Application of Hygiene


   The patient has pneumonia and we seek to care for him Hygienically. We give him enough food to meet the normal demands of nutrition, provide as much water as thirst demands, give him plenty of air to breathe, a daily sun bath and give him a daily bath. We require that daily he take a brisk walk; we provide him with a television program to watch and permit him to have plenty of congenial company. All of this is strictly Hygienic; but in defiance of it all, the patient would probably die--not for want of Hygiene, but for lack of proper adjustment of Hygiene to his needs.

   Writing in the Journal, June 1859, D. A. Gorton, M.D., said: "When we lay down the principle that nothing in this wide and expansive universe can restore the primitive harmony of the disordered organism but the conservative power resident in all living tissues, we have a grand physiological idea or basis upon which to work understandingly. Taking this principle as our guide, we necessarily discard the use of those agents whose effects are to disturb the equilibrium of the vital forces. When we select our remedial agents, therefore, our choice necessarily lies between two classes of substances, which we might denominate usable and non-usable agents. Hence we are to select the former; and in so doing, we do but imitate unerring nature."

   She pointed out on this occasion that when the body is violently active in remedial effort, to supply her plentifully with pure Hygiene in the same way that we would a healthy individual, would facilitate its destruction. Then she adds: "It is obvious, therefore, that the mere supply of the elements of hygiene are not adequate, in all cases, to cure disease. And when we assume this obviously erroneous position, we expose ourselves to the unrelenting attacks of our enemies, our fancied arguments are liable to be blown into 'thin air,' and the fabric of (our) boasted system shattered into a thousand fragments. When art, therefore, affects the cure of disease by the use of hygienic remedies, it is cured hygieopathically, not hygienically. In an argumentative sense, the distinction is broad and important; in a practical point of view it is superfluous . . ."

   Hygiene is the preservation and restoration of health by the use of means that are absolutely essential to life and that are abundantly supplied to man to preserve him in a normal state. But in an abnormal state these means have to be adjusted to the body's capacity to use them. Dr. Gorton wrote that the distinction between preserving health and restoring health should be borne in mind. She wrote that many prominent advocates of the Hygienic System had failed to fully define the difference between the two processes; that they have argued so indefinitely on this point that the opponents of Hygiene have maintained, with a fair degree of logic, that Hygienic care fails to meet the demands of an age of suffering and disease. She added: "It would not, certainly, were the elements of hygiene applied in a diseased state hygienically." She differenciated between the normal application of the means of Hygiene, that is, for use in health, and their application in disease, calling the latter pathologically. She said: "Applied pathologically--according to pathological indications--their potency in restoring harmonious activity is not equalled by any drug in the materia medica."

   Applied to the sick, the amount of food the patient should receive, the amount of bathing he should do, the length of time he should stay in the sunshine, the amount and vigor of exercise he should have is dependent upon the ability of his organism to appropriate and make constructive use of these substances and influences. The more vigorous patient may bathe regularly, exercise freely, eat more food; the feeble patient must rest more, bathe less, take less sun, eat little or not at all and treat himself with the utmost gentleness. Any heroic measure will prove harmful.

   Returning to our hypothetical case of pneumonia, we provided the patient with all the means of Hygiene, but without adapting these to his needs in the state of disease, hence, probably killed the patient. The lesson derivable from instances of this nature could have been learned ages ago had intelligence reigned, rather than a pretended and imperfect science. The superior efficacy of physiological care is soon evident to the candid observer.

   At the time when Graham and Jennings began their work, the first thing a physician did when called to the bedside of a sick man was to have him sit up in bed and then bleed him until he sunk down, fainting. The lancet was regarded as a most powerful remedy to counteract inflammation. Hygienists advised, instead of opening the veins and letting out the vital fluid, that the capital of health should be left untouched. They had learned not to interfere with the living process, except to supply suitable materials for its use and to supply conditions favorable to their appropriation. The true principle of caring for the sick is that of providing the sick organism with favorable conditions for the efficient operation of its own remedial processes. This principle rejects in toto every means and process which, in its nature and tendency, in authorized medical quantities, degrees or modes of application, is known to directly destroy life or to injure the living tissues, or to interfere with the performance of the normal physiological activities of the organism.

   Having recognized the profoundly important fact that the vital system may be consciously directed in its physiological actions by due attention to its basic requirements and that these requisites may be adapted to every pathological requirement, the Hygienist may extend his investigations in many new directions and an almost endless variety of detail may be entered upon in adjusting the special use of the several means of life to the varying requirements of life under many circumstances and conditions. He should recognize that in proportion as this is effected shall we acquire a more effective system of Hygiene. Such a perfected Hygiene must displace the vague and contradictory plan of treating the sick that is in vogue.

   Hygiene in sickness is the use of all the means by which the living organism is originated, preserved and perpetuated in nature. It is the complete bringing of the sick under normal physical and emotional conditions. Under the benign influence of the normal things of life, health soon returns.

   The Hygienic System, in its application to the sick, comprehends in the broad scope of its means, the adaptation of all normal materials and conditions to the needs and capacities of the diseased organism in the restoration of health. Replying in the Journal, March 1859, to a criticism made by Joseph Bigelow, M.D., of Boston, Dr. Trall said that among its Hygienic resources are "air, light, caloric, electricity, magnetism, personal influences, exercise, food, sleep, rest, clothing, drink, bathing, etc." (Referring to electricity, Gorton said: "Electricity and magnetism are generally classed among the hygienic agents, and perhaps justly so; but they can not be considered primitive agents.") The Hygienic System, he pointed out in this same editorial, embraces every directly remedial agency in the universe and rejects nothing that nature does not reject. He said it excludes nothing except those poisons which nature declares to be incompatible with the living organism. Bigelow had accused them of relying exclusively on cold water. Trall replied that: "In very many cases, cold water, so far from being the 'one remedy,' is not used at all. In the majority of cases, water, of any temperature, so far from being the 'only remedy,' is not the chief or leading remedial appliance. And in a large list of diseases we place much more stress on either eating, breathing, or exercise, than we do on bathing."

   "How are pathological conditions removed by hygienic remedies?" asked Dr. Gorton. Replying to her own question, she stated:

   1st. By a normal supply of those agents by which life is preserved and maintained.

   2nd. By the application of the most available Hygienic remedial resources, according to the principle of care which she had previously indicated, which consisted in the modification of the remedial effort by a wise discrimination in the use of the different Hygienic means available. She added: "Particular remedies (by which she meant particular Hygienic means) are indicated in particular cases." We can deny the body water only as it refrains from demanding this element of Hygiene; we cannot deny it air at any time; food can be withheld only so long as the body is in possession of reserves to sustain it while no food is taken; rest is imperative in states of great weakness or prostration; exercise must be adjusted to the abilities of the chronic sufferer, etc.

   The Hygienist regulates the food, temperature, activity, rest, etc., of the sick not with the thought that such regulation constitutes a cure, but with the full knowledge that these are the fountains of organism without which life cannot continue. He knows that healing is a vital or biological process, as much a function of the living organism as digestion, circulation, respiration, nutrition, excretion, etc., and that he can neither imitate nor duplicate the process.

   If there is fever, the Hygienist does not administer antipyretics or febrifuges to reduce the temperature. Experience has demonstrated that such things are neither necessary nor beneficial. They are impediments thrown in the way of the organic energies and, though they may occasion an apparent change in the condition of the patient, they are not wanted by the living system and must be expelled from it as rapidly as possible. In thus diverting the body's effort in expelling the drug, the life of the patient may be snuffed out. At the least, his suffering is prolonged.

   All this is out of place at all times; it becomes dangerous in low or atonic states of the body, when energy is low and must be husbanded with great care. Medical students study physiology, but never think of applying its laws to life, nor do they ever think of doing so when, after graduation, they are engaged in treating the sick. No amount of study of physiology causes the medical student or the medical practitioner to alter his ways of life. His studies are all related, both by his texts and by his teachers, to medical and surgical practices.

   Hygienists do not treat disease, but supply the means of life to the sick organism in different circumstances and conditions in accord with certain definite natural principles, not with the idea that this cures disease, but with the purpose of supplying physiologic needs. These needs are not supplied by any mechanical routine, but according to the conditions and actions of the organism. In Hygiene, the healing processes of nature are aided from the beginning by supplying the normal needs according to the capacity to use them; hence, recovery is proportionately rapid.

   There are no radical changes in the sick organism to cause it to need that which it does not need and cannot use in a state of health. Its needs are the same in kind; its changed needs reside, not in the kind of needs, but in the amounts of these it can appropriate and utilize. If digestion is suspended, it does no good to take food; if there is great weakness and an unmistakable demand for inactivity, exercise would be ruinous. The measure of good care of the sick is the capacity of the impaired organism to appropriate and constructively use the normal needs of life.

   This rule--that the ability of the organism to utilize the normal factors of life--constitutes the measure by which these are to be supplied to the sick person and is identical with the rule that should govern us in supplying these same needs to the well. Excess, which I shall here define as any amount above the genuine needs of the organism, whether well or sick, is hurtful rather than helpful. A strict observance of this rule in caring for the sick will enable us to handle the sick according to individual needs or limitations and not according to any cut-and-dried formula which is supposed to fit everybody. Needs and capacities vary with individuals and with the same individual at different times.

   The adjustment of means to ends that this requires is the same in kind as the adjustments that the healthy body is making ordinarily at all times; they are the very adjustments that the sick body would make were it left to its own devices. In health we take more water or less water, as need arises, and are guided in this by our sense of thirst; we take more food or less food as we require more or less, and are guided in this by the demands of hunger; we take more rest and more sleep, or less of these as we need them, and are guided in this by our sense of fatigue and sleepiness. Such adjustments are normal parts of the process of living. Our trouble in sickness arises out of our desire to have the sick, hence, crippled organism take food, air, water, exercise, etc., as though it were well and leading an active life.

   We do not, as some early Hygienists thought we should, employ Hygienic means for the modification of the remedial effort--to exhaust, depress or diffuse as circumstances demand. Hygiene is not a means of controlling vital activities in the way the practitioner thinks they should be controlled. All the control that the vital activities require may always be secured by supplying physiological wants--that is, by placing the sick organism under the proper conditions for the successful operations of the body's remedial actions. Were Hygiene a system of arbitrarily controlling physiological activities, it would simply be another system of cure, hence false. (Charles F. Taylor, M.D., was of the opinion that, as Hygienists continue the development of their system, "a complete system of medical hygiene" will be wrought out.) As study and experience have increased our understanding, we no longer consider it legitimate to juggle Hygienic means, as some early Hygienists thought they should be juggled.

   It is true that by manipulating the means of Hygiene, it is possible to control physiological activity to a marked extent and it may still be thought by some that we can and should do this for remedial purposes; but it is doubtful that we can consider meddling with the activities of life as constructively as these may think. Instead of control, we should seek to supply needs. The greatest danger, both with the practitioners and the patient, is in overdoing and this results from ignorance of the truths of physiology and biology. Unless these truths are known and observed, Hygiene will degenerate, like the drugging system, from a matter of principle into a matter of routine and this will end its power.

   When we fully understand that Hygienic means do not act on the system, but are used by the body in virtue of their fitness to serve its vital needs, then we will understand that the needs of two sick persons with the same symptom-complex are not identical in degree, although they are identical in kind. One will require more rest or more water or more abstinence or more warmth or more food, etc., etc. This adjustment of the physiological needs of life to the requirements or capacities of the sick organism is the very essence of Hygienic care of the sick.

   Note particularly that these are not means of cure, but needs of life--the same needs, in fact, that are required by the healthy body every day in order that life can go on at all.

   To make this plain: if we supply the sick with fresh air, we do so for the same reason that we supply fresh air to the well--not to cure, but to supply an indispensable need of the living organism under all conditions of existence. Hygiene is the preservation and restoration of health by the use of means that are absolutely essential to life and that are abundantly supplied to man to preserve him in a normal state.

   The sick person is not to be cared for by some mechanical routine, but according to vital needs and vital actions. Hygienic means are not applied by routine according to the name of the disease. Dr. Trall was right when he said: "There is no such thing in the universe as telling a person what to do because he has a given disease. We can only indicate the rule of action." It is possible to tell him the principles that govern our actions or that should govern them, but if he does not understand the principle, he cannot follow it.

   How can the people or the Hygienic practitioner apply a principle if they do not know what the principle is? Hygiene has long held out to the people the principles which govern the employment of all the legitimate means of care; but few people, as yet, have a comprehension of these principles. By applying these basic principles (not specific cures) to the circumstances of each individual sick person, genuine recovery is promoted.

   Hygienic care is not directed to the cure of disease, but seeks to provide the most favorable conditions for the efficient operation of the body's own healing processes. We recognize the so-called disease as an effort to resist and expel morbific causes and repair damages, not as an enemy to be cast out or killed. When you know how to care for the sick body, you will know how to care for all sick bodies. Of necessity, all sick bodies have to be cared for alike, for the reason that, basically, all human organisms are alike. Their needs are the same. The principle of adjusting these needs to the condition of the sick body is the same in all cases. In caring for the sick, no matter what the symptom-complex is called, we are but applying a principle.

   The often-heard complaint that Hygienists treat all diseases alike is wrong. Hygienists do not treat diseases. Hygienists are not in the curing business. They peddle no cures; they sell no treatments. They supply only the ordinary, everyday physiological needs of the living organism. As these are the same for everybody, it is natural for everybody to be supplied with the same primordial requisites of organic existence. It is a false idea that we should supply one person with fresh air to breathe and another with poisonous fumes to breathe, that we should supply one patient with wholesome food and another with unwholesome food.

   The successful practice of Hygiene consists of applying certain principles or rules to the ever-varying conditions of invalids and to the various circumstances of disease, having not, as most people seem to imagine, a routine of processes, according to the name of the disease. Instead of resorting to a particular plan of care with a certain amount of fasting, a particular diet, a predetermined amount of rest, etc., etc., we must take a universal principle and apply it to the needs or circumstances of each individual in his particular condition. No man can tell beforehand how much rest, how much abstinence, how much sunshine, how much time, and how often and how many times the Hygienic means must be repeated for health to be restored. Fortunately, this is not as serious as it may at first appear; for, unlike drugs, these means of care do not poison. One needs only to persevere until the desired results are achieved.

   A routine practice, adopted simply because somebody who is looked up to as an authority advised it, is unworthy of thinking beings. We should have well-defined ends in view in all our applications of Hygienic means. We should know why we employ a fast, or a diet, or a form of exercise, or why we demand more rest. We should know why we do one thing instead of another. One man needs only a short fast, another a long one; one needs more food, another less; one woman needs corrective exercise, another only general exercise--it is essential that we employ Hygiene intelligently. The indiscriminate, outrageous and unphysiological employment of the means of Hygiene cannot be logically expected to yield ideal results.

   Of course it is true, as is often complained, that Hygienic care of the sick, like Hygienic care of the well, is a "simple monotonous repetition." What else can one expect? The needs of life are simple, monotonous and daily repeated. Of course, Hygiene is alike for all. All need fresh air--this is not a need of only an occasional individual. All need rest. All need food. All need sunshine. We need fresh air all the time, rest and sleep daily. It does become monotonous, doesn't it? It is repetitive, isn't it? But while we can break the monotony of daily eating by fasting, we cannot break the need for breathing by cutting off the supply of oxygen--too bad, isn't it?

   The employment of Hygiene requires knowledge, judgment, wisdom and experience. A man, like a parrot, may be taught to repeat wise sayings; but if he lacks good judgment, he will not understand them. Judgment, understanding and wisdom cannot be inoculated into a man so as to saturate his system with them. Until biology and physiology have established for us a perfect science of life, more or less enlightened empiricism will continue to constitute a part of our work; but we must recognize that in accepting experience as a guide, we are faced with the difficulty of finding the right experience.

   In consequence of the persistent misrepresentation of the system of Hygiene by the practitioners of the various schools of so-called healing and the general air abroad that fasting alone or dieting alone is our panacea for all forms of disease, there has resulted a tendency to obscure the fact that Hygiene involves the application of all Hygienic measures in the care of the sick. These need but be employed in keeping with the capacity of the sick organism to constructively utilize them.

   When we ask: how shall the daily supply of the needs of life be adjusted to the altered needs or capacities of the sick body, we meet with a wide variety of answers and with many proposals intended to solve this problem. We need a simple and entirely physiological means of meeting the modified, but not radically changed needs of the body in illness. Certainly, the most important factor in any successful and biological method of caring for the sick organism depends on a satisfactory solution of this problem. Certainly, we cannot accept those proffered modes of care or cure that propose to meet the needs of the sick organism with unphysiological means.

   All processes of recovery or healing are but extensions and modifications of the processes that preserve health and the materials and processes employed in caring for the sick must be in consonance with physiology and compatible with all other useful measures. There must always be a normal connection between the living organism, whether in its normal or abnormal activities, and the material things that contribute, more or less perfectly, to sustain psychological and physiological phenomena. As we have emphasized elsewhere, no substance or process that is not a factor-element in physiology can have any value in the living structure under any circumstances of life. That which is not useful in a state of health is equally non-useful in disease.

   All the needs of normal physiology are present in states of disease and require to be supplied to the end that organic and functional integrity may be preserved or restored. Hygienic care, therefore, comprehends not only regulation of diet, but a synthesis and coordination of all the factor-elements of normal life--drink, breathing, sunning, temperature, growth, exercise, rest, sleep and the emotions, in keeping with the altered needs of the organism.

   Can we reach precision in adapting the normal requisites of life to the reduced capacities of the sick organism? The attempt to do so becomes so complex and confusing that it may be doubted that it can be done or that it is even desirable. We have to leave most of this to life itself.

   The bewildering confusion that has resulted from trying to attain precision in supplying the body with the requisite amounts of the several vitamins, the various salts, the several amino acids. etc., illustrates the complexity of the subject. We simply lack the definite and conclusive knowledge and the means of supplying such elemental needs of life with precision. The senses and instincts of the sick man are often more reliable guides than is science. The sick man knows when he is chilly (in need of warmth), thirsty (in need of drink), tired (in need of sleep), hungry (in need of food), not hungry (in need of abstinence), etc. Science can be of service; it is not supreme, except insofar as it serves as a handmaiden to the instincts of life.

   Dr. Jackson warned that Hygienists should be cautious in their application of Hygiene to those whom he called the "drug-smitten," making as few mistakes as possible. This is in line with the warning given by other Hygienists about caring for those who have been damaged by much drugging. They are by no means easy patients to care for.

   Not every patient who turns to Hygiene successfully applies its measures and not every practitioner who calls himself a Hygienist properly administers Hygienic care. Because miraculous recoveries do not continually result from an indiscriminate, haphazard and often injurious routine of Hygienic applications, people become discouraged with the system and its practitioners and often disgusted with its consequences. Happily, however, large numbers of people are now studying Hygiene in earnest, with the view of understanding precisely what may be expected from Hygienic means and the proper ways of securing such benefits.

   It would be false to say that Hygiene will save every sick individual who turns to it. The Hygienic practitioner, however skillful, cannot be expected to do the impossible. The value of Hygiene over every other plan of caring for the sick is that, when judiciously administered, it will save every sick individual who is capable of recovery, while other means of care and especially those modes that administer poisons (drugs), which tend naturally and legitimately to kill and when they do not kill, to render the condition permanent or irreversible or increase the disease, will register a great number of failures.

   Let all those of us who conduct Hygienic institutions and all of us who live Hygienically at home claim for Hygiene that which belongs to it, that is, that it is sufficient for the restoration of health in all restorable conditions, doing this more certainly, more satisfactorily, more quickly, more safely, more expeditiously, than it can be restored under any other plan of care, and that it can restore health in many instances in which failure results under other plans of care.