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Arnold Lorand.

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always, as already mentioned, it may be traced to certain of
our own actions.



CHAPTER LIII.
Disease Considered as a Self-defence of Nature.

Many a man bemoans his fate when bed-ridden and tor-
tured by pain, and yet we cannot fail to recognize, upon further
consideration, that such suffering often serves but to pave the
way for recovery. Very frequently the advent of slight pain is
the earliest indication that something in our organism is amiss,
and promptly leads us to think of measures for the prevention of
further trouble. A sickness can often be controlled at the outset
upon using proper measures, and thus entirely averted. Severe
pains not infrequently mean the saving of life, since they compel
indolent or careless persons to seek the physician's help while
there is still time. How few persons, indeed, would consult the
doctors and discontinue excessive eating, were they not forced to
do so by their aches and pains.

Not a few diseases are to be classed as serious and dangerous
to life owing to the fact that, of themselves, they do not give rise
to discomfort, and lull their victims into a false sense of security.
Many a diabetic would live longer, were he reminded by torment-
ing pains of the necessity of careful treatment and restriction in
his diet. Thus even pain is of service to mankind.

Other annoying symptoms of disease must also be regarded
as expressions of nature's efforts towards self-cure. When a
person makes use of an article of food that has undergone deteri-
oration, nature often endeavors to remove it by an evacuation
of the intestinal canal. Again, no harm is done when a glutton
at length upsets his stomach, loses his appetite, and allows the
ill-used organ to rest. And he is being let off cheaply, if his over-
burdened stomach procures its own relief by vomiting. When a
person has an attack of gout and sweats profusely, noxious

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420 Old Age Deferred.



substances are likewise eliminated thereby. When the illness is
over, however, one feels not infrequently all the more fresh and
rested after convalescence, whence the ancient Greeks not incor-
rectly said: "To 7ra0os taT/sos err*."

Indeed that sickness is oftentimes directly beneficial in its
effects is a matter of frequent observation. If, for example, a
markedly obese person becomes diabetic— in such cases the
disease appears in a mild form, as a rule, — his chances of long
life are thereby not infrequently improved. I observed this in the
case of an American lady who weighed 162 kilogrammes (357
pounds). The mild form of diabetes which this lady developed
was certainly not to her detriment, for whilst she could lose
weight as a result and live for a long period, her situation would
have been far different had the obesity progressed still further.

We have already endeavored to show that fever is in reality
an expression of efforts of the body at self-healing, as we like-
wise maintained with reference to skin affections. So, too, the
syphilitic patient who exhibits diffuse skin-eruptions, as well as
other localized manifestations in the peripheral tissues, has a
better outlook with respect to the dreadful nervous consequences
of this disease than one who never exhibits the outer signs of the
infection.

We perceive, therefore, that that which we call disease is
nought else but nature's attempt to attain health — a kind of
defensive reaction against harmful substances. The disease
proper has often already been present for some time; it already
exists at the very instant in which the invading foe makes its
entrance into the body. Between this time and the moment when
the reaction of the body, — that is, what we are in the habit of
calling the disease, — appears, a considerable period may fre-
quently elapse ; oftentimes it may even extend through several
years, as in leprosy or in the sleeping sickness. It would thus be
entirely rational to interfere at a time when the enemy has not
yet penetrated into the body. Unfortunately the signs which
might acquaint us with its presence have not at that time found



Disease as a Self-defence. 421

distinctive expression. Vague symptoms such as mild headache,
want of appetite, lassitude, low spirits, etc., may alone exist, and
yet it is necessary that even these should be watched for. Already
in this period it would be advisable to seek the physician's aid, and
if many be deterred therefrom because of the expense involved, it
should be recalled that oftentimes fifty visits cannot procure the
result which might have been obtained by a few preventive
measures. Thus the very mildest symptoms of illness are not
to be disregarded, — a fact with which children in particular must
be impressed. Older persons and teachers should likewise be
made familiar with* this precept. What a multitude of human
lives could be saved in this way!

But in order to recognize the slightest indications of an
approaching illness, deviations from the normal state of health
would have to be closely studied. The science which apprises
us of the functions of normal organs would have to be given
more extensive recognition, and physiology would have to become
the basis of the physician's every thought and method of treat-
ment. The system prevailing among the Chinese, who in many
ways surpass us in logic, and who pay the doctor only so long as
they are in health, is thus not so unreasonable. The best plan
of all would be for each family to have its own house-physician,
whom it could consult regularly, especially if there be children;
for such a person alone is capable of recognizing the earliest
deviations from the normal. The prevention of disease would
have to constitute the basis of all our therapeutic endeavors.

In order to become of real assistance to Nature, however,
the physician must be continually following in the wake of her
efforts to secure health. If the defensive reaction brought about
by Nature against toxic materials is too feeble, he must assist
her by proper remedies. Thus when the use of spoiled food is
followed by diarrhoea, he must not arrest the latter ; otherwise he
would, indeed, be locking the wolf in with the sheep. On the
contrary, he must imitate Nature and accordingly administer a
purgative. Again, if on taking cold or during a gouty attack a



422 Old Age Deferred.



person falls into a profuse sweat, it would certainly be illogical
to administer a remedy to counteract this beneficent influence;
another means of producing perspiration should rather be availed
of, as, for example, the salicylates. If, on the other hand, the
reaction is too strongly marked, as, for instance, in a young girl
with very active thyroid gland, who in consequence of typhoid
exhibits a dangerous rise of temperature or hyperpyrexia, then
the physician must put on the brakes and save her life by appro-
priate antipyretic measures.

In view of the above deductions, it is not unjustifiable to
believe that the symptoms of disease, i.e., what we designate as
disease, together with many other supposed ills, in reality con-
tribute toward the preservation of mankind.



CHAPTER LIV.
Hygiene of the Mind — Advice to Brain Workers.

Scholars, who live entirely from the product of their mental
labors, often do not present a healthy appearance, and are not
infrequently subject to nervous, gastric or intestinal disorders,
chronic constipation, etc. In laborious mental activity an exces-
sive amount of blood flows to the brain, that of other organs
being withdrawn, and thus diminished formation of gastric juice
is favored and the appetite reduced. Intellectual activity should,
if possible, be suspended a full hour before and after meals.
Congestion of the brain likewise interferes with proper sleep,
which, as a rule, can only become truly deep when the brain is
bloodless. Intellectual efforts should therefore be avoided for a
period of one to two hours before going to bed, and especially
one should not read in bed.

After a good night's sleep the brain is adequately rested and
hence capable of doing the most work. For this reason the
morning hours are the best of all for mental labor ; the very early
hours have the additional advantage of absolute quiet and
freedom from disturbance. Personally I work preferably from
5 to 8 o'clock in the morning, especially in the winter time when
one cannot well go out walking so early.

In a previous chapter I mentioned the fact that organs upon
which great demands are made more readily become the seat of
arteriosclerosis because of the abundant flow of blood to them. In
persons of great intellectual activity we accordingly find marked
sclerosis of the cerebral arteries, especially if they have the
bad habit of smoking and drinking excessively. Besides, drinking
interferes with the quality of work done. The influence of smok-
ing in the production of arteriosclerosis we have already dis-

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424 Old Age Deferred.



cussed. Under normal conditions intellectual workers can live
to an advanced age — this we know from numerous celebrated
instances: Hippocrates, Democritus, Plato, Plutarch, Leibnitz,
Newton, Galileo, Michael Angelo, Carlyle, etc. Socrates wrote
his Panathenae in his 94th year, the celebrated Dr. Hufeland the
fifth edition of his "Makrobiotik" at a ripe old age, while Goethe's
powers of execution remained to the last undiminished. Recently
I received from an English colleague 80 years of age, who had
attained eminence by his studies on metabolism, an excellent work
on diabetes, which he had just brought out.

With but very few exceptions, we find that the great master-
intellects who attained to an advanced age led lives of modera-
tion in every respect — not only as to their bodies, but also their
minds. Whoever lives as hygienically as did Newton, can, like'
him, become very old in spite of bodily weakness. Newton was
a very frugal eater, had no passions and never worked until
over-fatigued. Not to work to excess, to permit one's self to rest
at the proper time — this is the chief precept in the hygiene of
the mind. The brain requires rest even more than any other
organ from which great activity is demanded. One should not
work more than a few hours at a stretch.

I strongly recommend going to bed at ten or eleven o'clock,
rising at five to half-past six o'clock, and then after refreshing
one's self, at once settling down to work. Breakfast may be
eaten at about eight o'clock. A walk should then be taken before
going back to work, which should be interrupted an hour before
dinner-time and only resumed an hour after the meal. In the
warmer seasons it is best to work in the garden or in the woods
whenever the nature of the work permits. It is advisable to leave
off one hour before supper, and then, as a general rule, do nothing
further, but take a walk, if possible also before supper. In
general, mental workers need plenty of exercise in the open air;
especially in the woods or elsewhere in the midst of foliage is the
flow of ideas more easily aroused. When it is not too hot, one
may sit out in the sun while working, though the eyes and the



Advice to Brain Workers. 425

book or paper should be shaded. The combination of pure air,
sunshine, and mental occupation is of great value. Laboratories
and libraries should be so disposed as to correspond strictly to all
rules of hygiene regarding air and light.

In winter time one gains distraction by visiting friends,
attending society meetings, concerts, theatres, etc. In every
season of the year it would be well to spend Sundays in the
country. It is necessary, likewise, to follow the general rules of
hygiene. Insofar as the diet is concerned it is strongly to be
recommended during heavy mental labor, especially where much
thinking is required, that meat-eating be given up and a vegeta-
rian diet, with the addition of milk products and eggs, adopted.
At any rate, a diet rich in meats must be avoided ; it not only
makes one heavy and dull, but also creates a want for alcohol,
coffee, tobacco and other unwholesome stimulants, for which a
diet containing little or no meat need evoke no desire.

Regularity and moderation heighten the expectations of long
life in mental workers and guard against the premature failure
of the intellectual powers which must sooner or later follow upon
overwork. This not infrequently happens quite early in life.
Boerhave could already cite two such cases ; "I have known a
young man who knew everything and was a prodigy of learning,
but who hardly lived to the age of 25, and another who worked
day and night with the industry of a bee, and without any
definite illness died in his nineteenth year in a state of emacia-
tion." In common with scholars and men of letters physicians
must take particular care of themselves, their brains being con-
tinually on a stretch. The efforts they make to prolong the lives
of others shorten their own — the irony of fate! Few callings
demand as much mental work as that of the medical man. We
physicians often have to deal with infectious diseases; since the
continued mental strain is capable of injuring our bodily health
and hence diminishing our resisting power against infections, it
is advisable for us as far as possible to avoid all harmful influ-
ences,— and especially excess of any kind.



CHAPTER LV.

On the Prevention of Premature Old Age, and the Treat-
ment of Old Age, through Certain Drugs :
Arsenic, Iron, and Iodides.

It can often be observed that people who habitually take
arsenic, either for medicinal or other purposes, look better and
younger; and we have, ourselves, noted in some of them a dis-
appearance of wrinkles. Wrinkles are caused by the loss of the
fatty tissue from under the skin, and as arsenic causes an increase
of fat in the tissues it may improve such a condition.

As is well known in some parts of Europe, notably in
Styria, the habit of eating arsenic is very prevalent among the
peasants; and it is strange to note that most of these people live
to a great age, and at the same time are extremely immune
to all kinds of bodily fatigue — for instance, they can climb
the highest peaks in their native mountainous country without
great exertion. They take arsenic because it enables them to
undertake harder work, such as climbing, with greater ease, and
also improves their appearance.

We have known several ladies, famous actresses among
them, who have indulged in this habit from vanity. A very
interesting case was tried, about ten years ago, before an Aus-
trian court of justice, in which a servant girl tried to poison her
mistress by arsenic in small quantities. To the dismay of the
servant, however, the lady continued to become more beautiful;
so the murderess determined to give a larger dose, which in-
duced grave symptoms of intoxication, and caused the discov-
ery of the plot.

It is equally well known that animals obtain a glossy and
sleek coat through the administration of arsenic in small quan-
tities.

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Prevention of Premature Old Age Through Drugs. 427

There can be no doubt that when arsenic is taken in small
quantities it may prove of therapeutic value against old age;
but as very aged people are often antagonistic to its use, it would
seem to offer better results if used as a preventive against
premature old age rather than as a cure after old age had much
advanced.

As arsenic can give good results, especially in combination
with iron, in anaemia, and also in neurasthenia and hysteria, we
think that its use would be particularly beneficial in women near
the forties, and especially during the years before and after the
climacteric until about the sixtieth year. According to Grawitz,
arsenic acts better than iron in the anaemia of the aged.

Arsenical treatment has given us excellent results also in
nervous troubles of women at a much earlier age. It has often
produced an increase in the weight and an improvement in the
personal appearance of our patients.

As, according to Gauthier 1 and Bertrand, the thyroid gland
contains arsenic, we are thus administering an important ele-
ment of this gland. The observation of Dr. Sajous 2 is of great
importance, that arsenic dilates the arterioles. Indeed, we have
also made similar observations; thus we found after the use of
arsenic in several cases a higher vascular pressure and irregulari-
ties of the pulse similar to those occurring after tobacco smoking,
which, as shown before, has also a stimulating action upon the
adrenals. In a few cases there was also pigmentation of the
skin. By using arsenic while taking thyroid extracts we stimu-
late the antagonists of the thyroid, the adrenals; and thus the
symptoms of hyperthyroidia can be avoided by simultaneously
giving arsenic in small doses. As we shall, in the next chapter,
recommend the use of thyroid extracts in the prevention of
premature old age, and in the treatment of old age, this simul-
taneous use of arsenic can increase the benefit of such treat-
ment; but for the purpose in question arsenic should be given



1 Revue de Medecine Bulletin Acadgmie de Medecine, vol. xliii, p. 116, 1900

2 Sajous: "Internal Secretions," vol. ii, p. 1.312, 1907.



428 Old Age Deferred.



in the smallest possible closes, as Fowler's solution, beginning
with 3 drops and increasing to not more than 5 or 6 drops per
day, by slow and gradual degrees, and then decreasing slowly
again, but not for longer than for three or four weeks altogether.
In women something more could be given. Far better than
Fowler's solution would be the various mineral waters that con-
tain the most useful form of arsenic, as such waters usually con-
tain also iron, which still further increases their value. Such
mineral waters can be found in various countries, viz. : in Aus-
tria, in the Tyrol : Levico, very rich in arsenic and iron, and
Roncegno, rich in arsenic ; in Bosnia : Guberquelle, very rich in
iron; in Switzerland: Val' Sinistra; in PVance: Royat, Bour-
boule, etc. They are absolutely innocuous if taken under medical
care. We must begin by taking one tablespoonful of these
arsenical waters, and gradually increase to five or six tablespoon-
fuls a day, when we must then again gradually diminish the
amount.

By taking such waters, increasing slowly and gradually
and then decreasing in a similar way, the most efficacious arsenic
and iron treatment can be obtained, and a simultaneous thyroid
treatment better endured. It is better to take such remedies
after meals, and the patient must be kept under constant medical
supervision, just as they are during iodine or thyroid treatment.

We have often observed that women, especially in the
forties or fifties, looked much younger after a treatment by iron
preparations, particularly when in combination with iron and
arsenic; mineral mud baths, containing much iron, have been
used; and we are quite emphatic in asserting that such treat-
ment, possibly more in women than in men, though in these we
have not infrequently noted the same results, is able to improve
the symptoms of old age; for we have had opportunities of
observing this in many cases, sometimes even in women at the
beginning of the sixties.

The best results can be observed in women between 30 and
60, even though they sometimes have no previous anaemia, who



Prevention of Premature Old Age Through Drugs. 429

look much healthier after such a combined iron, arsenic, mineral
water, and mud-bath treatment. In men similar results have
been noted; but in the case of women it must be regarded as a
specific.

In the same way as iodides act on the thyroid, we are in-
clined to think that arsenic and iron are specifics to promote a
better action of the sexual glands, especially the ovaries, and
probably also of the adrenals.

According to Professor von Noorden 3 and other authors,
chlorosis is due to a degenerated condition of the ovaries. But
the adrenals also may be altered, causing the great muscular weak-
ness of chlorotic girls. Thus Dr. Sajous 4 has attributed chlo-
rosis to adrenal degeneration. If, as observed for centuries,
arsenic and iron are specifics in augmenting haemoglobin in the
blood, it is a question whether this effect is obtained by the action
of these preparations upon the ovaries, or upon the adrenals, as
advocated by Dr. Sajous. 5 The probability is that they act upon
both glands. Mud baths which are rich in iron are especially
potent and successful against chlorosis and anaemic conditions,
and at the same time against ailments of the ovaries and uterus,
as is well known to gynaecologists. Iron seems also to exercise
beneficent action on the male sexual glands. Impotency, as we
have also seen, can often be improved by iron preparations, or
by mineral waters containing iron and arsenic. Hysteria, as
ancient physicians supposed it to be, and as we have tried to
show, 6 is due, in great probability, very frequently to alterations
in the female sexual organs, and iron treatment, especially arsenic
and iron mineral waters, improves many cases.

As well known to urologists, the general condition in cases
of chronic posterior gonorrhoea, and in prostate troubles from



3 v. ' Noorden : "Die Bleichsucht" Nothnagel's "Handbuch der pract
Medicin."

4 Sajous : "Internal Secretions," vol. i, p. 87, Philadelphia, 1903.

5 hoc. cit., p. 95.

6 Congress of Belgian Neurologists, 1906.



430 Old Age Deferred.



such a cause, is often improved through iron treatment; as also
is neurasthenia, even though some cases are not in etiological
relation with such a cause.

We must thus consider iron, especially when in combination
with arsenic, as one means of improving the condition of the
sexual organs judging from the foregoing reported clinical
observations. The fact that iron of itself is no longer regarded
as being useful in senility — i.e., when the sexual glands are more
or less degenerated — points to the value of its combination with
arsenic. We consider iron, especially in the form of the easily
absorbed iron mineral waters, and in the form of the iron con-
tained in mud baths, as a valuable means for the prevention
of premature old age, and for the treatment of old age. Iron,
and especially inorganic iron, is indicated as a preventive of old
age for the reason that it stimulates to greater activity the blood
forming organs, as has been shown by Harnack and von
Noorden. It is a fact, upon which we have already insisted, that
the organs which control the condition of the bone marrow, the
seat of the blood forming mechanism — i.e., the thyroid and the
ovaries, — are degenerated in old age. Iron acts upon the bone
marrow through the intermediate agency of these glandular
structures.

It can be administered in the form of the perchloride or of
other inorganic preparations. According to Bunge, organic iron
preparations and iron contained in food have the advantage of
being more readily absorbed and assimilated. (See chapter on
the blood as an article of iron-containing food.) But Grawitz
still prefers to prescribe inorganic iron, such as reduced iron or
perchloride of iron. An old iron preparation of great efficacy is
the Blaud pills.

A very successful method of iron treatment is by mineral
waters which are rich in iron — in Austria, Franzersbad; in
Germany, Langenswalbach. We prefer such waters as contain
arsenic besides iron, as already mentioned.

When mud baths are used simultaneously, it will be advis-



Prevention of Premature Old Age Through Drugs. 431

able not to take thyroid extracts also; but to await doing so till
after the course of baths is finished.

Increase of fat and of connective tissue are the most typical
and anatomo-pathological changes in the tissues produced by
old age. It is evident that drugs which can combat these
changes are also able to treat and improve the condition of old
age. There is no inorganic drug which can give such good
results in these conditions, according to our present knowledge,
as the iodides. It is generally believed that through the use of
potassium iodide we are able to diminish fat in many cases. The
increase of connective tissue in different organs, that takes place
in the cirrhosis of these organs, has also been treated by iodides
with success, according to some authorities, and, according to
others, without any. At any rate, in arteriosclerosis there can be
no doubt that iodides do give good results as they facilitate the
circulation of the blood by diminishing its viscosity. According
to Heinz, 7 iodides can combat connective tissue hypertrophy by
rendering the vessel walls more permeable. They also increase



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