Weight And Good Feeling
Probably the most important single condition for the maintenance of
good health and good feeling is the carrying of weight normal for
the height and age of the individual, or slightly in excess of normal.
Popular expressions contain many proofs of this. The proverb "laugh
and grow fat" is undoubtedly due to the recognition by all the world
that stout people are nearly always laughers, and as a consequence,
perhaps plac
as a factor in putting on flesh. [Footnote 27] There is no doubt that
the exercise for the diaphragm afforded by hearty laughing, with the
stimulation of the intra-abdominal circulation consequent upon
vigorous diaphragmatic movements, is an important element in producing
a healthy state of the important organs of the human economy contained
within the abdominal cavity. Dr. Abrams in his book, "The Blues,
Causes and Cure," attributes this disturbing condition of depression
so familiar to those who have much to do with nervous patients, to a
disordered blood and nerve circulation in the splanchnic area, and
calls it scientifically, splanchnic neurasthenia. This undoubtedly
sums up one important element in the causation of a great many
depressive conditions. Most of them are banished by frequent hearty
laughter which, with its exercise of the diaphragm, tends to stimulate
splanchnic blood vessels and nerves.
[Footnote 27: Those who are interested in fossil words will find many
curious confirmations of the connection between weight and good
health and good humor. A typical illustration is the word buxom,
derived from the German biegsam, which means "ready to obey," from
the original significance of being ready to bend, that is bendsome.
In our day it has come to have quite a material rather than an
ethical significance. A buxom woman is one who is round and full of
form and while she usually also is cheerful and tractable, the two
ideas are not necessarily connected. It is curious that what was
originally the obedient wife should now have become the stout and
healthy wife, as if stoutness and healthiness were somehow
inseparably connected with the preceding idea so that gradually one
portion of the meaning was lost sight of and now only the physical
significance remains.]
Thinness and Discontent.--In general, it is well understood that thin
people are likely to be more gloomy and discontented than those of
stouter build. The pessimists of the world have usually been lank and
lean. Shakespeare, in "Julius Caesar," has the great Roman declare
that he likes not "the lean and hungry Cassius," and that "discontent
is bred in such bodies." The issue shows his prophetic power.
Discontent with life is much more likely in thin people than in stout.
Most suicides are under-weight. Where nutrition is under the normal,
digestion is sure to be poor because the digestive organs themselves
suffer even more than others from lack of food, apparently giving up
some of their own substance at the call of other tissues; sleep is
nearly always disturbed, constipation is almost the rule, and muscular
action becomes distasteful. While in our day we hear much of people
overeating, the nervous specialist finds that many of his patients are
undereating. These patients grow out of many discomforts,
dreads, and symptoms that often seem, even to the physician, to be due
to organic change, when they take on enough weight to relieve them
from the incessant calls for more nutrition to which insufficient food
has made them subject.
Physical Disadvantages of Thinness.--There are many dangers that go
with thinness besides the tendency to that irritability of the nervous
system which we have come to associate with neurotic symptoms. It has
long been known that a person who is under weight is much more likely
to contract tuberculosis than a normal individual. From carefully
selected statistics, the large insurance companies have determined,
that it is far more dangerous to insure a man who is twenty pounds
under weight and who has no family heredity of tuberculosis than to
insure a man with a family history of tuberculosis on both sides of
the house, provided he is well up to or above the normal weight, and
is not living in special conditions of danger from contagion. It is
contagion and not heredity that plays the most important role in
tuberculosis, and the element that is still more important is that of
vital resistance. Every adult of thirty years or over has probably at
some time had tuberculosis, for traces of its presence are found in
the bodies of all adults who come to autopsy. Seven-eighths of the
human race are, however, able to resist, and among these seven-eighths
by far the greater proportion are those who are above normal weight.
Of course, this matter of the relation of normal weight to good health
did not escape the acute observation of the old physicians.
Hippocrates, to take the first and greatest of them, realized that
while excessive eating and drinking was serious, there were many
people who suffered from not eating enough. One of his aphorisms runs,
"A slender and restricted diet is generally more dangerous [manifestly
he means to both the well and the ill] than one a little more
liberal." He appreciated, too, the fact that while the old may
restrict their diet with more or less impunity, this practice may be,
and indeed is likely to be, more serious in young people. He has
marshaled the ages and stated the effects of a low diet on them very
definitely:
Old persons endure fasting most easily, next adults; young persons
not nearly so well, and infants least of all, especially those who
are of a particularly lively disposition.
Discomfort Due to Lack of Fat.--Many of the vague discomforts of the
internal organs seem to be due to a lack of fat cushions round them,
and fat blankets to keep them from being too much subjected to the
vicissitudes of external temperature. Anyone who has noted in a series
of cases the difference between the condition of patients suffering
from a slightly movable kidney when they are well up to weight, and
when, on the other hand, they are considerably reduced in weight, will
have the significance of the first of these conditions brought home
very clearly. Most of the people who suffer much from cold in winter
are greatly benefited, as might be expected, by a blanket of fat. It
is rather easy to grow accustomed to carrying ten additional pounds of
fat when ten additional pounds of clothes would be an insupportable
burden. Some fat people are prone to complain of the cold. These are
not the plethoric but the anemic. This latter class often have a
sluggish circulation, besides a lack of hemoglobin. As a consequence
of this their oxidation processes are slow and imperfect, and
this is one of the reasons for the over-accumulation of fat. The
healthy individual with normal heart and normal blood-making apparatus
will always be ever so much more comfortable with a reasonable
panniculus adiposus and fat cushions and coverings for the internal
organs.
Muscular Weakness and Discomfort.--There are a number of pains and
aches occurring in lean persons that are due to nothing else than the
weakness of muscle consequent upon the poor nutrition of their
muscular tissues. Muscles which do not receive as much nourishment as
they should, must necessarily be weak, and if asked to do much work
they will resent it. Ordinarily it is not realized how much work is
required even for such common muscular efforts as those that are
needed to hold the body erect, or to keep it in a stooping position at
a definite angle, or to move around on the feet.
I have seen patients lose their aches and pains, and become quite
capable of standing weather changes and ordinary hard muscular labor
without discomfort, simply as the result of a decided gain in weight.
All that was needed was the persuasion to eat more, and especially to
eat a full breakfast, the meal likely to be neglected. In some
persons, appetite will only return after the correction of
constipation and insistence on a certain amount of outdoor air every
day, not necessarily exercise--for bus riding or the open cars are
excellent appetizers.
Eating Enough.--It is very difficult to persuade some people to eat
enough! They have all sorts of excuses. They rather pride themselves
on the fact that they do not eat much. Persons who are twenty pounds
under weight will calmly tell you that they do not need more than they
eat. They are actually in debt to that extent to their tissues, yet
they are persuaded that they are paying nature's claims in full.
Sometimes the excuse is that they have heard, or read, of how much
harm is done by overeating; they have taken to heart the phrase that
people are digging their graves with their teeth, and so they are
actually cultivating the habit of undereating instead of allowing
their instinct for food to manifest itself. Many are found to be
following the good old saw of getting up from the table hungry. The
inventor of it is not known, but quite unlike the inventor of sleep,
it would have been a great blessing if he had kept it to himself by
patent right.
After a time habit for these people becomes second nature, and it is
hard to get them to eat enough. When people undereat it is the
digestive organs that, in my experience, always suffer the most. As a
consequence, the appetite decreases because of gradually acquired lack
of vitality in the digestive system, its nutrition having been lowered
by drafts upon it from other portions of the body. Quite contrary to
what is told in the old fable, the stomach apparently is not selfish
and does not keep the lion's share for itself. The decrease in the
amount of food brings on a decrease in digestive power.
Weight for Height.--The physician who wants to help patients by
suggestion must keep before him weight tables for height, as they have
been determined by statistics. When people are under weight, it
matters not what they may be suffering from, improvement will come if
they are made to gain in weight. To be able to show them that they are
considerably below the normal and to point out what this probably
means in lack of surplus energy, suffices of itself to make many
people understand the necessity for effort in the matter and to
give them a strong suggestion as to probable relief of their symptoms.
The following tables are the best-known averages for men and women:
ADJUSTED TABLE OF WEIGHTS FOR INSURED WOMEN, BASED ON 58,855 ACCEPTED LIVES
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 Combined
Ages
4' 11" 111 113 115 117 119 119 122 125 128 126 118
5' 0" 113 114 117 119 122 122 125 128 130 129 120
5' 1" 115 116 118 121 124 124 128 131 133 132 122
5' 2" 117 118 120 123 127 127 132 134 137 136 125
5' 3" 120 122 124 127 131 131 135 138 141 140 128
5' 4" 123 125 127 130 134 134 138 142 145 144 131
5' 5" 125 128 131 135 139 139 143 147 149 148 135
5' 6" 128 132 135 139 143 143 146 151 153 152 139
5' 7" 132 135 139 143 147 147 150 154 157 155 143
5' 8" 136 140 143 147 151 151 155 158 161 160 147
5' 9" 140 144 147 151 155 155 159 163 166 165 151
5' 10" 144 147 151 155 159 159 163 167 170 169 155
Combined 123 126 129 132 136 136 139 142 145 142 133
Heights
The average shoes of the average woman will raise her about 1-1/2 to 1-3/4
inches.
DR. SHEPHERD'S TABLE OF HEIGHT AND WEIGHT FOR MEN AT DIFFERENT AGES
15-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69
5' 0' 120 125 128 131 133 134 134 134 131
5' 1' 122 126 129 131 134 136 136 136 134
5' 2' 124 128 131 133 136 138 138 138 137
5' 3' 127 131 134 136 139 141 141 141 140 140
5' 4' 131 135 138 140 143 144 145 145 144 143
5' 5' 134 138 141 143 146 147 149 149 148 147
5' 6' 138 142 145 147 150 151 153 153 153 151
5' 7' 142 147 150 152 155 156 158 158 158 156
5' 8' 146 151 154 157 160 161 163 163 163 162
5' 9' 150 155 159 162 165 166 167 168 168 168
5' 10' 154 159 164 167 170 171 172 173 174 174
5' 11' 159 164 169 173 175 177 177 178 180 180
6' 0' 165 170 175 179 180 183 182 183 185 185
6' 1' 170 177 181 185 186 189 188 189 189 189
6' 2' 176 184 188 192 194 196 194 194 192 192
6' 3' 181 190 195 200 203 204 201 198
Correction of Underweight.--Underweight is undesirable for many
reasons, and gain in weight is often the solution of many problems in
ill feeling. It is well to bear in mind that most patients who are
under weight can be made to gain in weight by an appeal to their
reason and by proper directions and care in seeing that those
directions are carried out. Patients have told me that they could not
eat more and yet I have been able to persuade them that they must eat
more, and they have done so. Anyone who has much to do with
tuberculous patients knows that utter repugnance for food can be
overcome by will-power, when it is once made clear to the patient that
they must eat if they want to live. The most interesting event
in the process is that with the increase in the amount of food taken,
instead of the appetite becoming more and more satiated, as patients
are likely to anticipate, and instead of the repugnance for food
growing, the appetite grows stronger, and the repugnance gradually
disappears. There is only one way to gain in weight; that is by eating
more than one has been accustomed to eat. Persons who are twenty
pounds under weight ought easily to gain three pounds a week, half a
pound a day, if seriously intent on doing so, but in order to do this
they will probably have to increase the amount they eat by double this
quantity. That means that a solid additional pound of food, quite
apart from the watery elements of the food, must be taken every day.
In the correction of under-weight details are all-important. Patients
must be given specific directions as to what and how much of the
various foods they should take. With regard to supposed idiosyncrasies
against such nutritious substances as eggs, milk and butter, enough is
said elsewhere to make it clear that, as a rule, these are merely pet
notions, beginning in some unfortunate incident and cherished until
they have become a mental persuasion strong enough to disturb the
digestion of these substances. What is true for quality of food is
true also for quantity. People must be made to understand that the
amount of food is to be increased. The results attained by this method
are well worth the efforts required for it. Of course, the bitter
tonics, especially strychnin and cinchona, will do much to help. Just
as soon as patients begin to gain in weight many of their neurotic
symptoms leave them. Their tired feelings are no longer complained of
and when they are up to normal weight they are quite other
individuals, both in good humor and efficiency.
If for years patients have been eating less than they should, then
they will have discomfort when they begin to eat more. They will have
no more discomfort, however, than would be occasioned if they took
more exercise than they had been accustomed to. The stomach and
intestines must be gradually accustomed to the new task of disposing
of more food. Unfortunately, the usual impression among these patients
is that discomfort in the abdominal region, by which they mean any
sense of fullness, proceeds from indigestion, and indigestion
signifies developing dyspepsia with all the horrors that are supposed
to go with it. In reality the slight discomfort which comes from
increased eating is usually not manifest whenever the patients are
occupied with something reasonably interesting. After a time the
organs will become accustomed to it, and then the discomfort will
cease.
Nervous Patients.--One of the strongest suggestions that we have in
our power for thin nervous patients, suffering from many and various
ills, is to have them gain in weight. Many of them will be found to be
distinctly under weight for their height. They insist that they cannot
eat more, that they are eating as much as they care to, and that they
have no appetite, that when they eat more they have discomfort, etc.
It must be made clear to them that their one easy road to health is to
gain in weight. If they are under weight this makes a very definite
purpose to put before their minds. The objection so often urged, that
they come from a thin family, must not be listened to. The unalterable
purpose to make them gain in weight must be insisted upon. If they can
be made to eat more than they have been eating before, they will
surely gain in weight. To see themselves gaining in weight is a daily
renewal of the suggestion that they will be better when they get up to
their normal weight. It is much better than electricity or the rest
cure, or anything else that I know; it is perfectly natural and, above
all, because it may be made an auto-suggestion, it does not leave the
patient after a time dependent on anyone else.
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