NATURAL LIFE AND DEATH: AND RULES FOR HEALTH

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Benjamin Ward Richardson, M.D.

[Dr. Richardson was an English physician of uncommon originality and ability. He founded and for some years edited the Journal of Public Health, chiefly directed toward the prevention of disease. In 1875 he created widespread interest by sketching an imaginary “Model City of Health” to be called Hygeia. He wrote several important books; from “The Diseases of Modern Life,” published by D. Appleton & Co., New York, are taken the extracts which follow.]

By the strict law of Nature a man should die as unconscious of his death as of his birth.

Subjected at birth to what would be, in the after-conscious state, an ordeal to which the most cruel of deaths were not possibly more severe, he sleeps through the process, and only upon the subsequent awakening feels the impressions, painful or pleasant, of the world into which he is delivered. In this instance the perfect law is fulfilled because the carrying of it out is retained by Nature herself: human free-will and the caprice that springs from it have no influence.

By the hand of Nature death were equally a painless portion. The cycle of life completed, the living being sleeps into death when Nature has her way.

This purely painless process, this descent by oblivious trance into oblivion, this natural physical death, is the true Euthanasia; and it is the duty of those we call physicians to secure for man such good health as shall bear him in activity and happiness onward in his course to this goal. For Euthanasia, though it be open to every one born of every race, is not to be had by any save through obedience to those laws which it is the mission of the physician to learn, to teach, and to enforce. Euthanasia is the sequel of health, the happy death engrafted on the perfect life.

When the physician has taught the world how this benign process of Nature may be secured, and the world has accepted the lesson, death itself will be practically banished; it will be divested equally of fear, of sorrow, of suffering. It will come as a sleep.

If you ask me what proof there is of the possibility of such a consummation, I point to our knowledge of the natural phenomena of one form of dissolution revealed to us even now in perfect, though exceptional, illustration. We have all seen Nature, in rare instances, vindicating herself despite the social opposition to her, and showing how tenderly, how soothingly, how like a mother with her foot on the cradle, she would, if she were permitted, rock us all gently out of the world. How, if the free-will with which she has armed us were brought into accord with her designs, she would give us the riches, the beauties, the wonders of the Universe for our portion so long as we could receive and enjoy them; and at last would gently withdraw us from them, sense by sense, with such imperception that the pain of the withdrawal would be unfelt and indeed unknown. Ten times in my own observation I remember witnessing, with attentive mind, these phenomena of natural Euthanasia. Without pain, anger, or sorrow, the intellectual faculties of the fated man lose their brightness. Ambition ceases, or sinks into desire for repose. Idea of time, of space, of duty, lingeringly pass away. To sleep and not to dream is the pressing and, step by step, still pressing need; until at length it whiles away nearly all the hours. The awakenings are shorter and shorter; painless, careless, happy awakenings to the hum of a busy world, to the merry sounds of children at play, to the sound of voices offering aid; to the effort of talking on simple topics and recalling events that have dwelt longest on the memory; and then again the overpowering sleep. Thus on and on, until at length, the intellectual nature lost, the instinctive and merely animal functions, now no longer required to sustain the higher faculties, in their turn succumb and fall into inertia.

This is death by Nature, and when mankind has learned the truth, when the time shall come—as come it will—that “there shall be no more an infant of days, nor an old man who hath not filled his days,” this act of death, now, as a rule, so dreaded because so premature, shall, arriving only at its appointed hour, suggest no terror, inflict no agony.

The sharpness of death removed from those who die, the poignancy of grief would be almost equally removed from those who survive, were natural Euthanasia the prevailing fact. Our sensibilities are governed by the observance of natural law and the breach of it. It is only when nature is vehemently interrupted that we either wonder or weep. Thus the old Greeks, fathers of true mirth, who looked upon prolonged grief as an offence, and attached the word madness to melancholy,—even they were so far imbued with sorrow when the child or the youth died, that they bore the lifeless body to the pyre in the break of the morning, lest the sun should behold so sad a sight as the young dead; while we, who court rather than seek to dismiss melancholy, who find poetry and piety in melancholic reverie, and who indulge too often in what, after a time, becomes the luxury of woe, experience a gradation of suffering as we witness the work of death. For the loss of the child and the youth we mourn in the perfect purity of sorrow; for the loss of the man in his activity we feel grief mingled with selfish regret that so much that was useful has ceased to be. In the loss of the aged, in their days of second childishness and mere oblivion, we sympathize for something that has passed away, and for a moment recall events saddening to the memory; but how soon this consoling thought succeeds and conquers—that the race of the life that has gone was run, and that for its own sake the dispensation of its removal was most merciful and most wise.

To the rule of natural death there are a few exceptions. Unswerving in her great purpose for the universal good, Nature has imposed on the world of life her storms, earthquakes, lightnings, and all those sublime manifestations of her supreme power which, in the infant days of the universe, cowed the boldest and implanted in the human heart fears and superstitions which in hereditary progression have passed down even to the present generations. Thus she has exposed us all to accidents of premature death, but, with infinite wisdom, and as if to tell us that her design is to provide for these inevitable calamities, she has given a preponderance of number at birth to those of her children who by reason of masculine strength and courage shall have most frequently to face her elements of destruction. Further, she has provided that death by her, by accidental collision with herself shall, from its very quickness, be freed of pain. For pain is a product of time. To experience pain the impression producing it must be transmitted from the injured part of the living body to the conscious centre, must be received at the conscious centre, and must be recognized by the mind as a reception; the last act in truth being the conscious act. In the great majority of deaths from natural accidents there is not sufficient time for the accomplishment of these progressive steps by which the consciousness is reached. The unconsciousness of existence is the first and last fact inflicted upon the stricken organism: the destruction is so mighty, that the sense of it is not revealed.

The duration of time intended by Nature to extend between the birth of the individual and his natural Euthanasia is undetermined, except in an approximate degree. From the first, the steady, stealthy attraction of the earth is ever telling upon the living body. Some force liberated from the body during life enables it, by self-controlled resistance, to overcome its own weight. For a given part of its cycle the force produced is so efficient, that the body grows as well as moves by its agency against weight; but this special stage is limited to an extreme, say, of thirty years. There is then another period, limited probably also to thirty years, during which the living structure in its full development maintains its resistance to its weight. Finally, there comes a time when this resistance begins to fail, so that the earth, which never for a moment loses her grasp, commences and continues to prevail, and after a struggle, extended from twenty to thirty years, conquers, bringing the exhausted organism which has daily approached nearer and nearer to her dead self, into her dead bosom.

Why the excess of power developed during growth or ascent of life should be limited as to time; why the power that maintains the developed body on the level plain should be limited as to time; why the power should decline so that the earth should be allowed to prevail and bring descent of life, are problems as yet unsolved. We call the force that resists the earth Vital. We say it resists death; we speak of it as stronger in the young than in the old; but we know nothing more of it really, from a physical point of view, than that while it exists it opposes terrestrial weight sufficiently to enable the body to move with freedom on the surface of the earth.

These facts we accept as ultimate facts. To say that the animal is at birth endowed with some reserve force, something over and above what it obtains from food and air, would seem a reasonable conclusion; but we have no proofs that it is true, save that the young resist better than the old. We must therefore rest content with our knowledge in its simple form, gathering from it the lesson that death, a part of the scheme of life, is ordained upon a natural term of life, is beneficially planned, “is rounded with a sleep.”

[Then follow chapters on disease, leading up to rules for health.]

RULES FOR HEALTH

I

The first step towards the reduction of disease is, beginning at the beginning, to provide for the health of the unborn. The error, commonly entertained, that marriageable men and women have nothing to consider except wealth, station, or social relationships, demands correction. The offspring of marriage, the most precious of all fortunes, deserves surely as much forethought as is bestowed on the offspring of the lower animals. If the intermarriage of disease were considered in the same light as the intermarriage of poverty, the hereditary transmission of disease, the basis of so much misery in the world, would be at an end in three or at most four generations.

II

Greater care than is at present manifested ought to be taken with women who are about to become mothers. Wealthy women in this condition are often too much indulged in rest and are too richly fed. Poor women in this condition are commonly underfed and made to toil too severely. The poor, as we have seen, fare the best, but both, practically, are badly cared for. Nothing that is extraordinary is required for the woman during this condition named. She needs only to live by natural rule. She should retire to rest early; take nine hours' sleep; perform walking or similar exercise, to an extent short of actual fatigue, during the day; partake moderately of food, and of animal food not oftener than twice in the day; avoid all alcoholic drinks; take tea in limited quantities; forego all scenes that excite the passions; hear no violence of languages, be clothed in warm, light, loose garments; and shun, with scrupulous care, every exposure to infectious disease.

III

In meeting the uncontrollable causes of disease the special influence of season deserves particular regard. It should always be remembered that, other things being equal, during winter the body loses, during summer gains in weight. Further, it should be remembered that these changes are abrupt: that usually the loss commences, sharply, in September and lasts until April, and that the gain commences in April and lasts until September. In September, though the weather even be warm, it is right, therefore, to add to the clothing and to commence a little excess of food. In summer it is right not only to reduce the clothing, but to eat less food than in winter.

IV

The best means of preventing the spread of the communicable diseases is perfect and instant isolation of the affected, and removal and thorough purifying of all clothing and bedding with which the affected have come in contact. It is a vulgar error to suppose that every child must necessarily suffer from the contagious maladies, and that the risk of exposure to infection is, therefore, of little moment. The chance of infection lessens with advance of life, and that person is strongest who has never passed through a contagious malady. Against small-pox vaccination is the grand safeguard, but even vaccination ought never to prevent the isolation of those who suffer from small-pox.

V

The mortality from the uncontrollable causes of disease amongst persons of advanced life is best prevented by providing against sudden vicissitudes of heat and cold. The primary care is to guard against sudden change of vascular tension from exposure to heat when the blood-vessels are weakened by cold. Such exposure is the cause of nearly all the congestions which occur during winter, and which carry off the enfeebled. The sound practice is to maintain the body, at all hours and seasons, but especially during the hours of sleep, at an equable temperature. The temperature of 60° Fah. may be considered a safe standard.

VI

The true danger of every form of mental exercise is the addition of worry. Laborious mental exercise is healthy unless it be made anxious by necessary or unnecessary difficulties. Regular mental labour is best carried on by introducing into it some variety. New work gives time for repair better than attempt at complete rest, since the active mind finds it impossible to evade its particular work unless its activity be diverted into some new channel. During the new work a fresh portion of the brain comes into play and the overwrought seat of mental faculty is secured repose and recovery. Excessive competition in mental labour is ruinous at all ages of life.

VII

The idea that excessive physical exercise is a sound means of promoting health is erroneous. Man is not constructed to be a running or a leaping animal like a deer or a cat, and to raise the physical above the mental culture were to return to the shortness and misery of savage life. Physical training, while it should be moderately encouraged, should be refined and made secondary to mental training. Every rash and violent feat of competitive prowess should be discountenanced.

VIII

The combination of mental and physical fatigue, as it is practised in many pursuits at this time, are exceedingly dangerous. Long journeys each day, to and from the sphere of profession or business, are hurtful. The idea that mental labour may be advantageously supplemented by violent muscular exercise, such as is implied in long and fatiguing walks or laborious exercise on horseback, is an error. Moderate and regular exercise, at the same time, favours mental work. The practical point is to regulate the physical labour that it shall not induce fatigue.

IX

One of the surest means for keeping the body and mind in perfect health consists in learning to hold the passions in subservience to the reasoning faculties. This rule applies to every passion. Man, distinguished from all other animals by the peculiarity of his reason, is placed above his passions to be the director of his will, can protect himself from every mere animal degradation resulting from passionate excitement. The education of the man should be directed, not to suppress such passions as are ennobling, but to bring under governance, and especially to subdue, those most destructive passions, anger, hate, and fear.

X

To escape the evils arising from the use of alcohol there is only one perfect course, namely, to abstain from alcohol altogether. No fear need be entertained of any physical or mental harm from such abstinence. Every good may be expected from it. True, a certain very qualified temperance, a temperance that keeps the adult to a strict allowance of one ounce and a half of alcohol in each twenty-four hours, may possibly be compatible with a healthy life; but such indulgence is unnecessary and encourages the dangerous desire to further indulgence. A man or woman who abstains is healthy and safe. A man or woman who indulges at all is unsafe. A man or woman who relies on alcohol for support is lost.

XI

Smoking tobacco, and the use of tobacco in every form, is a habit better not acquired, and when acquired is better abandoned. The young should especially avoid the habit. It gives a doubtful pleasure for a certain penalty. Less destructive than alcohol, it induces various nervous changes, some of which pass into organic modifications of function. So long as the practice of smoking is continued the smoker is temporarily out of health. When the odour of tobacco hangs long on the breath and other secretions of the smoker, that smoker is in danger. Excessive smoking has proved directly fatal.

XII

Indulgence in narcotics, opium, chloral, chlorodyne, ether, absinthe, and all others of the class, is an entire departure from natural law. Except under the direction of skilled opinion and for the cure of disease, the use of these agents is subversive of the animal functions, and is a certain means of embittering and shortening life. It is doubtful whether the freedom of the subject ought to be permitted to extend to the uncontrolled self-indulgence in these poisons. The indulgence indicates an unsound reason which requires to be governed by sound reason, temperately enforced.

XIII

The food on which the man who would be healthy should live should be selected so as to ensure variety without excess. Animal food should not be taken oftener than twice daily. The amount of animal and vegetable food combined should not exceed thirty ounces in the twenty-four hours, and for the majority of persons an average of twenty-four ounces of mixed solid food, a third only of which should be animal, is sufficient. All animal foods should be eaten while they are fresh and after they are well cooked. The habit of eating underdone flesh is an almost certain cause of parasitic disease. The amount of fluid taken, in any form, should not exceed an average of twenty-four ounces daily. Water is the only natural beverage.

XIV

To escape the injuries arising from impure air it is necessary to attend to the following rules: To avoid the admission into closed apartments of air charged with any substance that offends the sense of smell. To avoid surcharging the air with vapour of water. To keep the temperature in every room as nearly as possible at the safe standard of 60° Fah. To take ample means of allowing air to escape from the room by every available outward draught, by the chimney flue especially. To admit air freely at all times, and, when a room is not in use and the external air is not charged with moisture, to allow the entrance of air from without through every window and door.

XV

Occupations of every kind, however varied they may be, require to be alternated, fairly, with rest and recreation. It is the worst mistake to suppose that most and best work can be done when these aids are omitted. Strictly, no occupation that calls forth special mental and physical work should fill more than one-third of the daily life. The minds of men of all classes ought now to be devoted to the promotion of a systematic method by which the productive labour of every life should be carried on within the limited term of eight hours in the twenty-four. The body of man is not constructed to run its completed circle under a heavier burden of labour.

XVI

Enforced idleness, by those who have acquired wealth, is always an error so long as the health is good. Men of business should never actually retire while they retain fair bodily and physical faculty. It is one of the gravest of errors to attempt to enforce idleness on others from the mistaken sentiment of wishing to place them beyond the necessity for work. This is against nature. The earth, which is itself ever in motion, demands ever the motion of cultivation from its inhabitants that it may be a garden properly arranged from age to age. Those, therefore, who have idleness thrust upon them, by their progenitors, should throw it off as if some necessity for work were equally theirs. By this plan they will live longest to enjoy the greatest happiness.

XVII

The natural duration of sleep is eight hours out of the twenty-four, and those who can secure this lead the soundest lives. It is best taken from ten o'clock till six, and it is most readily obtained by cultivating it as an automatic procedure. All stimulants, all excitements, all excessive fatigues, all exhaustions pervert sleep even if they do not prevent it. The room in which sleep is taken should be the best ventilated and the most equably warmed room in the house. The air of the room should be maintained at the natural standard of 60° Fah., and the body of the sleeper should always be kept completely warm. The bed should be soft and yielding. A regular tendency to sleep at other hours than the natural is a sure sign of error of habit or of nervous derangement.

XVIII

Dress, to be perfectly compatible with healthy life, should fit loosely, should be light, warm, and porous, should be adapted to the season as to colour, should be throughout every part of the clothing, upper as well as under, frequently changed, and should be, at all times, scrupulously clean. The wearing of clothes until they are threadbare, is an invariable error in all that respects the health, to say nothing of the comfort of the wearer. All bands or corsets which in any way restrict the course of the blood in any part of the body are directly injurious. Dresses dyed with irritating dyestuffs ought to be carefully avoided.

XIX

Connected with cleanliness of clothing, as a means of health, is personal cleanliness. Perfected action of the skin, so essential to the perfect life, can only be obtained by thorough ablution of the whole body. The ablution ought, strictly, to be performed once in every twenty-four hours. It is best to train the body to the use of cold water through all seasons, so that the requirement for water of raised temperature may not become a necessity. The simplest and best bath is the ordinary sponge-bath. Plungings, splashings, showers, and the like are mere pastimes. The occasional use of the hot air or Turkish bath is an important adjunct to the means of maintaining health.