THE “TWELVE COMMANDMENTS” FOR THE PRESERVATION OF 455
YOUTH, AND THE ATTAINMENT OF A GREEN OLD AGE
GLOSSARY 459
INDEX 467
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SPECIAL ANNOUNCEMENT
TO THE READERS OF “OLD AGE DEFERRED.”
WE have just recently received the manuscript for the following
introductory pages, which are intended as a message direct to the
American people by Dr. Lorand. Their importance justifies a careful
reading.
Although, in accordance with his duty as a citizen of Austria, Dr.
Lorand has had to practically abandon his private practice, and devote
his energies and his abilities to the service of his country in the time
of trial, he has, nevertheless, been so situated as to have a pretty
intimate knowledge of American affairs. He has been especially grieved
and shocked to learn of so many sudden, untimely, and in his judgment,
unnecessary deaths among prominent Americans since the great war began.
Counting as he did, a great number of friends, not only among American
physicians, but among American tourists, and knowing, as he does, so
intimately, the peculiar physical characteristics of the high-grade
American citizen, he is appalled at the wastage of valuable lives in a
country teeming with prosperity and incidental home comforts.
The following introduction is designed as a warning to high-pressure
Americans that by a little care and the exercise of reasonable judgment
a large number of these premature deaths may be prevented.
Even if you were to read no further, the careful perusal of this
introduction is well worth while, as it deals directly with the most
important personal problems.
THE PUBLISHERS.
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PREMATURE OLD LOOKS:
THEIR PREVENTION AND TREATMENT.
────
IN the previous editions of this book I have attributed premature old
age to the degeneration of certain glands of our body, such as the
thyroid gland and the ovaries. It is my intention now to show, that
precocious old looks can often be caused by certain faulty habits; thus
for instance by not drinking daily a sufficient amount of liquids. There
are many women, who be it by an unjustified fear of obesity, or for
other reasons, scarcely drink any liquids except possibly a cup of tea
or coffee for breakfast. They neither drink with their meals nor much at
other times. In such cases the tissues of the face will lack the
necessary amount of fluids to which is due, mainly, the roundness and
fullness of the cheeks which we so much admire in the fresh faces of
young girls and children. In consequence the face will appear lean and
haggard, the skin shrivelled and folded, and lines and wrinkles will
appear already in the faces of young women. Besides, as the sufficient
amount of fluids will be wanting, the toxic products formed daily in our
bodies is not washed out through those natural channels, the kidneys and
the intestines, but will take their way through the skin, and eruptions
and pimples will develop, much to the damage of the complexion. An
obstinate constipation will be another consequence, which, giving to the
skin of the face a dirty yellow-brown hue, naturally contributes to
produce an old appearance of the face. More and more, am I convinced
that a generous purging, as for instance by certain mineral waters, is a
most efficacious remedy to prevent old looks and at any rate to improve
them. Drugs as a general rule are far less wholesome and effective for
this purpose.
By not drinking sufficiently, such substances as, for example, uric
acid, cannot be washed out and their retention will cause a serious
damage to health, facilitating the origin of arteriosclerosis, which
very frequently is associated with such conditions. Persons suffering
from uric acid present frequently an older aspect than corresponds to
their years and the falling out of the hair, or the appearance of gray
hair, in early years, is often the case with them.
It is erroneous to think that water produces fatness. If this were the
case we would advise the poor people to drink plenty of water that costs
nothing, to get fat. It is not water that makes fat, but water that is
taken with the meals, together with copious food, thus aiding the
absorption and assimilation of the same. To avoid obesity after rich
food it is therefore advisable not to drink with the meals, but at other
times. Copious food must be avoided, especially fat, starchy food and
sweets. A diet consisting of plenty of meat, fats, and above all milk
and butter and sweets, is the surest road to obesity. They must be
avoided and the preference given to a diet of little meat, green
vegetables and fruits. For further details of such a diet I must refer
to the chapter, “The Treatment of Obesity,” in my book, “Health and
Longevity through Rational Diet,” publishers, F. A. Davis Co.,
Philadelphia. I must emphasize the necessity of great prudence in
reducing cures, for, as I know from my practice in Carlsbad, there is
scarcely anything, unless a serious disease, that can produce so rapidly
the appearance of age in young persons and the more in riper years, than
imprudent and reckless obesity cures, causing wrinkles and the hanging
and sunken cheeks.
I must certainly blame the eagerness of many ladies to transform their
fresh, round and elastic forms into lean and skinny ones, thinking that
thus they will look younger. No; I am certain that many young women look
considerably older after these atrocious and imprudent diet-cures.
Dieting is more permissible with older persons, if not exceeding certain
limits; but young women and girls I would strongly advise to eat hearty
meals of mixed food, for, as I also show in my above-mentioned book on
Diet, we are introducing in our systems very valuable substances, which
are in reality useful remedies with certain articles of food. Most
important among these are fresh milk (uncooked), numerous fruits,
certain kinds of animal food, which all contain considerable quantities
of important mineral salts, indispensable to our well-being, and to the
freshness and elasticity of mind and body. Besides these salts and
valuable ferments these articles of food contain also a most important
substance, called _vitamines_, which, as its name shows, conveys a kind
of vitality to the tissues. It is indispensable to the well-being of the
nervous system and also of the muscles, and thus also to the most
important muscle of the body, the heart. The vitamines are largely
represented in the outer coverings of the rice, of the corn, and also in
eggs, potatoes, etc. In fine white bread there is scarcely any, but
there is far more in the brown bread containing all parts of the grain.
Milk also contains them, but mainly fresh, uncooked milk; strong cooking
destroys the vitamines in the plants and the animal food, and besides
such cooking, as I show in the chapter on “Rational Cooking” of my book
on Rational Diet, also destroys other valuable ferments of great
importance for our body. It is certain that our looks, the beauty and
size of the human body and of animals, and even the color of the
feathers of the birds, depend very much, as I show in the same book, on
the wise selection of the food which we eat. Not only in young growing
persons, but also in the adult and even in aged persons.
Of the different faulty habits there is probably none that would produce
so rapidly the premature appearance of old age in young women as
smoking.
THE DANGERS OF SMOKING IN WOMEN.
If excessive smoking is deleterious to man, in the woman moderate
smoking may cause serious alterations. We must not forget that the
tissues of women are more delicate and tender than those of men, and
especially young women can in this respect be put in the same class with
children. The woman is not so well protected against the influence of
poisons such as nicotine as the man, for in her some of those glands
whose duty is to destroy such poisons, as, for instance, the thyroid,
are kept in much greater activity on account of the frequent changes in
the ovaries with each menstruation, pregnancy, the climacteric, etc.,
and with their consequent repercussion upon the thyroid gland, with
which the ovaries are closely related. If to this comes such extra work
by the daily introduction of poisonous substances, although even in
small quantities, the gland may the more readily lose its efficiency.
After my own observations which I made upon my patients in Carlsbad
coming from eastern countries in Europe, I know that smoking women
present a much older aspect, if they have indulged in this habit to a
large extent and for years. They soon fade, the cheeks are pale, as a
rule, and sunk in. The general nutrition suffers, there is loss of
appetite, frequently a catarrh of the stomach and very often pains in
the stomach; indeed there is often neurasthenia with sleeplessness. With
more excessive smoking there will appear all the symptoms which are
common to the chronic nicotine poisoning of men.
I am not prepared to maintain that, _after the dinner_, a cigarette or
sometimes two are dangerous to adult women. The aspect of a lady smoking
a cigarette after dinner surely cannot be called attractive, and it
certainly does hurt the æsthetic feelings of a normal man to see a woman
smoking one big cigar after another. It looks too masculine in a woman,
as I have observed in a ladies’ club in Copenhagen, where most of the
women sat with big cigars in their mouths. Such habits take away all
charm even from the finest looking women, and as a normal woman is
attracted by all that is manly in man and is repelled by an effeminate
man, we men dislike masculine women, just as we dislike a woman having a
mustache and whiskers. If I were a married man, I know I would not like
to kiss my wife if she strongly smelled of tobacco, just as it would be
repulsive to kiss a man; the smell of strong tobacco creating
involuntarily the sensation of associating with a man. Until recently
women have presented far less frequently the symptoms of
arteriosclerosis than men, excessive smoking being rare with them. But
as the effects of smoking are more deleterious to them, naturally
arteriosclerosis will arise much sooner in them, and as through the
hardening of the arteries the nutrition of the tissues suffer, the
nourishing blood not rendering them in sufficient amount—necessarily
such persons will begin to look old at a comparatively early period of
life.
A FEW COSMETIC HINTS FOR THE REMEDYING OF OLD LOOKS.
In the previous editions of this book I have shown that it is possible
to improve old looks through hygienic measures, the use of the extracts
of certain glands, like the thyroid and ovaries and also by the
employment of certain drugs like arsenic and the preparations of iodine.
I would like to add now a few cosmetic hints against old looks some of
which I had already published a few years ago, as a collaborator to the
handbook of cosmetics of the dermatologist, Prof. M. Joseph, of Berlin
(M. Joseph, Handbuch der Kosmetik, Leipzig, 1912).
In persons of certain age and also in younger persons with a fading
expression of the face and beginning wrinkles I have found, as
efficacious in producing an immediate improvement, the gentle
application to the face of any kind of fats of pure quality and the
rubbing thereon of some reliable preparation of white powder. The powder
should afterward be wiped off very carefully. It should not be put on in
thick layers, for then, as after the use of pastes and paints in
general, lines may be created where they are not yet present and lines
already existing may be hollowed out to veritable wrinkles. No powder
should be visible on the face. The object is to add to faces with dry
skin the best variety of fat with reference to its animal origin so as
to make up for the wanting secretion of the sebaceous glands and to
replace, if possible to a certain extent, the fat wanting in the
tissues. All kinds of massaging of the skin should be avoided; only a
gentle rubbing is allowed. In fact, I consider massage as deleterious to
the face, except it is done by a qualified masseur who is an expert in
this kind of massage with a correct anatomical knowledge of the muscles
of the face and of the direction they are running. Special care must be
taken that the massage of the face should never be done with fats, as
this would promote the formation of lines and wrinkles and even of deep
ones, if done unskillfully. The massage of the face should consist in
gentle strokings of the face with the end of the fingers and always
following the direction of the muscles.
The powders used should be of the best possible quality. Before all they
should not contain any metallic salts and especially not lead. Unhappily
some of the very best powders are prepared with it, as lead gives to the
powders a specially white and attractive aspect. But I should like to
bring home to the ladies the fact, that these powders are the most apt,
especially in persons who perspire easily, to create lines and wrinkles
and to give to young faces in a short time an old appearance.
The best powders I consider those which consist of fine rice-powder,
amylum, or talcum, and they produce the best effect, if they are not
visible on the face. I have often seen the finest complexions ruined by
the frequent usage of thick powders, pastes, and paints. The
above-mentioned procedure of rubbing in fats and thereupon some of the
finest hygienic powders should only be done every other day. To give to
fading faces a certain tonicity I recommend the use of alcohol, diluted
with three times as much water, which, in the same manner as diluted
vinegar, will also improve the complexion. I have found that a very
strongly diluted solution of the extract of the suprarenal glands has
also a marked effect in toning up the muscles of the face, if rubbed in
gently. Only small quantities of the diluted solution should be used for
this purpose.
As gray hairs create, even in persons still young, an elderly
appearance, it might appear to their advantage to color them. It is best
to use such coloring only in regions of small extent rather than in a
general way. As the most inoffensive coloring of gray hair among dark
hair, I would consider the preparations containing nitrate of silver.
Those which contain lead or copper should be condemned.
After all the best weapon against old looks is a hygienic life by which
we can best avoid the development of a condition which already at an
early age gives an old aspect to the tissues, i.e., of arteriosclerosis,
or hardening of the arteries.
RAPID AND EARLY DEATH THROUGH ARTERIOSCLEROSIS AND ITS PREVENTION.
For most arteriosclerotic persons there can be only little hope to live
up to a green old age, to become 80 or 90 years old or even to pass on
to still higher years. But there are exceptions not so very seldom, and
it gives comfort to my patients suffering from this disease and
apprehension of the future, when I tell them that nearly all the
brothers and sisters of both my parents suffered from this disease for
many years, which did not prevent them from attaining ages varying
between 80 and 96 years and more. My father ever after his forty-fifth
year suffered from attacks of asthma. As a child I was often awakened
through his nightly asthmas, but in spite of many symptoms of
arteriosclerosis he lived to a great age.
One of my aunts is still living, not very far from 100 years old,
although suffering in a high degree from arteriosclerosis for many
years. Such protracted cases generally happen in families of longevity
and they are only due to, as a rule, regular habits, although it is true
that my father was a great smoker in his younger years and even in his
last years enjoyed one or two light cigars daily.
Such long survivals constitute, however, a great exception in
arteriosclerosis, and it usually happens only in cases where there are
no symptoms of that most dreaded form of arteriosclerosis, i.e., the
sclerosis of the coronary arteries of the heart. These arteries are
probably the most important ones of our body, for they provide the
muscles of the heart with the nourishing blood without which they could
not do their work. It is the sclerosis—the hardening—of these arteries
which, causing an obstacle to the passage of the blood, is the most
frequent cause of rapid death in arteriosclerosis, often in
comparatively young people. It is a sad fact, that such a condition, as
so often is the case with arteriosclerosis, can exist without exhibiting
any marked symptoms of it being present. A very frequent symptom of
sclerosis of the coronary arteries is attacks of _genuine_ angina
pectoris (stenocardia),—to be distinguished from the pseudo-attacks of
angina pectoris of neurasthenic persons. In such attacks there are
strong radiating pains in the heart region, and a feeling of great
anxiety, of utter annihilation, and of instantaneous death; and indeed
not so seldom such attacks may terminate in death. These attacks may be
considered as a warning of nature that such persons stand on the verge
of a precipice and thus urging them to the greatest precautions to avoid
anything that may bring about such an attack. From my own observations,
rapidly fatal attacks of angina pectoris in such cases of
arteriosclerosis happen frequently after a heavy dinner. The stomach
being distended, the diaphragm is pushed upward and thus impeding the
movements of the heart, which has not sufficient space for the play of
its muscles. Such a condition may also be often caused by the ingestion
of dishes causing flatulence. In consequence heavy dinners and flatulent
foodstuffs must carefully be avoided, and I declare any person who
presents attacks of genuine angina pectoris as a determined suicide if
he continues to indulge in them. There should be taken 5 small meals a
day, so as to avoid the keen appetite which results in overloading the
stomach. Foodstuffs causing flatulence such as cabbage, fried potatoes,
etc., should, above all, be avoided. Food that is rich in cellulose
(wood fiber) is strictly forbidden in such cases. For further details on
food producing flatulence I must refer to my above-mentioned diet book,
which contains a special chapter on the best food in flatulency and also
a list on the amount of cellulose (wood fiber) in different articles of
food. For the treatment by drugs refer to the chapter of this book on
arteriosclerosis. Besides moderate habits, including the use of very
light cigars in the smallest possible quantity (if smoking cannot be
given up entirely), overexcitement of any kind, especially sexual, as
also overexertions (_hill climbing_), must strictly be avoided.
Transgression of these commands, especially hill climbing, may sometimes
mean instantaneous death in advanced cases. Persons suffering from
coronary sclerosis with attacks of angina pectoris will do very well to
give up their positions if heads of companies with great
responsibilities and heavy burdens resting upon their shoulders, as any
stormy shareholder meeting may prove fatal to them. As already said it
is a sad fact, that persons may suffer from coronary sclerosis without
even knowing it, as there are also thousands of victims of
arteriosclerosis who are utterly ignorant of their condition, as this
disease often presents no marked symptoms. I must deplore that most
stupid habit of seeking for medical aid only when the ravages of disease
have gone so far that reparation is impossible. How often do people
forget the wise English proverb: “An ounce of prevention is worth a
pound of cure.” Just the same as children are sent every three months to
the dentist to see if any of the teeth present may be decaying in order
to save them, people already before feeling ill ought to at least once a
year be examined thoroughly by a doctor to see if anything is wrong in
the human machinery. I feel certain that in such a case many thousands
of persons, instead of lying in their dark, cold graves below the earth,
could still tread the soil enjoying sunshine and the scent of the
flowers. There is no doubt that arteriosclerosis and especially coronary
sclerosis could be avoided in many cases, through such an examination,
for the onset of arteriosclerosis is generally insidious and slow,
especially if it develops in the younger years, when due to syphilis,
and thus, if in time recognized, it could be cured. But even without the
syphilitic infection, cases in young persons are more frequent than we
think.
It is to the present terrible war, raging and destroying so many lives,
that we owe the observation made by many of the military doctors that a
goodly number of young soldiers present symptoms of arteriosclerosis,
many of them having never suffered from syphilis. Often it is but a
slight elevation of the blood-pressure, but which, if persistent, may
indicate a beginning arteriosclerosis.
THE PREVENTION AND TREATMENT OF HIGH BLOOD-PRESSURE AND THE PREVENTION
OF APOPLEXY.
Apoplexy is the consequence of a condition, which may be considered as
the highest degree of a scale whose lowest step is often a slight
elevation of the blood-pressure, when in a younger person. Thus, if
before the 45-70 year period the blood-pressure is somewhat elevated and
remains so for a certain length of time, we must, if there are no
special reasons for this elevation, for instance, kidney trouble, be
suspicious of arteriosclerosis. It is true, that there are cases of this
disease without a high blood-pressure, but if we find, besides
considerably elevated blood-pressure, traces of albumin in the urine and
also renal elements, a swelled liver and an accentuated second sound at
the aorta, there cannot be much doubt that we have probably to do with
arteriosclerosis. A high blood-pressure can most frequently be caused
through difficulties in the circulation of the kidneys; therefore in
each such case the urine must carefully be examined. By improving the
circulation through the kidneys we can also influence favorably the
blood-pressure. Certain drugs producing a great flow of urine have
indeed given good results in high blood-pressure, like, for instance,
diuretin in some cases. I am, however, averse to the use of drugs if
there are more natural remedies, and so I would advise the use of a
quite harmless one like the juice of lemons. It is very diuretic and, as
I have observed, there are also cases of chronic inflammatory conditions
of the kidneys which are very favorably influenced through a treatment
by lemons, in the same way as also gout and the uric acid ailments in
general. I have found that with lemon-juice given in mineral water we
obtain still better results if a little glycerin is added. Besides
lemon-juice the juice of certain other fruits like grape-fruit, oranges,
and grapes can also give good results. Besides a good diuresis, a
thorough cleaning of the intestines is desirable, high blood-pressure
often being caused by habitual constipation with stagnation of the
intestinal contents and subsequent flatulence. I must repeat with
emphasis again that daily bowel movements do not prove at all a clean
intestine following a good evacuation, and I am sure that the good
results obtained in the treatment of arteriosclerosis in certain spas,
like Carlsbad, Marienbad, and Kissingen, are not so much due to the
action of these waters upon arteriosclerosis, but simply to their
eminently purging action. Neither of these springs has a direct effect
upon arteriosclerosis, but besides the dietetic advantages of the
installation of these spas, the waters from their springs evacuate
thoroughly the intestines, ridding them of toxic products most
deleterious to the arteries, and at the same time facilitating in a
powerful way the circulation of the blood through the abdomen with its
most wholesome repercussion upon the whole general circulation. A
thorough intestinal evacuation can relieve a high blood-pressure nearly
the same way as an extensive venesection. A good perspiration can also
give good effects; however, to produce it there would be necessary to
take hot-water or air bath, which may prove most deleterious. There are
means, however, to avoid this for, as I know it from my own experiences,
it is possible to have a profuse perspiration without the sensation of
great heat and a red head through application of electric light bath
with blue light. In this blue light bath, studying its action, I have
myself obtained, after about twenty minutes’ time, the desired effect
without the depressive feeling afterward as so often is the case with
the usual steam bath. These baths are the more indicated in cases of a
nervous heart.
There are also different drugs, which may in many cases prove useful:
thus, a French preparation, prepared from the viscus kinds called
guipsin, then diuretin prepared by different concerns. Very valuable are
the nitrate preparations, especially in cases with coronary sclerosis,
also vasotonin, etc. But from my own experiences I give in many cases
the preference to preparations of iodine. But I have found that iodine
should not be given in too small doses and that they must also be taken
for a certain length of time. Besides iodine I have found, as most
efficacious in cases with very high blood-pressure, the application of
electric currents after the system of D’Arsonval (arsonvalization). In
each case of several patients I have seen the dropping of the
blood-pressure to the normal. As soon as we find a high blood-pressure
in a patient we must do our best to diminish it, for if we allow it to
become persistent the high blood-pressure will produce a loss of the
elasticity of the walls of the blood-vessels, there will arise
pathological alterations and arteriosclerosis may easily establish
itself. Aided by persistent, very high blood-pressure the degeneration
of the walls of the blood-vessels may in the long run go so far that a
destruction of their tissues can arise. Then by any sudden great
elevation of the blood-pressure it may come to a rupture of the vessel,
to apoplexy. If such a thing happens to a blood-vessel of the brain,
then such vital parts of the brain may be destroyed that sudden death
will follow. But in many cases, happily, other less important parts are
affected, without involving death, and then follows lameness of those
regions of the body which are provided with nerves coming or going to
these parts. Sclerosis and degeneration of arteries happen most
frequently in parts of the body where the circulation is the most
copious by hyperfunction of these parts; thus in the legs of country
people walking and climbing much (Romberg).
Mental exertions produce a great afflux of blood toward the brain each
time, with deep thinking more blood arrives to the brain and it is
therefore not surprising, as I show in my book on “Human Intellect and
its Improvement through Hygienic and Therapeutic Measures.” Such an
appalling number of prominent brain workers, men of science and of
business, are suffering from hardening of the brain-vessels and are
struck by apoplexy of the brain, sometimes even at early ages, before or
shortly after their fiftieth year. Indeed a vast majority of the great
men of science and business are thus afflicted, as I show in this book,
apoplexy being very frequent amongst them. It is reckless overwork,
unhygienic methods of mental work that may with surety produce a
hardening of the arteries of the brain. It would exceed the short space
allowed to this chapter if I should enter here upon the hygienics of
mental work, which I am treating in several chapters of my book on the
“Human Intellect,” but it will suffice here to emphasize the necessity
of interpolating resting days between days of mental overexertion. It
would be too much for me to demand that a successful man of business
retire entirely from his affairs, but what he could do, especially if
the head of the business, is to leave the city on Saturday for the
country, with the custom of walking about in the fresh air, returning
Monday with fresh strength; and, further, to avoid anything that
produces high blood-pressure, hill climbing, hot or cold drinks, strong
coffee, tea, and above all tobacco, which is one of the very surest
means to increase the blood-pressure. There is no condition where
smoking can produce such fatal effects as in arteriosclerosis, and
especially if the arteries of the brain, as so often in brain workers,
are affected. In inveterate smokers, perhaps a few de-nicotinized
cigarettes or cigars may be allowed. In place of regular coffee or tea,
coffee without caffeine and the Brazilian tea, maté, whose properties I
have described in my book on Rational Diet, may be allowed, but also not
in indiscriminate quantities. If too much of them is taken, they may
prove not less harmful, therefore also caffeine-free coffee and maté
should be taken with wise moderation. Against the troublesome symptoms
of arteriosclerosis of the brain like dizziness, loss of memory,
difficulty of reasoning, headaches, feeling of pressure upon the brain,
etc., I have seen, as I described in special chapters of my book “The
Human Intellect,” very good results through the combined use of
preparations of iodine and extracts of the thyroid gland. The dizziness
disappeared and also the headaches, the memory got much better and also
the reasoning power. These effects were, however, obtained in cases not
too advanced. As a preventive against arteriosclerosis of the brain and
as a remedy against headaches and feeling of pressure in the head I am
recommending snuffing in my book on Intellect, showing that through its
use the circulation of the congested brain is much relieved. In
confirmed cases of arteriosclerosis of the brain, however, snuffing
should be avoided, for it may have fatal results. Excessive snuffing is
also deleterious to healthy men, especially when tobacco is used. To
prevent apoplexy the hygienic advice we have given in the beginning of
this chapter to avoid high blood-pressure must strictly be followed. I
should like to add to them hot foot-baths for about five minutes, to
which mustard powder could be added. There should also be a special care
for a wise diet, avoiding constipation; of meat only very little should
be taken, fish should be preferred, and of meat only chicken and veal
allowed. The best food against arteriosclerosis and heart trouble
consists of a milk and egg diet, with vegetables and fruit, to which
fish and cheese may be added. As a most valuable food for overwork of
the heart and the general circulation, I recommend honey, whose merits I
show in next chapter.
THE BEST FOOD FOR A FAILING HEART.
There is one muscle in our body that never takes a rest. It never ceases
to work, either day or night, and the better for us, for if it should
stop it would mean the end of life. This muscle is the heart. Of course
we must feed well such a hard-working organ, and have special care to
select such a food that is the most genial for it and can the best
promote its activity. As the heart is a muscle we must give the food
that is best indicated for muscular activity. Observations have shown
that the muscles of our body are doing their work at the expense of a
certain sweet stuff (glycogen) contained in them. Experiments also prove
this, for it has been found that the heart of animals removed from the
body will survive for days the death of their owner if kept in a salt
solution, with grape- or fruit-sugar added. The addition of certain
mineral salts like lime and carbonate of sodium is also able to prolong
the survival of the cut-out heart of dead animals. So there can be no
doubt that the same elements must also prove useful to the heart of the
living, as is indeed the case.
As I have shown in my diet book the ingestion of sweets promotes
muscular activity and fatigues from bodily exertion are better borne.
And this also holds good for our most important muscle the heart. I have
seen in my heart patients very good results through the addition of a
generous amount of sweets to their ordinary diet. On the other hand, I
have, as a rule, observed a weak activity of the heart with my patients
in Carlsbad suffering from the graver forms of diabetes who were kept on
a diet strictly excluding sweets and starchy food in general. Indeed a
weak heart is most frequent in severe diabetes, as in such a condition
the sugar ingested cannot be utilized and entirely eliminated in the
urine. For this reason I consider it unwise to place severe cases of
diabetes on a strict diet and I recommend to them the use of fruit sugar
(levulose), which is often well utilized and especially in a case of
diabetes with heart-failure I like to do this. Such persons should never
be strongly dieted. As the best food for the heart I recommend honey on
the base of the above-mentioned observations. Honey is easily digested
and assimilated; it is the best sweet food, as it does not cause
flatulence and can even prevent it, to a certain extent promoting the
activity of the bowels. It can easily be added to the 5 meals a day I
recommend in cases of arteriosclerosis and of weak heart. As it would be
unwise to leave such a hard-working organ as the heart without any food
over the long hours of the night, I recommend heart patients to take
before going to bed a glass of water with honey and lemon-juice in it
and also to take it when awaking at night (honey dissolves in warm
water).
Before and after muscular exertion honey should be given in a generous
dose; no coachman would allow his horses to run for hours without giving
them food at the resting intervals. Only man is so unreasonable as to
undertake heavy exertions often with an empty stomach. No wonder that so
many sportsmen get a weak heart simply for just such a reason. The use
of sugar cannot well replace honey. In the same amount sugar is
chemically irritating to the stomach. At any rate the preference should
be given to cane-sugar; sugar of beet-root is chemically pure, although
through modern civilization it is, unhappily, deprived of the important
mineral salts the beet-root contains, and it has also been shown that
through the use of chemically pure sugar the body loses in lime, which
is eliminated in larger quantities. If honey is alone taken in larger
dose it is better borne if water is drunk afterward. Besides honey I
like to recommend grapes, as containing much sugar and also valuable
mineral salts like lime. If grape cures as conducted, for instance, in
Meran (Tyrol) give good results in arteriosclerosis and heart cases, the
results I think could be explained by the above observations. We can
best introduce lime in our bodies through milk, cheese, eggs, fruits,
and vegetables. The latter, especially fruits, are also rich in sodium
and potassium, which are also valuable elements for the activity of the
heart. I would especially insist upon the fact that the heart-muscle is
rich in lime, as it contains about seven times as much of it as the
other muscles. If we introduce in our system fresh, uncooked milk and
eggs we also introduce a very valuable substance of which we have spoken
before, vitamines. I believe that these substances must be very valuable
for the activity of the heart because in all the diseased conditions,
the deficiency diseases, arising, we have found, a want of this
substance (Funck). Besides, in nervous troubles a weakness of the heart
and muscles is common. If in one of this class of diseases, like
beriberi, even in the latent cases, strong muscular exertions are made,
then cardiac attacks will appear with great weakness of the heart.
According to Funck, chief of the laboratory of the London Cancer
Research Institute, muscular exertions are apt to make these diseases
break out at once in cases, until then latent, without any symptoms. He
also impresses upon the fact that when vitamines are wanting in the
food, it is the vitamine stores of the muscles which are attacked first
(Funck, “Die Vitamine,” Wiesbaden, 1914). But as the best proof for my
opinion that food containing vitamines is indisplaceable for the
heart-muscle I mention the fact, determined by Cooper and quoted by
Funck, _Journal of Hygienics_, 1913, that the heart-muscle is very rich
in vitamines. Beriberi and other deficiency diseases are the highest
degree of a condition that is due to the entire want of vitamines in the
blood. But no doubt there may be lower degrees due to the insufficient
amount of vitamines, in which may simply show symptoms of neurasthenia
with nervous heart troubles, as an expression of the craving of our
system after these substances. Milk containing vitamines, and also
containing a considerable amount of sugar and lime, it must be
considered as the most valuable food for the heart. But only fresh milk,
for by boiling it the vitamines are lost. Boiling above 100° C, and
especially in large apparatus under high pressure like in the autoclave
used in many of the large institutions and some of the big hotels,
destroys the vitamines. I have already in my diet book, in the chapter
on rational cooking, insisted upon the dangers of overcooking our food.
Another rich source of vitamines, the bran of wheat and rye, is taken
from us through another invention of our so-called modern civilization,
the machine milling, simply for technical reasons. Forty or fifty years
ago there was no cases of beriberi in the far east; the natives ate rice
with its wholesome outer layers; then modern civilization introduced
machine mills instead of the old hand mills, robbing the rice of the
silver fleece rich in vitamines, and beriberi appeared. It is true that
the bran presents obstacles to our intestinal juices, but there exist
certain methods by which it can be ground to a fine flour and all its
valuable parts assimilated and introduced in our body. We have quoted
here several instances of the fateful influence of our modern progress
upon our health. What is the good of the great progress of medicine if,
on the other hand, our modern progress through reckless inventions
separates us from Mother Nature and, inducing us to unnatural habits and
ways, exposes us to disease and untimely death. No wonder, then, if
arteriosclerosis and old age appear in relatively young people.
------------------------------------------------------------------------
CHAPTER I.
ON THE APPEARANCE OF SYMPTOMS OF OLD AGE IN YOUNG PERSONS.
AS a general rule the first symptoms of old age do not appear before the
fortieth or forty-fifth year. There are, however, many persons who, much
earlier, occasionally even before thirty, show some of the typical
symptoms of senility: corpulence, gray hair, wrinkles in the face,
falling out of the hair and loss of teeth, etc., for example. The gums
also are retracted from the teeth, which consequently appear greatly
lengthened; later on the teeth become loosened and fall out. This then
causes the jaw bones to atrophy, when the face becomes sunken, and the
individual appears many years older. The hair loses its original color
and becomes dry and gray, especially on the temples. The appearance of
bald spots surrounded by gray hair increases the aged appearance of the
face. On examination, the pulse of such persons may exhibit a high
tension, the temporal arteries may be tortuous, and the skin found to be
dry. A sensation of cold in the extremities is especially frequent.
There is, as a rule, a tendency to constipation. The mental faculties
are also altered; the memory weakens, and the mind is often depressed.
Neurasthenia or hysteria become frequent in such persons, while
impotence in men and menstrual disorders in women develop. The urine may
be found to contain traces of albumin and occasionally a few hyaline
casts. The presence of these, according to Professor Senator,[1]
indicates a degeneration of the convoluted tubules of the kidneys, and
thus the loss of important elements of the chief excretory organ of the
human body.
Footnote 1:
Hermann Senator: “Die Erkrankungen der Nieren;” Nothnagel’s “Handbuch
der praktischen Medicin,” ii Auflage, 1902.
On examination of the state of nutrition in these persons, it may often
be found to be below the normal. It is certain that such a condition in
young people is abnormal, and, therefore, a pathological condition.
The question now arises: In which category of diseases is this condition
to be classified?
In typical cases of this class there is a diminution of metabolism,
i.e., of the assimilation and conversion of food into energy. We shall
have to think of the possibility of alterations in those organs which
govern the process of metabolism.
These organs are the glands with internal secretion (especially the
thyroid gland, testicles, ovaries, the adrenals and pituitary body),
according to recent researches, among which those of the author of this
book may be mentioned. He was among the first to show the fact that
glands with internal secretion control all the processes of
oxidation,[2] and that the diseases of metabolism: diabetes, obesity,
gout, etc., are the direct consequence of alterations in these important
glands. This is further sustained by the labors of Sajous[3] who was the
first to describe the mechanism through which these organs govern
oxidation and metabolism, and to explain how they produce the disorders
just enumerated.
Footnote 2:
Intern. Congr. of Med., Madrid, April, 1903; and various Addresses to
the Brussels Royal Society for Med. and Nat. Sciences, 1903, the
Hamburg Med. Society, 1904, the Paris Biolog. Society, 1904, the
London Path. Society, 1905, etc.
Footnote 3:
Sajous: “Internal Secretions and the Principles of Medicine,” vol. i,
1903, and vol. ii, 1907, and Philadelphia Medical Journal, March 7,
1903.
The most important part herein is taken by the thyroid gland, whose
increased activity is followed by an augmentation of the processes of
oxidation in the body, whereas its degeneration is followed by a
diminution of these processes. When the thyroid gland is degenerated
entirely, as in myxœdema, there is also a great diminution of all
oxidation processes. There are also cases where the thyroid is only
partially altered by the increase of connective tissue, cases called
partial myxœdema, and in these cases, accordingly, the diminution of the
processes of oxidation does not take place to the same extent as in
complete myxœdema.
When we thus find symptoms of old age in young persons, together with,
in the most typical cases, a state of decreased oxidation, we have to
determine whether or not we are dealing with a degeneration of the
thyroid gland. And, indeed, such a condition is before us, for the
symptoms we have just mentioned are characteristic of myxœdema.
If complete myxœdema, the highest degree of this condition, is rare, on
the other hand the incomplete forms, where the thyroid is only partially
replaced by connective tissue, are fairly common.
This is shown by the fact that, after the fortieth or forty-fifth year,
the thyroid shows an increased amount of connective tissue, and thus
cannot be so active as a thyroid with more secreting elements and less
connective tissue.
We have thus reasons to suppose that the persons above mentioned, who
only exhibit some but not all of the symptoms of old age, symptoms which
are also found as typical in myxœdema, are suffering from a partial
myxœdema or hypothyroidia. And it does not necessarily follow that in
all such cases the processes of nutrition will be diminished, as is the
rule in typical cases of myxœdema.
The resemblance between senility and myxœdema was first pointed out in
1890 by Sir Victor Horsley, one of the foremost authors on myxœdema, and
afterward by Vermehren,[4] Ewald,[5] of Berlin, and the author. Horsley
ascribed old age to degeneration of the thyroid gland, and we have shown
(in a communication to the Paris Biological Society, presented by Dr.
Gley, Professor of Physiology at the University of Paris, December 4,
1904) that, besides the thyroid, there are also different other ductless
glands whose degeneration produces old age. These are the sexual glands,
the pituitary body, and the adrenals.
Footnote 4:
Over Myxœdemet, Kjöbenhavn, 1895.
Footnote 5:
Ewald: “Die Erkrankungen der Schilddrüse,” Nothnagel’s Handbuch,
Vienna, 1896.
It is a well-known fact that extirpation of the testicles and of the
ovaries is followed by obesity and other symptoms of old age; in the
same way cessation of the menstruation with degeneration of the ovaries
at the climacteric is followed by all the symptoms of old age and
certain nervous disturbances, as, for instance, troublesome flushings,
which occur here, as after castration. Eunuchs, as a rule, look much
older than their age. The Oriental eunuchs, and also the members of a
religious caste in Russia, the Skopse, who castrate themselves through
fanaticism, because of their parchment-like face covered with
innumerable wrinkles, appear aged beyond their years.
Degeneration of the pituitary body is also followed by premature
senility. This is shown by the fact that acromegalic persons, as a rule,
look much older than their age. This also holds good in the case of
myxœdematous patients. We have had opportunity to see, quite recently,
the skeleton of a female acromegalic patient of Dr. G. A. Gibson in
Edinburgh, and found typical indications of old age, an enormous
augmentation of connective tissue and vascularization of the bones, with
great porosity.
It must be remembered that all the glands with internal secretions,
according to Pineles,[6] Sajous,[7] and the researches of the author,
stand in very close relation to one another. Thus, degeneration of the
thyroid is followed by that of the pituitary body. This was shown by the
experiments of Hofmeister,[8] Stieda,[9] Rogowitsch,[10] Benda, and many
others. Degeneration of the pituitary is followed by a similar lesion in
the thyroid.
Footnote 6:
Pineles: Volkmann’s klin. Vorträge, N. 242, 1899.
Footnote 7:
Sajous: “Internal Secretions,” Philadelphia, vol. i, p. 140, 1903.
Footnote 8:
“Beiträge zur klin. Chirurgie,” 1894.
Footnote 9:
Ziegler’s Beiträge, Bd. vii.
Footnote 10:
Ziegler’s Beiträge, vol. iv, 1889.
Arteriosclerosis is a condition very frequently met with in elderly
persons, and, according to recent researches, this disease is caused by
a toxic agent with subsequent degeneration of the walls of the
blood-vessels. Such a change can be produced artificially, as shown by
Josué,[11] by injecting adrenal extract into rabbits.
Footnote 11:
Josué: C. R. Société de biologie, Nov. 14, 1903.
That the ductless glands are closely related holds good also for the
thyroid and adrenals. This relation, however, is an antagonistic one.
The adrenals increase the blood-pressure (Oliver and Schäfer[12]), and
the thyroid diminishes it. It is an interesting fact, demonstrated by
Professor Eiselsberg[13] in Vienna, that extirpation of the thyroid
gland of dogs results in atheroma of the aorta. In connection with this
we also mention the clinical fact, that all those agencies which are
harmful to the thyroid gland, as syphilis, abundant meat food
(Breisacher,[14], Blum,[15] Lorand[16]), alcohol (Hertoghe and de
Quervain[17]), and tobacco (Hertoghe), are also those which are commonly
considered to be the causes of high tension and arteriosclerosis.
Infectious diseases are also brought in etiological relationship with
arteriosclerosis, and it has been shown by a series of authors, that in
infectious diseases the thyroid undergoes important alterations which
may involve its degeneration (Roger and Garnier, Crispino, Torri, Bayon,
de Quervain).
Footnote 12:
Oliver and Schäfer: Journal of Physiology, vol. xviii, 1895.
Footnote 13:
Eiselsberg: “Die Krankheiten der Schilddrüse,” Stuttgart, 1901.
Footnote 14:
Breisacher: Archiv für Anat. und Physiologie, Suppl., Bd., p. 509,
1890.
Footnote 15:
Blum: Virchow’s Archiv, p. 495-514, 1899.
Footnote 16:
Lorand: Transactions of the Path. Society of London, vol. lvii, Part.
1, 1906.
Footnote 17:
La Semaine Médicale, 1905.
Infectious diseases also induce changes in the adrenals, as shown by
many authors (see Chapter III).
Various toxic products, such as lead, alcohol, and tobacco, which are
considered causes of arteriosclerosis, are also able to produce
hypertrophy of the adrenals.
And, if we consider those agencies which are commonly considered the
causes of premature senility, we notice the singular fact that they are
also considered to be especially harmful to the various glands with
internal secretion, particularly the thyroid and sexual glands.
Among these agencies may be mentioned infectious diseases, sexual
excesses, frequent pregnancies, strong emotions continued for a long
time, such as grief and sorrow, chronic intoxications (by poisonous
products produced in the body, or introduced from without). We will show
later, in an exhaustive way, the action of these agencies upon the
glands with internal secretion.
Between the thyroid gland and the ovaries, a close relationship also
exists. Thus, invariably, when we find the thyroid altered, we can also
see changes in the ovaries. Consequently in myxœdema and Graves’s
disease we find, with great frequency, disturbances in the functions of
the ovaries, e.g., cessation of the menses, or disorders of
menstruation. In such conditions the ovaries have often been found to be
atrophied. We also frequently find such disturbances in acromegaly,
where they may either be due to changes in the pituitary, associated
with an altered condition of the ovaries, or they may be ascribed
directly to changes in the thyroid which, as we have shown in a
communication to the International Congress in Madrid, 1903, is very
often altered in acromegaly. If microscopically examined it is probably
found changed in every case. Indeed, we have attributed acromegaly to
the primary changes in the thyroid which lead only secondarily to those
in the pituitary body.
In diabetes, which disease, according to our investigations, is often
caused by changes in the thyroid,[18] and subsequently in the pancreas,
or _vice versâ_, amenorrhea or impotency is frequently met with.
Footnote 18:
Lorand: “Die Entstehung der Zuckerkrankheit und ihre Beziehungen zu
den Veränderungen der Blutgefässdrüsen,” Berlin, A. Hirschwald, 1903,
and French Translation, Maloine, Paris, 1904.
On the other hand, changes in the ovaries are also, as a rule, followed
by changes in the thyroid gland, as may be seen in puberty,
menstruation, pregnancy, lactation, and the climacteric. We will enlarge
upon this later, in greater detail, but we will only briefly mention
here that we may frequently see a swelling of the thyroid gland as an
expression of increased activity during these conditions. We can also
see this in diseases of the ovaries, and, as certain authors show, even
sexual excesses can produce an altered state of the thyroid. This was
known to the ancient Hebrews, for they used to examine the neck of the
newly-married bride the morning following the wedding night to see if
the neck had become larger by the swelling of the thyroid gland.
Thus we can readily understand that, frequently, swelling of the thyroid
is the consequence of overwork of this organ, and, as in the case of
great sexual excesses or frequent pregnancies, may lead to exhaustion of
the gland with its grave clinical consequences.
Indeed it has been shown by the earliest authors on myxœdema, that this
disease is very frequently caused by too frequent pregnancies,
especially if connected with prolonged lactation (Ord, Morvan, Combe).
This will also explain why women more frequently show the symptoms of
precocious senility than men, whose sexual glands are not put to such
constant activity and change as are the female sexual glands. Similarly
women, after frequent pregnancies, especially with prolonged lactation,
or women with diseases of the ovaries, and also those addicted to
habitual sexual excess, such as prostitutes, very soon become fat and
fade before their time. Thus we may see symptoms of precocious senility
in such women even before the end of the third decade, especially if
they have begun to lead an immoral life at an early age. Even young
girls may look much older through the abuse of their ovaries from sexual
excesses. Their breasts become large and pendulous, and their faces
bloated and relaxed. Menstruation may likewise be made to appear in
early childhood by sexual abuses, as Pauline Tarnowska[19] has found
through the examination in St. Petersburg of 150 very young prostitutes.
Footnote 19:
Tarnowska: “Etudes antropométriques sur les prostitutées et les
voleuses,” Paris, 1889.
We shall show in the next chapter that obesity, which has nothing to do
with overfeeding, can be caused by like agencies.
That mental emotions, especially care, grief, sorrow, etc., powerfully
influence the different ductless glands, and are able to produce
degeneration of the thyroid, adrenals, and sexual glands, etc., is shown
by conclusive proofs in the chapter on the “Hygienics of the Mind.”
Infectious diseases are especially liable to cause change in the
kidneys, and in various infectious diseases, sometimes even in
tonsillitis, we may find an inflamed condition of these organs.
The kidneys can also be damaged by the passage of various toxic
products, which are either produced in the body (auto-intoxication) or
introduced with the food (condiments), or as stimulants—e.g., alcohol,
strong tea, etc. All these toxic agents are capable of doing damage to
the kidneys just as to the thyroid gland. We shall treat later on, in
separate chapters, of the action of these stimulants upon the ductless
glands.
The condition termed auto-intoxication may be induced by many different
factors, among which may be mentioned the products of intestinal
putrefaction (Senator[20]) and the waste products from the processes of
oxidation, such as uric acid, for example. Animal food is more apt to
produce intestinal putrefaction than any of the various other
foodstuffs.
Footnote 20:
Senator: Berliner klin. Wochenschrift, Nu. 24, 1868.
There are three important organs which protect us against such a
condition of auto-intoxication; these are the kidneys, liver, and
thyroid, and possibly also the parathyroids.
The kidneys act by promptly eliminating such toxic products in the
urine. They are glands with internal secretion, as shown by the
experiments of Brown-Séquard,[21] E. Meyer,[22] and clinical
observations of Senator[23] and H. Strauss.
Footnote 21:
Brown-Séquard: Archives de physiologie norm. et path, p. 778, 1893.
Footnote 22:
E. Meyer: _Ibid._ p. 179, 1894.
Footnote 23:
Senator: Loc. cit.
The liver, which, according to Gilbert, H. Strauss,[24] and others, is
also a gland with an internal secretion, is strongly antagonistic to
intestinal poisons. It destroys toxic products brought to it from the
intestine through the portal vein, and several authors, Professor Adami,
Sir Lauder Brunton and Bokenham,[25] show that it is also able to
eliminate such products with the bile after previous transformation. We
will treat of these protective functions of the liver in a separate
chapter, together with the hygienics of this important organ; but we
will just mention here that the liver plays a great rôle in the
transformation of the toxic end-products of albuminous food into
harmless substances, such as urea.
Footnote 24:
H. Strauss, Senator: Festschrift.
Footnote 25:
Sir Lauder Brunton and Bokenham: The Journal of Pathology and
Bacteriology, p. 50, Nov., 1907.
The third important toxin-destroying organ is the thyroid gland, which,
as shown by the experiments of Dr. Leo Breisacher,[26] of Detroit,
formerly assistant to Professor Munk, of Berlin, and of Dr. F. Blum,[27]
of Frankfort, as well as Dr. Chalmers Watson,[28] of Edinburgh, destroys
those poisonous substances produced by the decomposition of proteid
food. Moreover, Sajous has shown that this is a prominent function of
the pituitary body, the thyroid and the adrenals, acting jointly as the
“adrenal system.”
Footnote 26:
Breisacher: Loc. cit.
Footnote 27:
Blum: Virchow’s Archiv, 1899.
Footnote 28:
Lancet, Feb. 11, 1905.
It will be evident that these various glands can only do their work to
perfection so long as their parenchymatous tissue is not replaced to any
large extent by connective tissue. Of these glands the thyroid takes the
foremost rank, as it governs the other glands. As we have shown in a
communication to the French Congress of Medicine, in Liège, 1905, the
thyroid influences the liver, and in a paper before the Paris Biological
Society, February 25, 1907, we have shown that the thyroid also
influences the kidneys. In fact, the liver and kidneys are closely
allied to the thyroid, and when this organ is degenerated, the other two
glands follow suit.
Accordingly we may expect that, when the thyroid undergoes a process of
degeneration, such an event may also take place in these two protective
organs, as we have shown in our above-mentioned two communications. In
consequence of the diminished activity of these organs the development
of a condition of auto-intoxication may be facilitated. Patients showing
symptoms of old age in early years, also show to a greater or less
extent symptoms of such a condition, as do myxœdematous persons.
Meat food especially, if taken in large quantity, is a certain producer
of uric acid, and it is an interesting fact, shown by several authors
and also by the writer,[29] that by thyroid medication we can augment
the elimination of uric acid, and also prevent its formation in large
quantity, both in the case of uric acid formed in the body or introduced
from without by the food.
Footnote 29:
Lorand: Comptes Rendus de la Société de biologie de Paris, Février 25,
1907.
This fact stands in relation to the powerful influence exercised by the
ductless glands, and especially the thyroid, upon the process of
oxidation; and, as we are anxious to prove the assertions we here
advance, we shall show in the next chapter how these wonderful glands
influence the processes of nutrition in the tissues, and at the same
time the external appearance. We have already mentioned a form of
obesity that has nothing to do with overfeeding, as one of the symptoms
of precocious old age, and in the next chapter we will review in detail
the agencies which govern this condition.
------------------------------------------------------------------------
CHAPTER II.
ON THE AGENCIES WHICH GOVERN OUR EXTERNAL APPEARANCE AND THE NUTRITION
OF THE TISSUES.
AS a general rule infants of both sexes look very much alike, so much
so, indeed, that sometimes it is only possible, upon close inspection,
to determine the difference in sex. This, however, can only be so for a
certain period until certain changes take place in the ductless glands,
especially in the sexual glands and the thyroid.
The latter contains but very little, if any, colloid substance in
infancy, and the colloid increases only gradually until it is present in
abundance at the time of puberty, when also the changes in the sexual
glands reach a climax coincident with the ripening of the follicles in
the ovaries and their rupture at a menstrual period. This latter process
is, as we have mentioned before, under the influence of the thyroid.
Puberty and menstruation do not take place, as a rule, in persons with a
degenerated thyroid gland.
With the onset of puberty there is seen, also, a change in the external
appearance of the individual and the attributes of virility—e.g.,
moustache, hair in the pubic region, alteration of the voice, etc.,
appear. In the female the development of the breast, hair on the pubis,
etc., occurs. At the same time the features attain the peculiar
characteristic which distinguishes the male face from the female, even
without the aid of a moustache.
In those persons in whom puberty has not occurred at the usual age
(fourteen to sixteen years in our climate) the attributes of sex are
absent. In these cases the male looks very much like the female. A
similar phenomenon may be seen in women after castration and the
climacteric, when they may even show a tendency to develop a moustache
and hair on their face in places, corresponding to the male beard.
This we can also observe in women whose ovaries have been altered by
disease or by sexual excesses.
These attributes of sex are also called external sexual characteristics,
and they are the direct result of the internal secretion of the sexual
glands. They only develop through the presence of such a secretion, and
this is easily demonstrated by the fact that after castration of the
infant, they do not appear at all. Hence, if we see grown-up men with no
trace of a moustache it may indicate an undeveloped condition of the
testicles. Again, we castrate a young cock, he will not grow a comb and
spurs, and other cocks will pass by, too proud to fight with a
degenerate deprived of its male attributes. If we now take the
extirpated testicle of such cock and graft it under his skin, the other
cocks will commence to fight with him, for his comb and spurs will
develop as in other normal cocks.
That the whole external appearance of a castrated animal or man is
changed, is also demonstrated by important changes in the skeleton and
size of such animals or persons.
As Poncet[30] has shown, the extremities of a castrated rabbit become
abnormally long, and it is a well-known fact that eunuchs have
abnormally long arms and legs. This also occurs in cases of infantilism,
which, as we know, is due to a non-development of the sexual glands.
Moreover, the thyroid of such individuals is also found to be in a
pathological condition, as was shown by Hertoghe.
Footnote 30:
Poncet: C. R. de la Société de biologie de Paris, 55.
Men who have been castrated before puberty or whose testicles are
undeveloped, present such an external appearance. They have no
moustache, as above mentioned; their hair is dry and brittle and remains
short; their faces are pale, and of a yellowish hue; their hands are
cold and reddish blue. Often the skin of the face is like parchment and
has many wrinkles. Their intelligence is often diminished, as we will
show later on, and they are usually anæmic.
Women with undeveloped ovaries have flat breasts and hips; their faces
are often irregular in structure, and their jaws are often prominent;
their gums are shrunken and their teeth are long and soon fall out. Some
cases may show a colossal obesity, but in the partial forms of ovarian
insufficiency they may be remarkably thin. They also are, as a rule,
anæmic or chlorotic.
In some parts of the Orient, as in India, there are female eunuchs, such
as Roberts has seen on the way from Delhi to Bombay. Such eunuchs had no
bosom; the pubic hair was absent, and their buttocks were like those of
men; but the rest of the body was stouter. Of course these women had
been castrated during their childhood.
If we make a Roentgen-ray examination of the skeleton of a person
castrated in childhood, we shall find that the epiphysial cartilages
remain unossified for a long time after puberty.
It is a very interesting fact that, both after castration and in
myxœdema, the same persistence of the epiphysial cartilages and
retardation of ossification have been observed by means of the
Roentgen-rays: by Hertoghe in 1896; Springer and Serbanesco in 1897;
Gasne and Laude in 1898; Legry and Renault in 1902; Jeandelize in 1903.
The same thing has also been observed by Hertoghe in “Infantilism of the
Type of Lorraine.”
The influence of the thyroid upon the skeleton and size of the body is
easily shown by simple observations.
Children of parents with cachectic diseases like chronic tuberculosis,
syphilis, alcoholism, etc., in which the thyroid gland is, as a rule,
found degenerated (Gamier,[31] Hertoghe[32]), are (as shown by Prof.
Perrando[33] and Garnier) born with a congenital atrophy of the thyroid.
Just as young animals with an extirpated thyroid, so these children will
not grow, and we know that cretins (degeneration of the thyroid) remain
as a rule dwarfs all their life long. We can now produce in such persons
certain and very curious changes by feeding them with thyroid extract,
and we can see them, as Hertoghe has shown, grow inch by inch in a short
period; their mental faculties improving at the same time in an
incredible manner.
Footnote 31:
Garnier: “La Thyroide dans les maladies infectieuses,” Thèse de Paris,
1899.
Footnote 32:
Hertoghe: Loc. cit.
Footnote 33:
Perrando: “Sulla struttura della Tiroide,” Sassari, 1900.
The influence of the thyroid upon the skeleton is also shown by the
fact, established by Gauthier,[34] that in a fracture with but little
tendency to the formation of a callus, union takes place much more
quickly after administration of thyroid extract.
Footnote 34:
Les Médications thyroidiennes, 1902.
In Graves’s disease, with exaggeration of the thyroid activity, there
is, on the other hand, an increased elimination of the most important
constituent of the skeletal tissues: calcium carbonate, and this occurs
also in acromegaly and diabetes, in which conditions the thyroid is very
frequently altered (Lorand[35]).
Footnote 35:
Lorand: Loc. cit.
Osteomalacia, which is associated with an enormous elimination of
calcium carbonate is, as we at present consider, due to an exaggerated
ovarian activity (Fehling), and can be favorably influenced by
castration or, by what would be more reasonable, thyroid treatment.
No less powerful than that of the thyroid is the influence of the
pituitary body upon the skeleton, especially upon the hands, feet, and
skull. And if we wish to demonstrate how much the ductless glands
influence the looks of a person, it is sufficient to point out the great
changes that take place in the face of a patient with acromegaly. This
disease makes such persons look very much as “Punch” is depicted.
The skin and complexion of persons suffering from changes in the
ductless glands are also very different from normal. Thus Addison’s
disease, due, as well known, to a degeneration of the adrenals, makes a
white man look more or less like an Indian, and there is a pigmented
skin also in persons affected by the
partial form of that rare disease. We can also easily show that changes
in the thyroid are followed by changes in the condition of the skin.
Thus, with thyroid degenerations, as in myxœdema, the skin is pale with
a yellowish tinge. In Graves’s disease pigmentation of the skin can
often be observed, and not rarely cutaneous eruptions.
In affections of the sexual organs in woman similar conditions of the
skin can occur. Such persons often present wrinkles at a very early age,
and certainly look older than their years. Infants suffering from
congenital degeneration of the thyroid gland often look withered and
present a face as wrinkled as a sexagenarian. We see this also in
congenital syphilis (atrophy of the thyroid).
The hair also very often shows alterations in diseases of the thyroid,
or ovaries. Thus, in myxœdema there is an atrophy of the follicles of
the hair, which falls out, even in the case of the eye-brows.
It is particularly interesting that, by thyroid medication, a new growth
of hair has been observed in places where it had fallen out years
previously, as we have observed, with other authors, in several cases
after thyroid medication. And, very strange to say, this newly-grown
hair was quite dark while the hair that had previously been in its place
was gray in color. It has been authentically stated by several
authorities that old persons of sixty or seventy have acquired black
hair under thyroid treatment.
On the other hand, in much younger persons, perhaps under thirty, who
are suffering from complete or partial degeneration of the thyroid
gland, the hair very often turns gray; so much so that Hertoghe
considers this to be one of the typical symptoms of such a condition.
The falling out of hair, or its turning gray, after acute infectious
diseases or after grief and sorrow, may have some connection with the
well-known changes in the ductless glands, especially in the thyroid, in
these conditions. This is made quite clear by Sajous’s demonstration
that these glands collectively govern the activity of general oxidation,
that is to say the vital process itself.
As we have previously mentioned, a moustache or whiskers may grow in
women suffering from disease of the ovaries, just as after castration or
the climacteric. It is also very interesting that a premature grayness
often occurs in cases of insanity, and can be attributed to the frequent
changes in the thyroid and sexual glands in these conditions.
The nutrition of the skin is entirely under the influence of the
thyroid. After extirpation or degeneration of the thyroid, there occurs
atrophy of the sebaceous and sudorific glands.
In myxœdema the skin is dry and never perspires. On the contrary, in
Graves’s disease, or after thyroid medication in large doses, there is
abundant perspiration.
Deposits of tartar are common symptoms in all forms of thyroid
degeneration. Retraction of the gum follows and the teeth loosen and
fall out. This is also a common symptom in diabetes, but here only in
advanced cases. In such cases there is, as we[36] have shown, an
exhaustion of the thyroid gland, which develops as a consequence of the
previous hyperactivity of the thyroid gland in the early stages of the
disease. As a rule the teeth of a diabetic only fall out in the severer
form of the disease, generally after acetone has begun to show itself in
the urine.
Footnote 36:
Lorand: “Die Entstehung der Zuckerkrankheit,” Berlin, 1903, and in
French translation, Paris, 1904.
Important changes take place in the subcutaneous tissue after
extirpation of the thyroid gland. In such cases there is either
augmentation of connective tissue or of fat. Thus, in the case of a
young bull, whose history we followed, there has been an increase of
thirty pounds of fat within a few months after extirpation of the
thyroid. The same thing happened in the case of a young horse, whose
thyroid was also extirpated.
There are, however, still more facts which show the great influence of
the thyroid upon the metabolism of fat. Thus we know very well that by
thyroid medication we are able to reduce fat considerably. This is due
to the action of the thyroid which, as shown by many authors, increases
the process of oxidation. In Graves’s disease these processes are
augmented. In the opposite condition (myxœdema) they are diminished. By
giving thyroid extract we are able to augment, positively, the processes
of oxidation in the tissues, as shown by Professor Magnus-Levy,[37] of
Berlin, and many others.
Footnote 37:
Magnus-Lévy: “Der Stoffwechsel bei Erkrankungen einiger Drusen ohne
Ausführgang,” in v. Noorden’s “Handbuch der Pathologie des
Stoffwechsels”, vol. ii, Berlin, 1907.
As we have shown in our previous researches, there is an abundant
formation of fat in the early cases of degeneration of the thyroid
gland, which sometimes progresses to a colossal obesity, which obesity
has nothing to do with overfeeding. Such individuals have, as a rule,
but poor appetites, and eat very little. Therefore, in a communication
to the French Congress of Internal Medicine in Paris, 1904, we
differentiated two kinds of obesity: 1. _Exogenous obesity_—i.e.,
arising by agencies coming from without by the food we introduce into
our body. 2. _Endogenous obesity_, having its origin within our economy,
and depending on changes in certain glands which govern the processes of
oxidation—e.g., thyroid sexual glands, pituitary body. This second form
is independent of our feeding. As we have shown, this latter can be
produced by any of those agencies which are harmful to the ductless
glands, especially the thyroid and sexual glands, as, for example,
infectious diseases, frequent pregnancies, certain toxic products
(alcohol), sexual excesses, climateric. All these conditions may have
the effect of producing obesity, which can be explained by an exhaustion
of the thyroid and ovaries following a pre-existing hyperactivity.
The influence of the ovaries upon the production of obesity can be
demonstrated by the sequels of castration, and also by the fact that
women, after one or more, especially several pregnancies, or after
sexual excesses, may become very fat. In such women this obesity may be
only partial and limited (as we have shown in a recent communication to
the International Congress of Medicine in Lisbon, 1906) to certain
parts—e.g., the mammary glands or hips.
There can be no doubt that the sexual glands influence the nutrition of
the tissues in a powerful manner, and this has also been shown,
experimentally, by the researches of two Berlin experimenters,
Professors Loewy and P. I. Richter,[38] performed in the physiological
institution of Professor Zunz. These savants have shown that after
castration there is a diminution of oxidation. By giving extracts of
dogs’ testicles to castrated male dogs, they were able to augment the
processes of oxidation. These processes, however, were still more
increased after the administration of female extracts to these castrated
male dogs. The administration of ovarian extracts to the spayed bitch
has, of course, given still better results. Thus there was here an
increase of 67.7 per cent. after castration, and 37.6 per cent. of the
original value. The increase of the oxidation in male dogs was 44.5 per
cent. after castration, by the treatment with ovarian extracts, and 24.8
per cent. above the normal value. If the results after feeding with male
extracts were not so successful, it must be attributed to the
circumstance that we are at present unable to produce testicular
extracts of the same efficacy as ovarian extracts.
Footnote 38:
Loewy and Richter: Archiv für Anat. u. Physiologie, Supplement, 1899,
and Berliner klin. Wochenschrift, 1899.
The action of the pituitary body upon metabolism has been shown by
Narbuth, who found a diminution of oxidation after degeneration of the
pituitary body, and an increase after medication with extracts of the
same organ. This fact is also shown clinically by cases of obesity after
degeneration of the pituitary body in acromegaly, and by the interesting
fact (shown by a great number of authorities and recently by
Fröhlich,[39] Berger,[40] and Erdheim[41]) that cases of pituitary tumor
may be met with, associated with obesity, and without any of the
symptoms of acromegaly. Especially interesting is the case of
Madelung[42] showing a colossal obesity in a girl aged 9 years, after a
gunshot injury of the pituitary body. This observation sustains, and is
clearly explained by, Sajous[43] who showed that the posterior or neural
lobe of the pituitary body contained a nerve center which governed the
functional activity of the thyroid, and that the secretion of the latter
insured the catabolism of fats by increasing their vulnerability to
oxidation.
Footnote 39:
Wiener klin. Rundschau, p. 78, 1901.
Footnote 40:
Zeitschrift für klin. Med., liv, p. 5, 6.
Footnote 41:
Ziegler’s Beiträge, 1903.
Footnote 42:
Archiv für klin. Chirurgie, p. 1066, 1904.
Footnote 43:
Sajous: “Internal Secretions, etc.,” vol. ii, 1907.
The external appearance of such cases of obesity, which we have
described before the French Congress of Medicine in 1904, and the London
Pathological Society, February 21, 1905, as endogenous obesity, is also
clinically different from the appearance of those caused by overfeeding.
As we have shown, persons addicted to rich food, with little exercise,
are often red in the face, and are plethoric; they easily become
overheated and perspire freely. They seldom complain of constipation. On
the other hand persons suffering from endogenous obesity generally look
pale, always complain of cold and dry skin, and perspire very seldom, if
at all. As a rule they are also very constipated.
There is still another ductless gland which influences metabolism in a
powerful way. This is the pancreas which, by its three enzymes, brings
about the assimilation of the proteid carbohydrate and fatty materials.
To these may also be added its production of labferment. By its internal
secretion, which is probably produced by the islands of Langerhans, it
aids in the oxidation of the sugar, introduced into our alimentary canal
in the shape of starchy food, or contained in the carbohydrated radicle
of the albuminous molecules, as demonstrated by Pavy. The entire
degeneration of the pancreas, especially of the part containing the
islands of Langerhans, produces a disease that is, as a rule,
characterized by loss of weight and the production of emaciation often
to an astonishing degree—i.e., diabetes.
Persons suffering from the milder form of this disease often present a
rosy and healthy appearance, and as we have pointed out previously,
often look younger than their age. We believe that, as we shall show
further on, this fact is not without relation to the condition of the
thyroid in this disease. We have shown by researches made in the
laboratory of Professor Minkowski, then of the Augusta Hospital in
Cologne, that in diabetes the thyroid contains large, sometimes
enormous, quantities of colloid substance, thus indicating a condition
of thyroid hyperactivity.
As we have mentioned in the first chapter, corpulence is often one of
the first symptoms of old age, and we have also insisted upon the fact
that this can be brought about by infectious diseases (e.g., typhoid,
pneumonia, scarlet fever, etc.). As we have also mentioned the fact, in
the first chapter, that old age can be brought about by an infectious
disease which acts upon the ductless glands, especially the thyroid, we
believe it will be necessary to enter a little more in detail into this
subject, to which we will devote the next chapter. We will enlarge upon
the fact that our immunity against infectious diseases is entirely
dependent on the proper working order of certain ductless glands.
------------------------------------------------------------------------
CHAPTER III.
ON THE AGENCIES WHICH GOVERN IMMUNITY AGAINST INFECTIONS AND
INTOXICATIONS—THE ORIGIN OF FEVER.
FROM the moment of our birth we are constantly exposed to the incessant
attacks of innumerable bacteria and to the effects of a large amount of
poisonous material formed within our body or introduced from without,
and if we survive this ceaseless battle it is due to the powerful weapon
we possess in the internal secretion of the ductless glands, especially
of the thyroid gland. That this gland possesses very energetic antitoxic
properties can be shown by the fact that when it is extirpated animals
or persons very readily acquire infectious diseases of all sorts. Thus,
the late Professor Charrin,[44] of Paris, showed several years ago how
readily dogs that have lost their thyroid succumb to all possible
infections. Professor W. S. Greenfield,[45] of Edinburgh, has found that
persons suffering from myxœdema (athyroidia) very often die from
tuberculosis, and Professor Pel,[46] of Amsterdam, found a great
frequency of tuberculosis in the families of myxœdematous persons. This
coincides with the conclusions of Prof. G. R. Murray,[47] Professor
Lanz, and ourself, that the properties of the thyroid can be inherited.
Sajous has shown, moreover, that the pituitary, the adrenals and the
thyroid constituted the autoprotective mechanism of the body against
disease, a fact not only sustained by the above evidence, but also by a
vast number of additional facts.
Footnote 44:
Charrin: “Les Defenses naturelles de l’organisme,” Paris, 1898
(Masson).
Footnote 45:
Greenfield: Quoted after Ewald, “Die Erkrankungen der Schilddrüse,”
Nothnagel’s Handbuch, Wien. p. 159, 1896.
Footnote 46:
Pel: “Myxœdema,” Volkmann’s Sammlung klin. Vorträge, 1895, No. 123.
Footnote 47:
Murray: “Diseases of the Thyroid Gland,” Part i, London, 1901.
As we showed at the last Congress of Tuberculosis in Paris, 1905,
tuberculosis is especially frequent as a sequel to any process
deleterious to the thyroid gland, as after the puerperium, especially
with prolongated lactation; after sexual excesses, as there is a
relation between the sexual glands and the thyroid; after various
infectious diseases; after rapid growth in puberty, due to hyperactivity
of the thyroid which influences the growth of the body; after severe
diabetes due to exhaustion of the thyroid; and after previous
hyperactivity in chronic alcoholism due to the action of alcohol upon
the thyroid. On the other hand, all those agencies which excite thyroid
activity may be a preventive against tuberculosis, such as raw meat and
milk. It has been shown that milk contains the internal secretion of the
thyroid.
The thyroid protects us against poisons of different origin, such as the
products of decomposition of protein food. This fact is shown by the
experiments of Dr. Leo Breisacher, of Detroit,[48] formerly assistant of
the late Professor Munk, of Berlin, and from those of Dr. Blum,[49] of
Frankfort. The experimental results of Dr. Chalmers Watson,[50] showing
alteration of the thyroid in certain animals after an exclusive diet of
raw meat, and those of Dr. D. Forsyth[51] concerning the pituitary body
in some animals, may be correlated with this fact. As is well known, the
thyroid and pituitary body stand in very close relationship. Galeotti
and Lindemann,[52] in 1897, have also shown that the products of
decomposition of meat produce an increase of the colloid substance of
the thyroid.
Footnote 48:
Breisacher: “Untersuchung über die Gland Thyroidea,” Archiv für
Anatomie und Physiologie, Suppl., Bd., p. 509, 1889.
Footnote 49:
Blum: Pflüger’s Archiv, vol. xc., p. 285, 1902; Archiv für die
Gesammte Physiologie, p. 617, 1902.
Footnote 50:
Chalmers Watson: The Lancet, p. 347, Feb. 11, 1905.
Footnote 51:
Forsyth: The Lancet, p. 154, Jan. 19, 1907.
Footnote 52:
Lindemann: Virchow’s Archiv, p. 202, 1897.
The antitoxic properties of the thyroid against different products is
also shown by the observations of Lanz[53] and Walter Edmunds,[54] who
have found that animals without thyroid resist narcosis badly; and, as
we have shown in a communication to the Paris Biological Society,[55]
chloroform, like alcohol, produces a condition of hyperactivity in the
thyroid gland, which results also in an excited mental condition. The
observation that cases of Graves’s disease and of severe diabetes cannot
stand narcosis may be related to this fact.
Footnote 53:
Lanz: Zur Schilddrüsenfrage, Leipzig, 1894.
Footnote 54:
W. Edmunds: The Lancet, May 11th, p. 1317; 18th, p. 1381; 25th, p.
1449, 1901.
Footnote 55:
Lorand: C. R. de la Société de biologie, 1906.
It has been shown recently by Hunt[56] that the thyroid protects us
against poisons like acetonitril, and that iodine acts through the
thyroid. Garnier,[57] of Paris, has found that certain chemical
products, such as iodine, produce great alterations in the thyroid. As
is well known, cases of Graves’s disease (hyperthyroidia) have been
observed after iodine treatment. That the thyroid fulfils a protective
rôle against infectious diseases may already be considered proved by the
fact that, as Roger and Garnier,[58] Crispin,[59] Torre,[60] Bayon,[61]
of Würzburg; de Quervain, and others have found, the thyroid is, as a
rule, altered in infectious diseases. As Roger and Garnier have shown by
a series of investigations confirmed by the above-named authors, the
thyroid shows in acute infectious diseases with fever an increased
activity with enlargement of the follicles, which are filled with a
large quantity of colloid substance which may even enter into the
adjacent lymphatic spaces. However, this hyperactivity of the thyroid
gland may be followed by its exhaustion, and thus after a certain
duration of high fever there may be no colloid substance at all in the
folliculi.
Footnote 56:
Hunt: International Congress of Physiology, Heidelberg, 1907.
Footnote 57:
Garnier: “La Thyroide dans les maladies infectieuses,” Thèse de Paris,
1899.
Footnote 58:
Roger et Garnier: Presse médicale, April 19, 1899.
Footnote 59:
Crespin: Giornale dell’ Associazione Napolitano di Medici, xii, 3.
Footnote 60:
Torre: “La Tiroide nei Morbi Infettivi,” Il Policlinico, No. 6, p.
145; No. 8, p. 226; No. 10, p. 280.
Footnote 61:
Bayon: Würzburger Abhandlungen, 1904.
It is only logical to suppose that with anatomo-pathological alterations
of the thyroid, indicating a condition of hyperactivity, there must be
corresponding clinical symptoms and that these must necessarily be
similar to those found in another condition of hyperactivity of the
thyroid gland—i.e., in Graves’s disease, the condition of
hyperthyroidia. And, indeed, such must be the case, for, as we shall try
to show, fever and Graves’s disease have similar clinical symptoms. Thus
their most typical symptom is the same: tachycardia or increased
frequency of the pulse, without which no case of Graves’s disease should
be diagnosed. There is a sensation of heat in most of the cases of
Graves’s disease, and the temperature sometimes reaches a dangerous
degree in fully developed cases of this disorder. Thirst, frequent in
fever, is also a frequent symptom in Graves’s disease (polydipsia in 14
out of 59 cases recorded by Albert Kocher[62]), and can also be produced
by thyroid feeding (Lanz,[63] Georgiewski,[64] and others). After a
certain duration of fever further symptoms of an increased activity of
the thyroid appear, such as abundant perspiration—a typical feature of
Graves’s disease. Vaso-dilatation and excessive perspiration can also be
produced by thyroid feeding. The latter symptom of fever is a device by
which nature tries to eliminate toxic products, and accordingly there
generally follows upon it a fall in the temperature and an amelioration
of the symptoms of fever. The diarrhœa which we find in some infectious
diseases, like that of typhoid fever, trypanosomiasis, etc., is also a
typical symptom in Graves’s disease. When the fever subsides there
appears another typical symptom of this condition: polyuria. To complete
this analogy we may mention toxic decomposition of proteins, diminution
in the body weight, great muscular weakness, and increased elimination
of urea and uric acid as typical symptoms of both conditions. As in
Graves’s disease, there is also in fever an augmentation of the
processes of oxidation. Glycosuria is frequent in both conditions, and
acetonuria may occur in fever and also in Graves’s disease. Glycosuria
and diabetes in consequence of infectious diseases are, as we have shown
in a paper read before the London Pathological Society,[65] probably due
to the increased activity of the thyroid, and their disappearance,
occasionally after a high fever, may be ascribed to the exhaustion of
the thyroid after a previous hyperactivity. We know that a condition of
Graves’s disease may be followed by a myxœdematous condition in which,
as we have shown previously, glycosuria is very rare. In the few
hitherto published cases there was no complete myxœdema.
Footnote 62:
A. Kocher: “Mittheilungen aus den Grenzgebeiten,” etc., 1901.
Footnote 63:
Lanz: Quoted after Buschau, Wein, 1895.
Footnote 64:
Georgiewski: Zeitschrift für klin. Medicin, Bd., xxxiii, f. 1-2, p.
153, 1897.
Footnote 65:
Lorand: Transactions of the Pathological Society of London, vol. lvii,
part 1, 1906.
Both in Graves’s disease and fever there is an augmentation of the
processes of oxidation. After convalescence, however, oxidation may be
diminished, and this explains, as we have shown at the French Congress
of Medicine in 1904,[66] why obesity so frequently occurs after
infectious diseases on the basis of degenerative changes of the thyroid,
which governs oxidation; during the course of infectious disease with
fever increased activity of the thyroid and loss of weight occur, and
these are followed by exhaustion of thyroid activity and obesity.
Footnote 66:
Lorand: Congrès Français de Médecine, Paris, 1904.
The conditions of delirium and maniacal exaltation in cases of high
fever are analogous to the condition of mental exaltation that may occur
in Graves’s disease. According to the late Moebius,[67] in cases of
Graves’s disease there are sometimes symptoms like those of alcoholic
intoxication due to the toxins of the thyroid. We believe that the
mental exaltation in chloroform narcosis and alcoholic intoxication
stands in relation with the action of these drugs upon the thyroid. That
alcohol acts upon the thyroid has been shown by de Quervain,
Hertoghe,[68] and others. Sajous in his work on the “Internal
Secretions,” urges that the thyroid is not directly excited by toxins
and other poisons which produce fever, but that these toxics excite
primarily the thyroid center (or better the adreno-thyroid center, for
he holds that the adrenals are also governed by this center) thus
increasing the secretory activity of the gland. The correctness of this
view is proved by the fact that, as shown by Sawandowski,[69] section of
the basal tissues, and, therefore, between the pituitary and the bulb,
prevented the production of fever, due to putrid materials, and also the
influence of antipyretics, antipyrin, for instance.
Footnote 67:
Moebius: “Die Basedow’sche Krankheit,” Nothnagel’s Handbuch, second
edition.
Footnote 68:
Hertoghe: “Die Rolle der Schilddrüse,” etc., München, 1900; and
“Paludisme et Myxœdème,” Progrès médical Belge, No. 2, 1902.
Footnote 69:
Sawandowski: Centralbl. f. d. med. Wissensch. B. xxvi, S. 145, 161,
1889.
Cutaneous eruptions may occur in fever or in Graves’s disease. In the
same way as in many skin diseases they may be considered as the
expression of an elimination of toxic products through the skin.
All the above symptoms of fever may be considered as expression of the
efforts of nature to defend herself by eliminating toxic products. All
toxic products which are the causes of infection act upon the thyroid
gland, this organ, through increased activity, produces symptoms such as
we see in Graves’s disease. That these symptoms, especially abundant
perspiration, polyuria, and diarrhœa, typical in some infectious
diseases, may be considered as the direct consequence of thyroid
activity, can best be shown by the fact that the thyroid gland governs
the functions of the skin, intestines, and kidneys.
That the symptoms of fever may be considered as due to increased thyroid
activity is also shown by the fact that nearly all such symptoms may be
produced by thyroid preparations. We have personally taken for
experimental purposes, during ten months, thyroid tablets and
experienced the sensation of heat, flushings, and abundant perspiration.
It is interesting to note that all kinds of wounds and contusions we got
during the time we took these tablets, healed with surprising rapidity
with fine granulations far better than previously; on the other hand, we
very frequently suffered from tonsillitis and acne eruptions.
Symptoms similar to fever have also been produced in animals by thyroid
feeding; thus, very often elevation of the frequency of the pulse from
100 to 140-160 beats (Lanz), and from 150 to 200 beats (Georgiewski),
while Ballet and Enriquez[70] produced regular fever in their animals;
Easterbrook[71] also produced “some pyrexia” in his animals and an
increase of pulse-rate of about 40 a minute. As Dr. Tanberg, former
assistant of the Physiological Institute in Christiania, told us, he has
produced an increase of the temperature of two and a half degrees in
animals, whose thyroid he had extirpated, after giving very large
quantities of thyroid gland.
Footnote 70:
Ballet and Enriquez: Quoted after Buschau.
Footnote 71:
Easterbrook: The Lancet, p. 546, August 27, 1898.
It is of great interest to the question at issue that the remedies which
we employ to fight fever should also produce symptoms like the thyroid
does when it is in increased activity. Thus salicylates produce a
vaso-dilatation and abundant perspiration, and afterward diminution of
the temperature. We have, ourself, taken salicylates or acetonitril
preparation and felt the sensation of heat and afterward perspiration.
When we take a hot air or steam bath for cold or gouty pains we produce
first, great heat, tachycardia, and then abundant perspiration, and the
typical symptoms of fever or increased thyroid activity.
We know that certain drugs, as found by Garnier, have an exciting action
upon the thyroid, such as iodine, and what is especially important,
pilocarpine. The great sudorific action of this drug may stand in some
relation to its effect upon the thyroid. It is permissible to suppose
that the different drugs which antagonize fever do so by acting first
upon the thyroid gland and exciting its increased activity to fight
infection. But if we gave too much of these we might exhaust the
activity of the gland in the same way as Garnier found an exhaustion of
the colloid of the thyroid after too much iodine. This shows that we
should not give antipyretics in too large doses. We should excite
thyroid activity but not overdo it.
That the thyroid is able to protect us against infectious diseases can
be best shown by the fact that it exercises a great influence upon
phagocytosis. According to the findings of Fassin, the alexins disappear
from the blood after the extirpation of the thyroid gland; and,
according to Sir Almroth Wright, the production of opsonins is dependent
upon internal secretions. Hence, it is of the greatest value to us that
Stepanoff[72], and Marbé have proved by experiments conducted in the
Pasteur Institute of Paris that the opsonins disappear after the
extirpation of the thyroid gland but increase after thyroid treatment,
these experiments thus proving the correctness of our clinical
observations on the rôle of the thyroid gland as an organ for protection
against infections, as published in _The Lancet_ two and one-half years
ago. Sajous, who was first (1907) to point out that the thyroid
secretion was the agent which Wright termed “opsonin,” is also shown to
have been right by the investigations of Fassin, Stepanoff and Marbé,
thus proving further the intimate relationship between the thyroid and
our immunizing functions.
Footnote 72:
Stepanoff: Comptes Rendus de la S. B. de Paris, 1908.
Fever can be produced with similar symptoms by toxic products of
different origin, as from small elements of the vegetable kingdom like
bacteria, certain plants, and even fruits, as is shown by the urticaria
which follows in some persons after eating strawberries. Certain minute
elements of the animal kingdom have a similar power, such as protozoa
like trypanosomes, and we may also instance certain kinds of animal food
like oysters in certain persons, the poison of snakes, and certain
insects like tarantulas and scorpions; also certain minerals like
arsenic and phosphorus can produce fever. Besides these poisons coming
from without, fever with similar symptoms can also be produced by
poisons formed within our body by the hyperactivity of a gland—the
thyroid. When so many different poisons produce the same result it lies
near to suppose that they do this by means of the same agency, which,
according to the aforesaid observations, is very probably a thyroid
hyperactivity. The _modus operandi_ of all these agents is well studied
in Sajous’s work, to which the reader is referred.
As is well known, a condition of hyperactivity of the thyroid may be
followed by its exhaustion, and thus Graves’s disease may often be
followed by myxœdema, i.e., athyroidia. In the same way the
hyperactivity of the thyroid gland in infectious diseases may also be
followed by its exhaustion and a myxœdematous condition. Even complete
myxœdema most frequently appears after a previous infectious disease—a
fact recognized by the earliest English authors on this disease.
Accordingly, it is not surprising if an infectious disease like
trypanosomiasis is followed by a condition like sleeping sickness,
which, as we have shown at the German Congress for Internal Medicine in
1905, presents all the clinical symptoms of, and identical
anatomico-pathological alterations of the central nervous system noted
in, myxœdema. On the other hand, trypanosomiasis presents all the
typical symptoms of Graves’s disease. In syphilis also, after the fever
with eruptions in the secondary stage, in which we not infrequently see,
especially in women, a swelling of the thyroid, we find in the tertiary
stage many symptoms of a condition of myxœdema or hypothyroidia, and
with the iodine treatment we add to the blood the main element of the
thyroid gland. Iodine is also especially active, if not given in too
large doses, in exciting thyroid activity, and sometimes it even
provokes Graves’s disease.
Persons of healthy constitution with a good working thyroid may get the
sensation of heat and perspiration spontaneously after a cold, or gouty
pains, even without salicylates, and feel better afterward, whereas
persons with a deficient thyroid have difficulty in producing the
symptoms of fever. Recently we observed a young man, aged 22 years, with
symptoms of hypothyroidia as described by Hertoghe, who had follicular
tonsillitis. He presented none of the symptoms of fever, but it took him
ten days to get over it and he felt very weak afterward. There was this
summer an epidemic of typhoid fever in the lunatic asylum of Colorno,
near Pavia. We have it from Dr. Gassenghi, of the University of Pavia,
that half of the patients died; but it is very interesting to note that
there was no fever. This may be explained by the fact that many cases of
insanity and idiocy stand in etiological relation to alterations of the
thyroid gland, and may get better after the hyperactivity of the thyroid
through fever. Indeed, by some authors,—e.g. Wagner—an improvement has
been observed to occur in insanity by producing fever through injections
with tuberculin. We feel sorry not to be able to enter more fully into
this interesting subject, but we may briefly mention that, as we have
stated in the Neurological Society of New York (April 2, 1906), we have
observed several cases of dementia præcox and melancholia with
alterations of the thyroid and sexual glands in each case. Alcoholics
suffering from pneumonia seldom get high fever, but often die in a short
time. Alcohol in large quantities not only causes degenerative changes
in the heart, but also in the thyroid. And we should not forget that
there exist very close relations between the activity of these two
organs.
It seems to follow from these observations that persons with a good
sound thyroid have a better chance in fighting infections and
intoxications than persons with a degenerated thyroid. In persons with
an active thyroid, an increased activity of the gland, and thus a better
functioning of the eliminative organs which are governed by it, can take
place more easily than in persons with a degenerated thyroid, and, in
consequence, with a dry skin, constipated bowels, and lazy kidneys. Some
hints may be derived from these observations in the interest of
prophylaxis and prognosis, and also for the purposes of life insurance.
It seems to us that the conclusion is not unjustified, that fever is a
beneficial process of our organism which is produced by an increased
activity of the thyroid gland as a reaction against toxic products and
poisons in general. The symptoms of fever are the expression of this
increased activity, and they are directed toward the elimination of
noxious elements. It would be unreasonable to oppose this spontaneous
healing tendency of nature by fighting these salutary symptoms, unless
there be hyperpyrexia. Fever, as probably disease in general, serves the
ends of nature in the interest of our conservation. In addition to the
thyroid, the other ductless glands protect us from infections and
intoxications. Thus, the pituitary body which Casselli,[73]
Guerrini,[74] Torri, and many others found, as a rule, altered through
infectious diseases. Torri noticed a hyperplasia of the chromophile
cells of the pituitary body, and disappearance of the colloid from the
follicles in the majority of cases of pneumonia, typhoid fever,
tuberculosis, diphtheria, and other infectious diseases. Garnier also
noted changes in this gland in chronic tuberculosis. Thaon,[75] in his
recent thesis, also found changes in the pituitary body in many cases of
various sorts of infectious disease, and, what is most interesting, also
in intoxications from intestinal origin. We must conclude with Sajous
(1903) that the pituitary body reacts to the effects of infections and
intoxications and that these anatomo-pathological alterations of the
pituitary also provoke clinical symptoms. Renon[76] and Delille have
drawn attention to the fact that the decrease of the blood-pressure, and
increase in the number of pulsations, in fever, as also the other
symptoms of this condition, such as insomnia, heat, perspiration, etc.,
are due to the alteration of the pituitary body. When this is active and
healthy it augments blood-pressure, according to Oliver and Schäfer,[77]
Cyon, Livon, Garnier, Thaon, Hallion, and Carrion, etc. At the same time
the pulse is diminished, but when this gland is degenerated the pressure
naturally falls and the pulsation goes up.
Footnote 73:
Studie anatomici e sperimentali sulla psycho-pathologia della glandula
pituitaria, Reggio Emilia, 1900.
Footnote 74:
Revista di Patol, nerv. e mentale, Nov., 1904; and La Sperimentale,
lviii., 1904.
Footnote 75:
Thèse de Paris, 1907.
Footnote 76:
Société de therapeutique, Jan. 22, 1902.
Footnote 77:
Journal of Physiology, t. xviii, 1895.
It is also very interesting that Renon, with his assistants, Delille and
Azam,[78] were able to increase blood-pressure in numerous cases of
infectious diseases and diminish the pulse, and also produce a marked
improvement in the feverish condition through the administration of
extracts of the pituitary body.
Footnote 78:
Azam: Thèse de Paris, 1907.
We must insist on the fact that the thyroid and the pituitary body are
antagonistic; the thyroid diminishes, the pituitary augments,
blood-pressure. The same antagonistic relations exist also between the
thyroid and adrenals, as already mentioned.
The adrenals play an important rôle also in the defense of the organism
against infections and intoxications, as we will point out in a separate
chapter. We will only recall here that already (1903) Sajous[79] has
insisted upon the important rôle of the adrenals in the production of
fever.
Footnote 79:
“Internal Secretions,” vol. i, p. 33.
The co-operation of the sexual glands in protecting the body from
infectious disease can be shown by the fact found by Professor
Cornil,[80] of Paris, that in infectious diseases, such, for instance,
as typhoid fever, there is frequently sudden menstruation, with abundant
metrorrhagia, the autopsy often showing hypertrophy of the corpus
luteum.
Footnote 80:
Quoted after Loisel.
Metschnikoff[81] and Matschinski found, after injections of the bacilli
of tetanus, or of diphtheria, the greatest number of them in the
ovaries, or in the testicles, of the animals. It is also of great
interest that Lingard[82] found that the subcutaneous injection of
testicular extracts into cattle induces a resistance to infection from
bovine plague, against which other cattle can also be rendered immune
through the serum of the treated animals—which seems very important to
us. Brown-Sequard and d’Arsonval employed testicular extracts with good
result in tuberculosis, and Uspenski in cases of Asiatic cholera.[83]
Footnote 81:
Metschnikoff: Annales de l’institut Pasteur, 1900.
Footnote 82:
Lingard: Centralblatt für Bacteriologie, vol. xxxviii, Nu. 2, p. 246.
Footnote 83:
Comptes Rendus de la Société de Biologie de Paris, Nov. 5, 1896.
In the chapter on the treatment of old age by organic extracts, we
submit evidence showing that infectious diseases have been treated
successfully by several authors by these extracts. Many others have also
shown that spermin, prepared by Professor Poehl from the testicles of
various animals, has also a marked effect against different infectious
diseases, sometimes even in cases of desperate septicæmia. It has been
shown by Professor Loewy and Dr. Richter, that after giving spermin
there is at first a great diminution of the leucocytes in consequence of
leucolysis, which is soon followed by hyperleucocytosis, and at the same
time there was considerable increase of alkalinity in the blood.[84]
Footnote 84:
Richter: Organotherapie.
Loewy and Richter were able to cure animals by injecting spermin even in
cases of experimental pneumonia, where they had received three or four
times the fatal dose of pneumococci. These observers also tried spermin
in diphtheria, but here the results were less marked, although in some
cases where the exact fatal dose was given, a cure was effected.
According to Professor Poehl[85] the increase of alkalinity of the blood
through spermin, explains its action to increase immunity against
infection. Sajous also urges that immunity is closely related with
alkalinity.
Footnote 85:
Poehl: Organotherapie, vol. i, St. Petersburg, 1905.
It is interesting to observe that spermin has also given good results in
intoxication through leucomaïnes, which play a great rôle in
auto-intoxications in the body. This applies to neurin and cholin, as
noted by Professor Prince Tarchanow, and Dr. Poehl.
We have already mentioned that the thyroid protects us against various
poisons, such as chloroform, and it is of interest to note that the
testicles may also have a similar action; for, as Tarchanow has shown in
frogs, and also dogs, after injection of spermin, these animals were
better able to resist chloroform narcosis, and could also withstand a
greater dose of it. Weljaminoff found the same also in man. Krüger found
that this applied also to ether narcosis.
The liver, as we shall show later in a separate chapter, also
antagonizes intoxication. Another organ in close relation to the
ductless glands—especially in infants—the thymus, must also be
considered in the same way as the spleen as taking an important part in
our protection against infections. As well known, the spleen is a
foremost organ for the production of protective substances, the frequent
swelling of the spleen in infectious diseases shows its co-operation in
the defense of the body (see also Chapter X). Respecting the thymus, it
has been shown by Brieger, Kitasato, and Wassermann, that cultures of
cholera bacilli lose their toxic action in extracts of the thymus.
There can be no doubt whatever, from the foregoing, that our immunity
against infections and intoxications depends on the intact condition of
the ductless glands, the great importance of which, as defensive organs,
has been demonstrated and explained by Professor Sajous in 1902.[86] As
he says: “The overactivity of the adrenal system is the inciting factor
of leucocytosis, and, therefore, of phagocytosis;” and later in the
second volume: “that the adrenal system, composed of the pituitary body,
the adrenals, and the thyroid apparatus, constitutes the immunizing
mechanism of the body.”
Footnote 86:
Sajous: “Internal Secretions,” vol. i, p. 624, 1903 (see also vol. ii,
p. 13, 1907).
When the ductless glands are not in good working condition, there are
three principal things which can occasion infection or intoxication.
These are deficient nutrition, exposure to cold, and a depressed mental
condition. By these the resistance of the cells against the energy of
the invading microbes is lowered, and the greater the invasion the
easier will be their victory.
We will often refer to this in the chapters on personal hygiene, and
propose certain remedies for avoiding these predisposing sources of
infection and intoxication.
------------------------------------------------------------------------
CHAPTER IV.
ON THE AGENCIES THAT GOVERN THE CONDITION OF THE NERVOUS SYSTEM AND
MENTALITY.
BY treating with thyroid extracts a child that has remained backward in
his mental development we can make a curious observation. The child who
had previously been a cretinous idiot will not only improve bodily but
also mentally, and he will be transformed into an intelligent being with
normal mental faculties. The logical deduction is that the thyroid must
influence powerfully the condition of our nervous system and mentality.
Indeed, the physiological activity of the nervous system and mentality
depends entirely on the co-operation of the ductless glands with
internal secretion. In fact, we do not think we are going too far in
saying that the condition of the nervous system and mentality is mainly
governed by these glands. The truth of this assertion is shown by the
fact that any alteration of these glands, especially the thyroid and
sexual glands, and pituitary body, is always followed by alterations of
the nervous system. This is strikingly sustained by the elaborate
researches of Sajous who found that the reactions of fluids circulating
in all nervous elements corresponded with those of internal secretions
and particularly that of the adrenals.
Removal of the thyroid also produces far-reaching anatomical changes in
the central part of the nervous system which, as we have mentioned, has
been described by Albertoni, Tizzoni[87] Blum,[88] Walter Edmund,[89]
and others. These consisted of the destruction of nervous cells and
nervous processes, chromatolysis, and also the augmentation of the
neuroglia, which increases in the same way as the connective tissue in
all other organs and tissues.
Footnote 87:
Arch. per le scienze Mediche, vol. x., p. 45, 1886.
Footnote 88:
Blum: Virchow’s Archiv, 1899.
Footnote 89:
Walter Edmunds: Transact. of the Path. Soc. of London, vol. liii.,
Part 3, p. 343, 1902.
These changes have been found by Whitwell[90] also in myxœdematous
persons. In accordance with these anatomo-pathological changes we must
also expect clinical symptoms, and we shall thus find in persons with
degenerated thyroids an idiotic condition termed cretinism, while in
persons suffering from myxœdema mentality is considerably altered. Thus
Pilcz[91] notes as typical symptoms of myxœdema: slowness of thought,
apathy, defective memory, and somnolence. In fact, after removal of the
thyroid gland or after its degeneration by disease, we observe changes
in all those functions which, according to our present knowledge of
physiology, are situated in the cortex cerebri, such as intelligence,
power of imagination, will power, memory, sleep, etc. The thyroid must
govern these functions, as they are seriously damaged after the
degeneration of this gland. Thus, myxœdematous people think and speak
very slowly, have a weakened intelligence, are completely apathetic, and
have no will-power, and the memory is either gone or is defective. In
the same way, as in old age, myxœdematous people can remember events
which have happened a long time ago, but cannot do so as regards recent
events—all facts we explain by assuming they are able to remember what
has happened at the time prior to the degeneration of the thyroid; but
after such a condition they are not able to mirror recent events in the
greater brain. The wonderful effect of the thyroid on intelligence can
be observed, as above mentioned, in backward or cretinous children who,
by means of the thyroid extract, become intelligent children gifted with
a better memory. We, ourselves, through personal observation and
experiments, observed the fact that thyroid tablets improve the memory
(see also Chapter LIII), and it is interesting to mention here the case
of a very stout patient who, after the first day of thyroid treatment,
felt in such a condition of mental activity that he sat down, in the
middle of the night, at his writing table to compose a scientific
article instead of going to sleep. We did not mention to this
gentleman—a lawyer—anything about the effects that the thyroid might
have. Dr. Hertoghe, the well-known authority on the thyroid gland, told
us that he sometimes takes before strenuous mental work, such as the
delivery of a lecture, three or four thyroid tablets at a single dose.
We must not, however, allow ourselves to be seduced to thyroid
medication by the action of thyroid on mentality, unless the condition
of our gland demands it, for the administration of such extracts in
large doses and without special diet and precautions may produce
disagreeable symptoms, a description of which we will give in a special
chapter on the treatment of old age by means of extracts from the organs
of animals.
Footnote 90:
Whitwell: British Med. Journal, p. 730, Feb. 1892.
Footnote 91:
Quoted after Oppenheim: “Lehrbuch der Nervenkrankheiten,” p. 1383,
Berlin, 1906.
We have also frequently seen a marked improvement in the mental
faculties of adults through thyroid treatment. Thus last winter, during
a stay in Nice, we were consulted by an American lady of 69 years who
was suffering from arteriosclerosis and dizziness. Through thyroid
treatment the intelligence of this lady improved so much that it became
very noticeable to her English trained nurse, who told us that whereas
before she could do anything with this mentally torpid woman without
comment, now she first demanded to know the reason for everything before
she complied with the dietary and hygienic measures the nurse wanted her
to follow.
That the thyroid gland affects the intellect is also proved by the very
important fact that the serum of animals whose thyroid has been
extirpated, and which is thus antagonistic to the thyroid gland, is able
to impair the intellect. Dürig[92] noticed this after using large doses
of such serum in a woman with Graves’s disease, thereby causing an
appearance of great stupidity, loss of memory, and incapability of
thinking, so that he had to suspend the treatment. These symptoms
continued for fourteen days after the treatment had been discontinued.
Footnote 92:
Dürig: Münchener Med. Woch., 1908, Nu. 18.
Sleep is also one of the functions controlled by the thyroid, and as its
changes are able to promote senility, we believe it will be well to
discuss this more fully in a special chapter (XLIII).
We cannot recall any alteration of the thyroid gland that is not
accompanied by nervous symptoms. In Graves’s disease (exaggerated
activity of the thyroid) we observe a condition of great nervousness, so
much so that, according to some authorities, Graves’s disease may be
termed a neurasthenia with tachycardia. There are many women treated for
simple hysteria who are, in fact, suffering from a partial form of
Graves’s disease with its cardinal symptom: tachycardia. In cases of
Graves’s disease we often find conditions of exaltation, even manias,
and very frequently, at the very least, great irritability. On the other
hand, in myxœdema there is, usually, a condition of melancholia, and it
is interesting in this connection, that in a number of cases of
melancholia we have found a swelling of the thyroid with a cessation of
the menstrual flow; such cases improved after thyroid treatment,
particularly when conjoined with treatment by ovarian extracts. In the
lunatic asylum of Pontiac, Michigan, some 100 cases of swelling of the
thyroid have been traced out of 600 insane inmates, as we heard on the
occasion of our visit to our friend, Dr. Edwin S. Sherril, of Detroit,
four years ago.
As we have seen already, the thyroid stands in very close relation to
the ovaries, and, as we have often stated, the alteration of the
ovaries is very apt to produce a swelling of the thyroid, as witnessed
during menstruation, puberty, pregnancy, the puerperium, lactation,
and the climacteric. Not only may the thyroid swell in many of these
conditions, but the mental system is also changed during each of these
processes. Sometimes it may be simple irritability, but at times the
changes of the mind may develop into lunacy. Thus, in young girls, we
occasionally see in the years of puberty mental changes, such as a
tendency to wandering away from home, and even cases of lunacy, the
so-called psychoses of puberty. Similar cases of insanity are equally
frequent in pregnancy, and during the climacterium or after the
experimental climacterium—castration. Again, insanity is not
unfrequent in cases of degenerative disease of the ovaries; to such an
extent, indeed, that sometimes a gynæcologist can treat a case of
insanity in women better than a specialist in psychiatry. Not only in
women, but in men changes in the sexual organ always produce
far-reaching changes in the mind. Chronic gonorrhœa is the more to be
feared on account of its invariably involving the prostate, the
inflammation of which, in the same way as that of the testicles, is
usually followed by symptoms of neurasthenia. If we now note this and
remember that, according to Baldwin, in most cases of hysteria we may
find at the autopsy alterations in the ovaries, we shall understand
that the author of this book did not go too far when he stated, in a
communication to the Belgian Congress of Neurologists, in Brussels, in
1906, that all cases of neurasthenia and hysteria are based upon
pathological anatomical alterations, and that it is not true that, in
contra-distinction to all other diseases, these should be the only
ones without any pathological anatomical foundations. In fact, in
nearly all cases of neurasthenia or hysteria we shall find changes in
some of the ductless glands, particularly the thyroid, sexual, or
pituitary body, if we only take the trouble to search for them. The
degenerative alterations of the pituitary body are, as a rule,
followed by the symptoms of the disease called acromegaly, and this
also presents all the symptoms of a neurasthenic or hysteric
condition.
From the foregoing we shall understand why so many people, whether male
or female—possibly the latter in greater number—who live in total sexual
abstinence, present symptoms of neurasthenia or hysteria; for it has
been shown by Rigaud and also by Mingazzini, that animals, living in
total sexual abstinence, present alterations in the epithelia of the
sexual glands (see Chapter XLVII).
It would be simply hypocrisy and unworthy of a scientific work which
should always aspire to reveal the truth, were we to deny the fact that
many old bachelors and spinsters present a series of nervous symptoms,
especially dyspepsia and hyperchlorhydria and pains in the stomach, far
more than other persons, which we must explain by the action of impulses
coming from the sexual organs to the sympathetic and pneumogastric, the
principal nerves of the stomach and intestines, and thus producing a
hyperæsthesia of the nerves of the stomach. In such persons some kinds
of food, well digested by a normal stomach, will act as an injurious
foreign body, and be felt as such by the over-sensitive stomach nerves,
and the gastric glands will respond with a large flow of secretion and
much acid upon agencies that produce no such stimulation in a normal
stomach.