 36. Found she
had just miscarried at about four months pregnancy. The fetus and
placenta had been expelled, but owing to inefficiency of uterine
contraction, there was profuse hemorrhage; consequently soon after my
arrival I found I had to contend with not only hemorrhage, but a grave
case of syncope. Her extremities became cold, and the heart-beat was
scarcely perceptible; and surely the case was rapidly becoming one of
heart-failure. Quick action was necessary, and I at once concluded to
test nux vomica, and proceeded immediately to administer one drop doses
of the tincture every five minutes. When the sixth dose had been given
the radial pulse-wave could be felt, and the heart-beat distinctly
heard. After five more doses the pulse was nearly normal; warmth of body
was restored and she was able to converse. Hayden’s viburnum compound
brought on good uterine contraction, and I succeeded in controlling the
hemorrhage. In a few hours after the first dose of nux vomica I found my
patient in such a comfortable condition of reaction that I left for
home.
About six months afterward I was called in the early part of the evening
to Mrs. McG., who believed she was again pregnant and threatened with
miscarriage. She had pain in the back and profuse hemorrhage. I was
getting good control of the hemorrhage when syncope set in, and on
finding it was becoming protracted and her condition very similar to
that for which I had used the nux vomica so successfully, I at once
resorted to the same treatment and with the same satisfactory
result.—But I must state, she was mistaken as to pregnancy. In the
course of that night she passed a very large blood-clot which was the
cause of her trouble; it evidently had been accumulating in the uterus
through several menstrual periods.
CASE II.—In the fall of 1892, I was called to Rose L., (colored), age,
20. Her symptoms at first were of indigestion and sluggish liver, and
congested portal circulation; but on further investigation of the case I
discovered considerable tenderness over the left ovary. On the third day
of my attendance, contrary to my advice to remain in bed and keep quiet,
feeling quite comfortable in the afternoon, and getting permission of
her mother, she left her bed to sit in an adjoining room. In the early
evening of that day I was sent for in haste to see Rose. I found her in
a prolonged state of syncope, and her mother was greatly alarmed,
fearful she would die. The patient’s pulse was small, weak and frequent,
and counted 112; extremities cold; she was in a semi-conscious state,
and when aroused would reply in a whispering voice, but immediately
relapse into indifference to her surroundings. It seemed to approach so
nearly to a case of heart-failure that I administered nux vomica in my
usual way as to dosage and intervals, resulting within an hour in
complete restoration of pulse, warmth of body and consciousness, and my
patient became quite cheerful and talkative.
CASE III.—C. M., age, 28, had an attack, of acute inflammatory
metastatic rheumatism. In the third week of the attack and while the
disease was yielding to treatment, he was attacked with an exceedingly
troublesome cough, but as he had been confined to his room, and in fact
to the bed, by the rheumatism during this time, I was puzzled to account
for the cough. Then I began to observe more closely the character of the
cough and expectoration. A careful auscultation did not reveal any
bronchial inflammation. By closely questioning the patient I found the
cough was paroxysmal, and commenced with an annoying tickling in the
throat; the cough steadily increased in violence with the return of
every paroxysm until it became exhausting, and the patient would feel
quite prostrated after each attack. I found also, his most severe
paroxysms came on within ten minutes after his evening meal. I
accordingly timed my evening visit for observation. I was now
satisfied—having watched a paroxysm from beginning to end, which lasted
over 30 minutes—that the cough was laryngeal and neurotic.
On examining the sputa it was found glairy and tenacious, and not such
as we find in inflammatory conditions of mucous membrane of the air
passages. I had given him a mixture which included compound tinct.
benzoin and codeine without effect, but now being convinced the
affection was of neurotic origin, it occurred to me to make a trial of
tincture nux vomica in my one-drop-five-minutes-dosage. I timed my call
the next evening so as to be present when the paroxysm of cough
commenced. My patient had just finished his evening meal, and we had
been conversing hardly ten minutes when the cough set in and rapidly
increased in violence, and then came my opportunity for the crucial
trial of nux vomica in this case. When I had given the seventh one drop
dose the paroxysm began to yield, and by the time we had given the tenth
dose it was almost over, the patient having an occasional cough. My
patient was very happy over the sudden and unexpected relief afforded by
the medicine I had just given him in such small doses, and of course was
curious to know what it was. He then told me, these hard paroxysms
sometimes lasted up to midnight, and on one occasion it had lasted
almost until morning. I left him drops to take in the night in case he
should have another paroxysm.
When I reached home that evening I do not think my patient was any
happier than I was over my success with the nux vomica in a purely
experimental case. The next morning Mr. M. informed me that he had slept
through nearly the entire night, which, owing to the cough, he had not
been able to do in a week. The patient from that night had no return of
severe paroxysm of coughing. I furnished him with fresh drops every day,
and he became so well posted in their dosage and use that in a few days
the cure of the cough was complete. And I may here add that I have had
several similar cases of cough since that, and the nux vomica has
succeeded in all. If physicians would more closely diagnose their cases
of cough, I will venture to say, there might be discovered more than one
case of neurotic origin and laryngeal.
CASE IV.—Mrs. L. S., age 40, is of nervous temperament and has
occasionally attacks of a mild form of hysteria. About one month ago I
was called to Mrs. S., who, I found, had the usual symptoms of “grippe.”
I treated her accordingly, and she was convalescing nicely. I had made
my morning call, and found her doing fairly well—excepting that she
complained of a slight shortness of breath. I carefully examined her
lungs, but there were no indications of pneumonia. In the afternoon,
about 3 o’clock, I received a hurried message to come without delay to
see Mrs. S. I found her in a very nervous, somewhat hysterical and
desponding condition; her face was flushed, she had distressing dyspnea,
cardiac palpitation, pulse 112, small, weak and frequent, which of
course was due to the functional cardiac derangement—there being no
indication of organic disease. She called my attention particularly to
her difficult breathing so soon as I reached her bedside, and begged for
relief. I took in the situation at a glance, and wasted no time in
thinking of a remedy to meet the case. My previous experience, and
knowledge of the efficacious therapeutic action of nux vomica in
neurotic affections, prompted its immediate use in this case.
The fifth one drop-five-minute dose reduced the pulse to 100, and in a
measure relieved the distressing dyspnea. When four more doses had been
given the pulse dropped to 90, and the dyspnea was so nearly conquered
that the patient expressed her thankfulness for such speedy relief after
a steadily increasing suffering of over four hours. By the time four
more doses had been taken respiration was normal and the pulse 84. My
medical mission was accomplished, and I left my patient—who was now
feeling very comfortable—with instructions to continue the one-drop
doses every half hour for four more doses, and then every hour up to
bedtime. Next morning she was sitting up in her bed feeling quite
comfortable, with respiration normal and pulse 78, the palpitation
having entirely subsided. She has had no further trouble up to date.
CASE V.—About two weeks after the occurrence of this last, I was called
to Mrs. E. C., age 31. I found her suffering from great dyspnea and
palpitation. She was also greatly troubled with flatulent dyspepsia and
frequent eructations. The difficulty of breathing and the palpitation of
the heart had been increasing for several hours, and as it was a new
experience in her life, she and her husband became greatly alarmed lest
the attack should prove fatal. But I knew my patient, as she had been
one of my clientele for many years. I knew she was of nervous
temperament and slightly hysterical. I wasted no time, but administered
tinct. nux vomica according to my usual plan; the particulars in this
case would only be a repetition of others, and it is unnecessary to
recite them. The result was an equally happy recovery.