"How are pathological conditions removed by hygienic remedies?" asked Dr. Gorton. Replying to her own question, she stated:
1st. By a normal supply of those agents by which life is preserved and maintained.
2nd. By the application of the most available Hygienic remedial resources, according to the principle of care which she had previously indicated, which consisted in the modification of the remedial effort by a wise discrimination in the use of the different Hygienic means available. She added: "Particular remedies (by which she meant particular Hygienic means) are indicated in particular cases." We can deny the body water only as it refrains from demanding this element of Hygiene; we cannot deny it air at any time; food can be withheld only so long as the body is in possession of reserves to sustain it while no food is taken; rest is imperative in states of great weakness or prostration; exercise must be adjusted to the abilities of the chronic sufferer, etc.
The Hygienist regulates the food, temperature, activity, rest, etc., of the sick not with the thought that such regulation constitutes a cure, but with the full knowledge that these are the fountains of organism without which life cannot continue. He knows that healing is a vital or biological process, as much a function of the living organism as digestion, circulation, respiration, nutrition, excretion, etc., and that he can neither imitate nor duplicate the process.
If there is fever, the Hygienist does not administer antipyretics or febrifuges to reduce the temperature. Experience has demonstrated that such things are neither necessary nor beneficial. They are impediments thrown in the way of the organic energies and, though they may occasion an apparent change in the condition of the patient, they are not wanted by the living system and must be expelled from it as rapidly as possible. In thus diverting the body's effort in expelling the drug, the life of the patient may be snuffed out. At the least, his suffering is prolonged.
All this is out of place at all times; it becomes dangerous in low or atonic states of the body, when energy is low and must be husbanded with great care. Medical students study physiology, but never think of applying its laws to life, nor do they ever think of doing so when, after graduation, they are engaged in treating the sick. No amount of study of physiology causes the medical student or the medical practitioner to alter his ways of life. His studies are all related, both by his texts and by his teachers, to medical and surgical practices.
Hygienists do not treat disease, but supply the means of life to the sick organism in different circumstances and conditions in accord with certain definite natural principles, not with the idea that this cures disease, but with the purpose of supplying physiologic needs. These needs are not supplied by any mechanical routine, but according to the conditions and actions of the organism. In Hygiene, the healing processes of nature are aided from the beginning by supplying the normal needs according to the capacity to use them; hence, recovery is proportionately rapid.
There are no radical changes in the sick organism to cause it to need that which it does not need and cannot use in a state of health. Its needs are the same in kind; its changed needs reside, not in the kind of needs, but in the amounts of these it can appropriate and utilize. If digestion is suspended, it does no good to take food; if there is great weakness and an unmistakable demand for inactivity, exercise would be ruinous. The measure of good care of the sick is the capacity of the impaired organism to appropriate and constructively use the normal needs of life.
This rule--that the ability of the organism to utilize the normal factors of life--constitutes the measure by which these are to be supplied to the sick person and is identical with the rule that should govern us in supplying these same needs to the well. Excess, which I shall here define as any amount above the genuine needs of the organism, whether well or sick, is hurtful rather than helpful. A strict observance of this rule in caring for the sick will enable us to handle the sick according to individual needs or limitations and not according to any cut-and-dried formula which is supposed to fit everybody. Needs and capacities vary with individuals and with the same individual at different times.
The adjustment of means to ends that this requires is the same in kind as the adjustments that the healthy body is making ordinarily at all times; they are the very adjustments that the sick body would make were it left to its own devices. In health we take more water or less water, as need arises, and are guided in this by our sense of thirst; we take more food or less food as we require more or less, and are guided in this by the demands of hunger; we take more rest and more sleep, or less of these as we need them, and are guided in this by our sense of fatigue and sleepiness. Such adjustments are normal parts of the process of living. Our trouble in sickness arises out of our desire to have the sick, hence, crippled organism take food, air, water, exercise, etc., as though it were well and leading an active life.
We do not, as some early Hygienists thought we should, employ Hygienic means for the modification of the remedial effort--to exhaust, depress or diffuse as circumstances demand. Hygiene is not a means of controlling vital activities in the way the practitioner thinks they should be controlled. All the control that the vital activities require may always be secured by supplying physiological wants--that is, by placing the sick organism under the proper conditions for the successful operations of the body's remedial actions. Were Hygiene a system of arbitrarily controlling physiological activities, it would simply be another system of cure, hence false. (Charles F. Taylor, M.D., was of the opinion that, as Hygienists continue the development of their system, "a complete system of medical hygiene" will be wrought out.) As study and experience have increased our understanding, we no longer consider it legitimate to juggle Hygienic means, as some early Hygienists thought they should be juggled.
It is true that by manipulating the means of Hygiene, it is possible to control physiological activity to a marked extent and it may still be thought by some that we can and should do this for remedial purposes; but it is doubtful that we can consider meddling with the activities of life as constructively as these may think. Instead of control, we should seek to supply needs. The greatest danger, both with the practitioners and the patient, is in overdoing and this results from ignorance of the truths of physiology and biology. Unless these truths are known and observed, Hygiene will degenerate, like the drugging system, from a matter of principle into a matter of routine and this will end its power.