feet. This must logically make it obligatory for all who wish strictly
to follow the rules of health and long life not to prevent the free
access of air by impermeable rubbers or heavy high boots. Leather, of
course, is not a porous material, like certain kinds of cloth, and
hinders the free passage of air and the evaporation from the surface of
the feet. The most suitable footwear, and that best adapted to the
demands of rational hygiene, would be sandals, similar to those worn by
the Greeks and the Romans. Such, however, could only, in present days,
be worn in villages, at the seaside, or in the country generally, if we
do not want to be criticized as queer or eccentric by our neighbors, who
have less knowledge of the hygienic methods of living.
It might be possible to make footwear in such a manner as to overcome
this feeling as to wearing them—of the nature of sandals, or part
sandals and part shoes—such as slippers or “pumps.” At any rate it is
advisable never to wear other footgear than half-shoes, and the author
of this work wears such even in winter time without inconvenience and
without feeling cold. The best half-shoes for summer wear would be those
made of canvas with leather soles. It goes without saying that one has
to get accustomed to this habit of wearing low shoes, by beginning in
warm weather and continuing uninterruptedly to the winter, and even
throughout that season, unless very severe weather prevails, when
gaiters should be worn above them.
If porous woolen socks of the best quality are worn in conjunction with
the half-shoes cold is not felt, especially if we do not remain still
but walk about briskly, which will practically convince us of the
necessity of walking and running for exercise.
Rubbers are unquestionably unhealthy things to wear, and to many will
cause a disagreeable sensation owing to the hindrance to foot
perspiration.
It is advisable to take off our shoes, as the Mohammedan does, as often
as possible during the day; for instance, while working or reading, and
at any time when we are in private, and only put them on again when
visitors are present. Everybody appreciates what an agreeable sensation
it is to take off one’s shoes and have a good airing of the feet,
especially after a long walk, in which latter case a foot-bath is also a
capital thing which will certainly increase our comfort, especially if
we have been wearing sandals or half-shoes and we have been wandering
about the country exposed to dust.
We have referred more fully to the use of the foot-bath in another
chapter. In the same way as with our footwear, we should reform our ways
by removing the yoke which cruel fashion obliges us to wear round our
necks—the high, stiff collar. How long shall we continue to put up with
these continuous impediments to our health? Top hats! tight collars!
tight boots with a pointed toe! and a fur coat over our dark clothes!
How can the sun and air penetrate such idiotic harness, and how can the
poisonous exhalations of the body find their way into the fresh air when
they are retarded by very heavy and warm woolen underwear? We must again
repeat that we catch cold much more easily when we are clad too warmly
than too lightly. The more freely we perspire in our clothes the more
easily we catch cold. We found this from personal experience. We were at
one time always catching cold, in consequence of too sedulously wrapping
ourself in woolen garments and heavy clothing. But since we have taken
to wearing linen or cotton underwear and light clothes, with half-shoes,
carrying our hat in the hand, and the overcoat rather on the arm than on
the body, we now rarely ever catch cold.
All of our garments should be loosely fitting, and in this respect the
American fashion for men’s clothing is superior to the European fashion
of tightly fitting garments. Also the present style of long, narrow
trousers is not only unæsthetic but also unhealthy and unsuitable for
quick movements. Let us go back to the knee-breeches of forefathers, who
were thereby made much more pleasing to the eyes—at least, those of
normal build were.
A sufficient aëration of the body is necessary not only by day, but by
night. In fact, it is more necessary at night, for as mentioned in the
chapter on sleep, the ridding of the body from toxic products is
performed more actively during the night. It will logically follow from
this consideration that heavy feather beds and, in fact, all kinds of
heavy coverlets are not beneficial to health, as they are apt to
suppress the exhalations of the body and to prevent the access of air to
the body. For the same reasons it is also imprudent to go to bed in
underwear, and particularly if woolen. I would even go so far as to
dispense with the use of the night-shirt, a garment which was quite
unknown to our ancestors until a few hundred years ago. By going to bed
quite nude, in a large bed, with ample bed clothes of a porous material
wrapped not too tightly about the body, we have thus a kind of air bath
in bed and feel more refreshed in the morning, especially after having
slept in a room where the air can enter freely. In cold weather in
winter a double woolen coverlet can be used.
It may be that in carrying out strictly the rules of a rational hygiene
of clothing as laid down above, many people may have to revolutionize
their old habits of an unhealthy and life-shortening way of living. But
the real question is: Do we want to live long and retain as long as
possible our youth that is passing away only too quickly in any case, or
do we want to descend into an early grave before our time? Those who
desire the first alternative and who wish to enjoy their lives up to the
very last may follow my advice; then they will soon be rewarded by
fresher looks and increased vital power.
------------------------------------------------------------------------
CHAPTER XXVI.
IMPROVED HYGIENE OF THE SKIN AND KIDNEYS THROUGH BATHING—FOOT-BATHS.
EVERY day we are getting rid of the superficial layers of the skin,
which process can become so intense in some people that the skin looks
as though it were covered with flour dust; and in some persons with dry
skin such apparel as stockings sometimes gets full of this. These minute
scales, which get necrotised in the upper parts of the skin, are apt to
clog the pores, which can also become closed by particles of dust, or by
products of the sebaceous glands and by perspiratory residues. As the
free entrance of air to the pores is an essential condition for skin
respiration, and as the elimination of harmful products is only possible
when the pores remain open, we must get rid of the foreign matters which
clog them, for which purpose we take a bath. But water alone, even if it
be hot, is not able to effect a thorough cleansing of the skin on
account of the oily substance which is secreted by the sebaceous glands;
so, to obtain the fullest cleansing effects, we add the use of soap and
a brush, as already mentioned before. We must rub the soap well in, and
then rub it off energetically, if we desire to benefit by a fully
hygienic bath.
As we are daily getting rid of the above-mentioned skin scales, so it
behooves us to take a daily bath. It is not necessary to stay in the
bath more than ten to twelve minutes, or at the most fifteen. For the
reasons above mentioned the effect of bathing is a rational hygiene of
the skin.
By the action of the water, soap, and brush friction the skin receives
more blood, which is, at the same time, a great advantage to the
internal organs, as the blood drawn away from them facilitates the
circulation through them should they be congested. When more blood
reaches the skin the muscles that contract the pores are also better
nourished, and they then react better to certain agencies—cold, for
instance. They quickly contract the pores, so that the blood will be
kept back in the interior of the body and a cooling off of the periphery
of the body, with its dangerous consequences from catching cold, may
thus be avoided.
A daily bath can also be advantageous for those who perspire too freely.
After a bath, and this is one of its greatest advantages, the insensible
perspiration is much increased, and more water leaves the body through
the pores than before, and when a bath has been too hot, a very free
perspiration may ensue. But usually with people with a too free
perspiration, this tendency would be diminished, as it can often be
noted that those who daily take a lukewarm bath perspire less than
others on warm summer days.
Besides exciting the functions of the skin baths are also an excellent
means for diminishing a possible overwork of the kidneys, and thus
keeping them in good condition. It is possible to eliminate, through
bathing, such products by the skin which otherwise would have to be
eliminated through the kidneys.
It has recently been shown by experiments conducted by Strasser and
Blumenkranz[237] that baths taken for a long time and at a temperature
of 34-35°C., are able to create an increased elimination, not only of a
considerable quantity of water, but of common salt also, and of the
products of decomposition of nitrogenous matter.
Footnote 237:
Strasser und Blumenkranz: “Die Wirkung indifferenter und
schweisstresbender Bader bei Nephritis,” Med. klin., Beichfte Hefte 6,
1907.
These authorities come to the conclusion that through bathing there can
be brought about a true increase not only of the water-secreting
activity of the kidneys, but also of their ability to eliminate
nitrogenous end-products and salt. They found an increase of diuresis to
double the usual amount and an increased elimination of from 50 to 100
per cent. of nitrogen, and from 100 to 200 per cent. of salt. According
to Liebermeister, Loewy, Rubner, and others, the processes of oxidation
can be increased by cold baths from 50 or 100 to 200 per cent., and by
hot baths, according to Winternitz and Rubner, 50 to 100 per cent.
Rubner also asserts that the processes of oxidation can be wonderfully
increased by cold douches.
There can thus be no doubt that baths are able to influence the
conditions of the kidneys in a very favorable way, and that their
vitality may be augmented by the daily use of the bath.
The drawback to the bath is that so many people easily catch cold
afterward; to prevent which, such persons should not wet the head, and
especially the back part of it, as otherwise catching cold is easily
effected; and it is also of importance that the bath-room should not be
left while the skin is hot. The best way is to allow cold water
gradually to enter the bath, getting out directly there is the least
sensation of cold. The rule should be not to leave the bath when the
skin is hot and red and the pores wide open, without letting cold water
contract them by taking a short douche, and on getting out of the bath
the skin should be quickly dried by energetic friction with a rough
towel until the skin becomes quite scarlet. Not sufficiently drying the
skin will cool it rapidly, and even intensely, owing to the evaporation
of the water from the periphery, and surely cause a severe cold.
To prevent the habit of catching cold the best way is to accustom the
skin to the action of cold water. Rubbing the skin with a cold wet towel
until the skin glows, especially the chest and extremities, is a good
way to effect this, beginning in warm summer weather and continuing
through the winter, but not _vice versa_. Decidedly the best
preventative to catching cold is to get the skin accustomed to fresh air
and cold water.
To prevent catching cold after a bath a reaction of the skin is
necessary, and this is best attained by a rough towel, as before
mentioned, and by rubbing the body with a hard brush. Massage is an
excellent addition to bathing, as by this means the circulation through
the skin and muscles is much increased, thereby increasing the oxidation
of the body. By kneading the muscles waste products are brought into the
lymphatics (see, also, chapters on exercise).
It is only logical that we must pay special attention to cleanliness in
those parts that have the greatest number of sudorific glands, such as
for example the axillæ and the toes of the feet. Circumstances often, as
when on a journey, do not allow of the luxury of a complete bath, and in
such cases we must be content to wash the body with water and soap, and
to rub down with a rough towel and brush, paying particular attention to
the axillæ and feet. These may also be bathed in alcohol and water, ½ to
⅓ of the latter, and also with vinegar and water; the feet can best be
cleansed in a foot-bath.
From ancient times, especially in the East, such foot-baths have been
largely used, probably for the reason that sandals were worn, which
allowed dust and dirt to accumulate on the feet; people whose feet
perspire freely should always use a foot-bath daily; and, because the
feet are a part of the body which are the worst aërated from being
covered with impermeable leather, while they are, at the same time, the
best provided with sudorific glands, a daily foot-bath is advised for
all.
When the feet perspire freely, hot water must be used; but after using
such we must immediately use cold water so that the opened pores will
close again. Pouring cold water into the bath or over the feet will
effect this, but it must be done quickly.
Foot-baths are excellent things for those who suffer from cold feet, and
what at first sight seems paradoxical, a cold foot-bath in particular,
which acts by enlivening the circulation in the feet; the bathing
should, however, only last about a couple of minutes. Cold baths for the
feet also act very beneficially in cases of headache, and especially in
insomnia. They act upon the distribution of blood in the brain; the
blood-vessels are thereby first distended and afterward they contract,
which, lasting for a certain time, induces sleep; for, as mentioned in
the chapter on sleep, the brain must be free from blood if sleep is to
result. In hot summer weather it is quite delightful to sit on the banks
of a river and allow our feet to dangle in the water, and we always feel
refreshed after it; walking with bare feet is also very pleasant and
healthy in summer time.
The action of a foot-bath is much increased by the addition of salt or
mustard, and with the latter is an excellent preventative against a
hyperæmic condition of the brain, such as apoplexy, as thereby we favor
a decreased congestion of this noble organ.
Cold foot-baths should not be used by very old people, as they distend
the brain-vessels which, as a rule, are altered in such people and may
more easily rupture; if taken, a wet, cold towel should be wound round
the head.
Cold baths generally are often beneficial in the case of certain nervous
troubles, such as neurasthenia and hysteria; only they must never be too
cold nor too prolonged, as otherwise the effects may be very depressing.
A short cold friction of the body every morning on rising is of great
advantage in the preservation of health. In kidney trouble we must,
however, be careful, as often an increase of albuminuria has been
observed after them. Sea baths are especially refreshing, owing to the
sodium content of the salt water. Our own observations teach us that a
bath had best be taken by first using water of the highest temperature
that can be borne (about 42 degrees C.). Those who can stand it might
continue to add hot water until the skin is quite red. Abundant
perspiration will then appear on the head, face, and neck. After having
perspired freely, we should then allow cold water to enter until the
bath has become cool. It usually takes some time to cool the water off
thus gradually, but after such a bath there is a feeling of great
exhilaration, especially after warm sea baths taken in this manner. We
consider that hot baths of long duration—say 30 to 45 minutes—are
especially useful in cases of kidney disease, or as a preventive of
such. We could take them twice a week as a means of eliminating the
toxic products of metabolism, but _it is an essential condition that the
heart and blood-vessels be in good condition_. The Japanese are in the
habit of taking such hot baths at an enormously high temperature, and
they feel the better for it.
Bathing generally is favorable not only to the kidneys, but to all the
organs, as the processes of oxidation are thereby promoted, and our
prospects for long youth and long life are bettered.
------------------------------------------------------------------------
CHAPTER XXVII.
HYGIENE OF THE SKIN AND KIDNEYS BY MEANS OF PERSPIRATION.
UNDER normal conditions we daily lose a certain amount of water and also
of gaseous and solid products, among them many harmful ones, through the
invisible and insensible perspiration of the skin. That such a process
does actually take place is proved by our personal observation and by
the disagreeable feeling produced in cold and damp weather by the
checking of such perspiration. We can even be seriously affected if by
disease or by extensive burns a large portion of the skin be destroyed,
thus abolishing this insensible perspiration.
The invisible and insensible perspiration can become visible and
sensible when either its evaporation into the air is checked, as in the
case of tight-fitting clothing, such as a rubber overcoat, or when the
temperature of the medium around the body is raised. Both conditions can
be fulfilled by fur clothing, for which reason its use as wearing
apparel is to be deprecated.
When in a state of perspiration we should take special care that the
passage of the perspiratory products into the air shall not be impeded
by any means. Fur garments are not so unsuitable for old people in whom
the perspiratory functions of the skin are much diminished. We have, in
this connection, observed an old lady of 76 sitting at the dinner table,
close to an overheated fireplace, and wearing a large fur collarette, in
which she felt quite comfortable. As frequently mentioned in this book,
in old age there is a degeneration of the thyroid gland to a greater or
lesser degree, and consequently a lowering of the temperature of the
body and a diminution of the functions of the skin, which is dry and
rarely perspires.
When the temperature of the medium which surrounds the body is raised to
a high degree, the capillaries of the skin are widened and more blood
circulates through them; thus also more blood is conveyed to the
sudorific glands, and naturally more water is then excreted by them, and
at the same time also more of the solid and harmful products. According
to Camerer, the sweat contains in each 100 grammes 50.6 g. ashes, 10 g.
fat, and 10 g. nitrogenous matters, of which 30 per cent. is urea and 75
per cent. is ammonia. Uric acid was also found in the sweat of healthy
people, but Magnus-Levy found it missing in gouty patients. By frequent
sweating procedures the hygienic conditions of the skin can be promoted,
and especially so in individuals whose skin is generally dry and
inactive. In those who perspire much too freely, however, after several
procedures of this kind the overactivity of the sudorific glands can be
diminished. After very free perspiration the condition of the skin will
be improved, and then we will note the disappearance of certain skin
diseases, such as psoriasis in hot summer weather.
Habitual excessive perspiration can, however, impair the skin through
the elimination of harmful products, although the skin is, to a certain
extent, protected by the greasy matters secreted through the sebaceous
glands. Likewise we can also note the loss of hair in persons perspiring
very much about the head and more particularly in those parts where the
sudorific glands are situated, such as the forehead and temples. This is
most frequently observed in those who have dry hair, in whom accordingly
there is a diminution of the functions of the sebaceous glands. In
persons who wear fur caps and whose head is always covered, we most
frequently find bald heads, especially if they have a tendency to
perspiring about the head. For this reason it is also more reasonable
never to wear hats if we desire to retain as long as possible the
natural ornament of the head.
We can cause abundant perspiration by all the various means by which the
temperature of the body is raised. In such cases more blood comes to the
periphery of the body, and thus also to the sudorific glands. The
essential factor is the widening of the capillaries, and this can be
produced not only by agencies influencing the body from without, such as
hot air or a vapor bath, but also by agencies from within the body which
act on the vasomotor centers and thereby cause a widening of the
capillaries, such as certain drugs like salicylates, and also organic
preparations like thyroid extracts; mental emotion will also cause such
an occurrence. Salicylates are excellent drugs for producing abundant
perspiration, and are also less dangerous than pilocarpine. After the
use of the former and very free perspiration, we notice an improvement
in the symptoms of gout, for reasons we will give later.
Of the different baths which are used to induce perspiration we award
the preference to electric light baths, where we obtain a double
advantage, for we can unite the advantages of perspiration with those of
the influence of light upon the body. We are able to prepare such a bath
so that the chemically active rays (see chapter on the advantages of
sunshine) are obtained. Not only is a very abundant perspiration
produced (indeed sometimes about a liter of sweat can be removed from
the body in from twenty to twenty-two minutes), but also the processes
of oxidation can be augmented. As a consequence we often note a great
diminution of fat in persons with a superabundant accumulation of this
substance. When in such baths blue light is used and the blue rays are
acting in overwhelming quantity, the condition of the nervous system can
be influenced in a very favorable way, and especially can excited
conditions be calmed. It is also probable that by such sweating
procedures toxic products, which are deleterious to the nervous system,
can be removed. Perspiration can also be caused by bodily movement
through exercise. In such cases, as proved by physiological experiments,
impulses are sent to the vasomotor centers, which result in a widening
of the capillaries through the excitation of such centers. Thus sweating
is created by fast walking, running, and frequently also by horseback
riding, and by various kinds of sports, such as cycling. In all these
cases it is essential, however, to change the clothes and underwear
which we have worn when perspiring, and to take a bath; for the
possibility is not to be denied that a part of the toxic products which
adhere to the skin after such sweating exercises may be re-absorbed,
although we are not in a position to give exact experiments to prove
such a supposition.
Taking a bath and using soap and brush, and creating a friction until
there is a red reaction of the skin, may then prevent the danger of
catching cold, but after such a bath it is most important not to leave
with a hot, red skin and opened pores, but to cause their contraction by
a quick cold douche, continued at intervals until the skin is cooled and
the pores thereby contracted. An energetic friction of the skin must
follow before leaving the bathing place.
After such a bath we shall experience a sensation of great comfort, and
shall feel much lighter and fresher. Such baths should be taken
frequently, at least once a week, and if we are very desirous of keeping
a youthful appearance for a long time, even more frequently. In stout
people, however, it is necessary for such baths that the muscles of the
heart be not degenerated; and also that there should be no serious
affection of the heart valves or of the blood-vessels, if baths of a
very high temperature and lasting a considerable time are indulged in.
In cases of chronic intoxication and such like diseases of metabolism,
such as gout, and in cases of old age, perspiration induced by very hot
baths, providing the circulatory system is in good condition, should be
tried and given often if the results prove satisfactory, as we thus
obtain the benefit of the bath and also of the perspiration.
The sweat baths should not exceed 15 to 20 minutes in duration unless
they are well borne, when a few more minutes may be added. In old people
cold douches should not be resorted to, but directly after the bath they
should be put to bed, which should have been previously warmed by
hot-water bottles. In persons where the processes of oxidation are
diminished and the skin very inactive, as is the case with many aged
people, such baths give very excellent results.
Sweating improves the functions of the kidneys in a much greater degree
than those of the skin. By insensible perspiration water is eliminated,
together with certain harmful solid products which otherwise would make
their way through the kidneys; this occurs much more so when the
perspiration is greatly increased by sweating processes. In such cases
about a liter of water can pass through the skin daily, and in addition
a considerable part of the nitrogenous end-products of metabolism and of
common salt. It has been discovered by Professor Hermann Strauss[238]
that in a liter of sweat, under favorable circumstances, fully six
grammes of common salt can be removed from the body. Leube once found
2.31 grammes of chlorides in 800 grammes of sweat.
Footnote 238:
Deutsche Med. Wochenschrift, p. 34, 1904.
Of nitrogenous bodies, according to Strauss, about 2 grammes can be
removed through the skin daily, and according to Professor von
Noorden[239] only 1 gramme. Leube discovered, about thirty years ago,
that the amount of nitrogen in the urine was 2 grammes less on such days
as sweating processes had been used than was usual on other occasions.
Kovesi and Roth-Schulz found 29 grammes of nitrogen and 29 grammes of
common salt in the sweat of patients suffering from Bright’s disease.
Strasser and Blumenkranz found, after electric light baths, a
considerable increase in the elimination of common salt up to 18
grammes, 4 grammes more than had been ingested. Nitrogenous bodies have
also been eliminated in larger quantities than have been introduced, as
has also more water. This has been proved in experiments on the effects
of bathing, in which people with diseased kidneys have been used as the
subjects. In these cases the elimination of common salt and nitrogenous
products is certainly greater than in normal individuals. Still there
can be no doubt that with such, by perspiration and bathing, an
increased elimination of these products can be obtained.
Footnote 239:
v. Noorden: Pathologie des Stoffwechsel, vol. i, 1906.
The experiments of Roth-Schulz and Kovesi are most interesting. These
authorities discovered, and before them H. Strauss, that the sudorific
glands of nephritic patients when in increased activity can secrete a
liquid that is more concentrated than the blood. Thus a compensatory
action can be obtained. They hold that, through sweating, from 10 to 20
per cent. of the solids in the urine can be eliminated through the skin.
It is also most important that they discovered a reduction in the
molecular concentration of the blood, which, as we know, is increased in
nephritic conditions. The frequency of sweating processes for persons
suffering from affections of the kidneys is all the more indicated
because such persons, generally, have a pale and very dry skin, the
temperature of which is, as a rule, diminished.
To this great amelioration of the kidney functions by perspiration is
also due the fact that gouty patients are much relieved after frequent
sweatings. As already mentioned we attribute gout to an alteration of
the tissues of the kidneys, by which uric acid is retained. By diverting
the end-products of the nitrogenous bodies to the skin and relieving the
kidneys of a part of this strain, we may also improve their condition
and thereby the gouty element. At the same time, in consequence of these
procedures, the excretion of urine has much increased; and this has been
going on for several days, not only after the bath, but after the
sweating. By such an increased diuresis the condition of gout can also
be much improved, as everything that improves the kidneys improves that.
From the observations of Haig, the elimination of uric acid is rendered
more difficult by reason of the presence of common salt; the increased
elimination, therefore, through the skin must necessarily be more
advantageous in the case of gouty people.
There can be no doubt that sweating processes are of great benefit, not
only to the kidneys, but also to the other organs, such as the liver.
We also generally observe perspiration in all processes of infection or
intoxication, and it may therefore be regarded as a probable species of
self-defense of the human body against the attacks of microbes or other
toxic products, for it would seem that by this means nature desires
spontaneously to get rid of the various toxic matters. Indeed, when we
treat fever with salicylates we are assisting nature to this end, for we
thus create perspiration. As already mentioned in Chapter III, persons
with a dry skin, who perspire but rarely, have less protection from
infectious diseases than others. Thus everything supports the theory
that the various toxic products, including those from microbes, are
eliminated by perspiration. Many years ago we tried to find microbes in
the sweat of typhoid fever patients in the St. Pierre Hospital in
Brussels, but as has been found in the bacteriological laboratory of the
Institute Solvay, the cultures that formed were due to a pollution of
the perspiratory products with foreign microbes. The efforts of other
authorities have also failed up to now to discover, by exact research,
the presence of microbes in sweat, as expressive of their elimination
through sweating. But, even if not supported by exact evidence, we feel
inclined to believe that by perspiration in abundance a number of toxins
of bacterial origin can be eliminated from the blood, because in
feverish ailments, after great perspiration, as in the case of
pneumonia, a great improvement takes place in the condition of the
patient. In former times bleeding gave similar results, perhaps in a
greater degree; but in the present day sweating has superseded this.
To the hygiene of the skin through bathing we would wish to add, before
concluding this chapter, that carbonic acid baths may also give good
results, as they cause a better circulation of the blood through the
skin, which gets red. Such baths are also excellent preventatives
against arteriosclerosis.
------------------------------------------------------------------------
CHAPTER XXVIII.
ON EXERCISE, SWEDISH GYMNASTICS—MASSAGE—SPORT, AND WALKING AND RUNNING
EXERCISE.
ALL kinds of exercise have one essential point to them—they produce a
contraction of the muscles. As Ludwig and his disciples have shown,
contraction of the muscles produces an increased supply of blood in
them; more arterial blood being brought to the muscles, more oxygen and
heat is generated through them, which results in a general increase of
the process of oxidation.
When muscles are undergoing contraction impulses are conveyed to the
splanchnic nerves, which are the regulators of the vasomotor system.
Through the irritation of these nerves, the blood-vessels of the
internal organs supplied by the splanchnics contract, and more blood is
despatched to the periphery of the body. The capillaries of the skin
will be dilated, and more blood will also be brought to the sudorific
glands; these also excrete more water, which takes the form of sweat.
Thus, by exercise that causes some exertion, abundant perspiration
follows, by which means we can obtain the advantages we have mentioned
in the chapter on the hygiene of the skin and kidneys; and it is for
this reason also that we place this chapter on exercise immediately
after the above-named one.
The essential point in these exercises is that a great part of the
circulating blood will be brought to the periphery of the body, and thus
the congestion of the internal organs will be prevented or relieved.
Among these organs the kidneys will be benefited, but only in a
preventive sense, for in inflammatory conditions of the kidneys,
especially in the parenchymatous forms, all kinds of exercise should be
avoided. Besides the kidneys and other organs, the heart also may
benefit by exercise if such be taken in moderation. The greatest
benefit, especially for those with a diseased heart, will follow
exercises carried out in the form of Swedish gymnastics.
The originator of the Swedish gymnastic movements was Peter Ling, who
gained great credit for himself and his country by the invention of this
system, which has prolonged the life of many persons suffering from
chronic ailments. In the Royal Central Institute for Gymnastics in
Stockholm, and also in private schools in that city, many experts have
been trained in these methods, and from thence they have spread all over
the world, many coming to the United States, where Dr. S. Weir Mitchell
introduced these salutary systems, and also massage.
Massage was known thousands of years before Ling’s time, notably in
India, Java, and other countries of the Malayan race. Even the great
Harvey knew the effects of massage, for he quotes the case of a man who,
in consequence of an insult which he could not avenge, became so
overcome with passion and rage that he fell into a strange
disorder—suffering from extreme compression and pain in the heart and
chest, from which he only eventually received some relief when his chest
was pummeled by a powerful man—just as a baker kneads dough.[240]
Footnote 240:
Quoted after Sir Lauder Brunton, Harveyan Oration.
The essential thing in massage is the kneading of the muscles. We thus
artificially increase the flow of the blood in them through the local
irritation of the skin and the mechanical diffusion of the blood in the
direction of the muscle. We thus produce artificial hyperæmia, not
unlike the effects of a mustard plaster, and, in the same way as the
plaster, we are also drawing blood from the congested organs, and
especially from the engorged heart; thus we obtain a better distribution
of the blood throughout the body and facilitate the action of the heart.
It has been shown by the experiments of Sir Lauder Brunton and
Tunnicliffe that kneading the muscles increases circulation through them
in the same manner as massage. They found that during such kneading the
amount of venous blood which issued from them was sometimes diminished
and sometimes increased; that just after the kneading was over the flow
diminished (apparently from the blood accumulating in the muscles), and
this diminution was again succeeded by a greatly increased flow. The
clinical results are precisely what one would expect from increased
circulation in the muscles, and cases apparently hopeless sometimes
recover most wonderfully under this treatment.
By means of massage the functions of the heart can thus be facilitated,
for massage mechanically diminishes the resistance of small capillaries
to the oncoming blood-waves sent from the heart. It mechanically
quickens the circulation of the blood through the capillaries by
dilating them in a way similar to exercise (see, also, Chapter XVIII).
By certain massage movements applied to the exterior region of the
heart—such as vibratory massage—this organ can also be favorably
influenced; and by kneading, friction, and massage together applied to
the periphery of the body, and by passive movements of the extremities,
many cases of heart disease have been treated with good results, and
premature death prevented. Still more thorough is the effect of such
treatment if carbonic acid baths are used in connection with the above,
as at Nauheim, for such baths stimulate the skin, which becomes better
provided with blood. We have referred to the effect of such baths in a
previous chapter on the hygiene of the skin and kidneys by means of
bathing.
The Nauheim treatment affords good results in mild cases of
arteriosclerosis, dilatation of the heart, and various other forms of
heart disease.
Massage is also an excellent thing in chronic diseases of metabolism, as
it helps the resorption of waste products and augments the processes of
oxidation; in cases of gout, obesity, and also diabetes, it can
therefore give very good results.
In the case also of healthy people who can afford to be massaged daily,
vital functions can be rendered more active and youthfulness prolonged;
and for those who do not possess facilities for being massaged by
others, they can perform it themselves by friction, rubbing the body at
rising and just before going to bed.
The Swedish movements can also be performed not only by free gymnastics,
but also by the use of mechanical apparatus, such as that invented by
Dr. Zander of Stockholm. These movements, combined with massage, also
give good results in many of the above-mentioned ailments, but it would
lead us too far to enlarge upon them here.
Much more strenuous for the body than Swedish movements and massage are
the exercises of sports, a complete description of which would exceed
the limits of the present work; but whether it be football, tennis,
golf, athletics, or cycling, the great object in all is to easily create
perspiration, by which the benefits described in the chapter on hygiene
of the skin and kidneys are obtained. It goes without saying, that a
diseased state of the kidneys excludes all kinds of violent exercise
which require a severe bodily movement. By means of sport the processes
of oxidation are also rendered more active, and thus obesity can be
prevented and cured, and at the same time the waste products are more
thoroughly consumed. Neurasthenic conditions, insomnia, etc., may be
improved if the sport adopted does not lead to too great fatigue;
otherwise they may be made worse. Taking into consideration, however,
the conditions of the circulatory mechanism, sport is a two-edged sword.
If undertaken in moderation all sport can improve our physical
condition; but it may prove disastrous if reason be not exercised and it
is indulged in to excess. By the strong muscular exertions referred to
an irritation of the splanchnic nerves takes place, resulting in a high
blood-pressure; more blood will pass with greater vigor through the
arteries and capillaries, which, consequently, become dilated. If this
occurs too frequently they will, as is only natural, lose their
elasticity, in which case degeneration of the arteries and development
of arteriosclerosis may follow.
When a succession of severe muscular exertions takes place an
accumulation of blood occurs in the right side of the heart, and, as the
right ventricle cannot empty itself, shortness of breath, and even
death, may result. The left ventricle then becomes dilated, and such
dilatation of the heart not infrequently persists for a long time, even
in persons who have been in good health before undertaking severe
exercises. If, therefore, the normally healthy may suffer from an
irrational indulgence in sport, how much more fatal must be the results
to those with heart or kidney complaints, and with degenerative
conditions of the blood-vessels?
To persons of advanced age sport may be very pernicious, for here the
elasticity of the arteries is wanting; they are more rigid, and
consequently cannot so readily dilate. Overexertion in such cases may
lead to the gravest results.
As those engaged in sport lose a large quantity of fluid, they soon feel
thirsty, and so may be inclined to make up the deficiency of water in
the blood by partaking of alcoholic beverages, such as beer, whisky, or
wine; and if such are taken in large quantities, necessarily further
dilatation of the heart and blood-vessels will result, as is usual from
the frequent use of large quantities of liquids, not taking into account
the mischief caused to the various organs by the alcohol. As a general
form of exercise sport in moderation can be beneficial to the heart.
Naunyn has shown that blood-pressure falls from continuous exercise, and
Masey has also demonstrated this on galloping horses. The best form of
exercise is walking or moderate climbing. Moritz has shown that after
exercise the volume of the heart is diminished, and the rate of the
pulse increased.
There are certain sports which do not require great bodily exertion, and
these are, in consequence, less harmful to the heart. Take, for example,
horseback riding, which produces a more or less accentuated rhythmic
shaking movement of the body. In a particular style of riding called
“the English trot,” the body rises and falls at regular intervals, which
causes—as we noted in our own person—free perspiration; the circulation,
especially in the abdominal organs and lower extremities, is also
promoted. We consider riding to be one of the most beneficial kinds of
exercise. We frequently note the healthy appearance of horseback riders
(except jockeys, who are underfed in their training). A well-known
member of the medical faculty in Berlin, a world-renowned specialist,
was a great horseman. He took part in the last Medical Congress in
Dresden, coming on horseback through the pouring rain from Berlin.
Possibly his good health was due to the vigorous exercise of which he
was so fond. By a strange irony of fate, this enthusiastic admirer of
riding died in consequence of an accident caused by his automobile a
short time ago.
In certain kinds of sport, such as riding and cycling, the greater
possibility of accidents is a drawback, and in nervous individuals
serious traumatic neurosis, and often diabetes, may sometimes develop,
particularly in those cases where such people are descended from
diabetic parents. We published a case of this kind some years ago. For
such people this kind of exercise should be prohibited, especially in
those descended from diabetic parents. Cycling has the additional
drawback, according to Zunz, that from it fatigue is not so soon felt,
and thus overindulgence may more easily occur.
Less injurious than sport, and much easier to be performed, is walking
exercise. As walking on the level does not necessitate great exertion,
unless performed rapidly, it can give good results if continued for a
considerable distance. It is desirable to walk as much as possible, and
never to use a street car or a carriage unless pressed for time; by this
means health may be greatly improved. In walking especially the muscles
of the lower extremities are contracted, and at the same time the
circulation is improved, the more so, of course, in the lower
extremities, but also in other parts of the body; and this is still more
the case when we walk briskly. For those possessing a good circulatory
mechanism, it is always advisable to walk briskly, thus indulging in a
healthy and practical and muscular exercise; and for such, also, running
for a few minutes several times daily is excellent, as perspiration can
thus be created, whereby harmful products are eliminated from the body.
This latter exercise is more suited to those living in the country, or
if in cities, to those who have a garden or large yard.
It is advisable not to run too fast, as such would cause severe exertion
with bad effects upon the heart; but if undertaken at all it should only
be for a minute or so. Running at a moderate speed, breathing deeply and
rhythmically at the same time, and with rhythmical, rather short steps,
can be kept up even for eight to ten minutes without any particular harm
to the circulatory system. Personally we used to do this, and often,
when the thermometer stood below zero, without hat or overcoat,
finishing thoroughly warm and comfortable. Standing still after running,
when so attired, might lead to catching cold, but running out of the
house and back again without stopping causes no such risk, even in a
strong wind, as we have personally proven. Such running may best be done
three times a day, before breakfast, dinner, and supper, as this running
in and out of the garden is the best of appetizers, and is far more
beneficial than drugs for those men and women who sit about all day and
complain of want of appetite. Such running practice is only good for
those who have sound blood-vessels, heart and kidneys. Deep regular
breathing while exercising is also indispensable.
Walking up a hill will naturally require greater exertion than walking
on the level, and may be more beneficial to the health than sports
conducted to a similar degree. At first the blood-pressure will
increase, but it will afterward decrease. Deeper respirations will have
to be taken, so that a larger supply of oxygen will be brought to the
lungs and tissues.
Climbing high mountains should be strictly forbidden persons suffering
from disease of the heart and arteriosclerosis, for the greater exertion
then required has often caused death in persons so afflicted. To prevent
the bad circulatory effects of climbing it is necessary to breathe
deeply and regularly, and this, indeed, should not be overlooked in all
forms of exercises; even masseurs are unable to work properly unless
they take deep regular breathing.
In mild cases of heart trouble, and even in more serious cases if
applied judiciously, Oertel’s treatment of each day slowly walking up a
steeper and steeper hill will give good results, giving good training
for the heart-muscle. But this treatment should only be carried out
under the direction of a competent specialist.
The great advantage of the various kinds of sport and of walking,
climbing, and running exercise is that several other agencies can be
combined with them that are very important in the treatment and
prevention of the effects of old age. These are fresh air and sunshine.
We think that the combination of the three agencies—exercise, fresh air,
and sunshine—is the best and most necessary means for the preservation
of youthfulness and for the prolongation of life.
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CHAPTER XXIX.
A FEW REMARKS ON COLD FEET—THEIR CAUSE AND TREATMENT.
IT is intentional that we present this chapter immediately after those
on the improvement of the functions of the skin and on exercise, as
these are the principal means by which, as a general rule, we are able
to prevent cold feet.
These are, for the most part, occasioned by an insufficient supply of
arterial blood to the extremities. This can be caused either by a
hindrance to the circulation—as for example in the case of irrational
use of articles of clothing—or through the want of muscular contraction
by exercise. In old people, especially, cold feet can be occasioned by
the degenerative alterations of the blood-vessels, in consequence of
which less arterial blood reaches the feet. If to this anatomical cause
there are other factors added, then naturally the sensation of cold feet
will much more easily result. We must bear in mind that the feet, like
the nose also, are the most distant parts of the body from the center of
the circulatory system—the heart, so that naturally in these parts,
through the less effective warmth of the arterial blood in old people,
and even in younger anæmic women, the sensation of cold will easily
arise.
Cold feet through irrational clothing can be caused by using garters or
thick footwear with tight shoes, owing to the circulation of the blood
being thus impeded in the lower extremities. It is of no use to wear the
thickest woolen socks or stockings as a protection against cold feet,
which should serve to retain the natural warmth of the feet, and then to
prevent this warmth being given off, this latter resulting in the
sensation of cold feet. But how can this thick footwear retain the heat,
the generation of which it prevents by mechanically compressing the
blood-vessels and thus rendering the influx of warm blood impossible?
It is also useless to wear thick socks if there be no layer of air
between them and the skin, which layer is the best means of retaining
warmth, as mentioned in the chapter on the hygiene of the skin in
connection with rational clothing. Neither the footwear nor the shoes
must, therefore, be close fitting. Many people wear such tight-fitting
socks or stockings, and boots or shoes, that the pattern of the socks is
impressed on the feet, in which case of course it need cause no surprise
if they complain of cold feet in spite of the thickness of their socks
or stockings.
As already mentioned in the chapter on hygienic clothing, it would be
preferable to wear thin wool of the best quality and low half-shoes;
when so clad we will not suffer from cold feet if we take exercise. The
writer of this book wears such even in winter, in which season he puts
on gaiters only when the temperature is below 20° F. On some very cold
days he might feel cold in them, but then only in the morning, for after
a brisk walk, or better, after a smart run (see previous chapter) the
cold sensation disappears for the rest of the day.
Exercise is, as a rule, the best preventative against, and the best
method of treatment for, cold feet, as it is through the muscular
contraction produced by walking or running that heat is generated, as
explained in the previous chapter on exercise.
Rubbing and massage of the feet will produce results similar to those
obtained by exercise, and are still more effective if supplemented by
walking.
When we sit still our body will naturally cool off. It is therefore a
good plan to make circular or other movements with the feet and not
allow them to remain still if we feel cold in them.
While residing as a guest with an elderly lady, the head of an
aristocratic Dutch family, I observed her putting her feet on a silver
warming utensil, in which her footman constantly burnt a little oil
lamp, in order to keep her feet warm. I told her she could easily
dispense with this if she would make up her mind to take exercise on
foot instead of driving in her luxurious carriage, and not confine
herself to merely walking from one room to another.
Defective circulation of the blood to the feet can not only result in
cold feet, but also in very serious ailments, and even in a shortening
of the ordinary span of life. Thus, in consequence of a deficient influx
of arterial blood and the stagnation of the venous circulation,
especially in old people with sclerotic changes of the blood-vessels, a
very trying and long-continued ulceration of the feet may result. By
bringing more arterial blood to the feet and causing hyperæmia,
according to Bier, we can cure this condition.
Still more serious consequences may be brought about by defective
circulation in the feet, and especially in the toes, in the form of
senile gangrene, which is far more frequently found in diabetic persons,
and sometimes even before the commencement of old age. In cases of
arteriosclerosis, where cold feet are the consequence of defective
blood-supply owing to arterial degeneration, iodides together with
thyroid extracts will be found successful. They produce a dilation of
the blood-vessels, diminish the viscosity of the blood, and thus produce
the sensation of heat. The method of application will be found in the
chapter on the treatment of old age by organic extracts.
As the promotion of a hygienic condition is an excellent preventative
against cold feet and also excellent for their treatment we repeat again
that a foot-bath should be used daily in such cases, and not only warm,
but also cold water should be used therein. Cold water acts as already
mentioned as a stimulant when applied as a foot-bath; but it should only
be used for a very short time, after which energetic rubbing of the feet
will produce active circulation and the feeling of warmth in them. We
recommend for cold feet to rub them with a cold wet towel, then to pour
over them a little eau de cologne or alcohol, and again rub them till
they begin to become red; we must next move the toes forward and
backward twenty or thirty times with our hand. We will then feel in the
feet a sensation of agreeable warmth.
------------------------------------------------------------------------
CHAPTER XXX.
ON THE BENEFITS OF SUNLIGHT.
IT is a matter of everyday observation that when we leave plants in a
room, where no sunshine can penetrate, they lose their color and soon
show quantities of parasites. Similar changes occur in persons who live
in dark rooms and seldom come into the sunlight. They become pale, and
are liable to all kinds of bacillary infections, especially
tuberculosis. An Italian proverb says, very justly, “Dove no viene il
sole viene il medico”—“Where comes no sun, the physician is coming,” and
a German proverb again says, “Auf die schattige seite der strasse kommt
der Leichenwagen doppelt so oft, als auf die sonnige,” which means in
English, “The funeral coach turns twice as often on the shady side of
the street as on the sunny side,” which saying, like most proverbs,
contains much truth.
We often notice that on days when there is no sunshine especially when
at the same time it is cold and damp, we feel depressed in mind. In such
an atmosphere there is a diminution of the respiratory and transpiratory
functions of the skin, and, in consequence, a retention of toxic
products. On the other hand, on sunny and dry days these functions are
facilitated, and there is less work to be thrown upon the kidneys. Such
a rest does good to an organ that is almost constantly at work, and is a
wise economy for the days of old age. It is astonishing how sunshine can
influence our mental condition. We feel better able to work, and also to
take outdoor exercise, on sunny days. Particularly in old age is
sunshine precious, and we see our old house dog and our cat lying in the
sunshine and taking a sun bath. In the same way, instinct tells old
people that the sun is good for them, and thus they eagerly watch for it
to shine, and like to sit in it, especially on cold days.
It has been shown by exact researches that the sun’s rays can kill
bacteria, and statistics have shown that in sunny weather there are
fewer infectious diseases, like influenza, than in dull weather. In
sunshine there are two elements which possess antitoxic and healing
properties: light and warmth. Its light is made use of in the treatment
of certain infectious diseases, like lupus (Finsen treatment). Both
these properties can be used to great advantage in the sunbath
treatment. Lying in the sun for a certain length of time causes a
dilatation of the blood-vessels and, later on, abundant perspiration.
The ancient Romans made use of the therapeutic action of sunshine, and
many of them took sun baths on the roofs of their houses. There were
also public sun-baths, much visited by the population. The ancient
physicians recognized the value of sunshine in the treatment of various
ailments. According to Hippocrates, the sun-bath augments transpiration
and makes us more resistant against disease, giving us more strength.
Celsus also advised its use in nervous diseases.
Certain people have undertaken scientific experiments on animals to
prove the great effects of light. Moleschott, the great physiologist,
found that the embryos of frogs gave off far more carbonic acid under
the influence of light than when they were in the dark. The stronger the
light the more carbonic acid was given off. Edwards found that such
embryos could not develop at all in the dark.
Very important was the discovery of Arloing,[241] and also of
Duclaux,[242] that the growth of bacteria when exposed to the sun is
checked, and that later on they will even be killed. This is mainly due
to the action of blue and ultra-violet rays.
Footnote 241:
Arloing: C. R. de l’Academie des Sciences, p. 378 et 511, Paris, 1885.
Footnote 242:
Duclaux: Revue Scient., 1887.
The chemical action of sunlight is exercised by the blue and
ultra-violet rays (Finsen), and the heat comes mainly from the red rays.
From our point of view, however, the chemical rays play the more
important part.
When we sit in the sun for a long time and get an inflamed skin, this is
due mainly to the chemical rays. This fact was established by Charcot on
the basis of clinical observations. Charcot’s work has been confirmed by
the researches of Widmark, and especially by the exact experiments of
the famous Danish physician, Niels Finsen,[243] in 1906. The latter
showed that when strong light killed bacteria, this was due to the
action of the chemical rays alone, and, specifically, to the
ultra-violet rays. He also showed that these are the rays which produce
dilatation of the blood-vessels and an inflammatory condition of the
skin.
Footnote 243:
Finsen: “Om anvendelsen af concentrerede chemiske Lysstraaler,”
Kjöbenhavn, 1896.
To the red cheeks of those people who pass much time in the open air and
sun, we can compare, as a contrast, the pale faces with a greenish hue
of those who live in the dark, like polar explorers. If strong light
dilates the blood-vessels, and sends much blood to the periphery of the
body, thus promoting the insensible perspiration and metabolism, on the
other hand, in the long night of the arctic regions there is contraction
of the blood-vessels, and the blood is kept back in the interior of the
body, with the retention of excretory products. It has been shown by
Oerum,[244] through experiments on animals, that the quantity of their
blood and its percentage of hæmoglobin is dependent upon the light. They
are reduced in the darkness and increased in the light. Through a light
bath the quantity of blood was increased 25 per cent. within four hours.
Finsen[245] has also found, through examination of twenty-nine persons,
that there is less hæmoglobin in the blood in winter than in summer, due
to the lack of sunlight in winter. Grawitz and Graffenberger have seen a
diminution of the hæmoglobin, as also of the quantity of the whole
blood, in animals which were kept in the dark. Marti found that the red
blood corpuscles are diminished in such animals, but become augmented
when they are again exposed for a time to the sunshine.
Footnote 244:
Oerum: Pflüger’s Archiv. f. d. g. Physiologie, vol. cxiv.
Footnote 245:
Hospitalstidende, p. 1209 and 1239, 1894.
We should aim to get our share of direct sunlight in the open air, for,
as Finsen has shown, the valuable chemical rays of the sun are excluded
by glass; and, after all, it is not warmth alone we seek, but also the
chemical and anti-bacterial action of the sunlight, together with its
effects upon the blood-vessels and nervous system.
To absorb as much of the active rays as possible, it is best to wear
light or light blue or light gray clothing, which allows the sun’s rays
to pass, whereas dark cloth does not, as found by Boubnoff and Lenkey.
The rays of the sun are always valuable, but their action varies with
the altitude. Thus, the higher the altitude and the rarer the
atmosphere, the more efficacious will be the action of the sun’s rays.
In lower altitudes the rays have to pass through dense strata of air
filled with vapors of carbonic acid and dust, and thus much of their
strength is lost. As Prof. Mohn[246] says in his book on “Meteorology”:
“The rays of the sun in transit meet always denser and denser air, which
contains large quantities of vapor, carbonic acid, and dust. A part of
their strength is absorbed by the substances contained in the air, and
these, as well as the air, are heated. Hereby some of the power of the
sunshine gets lost, as the rays of the sun are reflected off these
substances. Furthermore, they pass through clouds. Hence the rays of the
sun lose more and more of their strength before they reach the earth.”
Footnote 246:
Mohn: Quoted after Holm, Norsh Magazin. Laege, W. 6, 1906.
It is also an important fact that the higher the altitude, the more
numerous are the chemical rays of the sun which have the greatest
heating properties. In high localities sunshine contains much more of
the blue and ultra-violet rays, whose wonderful action upon the red
blood-corpuscles has been shown by the experiments of Niels Finsen.[247]
Not only on the blood, but also on the nerves, they exercise a tonic
action. As Niels Finsen has shown, it is due to these blue and violet
rays that insects regain their vitality as soon as the sun shines. As
Dr. Holm says, it is probably due to these rays that the quantity of red
blood-corpuscles and of hæmoglobin is increased at altitudes of 500 or
600 meters above the sea level, as found by Viault[248] and Mintz.[249]
Footnote 247:
Meddelelser fra Finsen’s “Chemiske Lysinstitut,” Kjöbenhavn, 1899.
Footnote 248:
Viault: C. R. Acad. Sciences, p. 917, 1890 and p. 295, 1891.
Footnote 249:
Mintz: C. R. Acad. Sciences, p. 298, 1891.
As a logical consequence of the above, we must try to enjoy sunshine on
mountains, or on the terraces of high buildings, as there can be no
doubt but that sunshine is more beneficial in such places. In high
altitudes sunshine is far more warming than lower down, probably due to
the fact that the sun’s rays pass fewer strata with vapor and foreign
substances, and thus less of their warmth is absorbed. Thus we can
explain the observations that, by exposure for a certain time to the
rays of the sun on the top of high mountains in mid-winter, erythematous
or eczematous eruptions were produced. At such great heights the air is
usually very dry, and so there is less loss of heat from the body.
Therefore we can sit comfortably in the sun at such heights without an
overcoat, even in winter, whereas several hundred meters lower down we
should feel cold even with an overcoat on, especially in a coast
climate.
Let us be grateful for every ray of sunshine and take advantage of it.
Some ladies avoid the sun, but it would be wiser to seek it and, if
possible, to expose our whole bodies to its rays. Let us remove all the
curtains from the rooms in which we sleep or sit, especially from our
work room. In the train let us sit on the sunny side, and not draw the
curtain unless we are reading; in short, let us seek the sun wherever it
shines. We shall soon observe how much better we feel after a long
sojourn in the sun. We have often been surprised at the appearance of
patients whom we have sent for a holiday to the Riviera in Egypt or to
other sunny places. Thus we have often seen pale patients come back
rosy-cheeked and flourishing, and in our own case we have observed the
same thing after staying in California, Arizona, Mexico, and Florida for
several weeks. There is no denying that, as a rule, those who spend much
time in the sun look better and healthier than those who live in dark
rooms or offices. It must be understood that we are talking about
sunshine at a moderate temperature. But even a somewhat higher
temperature, with sunshine, can do no harm, especially to persons
suffering from chronic kidney trouble. In old age, as in other
conditions of athyroidia, we often find chronic interstitial nephritis
and sluggish kidney functions. Therefore we should relieve the kidneys
of any overwork and make the skin do more, which can be accomplished by
warm sunshine. Old people, if their means allow it, should never be left
to pass a winter in cold climates, but should be sent to warm sunny
climates like the Riviera, Egypt, or California or Florida in America.
They require as much sunshine as possible. Americans may use with great
profit the climatological charts of Dr. Charles Denison, of Denver,
Colo., which show with great exactness those parts of America where the
greatest number of sunny days occur.
Against old age sunlight should be regarded as an excellent protection.
It safeguards our kidney functions by promoting skin activity, and it
aids the processes of metabolism. It is best used in combination with
exercise, like riding or some form of sport, and a daily sun bath. It is
our belief that, by such means, both youth and life may be prolonged.
The wonderful effects of sunshine are illustrated by an interesting
experiment of Benjamin Franklin. According to Hufeland[250] this savant
had received wine from Madeira which he was putting into bottles on his
Pennsylvania estate. In this wine he found a few flies, which were
apparently dead. The sharp-minded savant put these flies in the July sun
of the hot Pennsylvania climate, and before long the life that had been
so long interrupted appeared again. The flies became lively and soon
flew away. They thus showed the same reaction to the beneficent effects
of sunshine as the insects in the above-mentioned experiment of Niels
Finsen. The fly is a most objectionable animal, but it possesses one
good trait that reconciles me to its existence; and that is that it is
so fond of the sunlight that it may thereby serve as an example to those
foolish people who do their best to avoid it.
Footnote 250:
Hufeland: “Makrobiotik,” p. 129.
------------------------------------------------------------------------
CHAPTER XXXI.
ON THE ADVANTAGES OF AN OPEN AIR LIFE AND OF BREATHING EXERCISES.
WHEN we note the faces of persons who, by reason of their occupations,
pass their lives in the open air, such as peasants, gardeners, etc., we
usually find them healthy and fresh-looking, and looking more youthful
than their actual age. This is especially so in the case of their wives
and daughters, who are more exempt from certain injurious habits, such
as smoking, and are less addicted to other harmful agencies, like
alcohol. Their fresh rosy faces speak in eloquent terms of the benefits
of fresh country air.
On the other hand we see that others, whose daily avocations compel them
to stay all day in a close atmosphere, very frequently look pale and
sickly. Among such persons, as observation shows, infectious diseases
are frequent, and especially tuberculosis. This disease most frequently
develops in persons who pass all their time in close places, especially
when they are poorly fed at the same time. We can trace this plainly in
the working classes in certain European countries where, in Vienna, for
instance, until the past several years, about 70 per cent. of the total
mortality was due to tuberculosis.
If we now take such tuberculous persons and place them in a hospital or
sanatorium and subject them to the open air treatment, compelling them
to pass all their time exposed to the fresh air, both day and night, we
soon witness a marvelous change. Their appearance is improved, and also
their appetite; and after a time in most of the cases there will be an
increase in bodily weight. We thus see that the open air produces
wonderful effects in such persons, who, as a rule, have been immured in
close places, they shattering their health.
We have thus witnessed the clinical demonstration of the fact that fresh
air is able to improve our health. Fresh air contains much oxygen, and
this is a most indispensable substance, for without it we cannot live.
The red corpuscles in the blood which, loaded with carbonic acid, the
veins convey to the lungs, eagerly absorb the oxygen from the air that
we inhale and then convey it to the tissues to satisfy their
requirements for this precious substance.
By absorbing oxygen the elimination of carbonic acid is at the same time
facilitated. The greater the number of red blood corpuscles that comes
to the surface of the lungs the greater will be the volume of oxygen
which is taken into the system, and afterwards the larger will be the
volume of carbonic acid gas expelled. Thus in the lungs there takes
place a distintoxication of the organisms, and, according to certain
authorities, the cells of the lungs are co-operating in this process in
a manner analogous to the internal secretion by the cells of other
glandular structures.
The more fresh air, i.e., the more oxygen we get into our lungs, the
more we can contribute to the processes of oxidation in the tissues.
When the processes of circulation and of breathing are checked, and when
insufficient oxygen is absorbed, we soon see a very important change for
the worse in the condition of such persons, as exemplified by cases of
heart and lung trouble.
Given the great importance of oxygen, we must try by every means to get
as much of it into our lungs as possible; we shall get more of it from
air that is not stagnating, but always in circulation. When we are in a
closed room, after a certain time we absorb all the oxygen in it,
particularly when there are several persons present who are sharing with
us the oxygen in the air.
Staying for a long time in air so vitiated that it contains but little
oxygen and much carbonic acid and many microbes exhaled by the others,
we are liable to reap the disadvantages we have set forth in the chapter
on the dangers of a close room. According to Pettenkofer, the
exhalations from the persons present in a close room are much more
noxious than the carbonic acid gas. We, therefore, open the window and
door in order to create a current of fresh air, and so allow the oxygen
to be renewed. In this we but imitate nature, which sends a wind to
purify the close atmosphere on warm summer days. This is natural
ventilation.
If we want to preserve our youth for a long time and attain an old age,
we must take all available means to avoid such air contaminated by
billions of microbes and vitiated by the exhalation of so many human
beings and animals, who also absorb much of the oxygen. To this is added
the smoke from the numerous manufactories, houses, and plants, and the
dust and exhalations from many noxious substances of various kinds. As,
however, fortunately, all this vitiated air is generally found in the
lower strata, always endeavor to find a lodging in the more elevated
portions of the city, and on the highest floor possible if staying in an
apartment house or in a hotel. If possible our houses should be built on
the outskirts of the city, and preferably near a park, or wood, or at
least a meadow where there is a free circulation of pure air.
In our rooms, and especially in the sleeping room, the window, or at any
rate the transom, should always stand open, and if possible also during
the night. But when obliged to sleep in a room with a closed window to
avoid the noise of the street traffic, the first thing to do in the
morning, directly one gets up, is to open the window and let in the
fresh air, and do not close the window again until night-time. When we
are well covered we need not be afraid of catching cold. As a rule only
those take cold who keep in a warm room and live at enmity with fresh
air. Fresh air, as a matter of fact, never does any harm to its friends;
it is only dangerous to its enemies. As Captain Svaerdrup, a member of
Nansen’s expedition to the North Pole, told us, he and his comrades
never suffered from colds as long as they were in the polar regions.
They first caught them when they approached Christiania.
When standing at the window inhale the fresh air deeply several times
and retain it as long as possible before exhaling it.
Indeed we could preserve our health much more effectively if we imitated
the Indian and slept in the open air. It is a fact that many Indians
possess great immunity to all kinds of fatigue, enjoy very robust
health, and reach a green old age. This is undoubtedly due to the fact
that they pass the whole of their life in the open air. When tuberculous
people are kept under the free-air treatment we are, after all, only
following the example of the red man. Nobody who is accustomed to live
in a close room with heavy curtains at an average temperature of 75° to
80° from October to May, can imagine the pleasures of a wooden hut or
tent for day and night use. When Dr. Pottenger, of the Monrovia
Sanatorium, near Los Angeles, California, showed me around his little
wooden cottages in which his patients lived, I simply envied them. I
cannot imagine a more healthy dwelling-place than a tent in summer and a
wooden hut in winter, with a stove in it for the cold weather; and if we
cannot raise the heat over 75°, so much the better.
The son of a family in England, who are great friends of mine, has
formed a resolution not to sleep any longer in the comfortable family
mansion, but in a tent in the meadows of his property during both winter
and summer. His family and friends regarded this as an eccentricity,
against which they warned him; but still he got on very well in his
tent, and looks fresher and healthier than ever before. We are always
put down as eccentric if we have the courage to resist the foolish
prejudices of our surroundings. For my part I prefer to live to be 100,
and to attain this I do not object to be considered “eccentric.”
Anyone who is anxious to live long and preserve his youth should
endeavor to spend as much time as possible in the open air. After the
day’s work is finished we should always get out into the air, preferably
in a park or wood adjacent to our home, where there is more oxygen
contained in the air. We should follow the example of those English
people who leave town on Saturday and remain in the country until
Monday, leaving behind them the cares of business. There is probably no
nation which likes exercise in the open air so much as the English,
Scotch, and Irish, and among them is to be found the greatest longevity.
An agreeable way to get plenty of fresh air is by automobiling, and for
those whose means can afford it long journeys by automobile may
constitute an excellent fresh air cure, as they tend to improve the
appetite, produce sleep, and relieve neurasthenic conditions in general.
But automobiling can only be considered as a hygienic means for
longevity when the speed does not exceed twenty to twenty-five miles an
hour.
When in the country we should always prefer mountains, and the higher
they are the purer is the air and the more oxygen does it contain, as a
rule. At the same time very much depends also on the presence of
forests, especially of pines and fir trees. High mountains with such
arborization generally have pure fresh air full of oxygen, and there is
no drug in pharmacy that can equal this in its beneficial effects. It is
a fact, established by leading physiologists, that persons living on
mountains have more red blood-corpuscles than those living in the
plains. When patients are sent to spots so elevated in the air as
mountains with forests, we find them, as a rule, looking healthy and
fresh when they return from their holiday in the fresh air.
As found by A. and Y. Loewy and Luntz,[251] mountain air improves the
processes of oxidation and increases the number and depth of the
respirations. All this, however, according to these savants, is the
result of the exciting action of the sunshine. It speaks volumes for the
health-giving properties of mountain air that the inhabitants of such
spots, especially in Scotland, Switzerland, and Norway, have such fresh
rosy cheeks. These we notice more particularly among the females,
especially in young girls who are freer from the agencies harmful to
good health, such as alcohol, sexual excesses, etc. In Norway almost all
the young girls have fresh red cheeks, for which, indeed, they are
noted, due to the delightful air on its mountains and forests, with
which the whole land is almost covered.
Footnote 251:
Quoted after Landois: “Lehrbuch der Physiologie des Menschen,” Berlin,
Wien, 1905, eleventh edition, p. 235.
I had the opportunity of proving for myself, after spending a certain
time in a resort on the top of a mountain in Norway, the delightful
purity and invigorating quality of the air, which was due to the large
amount of oxygen. As a confrère expressed it, there was champagne in the
air! It was not soiled here by any manufacturing plant, the curse of so
many places with fine air. Norway, one of the most extensive countries
in Europe, has at the same time a very small population, only about two
millions, and very few factories, so that the air is not polluted either
by a dense population or by the smoke of manufactories. Scotland, with
its highlands, has also a similar air, and the color of the Scotch
lassies is not far behind their Norwegian sisters. This can be admitted
as a scientific argument for the relations of health in the country.
But Americans need not travel so far. There is as good a climate and
wonderfully fresh air in the Rocky Mountains, and also in other highly
elevated places, of which America can boast many more than Europe. But
whether there or in Europe it would be necessary to give up all
occupations for a few months, or at least for several weeks after every
six months. This time we should pass in those elevated places where we
can climb every day; climbing presents an excellent opportunity to get
much fresh air into our lungs, as we are then obliged to take much
deeper inspirations, thereby obtaining more oxygen from the pure air of
the mountains. As we shall show in the next chapter, exercise combined
with fresh air is of the greatest importance to our health and chances
for a long life and a green old age.
But in order to get plenty of air it is not indispensable to go to
forests or mountains or to the seaside; we can also get it at home,
although not with the same amount of oxygen. To absorb much air we must
breathe deeply and keep in the inspired air, and endeavor to get it into
all parts of the lungs. In ordinary life we forget this and we get just
as much air into us with our superficial breathing as is necessary to
keep us alive and to feel no harm from our want of air. Most people
breathe only superficially, and only inspire deeper when mounting the
staircase, unless, indeed, they adopt the less healthy habit of reaching
the first floor by the elevator. But as it is of apparent benefit to us
to get as much air into our lungs as possible, we improve this state of
affairs by breathing exercises. The great importance of these breathing
exercises for the prolongation of human life has been especially
insisted on by Sir Herman Weber.[252] But before him, Hamel and Harry
Campbell[253] had already demonstrated the great therapeutic results of
respiratory exercises. Sir Herman Weber recommends commencing with
moderately deep inspirations and expirations, continued during from
three to five minutes once or twice a day, and then gradually increasing
to ten minutes or a quarter of an hour. The depth of each inspiration
and expiration, and the duration of holding the breath, are to be
increased only gradually. Sir Herman Weber advises inspiring in an erect
position, with raised arms and closed mouth, bending the body forward
during expiration so that the fingers touch the ground or the toes.
Footnote 252:
Loc. cit.
Footnote 253:
Dr. Harry Campbell on “Respiratory Exercise in the Treatment of
Disease,” London, 1907.
According to this authority, besides the influence on the circulation,
the respiratory movements keep up the nutrition and efficiency of the
lungs, and also maintain the elasticity of the chest walls, which are
apt to become stiff in old age and thus interfere with the free action
of the lungs and pleura.
These respiratory exercises can also be performed in a sitting or
horizontal position.
According to Sir Lauder Brunton, the deep respiratory movements act as a
kind of massage to the lungs, thoracic walls, pericardium, and heart.
Sir Herman Weber mentions that he has seen persons who get out of
breath, even after short walks and climbs, and who for this reason
abstained from such, and consequently suffered in health and spirits,
become, by means of these movements, active walkers and climbers,
gaining improvement in every function of the body, and outliving by many
years their brothers and sisters who had not practiced them. He also
specially recommends these breathing exercises to literary workers,
statesmen, professional men, and others who get no time to take the
usual methods of exercise.
In certain heart troubles—for example, dilatation of the heart—these
movements are contraindicated.
It is natural that if we practice these exercises in the fresh air of
the forests or mountains their salutary action will be still more
pronounced. But if we are too indolent to perform the regular breathing
exercises, whose beneficial effect upon the heart’s nutrition and action
is so great, it will suffice for us to take deep inspirations and
expirations while walking. We must get into the habit of doing this
every day, and thus prolong our life.
As a general rule we only breathe with one part of our lungs, sadly
neglecting the other, by which the aëration of the blood will not be so
thorough. Independently even of the breathing exercises, it would be
very advantageous to our health if we gently took a long breath, which
should be so prolonged that we feel our stomach distended. The air will
thus reach the deeper portions of our lungs. This will also be the best
practice while singing; indeed, the latter would be the very best of
ways in which to obtain a good and thorough aëration of the lungs. We
have heard of cases where people without a voice have taken singing
lessons, for the simple reason that they were descended from families in
which tuberculosis was hereditary.
This latter disease is one of the most frequent causes of a shortened
existence, and it is, therefore, our duty to point out here the great
advantages not only of a generous diet, consisting of a certain amount
of underdone fresh meat, uncooked milk of healthy cows or goats, and
many eggs, sausages and puddings made of the blood of pigs (see Chapter
XXXIX), but also of regular deep breathing, thereby permitting of the
entry of oxygen to all parts of the lungs.
We always recommend breathing through the nose, as doing so through the
mouth dries up the mucous membranes, especially if throughout the night,
during sleep, the mouth is kept open. This bad habit permits of the
entrance of cold air which, not being warmed by passing through the
nasal passages, may be injurious to the lungs. The Indians are fully
cognizant of this fact, for in some tribes the mother binds up the mouth
of her child and thus compels it to breathe through the nose.
In the foregoing we have shown the great advantages of abundant fresh
air. We have referred to the fresh appearance of country people,
especially of those who live on mountains, as also to the improved
condition of tuberculous persons after having been exposed to as much
fresh air as possible. I ask, therefore, why, if people suffering from
this disease derive so much benefit from fresh air, should not we, who
are still healthy, be also benefited by it? Let us therefore remain in
the open air as much as possible, and never prevent its close approach
to us; for it gives health, long youth, and a good old age.
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CHAPTER XXXII.
ON THE DANGERS OF LIVING IN CONFINED AND ILL VENTILATED QUARTERS.
Persons in the enjoyment of complete health and vigor are frequently
very sensitive to recognize the different agencies deleterious to their
health. In the same way as animals they possess a certain instinct in
this respect. In fact it is by this faculty alone that they can enjoy a
normal and robust health, as they are thus enabled to avoid all kinds of
dangers to their health, the integrity of their healthy mind also giving
them the necessary will-power for this purpose.
Against all sorts of dangers to their health such persons, as a rule,
are prompt to act; thus, when they come into a close room the air will
soon become offensive to them, and they will either leave or ask for the
opening of a window or of a ventilator, closed through folly. On the
other hand sickly persons, or people who do not otherwise enjoy perfect
health or well-balanced minds, will remain in such a vicious air and
contract all the dangers consequent to it, shortening their prospects
for a healthy youth and long life.
That living in the vitiated air of a close room is deleterious to health
is proved by a simple observation of the faces of those stopping for a
long time, or habitually doing so by reason of their professions, in
close localities. They will present a pale, gray sickly appearance, and
it is a fact that they very rapidly acquire all sorts of infections;
especially is tuberculosis very prevalent in such cases. We observe
precisely the same thing in the case of plants which, if kept in a close
room, especially where little light reaches them, soon lose their color
and are destroyed by parasites; and exactly the same happens in the case
of man. Prisoners, unfortunate work-people, living and laboring in large
numbers in small and close quarters, waiters and similar employees, are
those in whom tuberculosis is most frequently found. In respect to
workmen, this may be more truly the case in Europe, where they live
under more miserable conditions, than in America, where their position
is possibly the most enviable of all wage earners.
Close air, just as much as stagnant water, promotes the growth of
dangerous microbes, and the chances of infection are greatly enhanced
where a number of people are gathered together in such places. Many of
them may be suffering from infectious diseases of the respiratory
organs; they exhale, and also eject by coughing or sneezing, an enormous
number of microbes, which mingle with the air and multiply at their
leisure in such close atmospheres; and this is especially so when they
are assisted in their growth by the great heat prevalent in such places,
particularly in winter time. Bacteriological examinations made of the
air of such localities have shown an enormous number of dangerous
microbes. We need, therefore, not be surprised when persons, and
especially children whose resistance is diminished, often contract
tonsillitis, diphtheria, bronchitis, or pneumonia, etc., after having
passed an evening in such a place, the air being hot, and particularly
if, at the same time, the temperature outside was very low.
Living in a close room will soon tell on the general health, and this is
easily visible in the appearance of such persons. Their pale faces form
a striking contrast to the fresh rosy cheeks of those who habitually
live in the fresh air. Those who have to pass their lives in offices are
to be pitied, although, to a large extent, it is their own fault; they
deprive themselves of the benefit of fresh air, which, after office
hours, they would have ample opportunity to obtain if they would not
persist in spending their leisure time in a club or other close place,
instead of taking a brisk walk and exercise in the fresh air. No wonder
that such people easily acquire dyspepsia and stomach troubles! Exercise
in the open air is most valuable for promoting an appetite, and persons
sitting constantly in close places often lack this; thus their gastric
juice, which is indispensable to a thorough digestion (see chapter on
hygiene of eating—how to obtain an appetite) fails, and eating without
this juice their food will not be well digested and will create stomach
troubles, which are extremely frequent in such office workers, but rarer
in the case of peasants, coachmen, and other fortunate individuals whose
occupation keeps them in the fresh open air. There is an increased
amount of carbonic acid in the air of all localities where many persons
are present. According to Pettenkofer, even in our living-rooms the
carbonic acid content of the air is increased above the normal; and
still more is this so in lecture-halls (3.2 per cent., against a normal
content of 0.5 per cent.), in public houses (4.9 per cent.), and most of
all in school rooms (7.2 per cent.).
We should, therefore, always keep a window open and never close the
ventilator. Fresh air is the thing we are most in need of to carry on
the oxidizing processes in our body. Exclude this and you exclude
health. We must also remove from the rooms all those things which can
absorb the air or hinder its entrance. There should never be flowers,
and particularly no potted plants, in a living room, as they require air
like ourselves; while to sleep in a room with plants is very deleterious
(see chapter on sleep).
Curtains should all be removed, especially those of a heavy nature and
dark color, which would prevent the entrance of the beneficial sunshine.
Every room should be provided with openings for ventilation, and the
transoms used in America are especially useful when they are open, and
not used only to let the electric light into the sleeping room during
the night, thus disturbing sleep. As a close room tends to shorten life
it should be the policy of the government authorities never to allow the
use of any newly built house, especially of public buildings, unless it
contains openings for ventilation, the closing of which should be very
severely punished by law.
If, during the day, it is necessary to have fresh air in every room,
there is still greater necessity for this during the night, as we
require more air during sleep than while awake; and, therefore, we
should never sleep in a room that is entirely closed, but always leave
the window (the upper part by preference) or the ventilator open.
We can easily convince ourselves how injurious it is to sleep in a close
room by leaving our room in the morning, taking a walk in the fresh air,
and then re-entering our sleeping chambers that have remained closed as
we left them, and we shall at once realize the unhealthy condition of
the air in such a room, filled as it is with carbonic acid that has been
exhaled during the night, and also loaded with the other deleterious
toxic substances cast off by our lungs and skin. We shall then certainly
make up our minds not to inhale during the next night the same air
again, but to allow it to escape by the open window and thus permit the
entrance of fresh air into our lungs, whose need for air is much
increased during sleep in order to replace the large volume of carbonic
acid exhaled.
As a consequence of passing the night in such a close room, we feel, on
the following morning, very heavy, and often have a headache; we also
often have no appetite for breakfast after such a night, unless we first
take a walk in the fresh morning air.
The danger of the close room should be brought home to all, even
children, through instruction in hygiene in the public schools; and even
from their very youngest days this should be instilled into the minds of
youth, together with the contra-advantages of fresh air. By these means
they will be accustomed to the fresh air and its beneficial effects, as
much as they will learn to detest the horrors of the air exhaled by
other people, which is the source of so many infections. Every one who
wishes to enjoy life during youth, and live to a good old age, should
abominate a close room and never, if he can possibly help it, pass an
hour in such an atmosphere.
------------------------------------------------------------------------
CHAPTER XXXIII.
HYGIENE OF ARTIFICIAL HEATING—THE DANGERS OF HEAT BY STEAM AND A FEW
HINTS ABOUT THEIR PREVENTION.
OLD people are particularly sensitive to cold, and they therefore need a
warm room when the temperature falls in the autumn. In old age,
especially in its advanced stage, the processes of oxidation are
diminished, and thus less natural warmth is produced; but, as we give
off more heat in cold weather, it is only natural that they will feel
the cold then much more than younger individuals.
The rooms, therefore, in which old people live must be kept very warm,
in the same manner as we do with infants, especially for those who come
of parents with degenerated thyroids. Thus we see again how old age and
infancy present many parallel features.
But, if a very warm room be compulsory for aged folks, no such necessity
exists in the case of the young or middle aged, and it is abusing their
health if they remain long in rooms heated above 75° to 85°, or
sometimes 90°, where, at the same time, every window is sedulously
closed on all sides, so that no fresh air can find entrance. Such
overheated rooms we usually find in northern climates, and the air in
such cases is frequently hotter in the house in winter than we find it
in the open on a comfortably warm summer day, when, being in the open,
the heat can certainly be better borne than in a close room.
In America many things are better than in Europe; but this certainly
does not apply to the method of heating used in the majority of the
houses, hotels, and office buildings, all of which are mostly
overheated, and that by steam heat, and very frequently with defective
ventilation, if there be any at all. The worst part of it is that a
uniform heat is maintained, whether it be a warm or a cold day; thus,
the air temperature was 55° F. on October 15, 1906, when I was in New
York, and in one of the most fashionable hotels the temperature was 75°
F. In Houston, Texas, there was a heat wave in February, 1907, with
disagreeable hot weather, yet 70° F. of steam-generated heat was
maintained in the hotels, which made life unbearable for those who, like
the author of this book, are so fond of fresh air.
As we are endeavoring in this work to give hints how to reach a ripe old
age and prevent diseases which may dissipate our hopes in that
direction, it is our duty to protest and to point out the dangers of
such irrational heating.
It seems to me, however, that in some northern countries in Europe
things are not much better, especially since steam heat is becoming more
and more used, as in Norway, even in the private houses. In some of
these countries—Russia, for instance—cotton is put around the window
panes to exclude the air, and also to absorb the moisture condensed on
the inside of the double windows.
In many European countries, however, fireplaces and stoves are common.
The most rational method of heating, though not the most economical, is
the open fireplace in England, whence the most ventilation is obtained;
for the essence of the problem is to obtain warmth and fresh air at the
same time. English, Scotch, and Irish are most sensitive to an
overheated room, and they are probably the most healthy inhabitants of
Europe, too. While a guest, some years ago, of friends in Derbyshire, I
well remember that, directly the temperature rose above 65, the windows
were thrown open.
Americans in Europe often complain that they are not warmed at the
fireplace, which only keeps the face and not the body warm. This,
however, will only apply to those who only feel comfortable at a
temperature of 75° F., which is distinctly unhealthy; for the open
English grate can very easily produce the standard temperature of 15° R.
(about 18° C.), which should not be exceeded if we want to have a
healthy warmed atmosphere in our rooms. Of course such fireplaces can
produce a much higher temperature, but even then the air is never so
offensive as that of rooms heated by steam.
It would seem, at first thought, that women can withstand cold much
better than men, considering how much lighter is their dress and how
much more it exposes them to cold air. We sometimes see young girls of
the poorer class in such light clothing in mid-winter, standing in the
streets and talking with their friends, that we men shiver at the mere
idea of such clothing. Yet it is women who most need a warm room,
probably because their dress is much the same indoors in mid-winter as
in mid-summer. They, however, when out-of-doors wear heavy furs which
entirely check the respiration of their skin; and their light clothes,
when indoors, do not afford much opportunity for their skin respiration,
for then there is usually no fresh air in the house, but an oppressive
heat, all air ventilators being sedulously closed. It is strange how
people try, by every means, to destroy their health!
In warm weather we give off less warmth and do not require so much food
in order to produce warmth, as the natural temperature also requires
less of us; in summer, therefore, we need less nourishment.
Circumstances, also, become much more equalized in the artificial summer
of the overheated room. Whereas people taking a brisk walk in a cold and
bracing atmosphere return with rosy cheeks and a roaring appetite, the
unfortunates who persist in passing the day in overheated, especially
steam-heated places with a confined atmosphere will not feel a natural
hunger, will eat without a healthy appetite, and will have insufficient
gastric juice (see chapter on appetite), exposing themselves to
digestive troubles in consequence. Their need for food will be less, and
a bad condition of health will follow.
Another and most imminent danger of overheated rooms is the facility
with which we are apt to take cold by walking from a room kept at summer
heat to the outside cold of winter. We all know how we catch cold, as a
rule, but we never know how it may end. Sometimes a simple cold is
followed by sore throat, but often also by catarrh of the bronchi, and
even of the lungs. In persons addicted to alcohol a fatal pneumonia from
such a cause is common; but, in any event, there is a great failing of
the general health for a long time, all of which may have originated
from an overheated room which has made us more sensitive to the effects
of cold.
When we keep ourselves cool we are less liable to catch cold, as is well
known; for then our body is not first heated up and then cooled off
rapidly. This has been shown by experiments on animals. It is certain
that people accustomed to a temperature of 15° R. have much less
tendency to take cold than those living in rooms at 75° to 90° F. Such a
temperature is also a breeding place for billions of dangerous microbes,
which certainly prosper better at such a warm temperature.
Still more dangerous are the consequences from the overheating of
railway compartments, as then it is still less impossible to avoid rapid
changes of temperature. When there are many persons in overheated
places, and the exhaled air from all of them contains an enormous
quantity of virulent bacilli, the danger of infection is still greater;
especially so when there is steam-generated heat, with its injurious
effects on the mucous membranes, whose resistance to bacillary invasion
is thus lowered.
Steam heat is the most injurious of all heat, as it dries up the mucous
membranes and renders them thereby more liable to infection. We have
often noticed in persons with large tonsils inflammation of these
glands, which commenced every time that such persons inhaled
steam-generated heat for several hours. Such frequent tonsillitis will
also undermine the health, especially if we consider that not
infrequently an acute glomerulo-nephritis may ensue (and often does
follow, in an insidious way, without even being diagnosed). There have
also been plenty of cases of appendicitis in which the tonsillitis has
been in prior etiological relation to its development.
We have observed persons who, in consequence of such frequent
tonsillitis due to steam heat, have run down in health, lost their
appetite, and presented a pale, gray and miserable appearance, whereas
before they were rosy-cheeked and vigorous. In others, continued
pharyngitis, bronchitis, and sometimes asthma, may be observed.
In order to mitigate these dangers of steam heat we must place basins
filled with hot water in the localities where the steam heat is
produced. Such basins can be readily placed behind and attached to the
radiators; but they must be of large dimensions and must be kept
properly filled.
Steam heat is most dangerous when there is insufficient ventilation;
there should, therefore, be behind the radiators, and also in the
opposite wall at a certain height, an opening for ventilation. It is, of
course, understood that such ventilators are to be always kept open and
not, as is unhappily so often the case, closed. It is of the utmost
importance that the radiators be thoroughly dusted every day, as this
heated dust is most injurious to health. This is a rule that should be
especially observed in railway cars.
Fireplaces and stoves, which allow of a renovation of the air in a room,
are superior to the steam heat. In a room with an open fireplace or a
good stove the air is renewed, for a current of air is created which
removes from the room microbes and dust. Thus the air is purified. But
it is quite different with steam heat, which does not remove bad air
from the room. Fancy, now, a steam-heated hall, with many people in it,
which is overheated at the same time, and you will understand the
frequency of tonsillitis and bad colds after staying in such a
hall—which we would feel inclined to spell in a different way, to show
better its real nature.
Hot-water heating is superior to steam heating.
Everyone who desires to preserve youth for a long time and attain a good
old age, should avoid living continually in places overheated by steam,
without proper ventilation, as this is one of the surest means of
shortening life.
------------------------------------------------------------------------
CHAPTER XXXIV.
FOOD HYGIENE—GENERAL REMARKS.
THE leading principle in the use of food is that we should eat to live,
but not live to eat. It is certain that more people die from eating too
much than too little. It is wonderful to consider how little food
animals, or human beings, can exist upon for a long time and remain in
good health; and it is certain that the foundations of many diseases are
laid by excessive eating. It must be borne in mind that the elaboration
and assimilation of a large quantity of food requires the activity, or
even hyperactivity, of several of our most important organs, upon the
condition of which our length of life depends. And here we may repeat
the statement that has been made so often in the course of this book,
that overactivity of an organ may be followed by its exhaustion. By
laying too great a burden upon an organ, and continually overworking it
without giving it any rest for recuperation, we are burning the candle
at both ends, and rapidly exhausting the vitality of such important
organs as the liver, kidneys, pancreas, stomach, and intestines, not
forgetting those important glands, the thyroid and parathyroid, which
take a great share in the destruction of poisonous products formed in
our bodies from the end-products of food.
We have just mentioned that with very little food animals, or human
beings, can live for a long time. But prolonged underfeeding may be
quite as dangerous as overfeeding. In starvation the resistance against
infectious diseases, and especially tuberculosis, is diminished. This
disease, the most common of all maladies, is found most often in
underfed people, especially if they live in confined localities with
little air and no sunshine. Moderation in food, as in everything else,
is the only way to attain a happy old age.
The Romans had a very appropriate proverb which ran: “Omne quod est
nimium, vertitur in vitium,” “Everything in excess becomes a vice.”
Much depends upon the quality of the food we take, for some foods are of
very little nutritive value; and even of the most nutritive food, some
parts may pass out as waste products, because those organs which
elaborate and assimilate food may be partially, or wholly, changed by
disease, and so unable to fulfill the work for which they are destined.
Therefore, given a moderate amount of food, the condition of the body
and the maintenance of strength will depend mainly upon the nutritive
value of that food. An exact method of estimating the nutritive value of
food has been shown by Frankland, Stohmann, Danilewsky, and Rubner.
The best method of calculating the nutritive value of any food consists
in estimating how many calories it produces in the body during
combustion. One calorie is the amount of heat necessary to raise the
temperature of one gramme of water one degree Centigrade. Comparing our
system to an oven in which food represents the fuel: Just as oxygen is
necessary for combustion in the oven, so we could not carry out the
processes of combustion in our system without a plentiful supply of
oxygen through our lungs and skin. Also, just as gases produced in a
furnace must have free exit, so the carbonic acid, formed in our tissues
in the processes of combustion, must be eliminated by the lungs and
skin, otherwise auto-intoxication will occur. The above-named
authorities have reckoned exactly how many calories the various kinds of
food produce in our body.
All articles of diet can be classified into three principal groups:
proteids, carbohydrates, and fats. According to the above-named
authorities one gramme[254] of proteid produces 4.1 calories; one gramme
of carbohydrates, 4.1 calories; but one gramme of fat produces more than
twice as many, i.e., 9.3 calories.
Footnote 254:
As well known, one gramme is the equivalent of 15 grains.
In order to maintain life without waste or without exposing ourselves to
disease, it is necessary to use all three kinds of food; for although
many animals, or human beings, can live for a certain time on only one
variety of food, most of them would die if this were persisted in for a
long time. The total exclusion of proteids especially would produce,
after a certain time, a considerable wasting of the body tissues and
certain death. According to Voith, it is necessary to take about 100
grammes of albumin a day if we want to avoid waste of body tissue.
Proteid food cannot be replaced by either of the other two groups of
food.
There are a series of facts which show that the estimate given by Voith
is perhaps too high. Horace Fletcher has shown by experiments on
himself, controlled by Professor Chittenden, that he could live in
splendid health with food not containing more than 45 grammes albumin,
and of 1600 calories heat value, in twenty-four hours, with a body
weight of 186 pounds.
As shown by Professor Noorden,[255] in Vienna, a man must take 30 to 34
calories for each kilo (2⅕ pounds) of his bodyweight when he is doing no
work, and 34 to 40 calories with light, and 40 to 60 calories with
harder work. Accordingly a man weighing 70 kilos would require to take
food equivalent to about 2800 calories for light work, and about 3500 to
4000 calories for heavy work. But Fletcher got along well on 1600
calories with a body weight of 186 pounds. However, he lost some weight,
36 pounds, but became healthier and stronger than he was previously.
Later on he still further reduced his diet and lived on 38 grammes of
albumin and 1581 calories, continuing in perfect health.
Footnote 255:
v. Noorden: “Die Zuckerkrankheit,” fourth edition; and “Pathologie des
Stoffwechsels,” fourth edition, vol. i.
By a series of experiments on a number of healthy American soldiers,
continued for a long time, Chittenden[256] and Horace Fletcher[257]
found that these men could do very hard work with an average of only 55
grammes albumin and 2700 calories; and, what is more interesting, their
muscular power was doubled.
Footnote 256:
Chittenden: “Physiological Economy of Nutrition,” New York, 1904, and
“The Nutrition of Man,” London, 1907.
Footnote 257:
H. Fletcher: “The A, B-Z of Nutrition,” New York, 1904.
The same result was obtained by Professor Chittenden by experiments on
seven of the finest athletes among the 2300 students of Yale University.
He found the strength of these students increased as much as 48 per
cent. One of them won the championship in gymnastics, open to all
American universities, during the course of these experiments.
Rechenberg found that the weavers of Zittau in Germany required 65
grammes of proteids a day.
Very interesting are the observations of Professor Baelz, of Tokio, made
on the Japanese coolies, who drew the jinrickshaw containing Professor
Baelz, who then weighed 160 pounds. These coolies took carbohydrates,
mainly rice, with a proteid content of only 60 to 80 grammes. They were
able to do their work exceedingly well on this meager diet. One day
Professor Baelz gave them a little meat which they took for three days,
and then refused it, saying they would take it after their journey was
done. Baelz made the interesting observation that these men were able to
go about 60 miles, drawing a man of 108 pounds, whereas Baelz, who
followed riding in a carriage, had to change his horse six times and
only beat them by half an hour.
The author of this book has observed that while taking 1½ liters of milk
a day, 2 eggs, 40 grammes of butter, 3 rolls, 3 oranges, a pound of
cherries, a cup of coffee with milk, and one tart, he was able to live
very well for about two months without any loss in weight. The milk was
of excellent quality, containing about 700 calories to the liter, and
about 34 grammes albumin; thus he was taking about 70 grammes albumin
and about 2300 calories a day, with a bodyweight of 155 pounds, and
leading a very active life and he felt better than ever before.
Still we would not like to generalize and say that 55 or 60 grammes
albumin in the day would be a suitable amount for every individual.
Here, as everywhere, individuality and many other circumstances must be
considered. What is good for one may not answer in the same way for
another. The Japanese have constitutions different to the Europeans, for
which reason we cannot apply to Europeans facts which hold good for
Asiatics. Moreover, not everyone’s digestive organs are capable of
utilizing ingested food to the same degree. The quality of the food is
also of great importance, and likewise its digestibility. Therefore the
question is very complex, and, for these and other reasons, the
discussion of which would lead us too far, we cannot recommend a diet
containing such a small amount of albumin for general use.
Everybody likes to judge from his own experience, and so the author is
inclined to the belief that, when milk is taken in large quantities, in
addition to fats and carbohydrates, it is possible to get along with a
smaller amount of albumin, and of calories in general. Milk, in healthy
stomachs and intestines, is very easily absorbed, and the food leaves
less residue than most other kinds of food. Then, again, milk contains
in a wonderful combination all the three main groups of food. So we
believe that when milk is taken as the main article of diet we can get
along with a smaller number of calories, without any prejudice to our
health.
According to Rubner[258] the following number of calories are indicated
daily:—
Albu- Carbo-
min Fat hydrates Calories
For an adult of 50 kilos (doing light work) 90 37 262 2102
For an adult of 70 kilos (doing light work) 123 46 317 2631
For an adult of 50 kilos (doing heavy work) 96 44 404 2472
For an adult of 70 kilos (doing heavy work) 118 56 500 3094
91 45 322 2111
Footnote 258:
Rubner: “Physiologic der Nahrung und der Ernährungtherapie,” Leipzig,
1897.
Albuminous food serves, according to the prevalent opinion, to build up
our body tissues, carbohydrates to produce the energy that is necessary
for muscular work, and the fats to produce heat.
Accordingly, persons who are growing will need more albumin in order to
produce body tissues; and albuminous food will be indicated for those
who have had much loss of tissue, as in convalescence after wasting
disease. By albuminous food the waste of body tissues can best be
replaced. Also after different kinds of excesses where tissue is wasted
(e.g., after sexual excesses) albuminous food will be indicated.
Such a food is also necessary for women during pregnancies, and
especially during lactation.
In any of these conditions the minimum of albuminous food, taken daily,
should certainly be 100 grammes. But other persons can often manage with
less without any wasting of the body proteids, so long as carbohydrates
and fats are taken simultaneously in sufficient quantities.
Besides the three principal groups of food there are certain other kinds
which are almost as indispensable, e.g., mineral matter and water,
without which no animal or man could live, and vegetable acids and
cellulose.
The most important mineral matters are lime salts, mainly in the form of
phosphates. They are present in greatest amounts in cows’ milk. Common
salt is a most important element of food, for which animals and men
often risk their life. As Bunge shows, where vegetables that contain
much potassium are taken, then common salt must be taken as well. He has
shown by experiment upon himself, that when potassium salts are taken a
great quantity of sodium chloride is eliminated from the body. The
reason is, that when a potassium salt is taken, e.g., carbonate of
potassium, and this, in the blood, meets with chloride of sodium, then
chloride of potassium and carbonate of sodium are formed. But the
kidney’s duty is to see that the composition of the blood is maintained,
and that foreign substances, or the surplus of a normal substance like
carbonate of sodium, are eliminated. Hence the carbonate of sodium and
the chloride of potassium are together eliminated, and thus our blood
loses two important elements: chlorine and sodium. Thus, when potassium
is taken, the body loses sodium chloride, and then more of this
substance is required.
A diet of potatoes necessitates much salt, as they are rich in
potassium; on the other hand, rice contains only minimal quantities of
potash. Potatoes contain 42 grammes of potassium in 100 grammes; rice
only 1 gramme. Thus rice as food would require only the smallest amount
of salt.
At the same time Bunge points out the great dangers to the kidneys of a
diet from which quantities of an alkali salt are formed and circulate
through these organs. We can draw a practical conclusion of great value
from Bunge’s observations, and not use much salt in our food, nor too
large quantities of vegetables containing much potassium, if we want to
save our kidneys from harm. That salt is deleterious to the kidneys,
especially when previously damaged, is shown by the works of Achard and
Loeper,[259] Strauss,[260] Vidal and Javal,[261] and others. We have
enlarged upon this in our chapters on the functions of the kidneys and
their hygiene.
Footnote 259:
Achard and Loeper: C. R. Soc. biologie, 23 Mars, 1901.
Footnote 260:
Strauss: Die chronischen Nierenentzundungen, Berlin, 1902.
Footnote 261:
Vidal et Javal: Soc. Méd. des Hôpitaux, 26 J., 1903; Vidal: “Le regime
dechlorusé,” Liége Congrès de Méd., 1905.
A mineral of great importance is iron, which is contained in pig’s blood
to the largest extent, and in certain vegetables and fruit in
considerable quantities. Vegetables and fruit are also rich in vegetable
acids, and also contain a large amount of cellulose, which plays an
important rôle in the normal evacuation of the bowels, being the most
natural stimulus for this purpose.
Condiments are also indispensable in a certain quantity with our food,
for without them the food would have no taste and would not stimulate
appetite, which is of great importance for digestion. On the other hand,
too much of these condiments would irritate vital organs, like the
stomach, intestines, liver, kidneys, etc. Therefore they should only be
used in moderation, and the more potent ones, like mustard and pepper,
should be avoided, or only taken in minimal quantities. Vinegar would
not be so bad if it did not so often contain sulphuric acid. Certain
sharp sauces which are much used are veritable poisons to the kidneys.
This is true of soup that contains them, and even strong bouillon, when
it is taken every day in large quantities, may be injurious to the
kidneys and affect unfavorably the blood pressure since it contains many
meat extracts. To minimize the dangers of all these kinds of harmful
materials, and also of the end-products of nitrogenous food when passing
through the kidneys, it is best and healthiest to drink large quantities
of water, hard water being most desirable, according to Roese, because
of its richness in lime salts. It is advisable to drink this after
meals; but if water is not taken in too large quantities it may be
perfectly harmless to take it during meals. It helps the appetite in
many persons, and encourages the absorption of the food. If taken in too
large quantities it may dilute the gastric juice, although in such a
case the glands of the stomach strive to keep up the standard acidity,
and secrete more acid in consequence. As shown previously, a certain
degree of fluidity of the intestinal contents is indispensable for the
healthy action of the bowels. For all these reasons we recommend a
moderate amount of good fresh water daily. Happily, most of our
foodstuffs, especially green vegetables and fruit, contain water in
large quantities.
Under the name stimulants we include various kinds of food accessories.
The most important of these are alcoholic drinks. It has been shown by
physiologic experiments that when alcohol is taken in moderate
quantities it is harmless, and at the same time may be of value as a
nutrient foodstuff. It is evident from the result of the experiments of
Atwater and Benedict that alcohol has a nutritive value, and that as a
kind of fuel it can largely replace carbohydrates and fats. In such
quantities it also stimulates digestion and other functions, e.g., those
of the heart and nervous system. Such small quantities of alcohol are
contained in beer and wine. According to Rubner, 100 parts of beer
contain:—
Alcohol Albumin Extracts
Bavarian 3.45 0.61 5.3
beer
Pilsner 3.46 0.4 5.0
English and American beers, however, are much stronger in alcohol; thus
Scotch ale contains 8.50 per cent. of alcohol; London porter, 6.90 per
cent.; lager beer, 3.90 per cent.
Beer is also of nutritive value on account of its sugar and dextrine,
which are in considerable amount, especially in dark beers; it also
contains an appreciable amount of albumin. On the other hand, beer has
the disadvantage of forming uric acid in considerable quantities, as
shown by Walker Hall and Haig. Beer also conduces to obesity. There can,
however, be no harm in taking a small amount of light beer every day.
Wine contains proteid substances, carbohydrates, and salts. In some
kinds of wine, like port, sherry, Tokayer, Malaga, and Madeira, there
are large quantities of sugar. The alcohol contents of the different
kinds of wine are given by Rubner as follows:—
per
cent.
Tyrolean wines 8.3
French red wine 9.4
Rhine wines 11.1
Palatial (Pfalz) 11.5
wines
Mosel 12.1
Thus, Tyrolean wines are the lightest, French wines come next, but Mosel
wines are the strongest, in spite of the popular belief that they
contain only little alcohol.
Wines contain more acids than beer (0.41 per cent. to 0.69 per cent.,
according to Rubner), whereas beer has only 0.1 per cent. As wine
contains vegetable acids, just as do vegetables and fruit, they may be
of a certain dietetic value on this account.
We do not think it harmful if old people drink, every day, a few glasses
of good French claret, although we are not prepared to indorse the
dictum of Hufeland that wine is the milk of the old. Much greater
precaution must be taken in the enjoyment of spirits: brandy (cognac),
whiskey, and rum. These beverages contains 50 to 60 per cent. of
alcohol. Still we do not think that small amounts of whiskey, if taken
occasionally and in measured quantities, can be dangerous. Care must be
taken to get whiskey of good quality. There can be no doubt, however,
that when large quantities are taken, as in dipsomania, old age is
brought on sooner. It is claimed that after taking whiskey less uric
acid is eliminated than after taking the other alcoholic beverages, as
beer or some kinds of wine.
Coffee, tea, and cocoa also belong to the class of stimulants, and we
will treat of them in a special chapter, as also of tobacco.
Great moderation must be observed in the amount of food we take daily.
Too rich food would induce not only diseases of the digestive organs,
but also disorders of metabolism, like obesity, gout, or diabetes, and
thus shorten life. Arteriosclerosis is also promoted by such a diet.
The more food also the more exercise should be taken, and the more we
work the more food should we take.
Aged persons should take less proteid food and more carbohydrates.
Proteid food is better suited to young persons who are growing. Besides
carbohydrates, milk is also especially indicated for old persons, as are
also certain amounts of fat, butter, etc.
The amount of food should also depend upon the climate; thus, in winter
more fat should be taken, for fat produces heat. Inhabitants of northern
climes eat much fat, and in Scandinavia more butter is taken than in
southern countries. In hot summer weather little proteid food is
required, and carbohydrates, vegetables, and fruit are more suitable.
Much depends on the preparation of food. In the process of cooking the
food should be brought into the most advantageous form for absorption
and assimilation. Therefore much depends upon the way in which the food
is cooked, and the great importance of this fact is shown by the
establishing of courses in cooking in Berlin under the direction of
Prof. H. Strauss.
In the choice of food attention must be paid to its digestibility. A
robust man, who works hard and takes much exercise, can digest easily
the most indigestible vegetable food, whereas a man occupied with
scientific work and sitting down all day will have a greater difficulty
in digesting it. Aged persons, whose digestive glands are atrophied, are
unable to digest food which presents great difficulties to the action of
their juices. Therefore raw milk, whipped eggs, tripe, lamb, rice, sago,
tapioca, barley, and soft boiled eggs, are the most digestible foods for
them. Of the vegetables, rice is among the easiest to digest, and it
will also soonest disappear from the stomach. There are special
preparations made from various kinds of cereals, finely ground, and
containing the most nourishing elements, and these may be advisable for
aged persons. There are also albuminous foodstuffs in which the albumin
is changed into the form of peptones. However, it has been shown by
Professor Ewald that they contain very little peptone, but mainly
albumose, its precursor. Others of these foodstuffs have the starch
transformed into dextrin or maltose. There can be no doubt that aged
persons will thrive and prosper on the best of these preparations, which
also have the advantage that they can be taken in conjunction with milk.
Another point in their favor is that they require little mastication.
We add here a table after Professor Ewald, of Berlin, on the
digestibility of the various kinds of food:—
TABLE INDICATING THE DIGESTIBILITY OF DIFFERENT KINDS OF FOOD.
The following food leaves the stomach in 1 to 2 hours:—
100 to 200 gr. of pure water.
220 gr. aërated water.
200 gr. tea.
200 gr. coffee.
200 gr. beer.
200 gr. light wine.
100 to 200 gr. milk.
200 gr. bouillon.
100 gr. eggs (soft boiled).
A longer time, 2 to 3 hours, is required for the digestion of the
following food:—
200 gr. coffee with cream.
200 gr. cocoa with milk.
300 to 500 gr. water.
300 to 500 gr. beer.
300 to 500 gr. milk.
100 gr. raw eggs, hard boiled eggs, or omelette.
250 gr. sweetbread, boiled.
200 gr. dried cod, boiled.
150 gr. asparagus, boiled.
150 gr. potatoes, boiled.
150 gr. potatoes, mashed.
150 gr. cherries, a compôte.
150 gr. cherries, raw.
70 gr. white bread, new or stale, dry or with tea.
72 gr. fresh oysters, boiled.
200 gr. carp, boiled.
200 gr. pike, boiled.
200 gr. haddock.
70 gr. biscuit, fresh or stale, dry or with tea.
50 gr. Albert biscuits.
A still longer time, 3 to 4 hours, is required by:—
230 gr. young chickens, boiled.
230 gr. partridges.
220 to 260 gr. pigeons.
195 gr. pigeon, roast or broiled.
250 gr. beef, boiled.
160 gr. ham, raw or boiled.
100 gr. roast veal, hot or cold.
100 gr. beefsteak, roasted.
100 gr. sirloin of beef.
200 gr. salmon, boiled.
72 gr. caviar, salted.
150 gr. dark bread.
150 gr. brown bread.
150 gr. white bread.
100 to 150 gr. Albert biscuits.
150 gr. potatoes.
150 gr. kohlrabs, boiled.
150 gr. carrots.
150 gr. spinach.
150 gr. cucumber salads.
50 gr. apples.
The following food demands the longest time for its digestion:—