On Slight Ailments

ACH one of us has, no doubt, suffered at times from slight derange ments of the health-derangements which are not dependent upon of likely to determine structural change in any tissue or organ in the body -due to temporary disturbance, to an alteration in the functional activity of tissues and organs, which may be soon succeeded by a return to the healthy state. In many instances the derangement depends upon the altered rate at which normal phenomena are performed. Perhaps, in consequence of changes in the blood itself or in the tissues outside the vessels, the blood flows too slowly or too quickly through the capillaries. These tubes often become unduly distended or relaxed. Disturbed action in the adjacent nerve-fibres is thereby occasioned, and pain or discomfort is in consequence experienced.

Among civilized nations a perfectly healthy individual seems to be the exception rather than the rule. I do not remember having seen more than two or three men in the course of my life who had never experienced any form of illness, and did not know what it was to feel out of sorts. It is indeed very rarely one meets with any one who has reached the age of thirty who will not admit that at various times he has suffered from many different, though slight, derangements of health. We are indeed often told by persons, whose prospects of longevity are nevertheless good, that they have scarcely passed a week without the occurrence of a very decided departure from the healthy state. The most healthy among us occasionally feel unwell and are less up to work than is usual. Some complain of feeling fatigued, others tell you they are 17

SLIGHT AILMENTS AND CIVILIZATION.

uncomfortable, or complain of being irritable and annoyed at slight troubles, which would not ruffle them in the least if they were in ordinary health. How few of those who take a very active part in the work of the world know what it is to enjoy uninterrupted health! Most have to work on in spite of lassitude, or headache, or muscular or nerve pains, or indigestion, or some other discomfort which continually troubles them. How many of us experience a confused feeling, an indisposition to mental exertion, a distinct sense of fatigue after what we cannot but regard as very moderate mental application! Many people take dismal so-called constitutional walks, not because they enjoy the exercise or from necessity, but because they have heard that this sort of penal servitude -walking for walking's sake-is necessary to keep themselves in a condition which some call health. Many a man thus imposes upon himself the regular performance of the most dreary form of task-work, and forces himself to go through his monotonous labors when his inclination would lead him to take rest and probably to go to sleep. In many instances the inclination would have the support of the reason.

Some, again, who are considered to be in perfect health, scarcely know what it is to sleep soundly and rise refreshed, with spirits buoyant, energetic, with a desire for work. Men and women there are, and in every class of society, poor as well as rich, hardworking as well as idle, who scarcely ever eat without discomfort, and suffer still more if they do not take their usual meal. Few, indeed, of those who live in cities pass through life without being troubled with various derangements connected with the action of the stomach and intestinal canal.

You will, of course, desire to know whether all these disturbances are necessary consequences of our civilization-of our somewhat artificial mode of living—or whether by altering our habits we could acquire and maintain a state of perfect health. Unquestionably not a few suffer because they are ignorant of the proper way of managing themselves in order that they may work most advantageously, or because they give way to habits of self-indulgence as regards the quantity and character of their food and drink. Many probably, from inherited weakness of various organs, would suffer more or less under any circumstances, and it is our duty to study the many ordinary slight ailments, in order that we may be able to mitigate the sufferings of our patients, if we cannot make them strong and vigorous. In this direction there is much to be done, and I cannot help thinking that of late years, in our zeal for pathological discovery, we have devoted less attention to functional disturbance than for the interests of the community might reasonably be looked for from us, and for the interests of true medicine might be expected.

What is the meaning of these slight, but perhaps very frequent, disturbances or derangements of the changes which take place in an organism whose tissues are in a perfectly normal state?

When any

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On Slight Ailments: Their Nature and Treatment