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upon the bicycle a most ungraceful and unhealthful attitude. Unlike such humdrum exercise as wood chopping, rowing, or working, the bicycle brings into most active play the nerves and nerve centers as well as the muscles, especially when one selects for his course a diversified country road rather than a race track. The constant occupation of the mind in looking out a safe and suitable road, turning aside to avoid obstacles, making a dash now and then over a stretch of smooth and level road, putting on extra steam to climb a hill, and coasting down the other side, quickens the velocity of the circulation, and the equilibrium, disturbed by too much mental work and too little use of the muscles, aggravated perhaps by excessive eating, is quickly restored, so that it becomes not only a means of muscle work resulting in improvement of nutrition, but an equally valuable means of nerve resting.
The writer first became personally acquainted with the bicycle while spending a winter's vacation engaged in writing a medical work in the city of Washington, D. C. The time at my command being limited to three months, and the task in hand, the production of several thousand pages of original manuscript besides a considerable amount of research, I found it necessary, in order to accomplish my daily task of from fifty to one hundred pages of manuscript, to maintain the highest possible degree of mental and nervous activity, and consequently I found it profitable to devote daily some attention to active exercise out-of-doors as well as the most scrupulous attention to diet. Finding that I always returned from my "constitutionals " fagged and exhausted, besides being constantly oppressed with the feeling that I was wasting time, which made my daily walk exceedingly distasteful, I possessed myself of a Columbia bicycle, and spent one hour daily in bicycle riding, which not only refreshed me from the labors of a long
day of incessant and intense mental effort, but prepared me for renewing my work in the evening, and prosecuting it with uninterrupted activity till midnight or one A、 M., my usual bedtime.
Last year my personal experience again afforded an excellent illustration of the value of the bicycle as a means of recuperation. A severe attack of la grippe confined me to my bed for a month, and left me in a miserable state, from which I seemed to be unable to rally. During the attack, the chief center of the disease was my right lung, which remained sore, and my breath so short and the occurrence of evening rise of temperature so frequent, I had grave apprehensions of beginning tuberculosis. My heart was also exceedingly weak, the heart beats frequently reaching 140 to 150, even without the provocation of active exercise. Finding it impossible to divest myself of the cares incident to the superintendence of a large Hospital 'and Sanitarium, with 600 to 700 people constantly under my supervision, requiring from half a dozen to twenty serious operations two days in a week, besides the labor of a very large correspondence and the literary work demanded by the editorship of three monthly magazines, I saw little chance for escaping a complete and possibly hopeless breakdown in health. In this emergency I recalled my former happy experience with the bicycle, which the urgent press of professional work had led me to neglect for several years, and procuring a good safety bicycle, I began renewing acquaintance with the wheel. I was at this time so weak and short of breath that I could not climb a short flight of stairs without much effort, and without finding myself out of breath. My first trip on the bicycle, a distance of less than forty rods, left me with lungs and heart so excited that I was obliged to place myself in a horizontal position, and remain absolutely quiet for several hours before the heart beat resumed its
normal rate. The second trip, a day or two later, of about the same distance, was recovered from in an hour or two, a fact which gave me courage to persevere, and by the end of two weeks I was able to ride half a mile without becoming completely exhausted, although still very short of breath. At the end of a month, however, I found to my delight that I had fairly good "wind" was able to ride ten miles in an hour over a road only fairly good, climb hills of considerable steepness, and had increased my lung capacity from 175 cubic inches to 210.
In another month my general muscular strength had increased to such a degree that my total lifting ability, including strength of the extensors as well as the flexors, was over 5500 pounds.
I felt that the bicycle had saved my life. Certainly it did save me from a complete breakdown, which, at the time, would have been most disastrous.
I have employed the bicyle as an accessory in the treatment of weakly women in dozens of cases, and with most happy results. I have never seen any untoward results from its use, except some slight bruises, which were wholly the result of carelessness on the part of the riders. With a good teacher and prudence on the part of the pupil, even these may be avoided. The majority of chronic invalids need more muscular activity than they have been accustomed to. Exercise involves increase of lung activity, and with increased vigor of respiratory movements come better liver action, improved digestion, accelerated absorption of the digestive products, better bowel action, purified blood, and more normal activity of brain and nerves.
The majority of those who take exercise for health do not take exercise enough to accomplish the purpose required. To accomplish its object, exercise must be sufficiently vigorous and sufficiently prolonged to induce a decided. impression upon the system-old tissues.
being broken down and the process of nutrition, assimilation, and disassimilation sufficiently stimulated to oxidize and carry off old waste elements and build up newer and better tissue.
For neurasthenia, nervous dyspepsia, rheumatism, general debility, hypochondria, brain fatigue, diabetes, and other difficult, common, and obstinate maladies which I might mention, the bicycle affords, in connection with simple diet and correct habits of life, one of the best means of cure. For the last-named disease, in curable cases, it is worth more than all other measures combined. By its use the amount of sugar eliminated may be diminished, and in favorable cases it may be made to disappear entirely. But the absolute restriction of diet required in such cases often becomes intolerable to the patient, so that he breaks over the rules laid down for him, and suffers the consequences, feeling that the remedy is worse than the disease. The bicycle, however, and other equally vigorous forms of exercise, afford an opportunity by which the excessive amount of sugar found in the blood may be oxidized, or burned up, thus rendering absolute restriction of diet to non-starch foods unnecessary. This we have demonstrated in many cases. An eminent French professor suffering from diabetes kept himself alive until an advanced age by vigorous daily work in the gymnasium. A young man observing the gray haired professor at his place regularly every night, engaged with men one third his age, in the most vigorous exercises of the gymnasium, intimated to him his surprise at seeing so aged a man so much interested in athletics. "Ah," said the professor, "you do not understand; I am burning up my sugar." The professor would have. found the bicycle a very much more agreeable means of burning up the sugar which his system had lost its power to oxidize without the stimulus of active exercise.
I have found that feeble women who are scarcely able to ride on a street-car in consequence of pelvic disorders which are aggravated by the jar of a street-car or the rattle of carriage wheels over a pavement, have been able to ride upon a bicycle with a pneumatic tire, not only without injury, but with positive benefit. The development of the muscles of the trunk is one of the most essential things to be accomplished in the treatment of disorders peculiar to women. The neglect of this development, probably be
cause of a lack of convenient means for meeting the requirement, is the principal cause of failure in the treatment of displacements of various sorts and a variety of ailments caused by prolapse of the abdominal viscera. The bicycle affords a most efficient and delightful means of developing all the trunkal muscles. It encourages a correct carriage, deep and full respiration, requiring loose garments, and by its fascination encourages women of feeble physique to increase from day to day the amount of exercise, thus securing gradual and efficient development. of the neglected and weakened muscles. J. H. K.
EVERY gynecologist who has given careful attention to the matter will be ready to testify respecting the great frequency with which the colon is found to be loaded with fecal matter, in women seeking advice for disorders supposed to be peculiar to the sex. There is no doubt in the writer's mind that the great share of ailments from which women complain, and which are attributed to some disease of the womb or ovaries, may be traced directly or indirectly to static disturbances of the abdominal viscera, such as intestinal prolapse, abnormal mobility of one or both kidneys, dilatation or prolapse of the stomach,
One of the most frequent consequences of intestinal prolapse is stasis of fecal matters in the colon. This accumulation of hard and fecal matter is most common in the descending colon, particularly in the region of the sigmoid flexure or the rectum, and is frequently found in the cæcum, sometimes in the transverse colon. In laparotomies I have frequently found the transverse colon several inches below the umbilicus, and sometimes immediately below the cite of the incision. In a recent abdominal section I found the omentum packed away in the pelvis, the lower border of the transverse colon lying at a point an inch above the pubes. In this instance it was necessary to disentangle the mesentery from the pelvic viscera before the colon could be returned to position. The patient had long suffered from intestinal stasis, the cause of which was evident. A pyosalpinx also existed, however, both appendages being diseased, rendering removal necessary; but I anticipate that as many symptoms will be relieved by the restoration of the colon to its normal position, which I took care to accomplish, as from the removal of the diseased appendages.
In many cases the only remedy for intestinal stasis is a thorough washing out of the accumulated fecal matters by means of what I term, for convenience, a coloclyster. As suggested by the late Dr. Jewell, who recognized this condition ast one of the most common causes of chronic nervous disorders, the colon may be conveniently filled and thoroughly flushed by placing the patient in Simm's position, or in the knee-chest position. The kneechest position, or the genu-pectoral, is most effective, but for a feeble patient the Simm's position is better. The patient should lie on the right side instead of the left, as the right Simm's position facilitates the passage of the water higher up into the colon.
The only inconvenience arising from
the frequent use of colo-clysters, is the fact that the frequent contact of the large quantity of water has a tendency to overdistend the colon, and to lessen the sensibility of the lower bowel, so as to render the practice, when once taken up, a permanent necessity. This is not always found to be the case, however, as I have not infrequently observed that in patients whose bowels were clogged, resorting to the colo-clyster for a few times sufficed to restore the natural function so that regular movements occurred daily without artificial aid. These cases are those in which stasis has not continued for a sufficient length of time to cause any considerable degree of permanent dilatation, and consequently weakening of the muscular walls of the intestines. In other words, these are cases in which motor insufficiency is not a permanent factor. But as a rule the adoption of colo-clysters as a means of emptying the bowels is likely to become a habit and a necessity, from increase of intestinal dilatation and lessening of normal sensibility of the mucous membrane of the lower bowels. This inconvenience may be obviated, however, by the employment of either one or both of two simple measures, namely, electricity and revulsion.
As electrical applications I find the slowly interrupted faradic current, the slowly alternating sinusoidal current, and the fluctuating galvanic current, applied with a protected metal electrode, the most effective means.
Revulsion is secured by employing, in the first place, water as hot as the patient can bear, hot water being much less relaxing than warm water and more stimulating to the bowels, and conclude the application by the injection of a small quantity of cold water. The cold water is injected after the bowels have been emptied. Half a pint of cold water, which should be of the temperature of 60° to 80°, is sufficient for the purpose. The cold water is injected and retained for a
minute, and then allowed to escape. a means of maintaining or awakening sensibility in the extreme lower portion of the alimentary canal, I find very useful a hard rubber irrigator which I have had made for the irrigation of the rectum, by means of which, and with suitable connections with two reservoirs, one containing hot and the other cold water, hot and cold water are brought in contact with the mucous membrane, alternating every 3 to 5 seconds.
I also employ for the same purpose an instrument consisting of a hard rubber cylinder, the inner end of which is closed, the outer presenting two openings, through one of which passes a tube to the upper extremity of the cylinder. By substituting this for irrigation, heat and cold without moisture may be applied to the rectum in the same way alternated, being timed to 5 to 10 seconds, the instrument possessing very thin walls, which are quickly brought to the temperature of the current of water passing through it.
By the employment of these means, electricity and revulsion, the tendency of the colo-clysters to produce a sort of paresis of the bowels when employed for a considerable length of time, may be completely overcome, and thus this method of treatment, which has been so so much abused by charlatans, may be utilized without the undesirable results. J. H. K.
Tea and Digestion. The popular idea that tea, coffee, cocoa, wine, and other beverages commonly used at meals, promote digestion, has been clearly proven by reliable physiological experiments to be an error. According to J. W. Frazer and W. Roberts, all these substances interfere with digestion. Tea, coffee, and cocoa retard the digestion of proteids, although the action of coffee is somewhat less intense than that of tea. The volatile oil as well as the tannic acid of tea, was found to have a retarding effect upon peptic digestion. It is well that this fact be known, as the idea has become prevalent that tea is harmless if the infusion is quickly made so as to obtain the volatile oil without so great a quantity of tannic acid as is dissolved by longer infusion. Wine also retards peptic digestion, as was clearly shown by W. Roberts. This effect of wine and other alcoholic liquors was so marked that Sir William Roberts concluded, as the result of his experiments, that wine and other alcoholic liquors are chiefly useful as a means of slowing down the too active digestion of the modern civilized man, thus acting as a safeguard against what he terms "a dangerous acceleration of nutrition." However much the digestion of the average Englishman may require. slowing down, the average American certainly does not need to put breaks upon his digestive apparatus.
Both Roberts and Frazer also showed that the effect of wines and tea is inimical to salivary digestion. Tea, even in a very small quantity, completely paralyzed the ptyaline of the saliva, while wine promptly arrested salivary digestion. Salivary digestion was not formerly considered a matter of very great consequence, as it was supposed that the action of saliva upon the digestion of food was quickly suspended in the stomach by the secretion of hydrochloric acid; but the observations of Ewald and others, which have been confirmed by the writer in the
chemical examination of more than eleven hundred stomach liquids, indicates that salivary digestion proceeds in a normal stomach so rapidly as to cause the complete disappearance of starch by the end of the first hour of digestion. Many cases of intestinal dyspepsia are doubtless due to the failure of salivary and peptic digestions in the stomach.
J. H. K.
New Forms of Intoxication.- Most of the new methods of intoxication seem to have originated in this country. Intoxication by ether was practiced by inhaling the drug, many years before it was used as an anesthetic in surgery. The writer once received a very graphic account of an ether party given by a physician, who was one of the participants. Tea chewing to the extent of intoxication seems to have originated in Boston. Snuff dipping was invented by a woman of the Southern States. Tea cigarettes were, however, the ingenious invention of Parisian ladies who were tired of the ordinary forms of intoxication.
The Medico, a French periodical, gives a recent account of a new form of intoxication which is becoming fashionable with Parisian ladies, in which the desired exhilaration is obtained by inhaling the fumes of naphtha. The intoxication induced by naphtha is similar to that caused by ether drinking, as practiced in Ireland, or as inhaled for surgical anesthesia, but lasts much longer and is very much more injurious. This mode of intoxication, it is claimed, was introduced into Paris by American ladies who had long practiced it at their homes in America.
There seems to be a mania at the present time for the discovery of some new nerve tickle, or some new means of fuddling the senses. dling the senses. It is time the medical profession raised its voice in solemn protest against the use of all felicity-producing drugs, every one of which is toxic and injurious in its nature.