intercourse, will show symptoms of premature senility, as much depends
on heredity and also on the surroundings in which they live. Certainly
if they live in precarious circumstances, as do the poorer women of the
working classes in many European countries, especially Germany and
Austria, where these women perform hard bodily work and are badly fed,
and have much sorrow and care, they will soon appear old; and women
looking like matrons at thirty are of common occurence in the lower
classes of these countries. But this is seen also in the women of
southern Europe, although they do not work so hard. This is due to the
fact that in southern countries girls reach puberty early and are
married very young, in the East often at the age of twelve. Thus, sexual
activity begins earlier and ends much sooner. Its end, of course, means
the beginning of old age. As soon as retrograde changes commence in the
ovaries, the summer of a woman’s life is over; and, just as summer is
sometimes prolonged into autumn, so at this period of her life may she
still retain strong sexual desire. Happy the woman whose heart, as well
as her ovaries, undergoes a senile involution, for there is nothing more
terrible for a formerly beautiful woman than to see her charms wane
while her heart remains young.
Yvette Guilbert, in her novel the “Demi-vieilles,”[162] describes in a
picturesque manner the pangs of a woman at the climacteric age. Let us
quote a few lines: “They try to remain young, hide the gradual onset of
their ugliness, and look for a chance to taste of love again. They cry
out for the past, for even while they fight against time they cannot
detain it in its course.” This description, however, does not apply only
to the majority of middle-aged women, but more especially to
professional beauties.
Footnote 162:
Quoted after Professor Kisch.
It can be seen from these considerations how necessary it is for a woman
who has frequent pregnancies to observe the rules of hygiene. That these
produce excellent results we have proved. We know of a score of ladies
of the aristocratic and wealthy classes who, though having six or even
seven children, look none the worse. A certain Austrian archduchess
still remains a beautiful woman, in spite of her eight children and the
fact that she is a grandmother. Such examples may be frequent in old
families with this hereditary tendency. Though the bearing of many
children can hasten old age, yet, on the other hand some women, after
the birth of their first child, become better and fresher looking. We
can see this especially in girls of twenty or more who, having appeared
somewhat withered before marriage, begin to bloom afresh after the birth
of the first child. Increased activity of the ovaries and thyroid is the
explanation of this phenomenon. As already mentioned, the thyroid takes
an active part in ovarian changes. In a young girl of fourteen, just
previous to menstruation and puberty, we may find a swelling of the
thyroid gland. During menstruation we can often see a distinct
enlargement of the thyroid, and at the same time certain nervous
symptoms such as are usually connected with thyroid change.
Increased activity of the thyroid during pregnancy is shown by a
swelling of the gland, often causing a regular goiter, and, at the same
time, not infrequently by the typical symptoms of exophthalmic goiter.
Lactation is also dependent upon thyroid activity. After prolonged
lactation there is an exhaustion of thyroid activity; and, on the other
hand, by giving thyroid extract we can increase the flow of milk.
The swelling of the thyroid in the above conditions can be explained by
the greater demand for thyroid secretion, and that this hyperactivity
occurs is also shown by the observations of the early writers on
myxœdema. Morvan, Ord, and Combe found that myxœdema was frequently
caused by numerous pregnancies, especially if associated with prolonged
lactation.
This also explains why women become prematurely old so much more
frequently than men, for their ovaries are much sooner exhausted, in
consequence of their activity being much greater than that of the male
sexual glands. There is a much greater demand not only on the female
sexual glands, but also on the female thyroid, which enlarges every
month in many women, and is greatly exhausted by each pregnancy. As
Hertoghe[163] says, with reference to this exhaustion of the thyroid by
pregnancies, “each child demands one tooth.”
Footnote 163:
Hertoghe: “Die Erkrankungen der Schilddrüse und der chronische
gutartige Hypothyreoidismu,” München, Lehmann, 1900.
According to Hertoghe, pregnancies are especially apt to produce
degenerated conditions of the thyroid gland.
Sexual excesses, on account of the concomitant nervous excitement, are
also very prejudicial to the adrenals, for just as frequent nervous
excitement in general, they produce alterations in the blood-pressure
and favor the development of arteriosclerosis.
Sexual excesses are also very harmful to men, although their action on
the thyroid, in men, has not yet been ascertained. It is a fact,
however, that they diminish the resistance to infections, and favor the
onset of neurasthenia and arteriosclerosis.
Changes in the thyroid also become manifest during the climacteric, and
the troublesome nervous manifestations at this period are largely due to
this fact. Later, on account of the degeneration of the thyroid and
ovaries in many of these women, there is an accumulation of fat, of a
bacon-like character, in the same situations as was described above in
women after many pregnancies and sexual excesses—_viz._, the breasts,
the hips, and the abdomen. The facial appearance of these women who
become obese after the climacteric resembles that of a typical case of
early myxœdema. In the later stages, as old age advances, just as in
myxœdema, the fat may disappear and be replaced by great thinness and
emaciation—the cachectic stage of myxœdema. This is less frequently seen
now-a-days, on account of the improvement and checking of the disease by
thyroid treatment.
It is a very strange fact that although sexual abuses soon bring about
symptoms of old age, as do also many pregnancies, clinical observations
show that total suppression of sexual activity is also, if not still
more, a powerful factor in the production of premature senility. There
is no denying the fact that spinsters, after the age of thirty or forty,
often look older than married women with small families. See also our
chapter on the “Hygiene of the Sexual Glands” on this subject, in which
we show by experimental evidence the dangers of the total suppression of
sexual activity.
Evidently nature will not be trifled with, and the ovaries and testicles
are made by the Almighty to serve a certain purpose, just as any other
organ. Their remaining in total idleness is no less harmful than in the
case of any other organ. We fail to see for what reason this organ alone
should be made an exception, and to deny this fact would be hypocrisy.
Persons who live in total sexual abstinence are very often of a nervous,
neurasthenic, or even melancholic disposition. If we consider how
intimate are the relations of the sexual organs with the thyroid, we
cannot exclude the possibility of changes in this important gland under
such conditions.
The relationship between the sexual glands and the thyroid is also
demonstrated by experimental evidence. Thus Cecca found, after
extirpation of the ovaries or testicles, that the thyroid shows an
accumulation of colloid substance; again, Jayle saw the appearance of
exophthalmic goiter in a case after castration; and, on the other hand,
Prof. Hoffmeister, of Strassburg, found a premature ripening of the
follicles in the ovaries after thyroidectomy.
Freund constantly found goiter in cases of fibromyoma of the uterus, and
in two cases the goiter has disappeared after operation on the uterine
tumor.
It is a well-known fact that exophthalmic goiter can be improved by
ovarian extracts, as Latzko, of Vienna, and others, have shown.
Changes in the thyroid, as a rule, produce certain changes in the sexual
glands. Thus, in exophthalmic goiter menstruation is usually irregular
and often disappears. In myxœdema there is atrophy of the ovaries and
sterility. The above conditions in man often produce sterility.
In partial cases of myxœdema metrorrhagia is frequent. By giving thyroid
extracts these uterine hæmorrhages may be stopped.
After having shown that old age can be caused with more or less
certainty by degenerative changes in the sexual organs, we will now try
to show that it can also be caused by various kinds of intoxication.
Especially is this true of large quantities of alcohol continued for
many years.
Alcohol specially influences the ductless glands. Small quantities may
at first stimulate their action, but large quantities, if taken for a
very long time, will cause degeneration.
In the third chapter of this book we have already briefly mentioned the
bad effects of alcohol upon the ductless glands. We have seen that, as
de Quervain, Hertoghe, etc., have shown, alcohol produces very marked
degeneration of the thyroid gland. This has been proved by autopsies on
chronic drunkards. As well as on the thyroid, alcohol also acts upon the
other ductless glands. It acts, for instance, upon the adrenals. Its
action in small doses is similar to that of adrenalin. Alcohol in small
tonic doses excites the activity of the splanchnic nerves, and so may
produce an increased flow of adrenalin and a higher blood-pressure (see
Chapter XV).
Alcohol in large doses may also have a degenerating effect on the sexual
glands. Small doses can stimulate, but large doses are decidedly
harmful. Temporary impotence may result in such cases, and chronic
impotence in inveterate drinkers.
Though alcohol in large doses is harmful, and if taken in very large
quantities for many years can hasten old age, there is absolutely no
reason to suppose that in small doses it has any etiological relation to
senility. In fact, there are many cases on record of persons who have
taken alcohol, especially wine in limited quantity, every day, and have
lived to enjoy a healthy old age.
One of our confrères, a surgeon of Lotharingia named Politiman, lived to
be 140. As Professor Pel, whom we quote, says, the historian explains
that this old age was due to the medicine this worthy doctor took every
day after doing his work. He had drunk his fill every night since the
age of twenty-five years. Another surgeon, Espagno, lived to be 112 with
no less moderate habits! Countess K——, who died in Nicolajew in Russia,
a few years ago, at the age of 111 years, took daily a cordial in the
form of a good drink of cognac; and about one and a half years ago the
_Daily Mail_ of London brought to public notice the case of a Mrs.
Anderson living in Springfield, near Glasgow, who, in spite of her 103
years, was taking daily a tablespoonful of whiskey.
A strong point against the anti-alcohol faddists is the case of
Brown,[164] an Irish peasant, who, after many years of heavy
beer-drinking, attained the age of 120. His tombstone exhibits the
following epitaph:—
Footnote 164:
Quoted after Professor Pflüger.
“Here lies Brown, who became 120 only through the strong beer he was
drinking. He was constantly drunk, and in this condition so terrible,
that even death was afraid of him. When, however, one day contrary to
his habits he was sober and in a quiet mood, death got courage, seized
him, and thus at last was triumphant over this incorrigible drunkard.”
(See, further, Chapter XLI.)
All these examples merely show what we have so often insisted upon, that
everything depends upon heredity. There are many causes that produce
premature senility. It seems, also, that when only a few of these
causes, or only one, is acting, there is a possibility of a successful
fight against it. It is a different matter when all, or several, of the
causes of old age are present. As the German proverb says: “Viele Hunde
sind des Hasen Tod” (“many dogs mean death for the hare”).
It is a very interesting fact that seldom are all the various kinds of
immoderation united in the same person. Thus, some persons may drink and
smoke heartily and, perhaps as a result of the action of these poisons
upon the sexual glands, may be better able to combat their sexual
instincts. This will also explain the drinking habits of some old
spinsters or widows. They “drive out the Devil with Beelzebub,” as the
German proverb says. On the other hand, many total abstainers from
alcohol and tobacco are far less successful in combating their sexual
instincts, and for such persons marriage is a necessity.
As a rule, celibatarians show symptoms of old age much sooner than
married persons.
If among those addicted to drink there are many instances of long life,
among smokers such instances are much fewer.
As Professor Pel says, there was only one man among many, of those over
100, who was a smoker (see Chapter XLII).
It is also of interest that among very old people we find many with very
decided sexual tendencies. Evidently such persons must be in possession
of very active sexual glands, which indicates also a healthy thyroid
(see Chapter V).
We may class alcohol with tea and similar beverages. A small amount
every day may be a good thing, but in large quantities they may all
become injurious and tend to shorten life.
Tobacco, according to clinical observations (Huchard), is apt to cause
arteriosclerosis, just as alcohol in large doses; and this is also
proved by experiments—e.g., those of Isaac Adler and Hensel—which show
that atheroma of blood-vessels can be produced in animals,
experimentally, by nicotine.
Everything points to the fact that tobacco is especially injurious to
the adrenals. We will treat of this subject more fully later on when
discussing the hygienic treatment of old age.
Many conditions of chronic intoxication, and hence premature senility,
may be caused by faulty food, especially if taken in large quantity, for
a long time. Even fresh albuminous food of animal origin, if taken in
large quantity every day, may prove harmful. We have seen previously, in
Chapters III and IV, that meat produces by its decomposition certain
poisonous substances which should be destroyed by the ductless glands.
Premature old age frequently occurs in people who live a sedentary life,
and at the same time consume much rich food and alcohol. This causes
obesity, and the muscles and nerves which are little used, are prone to
show degenerative changes after a certain time. At any rate the
processes of metabolism are diminished in these structures, since their
supply of fresh arterial blood is always reduced if no work or exercise
be performed.
It is a well-known physiological fact, that nerves which are inactive
lose their excitability and degenerate. This holds good for motor
nerves, and we can also note degeneration of muscles and organs which
are not used. Thus, the nerves of an extremity, after amputation,
undergo a process of degeneration. The lower limbs of people affected
with infantile paralysis, or of persons obliged to remain in bed for a
long time, show atrophic changes. Hence we can easily see the necessity
for exercise, which increases the blood-supply to the muscles and
nerves. Work of any kind, even mental work alone, is a means of
preventing precocious senility; if manual exercise is combined with it,
it is still more efficacious.
Plutarch, in his “De educatione puerorum,” mentions that a certain
amount of work improves the mind, but excess of work is prejudicial.
We see the best illustration of this fact in American business men.
There are no men in any country who do such an amount of work, and at
the same time take so little recreation or exercise. They sit in their
offices till dusk, with a few minutes’ interval for a hasty meal,
consisting mainly of meat that has often been kept in cold storage for a
long time, after which business goes on again, at high pressure, until
the evening. Then, instead of walking home and taking exercise, they
take a car or carriage to their house or club, and pass the evening in
smoking and drinking, sometimes to excess. Day after day the same
killing of body and nerves goes on till these people look old long
before fifty, if, indeed, they reach that age. Arteriosclerosis,
diabetes, gout, and obesity find many victims among such men. It is sad
to think how many thousands of these splendid people, full of genius and
talent, could be saved for their native country if only they had been
taught in their youth the most elementary rules of hygienics. What joy
does money afford without health?
Some of the most powerful agencies in producing old age are frequent
mental emotions, especially sorrow and grief.
It is a common fact that after such emotions people soon look older. To
mention an example, there is positive evidence that young persons, after
a mental shock, have become gray in a single night, thus developing
abruptly one of the most typical symptoms of old age.
That mental emotions, especially anger, grief, sorrow, fright, anxiety,
etc., are very harmful to glands with an internal secretion, is shown by
a series of clinical observations. Sajous has in fact termed _sensorium
commune_, i.e., the center which receives all shocks, the governing
center of the ductless glands, located in the pituitary body.
With mental emotion there is often disturbance of a function,
interference with which is very liable to hasten the onset of old age,
and this is sleep.
We frequently notice that persons who have not slept well for several
nights, especially if passed on a railway journey, look worn out and
older. After a good night’s rest these effects disappear and they look
fresh and younger again.
There are other functional disturbances which are especially harmful as
they interfere with the elimination of harmful products either
introduced with the food or found in the body (e.g., uric acid). This
applies also to the bowels, perspiration, and diuresis. When these
important functions are checked, there is retention of poisonous
products and a condition of auto-intoxication. These functions are
governed by the ductless glands, especially the thyroid, as we have seen
in Chapter VI. It is easy to understand that by their interruption the
onset of old age is hastened, as these toxins will cause deterioration
and destruction of epithelium and the formation of connective tissue in
its place. Retained poisonous products play a very great etiological
rôle in the production of arteriosclerosis, which is found as a typical
symptom of old age in the large majority of aged persons.
We thus see that all those agencies which by common consent are usually
considered the most frequent causes of old age, are also very
detrimental to the ductless glands, especially the thyroid. They produce
hyperactivity, with subsequent exhaustion, in these important glands.
The pathological and anatomical changes indicating hyperactivity give
place to those of atrophy. We have given an example of this in
discussing the changes in the thyroid in infectious diseases. The
formation of connective tissue is the final result. Thus a condition of
the thyroid arises similar to that in myxœdema, which, as we have
stated, can be produced by causes similar to those which produce old
age—i.e., infectious diseases, exhaustion of the ovaries after
pregnancies or sexual excesses, mental emotions, etc.
The pathological and anatomical changes in the thyroid, consisting of an
increase in the connective tissue, as in myxœdema, will logically
produce clinical symptoms, and these symptoms are the same as those of
myxœdema.
Therefore we are justified in assuming that old age will show the same
clinical symptoms as myxœdema.
We have shown that, given changes in the thyroid gland, the other
ductless glands will be altered too; for instance, the liver and
kidneys. These glands have an important function in freeing the organism
of poisonous substances. As in old age their secreting elements are more
or less atrophied, they are unable to execute their task properly, and
these harmful products will accumulate. Now, there are important organs
which can act as corollaries to these glands. These are the intestines
and the skin. They also are under the influence of the thyroid. In
diseased conditions of the thyroid they are unable to perform their
functions regularly. The poisons will not be eliminated, and thus a
condition of auto-intoxication must arise.
Just as after extirpation of the thyroid there is an increase of
connective tissue or fat in various organs and tissues (as Demange
found), so in old age there arises a condition of sclerosis in the
tissues and organs.
On this account, strictures of the urethra are readily produced in old
men who have had gonorrhœa scores of years ago. The prostate gland,
owing to the abundant formation of connective tissue, will also enlarge,
although usually sclerosis of an organ is accompanied by diminution in
size. In the central nervous system, just as after extirpation of the
thyroid, there is proliferation of neuroglia. Through destruction of the
nerve cells those mental attributes arise that are deemed typical of old
age: Egotism, enmity against all new ideas, conservatism, etc., which we
described in our address on the origin of crime before the Philadelphia
Medical Jurisprudence Society, April 14, 1907.[165] The same mental
characteristics are also typical of degenerated conditions of the
thyroid and pituitary body, as we have seen in a case of acromegaly
whose history we owe to Dr. Dercum, of Philadelphia.
Footnote 165:
Journal of the Amer. Med. Assoc., May 17, 1907.
To recapitulate, we may state that old age is caused by degeneration of
the ductless glands, and that there exists a condition of
auto-intoxication in old age.
The symptoms of old age are the result of breakdown of the tissues and
organs which, owing to shrinking of the blood-vessels, are
insufficiently supplied with blood, and, owing to the disappearance of
nervous elements, are devoid of proper nervous control.
Degeneration of the ductless glands and of the organs and tissues cannot
be simultaneous, for the latter are under the control of the former.
These glands govern the processes of metabolism and nutrition of the
tissues, and by their incessant antitoxic action protect the organism
from the numerous poisonous products, be they of exogenous origin,
introduced with air or food, or endogenous, formed as waste products
during vital processes. After degeneration of these glands the processes
of metabolism in the tissues are diminished, and there is an increase of
fibrous tissue at the expense of more highly differentiated structures.
The fact that the changes in the tissues are secondary and take place
only after primary changes in the ductless glands, is best proved by the
circumstance that they can be produced, either experimentally by the
extirpation of certain of the ductless glands, or spontaneously by the
degeneration of these glands in disease.
Our theory as to the causation of old age by degeneration of the
ductless glands has been confirmed by several writers, some of whom had
no knowledge of our existing work.
Thus Campbell, in July, 1905, published a short note in the _Lancet_,
attributing old age to degeneration of the ductless glands, overlooking
our previous communication to the Paris Biological Society.
Two years afterward Pineles, in an article published in the _Wiener
klin. Wochenschrift_, comparing the origin of diabetes, tetany, and old
age, came to the conclusion that old age was caused by the same agency
(i.e., alteration of the ductless glands) as the other conditions
mentioned.
Sir Herman Weber, in his interesting work on the prolongation of life,
also attaches great importance to degeneration of the ductless glands as
a cause of old age.
In his work on the same subject, Professor Metschnikoff admits, only
partially, the truth of our theory on the causation of old age. He
admits the great importance of the ductless glands in the pathology of
old age, as they serve to destroy poisons. He denies, however, the
relation of old age to a myxœdematous condition; but everyone who knows
the pathology of myxœdema will see that the arguments of Professor
Metschnikoff cannot stand, for they have no foundation.
His arguments are that there is an œdema in myxœdema, but not
necessarily in old age; that the hair falls out in myxœdema, and that
myxœdematous women have abundant menstruation, while old women have
none; that myxœdematous persons have strongly developed muscles, and old
people, on the contrary, weak and feeble muscles.
The truth is that there is often no œdema at all in myxœdema; that the
hair often does not fall out in myxoedema, especially in its partial
form (hypothyroidia); that myxœdematous women have, as a rule, no
menstruation (atrophy of the ovaries); and that myxœdematous people have
not a strongly developed muscular system, which is rather degenerated by
a new growth of fat, or connective tissue, or a mucinous tissue,
following the degeneration of the thyroid just as it follows its
extirpation. Professor Metschnikoff also states that certain animals
that soon become old do not develop cachexia after extirpation of the
thyroid.
This was the belief about eighteen years ago, but now we know that they
all develop cachexia if the operation is so performed that the
parathyroids, or at least some of them, are allowed to remain untouched.
Professor Metschnikoff’s views have been greatly weakened by the far
more extensive researches of Professor Sajous which have conclusively
shown that the life process, its activity and duration, is dependent
upon the ductless glands, including the thyroid.
It is evident from the above considerations that all hygienic errors, be
they errors of diet or any kind of excess, will bring about their own
punishment; and that premature old age, or a shortened life, will be the
result. In fact, it is mainly our own fault if we become senile at sixty
or seventy, and die before ninety or a hundred.
It may be the privilege of a few to live until ninety, even though
worshipping immoderately at the altars of Bacchus or Venus! But these
are very few, and as we have seen, they have lived on the heritage of
their forefathers, not merely in an illustrative sense, but also in
reality, for the greater number of such persons have grown up in easy
circumstances without knowing the wear and tear of care and sorrow.
Not only old age, but the majority of diseases, are due to our own fault
in undermining our natural immunity against infections, and subjecting
our various organs to unreasonable overwork and exertion. We do not
believe that the worst slave-driver of olden days subjected his slaves
to such treatment as we do our own organs, and especially our nerves. At
last they must rebel, and disease, with early death or premature old
age, will be the result.
It is literally true, as the German proverb says: “Jeder ist seines
Glückes Schmied” (every man is the locksmith of his own happiness), and
as a variation on this we would say: “Every man is the guardian of his
own health.”
------------------------------------------------------------------------
CHAPTER IX.
THE RATIONAL PREVENTION OF PREMATURE OLD AGE AND THE TREATMENT OF OLD
AGE.
_General Remarks._
WE have shown in previous chapters, through facts from pathological
anatomy, experimental pathology, and clinical medicine, that old age is
a disease characterized by the abundant growth of connective tissue,
diminution of the oxidations, and a condition of auto-intoxication.
This disease is caused by the degeneration of the glands with internal
secretion, especially the thyroid, ovaries, testicles, liver, and
kidneys.
In the same way, and to the same extent as most other diseases, this
disease is also amenable to treatment, although a thorough cure, except
in cases beginning in very early years, is just as little possible as in
most other diseases.
In keeping with the majority of diseases, old age is progressive, and,
in fact, is so to a far higher degree than other diseases. It is seldom
stationary; it goes on all the time. This we shall easily be brought to
understand from the fact that the more time progresses, the more food is
taken to sustain the processes of life. By the deficient action of the
glands, whose rôle is the proper assimilation of the food and the
destruction and elimination of poisonous products of the body, these
toxic substances will accumulate, day by day, especially if meat be
taken, and thus the continual poisoning will be augmented as time goes
on. Thus it must be our most important task to check the progress of a
condition in so high a degree injurious to the body.
Let us consider the means by which we can prevent this disease, for
“prevention is better than cure,” says the English proverb.
The preventive treatment of old age is in no less degree possible than
that of any other disease. To prevent old age rationally, we must avoid
all those harmful agencies which may be deleterious to the glands with
internal secretions, as it is the degeneration of these glands that
brings it about. These agencies, however, being exceedingly numerous, we
have mentioned in the previous chapter only those which are in the
highest degree detrimental and also the most frequent.
By avoiding these we believe we could successfully combat old age, but
only for a certain time; and if not longer, in spite of our careful
hygiene, it would not be our fault, but that of our ancestors of many
generations ago who did not observe the rules of hygiene even as well as
we do, and left us ductless glands of inferior quality.
Parents can only bequeath to their children ductless glands of the same
quality as they themselves possess. This undoubted fact is clearly
proved by the experimental, pathological, and anatomical results we have
mentioned in the chapter on heredity. We will illustrate this by the
following examples, which will show how often it is difficult to avoid
harmful agencies, and how much depends on having been born with healthy
ductless glands.
A person inhales air that contains virulent bacilli and contracts
tuberculosis. Another drinks a glass of water or milk, contaminated by
water or kept in vessels that have been washed with water containing the
bacilli of Eberth, and contracts typhoid fever. Conversely, others who
have inhaled the same air and drunk much more of the same water, have
remained free from any infection.
The cause of this is that the first mentioned have inherited defective
ductless glands from their ancestors, and probably afterward have
ill-treated these glands by an immoderate use of all those agencies that
are detrimental to them, such as alcohol, sexual excesses, much meat,
tobacco, tea and coffee in large quantities, etc., and thus could not
produce anti-bodies to counteract the infection.
Of course, the fault does not lie entirely with such people, but that
from their birth they are the victims of the immoderation of their
ancestors; and by this fact alone are doomed to more easily succumb in
the incessant fight against the microbes, and therefore a limited
lifetime has been already meted out to them at birth.
We have, in the chapter on heredity, quoted instances of persons coming
of short-lived families, who reached a great old age; but this was due
solely to exceedingly careful hygiene. It is not always easy to observe
these rules scrupulously, and besides often necessitates the possession
of means to carry them out and to enable us to be more exempt from the
wear and tear of life—cares and sorrow,—which shorten the lives even of
persons with healthy glands, though much more of persons who have
inherited defective ductless glands.
It has been shown by statistics[166] that the present generation is
longer lived, and that the average of life is longer, than was the case
one hundred years ago. This is solely due to the fact that now-a-days we
know more of hygiene than our forefathers did, although the struggle for
existence and competition everywhere has certainly become more keen,
with the inevitable worry and depression of mind which it so frequently
brings about. This lengthened life is certainly due to more careful
hygiene, especially against infectious diseases.
Footnote 166:
Westergaard: “Die Lehre von der Mortalität u. Morbilität,” second
edition, Jena, 1901.
The extended life of an individual depends always, first, on the
inherited qualities of the ductless glands, and, secondly, on a sound
observance of hygienic measures.
To prevent old age coming on too soon, the first condition necessary is
the possession of healthy ductless glands, and this will depend, as just
stated, on heredity. We can exert no influence on the generations that
have passed away, and must therefore direct all our attention to the
generations that are to come. This can only be done by influencing the
laws of marriage, and particularly by prohibiting the marriage of
persons suffering from diseases that are most detrimental to the glands
with internal secretions.
Children of people suffering from syphilis, tuberculosis, chronic
alcoholism, etc., are, as we have seen, born with congenital atrophy of
the thyroid gland, and are especially apt to acquire all infectious
diseases, such as tuberculosis, with the greatest facility.
The Bible is literally true when it says that the sins of the fathers
are visited even unto the third generation.
Thus we can influence the baby even before it is born; let us then
consider what we can do after its birth to prevent premature old age and
to secure for it a prolonged existence.
The mother of the future child must carefully avoid anything that may
prove fatal to the fœtus or influence its nutrition. It is a well
demonstrated fact that different kinds of harmful products, i.e., drugs
and probably also stimulants like alcohol, coffee, etc., can be conveyed
to the fœtus. A pregnant woman must, therefore, most strictly observe
all the rules of hygiene, and especially abstain from the use of drugs
which (as for instance, iodine, the bromides, etc.) can also take effect
on the fœtus and prove detrimental; emotions must especially be avoided.
When the child is born the best nutriment for the baby is the milk of
its mother, and if the mother be not available for this purpose, a wet
nurse must be obtained, for human milk is indispensable in the
nourishment of the baby if we desire to influence its future immunity
against infections; for this important purpose all the internal
secretions of the ductless glands go into the child through the milk
which contains them. Sajous holds that millions of infants die solely
because they are deprived of what nature provided for them, the maternal
milk, which not only nourishes them, but protects them against disease.
The infant is practically helpless against infections, for its thyroid
contains scarcely any colloid substance, sometimes none; and it also
contains no iodine,[167] especially in children who are descended from
parents suffering from chronic cachectic diseases, such as tuberculosis,
syphilis, malaria, insanity, etc. The other glands are also not yet
sufficiently developed, as this takes place generally in the years
toward puberty.
Footnote 167:
Baumann: “Zeitschrift für Physiolog. Chemie,” 21, 319, 1895; 22, 1,
1896.
All the internal secretions will, therefore, come to the children from
the mother or wet nurse.
The above fact also explains why infectious diseases are so very
frequent among infants, and also among children before the years of
puberty.
The avoidance of infectious diseases is especially important for
infants, for in later life many other infections will occur preferably
in those children whose ductless glands have been weakened by previous
infection. Therefore, even with adults, when we take the history of a
case we should inquire whether, in childhood or later, the patient has
suffered from infectious diseases. The necessity of such a procedure
will be more clear after we have shown their relationship with a
weakening of the ductless glands.
The possibility of premature old age is greater in a person who has
suffered from one or several infectious diseases in childhood than in
another who did not contract any.
Very interesting experiments have been made on puppies fed on their
mothers’ milk, and some with raw and boiled cows’ milk, showing the
superiority of the bitches’ milk, and also of the unboiled milk.
When human milk is not available for divers reasons, fresh cow’s milk
should be employed, using it raw, however, in order not to destroy, by
boiling, various substances of the nature of ferments. Before giving it
to the baby, the cow’s milk should be diluted with water, and milk-sugar
and cream should be added to make it more like human milk (see Chapter
on “Milk Diet”).
Of course, when giving raw milk, we must ascertain that it comes from
cows examined specially for tuberculosis, and that the milk is of the
best quality and very fresh since it has been shown that its power to
kill bacteria—and therefore to protect the child—begins to decrease soon
after it is drawn.
Not only for the infant in arms, but for the growing baby and child
during its first year, milk food, containing largely of milk and
cereals, will be the best diet, excluding meat entirely, since in these
tender years the ductless glands are not sufficiently developed to
destroy poisonous products that arise from the end-products of
decomposition of meat. By giving these little creatures meat we may
depreciate the efficiency of their ductless glands through unnecessary
strain in the destruction of poisons, and thus diminish their chances in
later life, of a prolongation of youth and a happy old age. For the same
reasons and even more weighty ones, alcohol, coffee, tea, etc., should
be avoided.
It is sad to reflect that, in some countries, alcohol is given to
children, who are even far more helpless against it than adults.
We have observed in Northern Hungary that the children of the Slovacks,
a Slav nation that inhabits certain parts of Hungary—the native land of
the writer,—are stunted in their growth. The reason for this is, that in
these parts of Hungary, where there are plenty of potatoes, but a
scarcity of other food, the peasants give brandy to their youngsters. As
we have seen in the second chapter of this book, the growth of the human
body depends on the thyroid gland. The fact that these children do not
grow shows that alcohol is deleterious to the thyroid. This question
will be considered more fully in the chapter on alcohol. The advantages
of milk food we shall also treat more fully in a separate chapter.
To deal with old age rationally, we must begin in childhood to fight
against it, as all those agencies that tend to produce it prematurely
can at this age prove far more deleterious; and as in this world no
action is lost—whether for good or evil—we must reap the results of our
imprudence in later life.
Unhappily at this tender age we have no reasoning powers, the glands
governing them not having been developed, and therefore our parents or
guardians must act for us. Their want must also be supplied by the
teacher, and we believe it would be productive of great good to teach
the elementary rules of hygiene in school at the same time as reading
and writing.
The impressions we first get in childhood remain throughout life and are
never forgotten; therefore, hygiene should be learned even by small
children. The soul of a child is like plaster of Paris, that can, like
dough, be moulded into any shape we desire. It is at this early age that
we should learn of the necessity of a bath every day, of moderation in
food, the avoidance of certain stimulants, such as alcohol, and also of
tea and coffee in large quantities.
Alcohol, coffee, and tea are especially injurious to children. The
celebrated German clinician, Strümpell, writes as follows in the
_Pædagogical Pathology_: “Among the acute as well as chronic
intoxications—which can be the cause not only of a temporary, but also
of a prolonged psychopathic condition,—intoxication by alcohol, and by
stimulants generally, plays the greatest rôle. Such abuse is especially
noxious to children, and causes an enormous number of diseases with
psychopathic results.” We ourselves believe that it is a crime to give
alcohol to children, and that it should be punishable as such.
Dr. F. Heyn, in a statistical contribution on “Idiocy,” that appeared
recently in the _Psychiatrisch Neurologische Wochenschrift_, showed that
in 17.6 per cent. of cases of idiocy in children the above-mentioned
fault in hygiene—the use of alcohol, tea, and coffee—was the cause.
Thirteen years ago Director Trüper, in a monograph on the psychopathic
conditions of childhood, insisted on abstinence not only from alcohol,
but also from coffee, by women during pregnancy; but it should be noted
also that these agencies continue to be deleterious years after a child
is born.
Above all else we must try to make a good man or woman of the child, as
this also is an essential safeguard against disease and premature old
age. We should endeavor to interest children while they are yet of a
school age in the fine arts, such as music, painting, and literature, as
they have a very favorable influence on the hygiene of the mind in after
years. Religious instruction also gives good results in this respect.
When children approach puberty it is important to avoid an agency that
may prove very deleterious to certain of the glands with internal
secretions, and this is masturbation.
We will not commit the error made by so many unscientific writers of
ascribing much greater importance to this matter than it deserves. It
certainly is not true that tabes dorsalis, dementia paralytica, or other
serious nervous diseases will result from this source; but it cannot be
denied that neurasthenia or hysteria or impotency—sexual
neurasthenia—can be promoted by the exaggeration of masturbation, if
indulged in many years.
Masturbation is always injurious to the sexual glands, more so to the
male than to the female organs, and in addition to the thyroid, and—if
in excess—to the adrenals. It also very unfavorably influences the mind
and character.
In youth, instruction as to the control of the sexual passions will be
of the utmost importance, even considering alone the dangers of
infections, especially of gonorrhœa, which not only endangers the future
husband, but the future wife also. We need here but mention the
well-known fact that the thorough and radical cure of syphilis may even
more readily be accomplished than that of chronic gonorrhœa.
We have mentioned above that after gonorrhœa (every chronic gonorrhœa
involves the prostate gland) there are severe disturbances of the
nervous system, which may also influence the mind, causing hypochondria.
To prevent all these dangers there has been formed in France a society
called “Société Française de Prophylaxie Sanitaire et Morale,” which
advocates the necessity of instructing boys and girls as to all the
dangers that threaten them and how to avoid them.
Happy is the young man who is able to live in perfect chastity without
harm to mind or body. We will enter more fully into the consequences of
complete sexual abstinence in the chapter on sexual hygiene; but the
great majority of young men have the danger from sexual intercourse
suspended, as the sword of Damocles, over their heads, and the best way
to avoid this is by marriage.
Marriage is, indeed, an invaluable aid in the struggle against old age;
but sometimes, although this is an exception, it may turn out to be a
double-edged sword.
By marriage a young man acquires regular habits, and by the assistance
of a loving wife is better able to control his passions; and last, but
not least, the hygiene of the mind will also be improved. The inevitable
hardships of life are thus less felt.
These great advantages of marriage can, however, exist only in cases
where the two halves make one whole—i.e., where the sun of happiness
shines in the marital sky. For this purpose each of these two halves
must endeavor best to please the other. The husband must, as is quite in
the nature of things, show the utmost forbearance to the wife, and never
forget that, on account of her different anatomical and physiological
constitution, the mind of the female is far more exposed to frequent
irritation as a natural consequence of the frequent alterations of the
sexual glands and thyroid in women. It would be unreasonable to blame
her for a condition for which not the woman, but her Maker, is
responsible.
If married life is one of the best means to defer old age, on the other
hand it is positively certain that unhappy marriages are the surest
means to hasten its oncoming; but these are the exception, and, as in
everything else, the exception only proves the rule.
A single man, or woman, is far more exposed to all the agencies we have
referred to above as being deleterious in causing old age and especially
depressed conditions of the mind, these being the consequences of total
sexual abstinence, faults of hygiene in diet, use of stimulants (alcohol
in men, coffee, tea, etc., in women), fewer precautions against disease,
and so many other agencies of less importance that there can be no doubt
that the bachelor or spinster, as a rule, will become old in earlier
years than the married person. Therefore, although himself still a
bachelor, the writer feels compelled to sing the praises of married life
as a hygienic factor favoring old age.
The possession of children is heavenly bliss to married people, and
their pride and joy in them, and in living with youngsters, renders the
parents young, as the German proverb says. But as every good thing, if
in excess, may turn out to be harmful, _omne quod est nimium vertitur in
vitima_, so too, many pregnancies may prove very harmful in the fight
against old age, especially when the mother nurses for a long period
each of the children. In women who produce much milk this may prove
advantageous to health if not too greatly prolonged; but in women with a
meager provision of milk—as in cases of thyroid insufficiency—it may
prove disastrous by destroying the means of keeping youthful till an
advanced period.
In married women with many pregnancies much will depend on external
circumstances of life, and it is certain that nothing will hasten the
advance of old age as many pregnancies, the mother suckling all the
children herself, in combination with deficient food, the wear and tear
of poverty, and with anxiety as to the morrow. This cruel struggle for
daily bread is what renders the women of the lower classes old before
their youth has passed.
To prevent the deleterious consequences of too many pregnancies on
beauty, health, and wealth, in certain countries, as in France, the
habit of having one or two children has been encouraged by artificial
means. However, as is always the case when our acts disregard Nature,
great mischief may thus arise, and even in cases where death has not
followed abortions, very often such irreparable damage is caused to the
organs on which youth and beauty depend that the oncoming of old age is
still further hastened.
The endometritis and peri- and parametritis of many years duration,
which are sometimes the result of such procedures, influence the
appearance of these persons more unfavorably than many pregnancies.
Parents who have many children may be regarded as the happiest of
mankind. Their name is forever perpetuated through their numerous sons,
and their flesh and blood survives in their children, to quote the great
German philosopher, Schopenhauer.
The years of the climacteric are the most troublesome in married life,
not only for the wife, who is directly affected by it, but also in
almost equal degree for the husband, who must show the greatest
forbearance to his wife at this period. The sun is setting! It is not
merely that the decline of the sexual functions produces certain changes
in the body, which are especially noticeable in the external appearance;
the influence on the mind also produces deleterious effects. Therefore
we must direct all our attention to the hygiene of the mind. In married
women with loving husbands and children the task will be much
facilitated. As we have already mentioned, this stage of human life is
most felt by professional beauties, who witness with chagrin the
vanishing of their power over the hearts of men. In many spinsters
living alone, friendless, this is also a frightful stage of life. Here
we have again an opportunity to observe the wonderful soothing effects
of religion, which offers us consolation in all our troubles. Religious
women will, therefore, much better withstand this most difficult part of
their life. Religion and philosophy, too, may be still more helpful to
overcome mental depression.
It is interesting to note that many women, even those previously little
given to religious practices, turn over a new leaf, and to make up lost
ground, become quite pious. Such as in their youth were haughty and
proud beauties, and only went to church to exhibit their new hats and
toilette, now become meek and modest, and never miss a religious meeting
or exercise.
Still, even after a woman has passed the climacteric, everything is not
lost if only she be a clever member of her sex. In fact, something
remains that may even place her above her much younger sisters, and that
is experience and knowledge of the world; and if, by the aid of a
skillful toilette, she is able to make the best of what good looks
remain from better days, it is probable that she will outdo many of her
sisters far below her in age.
Even if at this time of her life, aware of the approach of old age and
its cruelties, she may be inclined to say with Longfellow, “but the
hopes of youth fall thick in the blast,” still there are, in the present
state of science, plenty of resources open to her, no less than to a
man, to put off old age for a score of years, or to mitigate its effects
when it has asserted itself with all its terrors.
We owe our knowledge of the fact that there is a treatment for old age
to the famous French scientist, Professor Brown-Séquard, whose father
was American and who, for a time, was professor of physiology at Harvard
and later a practitioner in New York which he left to become professor
of physiology at the University of Paris. Although, before him, Claude
Bernard, a man of no less fame, had shown the existence of internal
secretions, Brown-Séquard was the first to draw practical conclusions
from this fact, and the first who gave a solid basis to the doctrine of
internal secretion.
Brown-Séquard was the first to use the extracts of a ductless gland (the
testicle) for therapeutic purposes, although thousands of years before
him the Chinese had used different organs for purposes of healing, and
the savages of Africa ate certain portions of their enemies—the liver
and the testicles—to enhance their own courage.
Brown-Séquard obtained surprising results by using the crushed extracts
of rabbits, guinea-pigs, and dogs, of which we will say more in the
chapter on the prevention and treatment of old age by organic extracts.
Unhappily, as human nature is prone to attack every innovation or to
ridicule it, in spite of the great reputation of this savant, his
discoveries were skeptically received; and if the extracts of another
similar gland—the thyroid—had not yielded such marvelous results,
probably the author of the present work would never have had the
opportunity to write on the treatment of old age with organic extracts.
It has been shown by many authorities that the thyroid gland is able—as
we have already mentioned several times in different parts of this
book—to augment the processes of oxidation, and it has also been stated
by several authorities, such as George Murray, Vermehren, Hertoghe, and
Laache, that persons treated with thyroid extracts appear much younger
after the treatment—sometimes, as Hertoghe mentions, ten to twenty years
younger.
Now, if a person suffering from complete myxœdema can obtain such a
result by the use of thyroid extracts, should not a person suffering
only from a partial form of the same disease be able to obtain similar
results? It would be quite contrary to our physiological conceptions
that a person in a bad condition of health and in physiologically
inferior circumstances should benefit more, by exactly the same
treatment, than another person who is in a much better condition of
health. Therefore, the thyroid treatment of old age is justified. And
indeed, we ourselves have seen astonishing results from thyroid
treatment, not only in old people, but also in persons under 40.
Thus the thyroid can be of valuable aid for the prevention of old age,
and for deferring its onset as long as possible; and for this purpose it
will be necessary to begin our treatment in women at about the age of
35, or in certain cases, such as where many pregnancies have occurred,
even before this age, and in men at some time after 40 (see also Chapter
LIII). Still, to avoid abuses in the use of this efficient drug, it
would be necessary to pass a law prohibiting its sale without a medical
prescription.
Besides the thyroid gland, the extracts of the sexual glands can also be
used; thus, ovarian extracts for women, and testicular extracts for men.
We have also witnessed good results with ovarian and testicular extracts
of pigs. Long before ourselves, Brown-Séquard and Professor von Poehl
and many others made very interesting observations on testicular
extract, on which we shall dwell in the chapter on the treatment with
testicular extracts.
Besides the above extracts, those of the kidneys and of the pancreas
have also given us, and others, very good results, and they can be used
with advantage in the prevention and rational treatment of old age in
combination with the other extracts, though preferably in cases where
the functions of these organs are deficient. In old age that has already
become manifest they should always be used, as they will facilitate the
work of these very important organs, and thus prolong their vitality. In
this manner an old man will be able to employ these organic extracts of
the pig to work for the benefit of his own organs, or, at any rate, to
assist in their work.
We have given above a sketch of the dangers that follow us from the
cradle until old age, and hasten its arrival, and shown by what means we
can avoid or diminish them in the different stages of life; we would now
like to offer a few hints that may prove useful for any of these periods
in life.
We have shown in the previous chapters that the degeneration of certain
glands with internal secretions, especially the thyroid, liver, and
kidneys, will produce a condition of auto-intoxication, as poisonous
products will not be destroyed in the proper manner, and also not
eliminated from the body. Therefore our whole energy must be turned to
working in time against this auto-intoxication of the body. This can be
most rationally done by a careful hygiene of these different ductless
glands—into which we will enter later in separate chapters—and also by
special cultivation of the functional efficiency of those organs that
eliminate poisonous products from the body, such as the kidneys,
intestines, and the skin.
These three organs are in close relation to each other, for when one is
threatened the others come to its assistance and aid it in the work of
elimination. Thus, when the kidneys are not functionating as they
should, the skin comes to the rescue and helps to eliminate a large part
of the remaining products by increased perspiration. Nature often does
this spontaneously before we come to her aid.
The intestines will do their best, in like manner, to expel a part of
these products. Recognizing this co-operative action of almighty Nature,
we must also try to be of assistance by careful hygiene, and later on we
shall see what will be the best way to effect this; but let us at once
urge here that the necessity of having the bowels moved daily should be
insisted on from earliest childhood. Especially is this of the greatest
importance in the case of young girls, for with them this most necessary
rule of hygiene is so often neglected. There is no doubt that, in many
persons, fæcal matter can stagnate in the intestines for a few days
without much consequence, as the epithelium of the intestines, when in
sound condition, may prevent the entrance of poisonous products. But it
may be different when this becomes a habit; and when the epithelium is
not in perfect order,—as is often the case after prolonged constipation,
or with catarrhs of any kind, or with excreta which by their shape may
injure the epithelium mechanically,—resorption will follow.
At any rate, it is an every day occurrence for persons who have not had
their bowels moved, even for one day, to complain of headache and other
symptoms of uneasiness, so that it is impossible to regard these as
simple reflex actions, as some are disposed to think, but rather as
symptoms of auto-intoxication. Therefore the necessity of clearing the
bowels every day should be insisted on, and again especially in the case
of the young girls, for it can easily become a bad habit once they have
begun to neglect it, and the sluggishness of the bowels, to which
females have a peculiar tendency, is thus further encouraged.
Everything should be done to prevent habitual constipation in young
girls, for the important reason that stagnation of blood in the adjacent
organs of the pelvis is otherwise promoted, and thereby also a tendency
to subsequent diseases of the sexual organs, from which many women
suffer, at any rate much more frequently than men.
This movement of the bowels every day can best be secured by appropriate
food, such as exercises a gently stimulating action on the walls of the
bowels. Drugs should be avoided as much as possible, for reasons we will
mention in another chapter.
Habitual constipation, if persisting for years, can certainly facilitate
the oncoming of old age, while its appearance can be considerably
deferred by a good movement every day, owing to the prompt release from
the organism of a mass of toxic products.
The great importance of this can be easily realized if we observe the
face of any one who has been constipated for several days. After a
thorough clearing out, the face becomes fresher and the eyes brighter.
The complexion that was previously a dirty gray becomes white and rosy
again, particularly in the case of young women. Should not this prove an
object lesson as to the vital importance of a thorough evacuation daily
as a safeguard against premature old age?
Every physician who practices in a place where the mineral waters have
purging effects has occasion to observe that persons coming to these
spas, looking worn out and gray in the face, with pendant cheeks, and
showing all the signs of auto-intoxication from the retention of
poisonous products, always look much fresher, and, indeed, many years
younger, after the cure. We could observe the same effects in our own
case after each purge, although we do not suffer from habitual
constipation.
There is no doubt that freedom from occupation, and particularly life in
the open air, in the woods and meadows, have a very great influence in
effecting such cures; but we may note the same effects after courses of
purging without the aid of such conditions as the above.
The care, not only of the bowels, but of the skin, must be impressed on
every one from earliest childhood, especially the necessity of a bath
daily. Unfortunately, this is too much neglected on the Continent, and
becomes prevalent only as Anglo-Saxon customs are diffused abroad.
By a bath with soap the pores of the skin are better opened, as the dirt
that clogs them is removed, and thus the poisonous products can be given
off through the skin more easily, and the skin thereby justifies its
name as chief assistant to the kidneys. It is, in fact, our second
kidney. When the skin comes into greater activity through the action of
the sudorific glands, a part of the solids in the urine and many harmful
matters, which otherwise would make their way through the kidneys, are
eliminated through the skin instead, in which manner the powers of the
kidneys are economized.
It is, therefore, only natural that we should do everything to promote
these important functions, especially since we may regard the skin not
only as a second kidney, but to a certain extent also as a second lung;
for it possesses respiratory functions in addition, receiving oxygen and
giving off carbonic acid to a certain degree.
To assist these functions in every possible way, we must allow the air
to reach the skin freely, for which purpose clothing and underwear
should be porous, in order not to impede the process of respiration and
elimination. This end will also be attained by exercise in the open air
and sunshine; in fact, by remaining out-of-doors as long as possible.
All these important features will be dealt with fully in separate
chapters.
Before leaving the subject of the prevention and rational treatment of
old age, we will give a few hints that may be of use in any stage of
life.
First, great moderation in the diet should be observed, as large
quantities of food may, in the long run, impair the powers of the
digestive organs, and also of several of the ductless glands, which are
concerned in the operations of digestion and assimilation—the pancreas
and liver. Sajous has shown that the secretion of the adrenals takes
actual part in the functions of all these organs. Everything that is
eaten should be thoroughly masticated and not “bolted”; digestion, in
reality, beginning in the mouth.
Meat should not be consumed in large quantities, as it is injurious to
various glands with internal secretions, especially the thyroid and
liver, and after having been taken for a long time in large quantities
can promote arteriosclerosis (see Chapter XVI).
The best nourishment for increasing the chances of a long life and to
defer the effects of old age, is a diet consisting of little meat, much
milk, and vegetables. We have for many weeks lived on a diet consisting
solely of milk, eggs, bread, butter, and fruits, and, we believe, have
never felt so fresh and well disposed to work as during that time and,
as friends remarked, never looked so well, either.
A strictly vegetarian diet, without milk and eggs, is distinctly unwise
and dangerous to health, if followed for a long time. Our anatomical and
physiological construction is not adapted to such nourishment (see the
chapter on this subject).
By many authorities wine is called “the milk of old age.” This is not
true, although it is a fact that many old people feel better after an
occasional glass of claret, when they have been in the habit of taking
it for years.
We will deal with alcohol and its deleterious effects in a separate
chapter. Far more injurious than red wine used in moderation, are tea
and coffee used in large quantities. Unfortunately, many of those who
fanatically fight against alcohol, indulge in many cups of black coffee
or tea daily, and thus poison their nervous system. Besides containing
thein and caffein, they also aid the formation of uric acid, as they
contain bodies from which the purin substances are produced (Haig,
Hutchison, Walker Hall).
Cocoa and chocolate may be taken in larger quantities than coffee or
tea. Cocoa with milk is, at the same time, very nutritious, as it
contains fatty substances.
Spices should be avoided as much as possible, especially sharp,
irritating condiments, which are so freely taken, particularly in
America.
We must not forget that the greater part of all we eat and drink must
pass through the kidneys, the fine epithelium of which is thus easily
endangered. For the same reason drugs should only be taken under medical
advice, and with great reserve, for if taken too freely they may not
only injure the kidneys and liver, but also the stomach, which first
receives them.
Sound sleep is of the greatest importance. Most of the organs rest
during sleep; the great brain in particular being completely at rest;
but the disintoxicating glands are most active during sleep. This
function should therefore be promoted by all means, and we shall devote
a special chapter to sleep, its causation, and the treatment of
insomnia. Let us, however, at once mention that sleep can best be
encouraged by the use of a large, airy room, and going to bed early,
say, at ten to half-past, and rising at five or half-past, when sleep
has been undisturbed during the night. Seven hours’ sleep is the best;
longer sleep, if over seven and one-half or eight hours, injurious,
except for anæmic girls and women. Many people do very well with six
hours’ sleep, but less than this will prove injurious in the long run.
It is astonishing to note the large proportion of persons living to a
very great age that were early risers; for which reason we may conclude
that “early to bed and early to rise” is a valuable factor in the
struggle against old age.
We emphatically repeat, over and over again, the importance of fighting
against our passions and cultivating the hygiene of the mind; this must
be commenced in early childhood and continued through life; and the good
qualities of the mind, which we will call the “positive” features of the
mind, should be especially cultivated, such as kindness,
good-heartedness, friendship, love, magnanimity, hope, modesty,
liberality, generosity, frugality, and above all things, contentment
with everything. On the other hand we may describe wickedness,
unfriendliness, hatred, and jealousy as “negative” features of the mind,
which should be smothered at their very inception in the child.
The most successful way to fight the battle of life is to cultivate
equanimity and follow the beautiful precepts of Hindu philosophy, which
teach us never to hunger after honors and riches, but to be content with
what comes in our way. It should be a lesson to us as to what to avoid
when we take note of the manner in which so many American business men
sacrifice their mind and health in an insatiable thirst for success and
riches, and after attaining them, by a real battle with life, find their
health so impaired that they reap no enjoyment from it. What is the use
of a million when all that life holds dear is lost in the struggle to
obtain it, and when, probably, our children will squander it, as do many
sons of millionaires who have worked themselves to death. Rather be a
living beggar than a dead millionaire!
In the succeeding chapters we will enter fully into detail on all the
subjects we have touched upon in these general remarks. We will describe
the functions by which the body rids itself of toxic products, and the
means by which these functions may be improved. At the same time we
shall set forth the rational hygiene of the organs that cause the
elimination of poisons either taken through food or introduced from
without; and after having demonstrated the most effective mode of
freeing the body from such poisons, we shall mention the best kinds of
food and deal more specifically with the advantages and disadvantages of
the various kinds of food. The effects of certain agencies of great
benefit to the health, such as the open air, sunshine, exercise, etc.,
will be treated in an exhaustive way. Finally, we shall show that we are
able to prevent premature old age in an effective manner, and even to
treat successfully by means of certain drugs and organic extracts the
condition of old age itself.
------------------------------------------------------------------------
CHAPTER X.
THE DESTRUCTION AND ELIMINATION OF TOXIC PRODUCTS FROM THE BODY AND
HYGIENIC MEASURES FOR THE IMPROVEMENT OF THESE FUNCTIONS.
THERE is not one thousandth of an inch of our body surface which does
not swarm with innumerable bacteria, and as soon as the continuity of
our skin is severed, as by a small wound, they immediately invade our
tissues and attack us. Happily we are not without means of defense. Our
organism is so well arranged that, as soon as a foreign body enters
which might become injurious, a kind of police organization comes into
action, and the leucocytes, like policemen, arrest the bacilli, and
render them harmless by eating them up. This is phagocytosis, first
described by the great French investigator, Metschnikoff. And so
marvelously arranged is our body, that there are also special
substances, the alexins (Buchner), which aid the leucocytes, and the
opsonins, which first act upon the bacteria, so as to make them more
digestible for the leucocytes.
To make the bacilli still more sensitive to the influence of the alexins
there are the agglutinins, observed by Bordet, and by Gruber and Durham,
which immobilize the microbes, and thus aid the phagocytes and alexins
in the performance of their task.
The leucocytes are formed in the lymphatic tissues, especially the lymph
glands and spleen. Thence they circulate through the body and offer
opposition to the microbes and other foreign bodies which they meet on
their way. The red blood-corpuscles of the adult are formed chiefly in
the bone marrow.
The lymphatic glands play an important rôle, not only as the birthplace
of leucocytes, but also in that they are able to arrest noxious
substances, such as microbes, and keep them from entering the
circulation. That the lymphatic structures are able to protect us
against bacillary infection can be shown by the swelling of the spleen
in infectious diseases,—such as typhoid fever, malaria, etc.
The tonsils are also of some importance for our protection against
harmful substances. They become inflamed in various infectious
diseases—such as scarlet fever, measles, acute nephritis, etc. Their
great value may best be shown by the fact that not infrequently, after
total extirpation of both tonsils, a generalized eruption has been
observed. Thus we must always seriously reflect before advising the
extirpation of these important organs, the rôle of which as sentinels is
shown by their anatomical position on either side of the entrance for
the most indispensable elements of our life: air and food. Unless
frequent inflammation, and possibly irritative nephritis, demand an
operation, it would be better not to undertake it. Even if it is done,
the glands should never be entirely removed.
A great number of microbes enter our system through the mouth with the
air and food, but happily they are antagonized by the saliva and the
gastric juice, which are able to destroy a large number of these
obnoxious invaders. Like the ductless glands, the lymphatic glands are
closely connected with one another, and thus changes in one of these
glands are apt to be followed by changes in the others. Hence we can see
how a lymphatic structure contained in the intestine,—the appendix,—can
often become inflamed after previous inflammation of the tonsils. As is
well known, the appendix shows great similarity in its histological
structure to the tonsils, so much so that some call it an intestinal
tonsil. Several authors have drawn attention to the fact that
appendicitis has often been observed after tonsillitis, and Delcour has
written a monograph in which he attributes appendicitis, indirectly, to
thyroid degeneration,—e.g., congenital myxœdema. Adenoid vegetations are
always accompanied by chronic pharyngitis and tonsillitis, which bring
about appendicitis. And since adenoid vegetations are an expression of
thyroid deficiency, Delcour attributes appendicitis to a deficient
thyroid. We are not prepared to accept Delcour’s statement, as there are
cases of adenoid vegetations without a deficient thyroid. However, as we
have personally observed, chronic nasal catarrh and tonsillitis are very
frequent in persons subject to appendicitis. The appendix is an
important lymphoid organ and, if possible, it should be preserved.
As I have already shown in a previous communication,[168] the lymphatic
glands stand in very close relation to the thyroid gland. In diseased
conditions of the thyroid we find, as a rule, enlarged lymphatic glands,
as in Graves’s disease, myxœdema, cretinism, acromegaly, and also in
diabetes. The thyroid seems to exert a great influence, not only upon
the lymphatic glands, but also on the blood-corpuscles. The red
blood-corpuscles are diminished after extirpation of the thyroid, as
also in myxœdema, as well as in old age. On the other hand, they can be
increased very considerably by thyroid feeding. The white
blood-corpuscles are also influenced by the thyroid, for, after
extirpation of the thyroid, their number is at first increased and later
diminished. Very important is the discovery of Mlle. Fassin[169] (in the
laboratory of the University of Liège, Belgium), who found a diminution
in the production of alexins after extirpation of the thyroid, thus
confirming what Sajous had pointed out four years earlier. According to
Sir Almroth Wright, the discoverer of opsonins, the production of these
bodies also depends upon the internal secretions. We have seen that
Sajous has shown (a fact confirmed by others since) that opsonins are
mainly composed of thyroid secretion.
Footnote 168:
Policlinique de Bruxelles, Avril, 1903.
Footnote 169:
Report in Centralblatt für Stoffwechsel, 1907.
Thus we see that the production of antitoxins is greatly under the
influence of the thyroid, which governs the processes of phagocytosis,
and thus powerfully helps in the defense of our system.
Besides microbes, we introduce into our body a large number of harmful
products through food and drink (stimulants). Many toxic substances are
formed by the decomposition of food, and also in the processes of
metabolism in the tissues. We are protected against these substances by
certain organs which destroy them (as the thyroid, parathyroids, and
liver), and by other organs which eliminate them (as the kidneys, the
skin, and the intestines). When these organs are all working well, we
may get rid of these products and not be affected by them; but in old
individuals it is different, as their protective and eliminative organs
have more or less degenerated. Then these substances are not destroyed
entirely, nor wholly eliminated. They are retained, and cause the
condition of auto-intoxication.
It is very difficult to prove definitely by experiments, that there
really exists such a condition as auto-intoxication; but, practically,
its existence cannot be denied. We note after changes in the above-named
organs, when their functions are in abeyance, signs of intoxication in a
patient, which include headaches and other nervous symptoms, with a
haggard and colorless face. After a good movement of the bowels,
perspiration, and abundant diuresis, we see a great change for the
better. Thus, even if scientific experiments which are made on small
animals do not strictly confirm the existence of auto-intoxication, the
great improvement in our condition after improved elimination speaks
very strongly for its existence. Therefore, to prevent such a condition,
we must do our best to keep these organs in good working order. In the
succeeding chapters we shall consider in detail the protective and
eliminative functions of these organs, and the possibilities of their
improvement by hygienic and therapeutic measures.
------------------------------------------------------------------------
CHAPTER XI.
ON THE DESTRUCTION OF POISONOUS PRODUCTS THROUGH THE THYROID AND
PARATHYROID GLANDS.
THE earliest authorities on the thyroid gland, including Schiff and
others, have shown that when this gland is extirpated in a dog, as a
rule the animal develops convulsions after a few days, and subsequently
dies. It is very unusual to find a longer survival after such
operations.
Interesting and very instructive experiments by the American specialist,
Dr. Leo Breisacher, of Detroit, Mich. (formerly assistant to Professor
Munk, of Berlin), have demonstrated that it is possible to keep animals,
operated on as above, alive for a long time if they are debarred from
meat and kept on a milk diet.
A perfectly natural explanation of this prolonged survival, which had
never been observed until the above experiments, lies in the fact that
milk food is better adapted to animals deprived of their thyroid, and
that, as Dr. Breisacher maintained, meat acts in a poisonous manner on
the nervous system of dogs thus operated on. Thus we note that dogs in
this condition cannot live on a meat diet. The learned savant and others
noticed that dogs so fed succumbed very quickly, while at the same time
he observed that no attack of convulsions ever occurred in dogs fed on
milk, though many other authorities had noticed such symptoms in
corresponding cases.
He also observed,—and it is a most interesting point,—that dogs which
improved on a milk diet, again got worse after meat or bouillon was
taken and died in consequence. Of great importance also is his
observation that boiled meat is not dangerous to animals thus operated
upon, which he explains as being due to the fact that the extracts of
meat having a toxic action are soluble in water.
There can thus be no doubt, from these beautiful experiments of
Breisacher, that meat does contain substances that are poisonous, and we
may safely draw the conclusion therefrom that if we, who are in
possession of our thyroid, do not suffer from a meat diet, it is due to
the protection afforded us by this gland. If we remove this, as in the
instances given of the dogs, or if it is degenerated by disease, then
our immunity also disappears. In myxœdematous people this is
self-evident, for they are always worse after taking meat, and most of
them have an antipathy to this sort of food. Also in many cases of
severe diabetes (a myxœdematous condition), meat is very injurious, and
if taken in large quantities can contribute to the development of
acidosis.[170]
Footnote 170:
“Untersuchungen über die Glandula Thyroidea,” Breisacher: Archiv für
Anatomie und Physiologie, p. 504, 1890.
The above-mentioned experiments of Breisacher have been confirmed by F.
Blum, of Frankfort. He finds also that omnivorous animals operated on as
the dogs, if fed with meat, die from tetany in a few days. But when such
animals have been kept on milk for a long time, before and after the
operation, a large proportion have survived, or, at most, passed through
a mild form of tetany, and continued well until meat was again
administered, when their condition soon became worse, and death ensued,
as in the case of the animals kept on a meat diet. Some of the dogs fed
on milk also died, but before succumbing they underwent a long cachectic
illness. In any event they lived longer than the animals fed with meat,
which rapidly died with violent symptoms.
Dr. Blum arrived at the conclusion that the thyroid is a
disintoxicating organ (entgiftendes organ) the function of which is to
destroy poisonous products formed by the decomposition of the
albuminous food-substances.[171]
Footnote 171:
Virchow’s Archiv für Path. Anatomie und Physiologie und klin. Medicin,
vols. 158, 162.
The Japanese authority, Kishi, also arrived at the same conclusion,
after having removed the thyroid gland from 150 monkeys, dogs, and other
animals.
That the products of the decomposition of albuminoids can produce
changes in the thyroid has been proved by Galeotti and Lindemann, who
found an increase of colloid substance in the thyroid of animals after
the injection of leucin and tyrosin,—which are the products of
decomposition of albuminous substances. That meat acts in an injurious
manner on the thyroid gland, if eaten in very large quantities, has been
proved by clinical observations and by the experiments of Chalmers
Watson, into which we shall enter more fully in the chapter on the
dangers of too free a meat diet.
The thyroid not only protects us against the poisons in meat, but also
against many others; in fact, perhaps we may say, against poisons
generally. Let us, however, specially mention those poisonous products
which have been tried experimentally. That the thyroid protects the body
against bacillary attacks has been noted by Charrin in the case of dogs,
which succumb in a very short time to all kinds of infection after the
removal of the thyroid. We have demonstrated, in Chapter III, the
protective action of the gland against such poisons as chloroform, as
mentioned in our communication to the Paris Biological Society in 1906,
where we stated that in chloroform narcosis all the characteristics of
an increased activity of the thyroid are perceived,—including symptoms
such as we see in Graves’s disease. We have also found that the thyroid
of dogs contains an increased amount of colloid substance after
chloroform narcosis, which enables us to understand why this drug is not
well borne by animals operated upon as above, as discovered by Lanz and
by Walter Edmunds; likewise, we may thereby explain why patients
suffering from Graves’s disease of long standing, in which there
generally is a transition to a myxœdematous condition, are liable to a
fatal termination after an operation with anesthesia. Cases of diabetes
(in accord with frequency of thyroid changes) also often present serious
phenomena after an operation under anesthesia, including coma and even
death.
Alcohol also acts on the thyroid gland, there being a certain analogy
between intoxication by chloroform and by alcohol. The changes in the
thyroid after the long-continued use of alcohol are the consequences of
the frequent conditions of hyperactivity of this gland, expressive of
its antitoxic action. We have referred to the influence of alcohol on
the thyroid in other parts of this book. This gland also protects us
against injurious drugs. Hunt, of Washington, has shown from experiments
that when certain animals, such as rabbits, have been given acetonitril
and thyroid preparations at the same time, they do not become poisoned;
whereas when they have taken the former alone, they do. Jeandelize and
Perrin have also proved the protective action of the thyroid against
arsenic.
Garnier has also found that certain drugs, such as iodine, pilocarpin,
etc., when injected into animals, produce an increase of colloid
secretion in the thyroid glands. It is, therefore, but logical to regard
this hyperactivity of the thyroid gland as an expression of its
defensive action against toxic products (see Chapter III).
From the foregoing it is obvious what an important organ we possess in
the thyroid gland, and that by its degeneration, as in the state of
myxœdema or in the much more frequent athyroidia, we become more exposed
to all kinds of poisonous products; but what renders its degeneration a
still graver misfortune for us, is the fact that it is apt to bring
about the degeneration also of other organs which destroy and eliminate
poisonous products, viz.: the liver, kidneys, intestines, and skin.
The liver is always altered by extirpation of the thyroid gland,
likewise as a rule in myxœdema, and even in hypothyroidia; for
congestion and other changes follow, as found by Rogowitch, Sanquirico,
and Canales, Albertoni, Tizzoni, and others. A fatty degeneration of the
liver has also been described by Sciolla.
Laulanié has discovered, in the same way as Van der Ecke and Rosenblath,
very extensive changes in the liver after removal of the thyroid.
Jeandelize also found interstitial hepatitis after the removal of the
thyroid and parathyroids. Kishi also describes alterations in the
blood-vessels of the liver occurring in a great number of animals after
thyroidectomy.
Hun, Prudden, Mackenzie, G. Murray, and others, found usually a
cirrhosis of the liver in myxœdematous persons. Vermehren found an
interstitial hepatitis, with thickening of the blood-vessels of the
liver, and of the bile, in myxœdema.
It is also of great significance to note that Gley, Laulanié, and
others, constantly found biliary matters present in the urine of animals
from which the thyroid had been removed.
After due consideration of these facts it cannot be denied that the
liver and the thyroid stand in very close relationship, and this we
maintained at the last French Congress of Medicine at Liège, where we
were glad to see that the President of the Congress, Professor Bouchard
of Paris, and later Professor Neusser of Vienna, coincided in this
opinion.
We have also shown, as already mentioned (Chapter V), that degenerative
processes of the thyroid are able to facilitate the development of the
gall-stone complaint. The degeneration of the thyroid is not only
followed by degeneration of the liver, but also by that of the kidneys.
It has been noted by Albertoni and Tizzoni, that animals whose thyroid
has been removed show a condition of interstitial nephritis. Blum has
found the same thing, and has observed also that this condition
frequently comes about in an astonishingly short time after the
operation, say, in 18 to 20 days. The parenchyma also presents distinct
signs of inflammation; the urinary channels lose their epithelium and
present the appearance of hollow grooves. These changes occur in all
animals, except such as die a few days after the operation, and such as
are permanently immune from the intoxication that follows the removal of
the thyroid.
We can also observe clinically that removal or degeneration of the
thyroid are capable of producing changes in the kidneys; for after the
operation, as a rule, albumin appears in the urine.
In myxœdema and hypothyroidia there is also very frequently albumin in
the urine, as well as hyalin or granular casts. In such cases the urine
is usually not copious; very frequently it is scanty (oliguria), and its
light color and low specific gravity show that the solids have been
retained in the body. In such cases there is often retention of uric
acid. In a communication to the Paris Biological Society (February 25,
1905) we attributed gout to changes in the kidneys giving retention of
uric acid, after primary alterations of the thyroid as the cause (see
also Chapter V).
That the intestines also suffer changes after degeneration of the
thyroid is best established by the fact that there is obstinate
constipation in such cases,—as in myxœdema or in partial myxœdema and
hypothyroidia (old age). The functions of the skin also will be
diminished after degeneration of the thyroid, as we observe plainly in
the conditions of myxœdema and hypothyroidia. In these diseased
conditions there is an atrophy of the sudorific and sebaceous glands, so
that the skin cannot perspire; on this account a large amount of toxic
products is retained.
We can see plainly from the above that when a person has a degenerated
thyroid a condition of auto-intoxication must necessarily follow, as
there is in consequence a degeneration also of the other organs which
destroy and eliminate poisonous materials. The liver in such a case will
not be able to fulfill its function of destroying a mass of poisonous
substances; the sluggish kidneys and bowels will not eliminate them
sufficiently, and dry skin will also contribute to their retention,
since its insensible respiration is not taking place. All these
life-shortening agencies, which may combine to cause premature old age,
can be brought back to a primary cause—the degeneration of the thyroid
gland.
When the thyroid is removed from an animal, but the parathyroids are
allowed to remain, that animal will not then suffer convulsions, but
will only present the symptoms of cachexia typical of the operative
cases of myxœdema.
It has been shown by Gley, Vassale, and Generali, that these very small
glandular organs, of which there are four, two internal and two external
ones, possess quite a different structure from the thyroid gland.
It has been demonstrated by many authorities, among them Jeandelize,
that the convulsions which follow the removal of the thyroid are due to
the fact that the parathyroids have been removed completely, together
with the thyroid gland. Jeandelize was able to produce convulsions by
merely removing the parathyroids alone; he attributed tetany and
epilepsy to the changes in the parathyroids, in common with other
authorities, who have even obtained good results in epilepsy with
parathyroid treatment.
Several authorities besides Jeandelize have attributed tetany to
alterations of the parathyroids: for instance, Pineles; and at the
German Congress of Medicine in Munich, Erdheim communicated his
observations in three cases of tetany, in each of which, at the
post-mortem, there was found hypertrophy of the parathyroids.
Dr. Macallum, of Johns Hopkins University, has also reported the case of
a person who developed tetany in consequence of a dilatation of the
stomach, and in whom the parathyroids were found to be hypertrophied.
We learn from the foregoing that the parathyroids protect us against
poisons that arise from the stagnation of the contents of the stomach,
and that their integrity is necessary as a safeguard against important
alterations of the nervous system.
However, these glands, which were already described by Sandström
twenty-two years ago, have not been studied as yet to the same extent as
the thyroid, and we cannot enlarge further on this subject at the
present time.
------------------------------------------------------------------------
CHAPTER XII.
HYGIENE OF THE THYROID GLAND.
THE rational hygiene of the thyroid gland consists in the avoidance of
all agencies that may prove harmful to the gland, the most important of
which are infectious diseases; frequent pregnancies; sexual excesses;
intoxications by food, stimulants, or drugs; and emotions such as grief,
sorrow, etc.
It will not be difficult to prevent some of these, but it will be nearly
impossible to avoid others, such, for instance, as infectious diseases.
There is not the least doubt, however, that at times we expose ourselves
quite unnecessarily to infections, as when we drink water that has not
been boiled or filtered, or when we take milk from uninspected dairies
for a long time; or, again, when we remain too long a time in the
confined air of assembly halls, etc., and breathe the air that has been
exhaled by thousands of others, many of them possibly with infectious
diseases of the throat and lungs. Many a case of infectious disease,
with all its dangers to life or to important organs, such as the
thyroid, may be avoided by proper circumspection.
It is also quite unnecessary for us to expose ourselves to the dangers
arising from the decomposition of meat, which is particularly injurious,
when taken in large quantities, to the thyroid, as shown by the
experiments of Breisacher, Blum, Chalmers Watson, etc., more especially
if animal food be taken that is not quite fresh and can cause the
formation of ptomaines. According to Blum the thyroid has the special
function of destroying poisons formed in the intestines, in particular
by the decomposition of animal food. Now when too much work is thrown up
on this important gland, it is easy to understand that after a time it
will give out, and to prevent this we must avoid taking large quantities
of animal food or fish (which is meat also, a fact not realized by many
people), and when we do take it, we must first be certain that it is in
a fresh condition. To enable us to do this we are provided with special
sense-organs, and our eyes, nose, and the taste papillæ of our tongue
will inform us whether the meat, and especially the fish or crustacean,
is in a fit condition to be eaten.
We have mentioned several times that alcohol and tobacco, taken in large
quantities or for a long time, are deleterious to the thyroid, which
fact will justify our abstinence therefrom, or the greatest moderation
in their employment; those who can do without stimulants will always be
the best off.
Sexual excesses can also be easily avoided, and women who wish to retain
their youth will do well not to expose themselves to pregnancies year
after year after having had three or four children. It is, however,
great good fortune to have a numerous progeny, and by careful hygiene,
as plenty of instances prove, the struggle against premature old age can
be carried out successfully. In regard to this we may refer to the
chapters on the causes of old age and on sexual hygiene. Diseases of the
ovaries must be particularly avoided, as all changes in those glands
will react on the thyroid, which is closely related to them.
Doubtless one of the most difficult tasks will be the avoidance of
strong emotions: grief and sorrow; and yet we are not helpless against
them, as will be illustrated in the chapter on the hygiene of the mind
and on the advantages of a religious belief.
Having dwelt on the necessity of preventing injury to this important
gland, we will now show that there are certain means of enhancing its
vitality,—which effect we can obtain by improving the circulation, and
removing agencies by which this would be impaired. As Sir Herman Weber
has shown, it is possible to improve the working condition of this gland
by massage, which should be done daily and is readily carried out.
It is easy to see that a tight collar offers difficulty to the free
circulation of the blood through this gland, and therefore it is
advisable to wear a loose, and also low, one. Strange to say, many
ladies wear such tight, high collars, not availing themselves of their
immunity from such a yoke, which men have voluntarily endured for so
long a time. It is advantageous not to button both sides of the
shirt-band to which the collar-stud is fastened, but one side only,
which is easily done when low collars are worn and is not noticeable;
the great comfort and advantage of so doing will outweigh all other
considerations.
The vitality of the thyroid gland may be enhanced by various measures in
which thyroid secretion, or iodine—its main element,—is introduced into
the body. The easiest way to effect this is by taking foods, such as
plants and vegetables, which contain a maximum of iodine. The iodine in
the thyroid and other parts of the body is introduced therein mainly
with our food (or by drugs in the case of goiter). Another way is by
taking thyroid extracts. Since, at a certain age,—as mentioned in the
chapter on the causes of old age,—parts of the epithelium of the thyroid
are degenerated and replaced by connective tissue, thyroid extracts will
be the best means, if taken in very small doses, of supplying this
physiological need. Such doses of the extracts, freshly prepared and
from a reliable firm, can do no harm, but, on the contrary, will keep
the thyroid in good working order. As we have learned from personal
experience these very small doses can even be taken, at intervals, for a
long time, without injury to the health, and we need not await the
arrival of old age, but should use them as a preventative against it,
and in particular temporarily where there is, or has been, a great
demand for thyroid secretion, as, for instance, in convalescence after
an infectious disease, or after childbirth, especially if the flow of
milk is scanty, which is an expression of a defective thyroid; also
after sexual excesses, and in cases of mental depression, after we have
suffered grief; in fact, after any of the occurrences which we know to
be harmful to the thyroid gland, which, in such cases, has been giving
off larger amounts of its secretion.
We must, however, caution patients against ever taking these extracts
_save under medical advice_, since otherwise dangerous results may be
and have been produced, as will be shown elsewhere.
The diet of greatest hygienic value with regard to the thyroid will
consist of large quantities of milk, with little or no meat, but plenty
of vegetables.
With such a diet there will result less putrefaction in the intestines,
and thus also less demand for the thyroid secretion to destroy poisonous
matters; at the same time, along with the milk and vegetables, iodine,
the main element of the thyroid secretion, will be brought into the
body, and a loss of this product from it prevented.
------------------------------------------------------------------------
CHAPTER XIII.
THE DESTRUCTION OF TOXIC PRODUCTS BY THE LIVER AND THE IMPROVEMENT OF
ITS PROTECTIVE FUNCTIONS.
THE liver is one of the most important of our organs. As Professor
Hemmeter, of Baltimore, says, “The liver is an organ secondary in
importance only to the heart. Living things can exist without stomachs.
They can live for forty days without eating, but mammalia can only live
a few days, sometimes not twenty-four hours, without a liver.” The
importance of the functions of the liver is illustrated in this
picturesque remark of Dr. Rovighi[172]: “Like unto Minos in Dante, the
liver tests the conscience of those that want to enter, and knows their
sins.”
Footnote 172:
Quoted after Professor Hemmeter. Address to Sixty-first Annual Meeting
of the Ohio State Medical Association, May 9-11, Canton, Ohio.
We introduce into our stomach and intestines a number of poisonous
substances which, if injected into our blood, would kill us, or at
least, cause grave intoxication. Yet because they are taken by the mouth
they are harmless, and the reason for this strange phenomenon is that
they must pass through the liver, being brought to this organ from the
intestines through the portal vein, and are there destroyed. This is
illustrated in the case of the Indian snake charmers, who acquire
immunity against snake-bites after having first sucked the poisonous
fang of the snakes and absorbed the toxin via the intestine. They
thereby gradually accustom their body to this terrible poison, which,
taken in this manner, is far less harmful, since it passes through the
liver. That the liver destroys various poisons was first shown by our
esteemed friend, Prof. Paul Heger,[173] of Brussels University, who
demonstrated by experiments that nicotin added to blood soon disappeared
after it had been passed through the liver artificially. After this
remarkable discovery other authorities have found reason to state that
the liver also destroys other poisons, in particular alkaloids:
strychnine and atropine (Professor Roger[174]), hyoscyamine (Heger and
Buys[175]), quinine, morphia, curare (Lussana). According to Schiff, and
Lautenbach, alkaloids undergo a chemical change under the influence of
the liver. As Slowzoff[176] found, the liver also protects us against
poisons such as arsenic; therefore we can understand why persons
suffering from hepatic disease cannot tolerate arsenic. This should be
taken into consideration when we are treating patients with cacodylates,
or with atoxyl.
Footnote 173:
Thèse de Bruxelles, 1873; Journal méd. de Bruxelles, 1877; C. R. de
l’Académie des Sciences, May, 1880.
Footnote 174:
Thèse de Paris, 1887.
Footnote 175:
Quoted from Hanot, Archives Gén. de Médecine, II, 895.
Footnote 176:
Slowzoff: Beitr. zur chem. Physiologie u. Path., p. 281, 1901.
It has, however, been maintained by Zagari that this antitoxic action of
the liver fails in the case of bacteria and, according to Professor
Roger, especially with bacterial toxins in old cultures.
Yet other authors have shown that the liver probably has an antitoxic
action against bacteria and their toxins. Thus, Professor Adami, of
Montreal,[177] by experiments with a minute diplococcus similar to that
which is found in Pictou’s cattle disease, and Sir Lauder Brunton, and
Dr. Bokenham,[178] have shown that the lethal action of diphtheria toxin
is greatly diminished during the circulation of this toxin through the
liver, and also that the juice from such a liver has a slight antitoxic
power. These authors have also shown that the bile from such a liver has
a slight antitoxic action. They consider that the antitoxic power of the
liver does not depend upon the blood present in the organ, but on the
liver-tissue itself.
Footnote 177:
Adami: Montreal Med. Journal, p. 485, July.
Footnote 178:
Sir Lauder Brunton and Bokenham: The Journal of Pathology and
Bacteriology, p. 50, Nov., 1907.
It has been shown that the liver excretes into the bile poisons which it
arrests during their circulation through the portal system. This has
been shown by Lussana in the case of curare. That poisonous substances
are excreted into the bile is shown also by the immunizing experiments
of Professor Koch against bovine plague. He employs the bile of animals
which died of plague. This contains attenuated plague bacilli, of which
Professor Koch makes use in his experiments.[179]
Footnote 179:
Quoted after Metschnikoff.
Dr. Fraser[180] has shown that when increasing doses of snake-venom are
injected into an animal a condition of immunity is brought about, so
that finally fifty times the dose which would have proved fatal at
first, becomes innocuous. As Fraser found, the bile of such animals
contains an antivenine, and he made use of this bile as an antidote
against the original venom.
Footnote 180:
Fraser: British Med. Journal, vol. ii, p. 595, 1897.
These experiments prove that the bile contains poisonous substances,
including pathogenic bacteria in an attenuated condition, and also that
it has antitoxic properties. Thus we may understand how it can
neutralize putrefactive products from the intestines. Not only bacteria,
but all the various kinds of poison which the liver destroys, are
eliminated by the bile; hence the importance of a free circulation of
this fluid. The liver serves as a depot for metallic substances like
iron and copper, and also for the more dangerous ones such as lead,
mercury, arsenic, or antimony. After first keeping them in storage, it
then attempts to eliminate these noxious substances. According to
Slowzoff and Bamossi, the various poisonous metals and alkaloids enter
into combinations with the proteid bodies of the liver. Animals that
have been richly fed have been found to be better protected against
these poisons because of their livers being richer in proteid contents
and glycogen.
The liver also protects the body against the numerous toxic products
formed in the stomach and intestines during the process of digestion and
assimilation. The most important of these are the carbamins and ammonia
salts, which would be injurious to us if the liver did not protect us by
converting them into urea.
When the liver is excluded from the circulation, as Nencky and his
pupils have done by establishing an Eck fistula, toxic symptoms arise
when the animals are given albuminous food, and these symptoms can only
be explained from the fact that the liver is unable to destroy toxic
products. The more albuminous food taken, the more marked are the
symptoms of intoxication.
The liver aids in the transformation of the poisonous end-products of
proteid metabolism by bringing about the combination of the toxic
end-products with sulphuric acid (Baumann, Emden and Glaesner). Thus
these dangerous substances are eliminated as ethereal sulphates, which
are practically harmless. Even when these ethereal sulphates are present
in large amounts in the urine there may be no symptoms of
auto-intoxication.
When the liver is extirpated, a condition of acidosis arises, and a
large quantity of ammonia is eliminated, which is produced in order to
neutralize the acids present. The liver protects us against acids formed
in the organism. After eating a quantity of meat, we would be menaced by
the acids formed through its decomposition, were the liver not active.
We can prevent acidosis if we eat a considerable amount of
carbohydrates, at least 100 grammes a day as Hirschfeld has proved. It
has been shown by Waldvogel that these carbohydrates do not prevent
acidosis if they are given by a method which precludes their passage
through the portal circulation,—e.g., subcutaneously.
As we have seen above, the liver receives an enormous amount of toxic
products from the stomach and intestine, which it transforms or
destroys. Like any other organ which is overworked, the liver may
undergo certain changes when continually subjected to a strain, and
great quantities of these toxins might be able, after a long-continued
action, to alter the liver tissue. Such a condition we may note in
gastric and intestinal diseases, especially in those cases where large
amounts of fatty acids are formed.
Bouchard found an enlargement of the liver in 23 per cent. of all his
cases of dilatation of the stomach.
We can understand that when fatty acids, as a result of
gastro-intestinal disease, pass for a long time through the liver, they
may destroy the delicate epithelium of this organ. Boix demonstrated
this by experiments. By feeding animals with lactic, butyric, and acetic
acids, he produced hepatic cirrhosis.
So long as the liver is healthy it is able to withstand the constant
inflow of toxins and will transform them into less harmful compounds.
But when the liver is altered, as in cirrhosis, things are different. We
then find a diminution of urea, and an increase of ammonia. Happily such
a condition arises only when there are considerable anatomical and
histological changes in the liver.
Salaskin and Zaleski have shown in animals that when there are serious
anatomical changes in the liver, the ammonia is increased, and the urea
is diminished. We may suppose that in old age, when the connective
tissue is more or less increased and important liver elements destroyed,
a similar decrease in the urea formation may take place just as in
chronic cirrhosis.
That in diseases of the liver toxic products are formed and eliminated
by the urine in increased amounts, has been shown by Professors
Bouchard[181] and Roger. They found that the urine of patients suffering
from diseases of the liver is more toxic than that of normal persons.
Footnote 181:
Leçons sur les auto-intoxications dans les maladies.
That the normal urine is toxic has been proved by Séglas and
Vauquelin,[182] and also by Bocci.[183] Bouchard has designated as the
urotoxic unit the quantity of urine necessary to kill an animal weighing
1 kilogramme, and as the urotoxic co-efficient the relation of the
urotoxin eliminated in twenty-four hours to the body weight of the
animal. This latter, then, indicates the quantity of urotoxins a man
eliminates in twenty-four hours.
Footnote 182:
Journal de Magendie, vol. ii, p. 357, 1822.
Footnote 183:
Centralbl. für med. Wiss. 51, 1882.
All these calculations of Bouchard have had no great success, however,
for many authorities, as Gumprecht,[184] Heymans v. d. Bergh, etc., have
shown that the toxic effects of the injected urine may be explained in
part by the difference in osmotic pressure between the injected urine
and the blood.
Footnote 184:
Centralbl. für Inner. Med., 24, 1897.
Still the fact remains that the urine of many cases of liver disease has
been found to be more toxic than the urine of other persons.
When the liver is damaged it cannot destroy poisons in the normal
manner, as was shown by experiments. Thus, the liver cells have been
experimentally injured when it was found that such a liver was not able
to destroy strychnine as well as a normal liver. Very important findings
have been made by Roger and Gamier.[185] They have ascertained that
privation, bad nutrition, etc., can also lower the vitality of the liver
and diminish its antitoxic properties.
Footnote 185:
Roger et Garnier: C. R. Soc. de biol., p. 209, 1899.
------------------------------------------------------------------------
CHAPTER XIV.
THE HYGIENE OF THE LIVER.
WE have often observed that people suffering from diseases of the liver
feel and look much better after abstaining from meat and living on milk
and a vegetarian diet. If such a diet be beneficial in cases where the
tissues of the liver are degenerated, it appears reasonable to assume
that it will be equally efficacious when the liver has not yet been
altered by disease. We must realize that the various unwholesome matters
we eat or drink are carried to the liver to be dealt with, and that the
end-products of the decomposition of the meat, and other elements
contained in preserved meat which may not be perfectly sound, may injure
the liver-tissue, or, at any rate, throw more work on this organ than
food in the nature of vegetables or milk.
A milk diet has the further great advantages that it assists in
destroying toxic products in the intestine, and also that it can hinder
the development of gall-stone disease (see Chapter XXXIX).
Not only meat used in abundance, but also various kinds of spices,
condiments and stimulants may be very injurious, especially alcohol, if
taken in large quantity. Gin and brandy are the most deleterious in
their action. Wines containing little alcohol are less harmful, but acid
or strong white wines may injure the liver-tissue.
The well-being of this organ is essentially dependent on the good
condition of various other organs with which it stands in very close
relation, in particular the intestines, for instance. It is from here
that most of the toxic products enter the liver, either by the portal
vein or through the choledochus. The intestine always contains myriads
of microbes, which may enter the liver either by the blood or the bile,
and thus provoke very important changes in the liver-tissue. Professor
Adami,[186] of Montreal, found colon bacilli in a cirrhotic liver.
Footnote 186:
Quoted from Quincke: “Diseases of the Liver” in Nothnagel’s
“Practice.”
It follows, therefore, that we must maintain the intestine in the best
possible condition, and avoid constipation and stagnation of fæcal
matters, with the augmentation of toxic products. That constipation is
very deleterious to the liver can be best shown by the fact that very
often affections of the liver and bile-ducts,—and especially gall-stone
disease,—are developed in persons suffering from habitual constipation.
The best treatment for these liver affections is a purging treatment,
and it is mainly on account of their action in this manner that certain
alkaline mineral waters have attained so great a fame; in addition, due
to increased peristalsis, the circulation of the bile is enhanced.
Proper movements of the bowel are indispensable to a sound condition of
the liver and for the prevention of hepatic disease, and we, therefore,
refer the reader to the chapter that deals in detail with the prevention
and treatment of constipation.
Not only the intestine, but the stomach also, must be in good condition.
It has been noted by Bouchard and Hanot that chronic gastric and
intestinal troubles are apt to cause enlargement of the liver. Bouchard
has found an enlarged liver in 23 per cent. of his cases of dilatation
of the stomach. Hanot and Boit[187] have shown experimentally that the
different acids formed in the gastro-intestinal tract are able to
produce a genuine cirrhosis of the liver. Therefore acid fermentation
must be carefully avoided; and to prevent such fermentation in some
degree in the stomach and in the intestine, it is necessary to masticate
the food thoroughly, as will be shown.
Footnote 187:
Hanot and Boit: Congresso Med. Internat. di Roma, 1894.
Another very important organ, the sound condition of which is of great
importance to the liver, is the pancreas. It has been found by several
authors, particularly by Steinhaus,[188] in his investigation of some 40
cases of hepatic cirrhosis, that the pancreas is also affected in each
case of this type; and we further know that after disease of the
pancreas, as in diabetes, for example, the liver is also, as a rule,
altered. Thus these two organs are in close relationship.
Footnote 188:
Steinhaus: Deutsches Archiv für klin. Medicin, 1902.
As pancreatic diseases are among the most difficult to diagnose, and
people suffering from them live and die, as do also many diabetics,
without their particular state having been recognized, so, the rational
treatment of these diseases being still imperfect, we cannot offer
advice in regard to their prevention. But, at any rate, the safest
course will be moderation in diet, especially fatty food, which exacts
the active co-operation of the pancreas. As in the case of all other
organs, long-continued overwork will exhaust this gland, and thus induce
a diseased condition. Moderation in diet will be the best policy for the
pancreas, as also for the liver; and to maintain these organs in sound
working order, meat in particular should only be taken in small
quantities, and fat also should not be partaken of in large amount.
Milk and vegetable food, with but little meat, and that preferably as
fish, will certainly furnish the best diet to avoid diseases of the
liver. As Quincke[189] mentions, experience shows also that water in
large quantities, especially certain alkaline saline waters, can
increase the flow of the bile; and therefore, as also for other reasons
mentioned in this book in Chapters XXXIV and XLI, water should be drunk
in sufficient quantity every day. The alkaline waters referred to are
certainly superior in their action to ordinary water, especially those
kinds which at the same time cause purging.
Footnote 189:
Quincke: “Diseases of the Liver,” in Nothnagel’s “Practice,” 1907.
Hot climates have a deteriorating effect on the liver. We have often
noted the great frequency of liver complaints under these conditions,
and we have never had a patient from the hot parts of Mexico who has not
had a hypertrophied liver. We are inclined to believe that it is not so
much the climate as faults in hygiene, especially in diet and in the use
of stimulants, which are the cause of such a condition in Europeans
residing in tropical climates.
A vegetarian diet is certainly the best in tropical countries, as we
personally found during a stay in Southern Florida, Texas, and Mexico.
Just as for the kidneys, so for the liver, a bath, and particularly a
sweat-bath, is of great benefit, since by means of it toxic products may
be eliminated which would otherwise be carried to the liver.
We have found these baths to be of great benefit in liver diseases, and
considering the amelioration of the processes of oxidation brought about
by such baths, it seems highly probable that they are capable of
improving also the working condition of a liver not as yet diseased.
In general, it is our opinion that to prevent disease in an organ the
surest method is to use those means through which that organ, when
diseased, is found to benefit. Of course this is only meant as a general
statement; but in the children of those suffering from liver complaints
such preventive treatment is particularly indicated, as these
conditions, we have found, are most frequently inherited. We have
treated cases where three or four generations of one family had been
sufferers from the same complaint.
Here, as always, let us follow the wise precept: “Prevention is better
than cure.”
------------------------------------------------------------------------
CHAPTER XV.
ON THE DESTRUCTION OF TOXIC PRODUCTS BY THE ADRENALS.
THERE is ample evidence in support of the contention that the adrenals
play an important part in the destruction of toxic products in the body.
As long ago as 1853, one of the leading authorities on the adrenals as
ductless glands, Brown-Séquard, noticed that the blood of animals
without adrenals was more toxic than that of animals the adrenals of
which had not been removed.
Langlois and Abelous[190] confirmed the conclusions of Brown-Séquard.
They also established the fact that the blood and muscular extracts of
frogs whose adrenals had been removed, were toxic, and contained a
poison of the nature of curare. The animals died from auto-intoxication,
and these savants came to the conclusion that the adrenals were created
to neutralize or destroy poisons which are evolved during muscular work.
Frogs from which the adrenals had been removed showed also lessened
resistance to muscular fatigue. Similar results have been observed by
Langlois in the case of other animals: rabbits, dogs, guinea-pigs, etc.
Albanese[191] also found that animals operated on as above exhibited
more fatigue than those whose adrenals had been allowed to remain
intact. The recent labors of Sajous which have shown conclusively that
the adrenals furnish to the blood one of its important immunizing
constituents explain all the above observations.
Footnote 190:
Abelous et Langlois: Archives de physiologic norm. et path., p. 267,
vol. iii, 1892, and “Travaux de Laboratoire,” Lancet, August 20, 1898;
Société de biologie, 1892.
Footnote 191:
Albanese: Archiv. Ital. di Biologia, p. 338, 1892.
The fact, observed by all these authorities, that when one of the
adrenals is removed the other becomes hypertrophied, sometimes to a
great extent, seems also to point to the conclusion that greater demands
are made on the gland that remains, the hypertrophied condition of which
appears to be due to the increased work required of it in protecting the
body from infection.
That these organs really assist in the defense of the body against the
attacks of microbes or the introduction into it of certain toxic
products can be best demonstrated by the fact that after such infections
the adrenals are, as a rule, altered, showing that a pronounced reaction
antagonistic to these agencies has occurred.
It has thus been proved by a succession of authors: Charrin,[192]
Langlois, Roux, Yersin, Professor Roger, and more recently by Oppenheim
and Loeper,[193] that in experimental or in spontaneous infectious
diseases the adrenals present important alterations as a result of the
reaction against infection.
Footnote 192:
Charrin: “Les défenses naturelles de l’organisme,” Paris, 1898; C. R.
Soc. de biologie, 1892.
Footnote 193:
Oppenheim et Loeper: C. R. Soc. de biol., 22 mars, 1901.
Oppenheim and Loeper found that important changes followed upon
experimental infectious diseases; for example, after infection by the
bacilli of diphtheria or anthrax, or by the pneumococcus; also in such
infectious diseases as diphtheria, pneumonia, small-pox, typhoid fever,
etc.; and also after experimental poisonings, as with arsenic,
phosphorus, or mercury. There occurred leucocytic reaction, diffuse
diapedesis, or infectious nodules, and also a congested condition of the
adrenals, sometimes so marked that hæmorrhage took place, with complete
destruction of the parenchymatous tissue of the glands.
Very important are the conclusions of Oppenheim,[194] that when animals
have received poisonous products, together with adrenal extracts, after
having previously lost these glands by operation, such animals show a
longer survival, sometimes even of indefinite duration, as compared with
animals without adrenals to which have been administered the same toxic
products, but without adrenal extracts.
Footnote 194:
Oppenheim: “Les capsules surrénales,” Thèse de Paris, 1902.
With phosphorus and urinary poisons in particular, this author has
obtained most striking results from the injection into animals of
adrenal extracts at the same time as the poisonous substances.
Oppenheim comes to the same conclusion as Abelous, Charrin, Langlois and
Sajous: that the adrenals play a great rôle in the destruction or
neutralization of microbic or other poisons introduced into the system.
We are thus in possession of powerful arguments in support of the
presumption that the adrenals are antitoxic glands. The fact, found by
Langlois, that the adrenals contain less adrenalin after experimental
infectious diseases, and that established by Luksch, that after certain
experimental infectious diseases such as diphtheria, typhoid, or
tuberculosis, the extract from the adrenals no longer produces an
increased blood-pressure, do not seem to us sufficient to invalidate our
belief in the antitoxic properties of these glands; for here we are
witnessing the same occurrence as has been previously noted in reference
to the thyroid,—that the functional hyperactivity of the gland may be
followed by its exhaustion.
Moschini, Nicholas, and Bonnamour have also found histological evidences
in the adrenals in infectious diseases indicating a hyperactivity of
these glands.
The fact that different toxic products, such as alcohol, can produce
alterations in the adrenals, indicates also a rôle of these glands in
defending the body against toxic doses of this substance (see Chapter
III).
It was found by Aubertin[195] and other authors that there is a
hyperplasia of the adrenals after experimental intoxication of the
guinea-pig by alcohol. Bernard and Bigart found important alterations of
the adrenals after experimental poisoning by mercury, arsenic, lead,
etc. As shown by Professor Sajous,[196] various drugs act on these
glands, and he attributes the rise of blood-pressure therefrom to the
action of such drugs on the adrenals, whose function, as is well known,
is to raise the blood-pressure. We can thus understand how if alcohol be
taken in large quantities it is able to produce atheroma and
arteriosclerosis, as are also other toxic bodies, such as nicotine.
Footnote 195:
Aubertin: C. E. Soc. de biologie, 22 juillet, 1902.
Footnote 196:
Sajous: Loc. cit.
It is well known that arteriosclerosis is frequent in great smokers. It
has been found by several authorities, among them Borylac, that
inhalation, or mastication, of tobacco produces atheroma, and by Boverie
and Loeper[197] that similar changes have followed experiments with
tobacco or ergotin. Very important data have also been established by
Drs. Isaac Adler and Hensel, of New York,[198] who have found that
atheromatous alterations of the aorta can be produced experimentally by
powerful doses of nicotine. Such alterations were similar to those
effected by adrenalin, but were neither so constant, nor so marked.
Footnote 197:
Société d’Anatomie, Mai 31, 1907.
Footnote 198:
Deutsche Med. Wochenschrift 8, 1906.