Popular Science Monthly/Volume 24/November 1883/Correspondence
DR. OSWALD AGAIN REPLIES TO DR. BLACK.
Messrs. Editors:
DR. J. R. BLACK'S second epistle, published in the October issue of the "Monthly," can hardly have surprised your intelligent readers, and may even have excited their pity. When people like Dr. Black see a way to achieve publicity, they must be pardoned for trying to make the best of their chance, even on the terms accepted by that Paris quack who volunteered to be pilloried, if they would permit him to exhibit himself in a pair of canvas breeches, displaying a printed advertisement of his pills. Besides, the doctor has somewhat modified his original plan. Having undertaken to pose as a martyr of medical orthodoxy, but finding his nasal organ out of plumb to a degree he had not quite bargained for, he now attempts to effect his retreat under a dust-cloud of irrelevant obscurities.
After admitting that dyspepsia in children can be explained by the agency of causes distinct from hereditary transmission (which he had denied in his first letter), he now defies me to prove that, by moderate eating and abstinence from virulent drugs, children can escape the disease. Has the plan ever failed where it had a chance of a fair trial, as in hygienic homes, or in Schrodt's "Boarding Kindergartens"? Or does Dr. Black know what his thesis implies? He can not deny—1. That the digestive organs of children are governed by the same pathological laws as those of adults, the difference, if any, being in favor of the children, since every birth is a hygienic regenesis, and since diseases, as he himself admitted in his first letter, do not exist per se from the moment of birth. 2. That a correct regimen and abstinence from noxious drugs will prevent dyspepsia in adults, and cure even far-gone dyspeptics. Yet he holds that a correct regimen and abstinence from noxious drugs will not prevent dyspepsia in children. In other words, the laws of health hold good in the ordinary affairs of life, but may be set aside when it comes to account for the mortality in the infant-wards of an Ohio drug-hospital. Dr. Black informs us that the public is deeply interested in the issue of our controversy. Feverishly. But your readers can make their minds easy. Nature is not so inconsistent as Dr. Black; and I will under-take to insure any child against dyspepsia, nay, any cured dyspeptic against a relapse of the disease, on the sole condition that they shall avoid dietetic abuses and Dr. Black's prescriptions. In his distress to evade the logical inference of his admissions, Dr. Black suggests that some of my arguments might be used to disprove the hereditary tendency of insanity and consumption. Before the doctor's friends permit him to undertake another pathological controversy, I would advise them to enlighten his mind on the difference between functional and organic disorders, and thus enable him to understand the reason why consumption or cancer, but not dyspepsia, can be called an hereditary disease, and why hereditary diseases and not dyspepsia reappear in successive generations at the same period of life when they were first contracted. If I had ever doubted the chronic persistence of mental derangements, I confess that Dr. Black's arguments would have convinced me of my error. The manner of his attempt to defend the drivel of his first letter is a sufficient proof that the taint of idiocy is ineradicable.
In trying to explain away the silliness of his soap-water argument, Dr. Black volunteers the confession that Nature protests against the use of soap when the sensitiveness of the cutaneous tissue has been morbidly increased by the influence of a skin-disease. In other words, he admits that a morbid condition increases the danger of using even the mildest chemical depurative. Yet to the morbidly sensitive membrane of the diseased digestive organs he proposes to apply the virulent "intestinal soaps," as he calls his cathartic drugs. The "striking benefit" resulting from the use of patent laxatives is too exclusively confined to the experience of the patentee.
Dr. Black's assertion that I propose to cure syphilis on the let-alone plan is a fiction which can be pardoned only to a non-plused sophist at the brink of a reductio ad absurdum. Not only have I never propounded such a theory, but I have repeatedly named syphilis as the representative disorder of the exceptional class of diseases which (for reasons stated on page 729 of "The Popular Science Monthly" for October, 1881, and on page 199 of my work on "Physical Education") have to be cured by an artificial removal of the cause.
As a last attempt to retrieve the reverses of his game, Dr. Black tries to score a point on a lexicographical quibble. In defending my plea for longer pauses between meals, he says, I have spoken of digestion and assimilation as being one and the same thing. The truth is, that I mentioned them as synergistic operations. But within the scope of my argument I would have been justified in treating them as identical functions. Does Dr. Black wish to deny that intestinal digestion, in its normal phases, includes an assimilative process? But, as in the case of dyspepsia infantum, the doctor's experience is perhaps limited to the action of a drug-convulsed system, in which case the activity of the digestive organs does, indeed, but rarely lead to assimilation.
Dr. Black's exception-plea in favor of the stimulant superstition illustrates only the radical confusion of his pathological theories. For that energy of action which he mistakes for a sign of restored functional vigor demonstrates nothing but the urgency of an expulsive process. The functional activity excited by the influence of a drastic tonic proves only the virulence of the drug, and the system's eagerness to rid itself of a deadly foe. In my treatises on "Dyspepsia and Climatic Fevers" I have exposed the two most specious fallacies of the stimulant-delusion; and there is an end to all inductive reasoning if the analogies of the stimulant-vice and the medicine-habit do not establish my tenet that the poi-on-hunger in all its forms, whether as mania a potu, or a hankering after a digestive excitant, is wholly abnormal and mischievous; that its repeated gratification rarely fails to inoculate the system with the seeds of a progressive stimulant-habit; that the dyspeptic's dependence upon Dr. Black's calomel pills is an aggravation of the original disease; and that even the temporary results, effected at such risk, by the use of virulent drugs, can, in nine cases out of ten, be more safely and as directly attained by other means, as by refrigeration in the treatment of malarial fevers, or indirectly by reform of the predisposing habits, as in consumption and various enteric disorders.
In one of his tirades against heretical theories. Dr. Black carries his bravado to the degree of appealing to the testimony of "stubborn facts"—in other words, to the lessons of experience. I would advise my colleague to avoid that arena. Hospital statistics might prove that the homoeopathists can challenge our best record and demonstrate by proofs, which should satisfy a depredator of their sugar-pellets, that they can beat it. by total abstinence from the so-called remedies of the drug-shops.
In his first letter Dr. Black proposed to let dyspeptics trust themselves to the guidance of their morbid appetite, and, after I proved that the absurdity of that plan could be demonstrated by the analogies of the alcohol-habit, our entrapped medicine-man tries to slip out by the following hole: The chronic hunger of the dyspeptic, he informs us, is a craving after food, while the unquenchable thirst of the alcohol-drinker is a craving after poison. Does that subvert my tenet that, in regard to the persistency of the appetite, both cravings are wholly abnormal? For, let us remember that the original point at issue was the question about the proper number of daily meals. Now, in pursuance of Dr. Black's plan, his patients would have to eat about forty meals a day; for, in his first letter, he advised dyspeptics to follow the promptings of an appetite which he now admits to be morbid and unappeasable, as caused by a chronic state of semi-starvation. Thus Dr. Black continually shifts his ground, to dodge the inferences of his own premises. But the fact is, that he never expected to maintain his positions. He merely wrestles against time, and accepts his successive overthrows in the secret hope that the shrieks of his afflictions might attract the aid of some brother-sophist. Hence, also, his repeated allusions to a "numerous class of physicians" whose wrath he warns me to deprecate. Like other champions of orthodoxy who find that their logic leaves them in the lurch, he tries to retreat behind the shelter of a numerical majority.
By my outspoken denunciation of the stimulant-superstition, Dr. Black holds that I have offered an insult to that large body of medical men to whom is due the credit of the most important discoveries in hygiene, physiology, surgery, etc. My orthodox contemporary will try in vain to identify the interests of his cause with the progress of those sciences. All their promoters have contributed their share to undermine the foundations of the position which he tries to defend. For the last hundred years the history of medical science has been the history of a continued and increasingly rapid collapse of the drug-delusion—a delusion whose defenders have always tarried in the rear of progress, and, after doing their utmost to obstruct the path of reform, have recognized its triumphs only by sharing the fruits of its victories. My invectives were not directed against the thousand earnest seekers after truth, not against its great discoverers, the pioneers of the true healing art, not against men like Bichat,[1] Schrodt,[2] Magendie,[3] Bock,[4] Jules Virey,[5] Jennings,[6] Rush,[7] but against bigots like Dr. Black; against medical obscurantists who dread the enlightenment of their victims as vampires dread the dawn of the morning; who oppose independent thinkers with that rancorous hatred which Jesuits feel toward the divulgers of their trade-secrets; who, by holding on to the last planks of their wrecked dogmas, by illogical compromises and temporizing sophisms, are trying to perpetuate the curse of a life-blighting delusion; who subordinate the interests of mankind to the interests of their clique, and disparage reformers till they find it convenient to appropriate the credit of their discoveries.
"Some acute philosophers," our obliging correspondent informs us, "think that all the phenomena of the universe can be explained on the laws of mechanics, from the motions of a molecule up to those of the celestial masses." Just so. And Dr. Black might as well confess the secret of his predilection for that system. Its application to therapeutics has so simplified the practice of medicine; and its recognition as the law of the universe would confirm the prestige of the orthodox cause. Instead of troubling himself with a life-long study of the laws and revelations of Nature, the lessons of instinct, the interaction of the vital functions, their modifications under abnormal circumstances, the secrets of the reproductive and self-regulating principle of the human organism, our mechanical philosopher would prefer to re-establish the system of the good old times, when he could consult a pocket-index of drugs, set against an alphabetical list of diseases, point to his diploma as a presumptive proof that he had learned to repeat the Latin synonyms and construct the pharmaceutic symbols of the various "remedial agents," etc., and magisterially reprimand hygienic "idealists," as a village schoolmaster, well read in Genesis, would reprove an exponent of the evolution doctrine.
"Dr. Oswald," says our astute correspondent, "is apparently unable to discern that all the customs and habits of savages are intimately correlated to their vital organism, and that for us to adopt only one of them might prove murderous to civilized beings." Because we can not imitate all the customs of a primitive nation, is that a reason why we should not adopt some of them? With such arguments our medical censor dares to insult the intelligence of your readers! Must we avoid the unleavened bread of the ancient Hebrews because we dislike circumcision? Must we disparage Japanese temperance, because we do not want to commit hari-kari? Would the Samian water-cure prove more murderous to civilized beings than Dr. Black's blue-pills? If I should recommend the system of the medical philosopher Asclepiades, who used to prescribe a special course of gymnastics for every form of human disease, Dr. Black would try to retreat behind his correlation-dodge. "Such systems," he would probably remark, "were intimately correlated to the physical and social organism of the pagan savages and their uncivilized doctors; but nowadays every intelligent druggist would agree with me that it would never do to let people cure their diseases with such
remedies. In a country like ours," he would add in a whisper, "the introduction of such a system might prove murderous to some civilized beings."
Dr. Black complains of my superciliousness in preferring a charge of ignorance against a contemporary who has for a long series of years anxiously sought the solution of "the problem how the sick can be made well." Sad enough; but that is no reason why I should withdraw my charge. Dr. Black may have sought that solution for a most venerable series of years, but, unless he holds his own time as cheap as that of your readers, he ought to seek it more anxiously than ever, for it is very evident that he has not yet found it.
Felix L. Oswald.
THE GEOLOGICAL DISTRIBUTION OF FORESTS.
Messrs. Editors:
IN discussing "The Geological Distribution of North American Forests," in your August number (pp. 521, 522), Mr. Thomas J. Howell makes the general statement that the loess (or lacustral deposits) of the campestrian province "is devoid of trees," except where cut through by erosion; from which he infers that "the loess is not capable of sustaining forest-growths for any length of time." By way of explanation, he adds that the loess "evidently was timbered during the time that part of it was covered by lakes and marshes," but, "when the great rivers cut their beds down to nearly their present level, the timber gradually died out." To generalization, inference, and explanation, exception must alike be taken.
In much of Eastern Iowa, and in Southeastern Minnesota, the loess is confined to an irregular zone, five to fifty miles wide, flanking the deeply eroded valley of the Mississippi on the west, and overlapping the glacial drift which forms the greater part of the surface of both States. The western limit of this zone is exceedingly sinuous; lobes of drift extend for miles within its general area, and narrow, finger-like belts of loess, sometimes separating into isolated outliers, extend still farther upon the drift-plain. Now, this drift-plain is quite timberless; but the loess is naturally wooded to its extreme margin, and its outliers are also generally wooded. The coincidence of forest-growth with loess is indeed so perfect in this region that maps showing the wooded area indicate with almost equal accuracy the loess area. This is a region, too, in which not only the "great rivers," but many of their minor tributaries, have cut their channels through the loess, and far into the subjacent rocks, thus developing the picturesque river bluffs which lure so many tourists to the upper Mississippi region. A parallel relation between loess and forests obtains in Central and Southern Illinois. Here the loess first appears, in passing from north to south, as isolated mounds rising from the almost dead-level drift-plain; which mounds, however far from other forests, are well wooded. The Missouri River loess-belt is, it is true, generally treeless, except along water-ways, which may or may not, however, cut through its deposits; but natural timber is far more abundant than over contiguous drift-areas, while its capability of supporting arborescent vegetation is emphatically attested by the unprecedented growth of artificially-planted fruit and forest trees, which is at once the marvel of Eastern and the boast of Western horticulturists. The potent influence of geological structure in determining the flora of any region is demonstrated by these relations of loess and forests, especially in Northeastern Iowa; but the connection is directly opposite from that which Mr. Howell seeks to establish.
But other and equally significant relations exist. Thus, it has been repeatedly pointed out by the director of the Iowa Weather Service, Dr. Gustavus Hinrichs, that the lines of equal timber in Eastern Iowa correspond remarkably, though in a general way, with the lines of equal rainfall.
Again, the origin of the loess is yet a mooted point in geology, and the declaration that its surface was once marshy is scarcely warranted; while no unequivocal evidence that it was ever more heavily or continuously wooded than now has ever been adduced.
The question as to the distribution of forests, particularly in the campestrian province, is inextricably involved with that of the treelessness of the prairies, concerning which so much has been written, but concerning which it is evident (since neither of the relations pointed out in this note have ever been adequately considered by those who have addressed themselves to the problem) that the last word has not yet been spoken. Mr. Howell would sever the Gordian knot at a stroke; but certainly some of its strands have escaped his blade.
| Yours, W. J. McGee. |
| Washington, D. C., July 24, 1883. |
INFANTILE DYSPEPSIA.
Messrs. Editors:
Referring to the very interesting passage at arms between Dr. Oswald, representing the natural, and Dr. Black, the anti-natural school of medicine, while not desiring to provoke further controversy, I beg leave to offer a few remarks upon one point at issue, viz., that pertaining to the alimentation of infants. Dr. Black (see October "Popular Science"), while granting the soundness of Dr. Oswald's position as to the "millions of infants who from the moment of birth are overfed and drug-poisoned," viz., that we have here a sufficient cause of dyspepsia, asks: "Well, what of the millions that are not? Are they the ones who do not show any such tendency, despite the fact that some of their progenitors do?" Would Dr. Black have us believe that, outside of "baby-farms," a single babe, of all the millions who live to be born, escapes being constantly overfed and (in consequence) occasionally medicated? I assert that, as to the first count in the indictment, an infant is about as sure to be excessively fed as he is to be born. The only exception in general practice is where the babe is nourished at the breast, and the supply happens to be short of an excess, and even in these cases all haste is made to supplement his natural aliment with the bottle; for mothers are unhappy unless their babies are growing obese at the rate of a pound or more a week. Infants usually measure more round the body, arms, and legs, and weigh more, at some period during their first year—often at six months—than at the age of two and a half or three years. No growing thing, in either the animal or vegetable kingdom, can, under natural conditions, exhibit anything of this sort. Parents, no more than the average "druggist," are aware of the fact that the normal or true growth of an infant is never more than three to five ounces per week, and that all the gain above this is from fat, representing excess, though seldom all of the excess more or less being daily purged away by the bowels, or excreted through other outlets. All this produces or constitutes disease, leads on to sickness, and probably dosing. While we have to admit that only about forty or fifty per cent are, before the age of five years, stamped out by this combination a method of getting rid of the weakling[8] far more cruel than the Spartan plan, of freezing them, or the African, of feeding to the crocodiles ninety-nine in every hundred are made sick by overfeeding, and few of these escape being more or less drugged. Having made the question of infant dietetics a specialty for the past ten years, I find that to hold to cow's milk as the exclusive diet of bottle-babes (a portion of the cream to be removed in case the milk is very rich in this constituent), limiting the number of meals to three, and somewhat restricting the amount at each meal, and allowing nurslings three to five meals (according as the breast may or may not require the "stimulation" of frequent drawing), is an almost absolute guarantee against the gastrointestinal disorders which are popularly supposed to be unavoidable at this period of life.
Considerable restriction is essential with bottle-babies; for a greedy infant will at any age swallow at two "sittings" a full physiological ration for twenty-four hours, and, if there is to be no restriction as to the quantity taken at each meal, no more than two should be offered. Furthermore, every infant who is not fed ad nauseam will be "greedy." In case of infants nourished at the breast, the flow, if excessive, must be diminished by regulating the mother's diet; for in such cases the excess is due to an over-stimulating or slop diet, which affects the nursing-woman as a "driving" diet does our dairy cows, causing a large yield of unnaturally constituted, though perhaps "rich" milk. In order to show the wide contrast between the universal cramming and a truly wholesome diet, I will cite the case of my own infant, now a "stout, strapping boy" of twelve months, who is one of a number known to me as having enjoyed a really fair chance for proving their fitness to survive. His allowance at this time is a coffee-cupful, or about eighteen tablespoonfuls, at each meal. It is usual for infants to swallow as much, often more than, three such cupfuls, every day, at the age of three or four months, except when nausea or lack of appetite prevents. They are either "constantly" fed, or at least have a meal every two or three hours. This is the practice with the "million," by which I presume Dr. Oswald meant all "civilized" infants, including Dr. Black's, if he has been blessed with such "troublesome comforts," as they are universally called—a term, by-the-way, in itself very significant in this connection; for, again referring to the few infants who have been exceptinoally fed, "breathed," clad, and exercised, i. e.—1. Fed in the manner I have described as constituting a physiological diet; 2. Given the breath of life, viz., out-door air twenty-four hours a day, whether the babe is in-doors or out; 3. Saved from sweltering clothing—allowing the skin to "breathe"; 4. Rationally "neglected," or, in other words, instead of being constantly held, tended, or wheeled, early allowed the opportunity, on the floor or lawn, of rolling, tumbling, stretching out, and learning to creep at an early age, thus earning a good digestion, and avoiding one of the principal causes of infantile dyspepsia, by being, like kittens, puppies, and young monkeys, largely "self-supporting," and like them developing naturally in all parts of the frame—by these means, I would say, it has been shown to be entirely practicable to insure for the "infant race" a condition as comfortable, happy, and thrifty, as that enjoyed by the most fortunate of the nurslings of our domestic animals or household pets.
If in order, I would also venture to cite a case of gastric cramps similar to that mentioned by Dr. Black, but more "naturally" cured. I was called one day during the past summer to the bedside of an old lady friend, who is sixty-six years of age, and very frail. She was suffering intensely from acute dyspepsia. "Well, doctor," she moaned, between the spasms, "you—will—have—to—give—me—some—medicine—this-time!" "Very good," I replied, "here it is." (Having obtained a hint from the nurse as to the state of affairs, I had ordered up a pitcher each of hot and cold water.) "Just drink this cupful of warm water. Take it right down, please, as if it were a delicious draught, and you were feeling very thirsty." This she did, and then another and another, and so on until she had, within twenty minutes, taken eight full cups. Then I asked her to make a slight exploration to see if she could touch that warm water with her forefinger! She made the attempt and succeeded—the water meeting her more than half-way. Along with the water came the cause of the cramps, in the shape of undigested food. Directly after this she swallowed, though under protest, seven cupfuls more of the same safe remedy, which had just the effect I anticipated. She soon became entirely at ease, rested quietly for the balance of the afternoon, slept soundly that night, and awoke next morning to laugh over the experience of the day before. There was no poison taken to tax the organism. The water did its perfect work—washing the stomach, diluting the blood, and aiding in the elimination of impurities, instead of adding to them in the least degree.
| C. E. Page. |
| New York, September 17, 1883. |
- ↑ "To what errors have not mankind been led in the employment and denomination of medicines! They created deobstruents when the theory of obstruction was in fashion; and incisives when that of the thickening of the humors prevailed. Those who saw in diseases only a relaxation or tension of the fibers employed astringents and relaxants. The same identical remedies have been employed with all these opposite views. . . . Hence the vagueness and uncertainty our science presents at this day. An incoherent assemblage of incoherent opinions, it is. perhaps, of all the physiological sciences, that which best shows the caprices of the human mind. What do I say? For a methodical mind it is not a science at all. It is a shapeless collection of inaccurate ideas; of observations often puerile; of deceptive remedies, and of formulas as fantastically conceived as they are tediously arranged."
- ↑ "If we reflect upon the obstinate health of animals and savages, upon the rapidity of their recovery from injuries that defy all the mixtures of materia medica: also upon the fact that the homœopathists cure their patients with milk-sugar and mummery, the prayer-Christians with mummery without milk-sugar, and my followers with a milk-diet without sugar or mummery the conclusion forces itself upon us that the entire system of therapeutics is founded upon an erroneous view of disease "
- ↑ "I hesitate not to declare, no matter how sorely I shall wound our vanity, that so gross is our ignorance of the real nature of the physiological disorders called diseases, that it would perhaps he better to do nothing, and resign the complaint we are called upon to treat to the resources of Nature, than to act, as we are so often compelled to do, without knowing the why and the wherefore of our conduct, and at the obvious risk of hastening the end of the patient."
- ↑ "By special methods of diet nearly all known diseases can be cured as well as caused. . . . Twenty-five years' experience at the sick-bed and the dissecting-table, in the nursery and on the battlefield, have convinced me that, "with rare exceptions, the disorders of the human body, which have been treated after such an infinite variety of drug-systems, can be as well cured without any drugs at all"
- ↑ "Our system of therapeutics is so shaky" (vacillant) "that the soundness of the basis itself must be suspected."
- ↑ "It is unnecessary for my present purpose to give a particular account of the results of homœopathy; . . . what I now claim with respect to it is, that a wise and beneficent Providence is using it to expose and break up a deep delusion. In the results of homœopathic practice we have evidence, in amount and of a character sufficient, most incontestably to establish the fact that disease is a restorative operation, or renovating process, and that medicine has deceived us. The evidence is full and complete. It does not merely consist of a few isolated cases, whose recovery might be attributed to fortuitous circumstances, but it is a chain of testimony fortified by every possible circumstance. . . . All kinds and grades of disease have passed under the ordeal and all classes and characters of persons have been concerned in the experiment as patients or witnesses; . . . while the process of infinitesimally attenuating the drugs used was carried to such a ridiculous extent that no one will, on sober reflection, attribute any portion of the, cure to the medicine. I claim, then, that homœopathy may be regarded as a providential sealing of the fate of old medical views and practices."
- ↑ "I am here incessantly led to make an apology for the instability of the theories and practice of physic; and those physicians generally become the most eminent who have the soonest emancipated themselves from the tyranny of the schools of physic. Dissections daily convince us of our ignorance of disease, and cause us to blush at our prescriptions. What mischief have we done under the belief of false facts and false theories! We have assisted in multiplying diseases; we have done more, we have increased their mortality. I will not pause to beg pardon of the faculty for acknowledging, in this public manner, the weakness of our profession. I am pursuing Truth, and am indifferent whither I am led, if she only is my leader."
- ↑ Quoth Dr. Black. "Now, we nurse them (the weaklings) to adult life!" In fact, only about fifty to sixty per cent of all infants arrive at adult age, and these have been fitly described as "too tough to kill." Even these, to the last one, would make healthier men and women, if saved the abuses we have named.