James Rush Black

“ Passing over the evidence which has convinced those the most competent to judge in reference to the prevalence of disease—the physicians—to their conclusion, that if all possessed good constitutions, and lived as they ought to live, in accordance with hygienic law, there would be no disease, or next to none, and death would not come upon the human family through a morbid process, but by the only truly natural mode of dying—old age; the question arises, How do men come by good constitutions? ”

“ We have said that the applications of sanitary science must be made mainly by the individual members of society. This is true of the kind of air breathed, of the food and drinks partaken, of the clothing worn, etc., etc. But where human beings are clustered together, their sanitary relations are so intimate that it becomes absolutely necessary for the general good to define and regulate some sanitary matters by law, which each member of a community cannot, as an individual, regulate for himself. ”

“ Its truths, if applied at all, must be mainly applied by those who desire its benefits; or every one must apply the science for himself or herself, else nearly all the knowledge there may be on the subject will be as if it were not. Here we have plainly before the mind the great and peculiarly weak point, so far as the practical benefits are concerned, which this science may be capable of conferring. To make it profitable and useful, or, in other words, to make it an applied science in a community, that community must be made, one and all, experts in its knowledge and in its applications. ”

“ Then the observance of the true conditions which favor reversion in an inherited diathesis require no little judgment, self-denial, patience, and intelligence. In acute disease the physician and nurse see that the conditions of reversion are duly observed. Reputation, love, and alarm are all brought to bear for their enforcement. In a diathesis none of these are evoked until the development of all its signs renders the fact apparent that the fatal work has reached its culminating stage. The diathetic subject while in good health is himself indifferent and incredulous as to his danger. ”

“ There is absolutely no difference, except in the matter of will, between the danger of allowing a person who has a mania for putting poison into the drinking-water of a city, by which many perish, and one who puts the poison of small-pox into the air of a city by which hundreds are slain. ”

“ A blood-vessel of the brain, from causes which will presently be mentioned, has lost some of its elastic strength; food is abundant, digestion is good; blood is made in abundance, but little is worked off by exercise; the tension on every artery and vein is at a maximum rate; the even, circuitous flow is temporarily impeded at some point, throwing a dangerous pressure on another; the vessel which has lost its elastic strength gives way, blood is poured out, a clot is formed, which, by its pressure on the brain, produces complete unconsciousness. ”

“ The few who make diligent efforts to apply the rules of sanity are powerless in removing the obvious causes of the prevailing misery and death-gloom, and, like Lot, for safety, must flee the city.
With a private and public hygiene thoroughly understood and effectively maintained, there is not an intelligent physician in our land who would not acknowledge that the result would be to diminish the prevalence of disease at least one-half, and to send the average expectation of life, at a bound, up a decade of years. ”

“ It is all well enough for the young to learn more or less about the philosophy of electricity and magnetism, but, as the great majority of them in after-life will make very little, if any, use of this knowledge, its importance practically dwindles to very small proportions. Wholly different is it in the case of sanitary science. Every one can make of it in after-life most important, and ultimately momentous uses, not occasionally, but during every day and hour of life. ”

“ The nearer the approach to physical perfection, the less likely will be the occurrence of derangement and disease from slight causes, such as atmospheric vicissitudes, and the greater the chances that the termination of life will be natural, or from the harmonious, progressive, and painless decay of the body as a whole. Death by disease through one organ is abnormal, violent, and torturing; there should be no weak points in the citadel of life. Men with excellent physical organizations do not need to be ever on the watch for the preservation of their health. ”

“ Indeed, there is scarcely any room for doubt that, if our senses were far more acute, a diathesis or tendency to some special disease would be disclosed in definite signs of imperfection, or of disorder. A diathesis is often seen gradually merging into development, and development into a diathesis, and the frequency with which this is seen to recur in the same person gives tone to the conclusion that the letter state is only a very mild or occult phase of the former. ”

“ Not so much by plain evidences to the senses as by mental analysis can the reality of a struggle between a diathesis and reversion to the normal type be apprehended. Yet it is only the vis medicatrix naturæ of medical writers carried from the very obvious in acute disease to the less perceptible in chronic, and to the imperceptible in the diathetic. Although the opinion is very generally entertained that those who inherit a diathesis should be careful as to their mode of life, what effect there is on practice is commonly more injurious than beneficial. ”

“ The instances in which the operation of the law of reversion has had anything like an unimpeded sway are far more commonly casual than designed. Circumstances render a change of environment and habits of life necessary or desirable, and these may happen to include its favoring conditions, or they may not. Those who recover from the tendency to an abnormal inheritance through intelligent design ought to be found, if anywhere, in the ranks of the medical profession, and especially among those of them who have given the science of health no little attention. ”

“ Yet the father and mother with this taint in their and their children's veins, realizing that their boys and girls are delicate, from the moment of birth upward seclude them far more than ordinary in close, ill-ventilated rooms, they coddle and pamper them with unwholesome delicacies, and in effect carefully attend to the very conditions which secure weak and foul air as nutriment for their lungs and blood. Thus it is that the precise causes which originate the defect are with more than ordinary assiduity kept in constant action, and the tendency to reversion utterly overwhelmed. ”

“ The frequency with which the principle of reversion gains the mastery in attacks of acute disease is one of the most striking phases of vital action. Form and function are seen to revert to their old types and channels of action as if they had never nearly perished. The struggle against abnormal variations is violent, continuous, but not prolonged. Either the abnormity or reversion quickly gains the mastery; in the former case the end is dissolution, in the latter health. In some instances the morbid variation is slow, insidious, or mild in nature ”

“ The physician of to-day, who has devoted half as much thought to the prevention of disease as to its cure, firmly believes in human ability to avoid nearly all the ills to which flesh is now subject. Given a good constitution, and the conditions of health or sickness are almost wholly in our own power. ”

“ As acute diseases are only compatible with life for short periods, they are rarely transmitted; in fact, they are excluded from the list of diseases properly inheritable. The open chronic forms of disease, such as scrofula and syphilis, are not unfrequently handed down to the offspring, but far oftener is the heritage of the diathetic grade. This is better tolerated, or more compatible with the continuance of the life in the blood than the open chronic forms which quite commonly render the procreative act abortive. ”

“ IF there is any one disease that the diligent brain-worker, a little past middle life, has reason to fear, it is apoplexy. Although statistical evidence is wanting, the experience of the physician confirms the popular belief that more of our distinguished men are carried off by this disease, or by one of its sequels, paralysis, than by any other cause. ”

“ When the abnormal variation gains the mastery, it does not survive or establish its fitness by indefinite perpetuation, and so acquire the prepotency of reversion. Untimely death is the signal and sequel of its mastery, and until this or reversion gains supremacy no peace or continued harmony of action is possible. True, blood affected by a morbid variation chronic in its nature often displays sluggish and varying fortunes in its struggle with reversion for mastery ”

“ Morbid variations of structure and function present three leading phases of action, the acute, chronic, and diathetic. The primary causes of each are the same, a faulty personal hygiene and an unfavorable environment, but a derivative cause very generally predominates in the heritage of a defect or taint in the blood. In acute variations the struggle between the tendency to death and the tendency to reversion is usually short and severe, but decisive. The contending forces are often so nearly equal that a very little will turn the scale one way or the other. ”

“ In very many instances the overshadowing heritage is toward an untimely death, while in others it is simply toward some chronic insufficiency which embitters many a year of life.
The number who think themselves doomed to a premature death by some innate blood defect is very great. At this moment hundreds of thousands are ready to interpret every sign of thoracic derangement as the harbinger to the development of that dreaded inheritance—pulmonary consumption. ”

“ The genius each displays differs from the other: the one being delighted in finding out and making his way into the unknown, while the pleasure of the other consists in seizing results, and putting them into shape, so that they may be servants to our will. ”

“ IN the intellectual field there are two distinct classes of laborers: the discoverers, or those who pursue science for its own sake; and the appliers, or those who seek to make the knowledge it confers useful, and so turn it into a direct source of profit to themselves, and, in a general way, to the public. ”

“ Reverting to the history of electrical discovery and its applications, will give us aid in solving the question. We have seen that the discovery of the great truths about the electrical force employed one class of scientific experts, and applying these truths employed another class of scientific experts. Now, we have had in abundance the discoverers of the truths of sanitary law, but we have not, nor can we have, as in electricity, experts who can carry out for the advantage of all, the benefits which hygienic law is capable of conferring. ”

“ No other part of the body is subject to such droughts and floods in its blood-circulation. This inequality is yet further increased by severe mind-labor. The ardent student is well aware that deep thought heats the head and cools the feet. ”

“ Any ordinary observer, with a predisposition to some disorder, is aware that very slight exciting causes usually serve sufficiently to increase the imperceptible imperfection as to bring it within the cognizance of the senses. But there is yet more indubitable evidence that a series of morbid changes may be going on in the body of which no cognizance can be taken. During the incubative stages of scarlet fever, measles, small-pox, and syphilis, the contagium of each has a definite period of maturative action before the signs of disease are in any way apparent. ”

“ Yet even this has an outcome not to be deplored. High intelligence, and a will subordinate to it, will survive; while feeble minds and groveling instincts will carry the blood on to overt disease, to untimely death, and to extinction. ”

“ Great care in acute diseases is commonly taken that the third factor shall not turn the scale against the tendency to reversion, far less is expert systematic supervision as to this brought to bear in chronic disease, while in the diathetic there is as a rule worse than a fitful, or no care—the misjudged application of causes best calculated to increase and intensify the defect or taint in the blood. ”

“ On the other hand, those defectively organized can not overstep the bounds of the most watchful prudence without incurring suffering. Only by the most minute and accurate knowledge of hygiene, and unswerving attention to its requirements, are they enabled to avoid pain, disease, and an untimely end.
The genius of our civilization in its physiological aspect is to make spendthrifts of us all of our vital riches. It includes no such aim as race improvement. True, some youthful culture of the head and heart is supposed to reach after that object. ”

“ Optimists assure us that even if insanity, idiocy, deaf-mutism, blindness, and intractable disease and deformity be upon the increase, the evil is not unmingled with good, as it at once serves the twofold purpose of illustrating and exercising the benevolence of the age. ”

“ If the refuse matter and excreta of a city are not promptly and carefully removed; if the streets are not of the proper width, and regularly cleansed; if houses are allowed to be so constructed that effective ventilation is impossible; if the water-supply is insufficient, or tainted with organic matter; and if persons are allowed free entrance, suffering with dangerous infectious diseases, and no well-directed efforts are made to destroy the noxious matters thus introduced, misery, disease, and a fearful rate of mortality, will be the normal results. ”