The water cure in chronic disease : an exposition of the causes, progress, and terminations of various chronic diseases of the digestive organs, lungs, nerves, limbs, and skin : and of their treatment by water, and other hygienic means

Front matter

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Preface

Every writer supposes that his work is to supply some want. My object in publishing this treatise, is to afford a truthful and rational exposition of the value of the water treatment in certain chronic diseases. I apprehend that it is wanted, because the works on the subject of the water cure whicn have hitherto appeared in this country contain, so far as my experience informs me, much overstatement as to its operation, and are moreover written rather to catch the hopeful invalid, than to enlighten him as to the nature of his disease, or the mode in which the water plan is to relieve it. From this remark I except the work of Dr. E. Johnson, entitled "Hydropathy," wherein the manner in which the water cure operates on the chemistry of the living body is very ably traced. The other works have not the slightest claim to be called scientific.

In the First Part of this work the origin, progress, extension, and terminations of Chronic Disease in general, are delineated and explained, and one general deduction from the facts made, namely, that no disease becomes chronic, unless the central organs of nutrition are affected.

In the Second Part, this is further developed in the history of individual chronic diseases, the explanation of the pathology and symptoms of each of which is given, and also of the reasons for the water treatment applicable to each. In arranging the diseases, those are first treated of which affect

VI PREFACE.

the primary organs of nutrition, the organs in which the first step in bloodmaking from food, and therefore of nutrition, is taken. The next step of bloodmaking being effected by the luno-s and heart, their maladies are then treated of. The circulation of the perfected blood being under the control of the nervous system, the diseases of that system come the next in order. One portion of the general nervous system, namely, the brain and spinal cord and their nerves, having control ovei the locomotive organs, the diseases of the limbs come the next in order to be treated of. Finally, the blood having been made and circulated, certain elements of it are thrown off in the shape of secretions from the bowels, kidneys and skin : the diseases of which are the last to be mentioned. The whole arrangement of these individual maladies is thus strictly physiological, beginning with the formation of blood, and ending with the excretion of its useless portions.

Part Third treats, in the first place, of the mode in which the water cure operates in producing its beneficial results, the rationale being given under twelve sections. The subject is treated generally, as that of Chronic Disease was in the First Part. But, in the second place, the details of the water cure are brought forward, the rationale of each process given, and the circumstances which regulate their application stated.

Throughout the volume, the great pathological fact of the existence of visceral disorder in all chronic disease is kept in view ; and the attentive reader will find that, from beginning to end, it forms the basis of the practice recommended, and of its explanation. And as the viscera play this important part in the phenomena of chronic disease, it is not without useful intent that an engraving of the ganglions and networks of nervous matter which pervade them, and regulate their functions, is published at the commencement of the volume.

The Appendix contains facts and aiguments in answer to certain accusations brought orally against the water treatment, chiefly by medical men, although none has ever yet ventured to print them. This portion of the volume is a reprint from a former work of mine.

I put this work forward as an attempt in the right way of handling the subject of the water cure, with a hope that it will be carried out by more able observers and writers. Until it is treated gravely, earnestly, and truthfully, as a matter of scientific importance, it never will obtain the footing in the opinion of the public which it ought to have : for in this land of thinking heads, nothing endures unless it addresses itself to the sober thought. It is not by " Tributes" and " Confessions" of water patients that the water cure is to be permanently advanced : they are mere puffs indirect, which may answer a temporary purpose by luring the same class of credulous people who would swallow pills or have their corns cut on the strength of " Testimonials" in the newspapers. But productions of that class do permanent injury to the establishment of a new and philosophical mode of treatment ; the thinking see through them, and disappointment awaits the unthinking, who expect to realize the glowing pictures they exhibit : and thus a good cause is lost by bad advocacy. Such advertisements, and those more direct, which tell, in lengthened column, of water cure establishments, are precisely what the enemies of the treatment would desire :

Nor can the members of the medical profession be blamed for refusing to acknowledge a plan of treatment so advocated. Besides, they are probably aware that out of the number now practising the water cure, not more than three have legitimate right to the title of " Doctor" which they append to their names. All this is adverse to the advancement of the

PREFACE.

water cure, which, opposed as it is to old prejudices, requires and has claim to all the aid which Truth and Science can afford.

To that Truth I have strongly adhered in the following pages. What I have stated is altogether of my own experience in an extensive field of practical observation during four years : and be the result to lessen or exalt the reader's ideas of the water cure, the Truth is told The cases recounted were treated by me at Malvern. In publishing them I have not descended to the vulgarity of publishing also the names of the patients, nor can they be guessed at by initials or any other token. The reader who requires such objectionable evidence should apply it to himself and ask, " Who is safe if medical attendants publish the names with the infirmities of their patients?" Hence, such a proceeding is very properly rejected by the members of the medical profession as undignified and indecent : and I apprehend that non professional persons will not view it in any other light.

J. M. Gully.

Malvern, August 1, 1846

Part II. Of Particular Chronic Diseases And Their Treatment

Chapter I. Diseases of the Primary Nutritive Organs 65

Sect. 1. Mucous and Nervous Indigestion '. .. 68

— 2. Case of Nervous Indigestion 89

Mucous Indigestion 92

Case of Mucous Indigestion 95

— 3. Combination of Nervous and Mucous Dyspepsia. ... 99

Case of Nervous and Mucous Dyspepsia. — Another Case

of Nervous and Mucous Dyspepsia 102

— 4. Gastro-enteritis. — Chronic Inflammation of the Stom-

ach and small Bowel.— Atrophy 109

Case of Atrophy or Wasting 113

Case of Nervous Disorder of the Liver 128

Case of Congested and Swollen Liver 129

Case of Obstructed Liver 132

Chapter II. Diseases of the Secondary Nutritive Organs. Diseases

of the Lungs and Heart 136

Sect. 1. Nervous Cough.— Stomach Cough 137

Case of Stomach Cough 138

— 2. Chronic Inflammation of the Air Tubes of the Lungs. —

Bronchitis 140

Case of Chronic Bronchitis 142 jj CONTKNTS.

PAGE

Case of threatening Consumptive Disorder of the

Lungs. — Intense Stomach Irritation 147

Case of Pulmonary Consumption 150

Sect. 4. Palpitation of the Heart.— Organic Disease of the

Heart 151

Case of Nervous Palpitation of the Heart 152

Chapter III. Diseases of the Nervous System 157

Sect. 1. Nervousness. — Neuropathy. — Hypochondriasis .. .. 158

Case of minor degree of Nervousness 164

Another Case of minor degree of Nervousness .. .. 1GG Case of Hypochondriasis, the greater degree of Nervousness 1^9

— 2. Neuralgia. — Nerve Pain. — Tic Douloureux. — Sciatica. —

Nervous Headache 171

Case of Sciatica 170

Case of Neuralgia of both Legs 178

Case of Tic Douloureux of the Face 179

Another Case of Sciatica 182

— 3. Apoplectic Fulness of the Brain. — Congestion of the

Brain. — Palsy 187

Case of Apoplectic Fulness of the Head 196

Case of Apoplectic and Congestive Fulness of the Head.

— Deafness. — Intense Headache 198

Case of Palsy of the Right Leg 205

— 4, Spurious Palsy. — Chronic Congestion and Irritation of

all the Ganglionic Nerves 203

Chapter IV. Diseases of the Limbs 217

Sect. 1. Rheumatism 218

Case of Rheumatism of the Knee Joint 229

Case of general Rheumatism of the Body 233

Case of general Rheumatism with Nervous Signs. —

Neuralgic Rheumatism 234

Case of Nervous and Chalky Gout 245

— 3. Rheumatic Gout 248

Chapter II. Details of the Water Cure 327

Sect. 1. Hot and Warm Fomentations 323

— 2 Packing in Damp Towels and Sheets 332

— 3. The Sitz Bath 338

— 5 The Dripping or Rubbing Sheet 344

— 9. Foot and Hand Baths and minor Ablutions and Frictions 358

— 11. Air and Exercise 364

Diet Table for Patients under Water Treatment .. .. 368

Remarks on Water Cure Establishments 378

Part I. Of Chronic Disease In General

CHAPTER I .

PRELIMINARY.

Nomenclature of chronic disease — Phases between that and acute disease — Acute disease always precedes chronic—Arrangement of the subjects to be treated.

The epithet " chronic" is given by medical men to diseases whose duration passes a certain limit of time ; and that limit has been fixed at forty days. All within this period are generally designated as " acute ;" but as this would form but two extreme classes of disease, whilst Nature exhibits" several intermediate phases, some writers have subdivided the " acute " diseases into the most acute, when they terminate in three or four days, — into the very acute, when they do not continue longer than seven days, — into the simply acute, when they endure for fourteen days, — and into the sub-acute, when they reach forty days.

It will be plain, however, that these are merely arbitrary terras, of which there are far too many in medicine, since they are apt to be taken by the young or by the routinier as guides in practice ; and thus names, instead of conditions of body, come to be treated, and much mischief to be consequently perpetrated. Now, the term " chronic" has in itself no reference whatever to the actual state of the diseased frame ; and if I employ it in this Essay, it is only that I may explain it, and fix some meaning to it as regards that state — the word being, in other respects, convenient and precise enough.

Every disease is, in its onsetting, acute; that is to say, the 2

2 OF CHRONIC DISEASE IN GENERAL.

symptoms are intense, pressing in character, and if Nature, either with or without the aid of Art, does not soon bring relief, extinguishes the individual.

The relief and the escape from death are brought about either by transfer of the morbid action from the original seat of disorder to some less important part, and the elimination of some secretions therefrom, — an action to which the term crisis has for three thousand years l>een applied ;* or, no such transfer occurring, the acute state of disease in the affected part passes into the chronic state, — chronic disease is established.

Preliminary, therefore, to fixing what constitutes chronic disorder, it is necessary that we should obtain some precise idea of what constitutes the acute form. I shall next proceed to inquire into the minute changes of organs which induce the phenomena of chronic disease. All the circumstances of chronic disease, generally, will then be considered. Applications of the general doctri te and circumstances will then be made to individual diseases In the course of these inquiries, I shall take occasion to show now acute disease is originated, and chronic disease maintained and exasperated, by internal stimulation ; and finally, I shall show how the treatment of chronic disease by water, and other hygienic means, obviates this inconvenience, is more safe than any other plan of treatment, and comes in aid of the natural and only permanent process towards recovery.

• It is well to note this, as all the world has of late spoken of a " crisis" as a new prodigy : a mistake which some writers on the water-cure would seem to encourage, either from ignorance of the literature of medicine, or from some silly idea that the novelty may add to the eclat of the treatment they profess. Hippocrates was the first to use the term crisis as applied to a termination of disease, and he lived a.m. 3500.

DOCTRINE OF ACUTE DISEASE.

CHAPTER II.

DOCTRINE OF ACUTE DISEASE.

What is meant by " general disease " and " general debility " — Disease always begins in one organ — The ganglionic system of nerves — Its centre and extensive influence — Control over the blood-vessels-— Irritability and sensibility— Action of morbid causes on the irritability of the blood-vessels — Their contraction and exhaustion — Illustrations — Changes in the movement and character of the blood — Periods in the process of acute disease — Its extension — Shown in acute indigestion and simple inflammatory fever — Real cause of death from acute disease.

We are much in the habit of speaking of " general disease :" in truth, there is no such thing. All the organs of the body may give signs of diseased action, but there are invariably one or more parts whose malady originates all that we see.

The brain may evidence disease by impaired volition, delirium, sleeplessness, &c. ; the lungs, by rapid breathing, cough, &c. ; the heart, by excessively quickened action ; the digestive organs, by dry tongue, thirst, loss of appetite, nausea, constipation, &c. ; the kidneys, by diminished secretion ; the skin, by unnatural heat and dryness, — yet all these multiform diseased actions may, and very often do, depend on a small patch of inflammation in the stomach, perhaps no larger than a half-crown, or even a shilling. To treat all these multiplied symptoms under the name of " general disease," would be mere ignorance or sheer charlatanism, which ever aims at bustling complexity.

So also of " general debility," a term so common and so unmeaning ; there is no such thing. Debility always signifies the disorder of one or more parts oppressing the healthy functions of the rest of the body. Remove the disorder of those parts (it may be by positively lowering remedies), and straightway the " general debility" vanishes. Inflammation of any of the digestive organs very shortly brings down the physical and mental vigor : which as quickly rises when a few flannels wrung out of boiling water, and applied over the abdomen, have removed the internal inflammation. On this head I shall have more to say hereafter.

Disease, then, always commences in some one organ or set of organs, from which it spreads, with more or less rapidity, to others, by a sympathy whose physical agent is the nervous system.

By this term, " nervous system," the brain, spinal cord, and the nerves proceeding from them, are ordinarily understood ; but there is another system of nerves which, as it is neither obedient to the will, nor cognizant of pain, commonly so called, is rarely considered in the explanation of disease ; in which it, nevertheless, plays by far the most ■ important — I may say, the only important part. This system of nerves has been called the " ganglionic" (from the appearance of small knots or ganglions in the course of the nerves), the "organic" (as regulating the character of the organization of parts), the "nutritive" (as presiding over the organs that minister to the nutrition of the body), and the " visceral " (as pervading and having its centre in the viscera,* that is, in the contents of the chest and abdomen) ; and I shall use these terms indiscriminately in the course of this Essay. Perhaps the most accurate, however, are the epithets " nutritive" and "organic;" for, wherever there are organs in the body, or wherever nutrition goes on in it, there are nerves of nutrition to be found. Wherever, too, there is a blood-vessel (and we know not of nutrition without blood), organic nerves accompany it and regulate its action. In every part of the body, therefore, organic nerves exist, as in every part of the body blood-vessels exist : the point of the finest needle cannot be introduced into any tissue of the frame without entering one or more blood-vessels and organic nerves.f The brain itself, containing, as it does, so large a proportion of the blood of the body, is, in this view, supplied also with a large proportion of organic nerves.

The coincidence of nutritive blood-vessels (called also capillary) and nutritive nerves points to some strict organic connection between them. In fact, it is the presence of the nerves which imparts to the blood-vessels the property of receiving and reacting

* The word viscus, of which viscera is the plural, signifies, in the Latin, slime. And as the older anatomists found the membranes which line the lungs and digestive canal slimy from the mucus they secrete, they applied the characteristic term to the parts themselves, calling each organ of the chest and abdomen, viscus, and the general contents, viscera. This explanation was necessary, from the frequency with which I shall be compelled to use the term in these pages.

f Ruysch, William Hunter, and Lieberkuhn, asserted that every substance of the animal frame consisted of nothing but vessels.

upon impressions from agents within or without the body — a property to which the name of " irritability" is given.

Let not the reader confound " irritability" with " sensibility," another property of a portion of the body. Irritability exists in the blood-vessels and organic nerves all over the frame — has its central organs in the chest and abdomen — begets no sensation or volition — is ever in action. Sensibility exists in the nerves of the brain and spinal cord only — has its central organs in the brain and spinal cord — begets sensation and volition, and is suspended in sleep. But, on the other hand, sensibility and sensation are built upon irritability and irritation ; as thus — the brain is composed of matter deposited from the blood-vessels, and these are regulated in the manner and quality of their deposit by the amount and character of their irritability ; therefore, if the irritability be acted on vehemently (as in giving stimulants), the action of the blood-vessels, otherwise called their irritation, is vehement also, and they deposit more than usual of the brain matter which possesses the property of sensibility, and in this way augmented sensation is begotten. It is important to bear this in mind for the future application to the doctrine of chronic disease — irritation precedes sensation, sensation is built upon irritation.

The first effect, therefore, of causes of disease — excessive cold or heat, infectious matter, &c. — is upon that nervous system which presides over the capillary or nutritive blood-vessels, and whose central portions are in the viscera of the chest and abdomen — the ganglionic system.

It is ascertained by numerous experiments that the first effect of all kinds of agents upon the nervously-endowed capillaries is to produce contraction of them — a diminution of their calibre by the fact of their contraction. In other words, all agents are stimulants to them, and bring them into action, and that action is contraction. But as all action is effort, such effort must, in a living body, be succeeded by lassitude and exhaustion ; and in the case of these small blood-vessels, relaxation and increase of calibre is the evidence of this secondary state ; and further, it follows that the amount of relaxation will be in exact proportion to the amount of the previous contraction.

Of course the condition of the blood as to quantity is affected by these two opposite states of the vessels that contain it. When the vessels contract on the application of the morbid stimulus, they drive their contained blood from them ; and when relaxation ensues, the blood rushes into their increased calibre ; and the amount of blood thus brought into a part will be, of course, in exact proportion with the relaxation, and this with the contraction, of the containing blood-vessels.

To illustrate all this : — I apply water at 35° of Fahrenheit to the back of the hand when it is warm ; it first of all drives the blood from the skin, and renders it pale ; this is because the cold has stimulated the nutritive nerves of the blood-vessels, and caused them to contract and drive the blood from them ; but in a very short time the skin becomes more than usually red, and, if friction be used, hot too. This is because the vessels have been exhausted by the contracting effort, have relaxed, and admitted more blood into them. This is an approach to inflammation of the skin of the hand.

Or take a piece of frozen mercury, the temperature of which is 38° below the zero of Fahrenheit, and apply it on the hand. The stimulus is so violent, the contraction so excessive, as to be instantaneously followed by excessive relaxation and total loss of vital power of the blood-vessels, and inflammation of the most destructive kind is produced. The part is burnt, in fact, as effectually as if the opposite stimulus of red-hot iron had been applied.

Between these two instances the shades of stimulation and relaxation are infinite, according to the morbific agent applied. The more stimulating the agent, the more rapid and extreme the amount of blood brought to the part, whether that part be the skin of the hand, or the mucous lining of the stomach or lungs.

But whilst such are the conditions of morbid action in the blood-vessels, what changes take place in the blood they contain ?

In the first place, its movement through the blood-vessels of the diseased part is retarded, in consequence of the diminished contractile power of those vessels. There is more or less excess and congestion of blood in the part, an excess which obtains at the expense of other and healthy parts. It is this excess which causes the swelling of inflamed parts, their redness, their increased heal (the unusual quantity of blood secreting an unusual quantity of caloric), and their painfulness, the pressure of the excessive blood on the surrounding nerves rendering them irritable, although, as I shall have occasion to show hereafter, inflammation of internal parts may exist without pain (in the usual acceptation of the word) and without redness.

In the next place, the chemical changes that go on in the blood undergo modification, in consequence ol his excess and retardation of its movement. This is shown by the increased heat already alluded to ; and further, if the inflammatory congestion be not relieved, the blood secretes pus — the matter of abscess — either in the shape of a collection called an abscess, or the same flows freely from the surface of a mucous membrane, forming a bad kind of expectoration, &c. But the chemical changes in question vary endlessly with the diseased part. In the stomach, there is acid instead of insipid mucus and gastric juice ; in the liver, there is acrid and dark instead of slightly bitter and yellow bile ; from the kidneys, acid instead of alkaline secretion ; and so on. The most familiar instance of this as a signal of disease is the state of the tongue when the mucous lining of the stomach is disordered. The variety of the secretions there is endless, and each one corresponds with a certain shade of congestion of blood in the membrane that covers the tongue. Judge, then, how numerous are the shades of diseased action in that single tissue of the body !

Such, then, is the condition of a part when it is in the acute stage of disease. The phases of the process may be briefly stated as follows : —

1. The application of excessive stimulus to the nervously-endowed blood-vessels of the part.

2. Excessive contraction of the blood-vessels in consequence, with expulsion of their contained blood.

3. Exhaustion and relaxation of the same blood-vessels, with consequent excessive influx and retention of blood in them.

4 Diseased sensation, secretion, and nutrition of the part, consequent on the retention of the blood in the exhausted and relaxed vessels, the vital chemistry being, for the time, improperly carried on.

These phases apply to all acutely diseased parts whatever — from the small pimple on the skin to the most intense inflammation of the lungs or brain. In all, the same stages occur, whatever the exciting cause may be ; whether it be the atom of dirt irritating the follicle of the skin, and producing the pimple there, or the rush of cold air into the lungs, irritating their mucous membrane, and drawing excessive blood into it.

From what precedes, it appears that the intimate vital condition of a part in acute disease is one of debility. The blood-vessels have lost their contractile energy, and are oppressed with blood, which they lack the power to throw off. But we must not, meanwhile, lose sight of the fact, that the organic nerves themselves, whose re-action on excessive stimulus has produced all this mischief, are also supplied with and nourished by blood-vessels; and that therefore they, too, are in a slate implying diseased sensation and nutrition. In other words, they are exquisitely irritable, but their irritability is of a diseased quality, and not sustained, because they are badly nourished by the blood ; the result of which is a more than ordinary sensitiveness to the causes which first induced the disease, or to any stimulus whatever applied to the part. Feeble, contraction takes place, then more exhaustion ; contraction again, and so on until all power is lost. Thus, a man gets a slight inflammation of the mucous lining of the wind-pipe from breathing very cold air ; allows the same cause to exasperate it daily by acting on the highly irritable but feeble nerves and blood-vessels of the membrane; and, finally, induces the most intense form of inflammation of the lungs — a too frequent illustration of the fact that the most fatal maladies commence in a " slight cold."

Having thus established the fact, that acute disease of an organ implies extreme debility, morbid irritability, and congestion of its blood-vessels and organic nerves, we may now revert to the proposition, that all so-called general disease originates in some local disorder — a proposition that will best be developed by tracing the physical history of such a local condition as I have above described. And we will take the local inflammation of an organ whose sympathies are the most extensive — acute mucous inflammation of the stomach, commonly called " acute indigestion."

A man ingests highly seasoned meats and alcoholic drinks, and begets in the mucous lining of his stomach a patch of such disorder I have minutely described. Now, though that disorder is, as regards the patch itself, one of depressed vital power, it becomes to other parts a source of exalted vital action ; as if the very fact of the existence of a diseased point roused the system to efforts for its relief — an opinion that was held by Hippocrates, and has prevailed with some of the soundest physicians since his times.* The sympathy thus excited in other organs of the body

♦Indeed, the doctrine that disease — i, e ., a9eries of unnatural symptoms, ia constantly the signal of the whole body being excited to save some vital part from destruction, obtains countenance from all the facts that close is in proportion to the amount and kind of nervous matter they contain. Thus, in the case before us, the ganglionic nervous matter of the mucous membrane of the stomach excites the same matter distributed to the heart, whose beats are, in consequence, increased in frequency and force ; the pulse becomes rapid and hard ; as a result of this quickened pulse, the breathings also quicken. Then comes the sympathy with the spinal cord an<" the brain, whose functions are rendered irregular or are oppressed ; hence the lassitude of mind and limb, the prostration of strength, the somnolence first, and then the sleeplessness, &c. Then there are the sympathies with the mucous surfaces of all the other organs roused, causing the diminution and vitiation of their secretions ; hence the heaviness and the aching of the forehead, the suffused eyes, the fevered and dry tongue, the thirst, the stoppage of the bile, the constipation of the bowels, the scantiness of the secretion from the kidneys, all of them dependent on mucous membranes. And as this mucous surface extends to the outer part of the body, forming the true skin, the same morbid sympathy extends thither, accompanied with the same diminution and vitiation of sensation and secretion ; hence the dry and hot skin called " feverish heat."

In fact, here is a case of what is called " simple inflammatory fever," a general disease traceable to a small point of acute inflammation in the stomach. Sometimes the same general result follows on the application of cold air to the outer mucous surface — the skin, whereby the blood is thrown on an extensive portion of the inner mucous membrane of the nose, throat, and lungs ; and then nearly the same phenomena are present, and a " feverish cold" is said to exist. But in either case, and indeed in all cases of general symptoms, there is one organ, and sometimes only one spot of an organ, that originates the whole series, and which must be overcome, as the cause, before we can vanquish the symptoms, which are the effects. Too much stress cannot be laid upon this important fact. The denial or ignorance of it' leads to the most unscientific and unskilful treatment of disease — it leads to the treatment of effects instead of causes — and, as I shall have hereafter occasion to show, it furnishes the chief argument against the ordinary drug medication of the day.