T. Bodley Scott

“ Are we justified in regarding arterio-sclerosis as a true disease? I think not. One cannot justly compare it with entity diseases, such as the acute infections, as cancer, as tuberculosis, or the diseases that affect the brain and the spinal cord. It is, I think, one of the penalties of an artificial over-civilization, of social, business and competitive pressure, unwise in quantity and unscientific in method.52 Unfitted, as yet, in development, and lacking the necessary knowledge, men strive after a higher stage of evolution, or after illusions which they think to be so. ”

“ In the practice of medicine we must be prepared to maintain our position and to give a reason for the faith that is in us, for the issues are so great and affect others rather than ourselves.
I have said that this is somewhat of an occupation disease: it is a vicious circle, not originating necessarily in any vice, but in the pressure of life and the stress of circumstances. The causes often we cannot remove entirely, but only modify, and so we are compelled to treat symptoms only; our ambition and longing will be to do much more than this—to bring about a perfect reform ”

“ We must nevertheless be optimistic, and hope that the great advance in science may soon make life easier, and the food of the world once again sufficient for its inhabitants; then, please God, materialism may shrink into the background and things spiritual come into their own. Not, however, by a reformed and wiser life alone do I hope to show the more excellent way, but to show that modern science has placed in our hands a preventer of decay and a prolonger of life and energy. ”

“ Surely the fact of our life, the gift of our life,18 becomes a great personal responsibility, an acknowledged debt to our Maker that we can only repay by regarding it as a treasure to be daily cared for and cherished. Thus the promotion of health and the prevention of disease must manifestly be our first considerations, for without health our output of work ceases, or becomes both in quantity and character a poor thing. ”

“ We purposely side-track the worn-out thyroid of sclerosis and senility, and, by thyroid feeding, restore to a great extent the whole endocrine harmony, thus giving a new tone and stimulus to existence. We shall have to use more or less thyroid feeding for the remainder of life, but we must show our patients that it is not a medicine but a necessary food. As in myxœdema, so in sclerosis, thyroid feeding is the only means, as yet known, of producing absorption of those thickenings that characterize both diseases. ”

“ To attain their “ambitious” ends they live and work intensely, stoking their furnaces with far too much food, alcohol and other unnatural stimulants. Intemperate in work, intemperate in living, prodigal in waste, they come to an untimely end.
Such is the description of one type of case that we often meet, but there is another and a sadder class, where unfavourable circumstances through the greater part of life, pressure of poverty and ceaseless anxiety for others, produce a careworn existence, with no joy or colour in it, and often insomnia. ”

“ The history of the world right up to the present time has shown the futility of dividuality as against individuality both in politics and religion. The greater part of our Christian teaching is against separateness, and towards mutual love, consideration, and help. For this reason I have tried to write so that all may grasp the hope and possibility of a longer and more effectual life. Co-operation is the watchword of the future, isolation the disease and explanation of the past. ”

“ By learning to use our minds wisely, intelligently and economically, we shall accomplish far more and with far less expenditure of force; we shall grow in the true philosophical love of a high and simple life. The false aims, the conflicts, the disharmonies of this world will pass us by and leave us at peace.
Arterio-sclerosis, then, except in the sad cases of heredity, is very much of our own making; it almost comes under the heading of “an occupation disease”; it is a natural result of non-natural conditions of life. ”

“ Hence arise kidney disease, faulty liver action, and raised blood pressure. And yet, how many of us seek to restore failing strength by stronger food and more stimulation? In this futility, kind but ignorant friends aid and abet. Think on what a little food a baby lives and grows, and, at the other end of life, on what a simple frugal diet really old people thrive and work.
It is all very well to lay down rules for food, calculated in calories for strong working men and athletes, but in approaching old age every one must become more or less a lawgiver to himself ”

“ Sir Clifford Allbutt, in his distinctive way, says:—
“We recognize now, all of us, that, in the lapse of men’s years, one long reckoning of his mortality is, and from all known ages has been, written on the walls of his vessels. We may suppose that in the primitive man, by external conditions if not by innate capacity, life was of comparatively brief duration. Domestic animals seem, as a rule, not to live long enough to use up their arteries or not to live ill enough to abuse them, and amongst these creatures atheroma, though not unknown, has not been commonly observed. ”

“ These old civilizations perished, perhaps, more from enervating luxury and dissipation than from violence; though some of them gave way through feebleness, physical and mental, to a stronger, hardier race from without. In our own times there seems to loom the same danger, but the attack comes from another side. ”

“ Late hours should be absolutely avoided and little brain work should be done in the evening, so that the brain and all its important arteries can sink into relaxation and sleep at once. The rest to the heart and circulation is of course never so prolonged, but nature has designed them to get their rest only in moments. The heart in an adult rests more than thirteen hours out of the twenty-four, under quiet normal conditions, the time of rest being the diastole, and the time of work being the systole or contraction. ”

“ Besides excess of work and unwise work there is another cause which seems to raise pressure, and that is absorption of ptomaines or of the products of imperfect digestion; the overstrain cause and the absorption cause very often act concurrently, for imperfect assimilation is often the result of the unwise life. We see this more often, perhaps, where the unwise life is accompanied by overeating and injudicious alcoholic stimulation, even if this is not very excessive: such people rarely give themselves time to digest. ”

“ The condition of our arteries that we call sclerosis is much more common in the sedentary brain-worker than it is in the outdoor man. We see it rarely in the farmer, the sailor, the labourer, unless it is as the result of habitual intemperance; we see it rarely in the athlete. The average blood-pressure of the indoor worker is certainly higher than that of the open-air worker, even in perfect health. ”

“ We neither eat nor drink to such excess as our forefathers, and we are not grossly luxurious or debauched, but the strain and the competition of life, both in professions and in business, has become so intense that our nervous systems break down long before their time. This produces rather a new type of an old disease. What is this disease but arterio-sclerosis?—a word which means only thickening of the arteries, but which, after fifty, in its far-reaching results destroys life and working capacity20 far more than cancer or any other disease. ”

“ Our patients know as well as we do that medical knowledge is in a continuous state of flux and that as yet we are nowhere near finality. The dazzling garment of omniscience will be discovered to be the somewhat shop-worn cloak of ignorance. A wise and observant patient can help us enormously in the investigation of7 a difficult problem in disease, for the subjective symptoms are often as important as the objective. What the eye does not see may be there all the time. ”

“ There is no doubt that an indoor, sedentary life tends to high pressure far more than an active, outdoor one. This is partly due to the mental work and concentration that goes with it and partly to oxygen deficiency. The inhalation of oxygen lessens the viscosity of the blood and consequently the work of the heart and of the arterial muscles, while an excess of carbon-dioxide in the air increases the viscosity and the necessary heart force that must be expended. ”

“ As in alcohol, so in tobacco, we must not lose sight of the effect on the general nervous system: on many91 people tobacco, in moderation, has a distinctly soothing influence, and so leads to a quietude of mind which compensates for any other small evil effect. Used in excess, it certainly weakens both nerve and will power, and often heart power. The first effect in experimental nicotine poisoning is greatly raised blood pressure, but at the end dangerously low pressure, and so we find that the ultimate effect of excessive smoking is a feeble, low-tension pulse that is often irregular. ”

“ To go into actual details of diet is a thankless task, and not very helpful to the mass of men; it is better, I think, to point out directions only. If there are symptoms of hyperpiesis, the chief object is to arrange a diet that contains a minimum of protein (especially of animal protein) compatible with life and energy. Most of such cases are leading a life of no great physical strain and will do well on a diet calculated in calories, that contains:
If this is insufficient, add to the fat or carbohydrate rather than to the protein. ”