Rest : There are a number of reasons why complete rest must be had, at least during the first part of this treatment. One very practical reason is the fact that many weak stomachs cannot retain the milk unless the body is lying quietly and therefore more or less relaxed. A stomach that has long been making an insufficient supply of blood is in a rut, and is disinclined to take more food, and thereby be compelled to make more blood. Practical experience has shown that if the body (and stomach), is kept as motionless as possible, the necessary amount of milk is much easier retained in the stomach and digested. The same principle holds good on a sea voyage. All old travelers know that lying down at full length in the berth until used to the motion of the vessel often prevents seasickness. Another reason is that naturally, in all animals, digestion and assimilation go on better while the animal is at rest, or asleep. But the most important reason for resting while taking the milk diet may be explained as follows: The treatment is taken to correct some function, or to develop some part of the body; something is wrong, or lacking, or needs rebuilding. In short, growth is necessary, and growth is always a function of rest. We may, by exercise, build up big muscles, but the growth even of muscles, is performed between the periods of activity, for work always uses up energy and wears out cells. Continuous work, without relaxation, would be impossible for muscles or other tissues. The intervals of rest between the periods of work enable the blood to flow freely into the part and carry the needed nourishment to replenish the cells exhausted by the previous energy. Work may be the stimulant which causes subsequent growth, but in itself work is exhausting, destructive. Recovery and recuperation can only occur during relaxation; we grow while resting. The body requires its night’s rest after it day’s work, and for the same reason a body weakened by a long period of strain, misuse, illness, must have a period of rest, in some measure proportionate to the period of wear. If, during this period of rest, there is an increased supply of nutrition and blood, we have the ideal conditions for rapid repair. With the wear and tear and waste of the muscular system stopped, the nervous energy which usually directs it is saved, or diverted to more useful purposes. The voluntary muscles are useful as organs of locomotion, prehension, etc., but they are not vital organs. Men have lived minus all four limbs. In chronic illness it is the vital organs that we have to deal with, those concerned with digestion, nutrition, respiration, circulation, innervation, and depuration. By putting at complete rest as many of the muscles as may be possible, we save a large amount of nourishment and nerve force that would otherwise be expended without any useful return. Every unnecessary drain must be stopped to allow the vital organs to rebuild and restore themselves. The more complete the inactivity of the external muscles, the brain and nervous system, the sexual organs, the better the prospect of restoring the normal function of the other organs provided plenty of blood is supplied. I deem it an unfortunate, but unavoidable feature of the treatment that the organs of generation almost immediately share in the general improvement, because it is undesirable, at this time, to spare any of the blood from the important work of reconstructing the digestive apparatus, and the lungs (if there is a pulmonary disease), and there are too many men who cannot restrain themselves. The success of the Weir Mitchell treatment is largely due to the complete rest prescribed for severe cases. For weeks these patients are not permitted to sit up, or sew, or write, or read. They are even fed by a nurse, and talking is prohibited. Complete rest on an ordinary diet usually means that massage will be required to move the bowels, but on the milk diet this is unnecessary. My patients usually are allowed to read if there are no headaches, and the stomach is taking the milk without difficulty. But the reading should not be continuous. Read for ten minutes between drinks, and then lay the book or paper down for fifteen or twenty minutes. Reading helps to pass away the time, and satisfies people who, without it, would want to be doing something more harmful. But read as little as possible, and never by artificial light. Talking is usually unnecessary and seldom beneficial. Don’t think because you are lying abed for weeks and keeping quiet that you will get rusty. I never knew the rest part of the treatment to do any damage; most of the patients are inclined to get up too soon, rather than stay abed too long. But they all store up energy while resting and the good effect is apparent as soon as they return to ordinary life. Many people with tired nerves and poor stomachs cannot take a sufficient quantity of milk to do much good without being completely relaxed. But this state of relaxation is a hard one for some people to get into. They don’t want to go to bed, and when they do, they stack up pillows behind their backs, until they are almost in a sitting position. They are losing half the benefits of the treatment, and the opportunity of a lifetime to take a complete rest. Isn’t it worth while to really rest for a few weeks if comparative comfort can thereby be secured for all the remaining years of life? To enable these folks to let go a little, to reduce the tension, the warm bath is of great use. In the warm bath only, do some of them first learn to relac. It is sufficient for csome of people, to tell them to lie out flat in bed, breathe deeply a few times, and ten, beginning with the head and neck, relax all the muscles of the body, so that if the various parts were lifted they would fall like logs of wood. When all the muscles are relaxed there is a pleasant sensation, almost like floating in the air. Sleep secured after getting in this state is far more restful than where one simply drops off from fatigue, with all the weight of the day’s work and cares distorting the body. But many cannot properly relax at first. Here comes in the benefit of the warm bath. It is not “weakening” for these strained, nervous cases, any more than sleep is, but it does permit them to relax. Nothing supports the whole body so gently and easily as a good tub bath. I notice the insane asylums have grasped the idea, and many of them are fitting up bathrooms where very nervous cases may remain continuously in the neutral bath for weeks at a time, eating and sleeping therein until the nervous system has recovered. The relaxing and soothing effect of the warm bath is due to several causes. It is sufficient to mention here the warmth, which relieves the body of its heat generating function; the moisture, which is absorbed externally and inhaled internally; the cleansing and opening of the pores of the skin; the softening and removal of the dead epithelial scales; the growth of new capillaries; the relief of pain and soreness and the wonderful buoyancy caused by the equalization of the pressure on the surface of the body. No cabinet, or vapor bath, or electric light bath can do what the warm tub bath does in combination with the milk diet. When the patient has learned how to relax the body, and really rest, I have little doubt as to the final result of the treatment. To illustrate the great difference in taking the milk diet, with and without rest, I obtained permission to quote the following case: Mr. Aubrey Parks of Omaha, Nebraska, was attacked by acute nephritis, or Bright’s disease, about three years ago. It ran on for several months and finally became chronic, with a great deal of dropsy, in spite of treatment in two hospitals and by several good physicians. He finally went to a sanatorium in Michigan where the treatment consisted of a long fast, followed by an exclusive milk diet, a glass at a time, at frequent intervals, as I recommend. But, instead of resting, he was ordered to exercise daily, and went to the milk room every half hour for his milk. The result was that while his dropsy and albuminuria decreased somewhat on the fast, both increased markedly as soon as he started the milk diet. He was ordered to take another fast of about two weeks and then again too the milk diet, with no better results than before. Shortly afterward he wrote me about his case, without informing me, however, that he was not resting while drinking milk. I replied that I could not understand it, as I had never had a case of dropsy that was not cured on the milk diet. Mr. Parks finally made the long trip to California to take the treatment in the manner I recommend. On his arrival here September 1st, 1909, he showed a condition of general anasarca, or dropsy, literally all over the body. He could not wear any of his regular clothing, hat, or shoes, on account of the swollen, water-logged condition of his skin. His weight was 186 ½ stripped, although he had been fasting several days during his journey. By my direction, Mr. Parks went to bed and remained there over a month, except for the time he spent daily in a warm water bath. He took from six to seven quarts of milk in twenty-four hours, and passed some days over ten quarts of urine. In fifteen days his weight had gone down to 127—a loss of almost sixty pounds. From that time he slowly gained weight, up to 154 pounds of solid flesh, although the dropsy did not entirely disappear for several weeks, the ankles being the last to become normal. The albumin in the urine persisted for nearly the two months he was under my case, but finally disappeared. Mr. Parks, sixteen months after this treatment, is living in Long Beach and is quite well. No case that I remember shows so emphatically as this one does, the great benefit of rest while on the milk diet. Another case almost as instructive is that of Mr. S. – of Iowa, who being attacked by a slight stroke of apoplexy, went to the same sanatorium in Michigan of which Mr. Parks had been an inmate. Mr. S. knew that his arteries were in a diseased condition and this condition had no doubt caused the ruptured artery in the brain. He took the usual fast for about two weeks and then started in drinking milk, exercising vigorously every day, according to the system in vogue there. In less than forty-eight hours he suffered a second stroke which paralyzed his right arm and affected his speech – a result I should have expected under the circumstances, as the fast could in no way have strengthen his blood vessels to withstand the blood pressure consequent to exercise on the milk diet. This man came to me as soon as he was able to travel, in January, 1909, and after a short fast he went to bed and took five and a half quarts of milk daily for four weeks. I never had the slightest fear of another hemorrhage, because he was no making any excretion that could be avoided. After four weeks of rest and milk diet, I felt confident his arteries were in condition to stand exercise and gradually he began walking and using his arms. In less than a week, he could walk over two miles at a time, and soon after returned to his home. He wrote a few months afterward that he was resuming his occupation as a traveling salesman, and felt well.