Collective Investigation Returns, comprising 4287 persons, that the
average duration of life is greatest among total abstainers and very
moderate drinkers, and that but few addicted to much alcohol were among
the long lived; those in the latter condition can only expect a
shortening of life, which proves conclusively that alcohol is very
deleterious to the organism.
As post-mortem examinations show, all the organs of the body suffer
degeneration after coming in contact with large quantities of alcohol.
It would be impossible to dilate here upon all these different changes.
We will, therefore, only mention the effects of alcohol on the most
important organs—for example, the heart and blood-vessels.
As is well known, alcohol, if taken in large quantities, degenerates the
heart muscles and also produces the condition of arteriosclerosis. Its
effects on the brain are particularly deleterious. If taken once only,
but in large measure, it is sufficient to cause intoxication, with
changes in the mental faculty. Taken habitually, as by chronic
alcoholics, these mental changes may develop into a permanent character,
and thus insanity may follow. According to the official statistics of
the Kingdom of Württemburg, about 60 per cent. of the inmates of lunatic
asylums were alcoholics. Out of 579 lunatics of the Provincial Insane
Asylum, in Vienna, in 1899, there were 40 per cent. alcoholics.
As we have shown in our address at a special meeting of the Philadelphia
Medical Jurisprudence Society, insanity and crime stand in very close
relationship, and, in fact, crime may be regarded as a nervous disease.
We should, therefore, not be surprised to find so many criminals among
alcoholics. According to statistics prepared in Germany, some 63 per
cent. of cases of injury to the person, 69 per cent. of robbery and
murder, and 77 per cent. of sexual crimes were committed by persons
under the influence of alcohol; and according to Dr. Scharffenberg, of
Christiania, if there were no alcoholics crime would be diminished by
one-half.
A person committing a crime while under the influence of alcohol is no
more responsible than a person who does the same thing while in a state
of delirium caused by some infectious disease, or while under the
influence of such a poison as muscarin or atropin, which produces an
intoxication similar to that of alcohol.
Of the other organs which are injured by alcohol we must put in the
front rank the various ductless glands, which are of special importance
to us.
The frequency of impotency in chronic alcoholism proves how injurious to
the sexual glands are large quantities of alcohol. The same applies to
the adrenals, as shown by the frequency of arteriosclerosis in
alcoholics. From one dose of alcohol we can often see an increase in
blood-pressure. It has been shown by Dr. Sajous that alcohol acts in a
very deleterious way upon the pituitary body when taken in anything but
small quantities or well diluted as in beer or light wines; he
illustrates this fact in a very instructive microscopic specimen.[311]
Footnote 311:
Sajous: “Internal Secretions,” vol. ii, p. 1332, 1907.
In the same way the bad effects of alcohol on the kidneys and liver are
amply demonstrated in the handbooks of clinical medicine and
pathological anatomy, with which we are all well acquainted; and the
constant occurrence of cirrhosis of the liver and interstitial nephritis
in alcoholics plainly show this.
A matter of grave importance to us is also the degeneration of the
thyroid in alcoholics, as found by the researches of de Quervain[312]
and Sarbach[313] and the clinical observations of Hertoghe.[314]
Footnote 312:
de Quervain: Semaine Méd., 1895.
Footnote 313:
Sarbach: Mitth. Grenzgebiete Med. u. Chir., 1906, p. 213.
Footnote 314:
Hertoghe: Loc. cit.
These degenerating effects of alcohol on the ductless glands will
explain why premature old age is so often found in alcoholics,
especially when brandy and liqueurs are taken; but still worse
consequences than this also arise, viz.: the diminution of the powers of
resistance to infection or intoxication, in consequence of the lack of
those important protective elements which, as we see in Chapter III, are
derived from the ductless glands, a fact which various epidemics amply
prove. My friend, Dr. MacMeans, told me during a stay in Monterey,
Mexico, that in an epidemic of yellow fever, he observed that alcoholics
were among the first to contract it.
We know the great frequency of tuberculosis in alcoholics, and the great
mortality in such persons from pneumonia. They are unable to withstand
the high fever and cannot combat the infection, and the heart soon
fails; and also, as a general rule, in all cases of infectious diseases
their chances are much worse than are those of other people.
We note in Chapter VI that heredity depends on the condition of the
ductless glands of the parents. This is also the case with alcoholics,
and it is a fact that the descendants of such are heavily handicapped;
and, as also mentioned in Chapter VI, congenital myxœdema and
scrofulosis is prevalent among them, and their chances for a long youth
discounted. Nervous diseases are also of constant occurrence among
these, such as idiocy, epilepsy, etc., very interesting data as to which
are given by Legrain. A certain alcoholic was eight times in the insane
asylum for delirium tremens. He had nine children; three died at birth
from general debility, one died of convulsions within the first year,
and the other five suffered from trembling in the extremities. The
father of this person was also a drunkard, who hanged himself; the
mother, a brother, and a sister were also dipsomaniacs.
Martin found in 60 out of 83 female epileptics, alcoholism in the
parents. Demme examined 57 children among such, and found only 10 who
were normal, physically and mentally.
A terrible genealogy is that traced by Dr. Klausner concerning a woman
named Ada Take, born in 1740, who was a dipsomaniac. She had 709
descendants, among whom were 100 illegitimate children, 181 prostitutes,
142 beggars, 46 workhouse inmates, 76 criminals, and the remainder were
more or less habitual drunkards. This one family cost the country or
prison authorities for their support over three million florins
($1,200,000).
In tropical climates the effects of alcohol are most pernicious.
According to Dr. Hueppe, it is the greatest enemy to the European. From
the official report of the British Commissioner General for Central
Africa, in 1894, “the use of beer, wine, and spirits is more destructive
to our tropical colonies than all the bacilli and plasmodia;” and
according to the great African explorer, Emin Pasha, the tropics offer
no dangers to the health of such as can abstain from large amounts of
stimulants. It is very likely that what atrocities have been credited to
Europeans in Africa were due to alcohol.
From the foregoing facts it is clear that large quantities of alcohol
are most injurious, but there is no scientific evidence to prove, with
exactitude, that small doses are harmful.
Some experiments in this direction have been made by Laitinen,[315] but
they were performed on rabbits and guinea-pigs, to which he gave very
small doses (only 0.1 centimeter per kilo bodyweight). He found that the
hæmolytic ability of the blood was impaired, and that there was a
greater mortality among their young than among the young of those kept
on water. Laitinen, himself, did not dare to draw conclusions from these
experiments; nor can we, for there is a great difference between a man
and a rabbit. But if an inference may be deduced from such, we can apply
it to children, for, as is well known, the effects of drugs on small
animals offer better comparisons for children than for adults. For this
purpose, however, we need not refer to the experiments of Laitinen, for
Dr. Maurice Kende has lately experimented on 20 children between 6 and
15 years of age, who, after very small quantities of wine, exhibited an
impairment of their mental faculties.
Footnote 315:
International Congress of Anti-Alcoholics, Stockholm, 1902.
Dr. Hercod has also shown that out of 591 Viennese school children, the
best certificates for scholarship were gained by those who took no
alcoholic drinks; instructional results were not quite so satisfactory
in those who occasionally did so; but the worst scholars of all were
those who took alcohol two or three times a day. According to Viennese
life, beer is generally meant by the term “alcohol,” and, in a much less
degree, wine.
That children are susceptible to alcohol, as to all poisons in general,
has been already mentioned in Chapter X; so it is not surprising if only
small quantities should unfavorably affect their mental faculties. We
have also previously insisted upon the necessity of considering it a
crime, meriting a heavy punishment, to give alcohol to children. But we
again repeat that there is not sufficient strictly scientific evidence,
as yet, to prove that small quantities of alcohol (especially beer or
wine, and possibly whiskey) are deleterious to the majority of adults;
those who cannot stand even small quantities will be best without any;
but we fail to see why a working man, when he comes from his daily
labor, should be forbidden to take his glass of beer. It is certainly
not the temperate users of stimulants, the hard workers, that should be
persecuted by anti-alcoholics, but the intemperate users, who are a real
curse to humanity. If those fanatics will limit their action in this
useful direction only, every physician will be only too anxious to
support them; but instead of this, like Don Quixote against the
windmills, they forbid the use of alcohol entirely to persons who simply
cannot exist without it; in fact, they might just as reasonably forbid
them to eat, drink, or sleep!
We firmly believe that the best course is to discover the cause which
compels such people to drink so much that they cannot discontinue the
habit, and by finding the cause we shall ascertain the origin of the
disease and can then treat it rationally, as we will endeavor to show in
the succeeding chapter. Physicians, and not clergymen, are best
qualified to fight the alcoholic habit, just as they are best qualified
to fight all other diseases. That alcohol in small quantities cannot be
such a poison as claimed by these faddists, is also shown by the great
number of moderate drinkers who live to be much above 100 years old. At
the present time there are also within our knowledge several persons
over 100 years old who take every day a certain amount of alcohol. Thus
an old general in Berlin, who reached his 103d birthday last December,
is accustomed to go, every day, to a beer house to have his glass of
beer. Mrs. Andie Campbell, of Springburn, near Glasgow, who attained her
103d birthday in January, 1908, attributes, as the newspapers stated,
her old age to the moderate use of whiskey, which she has been
accustomed to drink all her life. According to the report of the
Collective Investigation Committee of the British Medical Association,
most of the 51 centenarians, whose cases were investigated, were total
abstainers, but 5 were very fond of alcohol. One of them, Peggy Walsh,
who is said to have attained 127 years, was in the habit of taking daily
before dinner an ounce of whiskey in water.[316] Thus it seems
conclusive that the use of moderate quantities of alcohol does not
seriously impair our chances for living to a good old age.
Footnote 316:
Quoted after Humphrey, “Old Age,” Cambridge, 1889.
------------------------------------------------------------------------
CHAPTER XLIII.
SOME REMARKS ON THE CAUSES AND PREVENTION OF THE ALCOHOL HABIT.
IT is a strange fact, but one in which all observers agree, that women
who have never been accustomed to take alcohol, can stand considerable,
and sometimes very large, quantities of it during convalescence after
infectious diseases, such as pneumonia, etc. It is equally strange that
in severe cases of diabetes, where previously opium had never been
taken, very large doses of this drug may be used without any
inconvenience. We have also observed that women suffering from severe
diabetes, though unaccustomed to alcohol, could take large quantities of
it—for instance, one or two tablespoonfuls of whiskey three times a
day—without displaying any symptom of mental excitation or other signs
of having taken liquor in a quantity which might provoke a state of
excitation in persons not used to alcohol; in fact, the alcohol has been
well tolerated and taken with pleasure.
In both these conditions—diabetes (Lorand) and infectious diseases—the
thyroid gland plays an etiological rôle, as we have frequently indicated
in this work. It is, therefore, justifiable now to discuss the point
whether the thyroid has something to do with the apparent paradox that
alcohol can be taken, without the display of any signs of intoxication,
by women who are otherwise never in the habit of taking spirits.
That this is really so cannot be denied, _a priori_, for the reason that
between the activity of the thyroid and the influence of alcohol a
certain relationship exists. This is evidenced from the observation,
mentioned previously, that alcohol acts upon the thyroid gland, at first
causing hyperactivity, and later on exhaustion of it. As we have already
mentioned, there is a certain analogy between the action of chloroform
and that of alcohol on the thyroid gland. In fact, we think that it is
permissible to assume that drunkenness is a consequence of the
hyperactivity of the thyroid, for in such a condition there are
observable a series of symptoms of thyroid hyperactivity; and it has
been shown by Moebius[317] that in women suffering from Graves’s disease
(hyperactivity of the thyroid) we may find a condition of intoxication
similar to that seen in alcoholic intoxication, although such women had
not taken even a drop of alcohol. This condition is provoked by the
over-abundance of thyroid secretion in the blood. In other words, women
suffering from this disease can be drunk without having taken any
alcohol at all, simply because of the entering into their blood of the
secretion of the thyroid in large, i.e., in toxic, quantity, this having
produced such a condition.
Footnote 317:
“Die Basedow’sche Krankheit,” Nothnagel’s Handbuch, second edition.
According to several authors, whom we have already quoted (de
Quervain,[318] Hertoghe[319]), alcohol has a great influence on the
thyroid, and in chronic alcoholism the thyroid is found to be
degenerated.
Footnote 318:
Semaine Médicale, 1905.
Footnote 319:
Loc. cit.
If it can be admitted that drunkenness is caused by the toxic products
of the thyroid, due to the alcohol acting on the thyroid and causing its
hypersecretion, we can also explain the mystery why persons bitten by
poisonous snakes can also, in the same way, take very large quantities
of alcohol without showing its effects, even when they have previously
been quite unaccustomed to it. Snake poison, as do all poisons, creates
a hyperactivity of the thyroid which results in the throwing off of a
large amount of colloid substance. Exhaustion follows this
hyperactivity, and in this condition, as in convalescence from
infectious diseases, and in severe diabetes, where there is also a
similar exhaustion of the thyroid after a previous hyperactivity, a
large quantity of alcohol can be taken, merely because of the fact that
when the thyroid is devoid of its colloid, a condition of hyperactivity,
which is the cause of drunkenness, cannot easily be provoked, unless
enormous doses are given. We must, therefore, in cases of snake
poisoning give greatly increased doses of alcohol in order to again
provoke an increased activity of the thyroid, and thus cause the
eventual destruction of the harmful toxalbumins of the snake poison.
If women, in a state of convalescence after pneumonia, or with severe
diabetes, and unaccustomed to taking spirits, can stand large quantities
of alcohol without exhibiting any signs of excitation, it is very
probably due to the circumstance that the thyroid has already thrown off
its available amount of colloid, is exhausted, and the doses given are
not yet sufficient to produce a fresh secretion, and thus the symptoms
of drunkenness do not develop.
The result of these observations is that a degenerated thyroid cannot
easily provoke a condition of drunkenness, which may also explain the
curious coincidence that frequently chronic alcoholics, even after large
quantities of alcohol, do not present typical symptoms of drunkenness;
in fact, sometimes so few of such signs are visible that, if a crime is
committed under such influences, it is difficult to prove they were
really intoxicated at the time, as they present no visible signs of such
a condition.
From the foregoing we shall, therefore, not be surprised to find that
persons suffering from hypothyroidia or myxœdema can take large
quantities of alcohol, and at the same time evince a great liking for
the same; in fact, at times, they have a regular craving for it. Several
things will explain why myxœdematous people like to take alcohol. They
invariably feel cold, as the thyroid regulates the temperature of the
body; they thus desire to obtain warmth from the spirit (which may
excite the function, in a small degree, of such parts of the thyroid as
are not yet degenerated), and thus produce symptoms of thyroid
hyperactivity, by which warmth may be produced, though they do not
realize that subsequently they will be all the colder. Such people are
also generally of a dull apathetic disposition, never cheerful, but in a
depressed mood, owing to the degenerated condition of the thyroid; and
being thus despondent they are easily dejected by worries or
disappointment. That such people should resort to drink is but natural,
if we consider that they can take alcohol without visible effects. We
must not forget that there are many degrees of hypothyroidia, from light
cases with a simple insufficiency of the thyroid up to graver forms
nearly approaching myxœdema; and all we have said on the above subject
will apply in varying degrees to them.
From this we shall now also understand why aged people can sometimes
take much alcohol without exhibiting signs of drunkenness, which is
probably the origin of the erroneous idea that “wine is the milk of the
aged.” This can have very baneful results, for if small doses can
undoubtedly produce—especially when light French wines are taken—a tonic
and stimulating effect on the thyroid, after larger doses the
hyperactivity may more readily be followed by exhaustion, in which case,
in old age, the degeneration of the thyroid will be still more
quickened.
If persons with a degenerated thyroid can take large quantities of
alcohol without getting drunk, on the other hand, those with an
overactive thyroid cannot stand alcohol so well; and that the latter is
the case in Graves’s disease has been already shown by the fact such
people can exhibit the symptoms of intoxication even when they have
taken no alcohol at all. Young girls and women generally, except those
past the climacteric age, are very sensitive to the effects of alcohol,
and easily get intoxicated, owing to the fact that the thyroid is, with
them, more active on account of the intimate connection between it and
the ovaries. Thus, during thyroid treatment we have seen intoxication
appear after a single glass of claret in persons who previously could
drink much more without becoming so affected.
During treatment with thyroid tablets alcohol is not well borne,
according to our observations.
It is probable that the sexual glands have also something in common with
this question. We have observed that people with marked sexual
inclinations are seldom habitual drunkards; in fact, we do not recall
having ever come across an instance; also, among total abstainers men of
strong sexual inclination are not infrequently met with, whereas
alcoholics do not usually seem to care much for the fair sex, which
should surprise us the less, in as much as among them impotency is very
frequent, alcohol in large quantities always having a baneful effect on
the sexual glands. In small quantities, to a certain extent, it may
prove stimulating to these glands.
It is an interesting fact that in those with degenerated sexual glands
there is always a greater liking for alcohol; thus women, after the
menopause, have a greater predilection for spirits, and the greatest
number of cases of drunkenness in women is to be observed among such.
Eunuchs also have a greater inclination for intoxicating agents than
have their more fortunate brethren who are still in possession of their
sexual glands. We do not think that psychic impulses, consequent on such
conditions, can be of sufficient influence to explain the craving for
alcohol, except, perhaps, through the circumstance that persons deprived
of the active sexual glands do not enjoy a high state of mental activity
and are unable to judge of the fatal consequences of the drink habit. If
women, after the menopause, exhibit a greater inclination to drink, we
think it cannot be explained solely by their seeking to drown the
sorrows of lost youth and by substituting for the pleasures of sexual
life those of the bottle. This may certainly influence them to a certain
degree, but in any case it is certain that without the possession of
healthy sexual glands the desire for stimulants is greater; and it would
seem also that in advanced age they can take alcohol more freely than in
their prosperous younger days. Such persons have a partiality for strong
sweet liqueurs. Happily such women are in a great minority. All we wish
to point out is that it is among the older people that this craving
exists, as in the younger ones alcohol cannot be so well borne.
From such observations on the greater frequency of the alcohol habit
among persons suffering from degenerated conditions of the thyroid and
sexual glands, and on its greater rarity in opposite conditions, we
believe that some therapeutic hints may be gained. The best preventive
against the alcohol habit (which is induced usually by the want of, and
a real craving for, stimulants) will be the satisfying of this tendency
by other means than alcohol. We can even prevent this craving if we can
improve the state of their thyroid or sexual glands. For single persons
marriage is an excellent stimulant, and a first-class psychic treatment
as well. Treatment by means of thyroid gland can also give good results,
as by this the mental condition will be improved and a cheerful
disposition may be gained, which will enable them the better to
withstand worry and depression after disappointment. At the same time
the temperature of the body will be increased, a feeling of warmth
produced, and fatigue much better borne. Thus no whip will be needed,
and the craving for stimulants will be prevented. To women not only
thyroid, but ovarian, extracts should be given. Both exercise a powerful
influence on the mental condition, relieve depression, and remove the
craving for constant stimulation. By these means we possess a basis for
the rational treatment of alcoholism, besides the psychical and ethical
one, on which we will not enter here. But we must emphatically remark
that we must, in the first instance, get rid of the real cause of
alcoholism, viz., the diseased condition of the thyroid and sexual
glands which induces it, and by the removal of the cause we also remove
the consequences. By merely forbidding the use of alcohol and doing
nothing to cure the diseased condition which sets up such an insatiable
craving for it, is like filling a barrel, which has a hole in it, with
water, before we have tried to stop up the orifice.
------------------------------------------------------------------------
CHAPTER XLIV.
ON OTHER STIMULANTS—TEA, COFFEE, COCOA, TOBACCO: THEIR MERITS AND
DISADVANTAGES.
In many people the use of the above stimulants produces greater energy,
especially for mental work, and the process of thought may be
facilitated by their means, although we are not prepared to approve them
as a general rule. At any rate if such properties are to be found in
these stimulants, they are available only in small amounts and not
exceeding a given limit, for in excess the same rule applies to them as
to alcohol.
There are, indeed, certain authorities who condemn them, and go so far
even as to call them poisonous. But it is a leading principle of this
work to condemn exaggeration and fanaticism in any form, and always to
observe the means that are best for all rules of life. Sobriety and
impartiality in everything must be the guiding stars for such a work as
this. We must not forget that the millions of human beings that are on
the earth have each a different kind of constitution, and many of them
practically cannot exist without the assistance of certain stimulants,
without which life would be a burden to them; and as it does no good to
make prohibitions which cannot be kept, even though made with the best
of intentions, all we can do is to endeavor to control certain things
and to see that some limit is set for their use.
There are two varieties of tea, both of which, however, are gathered
from the same plant; their only difference lies in their method of
preparation; their differentiation is in color—black and green. The
former undergoes a process of fermentation and is then dried slowly over
charcoal fires, while green tea derives its color from having been dried
in a fresh condition over a wood fire.
When we want to make good tea we must take finely washed leaves and make
an infusion, so that the greatest possible surface of the leaves shall
come in contact with the boiling water; and it is best to let this
contact be only for a short time, as otherwise the tea will be too
strong and less beneficial to health.
The most important elements in tea are thein, a substance that is
identically similar to caffein in coffee, ethereal oils, tannin, and
extractives. Green tea contains more thein and ethereal oils, and also
more tannic acid, than black tea; and the longer it is in contact with
boiling water the greater will be the quantity of tannic acid derived
from it. According to R. Hutchison,[320] the ashes of tea contain a
large percentage of manganates (1.09 per cent. manganese hydroxide) and
much iron (4.47 per cent. oxide of iron).
Footnote 320:
Hutchison: “Food and the Principles of Dietetics,” London, 1901.
After taking a cup of tea there is a feeling of great comfort; we feel
lighter and less fatigued, which is due, as discovered by Koch and
Kraepelin,[321] to the combined action of the ethereal oils and of the
thein. The tannic acid contained in tea may also give good results in
the treatment of certain diarrhœas. The actions of tea are very similar
to those of coffee, which is only natural, since both contain the same
chemical agent, thein or caffein. Still, though chemically the same,
physiologically doubtless there are some slight differences. Although
both promote endurance in physical and mental work, according to some
views, still in many people nervous irritability, such as sleeplessness,
is greater from tea than from coffee. Coffee is a better diuretic than
tea, and it has been found that common salt is eliminated in the larger
quantity after taking coffee. For weak stomachs neither is advisable.
Footnote 321:
Koch and Kraepelin: “Psychologies die Arbeiten,” vol. i, p. 378, 1895.
In many cases tea is less easily assimilated than coffee, on account of
digestive disturbance caused by its tannin contents; while to many
others tea proves more suitable than coffee. When these beverages are
taken in large quantities there are very serious symptoms of nervous
disorders, such as great excitability, sleeplessness, palpitation of the
heart, trembling, etc. Indeed, sometimes the very serious condition of
actual intoxication is brought about.
It is quite amazing what large quantities of tea are consumed in certain
countries—in England, for example; and in many instances the moderate
use of good wine would certainly create less mischief than the
immoderate use of tea. Tea is not so beneficial to the kidneys as
coffee, and as we have mentioned in the chapter on the hygiene of the
kidneys, irritation of the kidney tissues may be at times observed after
the use of tea. As in the case of alcohol, moderation with tea and
coffee is necessary. According to the researches of Böttger even weak
infusions of tea and coffee are harmful to children, and strong
infusions to grown up people.
The most important substance in coffee is caffein, a product already
mentioned as being chemically identical with thein. When we take a cup
of coffee about 0.1 gramme of caffein enters the system, and also 0.2
gramme of tannic acid, as shown by Robert Hutchison. When coffee is
roasted aromatic oils arise, which give coffee its delicious aroma.
Coffee acts as a stimulant to the heart and also to muscular
contractions. Its beneficial action on the kidneys has been referred to.
When coffee is taken it is more hygienic to take it not too strong, and
invariably with cream or milk.
According to Emil Fisher, caffein is a thrice methylated xanthin, from
which it can be produced artificially. As caffein, or thein, contains
purin bodies, they also augment the amount of uric acid in the body, and
especially so when they are taken in large quantities. Because coffee,
tea, or cocoa give rise to uric acid, Haig would like to banish them
entirely from the diet. We do not feel inclined to follow Haig in such a
fanatical view, for after all it is nearly impossible to so live that we
should not introduce some small amount of uric acid into the system; we
are always producing a certain amount of it in the system, as already
mentioned, and whether a trifle more or less be taken can make no
difference, as minute quantities of uric acid cannot play an important
rôle if our kidneys are in good condition to eliminate them. With a
large amount of meat we eliminate two grams of uric acid in every
twenty-four hours, and even with an entirely vegetarian diet the urine
still contains 0.2 to 0.7 gramme, according to Bunge. Should we be so
unreasonable as to refuse a person a cup of weak tea or coffee, after
their having been accustomed to such for a lifetime, merely to avoid a
few more atoms of uric acid. Especially should we refuse them a weak cup
of coffee, remembering that such is a good diuretic and assists in the
elimination of baneful products through the kidneys? Only to actually
gouty people might such a veto, perhaps, be reasonably applied.
Cocoa is a very valuable article of food, and at the same time a very
mild stimulant. As its active principle it contains theobromin, which is
a twice methylated xanthin. In its chemical and physiological actions
theobromin is very similar to caffein. It is, however, in some respects
superior to caffein. Thus it can assist muscular activity, according to
some authorities, to a higher degree than caffein or thein.
Cocoa has the further advantage of being more digestible than coffee or
tea; and as a foodstuff it shows a great superiority over both the
latter, as it contains 12 per cent. of albumin, 13 per cent. of
carbohydrates, and contains fat—indeed, about 50 per cent.—in a fresh
condition.
Cocoa presents fewer drawbacks than tea or coffee; it is less exciting
to the nervous system, more digestible, and much more nutritious also.
We think, therefore, it is clearly indicated as the best of all
stimulants, and, for reasons already stated, we are not afraid to
recommend it, in spite of the fact that it may nominally increase the
amount of uric acid. Cocoa was also the favorite beverage of the great
botanist Linné.
Chocolate is composed of cocoa and a large quantity of sugar, and is
quite a pleasant sugar food, which doubtless can be used with profit as
a dessert to a lacto-vegetarian diet. It is also suitable for the use of
tourists and sporting men in order to enable them the better to endure
great fatigue. We often recommend its use in its best quality and in
small quantities to those people from whose diet meat is excluded.
Tobacco is a plant, the leaves of which, when prepared by a special
process and smoked in the shape of cigars, or in pipes, are able to
produce in many people a feeling of exhilaration; and many such smokers
are able to do more work, especially brain work, with the aid of a good
cigar. Tobacco contains, in addition to noxious salts, a poisonous
alkaloid, nicotine, which produces in small amounts in those not
accustomed to it, and in all people if in larger quantity, a condition
of intoxication. When nicotine is taken for many years, and sometimes
even in a shorter time, either by smoking or chewing, very injurious
consequences from nicotine poisoning may ensue. According to König,
cigarettes are the most dangerous in this respect. It is quite a mistake
to think that no nicotine is introduced into the system through smoking;
and in chewing mixtures the presence of foreign matters must not be
overlooked. Nicotine may exercise a fatal action on various organs—for
instance, on the inner parts of the eye and the optic nerve, and the
nervous system; but without doubt its most injurious action is on the
heart and the stomach. At first it may cause only an irregular pulse and
an occasional feeling of a stopping of the heart; but if continued, in
spite of these symptoms, for a long time, it can undoubtedly produce the
condition of atheromatosis, and will assist in the development of
arteriosclerosis, which is probably caused by the action of this
substance on the adrenals; for it has been noted by many leading
authorities—e.g., Prof. Isaac Adler, of New York—that tobacco produces
effects similar to adrenalin.
According to Sir Lauder Brunton[322] and others, tobacco raises the
blood-pressure, sometimes enormously. As Brunton says: “I do not know
that there is anything that causes such a tremendous contraction of the
vessels and raises blood-pressure to such an enormous extent as does
nicotine, except, perhaps, the extract of suprarenal capsules, which has
an action almost identical with nicotine.”
Footnote 322:
Brunton: Lectures on the Action of Medicine, p. 321, 1897.
It has also been shown by Esser[323] that chronic nicotine poisoning is
able to produce in animals a great disturbance of the heart and
histological alterations of the vagus fibers, and that if nicotine is
injected into the circulation it excites the vagus and slows the action
of the heart.
Footnote 323:
Esser: Arch. für exper. Path. und Pharm., xlix, p. 168.
Clinically we have observed the great frequency of arteriosclerosis in
great smokers, but we do not think that two or three light cigars a day,
but never before meals, can do any harm, save in exceptional cases.
Indeed, there are a few instances of persons living to be over 100,
notwithstanding the fact that they were smokers—a fact contrary to the
observations of Hufeland, who pretends that he never heard of such a
case. The famous English painter, Mr. Frithe, who died in October, 1909,
used to smoke six cigars a day; and Mr. F——, of Chartres, in France,
passed last year his 100th birthday in spite of his having taken snuff
all his life.
------------------------------------------------------------------------
CHAPTER XLV.
ON SLEEP, AND ITS IMPORTANCE IN RIDDING THE BODY OF TOXIC PRODUCTS.
SLEEP is one of the most important functions of the body. As the
physiologist, Bunge,[324] remarks, “a man can live for a month without
food, but he must succumb after only a few days if he fails to sleep.”
Footnote 324:
Bunge: Loc. cit.
That sleeplessness leads to death has been proved by experiments on
animals by Maria de Manasseine, who has demonstrated that animals from
three to four months old invariably died if treated in such manner that
they could not sleep at all. At the same time their temperature fell
four to five degrees, and the number of their red blood-corpuscles
decreased from five millions to two millions per cubic millimeter.
Manasseine also discovered important changes in the brain of animals
which had died from sleeplessness.
Before we get sleepy, as a rule, we feel tired and suffer from fatigue.
Working from morning to night—for even idle persons work through the
action of their organs—our muscles make numerous contractions, and it
has been demonstrated by Weichardt[325] that toxic products are thus
accumulated in them. This savant made animals perform very fatiguing
movements for several consecutive hours; he then injected extracts from
those muscles which had been subjected to such exercise, into other
animals, which animals in turn exhibited symptoms of great fatigue; and
he has gone so far as to show that such animals may even die during the
next twenty to forty hours.
Footnote 325:
Weichardt: Munchener Med. Wochenschrift, Nu. 1, 1904; and
Verhandlungen der Physiolog. Gesellschaft, Berlin, Dec. 5, 1906.
Similar conditions prevail in human beings to a greater or less degree.
According to Prof. Obersteiner, of Vienna, and Binz, sleep is produced
by an accumulation of the products of fatigue in the brain, and these
substances are carried off during sleep. Thus sleep is similar to a
condition of auto-intoxication caused by the accumulation of the
products of work, be it muscular or mental, during the time that we are
awake.
In the next chapter we shall show that sleeplessness occurs in all cases
where the thyroid gland is degenerated. This gland, as we show in
different parts of this book, destroys the toxic products formed in the
body. When this gland is degenerated these products cannot be destroyed,
and thus a condition of auto-intoxication will follow, as in myxœdema,
which has sleeplessness as one of its most typical symptoms.
According to our present physiological knowledge the center of sleep is
seated in the brain just as are other functions, such as intelligence,
will-power, imagination, etc. As we have mentioned in the chapter on the
agencies which control the condition of our nervous system and
mentality, all these are changed when the thyroid is altered, for they
suffer alteration after the thyroid is removed or destroyed by disease;
and, on the other hand, they can be improved by thyroid treatment. Thus,
sleep being one of these functions, it is only logical to assume that
the thyroid controls sleep, which proposition we shall support with a
mass of evidence in our next chapter; we will also mention there that
after the injection of adrenalin, in the vicinity of the brain, Dr.
Zeigan[326] has produced sleepiness in animals. Adrenalin produces an
anæmic condition of the parts into which it is injected, caused by the
contraction of the blood-vessels.
Footnote 326:
Zeigan: Therapeutische Monatshefte, p. 193, 1904.
There has been a dispute on this question, whether it is hyperæmia of
the brain, or its anæmic condition, which induces sleep.
In addition to the experiments of Dr. Zeigan, which we have referred to,
and with which we will deal further in our next chapter, there are also
other circumstances which support the idea that in sleep the brain must
be in an anæmic condition.
We know that in order to fall asleep the brain must be at complete rest,
for otherwise it is impossible to sleep; if the function of the brain is
roused by any exciting influence, as for instance, if we ponder deeply
over any scientific problem, sleep is out of the question. We think this
can be amply proved by a very interesting experiment carried out by the
physiologist, Mosso, in order to show that the process of thought
produces a hyperæmia of the brain. Mosso made a man lie horizontally on
a sort of scale, so that the balance was perfectly level. The subject
was then told to think deeply, and upon so doing the head end became
heavier, and the balance was depressed in that direction.
We can also note that any other agency which produces a greater flow of
blood to the brain will be an impediment to sleep. For instance, many
people are unable to sleep when they have taken a certain amount of
alcohol, such as wine, just before going to bed; and this is more
observable in those who are unaccustomed to alcohol, and who become
flushed, feel hot in the head, and become mentally excited after taking
even small quantities. On the other hand persons accustomed to spirit
drinking, in whom no such symptoms are exhibited, may possibly be able
to sleep; this demonstrates toxic action, which may be followed by deep
sleep, by the action of alcohol on the thyroid gland. Taken in small
quantities alcohol excites thyroid action, but taken in large quantities
it causes its exhaustion as already previously mentioned.
Long ago it was accepted as a well-known fact that a hot head and
flushed face prevent good sleep; but good regular sleep is obtained when
the head is cold.
Sleepiness after dinner is attributed by Bunge to the accumulation of
blood in the digestive organs, which produces an anæmia of the brain. As
we show in the next chapter, the alteration in the thyroid by its
destruction of toxic products from the intestine, may also in part do
this.
Very interesting experiments have been carried out by Christern,[327]
under the direction of Prof. Kreis, of Freiburg, who showed that the
pressure of blood in the cavity of the skull of a boy decreased while he
was asleep.
Footnote 327:
Quoted after Bunge.
As we have already stated, sleep is attributed generally to a condition
of auto-intoxication. When we rise in the morning, after having slept
well and soundly during the night, we feel so fresh that these toxic
products must assuredly have left the body during the night. On the
other hand, after a sleepless night we feel so miserable and weak that
the supposition is not unjustified that possibly we have not gotten rid
of these harmful products. Professor Bouchard[328] has endeavored to
show, by an examination of urine passed during the night, that this has
a greater toxic action when injected into animals than has urine passed
during the day.
Footnote 328:
Bouchard: Loc. cit.
As before mentioned, according to Obersteiner and Binz, during sleep the
products of fatigue, which have accumulated in the brain during the day,
are removed by the blood.
Everything points to the fact that through sleep we are getting rid of
toxic products; and sleep is thus a function, the regularity of which is
of the utmost importance for our prospects for a prolonged youth and
healthy old age.
------------------------------------------------------------------------
CHAPTER XLVI.
ON THE CAUSATION OF SLEEP, SLEEPINESS, AND INSOMNIA.
WHEN any one is affected by African sleeping sickness, he wants to sleep
at all times. We observed the case of an officer of the Belgian Congo
Army, suffering from this sickness, who actually fell asleep over his
soup while at table. Dr. Willems, of Brussels, also mentions a case of a
patient who fell asleep during his wedding, and of another who went to
sleep on the doorstep while in the act of calling on him for advice.
Discovery of the cause of such a marked degree of sleepiness caused by
disease should be of the greatest possible assistance in solving the
mystery which enshrouds the lesser degree of sleepiness found in normal
cases. We will, therefore, now discuss the question of the cause of the
uncontrollable desire to sleep in cases of sleeping sickness.
As we pointed out in a communication to the German Congress of Medicine
in Wiesbaden, in 1905, sleeping sickness is clinically and essentially a
condition quite different to trypanosomiasis. It undoubtedly is the
consequence of the former, which is caused by the bite of the tsetse fly
(Glossina Palpalis); but sleeping sickness presents entirely different
clinical symptoms from the first, and it also takes a much longer time,
sometimes five to seven years, to develop, after the preceding
trypanosomiasis.
As we could not fail to observe, the above case presented all the
appearances of a myxœdematous condition, among others the same walk,
slowness of movement and of speech, and the same apathetic mental state,
with the same dullness of memory; and it was surprising to witness how
all these symptoms improved only a few days after thyroid treatment had
been instituted.
The pathological and anatomical changes in patients suffering from
African sleeping sickness, described by the English and Portuguese
Commission charged with the study of this disease, present also a great
similarity to the changes found in myxœdema, and this is especially the
case in connection with the central nervous system. Thus we find in both
conditions similar changes, such as destruction of the nerve cells and
nerve processes, chromatolysis, disappearance of the Nissl bodies, and
also the same typical agglomeration of white blood-corpuscles in and
around the blood-vessels, etc. The most striking point in reference to
this similarity is the fact that the condition in the central nervous
system is in both conditions named alike, viz., pylo-encephalo-myelitis.
Walter Edmunds has found similar changes in dogs and monkeys after
removal of the thyroid.
This singular similarity also coincides with the etiology of the two
conditions. Myxœdema is most often the consequence of a previous
infectious disease; in the case of sleeping sickness, this previous
infectious disease is trypanosomiasis. In trypanosomiasis we find all
the symptoms of Graves’s disease. In the chapter on the agencies which
grant us immunity against infections and intoxications, we explain the
presence of the symptoms of Graves’s disease. The symptoms of
trypanosomiasis can be explained in the same way, as can those which
occur in other infectious diseases, as they are expressions of the
defense of the thyroid against infection. The consequence of such
overwork of the thyroid is its degeneration, which results in the
symptoms of a myxœdematous condition, as found in sleeping sickness.
According to Koch, arsenic, in the form of atoxyl, can give good results
in such a condition; but with arsenic we introduce one of the main
elements contained in the thyroid gland, and arsenic can also afford
favorable results in the treatment of myxœdema.
The most typical symptom of African sleeping sickness is the great
somnolence which cannot be controlled or resisted, as stated in the few
examples given above. This somnolence is also one of the typical
symptoms of myxœdema, being according to Pilcz, one of the four cardinal
symptoms of this disease. We also find this in animals or persons in
which the thyroid has been removed. We have observed dogs in which this
has been done, and they were always so fast asleep that the loudest
noise could not rouse them. From the foregoing there can be no doubt
that the thyroid gland has something to do with sleep, and this is best
exemplified by the circumstance that there is sleepiness in all those
conditions where the thyroid gland is degenerated, as in the instances,
just quoted, of myxœdema and of animals in which the thyroid has been
removed. In addition to these examples, sleepiness can also be observed
in cases of tumors of the pituitary body—for instance, in acromegaly.
However, as has been shown by Gley, Rogowitsch,[329] Stieda,[330]
Sajous,[331] and others, the pituitary gland and the thyroid are in a
very close relationship, and, as I have also pointed out in a previous
paper, we find pretty constantly alterations of the thyroid gland in
acromegaly. Salmon also mentions that in tumors of the pituitary body,
with sleepiness, there was generally found an atrophic condition of the
thyroid.
Footnote 329:
Loc. cit.
Footnote 330:
Loc. cit.
Footnote 331:
Sajous: Loc. cit.
Sleepiness is frequently observed in certain cases of obesity. Such a
condition was described several years ago, under the name narcolepsy, by
Sainton. I have also observed similar cases. Thus, an English patient of
mine, a gentleman weighing 260 pounds, would fall asleep on any
occasion—in church, at the theatre, and at concerts; and I have heard of
a similar case from a confrère (related to me by Dr. Echlin, of Ottawa),
who was a very fat man and who snored much louder during an operation
than did the narcotized young lady, whom Dr. Echlin was operating on for
appendicitis.
The sleepiness in these cases must also be attributed to the thyroid
gland, which governs metabolism, as shown by the researches of Prof.
Magnus-Levy,[332] of Berlin, Thiele, Nehring, etc., and also by my own
works. The fat-reducing action of thyroid extracts confirms this
clearly.
Footnote 332:
Path. des Stoffwechsels of v. Noorden, second edition, vol. ii.
Sleepiness is a frequent symptom of chlorosis; and it is a fact that in
chlorosis the thyroid is very often altered, which might thus explain
it.
Sleep produced by narcotics and alcohol can also be brought in relation
with altered thyroid functions. We have already mentioned that we have
observed during narcosis with chloroform and ether a marked swelling of
the thyroid gland, indicating a condition of hyperactivity, which is
followed by exhaustion; and after previous mental excitation, depression
and sleep follow. The action of alcohol on the thyroid has also been
explained in a previous chapter on alcohol.
The sleepiness we notice after a heavy dinner, and more particularly
after partaking of a large amount of meat, can also be traced to thyroid
changes; for we know that the thyroid gland destroys toxic products
formed in the intestines, especially those toxines caused by the
destruction of albuminoids, as shown by Blum.
The best proof, however, of the truth of the assertion that a
degenerated state of the thyroid produces sleepiness, is to be found in
the fact, which we have established by a number of observations on
patients, and also on ourselves, that the serum of animals, in which the
thyroid has been removed, causes sleep. We will deal more fully with
this in our next chapter on the treatment of sleeplessness.
If sleepiness is so frequent in all degenerative changes of the thyroid,
on the other hand insomnia is the rule in cases of hyperactivity of the
thyroid gland, as in Graves’s disease, in which we know there exists a
condition of hyperactivity of the thyroid. We also find insomnia in
diabetes, but only in the preliminary stages, where there is no acetone
and diacetic acid in the urine. In severe cases we often find, on the
contrary, sleepiness; and this may be attributed to the fact that severe
cases of diabetes present features of a myxœdematous condition, as we
have found by the disappearance of the acetone and diacetic acid through
treatment with thyroid extracts. Sleeplessness can also be produced
artificially by giving thyroid preparations in large quantities.
If sleepiness may be produced by thyroid degeneration, and sleeplessness
through thyroid hyperactivity, the conclusion is not unjustified that
the thyroid exerts a controlling influence upon sleep; it is, however,
quite possible that the other ductless glands may also influence sleep.
Subsequently to my communication to the German Congress of Internal
Medicine in 1905, wherein I showed that the thyroid governs sleep, Dr.
Salmon, of Florence, in a monograph on sleep, tried to show, _without
any knowledge of my communication_, that sleep is governed by the
pituitary body. As, however, the pituitary body and the thyroid are in
close relationship, and as Salmon also mentions that in cases of tumors
of the pituitary body the thyroid has been found atrophic, I am inclined
to attribute the primary rôle to the thyroid. We can produce sleepiness
by the serum of thyroidectomized animals, and sleeplessness by thyroid
extracts; but we do not yet know any similar facts about the pituitary
body.
From the communications of various authorities, it appears possible also
that the adrenals influence sleep as first pointed out by Professor
Sajous in 1903 in the first volume of his work (p. 520) on the Internal
Secretions. Dr. Zeigan[333] injected a milligramme of adrenalin, mixed
with 5 grammes of physiological salt solution, into the vicinity of the
brain of cats, producing, within one minute, a deep sleep lasting from
thirty to fifty minutes; and when the cats awoke they remained very
drowsy for some time afterward.
Footnote 333:
Therapeutische monatshefte, p. 193, 1904.
From the above observations therapeutic conclusions may also be deduced,
as we will show in the chapter on the treatment of sleepiness and
sleeplessness.
------------------------------------------------------------------------
CHAPTER XLVII.
HYGIENE OF SLEEP—PREVENTION OF INSOMNIA.
WE are all acquainted with the tale of the man who was blind in one eye
and deaf in one ear, who at once went to sleep when his sound eye and
ear were closed. In this case there was nothing to stimulate the centers
of perception in the brain.
This example is very instructive for the question we shall now have to
discuss. The best hygiene of sleep is to avoid all agencies that may
cause excitation of the brain. We have seen, in the preceding chapter,
that an anæmic condition of the brain must be sought; and this is best
attained when the brain is at complete rest and nothing is acting on it
which may cause an afflux of blood, and thus hinder an anæmic condition.
A sleeping brain must not work, as any kind of mental labor, even the
smallest noise, when it is able to attract attention by having been
conveyed to the centers of perception, may impede sleep. Sometimes the
loudest noise, such as an electric car passing with bell ringing, will
not awaken us, or prevent our falling asleep, if we are accustomed to
it; for it will then excite no attention and consequently will cause no
work for the brain; but should some one speak loudly in an adjoining
room, or should any unusual noise occur in our vicinity, although
infinitely less than the above mentioned, it may be sufficient to
prevent our sleeping, for we pay more attention to it, and thus the
repose of the brain is prevented.
The miller will sleep soundly in spite of the rumbling of his mill
wheels, to which he has been accustomed for years; but should the mill
stop he may awake, for this would arrest his attention.
From the foregoing it follows logically that in order to sleep soundly
it is best to exclude everything that can arouse the organs of
perception, and which, if conveyed to the brain, may invite attention
and thereby brain work. We must, therefore, exclude noise and light from
our sleeping chamber, as we all know from personal observation that we
sleep soundest in a room that is thoroughly darkened and where no noise
can penetrate.
Some people are accustomed to a slight light in the room during the
night, for complete darkness would create attention, and thus they would
not be able to sleep so well. For such the light through the transom
will be advantageous; but for many people such light would prevent them
falling asleep.
When a sleeping chamber is too warm we may be prevented from sleeping;
people mostly sleep best in a room that is not warmed, as this favors an
anæmic condition of the brain and excludes the sensation of heat that is
adverse to sleep. We also sleep better in autumn and winter than in
summer, unless the room be heated and an artificial summer created
thereby.
The air in the room must not be oppressive, so as not to invite the
attention of our senses of perception; it would, therefore, be wisest to
take the largest room in the house to sleep in, and not the smallest, as
many do. People with a large bedroom and small sitting-room will have
more chances for a long life than those reversing this order of things.
A hygienic bedroom must be large, not heated during the night, and the
upper part at least of the window should always be open, and preferably
one at a part of the house facing a large garden or open space.
In order that the brain may be at rest it is essential that the other
organs should also be resting. Any organ that is working, particularly
if the work be laborious, or if the organ be diseased, will send
impulses to the brain. It is very difficult to sleep if any part of the
body is aching; the sensory nerves bring this to the center of
perception in the brain, and this awakens us. When the stomach is loaded
we may the sooner drop to sleep, for reasons mentioned in the preceding
chapter; but digestion during sleep is more labored, and thus again
impulses will be sent to the brain. The same occurs when the intestines
are filled with gases.
This necessitates the practical advice not to eat too much for supper,
and particularly not to go to bed for some two and a half to three hours
at least after that meal; and most people will sleep better if they do
not take much meat, and for such as suffer from sleeplessness not any
meat at all, at night. The most hygienic hour for our evening meal would
be about 7 o’clock, not later; and for the prevention of sleeplessness 6
o’clock is better.
But if it is difficult to sleep with the stomach full, an empty stomach
may also cause difficulties, particularly when there is much
hydrochloric acid in the stomach. A glass of milk and a biscuit is a
good remedy if awakened from such causes.
Flatulency also may often be the cause of disturbed sleep, and to
prevent this certain kinds of food, liable to cause it, should not be
taken in the evening; such are beans, peas, or lentils, and potatoes
especially, if beer be taken at the same time. By such combinations a
regular chemical laboratory in the intestines will be formed during the
night, and for five to six hours after such a meal, or longer, according
to the time we go to bed, sleep will be disturbed. So long as there is
flatulency it is impossible to sleep, and the quickest way to put an end
to it is to insert a suppository of glycerine into the rectum, which
will soon cause a copious evacuation, provided that the intestines have
not been previously weakened by too many drugs. After this remedy the
flatulency will cease, and sound sleep for the rest of the night will
follow.
Many people are apt to awake during the night after five or six hours’
sleep if they have partaken of much meat at the evening meal and then
gone at once to bed. Only to catch an early morning train would it be
permissible to commit such a breach of the true hygiene of sleep. To
observe this hygiene fully we must also avoid taking mineral waters with
diuretic action for some time before going to bed, for the dilatation of
the bladder from the accumulated urine may convey sensations to the
brain and thus disturb sleep.
Total sexual abstinence may cause insomnia, especially in persons who do
not observe complete chastity; for this marriage is the best preventive,
as it is for other troubles of a like nature.
In women, when menstruation comes on, there is also disturbed sleep very
frequently; and many unmarried women suffer from insomnia.
Sleep can the more easily be disturbed when it is the lightest, which is
generally the case during the early morning, for which reason at this
period all noise should be most carefully avoided. Sleep about midnight
is generally the deepest, and a noise that would not disturb us at that
hour will frequently do so in the early morning hours; thus, the
midnight hours being the best for sleep, it seems advisable to go to bed
about ten or half-past ten, and it is certainly not hygienic to retire
after twelve, as then it is more difficult for most people to get asleep
than it is at ten or eleven.
It follows from the preceding considerations that mental work in the
hours before going to bed will be contrary to the hygiene of sleep. When
the brain is engaged in intense thought there is an afflux of blood
thereto, as mentioned before. It takes some time before the brain
becomes sufficiently anæmic for sleep; for which reason also it is not
wise to read books, especially interesting ones, in bed. It is a very
bad habit to read in bed until late in the night, as is done by many
ladies who complain of insomnia and take somnifacient drugs instead of
extinguishing the light as soon as they go to bed, and excluding all
agencies that may excite their attention, in order to allow the brain to
come to a state of rest.
We must now answer the question: How many hours’ sleep shall we indulge
in?
On an average, for the adult male, six to seven hours’ sleep is
necessary to feel rested thereafter and to fully appreciate the saying
that “Sleep is Nature’s sweet restorer.” Young girls and women require
much more sleep than do men; but children, and especially infants,
require the most.
Infants are usually almost always asleep, possibly owing to the fact
that the thyroid and other ductless glands are not yet fully active; and
for this reason children also require longer sleep. The older we get the
less sleep we require. Sometimes in old age there is obstinate insomnia,
which is due to changes in the blood-vessels of the brain, by which high
blood-pressure is caused and the anæmic condition of sleep prevented.
It is unwise to say you must sleep six, seven, or eight hours to have
enough. Each individual requires a different time according to his
bodily requirements, which he must study by careful observation. The
deeper the sleep, the shorter will be the time that will be required for
it. The essential thing is to feel rested in the morning, and it does
not matter if we have slept only five and one-half hours if we only feel
that we have slept enough. There are many people, usually over 50 years
of age, who feel rested and perfectly well after but five hours’ sleep.
But if after even seven hours’ sleep we still have a feeling of
weariness and depression, so to speak, we have not freed the body of
toxic products during sleep, so the time was insufficient and must be
made up the following night.
It is a very strange thing, when we have not been able to sleep long
enough for one or two nights, and we do not feel in good condition in
consequence, that a longer sleep on the third night will be able to
restore us entirely. I believe this is a clinical argument in favor of
the theory that sleep serves to free the body from the products of
intoxication, which may be stored up for two or three days and disappear
after one night’s sufficient sleep.
Too much sleep may be nearly as bad as too little. After sleep too long
continued we feel very heavy and oppressed; we must, therefore, observe
the right medium in this as in everything else. The greatest maxim for
longevity is moderation in all things.
Granted the great importance of sleep as a function of ridding the body
of toxic products and of replacing spent energy, it will be only too
natural for us to do our best to assure its regular performance if we
are desirous of living long and retaining the vigor of youth as much as
possible. Indeed, sleeplessness, if continued for a few nights, is most
dangerous in tending to produce premature old age. We have only to look
at the face of a person who has passed a sleepless night or nights and
we shall see sunken eyes, hollow cheeks, and pendant features which bear
a strong resemblance to the face of an elderly person. It is then
interesting to note how one night of sound sleep will restore the normal
youthful appearance, which is an indication of the beneficial influence
of sleep in the problem of senility.
Sleepless nights must be avoided by every means. If possible never
travel at night, unless we feel assured that our sleep on the train will
not be disturbed; always, if we can, give the preference to day travel.
The less often we go to bed after midnight the better will be our
chances for the retention of youth and a long life.
Going to bed early enables us to rise early; and this is a powerful
factor in long life, proven by the fact that the majority of people
living to be 100 or over were early risers. The great importance of this
has been perpetuated by Franklin, the founder of many notable societies
and institutions, in the familiar verse:—
“Early to bed, and early to rise,
Makes a man healthy, wealthy, and wise.”
Franklin lived to be 85 years old.
We have often noticed very old people go to bed after sunset and rise
with the earliest dawn. As a rule, people who go to bed early, some
hours before midnight, enjoy the soundest sleep because of the fact that
sleep is always deepest at about midnight. Usually only those living in
villages can indulge in this healthy habit, and doubtless this is one of
the reasons for their long life and robust health.
------------------------------------------------------------------------
CHAPTER XLVIII.
THE TREATMENT OF SLEEPINESS AND INSOMNIA.
WE have mentioned in a previous chapter that insomnia is a source of
great danger to our prospects for a continued youthfulness and a long
life.
Before dealing fully with this subject it may be useful to refer to the
treatment of sleepiness also, as our remarks concerning this will tend
to explain better the novel and most rational treatment of insomnia
which we here advocate.
We have already seen that the degeneration or removal of the thyroid
gland produces sleepiness, and its hyperactivity sleeplessness, as in
Graves’s disease. It therefore appears rational that if we wish to treat
sleepiness we must first create a condition of hyperactivity in the
thyroid gland, or at least we must improve its action.
The best way to attain this is to administer thyroid extracts, which,
as we have stated before, are able, according to our researches, not
only to improve sleepiness, but even to create the opposite
condition—sleeplessness.
We have already referred in another part of this book to our observation
of a case of sleeping sickness in an officer of the Belgian Congo Army,
who was almost always asleep. To him we administered thyroid tablets,
and after a few days there was a marked change in his mental attitude
and in his whole condition, and the sleepiness improved. But we obtained
still better results in the case of a very stout man weighing 124 kilos,
who was always falling asleep, so much so that he was arrested in the
picture gallery at Versailles, where he had fallen asleep while looking
at the pictures. This patient would fall asleep when out walking, and
this occurring in the streets of Carlsbad, he was picked up under the
impression that he was drunk, while in reality he was perfectly sober.
Having treated him for a few weeks with thyroid tablets, his sleepiness
was much improved, so much so that he did not fall asleep in our waiting
room, where formerly the other patients would prevent him from falling
off his chair when sleeping. This gentleman was the patient of Professor
Launois, of Paris, and on his return home after a six weeks’ treatment
we found that he was cured of his sleepiness and had lost 16 kilos (35½
English pounds).
We were also able to observe, in our own person, the action of thyroid
extracts; for, having for a few weeks taken two tablets daily (about 10
grains), we began to suffer from sleeplessness, and our rest did not
again become natural until after we had discontinued the thyroid
treatment. This was an experiment that we made for our own personal
instruction, and judging from the results, we considered that they
indicated the trial of thyroid extracts in cases of habitual sleepiness.
To treat insomnia we naturally must first endeavor to prevent it, to do
which we must bear in mind the advice tendered in the chapter on the
hygiene of sleep. The best means to insure good sleep is to partake of a
light early supper, and to have a very dark and quiet room. It is
decidedly unreasonable to resort to injurious drugs for sleeplessness,
instead of darkening the window and transom to exclude the light, and
sleeping in a room where no noise can penetrate.
Persons suffering from sleeplessness must, above all, lead a hygienic
life; they must take exercise every day, walking or running in the open
air, even in cold weather, so as to produce some fatigue before going to
bed. Sitting the whole afternoon and living in an overheated room is
absolutely inimical to sound sleep; but overexercise and excessive
fatigue may also be as bad.
It is an excellent thing for persons, whose sleep is not as it should
be, to drive in an automobile or carriage for an hour, at least, before
going to bed, the former being preferable owing to the greater current
of fresh air. We often notice children getting drowsy after being out in
the pure open air; and in places which are situated at a certain height
up a mountain, we often obtain excellent results in insomnia.
Many people sleep better after a warm (not hot) bath, lasting twenty
minutes at least, just before going to bed; on the other hand, a cold
bath might prove too stimulating and hinder sleep.
Some people experience difficulty in falling asleep; others easily do
this, but awake soon, after four to five hours of sound sleep, and then
cannot fall asleep again. A very dark and quiet room may overcome this
perhaps, but a room into which light enters from the street or through
the transom will never do so. When there has been no sleep for a whole
night, and no sleep on the second night till after midnight, we may give
a remedy to produce sleep, but not otherwise. In principle we are
decidedly against the use of remedies to induce sleep, and we only
permit such after two partially sleepless nights—when on the third night
there is no sleep until midnight, or after a thoroughly sleepless night
when there is also no sleep the following night till midnight.
We have already mentioned that the effects of one sleepless, or several
partially sleepless, nights, may be compensated for by one thoroughly
good night’s sleep. As through sleeplessness toxic products are, in all
probability, retained in the body, certain hygienic rules must be
observed after a sleepless night, thus, for instance, a cold room ought
to be heated before we get up, for the effects of such a night are,
according to our observations, felt more when we get up in a cold room
than when we get up in a well-warmed one.
It will also be most beneficial to take a very hot, or even a Turkish or
Russian, bath after a sleepless night, in order to eliminate toxic
products by abundant perspiration. An electric light bath may give
better results, using principally the blue rays, as such have a soothing
effect upon the nervous system, besides creating a free sudorific
action.
If all the hygienic rules above indicated are applied and fail, then the
conditions are such that we may resort to sleeping remedies, adopting,
however, the principle to try first the most innocuous, and especially
such as the patient will not become addicted to the use of.
The principal object is to diminish the excitability of the brain, and
bromide is one of the least dangerous remedies to obtain this result. We
will therefore first try sodium bromide, say, 20 grains, in a glass of
water. Valerian also can give good results, and is not a dangerous
remedy. There is a German preparation, bromural, composed of bromide and
valerian, which is a very mild sleeping mixture. Chloral is also an
excellent drug for reducing the excitability of the brain, but it is not
so harmless as the others. There has, of recent years, been introduced
from Germany a preparation, isopral, made from chloral, and for which it
is claimed that it is a mild sleeping mixture to the use of which people
do not become addicted.
Such remedies may be prescribed when there is only a temporary
sleeplessness and not one of habitual long standing. When sleeplessness
is more inveterate and obstinate the above remedies will give no result,
and then stronger drugs must be resorted to, such as veronal; but this
must never be given in large doses, as it may produce in certain persons
symptoms of intoxication if more than 1 gramme (15 grains) be taken. The
principle of this remedy, which contains urea, is to produce a condition
analogous to intoxication, by producing fatigue. None of these agents
should be used otherwise than under the supervision of a physician.
Some of our patients complained of heaviness in the head after the use
of veronal, while others approved of it and found that they could also
sleep on the following night, even after only the one dose.
It would be most injurious to health to use these sleeping mixtures
habitually, especially opium and morphine. We have mentioned here only a
few with which we have experimented on ourselves or tried on patients in
cases of necessity, as all such remedies may be injurious to the brain
if taken often.
We feel inclined to attribute greater importance to a sleeping remedy
which is based on physiological observations of sleep. As we have
already stated, thyroid degeneration or removal produces sleepiness; we
have, therefore, tried the serum of animals whose thyroid has been
extirpated, and, as will be proved, we have had good results in each
case.
Being struck by the similarity of the symptoms of diabetes to those of
Graves’s disease, and as a logical consequence of our researches on the
frequency of a hyperactivity of the thyroid in diabetes, we tried a
remedy for this condition which has produced as good results as many
authorities have obtained in their treatment of Graves’s disease. This
is the serum of goats from which the thyroid has been removed, prepared
according to the formula of the celebrated neurologist, Dr. Moebius, of
Leipzig, who died recently. This remedy, named after its discoverer
“anti-thyroidin Moebius,” has not only afforded us good results in the
diminution of glycosuria, as we showed by a number of cases in the book
that we published upon the origin of diabetes, but also, what is still
more interesting to our present subject, every patient suffering from
insomnia exhibited an improvement; in fact, there was not a single case
which did not benefit by this treatment.[334]
Footnote 334:
Loc. cit.
Following an automobile accident we suffered much from insomnia. We
tried this remedy personally, and after doses of 5 grammes (75 grains)
we were each time able to sleep for about eight hours, and felt
refreshed afterward. We have found this remedy superior even to veronal,
for the latter, when tried personally and afterward in patients, did not
give the same effect as anti-thyroidin.
This remedy has, however, one great drawback, and that is the exorbitant
cost; and it requires to be taken in considerable amounts, at least 45
to 70 grains at a dose, although in some patients a soothing result has
been obtained from 20 grains three times a day.
This drug diminishes the excitability of the nervous system, and is,
therefore, an excellent remedy for insomnia, for it depends on a
physiological appreciation of our knowledge of the influence of the
thyroid gland on sleep. We have lately published an article on the
hypnotic effect of anti-thyroidin Moebius in the “Therapie der
Gegenwart” of Berlin, November, 1907.
Instead of the anti-thyroidin Moebius—the extravagant price of which
forbids its general use—we would recommend extirpating the thyroid gland
of a goat, which is a very simple operation, and making use of the milk,
following the example of Professor Lanz, of Amsterdam, and of Walter
Edmunds in London.
Our observations on the great influence of anti-thyroidin on sleep were
confirmed by Professor Lanz in a discussion following an address we
delivered before the Society for the Advancement of the Medical and
Natural Sciences, in Amsterdam, on the 15th of March, 1905.[335] He also
mentioned the case of a dog whose master, a peasant, was tending the
professor’s goats, whose thyroids had been removed and whose milk was
being administered by the professor to his patients suffering from
Graves’s disease. The peasant was told to give the goats’ milk to his
dog, but after a time, the peasant refused to do this, as since the
goats’ milk had been given to the dog, he always wanted to go to sleep,
even when accompanying his master in his walks.
Footnote 335:
Nederlandsch Tijdschrift voor Geneeskunde, 1905.
------------------------------------------------------------------------
CHAPTER XLIX.
HYGIENE OF THE SEXUAL GLANDS—THE DANGERS OF SEXUAL OVERACTIVITY AND OF
TOTAL SEXUAL ABSTINENCE.
WE have referred, in previous chapters of this work, to the great
influence of the sexual glands on several of the most important organs,
and shown in what a marvelous way these glands affect our vitality and
prospects of longevity (see Chapter V); consequently it is only natural
that we should use our best endeavors to maintain these glands in good
working condition, which we can do in a rational manner by protecting
them from all harmful agencies, which may be numerous. It would exceed
the limits of this book to enumerate all the different causes of
diseases of the sexual glands, so we will confine ourselves to the most
frequent, which, although not immediately producing actual disorders of
the glands, may yet lower their vitality in the long run and finally
lead to their degeneration.
The infectious diseases of the sexual glands, acquired by contagion
through sexual intercourse, occupy a prominent place among the agencies
deleterious to them. They are well dealt with in the handbooks on this
subject, so will not be further referred to here. The best way to avoid
them is by marriage. This may, in the majority of cases, be a safeguard
for the man but not for the woman; for, unhappily, in very many
instances women are infected by their husbands as soon as they enter the
bonds of matrimony.
In Chapter VII we mentioned the injurious consequences of these
infections, not only for men, but also for women, and told how in the
former sexual potency, and in the latter fertility, may be ruined by
such. The best way to deal with the matter would be to pass a law
enforcing the examination of the prospective husband by a physician; and
if such a law were applied also to the woman, the propagation of certain
hereditary diseases might be arrested. Long ago Plato thought of such an
emergency. He recommended that before a marriage judges should examine
both man and woman, the man to be stark naked, and the woman partially
so; after the inspection the judges were to deliver their opinion
whether the couple should be married or not.
Nearly as injurious as infectious diseases may be the abuse of the
sexual glands by too frequent intercourse, by masturbation, or by other
irritations of these glands, such as excitation, without subsequent
satisfaction, especially in cases of interrupted copulation with a view
to avoid offspring.
Too frequent sexual intercourse may soon sap the vitality of these
glands and, indeed, hasten the symptoms of old age, even in young
persons. As already mentioned, even young girls may acquire some of the
attributes of old age by such means. They soon become fat and bloated,
the features lose their juvenile aspect, and the cheeks become pendant;
the muscles lose their tonicity, and there is a marked difference
between the muscles of a young maiden and those of a woman of the same
age who has been leading a life of debauchery for some time. The latter
will invariably, if not always, look older—which ought to be an object
lesson on this subject. Premature old age can similarly be brought about
by constant conditions of exhaustion of the ovaries consequent to
frequent pregnancies. When a woman has a child year after year, as a
rule, especially if living in straitened circumstances, she usually
looks older; but this is not so in all cases, as we have before
remarked.
Moderation, therefore, must be strictly observed.
The ancient Hindoos recommended to men sexual abstinence of long
duration, thinking that by this means the internal secretion of the
sexual glands would be absorbed into the system and that they would
thereby reap all the benefits inherent in such a secretion. By this it
seems that thousands of years before Claude Bernard and Brown-Séquard
the Hindoos already appreciated the great importance of the internal
secretions.
According to the Prophet Mohamed, sexual intercourse should not be more
frequent than once in eight days. Zoroaster recommends once in nine,
Solon and Socrates once in ten, and Moses eight days before and eight
days after menstruation, and Luther twice a week (der Woche Zwie). The
Holy Book of the Jews, The Talmud,[336] an encyclopædia of Jewish
knowledge embracing a period of from 500 years before to 500 years after
Christ, recommends the following in respect to marital intercourse:
Young strong men, every day; workmen, once a week; mental workers, once
a month. Acton advises copulation once only in from seven to ten
days.[337]
Footnote 336:
Quoted after Prof. Kisch “Das Geschlechtsleben des Weibes,” Vienna,
second edition, 1908.
Footnote 337:
Quoted after Prof. Kisch, as are most of the quotations in this
chapter.
Pomeroy says matrimony is Nature’s nectar, but if we indulge too freely,
instead of nectar Nature will offer us water or bile, and finally deadly
poison. To avoid sexual overactivity in married people Kisch recommends
a separate bed for man and wife.
Far more dangerous than too frequent intercourse are frequent
excitations of the sexual organs without final sexual satisfaction. In
this way a continual hyperæmia of the caput gallinaginis in the prostate
can be set up; and as this is where the ducts of the seminal vesicles
end, premature emissions and impotency may result. Thus we see that
masturbation and interrupted copulation may produce the same effect;
indeed, these practices are far more injurious to virility than sexual
overactivity if indulged in in the normal way.
Frequent sexual excitations are also very deleterious to the female
sexual organs, which are thereby brought into a hyperæmic condition; and
if this dangerous practice be often repeated serious disorders may
follow, and especially is this the case if intercourse be interrupted
before the seminal emission.
According to Professor Kish such preventive coition (_congressus
interruptus_) may be followed by a relaxation of the uterus and chronic
metritis. The hyperæmia and stagnation of the blood may lead to
inflammation of the ovaries and parametritis, and perhaps to new
growths. Neugebauer and Pigeolet have often observed cancer of the
uterus in women who made a habit of indulging in sexual intercourse with
the use of preventives against conception. Metritis and parametritis
after such a proceeding have been observed by Bircher, Valente, etc.
Certain abuses of the female sexual organs, such as copulation during
menstruation, may also be ruinous to those organs; metritis,
parametritis, ovarian inflammation, etc., may be the result of such
grave violations of this most elementary rule of the hygiene of the
sexual glands.
The ancient Mosaic Laws prescribed the punishment of death for
intercourse during menstruation. During this period all kind of work
should be prohibited, and for many women it would be wisest to rest
completely, especially during the first day.
Women should not marry under a certain age, preferably not under 20.
With the Spartans no man was allowed to marry before 30, and no woman
before 20, and we know what a robust and strong nation they were. This
is most essential to avoid premature senility, which can easily develop
in women who commence sexual intercourse at an early age. No woman
should be permitted to marry until she is fully developed physically and
mentally. There are cases where women are not fully developed at 18, or
even at 20, and in such cases marriage should be deferred to a later
period.
Close observation of the rules for a rational hygiene of the sexual
organs also demands that chlorotic girls should not marry until their
condition is improved by iron treatment, the sexual organs in cases of
severe chlorosis or anæmia not being fit for use.
We have referred to the dangers of sexual overactivity, and we will now
endeavor to show that the opposite extreme, viz., complete inactivity of
these glands, may also lead to disastrous consequences. When nature
created our different organs they were intended to be used, and there is
no part and no organ in the body that should not fulfil its function
(even the appendix, as lymphatic tissue, has one). No exception can be
made in favor of the sexual organs, although the hypocrisy of certain
faddists would have us believe that these organs alone out of the whole
body should serve no purpose whatever. Indeed, the whole anatomical
construction and the physiological working of these organs—differing in
each sex—shows that Nature intended them to be used in conjunction with
each other.
These organs are glandular formations having, like all other glands of
the body, a secretion, which, like the secretions of the other ductless
glands—as, for example, the thyroid—if produced in too large quantities,
may have toxic effects. That this really is the case is shown by the
experiments of Loisel, who found that the extracts from the testicles,
and still more so from the ovaries, if injected into other animals, have
toxic effects.
The sexual glands, being glands with an epithelial formation, must
certainly produce a secretion; they could not be an exception to one of
the fundamental laws of anatomy and histology. The accumulation of this
secretion may produce certain toxic effects, judging from the
experiments of Loisel.[338] We may, therefore, conclude that the
complete inactivity of these glands or, in other words, total sexual
abstinence, may have injurious effects on the general health, as also on
the condition of the glands themselves; and we are able, by experiments
and clinical and anatomo-pathological observations, to confirm this
view.
Footnote 338:
Loisel: Journal de l’Anat., xi, p. 536; C. R. S. B., L. ix, p. 403.
Regaud[339] has observed that when guinea-pigs are kept for a long time
in complete sexual abstinence, away from their females, the testicles
present degenerative changes, and at the same time the volume of the
gland is considerably diminished. The seminal epithelium shows many
cells with signs of degeneration. He also observed similar signs in the
epithelium of the seminiferous tubules during winter hibernation, and
also in the spring when the animals were not sleeping but if they were
kept in total sexual abstinence. Although they were well nourished these
animals showed no spermatogenesis.
Footnote 339:
Regaud: Comptes rendus de l’Association des Anatomistes p. 198, 1903.
Regaud comes to the conclusion that “la continence forcée peut done
avoir pour conséquence des modifications importantes de l’épithélium
séminal”—enforced abstinence (sexual) may thus lead consequently to
important modifications of the seminal epithelium.
According to Mingazzini,[340] the ovaries of female animals that are
kept in captivity and sexual abstinence present degenerated follicles,
this being very different to the ovaries of other females living in
freedom, the comparisons having been made in the same season of the
year.
Footnote 340:
Mingazzini: Corpi lutes veri e falsi; R. F. Laboratorio di Anatomia
normale della Reale Universita di Roma, vol. iii, 1893.
There is some evidence to show that similar results may happen in man.
When men live a long time—not for weeks or a few months, but for a very
lengthened period—in total sexual abstinence, the size of the testicles
may sometimes be found diminished. Unfortunately there have not as yet
been made, at least to our knowledge, histological examinations of the
sexual glands of those who really have led a life of total sexual
abstinence. But a remote proof in support of our proposition that such a
condition may lead to histological changes in these important glands, is
the fact that Baldwin has discovered histological changes in the ovaries
of hysterical women, of whom a large proportion were either spinsters or
women who became widows early in life. Of course this is but a very
indirect proof, devoid of the scientific value of the observations of
Regaud and Mingazzini.
There are, however, important clinical facts which support the
supposition that total sexual abstinence may lead to alteration of these
glands. Thus we have observed impotence in the cases of several men
after sexual abstinence of long duration, which entirely disappeared in
nearly every case after copulation at regular intervals; and we arrive
at the conclusion that a regular use of these organs, which are intended
by Nature to be used, is a necessity, and that impotence can frequently
be best cured by marriage. In marriage only can hygienic and regular
sexual intercourse best take place; and thus marriage is the best
hygiene for the sexual glands. For this and other important reasons we
will devote a special chapter on marriage, which will succeed this. In
some maidens near the thirties we can note the appearance of symptoms of
fading; through the loss of fatty tissue those parts of the body that
were formerly round become angular, and there thus develops the
condition of leanness so typical of old spinsters; hairs may also appear
on the chin and upper lip. That all this is caused by the inactivity of
the sexual glands, which, as already explained, influence the outward
appearance of the body, is best demonstrated by the fact that after
marriage a great change takes place in such women, and the fading
rose-tree blooms again. Thus marriage re-creates youth.
The deleterious effects of total sexual abstinence on the sexual glands
have also been observed. Professor Kisch noted that with women who had
lived an active sexual life and who had had several children, whom they
had fed from the breast, menstruation continued till a later period in
life than it did in old maids, or in women who early in life had become
widows, or in barren women.
That total sexual abstinence may have very injurious effects on the
nervous system, as mentioned in Chapter IV, and assist in the
development of hysteria and neurasthenia, is shown by the fact that when
there is an accumulation of semen in the male, or a swelling of the
Graafian follicles in the female, then an excitation of the nervous
system follows, with sexual desire. That the nervous system can be
excited and even seriously damaged by too frequent and too excessive
impulses conveyed from the sexual glands, has been mentioned by us at
various times in this book.
The continual resistance to satisfy sexual desire, and especially
satisfaction by artificial means, may lead to ruinous consequences for
the nervous system and the sexual glands.
Happily there can be no doubt that many men and women lead healthy
lives, in spite of their struggles against satisfying the desire of the
sexual organs to follow their natural bent; but such cases are not the
rule, and most of such people have some kind of disorder, especially of
the nervous system or the digestive organs, as, for instance,
cardialgia, or acidity of the stomach. We have already referred to the
alteration in these organs following changes in the sexual organs.
There are people with a frigid disposition,—which is certainly not
normal—and such may not be troubled by their sexual glands. On the other
hand, there are people with too great a sexual inclination. The
suppression of these desires in them may often lead to ruin of the
nervous system. Prof. Krafft-Ebing found that individuals with
neuropathic constitutions often have their desires exaggerated in a
pathological way, and he came to the conclusion that in such persons,
through enforced sexual abstinences, the nervous system may be ruined.
Professor Erb, the famous Heidelberg specialist for nervous diseases,
declared at the Congress of the German Society for the Suppression of
Vice, held a few years ago at Frankfort, that there are adult
individuals in whom sexual abstinence for a long time produces serious
mischief in the nervous system.
Buddha says: “Sexual instinct is stronger than the iron hook with which
wild elephants are tamed; it is hotter than fire; it is an arrow that
pierces the soul of man.”
Briefly, neurologists, especially since Freud’s labors, now realize the
importance of the injurious influences of an abnormal sexual life, many
disorders of the nervous system and mind having been traced to the
conflict between the demands of nature and a too rigorous sexual
repression, through fear, disgust, shame, etc.
One of the pioneers of the movement in Germany for the emancipation of
women—Johanna Elberskirchen—demands free scope for the sexual feelings
of women and their satisfaction within physiological limits and
according to physiological necessity.
We are of the opinion that, as a rule, there is a certain difference
between sexual desire in man and the same in woman. Man mostly wants
satisfaction simply; in women there is generally a higher motive: she
demands love, and refuses satisfaction alone.
Nature, who has created the sexual organs of male and female as a
masterpiece of very clever and skilful construction, with admirable
forethought in even the smallest details of this very complicated
mechanism, has appointed to them a very important purpose, viz., the
propagation of the race; and she pursues her ends in a most artful way,
giving to each sex certain attributes by which the opposite may be
attracted. The peacock, for instance, is furnished with a wonderful
collection of beautiful feathers to excite the sexual feelings of the
hen, which has a much plainer exterior. In man the relations are
reversed; here beauty is more conspicuous in the female, and it is by
their charms, the attributes of their sex, that men are attracted,—who,
unfortunately, look rather to the beauty of the outside, which is
transient, than to that of the soul, which is eternal.
This book is a plea for a simple and natural life, and for obedience to
the laws of Nature rather than for neglect or abuse of them. Sexual
desires are the outcome of the existence of the sexual glands, and they
are enforced upon us in a way that is sometimes nearly irresistible
after long-continued sexual abstinence. Disobedience to the imperious
commands of Nature will draw down upon us her revenge and punishment,
and ailments and disease, and bodily and mental misery, may be the
consequences of the complete suppression of the functions of these
glands in adults. There may be exceptions, and certain women or men may
pass a lifetime in such an unnatural way without any apparent ill
consequences to their health; but such are rare. It has been observed
not infrequently that spinsters were fast fading when they were married,
but that after a time they looked much younger, especially after their
first child. As already quoted above from Kisch, sexual life and,
therefore, youth are longer preserved in women who use their sexual
glands and have children than in those who do not. Thus there is no
alternative, and marriage is the safest course. Marriage, if the
partners are well suited, is indeed the most useful and beneficial
institution there is; and, as we will show in the next chapter, it is
one of the most important agencies in the treatment of old age, and for
the longest possible conservation of youth.
But the question now arises, what should those do who cannot get
married, not through any fault of their own, if they should escape all
the mischief due to an unnatural suppression of the sexual functions or
their satisfaction in an unnatural way? We will now endeavor to give a
few useful hints on the subject.
First of all, a hyperæmic condition of the sexual organs should be
avoided by all means, and care should especially be taken to have the
bowels opened every day, as otherwise hyperæmia of the pelvic organs
will follow. This may also be a consequence of rich food and a sedentary
life, which, therefore, should be avoided. Cold hydrotherapeutic
washings of the surface of the body, particularly of the sexual parts,
may also be beneficial. As during long sexual abstinence the probability
is that toxic products are being evolved and are accumulating in the
system, a good purge every five or six days would seem to be a
necessity, as also would a hot bath. Reading light literature should be
avoided. We especially recommend much exercise in the open air and
sunshine, long walks, mountain climbing, sports, long journeys
(especially by automobile), etc.
The best safeguard against sexual desires is an active busy life, which
affords no opportunity for idle thoughts.
For persons doomed, from one cause or another, to lead a life of
complete sexual abstinence, the best and safest course to prevent sexual
desire is to lead a strenuous business life, drowning the desires in a
flood of useful and busy occupations.
Thus unmarried girls and widows may well pass their time in charity,
nursing the sick, and other occupations tending to make them useful,
rather than spend their time in fruitless dreams; and by such
occupations they obtain a happiness which they might not have found,
perhaps, even in married life.
The surest kind of occupation for the prevention of the above-mentioned
desires is strenuous mental work. When the mind is busy with serious
problems these desires cannot obtrude themselves; and, indeed, we have
often observed in persons whose lives have been devoted to serious
scientific work, which has entirely absorbed them, a total absence of
sexual desire for a long time, and even impotency. This, however, we
will consider later as a consequence of defective hygiene during mental
labor (see Chapter L, on the hygiene of the brain worker).
We do not recommend mental work so exaggerated beyond the ordinary
limits that it might cause harm to the brain and nervous system; but it
is certain that when mental work is done within reasonable limits, and
when it occupies the greater part of our time, but not all, it is a
great protection against sexual desires, restricting them without any
injury to the functions of the sexual glands.
Thus, as we see, there are certain remedies against sexual desires for
those that cannot satisfy them; but the most natural solution of this
question can be brought about in the safest way by marriage.
------------------------------------------------------------------------
CHAPTER L.
ON MARRIED LIFE AS AN IMPORTANT MEANS FOR PROLONGING LIFE.
OPINIONS differ as to whether married life can be generally considered
as a source of happiness; some there are who say it is the acme of
happiness, while others do not agree that it is exactly a heaven on
earth.
Personally we possess positive evidence in favor of the view that
marriage can make people very happy; for we know of a number of cases of
suicide following the loss of husband or wife, and we have a clear
recollection of seeing many widows or widowers break down at the mere
mention of their departed, years after the bond of matrimony had been
thus severed.
Certainly agencies that can make people happy, such as marriage, ought
to be able to lengthen existence and remove petty cares, worry, and
sorrow that are so prevalent in this life, and which, in the long run,
tend to induce premature old age. As the Germans say, “Getheiltes Leid
ist halbes Leid” (“a sorrow shared is but half a sorrow”), and the man
who can share his misfortunes with a beloved wife does not carry his
burden alone.
This is of the greatest importance, for, as we shall show in the next
chapter, the body is governed by the mind, and thus mental emotions of a
depressing nature assist in the development of disease and the symptoms
of premature old age, in combating which a single man is always at a
great disadvantage.
We shall also show that, as a rule, our mishaps and disappointments are
due to our own fault of omission or commission, to want of foresight,
etc. It is a positive fact that many a man, famous in history, owed his
position and success to the advice and assistance of a clever and
sympathetic better half; this term is, indeed, not devoid of foundation,
for a man does not so seldom become perfect through his better half, the
woman. The female character is so essentially different to the male,
because of her different anatomical and physiological constitution, that
by the uniting of the female to the male some deficiency in the
character in the latter may be supplied, and _vice versâ_, with equal
benefit to both. Thus the uniting of the woman to the man is most
desirable, if only for this reason.
It would lead us too far to insist on the enormous advantage of married
life for public morality, for the prevention and repression of crime,
and even for the welfare of the State, the soundest foundation of which
is family life. Each family is a little community in itself, with the
father at the head as king, and the mother as queen. And as the State
wants subjects, so the family wants children; for the great pleasures
connected with the various stages of a child’s growth from the cradle to
the altar, serve as the key to a lengthened and the longest possible
existence. Cornaro gives us a very instructive example in his saying “in
the society of the young we become young again;” and so children restore
youth.
Not only because of the favorable mental influence exercised by marriage
must this be recommended as one of the most efficient means for
attaining a long life, but also because of various other advantages
induced by the improved hygienic conditions of various organs. Thus,
marriage is able to satisfy the sexual desires,—the complete suppression
of which is so injurious to most healthy men and women,—without there
being any risk of contracting diseases of the sexual organs with their
terrible consequences. For this reason alone married persons have the
best chances for preserving their youth, provided they exercise
moderation and do not indulge in the pleasures of matrimonial life
beyond the physiological limits.
It is much easier to observe the rules of hygiene for the various
organs, as outlined previously, in married than in single life; for in
the latter condition one is concerned for himself alone, whereas in the
former, four eyes instead of two are on the watch. Thus the first
symptoms of disease are often visible to the eyes of a loving wife, and,
as prevention is better than cure, such a disease may then be checked by
promptly applied treatment. Most diseases could be cured if treatment
could be administered at the very beginning, whereas curable diseases
often terminate fatally from neglect of a sufficienctly early treatment.
There can be no doubt about it, but that as a rule, a married man is far
better nursed, in case of sickness, than is a single man; and we all
know that a good nurse can often do just as much good, sometimes even
more, than the most skilful physician. It is certain that the
therapeutic results in the English and American hospitals would be
inferior to those obtained at present if there were not such excellent
nurses, of whom these countries may indeed well be proud. Marriage,
through the regular habits it causes, can also favorably influence
certain chronic diseases; thus, according to Rénon, even heart
affections can be favorably influenced by married life.
As a rule married life also implies the possession of a home, whereas a
single man or woman most often have no real home. They are obliged to
frequent restaurants for their meals, where there is great likelihood of
their damaging their stomach or intestines by irregularities in food or
drink—at least in the case of men, who also have no reason to stay
indoors in the evening, and are thus more exposed to the life-shortening
influences of an irregular life.
As we have already seen, the best means for attaining a very long life
is moderation in everything; and there is no doubt that this can be much
better observed in married than in single life.
For all the foregoing reasons we must emphatically advise all who desire
long life and the preservation of youthfulness as long as possible, to
marry, and if they become bereaved, to marry again. Celibacy is a
condition unknown to uncivilized nations; the ancient Hindoos considered
it a crime that should be punished; and, according to Du Perron, the
Parsees of the present time, who still follow the religion of Zoroaster,
regard celibacy as a deadly sin. According to Tsen-ki-tong,[341] an old
maid is a phenomenal rarity in China.
Footnote 341:
Tsen-ki-tong: “China und die Chinesen,” German translation from the
Chinese, Leipzig, 1875.
The best proof of the supposition that marriage is conducive to long
life is the example given us by the long-lived patriarchs mentioned in
another chapter, nearly all of whom were married; for if they became
widowers, even though over 100 years in age, they soon married again.
It is one of the saddest sights on earth to see an old bachelor alone in
the world; and we consider that the happiest beings are those who, in
their green old age, are surrounded by numerous children and
grandchildren. According to Schopenhauer, such persons never die, for
their flesh and blood survive in their descendants.
Being still a bachelor we may incur the reproach that we speak of
marriage as the blind man speaks of color, and particularly by seeming
blind to the evils that may be present in the married state. We cannot
deny the fact that some people are most unhappy; but it is our firm
belief that all the ills that befall us on this earth are due to
ourselves. If we select our nuptial mate with care and sound judgment,
paying more attention to the internal rather than the external
qualities, treating her with the utmost consideration of character,
first studying and then adapting ourselves to them, we shall not find
sharp edges but smooth sides, and we shall never come into collision
with them. Everywhere and anywhere, everyone is the author of his own
luck.
------------------------------------------------------------------------
CHAPTER LI.
HYGIENE OF THE MIND—EMOTIONS AND WORRY AS CAUSES OF OLD AGE.
WHEN the famous surgeon Vesalius was dissecting a woman, he discovered
that her heart was still feebly beating. He was so overcome by mental
distress at his discovery that he suddenly dropped dead. Other
instances, also showing that strong emotions of the mind are able to
kill people, are known, and history also tells us of the case of Louis
of Bourbon who dropped dead from fright at witnessing the exhumation of
his father’s bones. Not only can severe emotions caused by fear or
grief, but pleasing ones, when they exceed a certain limit, are also
able to produce instantaneous death. Thus it is said that when
Leibnitz’s niece found a large amount of gold under the bed of the
famous philosopher, after his death, she had such a powerful emotion of
joy that she fell dead. The same sudden end was the fate of Sophocles
when he heard that one of his tragedies had been awarded the highest
prize.
Death is happily rather rare under such circumstances; but diseases of a
serious kind, especially diabetes, can be caused frequently from strong
mental emotions of a depressing nature. We have published two cases of
young women who suddenly contracted severe diabetes after a fright,
while previously there had been no symptoms of such; and in a third case
glycosuria was increased very considerably. This last case was one of
mild diabetes; the sugar increased to a very great extent the day
following the intelligence that he had lost half his fortune through a
coal mine accident. Professor Naunyn, in his book on diabetes, after
quoting our own observations, also states the interesting fact that
after the bombardment of Strassburg in the war of 1870, many cases of
diabetes developed in consequence of the fear and anxiety brought about
by it.
Strong emotions of the mind thus tend to shorten existence by their
fatal action on several of the most important organs, such as the heart,
and in particular the ductless glands: the adrenals, thyroid, pituitary,
pancreas, liver, kidneys, and the sexual glands. These are governed by
the sympathetic and vagus, and mental emotions, by acting on these
nerves, produce alterations in these important glands.
By acting on the adrenals mental emotions produce higher blood-pressure,
in consequence of the toxic action of the increased adrenal secretion,
and thus favor the development of diseases of the heart and circulatory
system, especially arteriosclerosis, which so very frequently shortens
life (see also Chapter XVI).
That mental emotions act upon the thyroid is shown by the alteration of
this gland in consequence, which can sometimes go so far that often
Graves’s disease (hyperthyroidia) has been observed, at times shortly,
and at other times suddenly, after the mental shock. The hyperactivity
of the thyroid may eventually be followed by its exhaustion; and so it
happens that as one of the causes of myxœdema mental depression is often
mentioned.
That alterations of the pituitary body after mental emotions can take
place, is shown conclusively by the fact that competent authorities,
like Professor Pel and many others, have published cases of acromegaly
after such a cause. We personally observed a case in which grief from
incarceration caused the disease to which also diabetes was added.
Sajous has long urged that the pituitary is the _sensorium commune_,
i.e., the central organ upon which all severe emotions react.
It is indeed tragical that diabetes mellitus so frequently attacks those
who suffer reverses in their life. Unlike death in the cases above
mentioned, it is only brought about in those who have had mental emotion
in consequence of disappointment, loss of fortune, and, in some cases, a
wife’s infidelity, etc. Thus, not satisfied with bringing misfortunes,
Fate adds disease, so that their lives are threatened with being
shortened. We shall insist, later on, that this disease, as most
diseases generally, only develops in consequence of our own fault or the
fault of our forefathers.
The alterations of the pancreas in consequence of mental emotions can be
best demonstrated by the frequency of diabetes after such a cause, as
just referred to above. Pawlow observed a checking of the pancreatic
juice after such an agency.
The action of mental emotions on the sexual glands is shown by the
sudden appearance of menstruation. We have recently heard of a young
lady who attempted suicide because of disappointment in love; she threw
herself into a river, which fortunately was not deep at the moment, and
this act caused the sudden return of her menstrual period.
Cases of sudden menstruation after various kinds of mental emotion have
often been observed; and in men under similar circumstances impotency is
not infrequently noted, though, in most cases, it is only temporary.
The alterations of the liver are shown by jaundice, and of the kidneys
by an increased flow of urine in consequence of mental emotions.
According to Clifford Allbutt,[342] strong, mental emotions play an
important part in the origin in many cases of interstitial nephritis.
Footnote 342:
Quoted after James Tyson. Loc. cit.
It is a well-known fact that persons, after strong mental emotion of a
distressing kind, have suddenly turned gray, as is related of Marie
Antoinette, Queen of France; and we ourselves have seen a similar case
in a young lady, one of our relatives, who in one night had her
jet-black hair turned white.
That care, worry, grief, and sorrow are able to bleach the hair,
although not so suddenly as above, is generally known; and not only gray
hair, but a haggard, worn appearance, and all the other attributes of
old age, with changes in the arteries, as is so often the case in old
age, have over and over again been attributed to the above causes. It is
a well-known fact that premature old age is probably brought about more
frequently by the above agencies than by any of the other contributory
causes.
Not only premature old age, but also premature death, can be caused by
such agencies; for there is no longer any doubt that, in persons with
mental depression, resistance against infections and intoxications is
reduced, and that such persons are thus at the mercy of the microbes,
which are to be found in billions everywhere. On the other hand, we can
often observe that a merry disposition may cause long-lasting youth and
a very long life. The celebrated English painter, Mr. Frithe, who died
quite recently at the age of 92, when asked the reasons for his vigor
and robustness used to answer: “No worries, and six cigars a day.”
Having seen on the island of Capri an old boatswain of 80 years
vigorously handling his oars, we inquired of him the reasons for his
robustness and received as his answer: “Sempre allegre” (always merry).
This “sempre allegre” should also be our own motto for life, because of
its efficacy in warding off old age.
There are some admirable teachings in the Upanishads and Vedanta of the
Hindoos: never to seek for riches and fame, and to give up ambition.
Indeed this, more than anything else, would assure a perfect
tranquillity of the mind, as exemplified by the image of Buddha; but for
the future of mankind and the progress of scientific research, a certain
amount of ambition is necessary. We think the noblest aim is to do good
for its own sake, and not for the sake of honors; but if honors are
obtained, to accept them calmly, going on in the usual way; for
otherwise it happens, as we so often witness, that too much ambition,
with its wear and tear, exposes us to premature disease by
arteriosclerosis, the most prevalent disease among men who have reached
fame, especially among statesmen, whose honors are, indeed, dearly paid
for.
It would lead us too far to enter into particulars as to how the various
organs, even the stomach, can possibly, even in a powerful way,
influence the conditions of the mind; but we must make an exception in
the case of the ductless glands. If the mind influences these, on the
other hand they exercise a marvelous action on the mind, as already
stated.
Degenerated conditions of the thyroid are always followed by weakening
of the mental powers, and they are also able to alter the normal
conditions of the mind. As a rule, as we so often see, persons having
such are low spirited and possess no will-power or energy. The loss of
will-power through extirpation of the thyroid or by its degeneration has
been already mentioned in Chapter IV.
People with a weak thyroid, and especially if to this be added a
degenerated state of the testicles, or of the ovaries are usually
melancholy and despondent. They have exceedingly often what the French
call “idées noires”—they are always full of “dark ideas.” In everything
they undertake they always foresee a bad issue; and it is not singular
that this bad issue very often really comes about, for it is caused with
mathematical certainty by their own incapability, absentmindedness, and
entire want of foresight. This is another illustration of our theory
that most of our want of success and our mishaps, if not all of them, we
bring upon ourselves by our own faults. We often notice that such people
lack the most elementary rules of foresight, precaution and
circumspection. They are horribly absentminded, a fact we have noted
especially in old spinsters, who may pass their best friends a dozen
times on the street without recognizing them. Such persons may also
easily fall victims to accidents, as being run over by a carriage, etc.
The fact that these “dark ideas” are frequent in people with a
degenerated thyroid has also been observed by Dr. Leopold Levi, of
Paris, and Dr. Baron Henry de Rothschild, who, in their Annals on
Children’s Diseases, published by Dr. de Rothschild’s Hospital for Sick
Children, give a detailed description of the alterations in the mind in
cases of thyroid degeneration. That these dark ideas must be ascribed to
degeneration of the thyroid and of the sexual glands, besides the proof
from the observations mentioned in Chapter IV, is best shown by the fact
that, as we have seen in many cases, they may be much improved and, not
infrequently, may disappear through the use of thyroid, testicular, and
ovarian extracts. Courage, as was shown in the same chapter, is a
quality of the mind which is entirely dependent upon the intact
condition of the sexual glands; it is lacking in castrates, and seldom
seen in persons with degenerated sexual glands.
These persons are like a reed in the wind, waving backward and forward
without any energy; the least untoward event may beat them down. They
are pained by circumstances and are always governed by them, whereas a
person with a healthy thyroid and healthy testicles, like the heroes
sculptured by the Greek artists, who have fire and courage in their
eyes, faces all circumstances. Such as these control all circumstances,
sometimes even fate, and it is not fate that governs them. Sometimes we
feel inclined to think that there is no such thing as fate, at least for
such men. They mould their own destiny themselves, and always succeed in
pushing on with their iron will.
Will-power is, as repeatedly mentioned, essentially a product of
thyroid, and also probably of intact testicular or ovarian, activity. It
is always wanting in persons who have been castrated, and is very often
absent in those leading a life of sexual debauchery.
According to the above, persons with weak thyroids or weak and
degenerated sexual glands are bound to fail in their undertakings, and
are thus more exposed to disappointments of all kinds, reverses of
fortune, etc.; therefore, such people are the most frequent subjects of
mental depression.
Taking into consideration what has been said above, we conclude that the
source of disappointment lies, in many cases, if not in most, in our own
fault, because of loss of foresight or some slight omission, which,
indeed, is so often apt to overthrow all our most beautiful plans. Often
it is due to errors of judgment, and frequently also to want of
perseverance, the consequence of defective will-power.
We have already shown in Chapter IV, and above, that degeneration of the
thyroid and of the sexual glands is always followed by similar
alterations of the mind.
If we want rationally to prevent mental depression we must first remove
its cause. In many cases it is caused by alterations of mental activity
subsequent to changes in different ductless glands, and also in other
organs that influence the condition of the mind. Logically, we must
improve the functions of these glands if we want to proceed rationally,
and then our mental activity will improve, and failures like
disappointments may, in all probability, be avoided. We can effect this
by means of extracts of certain animal organs.
It has been shown by the celebrated physiologist, Brown-Séquard,[343] by
experiments on himself, that testicular extracts were able to improve
his mental vigor and enabled him to do a much greater amount of work. We
have made similar observations in several cases, especially when at the
same time thyroid extracts were used, but also without them. Thus we
think that we do not go too far, on the basis of the observations of
Brown-Séquard and other authorities, including our own, when we say
that, through the improvement of our mental power by therapeutic
measures, like organic extracts, we may be able to influence success to
a favorable degree, and that everybody is, indeed, as already quoted,
“the smith of his own luck,” as the German proverb says; and thus we can
protect ourselves against failure, disappointment, and mental
depression. We are thus justified in saying that a man with healthy
ductless glands in perfect working condition, and thus of perfect mental
power, is the man who can face any emergency and, to a certain extent,
direct fate at his own pleasure. Such a man can get practically
everything he wants, and Napoleon probably was made of such stuff. For
such men there are no obstacles in the world.
Footnote 343:
Brown-Séquard: Loc. cit.
It is of great importance that not only the glands with internal
secretion, but also all the other organs of the body, should be kept in
hygienic condition, carrying out the rules laid down in other parts of
this book.
It has been shown by noted historians that great men, such as Napoleon,
had to blame their downfall indirectly to faulty hygiene—for instance,
of the digestive organs. That the condition of the stomach—this too
often ill-used organ—influences the mind in a powerful way, is borne out
by many interesting examples.
There can be no doubt, however, that there are causes of ill-luck which
we cannot avoid, as, for instance, loss of near relatives by death, such
as parents or children, or disappointment in nuptial affection or
love—although here, to a great extent, omissions, lack of sound
judgment, and last, but not least, lack of perseverance can be imputed.
If then, in spite of all our precaution, an accident or death of a dear
relative occurs, we must use every endeavor to control our grief and
sorrow. Fortunately the human frame is so wonderfully built that there
is self-defense not only against disease, but also against affections of
the mind. Thus we have the gift of forgetfulness, and if this sometimes
be a drawback, in most cases it is a divine blessing. We must endeavor
to obliterate the remembrance of our disappointments. We must remember
that mourning for a great number of years will not restore life for one
minute to the dear departed, but that a day of it is sufficient to run
down our own health and create deep furrows in our face. Happily,
average man is so constituted that, as time goes on, he must naturally
lose his sorrow; time heals all grief, and here also will-power has its
effects; and those who lack it, examples of whom we have referred to
above, are easily subject to suicide.
It would also be necessary to change such of our habits as are allied to
superstition and prejudice. As in many things, the Chinese are more
rational in their customs; at their times of mourning every one is
dressed in shining and beautiful white; they use a white coffin, which
is much more pleasing to the sight, and certainly much more cheerful,
than our depressing dark ones; and when the whole house and church are
draped in black our depression, with its terrible consequences to our
health and vitality, is so much the more increased. Thus the dead often
shorten the lives of the living.
Then, living in total seclusion, garbed in deep black, with long black
veil, remaining away from all places where the mind can be cheered, not
even allowed to attend a concert, how can a poor widow forget,
especially if her will-power from causes mentioned, is diminished? Shall
we then be greatly surprised if, as occurs occasionally, such a widow or
widower commits suicide, to which such irrational prejudices are simply
impelling them?
And yet it will certainly not be impossible to ameliorate such a state.
With a strong will-power systematically trained from childhood, we can
accustom ourselves to drive out disagreeable thoughts of bereavement,
fear, anxiety, etc. Realizing that what is irreparably lost can never be
recovered, notwithstanding oceans of tears and the deepest sorrow, we
must succeed in understanding the uselessness of it and make up our mind
to eradicate entirely from our recollections things that can never be
altered. Not to worry about anything is the surest and most successful
way to attain long life and a green old age, and by the exercise of some
will-power and consistent training such a mental condition can be
obtained.
There are certain external agencies which can powerfully assist to bring
about forgetfulness. Such are music, the arts, literature, and above all
scientific occupations. Where is there a grief that cannot be soothed by
one of the beautiful symphonies of Beethoven, or by the works of Mozart,
or by other classics: Haydn, Haendel, Bach, Schubert, Chopin, Wagner,
Grieg; or by the paintings of Velasquez, Rembrandt or Van Dyck; or by
the pictures of the beautiful women painted by the great English masters
Gainsborough, Reynolds, Romney, and Lawrence; and which of the saddest
faces will not turn to a smile when reading Mark Twain? The pursuit of
scientific research is also a mighty weapon, and we know a famous savant
who passed the remainder of the day in his laboratory after he had
accompanied the hearse of his wife to the cemetery.