Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and HysteriaMitchell, S. Weir (Silas Weir)
Science
Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria
Mitchell, S. Weir (Silas Weir)
Hysteria; Neurasthenia; Rest
"Let us take the simplest case,--that which arises daily in the
treatment of joint-troubles or broken bones. We put the limb in splints,
and thus, for a time, check its power to move. The bone knits, or the
joint gets well; but the muscles waste, the skin dries, the nails may
for a time cease to grow, nutrition is brought down, as an arithmetician
would say, to its lowest terms, and when the bone or joint is well we
have a limb which is in a state of disease. As concerns broken bones,
the evil may be slight and easy of relief, if the surgeon will but
remember that when joints are put at rest too long they soon fall a prey
to a form of arthritis, which is the more apt to be severe the older the
patient is, and may be easily avoided by frequent motion of the joints,
which, to be healthful, exact a certain share of daily movement. If,
indeed, with perfect stillness of the fragments we could have the full
life of a limb in action, I suspect that the cure of the break might be
far more rapid.
"What is true of the part is true of the whole. When we put the entire
body at rest we create certain evils while doing some share of good, and
it is therefore our part to use such means as shall, in every case,
lessen and limit the ills we cannot wholly avoid. How to reach these
ends I shall by and by state, but for a brief space I should like to
dwell on some of the bad results which come of our efforts to reach
through rest in bed all the good which it can give us, and to these
points I ask the most thoughtful attention, because upon the care with
which we meet and provide for them depends the value which we will get
out of this most potent means of treatment.
"When we put patients in bed and forbid them to rise or to make use of
their muscles, we at once lessen appetite, weaken digestion in many
cases, constipate the bowels, and enfeeble circulation."[15]
When we put the muscles at absolute rest we create certain difficulties,
because the normal acts of repeated movement insure a certain rate of
nutrition which brings blood to the active parts, and without which the
currents flow more largely around than through the muscles. The lessened
blood-supply is a result of diminished functional movement, and we need
to create a constant demand in the inactive parts. But, besides this,
every active muscle is practically a throbbing heart, squeezing its
vessels empty while in motion, and relaxing, so as to allow them to fill
up anew. Thus, both for itself and in its relations to the areolar
spaces and to the rest of the body, its activity is functionally of
service. Then, also, the vessels, unaided by changes of posture and by
motion, lose tone, and the distant local circuits, for all of these
reasons, cease to receive their normal supply, so that defects of
nutrition occur, and, with these, defects of temperature.
Public-domain text, read in full here on John Shaqi.
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