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Treatment Of High Blood Pressure

( Originally Published 1921 )

Much is said in these days about high and low blood pressure, and these terms are indeed a valuable addition to our means of describing diseases, as we will see later on in this chapter.

A large number of men and women who have not studied medical science, and not a few, of those who have, think that blood pressure depends upon the hardening or softening of the arteries, in the sense that they are hardened or softened in their structure, becoming more like stone or more like jelly. If the reader has paid attention to what has been said, namely that the pressure of the blood is dependent upon the muscular contraction of the vessels which contain the blood, you can see how mistaken this idea is. High and low blood pressure depend upon the efforts of these muscles to maintain the pressure, and not upon the structure of the blood vessels.

It is a fact, however, that nature does thicken the blood vessels to help sustain high blood pressure when it exists for a long time, and that blood vessels become soft when for a long time they do not have much pressure in them. The same thing might be said of one's arm. It becomes hard and firm under use, and soft and flabby when not used.

Blood pressure is so intimately connected with heart trouble that it must be thoroughly considered by those who wish to understand the latter.

The treatment of high blood pressure is not the correct term. We should say instead, the management of persons who have high blood pressure.

The question is often asked, what is good for high blood pressure. Nothing is good for high blood pressure, but there are three things which are good for nearly everybody who has high blood pressure, and these three things are castor oil, exercise, and starvation.

Castor oil should be given in a full dose at bed time. This will be followed by a great activity of the bowels on the following day. The next day after that the bowels should be allowed complete rest, and then at night another dose should be taken. That will be followed by a day during which the bowels move, and the next day after that they should be let alone and another dose taken at night. Then the bowels should be allowed to rest for two or three days, and if no movement takes place some customary laxative may be used, but salts should never be taken by people suffering from high blood pressure. A week after this treatment of castor oil, another dose should be taken, and after a wait of two weeks another and still three weeks later another. After that the person who has suffered from high blood pressure should take a full dose of castor oil once a month as long as he lives.

This method of using castor oil in high blood pressure has been worked out as the result of much experience, and should not be varied either in the size of the dose or in the frequency of administration. When I say that castor oil is the best remedy for high blood pressure, I mean castor oil used in this way, and not used in any other way. I find that many who have adopted this idea either give the castor oil in too small doses or give it too frequently, or not frequently enough.

That the bowels have rest is as important as that they have movement, and tends to restore their natural action. Habitual daily use of salts or any saline preparation leads to a deterioration of the general condition of people with high blood pressure and always leads in the end to disaster. Of course temporary relief through salts is a satisfactory sensation. In the use of laxatives in older 'people and those who are not strong the wise method is to give the laxative regularly every night and attempt gradually to diminish the dose. The administration of laxatives according to the whim of the individual often leads to a condition of supposed chronic constipation, when in reality the person is suffering from the alternation of an artificial constipation with an artificial diarrhea. If castor oil is used according to the method I describe, and the bowels are given two or three days' rest, very often there is no further trouble, particularly if the individual is on a suitable diet.

Exercise is the best remedy for high blood pressure, because high blood pressure is usually an expression of a disturbance of the body chemistry, which has much to do with defective action of the kidneys, liver, and other organs. Exercise is the best stimulant to the kidneys, to the liver, and to the lungs. There is truth in the old saying that the best medicine for the inside of a man is the outside of a horse. Horseback riding and walking are the two best forms of exercise.

Once when I was lecturing before a medical society and advising exercise in cases of high blood pressure, a gentleman stept forward from the rear of the platform and whispered in my ear: "Don't tell these doctors this, because they will go home and cause the deaths of a lot of people by having them exercise and burst their blood vessels." That is the old idea of high blood pressure. As a matter of fact, exercise lowers blood pressure, it does not raise it.

Strain, however, raises blood pressure. It is not safe for people with high blood pressure to run against a strong cold wind up a steep hill, but walking at the ordinary pace on level ground under proper conditions never hurt anyone. Fatigue does not injure, and exercise should be taken up to the point of moderate fatigue. Exhaustion is a different story, and should be avoided.

The third means to be employed in such cases we have called "starvation." By this we mean that food should be withdrawn except in such quantities as are proved necessary by actual experiment to keep up the body weight. This amount is usually about one-half what the aver-age person believes it to be. The pleasantest way to "starve people" is to fill them full of food that has a small food value. So people can eat as much as they want of things like spinach, lettuce, and other green vegetables.



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