15 OCTOBER 1932, Page 34

Beds, Tobacco, and Middle Age

THE late Sir Andrew Clarke, who, though not a great man, was quite a famous physician, was said to owe some of his success to a habit of punctuating his talk with what It. L. S. in a similar connexion called "cowardly and prudential proverbs." One of his .favourites was " Every man is either a fool or. a physician at forty." When Mr. Gladstone had heard this for the hundredth time, he blandly enquired, " Would it not be possible for a man to be both, doctor ? "—a pertinent question which, let us hope, did something to lessen the incidence of the tag.

The rather stupid saying is obviously intended to suggest that by the time a man has reached what has been called the self-complacent age he is a fool if he has failed to learn enough about his own constitution to enable him to regulate his physical life along the most suitable lines. And yet there is more of "tosh" than of depth in the seeming truism. The word " complacent " supplies the key to the situation. It is the complacency begotten of success in business and affairs generally—the destruction that wasteth at noonday—which blinds a man to the fact that his youth is past, and urges him to neglect Bacon's admonition, " Think not to do the same things still for age will not be denied."

The truthis that middle age is as truly a revolution as puberty is a miracle. But puberty is -relatively sudden and brings increased powers, whereas the years after middle age advance stealthily and bring an ever-increasing weakness, which is the less perceptible because it is so gradual. The troubles which afflict a man of fifty are such as 'never 'thought of, certainly never experienced, when he was thirty. Who ever heard of a healthy young man in the twenties complain of insomnia, of arthritis, of sciatica, of diabetes, or even 'of the present highly popular. blood pressure ? These things do not fall like the gentle dew from Heaven.; they are earned With grim, though' unconscious, determination, at the point sof the knife -and- fork.. - There arc hundreds of young men' and women in the educated classes who, by their present way of living, are steadily sowing the seeds which will produce these and many similar horrors- in full efflorescence when the fatal fifties are passed. These people are pursuing false gods, not because they love them, but because they have been brought up in the foolish Victorian faith of plenteous and plethoric meals, of thick and clinging under- clothing, of the fear of fresh air and cold water. No one of course would ever bend the knee to these gilded and fatted calves if the penalties were in full view, but the penalties are so tardy in arriving that crabbed effect is all too seldom attributed to complacent cause. If the nemesis for such a sustained debauch of over-eating, over- clothing, over-smoking and under-exercising ns any of us may witness among our younger acquaintances were as immediate and devastating as the consequence of a " thick night," called by the French mat aux cheveux, by the Germans Katzenjantmer, the crimes against physiological common sense would be feWer than they are. Nature is too kind ; in deferring the presentation of the demand note and by accepting payments in penny numbers, she cruelly obscures the issue. It would be better if she would make the punishment more immediately fit the crime. - - - - . If I were to be asked which particular counter in this toll of deferred payment I regard as most to be dreaded, I should unhesitatingly reply., insomnia ; and if I were asked what, apart from organic disease, and pain mental and physical, are the facts - most immediately provocative -of sleeplessness, I should reply, tobacco smoking and the ordinary bed. Into the question of tobacco smoking, it is not my present purpose further to probe than to say that it is '.one of the things which youth may do with seeming impunity—and the impunity is always more -apparent than real—which becomes less and less _tolerable as the years • advance. In addition mnia, there. we._ many serious 'counts in the indictment-against-Ai but-I-must not here-enumerate- them.' _ In their delightful brochure on Herbert Spencer, the two ladies who kept house for the philosopher tell us that': he insisted that his bed should be made with a dummy in it, a sort of mannequin d'osier, so that the clothes should not constrict him when he himself entered therein. This was an eminently sensible and practical expedient which deserves to be widely adopted. The ordinary chambermaid and, still more, the ordinary trained nurse tuck the bed clothes so tightly round the mattress that when the occupant gets in his first and urgent impulse is to kick himself free of the constriction. The Herbert Spencer plan should be adopted for all beds, certainly for all sick beds. But the fault of constricting clothes is not inherent in the bed ; it is due solely to the .stupidity and obstinacy of chambermaids, nurses and their mistresses. The real villain in this drama is the manufacturer. That he should make and sell mattresses which sag is a matter to which it is quite impossible to refer in reasonable terms ; the surprising thing is that anyone should buy them, and, having bought, should tolerate them. But, sagging apart, it is seldom indeed that one finds a bed which fulfils the very simple requirements of a couch on which the human body can recline so as to obtain the full physiological advantages of a recumbent posture.

The genus hoino is, in truth, very indifferently adapted to the erect posture.' When physically fatigued, the blood collects in his lower extremities and his abdothinal viscera tend to fall downwards and forwards. In order to correct this he instinctively lies down, and the position whi6h he adopts for choice may be seen -in the tired child,, who lies, when it can, 'face downwards with its feet rather higher than its head, which is the physio- logical counterpoise of the upright posture. Whether or not children place themselves for preference with the 'long axis running north and south, as a hardy recurring decimal suggests, I know not. There are no practical objections to the use of a bed so constructed or manipulated as to ensure for its occupant an inclined plane. from heel to heart. This not only rests the circulatory mechanism as nothing else can, but it calls gravity to the aid of the work of abdominal organs, especially the all-important ascending colon. Every bed Should be at least four inches higher at heel than at heart. A couple of wooden blocks or disused catalogues complete the necessary equipment.

LEONARD WILLIAMS.