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Impaired Health Its Cause And Cure by J. H Tilden, M.D.

Diseases Of The Nervous System

INTRODUCTION

   To introduce this subject, I desire to say a little about the influence of functional derangement of the nervous system on our daily lives. This subject is not considered in the average textbooks, nor by the average physicians in their general practice. Full nerve energy indicates full nutritive power. This means that metabolism will be carried on normally, that secretions and excretions will be balanced, and that the body will be in as near a normal condition as it is possible for a human being to be. It should be understood that full health is a state which only approximates the ideal; and this state is always in keeping with the nerve energy. To maintain nerve energy at a normal state, it is necessary for man to be adjusted to his environment, and his everyday experiences in that environment must be of such a character as not to overtax and draw too heavily upon his nerve energy. In other words, man's body must be adjusted to its environments. Any influence, it matters not what, that draws too heavily upon the nerve energies, weakens this energy to just that extent. If man uses up too much nerve energy, if he uses a little beyond his creation of nerve energy, each day, it is obvious that he must be gradually running out of this power, Overwork, over-enjoyment, exposure to the elements, physical influences, eating, clothing, etc., all have their influence in using up the nerve energy.

   Where nerve energy is used beyond the recuperative power for a time, we have enervation following. This causes an interruption--retarding--of secretions and excretions. Add to this retention of excretions the toxins that evolve when the eating is beyond the digestive power. This toxic state brings about functional derangement of the nervous system, and also functional derangement of various organs of the body.

   Much more on this subject will be found in [Tilden's book] Toxemia Explained.

Influences That Lead to Nervous Diseases

   I have explained above how enervation is brought about. Special tracts are affected by local injuries. An injury to any part of the body is liable to set up for the time being an enervated state of the nervous system supplying that particular part. Waste products fail to be eliminated, but are deposited, causing irritation. We have whole systems of healing based upon this derangement of the nervous system. Where the nerves pass out of the spine they are liable to become cramped or impinged because of slight deposits, luxations, or displacements. When this is true, the osteopath and chiropractor are almost invariably successful in giving relief and cure. Where the condition is due entirely to a slight misplacement, the readjusting and righting of the anatomy must necessarily bring a cure; but where nerves are passing out through small foramina or openings between bones or other points, deposits are liable to take place when there is such a state of the blood as toxemia, plethora, scurvy, or gout existing. In these constitutional states there is a certain amount of deposit taking place in different parts of the body, and if a certain part of the anatomy is exposed to irritations--if muscular energy is expended over a certain locality, causing a freer flow of blood to the part than is normal--deposits will take place. If these deposits take place in small bony openings, where nerves and arteries pass out, the nerves will be impinged upon, then cause pain--neuralgia or rheumatism--and, when continued, arteritis and endocarditis. To overcome nerve impingement, there must be absorption. Manipulation and exercise will often bring temporary relief by causing absorption of the present deposits; but so long as the constitutional derangement remains, there will be a redeposit, and all tender points throughout the organism--all points where discomfort is once developed on account of this state of the blood--will reappear. There can be no permanent cure until the habits of life are corrected to such an extent that the organism will no longer keep up its manufacture of toxins and pathological deposit.

   It is obvious that manipulations of all kinds will be beneficial. Electricity, vibratory treatment, massage, and certainly osteopathy and chiropractic adjustments, will be followed with positive relief. But such relief will often make the patient and doctor believe that a cure, has followed, when, if what I say is true, it is absurd to believe that a cure can be brought about in this way. In addition to the so-called cure, the righting of the system, by correcting disease-producing habits, will remove the cause; and then a cure may be had that can be depended upon.

    In injuries of all kinds there is a tendency for a deposit to take place, because nature rushes there with surplus material to make repairs. But after there has been a restoration to the normal of the parts destroyed, and surplus material is, left--for instance, in the healing of bones--after the bone has been thoroughly united there is a great quantity of debris, not unlike joints made by plumbers; and these extra deposits must be absorbed in the course of time, especially the soft structures. A bony deposit that has taken place will to a certain extent be absorbed, but there will always remain an extra amount, which is for bracing purposes. In injuries, however, where there is no need of this surplus material, and where the surplus material impinges on a nerve structure, either a painful state will remain at that point, or the irritation will be reflexed to other parts of the body. This will be the invariable experience, and will require a treatment which will overcome this condition.

   Manipulation will cause absorption; but if there is a slight irritation at the locality, which will bring a surplus amount of blood, there will be redeposits and a return of the discomfort. In all subjects where there is a scrofulous or gouty diathesis, and where there is a general toxemic state of the blood, the redeposits will continue until the toxemia is overcome and the system is readjusted to the original or normal state. It should be kept in mind, in treating the sick, that whatever is necessary to be done to bring them back to the normal should be done; and it should be obvious to all intelligent people that where there are irregular habits or bad habits--where the life is not up to the normal--in any respect, these perversions must be righted. There can be no hope of a readjustment and a bringing back to a normal state without correcting the errors of life.

 

A. DISEASES OF THE SPINAL CORD
I. LOCOMOTOR ATAXIA
(Posterior Spinal Sclerosis)

   This disease is characterized by disturbances of sensations and incoordinations of the muscular system. Nutritive changes are also in evidence. There is also found degeneration of the root fibers of the dorsal columns of the cord. The disease means hardening of the posterior columns of the spinal cord. This hardening is on the order of arteriosclerosis. It is really a changing, so to speak, of the spinal cord--a premature aging of the nervous system. The symptoms all point to more or less degeneration of the brain, especially that part related to the cord.

   Etiology.--This is a very common disease--more common in cities than in the country. Men are more inclined to have the disease than women; the proportion is estimated at ten to one. It is a disease of adult life, the majority of cases developing between forty-five and fifty. Occasionally cases are seen in young men. I think all authorities agree that syphilis is the cause. My experience--which has not been small--is positively contrary to this opinion. The disease is strictly an old-age disease, and so are most of the chronic symptoms attributed to syphilis; but there is good reason for young men thirty-five to fifty years of age being brought down with locomotor ataxia, for the disease is certainly an index to imprudent life from a sex standpoint. The general opinion about the cause is approximately right, yet absolutely wrong. By "approximately right" I mean that it is a disease brought on oftener from sex abuse than from any other cause. However, anything that will use up nerve energy and break down the nervous system is liable to develop locomotor ataxia. But in all cases that I have ever seen there has been a history of early self-abuse, beginning as early as eight years of age and continuing with either the practice of onanism or excessive venery to forty years of age and the full development of incoordination; and in the majority of these cases I have found that there was not a reliable history of any kind of venereal disease. Where the diagnostician starts out with the assumption that syphilis is the cause, he will convert every sort of pimple or blister around the reproductive organs, lips, mouth, or throat, which would hardly be noticed, into a syphilitic infection. Where trouble is sought for it is exceedingly easy to find; this is true in the search after the etiology of locomotor ataxia. In the majority of cases, so far as I have seen, it requires an exceedingly strong imagination to ferret out an excuse for syphilis; but it does not by any means require a sleuth hound to discover sex abuse to such an extent that it is a wonder that some of these people are left to tell the story. To add to this one cause, there are many others, such as deranged digestion, overwork, worry, anxiety, overworked emotions, exposure to cold and wet, the excessive use of alcohol, tobacco, coffee, and tea.

   In all subjects of middle age and over, prostatic enlargement with the accompanying symptoms must be kept in mind by the diagnostician. I am satisfied from years of experience that often first-class physicians pay little attention to prostatic enlargement with its varying symptoms, when reckoning up a diagnosis of any kind, and especially in diagnosing ataxia. I never pass up a patient over thirty-five years of age without an examination of the posterior urethra and neck of the bladder, for a possible pathology, caused by enlarged prostate gland. It is almost as common among men over thirty-five years of age as enlarged tonsils in children, but strange to say, it is criminally neglected and overlooked by many clinicians. For years such patients have been coming to me after getting the last word on diagnosis--the clinic not even hinting that there might be such a condition existing.

   The symptoms of locomotor ataxia and those accompanying enlarged prostate gland, inflammation of the urethra and urinary bladder, often parallel each other so that sometimes the symptoms would be summed up as locomotor ataxia when they really belong wholly and entirely to prostate gland enlargement and its varying symptomatology; which symptom complex is very much more simple to treat and more amenable to treatment than the complex of locomotor ataxia.

   The latter disease is one of a general giving down of the entire nervous system. The patients of the former may be brought back to very good health if they are willing to follow a rigid regimen for life. Men of no self-control will find the cards stacked against them at every turn, with either of these so-called diseases. The straight and narrow path is the only road to travel. The ataxia subject can do much for himself--not by drugging--not by any curing scheme, but by learning how to conserve every bit of nerve energy. "Regular" medicine has nothing to offer that will not hasten the end.

   Doctoring always comes to the end of palliation--either death of the patient, or the patient senses that he has been paying for a benefit he never gets, but, instead, a hurry all to eternity. All cures end in premature demise, the contention of medical superstition to the contrary notwithstanding.

   Symptoms.--There are three stages--namely, incipient, ataxic, and paralytic. Symptoms in the incipient stage, which is sometimes called the pretoxic stage, differ very widely. There will be pains of an indefinite character, which may be treated for rheumatism or neuralgia. Sometimes a very great discomfort will occur in the rectum, which may be treated as hemorrhoids or proctitis, or even stricture, when the irritability is wholly reflex and in reality there is absolutely nothing pathologic about the rectum. Some will complain about an irritability of the urethra. I had a case with one tormenting symptom--namely, a feeling as though there were a hair in the throat.

   This man had kept first-class specialists in New York, Philadelphia, Baltimore, Pittsburg, Chicago, and Denver in meal tickets before he came into my hands. After having a long talk with him, I told him to return home. He lived in Pittsburg. I told him that if he would forget his trouble he could live a number of years yet. I explained to him that it was simply a nervous irritation, indicating the development of tabes dorsalis. No treatment would be of any avail. So long as he annoyed himself by going from place to place, expecting to be cured, and then being disappointed, he would be annoyed so much that life would not be worth the living; but if he could manage to forget it, and think of something else, his life ought to be made fairly comfortable by living correctly, and he should live for a number of years.

   Two years afterward I received a letter from his wife, thanking me for my help to him. She declared that he had overcome his tendency to dig into his throat to such an extent that he would forget it for days at a time; at least he would forget it long enough to attend to a certain amount of business, and would pass days without making any remark about the discomfort or annoyance; for, as he declared himself, it did not amount to a discomfort, but he felt that, if he could just get hold of the hair and pull it out, he would be fully relieved.

   The pains that precede this disease are of a sharp, darting character. They may show in almost any part of the body. They do not last long. Their tendency is to appear around the belt region. However, there will be darting pains occasionally in the intestine and in the sensitive spots, and a very wise physician will probably advise that there should be an operation for appendicitis. In some cases there is started up a numbness in the feet--a tingling sensation; and then in others there will be a feeling of constriction about the waist, as though the clothing were too tight. In a small percentage of cases there will be an atrophy of the optic nerve. This causes blindness to come on very early in the disease. This atrophy comes on very gradually, and ultimately leads to total blindness.

   There is ptosis of the eyelids. The pupil is sometimes exceedingly small, due to spinal myosis. The Argyll-Robertson pupil indications, with the darting pains and ptosis, are considered diagnostic. The character of the pupil is a contraction, with loss of reflex to light. To show how very specific is the idea that syphilis is the cause of this disease, I will repeat a few lines from a well-known authority: "The time between the syphilitic infection and the occurrence of the symptoms of locomotor ataxia varies within a wide limit. About one-half the cases occur between the sixth and the fifteenth year, but many begin even later than this."

   Ataxic Stage.--The first symptom that the patient experiences is inability to get around in the dark, or inability to stand with the feet together and the eyes closed. Patients in this condition are wholly incapable of standing on one foot. The walk of the patient suffering from ataxia is very characteristic. There is a decided inability to control the movements. The feet come up with a jerk, and are pushed forward in an irregular way, and while clear of the ground there is more or less of a tendency to fall about either to the right or left. Coordination is almost entirely lost; that is, the power to control the movements is apparently not strong enough to do anything more than lift a projected foot and leg, but where and in what direction the movement will be made is conjectural. The patient evinces strength, but nevertheless there is this lost power of controlling the movements. The push and pull of the legs are strikingly strong, showing that incoordination is choreic rather than paralytic. There is paralysis to just the extent that the joints are more than usually relaxed, so that there can be a hyperextension and a hyperflexion.

   Sensory Symptoms.--Lightning pains may continue. These pains, however, vary greatly in different patients. Some patients will not complain very greatly. Others will complain a very great deal, and the pain is so persistent in certain localities that it is sometimes mistaken for rheumatism. Tingling sensations, described as pricks of pins and needles, are present in the feet. Sometimes patients have a sensation as though there were something between the feet and the floor--when the naked foot is put on the floor, as if there were cotton between the floor and the foot. These, of course, are symptoms of lost sensation--or perhaps I would better say incoordinate sensations.

   Sometimes there is lost power of localizing pain. A prick on one limb may be felt on the other, or a pin prick on one foot may be felt on both. In these cases a time comes when the patient loses power to recognize in what position the leg is. It may be extended far to the side, yet, so far as the consciousness of the patient is concerned, he will not know but that both feet are together and the legs parallel to each other.

   Reflexes.--Lost knee-jerk, or patella reflex, is an early symptom; in fact, this often exists when there are scarcely any other symptoms. But in all such cases I have found chronic, granular inflammation of the urethra. Almost invariably these cases have shown one or more strictures of the urethra, bearing out the belief I have had for a number of years that the disease is brought on from excessive venery and irritation of the reproductive organs, more than from any other one cause. Continuous subacute reflex irritation from stricture of the urethra--or what is sometimes called gleet--is capable of breaking down the nervous system and bringing on tabes dorsalis. This, however, will require a certain amount of toxin poisoning--toxemia--to hasten the development. There is nothing that so breaks down the nervous system and prepares it for taking on tabes dorsalis as venereal shocks and where these shocks are excessively frequent, and continue over a number of years, patients are liable to go down and out with locomotor ataxia before the chronometer has tolled off half the years that should come to man.

   Deafness is not uncommon as one of the early symptoms of this disease; yet it cannot be recognized as characteristic, for people who develop ataxia have in all probability been more or less troubled with catarrh all their lives, and the deafness may be wholly catarrhal.

   Vertigo is another symptom that does not necessarily belong to this disease, because it may be a symptom of indigestion and liver derangement. The irritations that cause such patients to consult physicians--such as laryngeal, gastric, nephritic, rectal, or urethral irritations, etc.--are what are in ataxia called crisis symptoms; but they belong to arteriosclerosis as well, and are brought on by hyperemia. As stated before, they are purely reflex. The most common, or gastric and laryngeal, both may be found in chronic irritation of the stomach of dyspeptics, tobacco-users, and those given to excessive use of any stimulants; hence such symptoms will be of no importance, unless they are found existing without the usual symptoms of gastric derangement due to improper living.

   One of the early symptoms of locomotor ataxia is a retarded, or rather a hesitating or halting, expulsion of the urine, The desire to, urinate will be present, but the patient will experience difficulty in starting the stream. Almost any kind of symptoms of a cerebro-spinal nature, due to degeneration, may be looked for in subjects of this disease.

   Paralytic Stage.--In time these cases arrive at paralysis, where there is no power to walk. Then, of course, they become bedridden. At this time, or before, such patients are often carried off with some intercurrent affection, or a hyperemia, or apoplexy, of a vulnerable organ, brought on from an indiscretion that in health would scarcely be noticed.

   Diagnosis.--Lightning pains, inability to stand with the eyes closed, etc., are considered almost diagnostic.

   Treatment.--There is only one cure, and that is prevention--removing the causes before the disease is developed. The habits of life must be corrected. A very foolish manner of treating such cases is for the physician to permit the patient to continue the use of tobacco, coffee, tea, or other stimulants, and prescribe such so-called remedies as strychnin, tonics, etc. Patients must be kept away from all stimulation, and they should be kept out of the atmosphere of them as much as possible. For instance, they should not be confined to offices where there is tobacco smoke, or in homes where the odor of coffee is in the air two or three times a day. It must be remembered that the farther down the nervous system is driven--enervated--the more easily it is affected, and patients may become so susceptible that the inhaling of tobacco smoke for a few seconds will produce as much irritation as two or three cigars would produce several years before the breakdown came. In this respect patients frequently do themselves great harm. They know what they have been able to do; they are quite willing to believe that they can indulge a little, compared with the old supply; and they treat the subject of overstimulation and bad habits in the same way all along the line; and too frequently physicians concur with the patient in this matter. Such patients should be impressed with the necessity of doing absolutely THE RIGHT THING ALL THE TIME; they should be made to see that there is everything to gain and little to lose, and that that little is more easily lost than even average physicians can be made to believe. Thus no one is justified in going on the principle that he has nothing to gain, that everything is lost; for nature is more than willing to meet all patients half-way--yes, nine-tenths of the way. Hence those who wish to get any benefit--continue in life and enjoy much comfort--must pay the price, which means absolute continence, complete abstinence from all stimulation, and a very simple diet, made up of fresh, uncooked fruits for breakfast; salad, cooked, non-starchy vegetables, and wholewheat bread, potatoes, or some one of the decidedly starchy foods, once a day for a second and last meal; and abstinence from strong meats, such as beef, pork, etc. Lamb, chicken, fish, or eggs may be indulged in once or twice a week, dropping the starch; but it is my opinion that those patients will live longer and enjoy better health if they do not indulge in animal albuminoids at all; for decomposition of the protein in the intestine is one source of toxin poisoning in this tragic disease.

 

II. GENERAL PARALYSIS

   Definition.--A progressive disease of the brain and meninges, associated with mental and motor disturbances.

   Etiology.--All nerve disturbances of a degenerative form are looked upon by a stereotyped medical mind as originating from syphilis. It is the consensus of opinion of the medical profession that syphilis is the cause of all degenerative cerebro-spinal affections in seventy to ninety per cent. I may be lacking in gray matter, but I do not believe that this is true; for the disease can be found in country districts, affecting people who have lived far from the centers, and who have never had syphilis or anything of a venereal character. The answer to that statement by those who advocate the syphilis idea, is that it has been inherited. It is necessary to make this assumption; for the theory would break down without it, and, according to the experiences I have had, it is not necessary to bolster an assumption with a fallacy to know the cause of the majority of diseases ending in cerebro-spinal degeneration. As stated under locomotor ataxia, excessive venery, plus toxin poisoning developed by putrefaction from imprudent eating--from a haphazard style of living--is quite enough to account for seventy to eighty per cent of the cases attributed to syphilitic infection. Heredity is said to be a very important factor; obviously, however, only to the extent that we inherit a tendency to take on certain lines of disease.

   In general paralysis, next to syphilitic heredity as a cause, it is said that an important predisposing cause is a life spent in ambitious projects that require strong mental effort to realize. Business propositions which require great nerve strain are in this class. This I accept, with the addition of a haphazard daily life for there is nothing that will harden and age the nervous system like a continuous strain or worry. But overstimulation is necessary to worry successfully. Such people take their business to bed with them, adding worry at night, and coffee, tobacco, and often alcoholics during the day, to hard work and this conglomeration of causes leads to enervation. No nervous system can long stand up under a continuous strain--under continuous hard work and bad habits--if there is worry added to it.

   Symptoms.--Irritability; inattention to business, amounting to apathy. Previous to the development of the degeneration, subjects may work night and day, when all at once they decide to have a little vacation and pleasure. They will take interest in affairs of life which before had never even drawn their attention, and friends who are close to them will be surprised to see them leave their desks, and the work that they had pursued so intensely, and go off for an hour, seemingly without anything to do, with the mind on subjects entirely out of keeping with their business. When anyone acts in this way, it is quite safe to assume a failing mind, and if dementia follows, friends should not be surprised. It is simply a giving-down of an overworked brain and nervous system. It is obvious that such people are profoundly egotistical and self-centered before, and even after, the mental degeneration.

   The Argyll-Robertson pupil is present, and often optic atrophy, which is liable to lead to total blindness. The facial symptoms--the peculiar stolidity of the features, tremulousness of the muscles of the face, and inability to protrude the tongue--are characteristic. It is said that those who lead a very active life and do a great deal of hard work are more liable to have tabes than paralysis. The truth of the matter is that hard work is blamed for what sensuality does. It has been my experience that office men--those leading sedentary lives, writers, etc.--are more inclined to develop tabes. Both diseases are remediable, if taken before organic degeneration has advanced too far. Some cases of tabes show topical paralysis early.

   Treatment.--Correcting the life is the only thing to do that will bring relief, and it is the only thing that is necessary. Stimulants must be tabooed, and eating should be light. Stimulating food, such as meat and bread three times a day, must be given up. Take bread about once a day, meat not at all in the summer time, and two or three times a week in the winter time; fruit for breakfast; a combination salad, meat, cheese, or nuts, with cooked vegetables, for dinner. Abstain from all stimulants.

 

III. HERPES ZOSTER (Shingles)

   Definition.--An acute inflammatory disease of the skin, which consists of vesicles on a reddened base, the lesions being distributed in relation to the course of the cutaneous nerves, and as a rule unilateral. The outbreak of the eruption is usually preceded by severe neuralgic pain.--Gould.

   The latest opinion is that this disease is an acute hemorrhagic inflammation of the dorsal roots of the spinal nerves; that it is an acute affection of the nervous system and localizes on one side of the body. One peculiarity of the breaking-out on the skin is that it will not cross the median line either in front or behind. This disease takes its name from the locality. When it is on the face it is herpes facialis; when it is on the lips, it is herpes labialis, etc.

   Herpes is a most disagreeable disease. The eruption is sensitive, and the rubbing and chafing from clothing, bandages, and dressings contribute to make the disease--affection is a better term--very disagreeable.

   Etiology.--Herpes is a reflex irritation. The real cause is intestinal putrefaction, causing toxin poisoning. Because of nerve inhibition, that part of the surface which is involved cannot eliminate through the natural channels; hence there is forced elimination by the cutaneous emunctories, with topical infection and consequent inflammation.

   Treatment.--Rest in bed when possible, and a fast of sufficient duration to establish full elimination. When the affection is controlled, then feeding should be fruit at first; then fruit and salads; then a dinner of starch, vegetables, and salad daily, with fruit for the first meal.

 

IV. ENDARTERITIS

   In people over fifty years of age it is quite common to find hardening of the arteries of the spinal cord. In all probability this is due to the fact that in the majority of people the spinal cord is allowed to become very inactive. Very few men keep up any very great amount of exercise after thirty years of age. What little they do does not bring into activity the spinal column. This naturally will lead to stiffening and hardening of the parts involved.

Next Diffuse and Focal Diseases of the Brain