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It is one of the outstanding disgraces of medicine that for centuries it practically neglected the primordial requisites of organic existence and failed to supply these in any adequate manner to either the well or the sick. At least from the time of Galen it classed these as nonnaturals, while classing its drugs as naturals, and tended to place all its reliance in its alleged naturals. Yet it is the larger, universal, material substances and influences that promote and conserve life. Living is subject to these larger influences and no system of caring for the well or the sick that ignores them can possibly be successful. Reserving for a future chapter the subject of food, in this chapter we shall briefly discuss a few of the primordial requisites of organic existence under separate headings, beginning with
The one universal natural Hygienic influence that man has most denied himself is sunshine. Inhabiting a system, as we do, of which the sun is the center and the chief source of heat, light and energy, we are essentially heliacal. It is not possible for us to attain and maintain a full degree of health unless we establish and maintain our normal relations to the solar orb. We are constituted for life in the sunshine and we need the benefits of regular contact with the rays of the sun, needing not only its warmth, but other of its elements.
So important is sunshine to the phenomena of life that there are many who regard the sun as the source of life and the fountain of all organic energy. Its heat, its light and its other rays are so indispensable to all growth, both plant and animal, and to the preservation of health, that we deny ourselves sunshine to our own undoing. Water and air and food, by themselves, are not enough to provide for the most perfect results in nutrition; by these alone the highest development is not attained and the most nearly ideal growth is not achieved.
The sun is probably not the source of life as is taught and as was believed by the sun-worshipping peoples of the past, but it is a vital ingredient in the material formula that makes life possible. The effects of the heat and light of the sun upon plant and animal life is constructive. Life's synthetic processes require the sun's rays in their work. Artificial heat, on the other hand, can be very destructive. Men pine for oxygen--fire destroys it. Vegetation, through the agency of the sun, increases the amount of oxygen in the air. No wonder many people have worshipped the sun as a god; no wonder there have been those who regarded fire as the devil!
Man has tended to deprive himself of the sun's rays and to live in darkness. In both summer and winter, in cold and heat, in dry and wet, man's false draperies hang about him, cling to him, are almost a part of him; while, both by day and by night, he hides himself in noisome enclosures of wood or brick or stone and escapes from the great outdoors of air and sunshine in which birds, beasts and insects move untrammelled above and on the earth in the enjoyment of a health and vigor of which he never even dreams.
The proud owner of a fine home will often expatiate with glowing enthusiasm upon the harmony of colors and outlines and shadings and groupings in frescoes and pictures and carpets and curtains, forgetful that her folly may mean a perfect work of art, inhabited by a poor, weak imitation of some work of God. The successful artist is almost deified while the true fashioner of nature is almost forgotten. Her carpet may be thick and soft, but it is never so delightful to the foot as the softly yielding sod of the great outdoors; it may be exquisitely colored and its patterns may be a delight to the eye, but no human art can make anything so beautiful as the flower-gemed countryside. Its look of cleanliness is but treachery, for it stores up dust and gasses. However beautiful a house, it shuts out the sunshine. Its darkened interiors may prevent the fading of the colors of the draperies and rugs, but they deprive the human cheek of its color and rob the human eye of its sparkle.
We have no means of measuring the extent to which the human organism has been debilitated by being deprived of sunlight (we expose only our hands and faces), but we may be sure that it is considerable. We are certain, today, that direct exposure of the body to the solar rays is important to the preservation and restoration of health. This was doubted and derided when Graham first suggested it.
Writing in The Science of Health, March 1875, Ernest Wellman, M.D., said: "If air is a necessity to human life, how much more so, if the comparison is permissible, is sunlight. Indeed, this is nature's great and primary vitalizing influence--the indispensable necessity to the existence of all forms of life, animal and vegetable . . . nature's richest productions, whether animal or vegetable, are found where the light of the day is unobstructed. The luxuriance of the tropics is due to light and heat, while the sterility of the frigid zone is due to a lack of them . . . in the same climate and under the same influences other than sunlight, the difference between those (men) who have it in abundance and those who are shut out from it, is very marked indeed. Animal organizations any more than vegetable cannot be fully and properly developed without sunlight in abundance. A weed may grow in the shade, but the finer fruits are found only under the direct rays of old Sol . . . rickety children are to be found seeking darkness rather than light; the well-developed, highly wrought, vigorous and normal productions of nature are only produced and flourish in the light of day. A tadpole, if deprived of sunlight, instead of progressing into a respectable frog, will remain a tadpole or, degenerate into some monstrosity . . ."
Trall was summoned to appear as a witness in an accident. He was invited by the head of the hospital where the patient was cared for to examine the hospital. The hospital was clean and well provided. To Trall's question about what proportion of his crippled patients recovered, the hospital head made the significant reply: "Nearly all on the sunny side of the hospital recover, while many on the shady side linger along till gangrene sets in, when death comes to their relief."
Trall expressed surprise that patients should be placed in rooms where the chances were against recovery and asked: "Why not have sunny rooms for all?" The physician and surgeon answered: "The hospital is not large enough for this, and when the good rooms are all full, those who come in later must accept such accommodations as we can furnish, whether they live or die. We do the best we can with the rooms at our disposal. As soon as south-side rooms become vacant, we remove north-side patients into them, and so keep them always full."
"What a picture is this!" exclaimed Trall. "We fall on the ice and break a leg; or from a ladder and break an arm; or we are smashed or burned in a railway train; or run over by a Broadway omnibus, and carried on a stretcher to the New York Hospital. The rooms on the sunny side--in which we are expected to recover--are all full, while the rooms on the north or shady side--in which patients are expected to linger till gangrene sets in, when they are expected to die--await us. We enter alive and come out a corpse," all for lack of sunlight.
"Live," said Trall to the readers of The Science of Health, "at least a part of the time in the sunshine. Never mind the fading carpetswhat are they when compared with life and health? Sleep in well aired and ventilated rooms, and thus throw off and throw out all impurities emanating from human bodies." Besides living much in the sunshine and fresh air, he advocated sleeping in well ventilated bedrooms in which the sun has shown during the day.
With sunlight around, above, below, everywhere, how shall we relate ourselves to it, asked the early Hygienists, that we may receive the highest degree of benefit from it? What is man's appropriate personal relationship to sunlight? Is it sufficient, for his health, that it shall reach his eyes, face and hands, while it is excluded from the rest of his body? They answered these questions by saying that the sun should come in contact with the whole body. Sun bathing in the nude was advocated and practiced, also sun bathing in thin cotton gowns of white. They considered colored clothing and experimented with it and found that it screens out much of the beneficial rays of the sun.
They said that, as a rule, sun baths are not to be taken by those in a feverish condition, but were to be taken wherever "there is torpidity, inanity, lifelessness or the like." Applying the Hygienic precept, remove the cause and the effects will cease, they said: "When want of sunlight has been the cause of disease, sun-bathing must be a valuable hygienic" measure.
Air is the source of oxygen. A constant supply of oxygen is essential to life. Deprived of air, man dies in a few minutes. Yet, at the time that Graham, Jennings, Alcott, Trall, Gove, Nichols, Taylor and their co-workers labored, they had to fight, not only the ignorance and superstitions of the people, but that of the medical profession as well to secure recognition of the need for fresh air. Through the furnace-heated, carpeted and curtained rooms, whose walls were lined with pictures and on whose floors were arranged fine furniture, there seldom stirred a breath of fresh air. People lived in unventilated homes, slept in unventilated bedrooms, while the sick were denied fresh air upon the order of their physician. Fear of night air, cold. air, damp air and draughts was practically universal. Birds, beasts and savages might live in the open air, but civilized man required the staleness of unventilated households and workshops if he was to maintain health.
Bare the shoulder of a man or bare his thigh and behold the palor of death! Behold the limb of a cadaver! Compare the appearance of the exposed part with that of his face that had the advantage of air and sunshine! What a difference! Man needs that great restorative, the fresh breath of heaven, to fan his brow, to play around his mouth, to enter his lungs, to reach and circulate through the citadel of life, carrying with it all of its invigorating and life-sustaining qualities. It was a long hard battle to get this fact recognized and even yet it is not fully appreciated.
The presence of water is essential to the performance of the processes of assimilation and those of excretion. Indeed, all the chemico-vital processes or changes that take place in the living body require the presence of water and a deficiency of it soon manifests itself in disturbances of these operations. Those tissues which contain least water, such as bone, possess but little vital endowment. Tissues which serve merely as supports and for protection are relatively low in water. Active tissues, such as muscles, glands, nerves and brain, contain a high percentage of water. The greater the percentage of water in a tissue, the more rapid are the nutritive changes that take place during activities. Man concocts no beverage which is so wholesome, so strengthening, so agreeable to the unperverted taste as pure, cool water.
We are fully justified in studying the offices universally performed by water in nature and the general relations it bears to living organisms as a Hygienic material, but we are not justified in any attempt to convert it into a therapeutic agent as did the Hydropathists. Still less are we justified in withholding water from the sick, as did the medical profession. As one of the primordial needs of life, it should receive proper consideration in all discussions of Hygiene.
In the days of Graham, Jennings and Trall, fever patients begged for water, even to the extent in many instances that they might drink and die. Burning with fever and begging for water to cool his parched tongue, the physician continued to deny a glass of water to the fever patient. Even as late as the death of President Garfield, and this was long after the Hygienic System had spread among the people, physicians continued to deny water to their fever patients. When Garfield died (history says from an assassin's bullet), he was denied water by half a dozen idiots who attended him. Begging, coaxing, threatening for a little water to cool his parched tongue, his stomach was burned with brandy until it refused to receive it.
William Lamb, M.D., of England raised the question: Is man a drinking animal? He pointed out that man is ill equipped anatomically for drinking water from a stream or pond and also that there are many animals in nature that never drink. Lamb was contemporaneous with Graham and he and Graham had considerable correspondence with each other. But he was never able to convince Graham of the soundness of his position. In the November 1855 issue of the Journal, a reader raised the question: Could not Lamb's question be satisfactorily answered if it were ascertained whether the proportions of fluid and solid in the foods eaten, at least in a physiologically correct diet, was in proportion to the fluid and solid in the body? Trall said in discussing the reader's question, that this was an interesting suggestion and that it "propounds a principle deserving thorough investigation. It is clear that there should be a close approximation in the relative constituents of the solids and fluids of the body and those of the very best proportions of a truly frugivorous diet."
It is obvious, however, that, inasmuch as the body is constantly losing fluid faster than solids in its excretions, there would be need for a greater proportion of fluid in the diet than in the body. The question contained this clause: "the excretions included." It is also obvious that in hot weather and under heavy physical exertion with rapid sweating, the loss of fluid may call for extra fluid at times other than meal time. Today it is proposed by many that the extra fluid be supplied by drinking fruit and vegetable juices or by eating juicy fruits instead of drinking water when thirsty. It is doubtful if eating foods or drinking juices between meals is a wholesome practice.
During the Dark Ages, Western man ceased to bathe. In America, up to the time of Graham, people did not take baths. They had no bath tubs and did not regard bodily cleanliness as a necessity of life. Graham and the other Hygienists taught Americans to bathe and in this work they had the active opposition of the medical profession. As late as the middle of the last century a Dr. Winship, who claimed to be the "strongest man alive," although not wholly opposed to bathing, as were so many of his professional brethren, was not overenthusiastic about cleanliness, advising: "Practice general ablution at least once a week in cold weather, and twice a week in warm, but seldom oftener in a New England climate. (In offering this rule, I expect to be censured by quite a large class in the community, who seem to delight in the daily soaking and splashing in water, not having, probably, the slightest consciousness that by so doing, they defeat every intention for which water is externally applied.)"
From Winship's statement, it will be seen that the objection to the daily bath was still quite strong, so that even a physician who indulged in physical exercise, including heavy exercise, could still oppose daily bathing. Today people take their baths regularly and without opposition and few of them have any knowledge of the mighty struggle that went on in the last century to overcome popular and medical opposition to bathing.
Exercise (physical activity) is a requisite of health, strength and development throughout the animal kingdom. Full development cannot be achieved without it. How suicidal, then, for us to cramp our bodies with tight clothes that do not admit of freedom of movement and confine ourselves indoors in inactivity. Even the caged bird, though limited in its sphere, skips from perch to perch for hours, for exercise, while we sit practically motionless for hours at a time at a desk, never getting any more exercise than is required to walk to the water fountain and back.
The incessant playful activities of young animals constitute a course in physical training that meets nearly all of their needs in this particular. Our own young are cooped up in class rooms and required to remain physically idle.
We have abandoned the old practice of tightly bandaging infants and confining them in swaddling clothes until they become blue from lack of air and from interference with circulation. We are killing fewer infants today than formerly partly because of having abandoned this cruel practice. We let them roll and tumble about and kick and use their limbs and body in freedom. Instinctively, they are as active and playful as the young kitten or puppy, or the fledglings in the nest flapping their wings as if trying to fly. Just as the fledgling thus educates his muscles for the act of flying, so the infant and young child is busy educating its muscles for future activities. Unfortunately, we interrupt this physical education at an early age by confining the children in class rooms and we do not adequately compensate for the enforced idleness.
Writing in the Herald of Health, January 1865, A. J. Wood, M.D., said: "Of all the Hygienic agencies as Food, Light, Water, Air, Sleep, etc., that should be used in correcting disordered action, none are more important than exercise." Obviously, this use of exercise in correcting physiological activity could not apply to acute disease. Exercise or physical activity serves its legitimate function in health and in many states of chronic disease.
Inertia, slothfulness and inactivity permit the body to become soft and flabby, its structures to deteriorate, its functions to weaken and its efficiency to decrease. The neglect of exercise by the medical profession was but one more of its crimes against the integrity of life. Graham pointed out that physical activity or exercise is absolutely essential to a proper flow of the body's fluids, hence to good nutrition. In its effects, exercise involves the whole body and not merely its muscles.
As essential to life as is exercise is the need for periods of rest and sleep. It is during periods of relaxation and repose that the body repairs itself and reinvigorates itself and prepares itself for renewed activity.
The practice of substituting stimulation for rest and sleep is a ruinous one. The practice was fostered by the medical profession; and while the profession can hardly be accused today of thinking that stimulation can be substituted for rest, it still defends the stimulating practice.
In our present culture, our evenings bring no pleasure for the reason that, just at the time when our tired body needs darkness and rest, we are placed in the unhealthful glare of artificial lights and subjected to the noise of radio, television, jukebox, phonograph and revelers and made to breathe the fumes of tobacco. Perhaps we drink alcoholic drinks or poisoned soft drinks and eat hot dogs and hamburgers. When morning comes with its dewey freshness, we are fitfully sleeping in a darkened room from which we finally emerge into the full glare of the day--little realizing that all sudden changes from light to darkness or from darkness to light are hurtful. Nature's changes are gradual. To sleep in darkness is good, but to live in darkness produces disease.