Reading Salisbury, Part 2: Something We Are Doing Every Day

Three pages

After the Preface, and before he gets anywhere near consumption or beef or hot water, Salisbury stops for three pages to state the cause of disease. Not a cause. The cause. He calls the section Introductory Remarks, and it is the shortest section in the book and the one everything else depends on.

“Succinctly stated,” he writes, “this cause consists in pathological appetites and desires.”

He is not saying that disease is caused by bad food. He is saying something stranger and more useful: that disease is caused by wanting the wrong things, and that the wanting itself is the first symptom.

Two kinds of hunger

“Appetites and desires are either physiological or pathological,” he writes. “They are the spontaneous yearnings of healthy states, or the cravings of diseased ones.” A healthy body wants what it needs. “In perfect health, those foods only are desired that are best adapted to maintaining the system in a healthy condition.” A sick body wants what is making it sick, and wants it badly, and calls that wanting hunger.

Anyone who has eaten nothing but meat for a month knows exactly what he is describing, because the strangest thing that happens is not the weight or the energy. It is that the cravings stop. The three o’clock reach for something sweet, the standing in front of the open refrigerator at ten at night, the low hum of wanting that most adults assume is just the sound a body makes: gone. Not resisted. Gone. And in its place a plain, quiet hunger that arrives at mealtimes, is satisfied by a meal, and does not come back until the next one.

Salisbury had seen that in 1888 and understood what it meant. The craving was never the appetite of a healthy person who lacked discipline. It was the symptom of a deranged one. Treating it as a moral failing, something to be fought with willpower, is like treating a cough with resolve. The cough is not the disease. Neither is the craving.

Emily Dickinson, who understood hunger better than most physicians, wrote a poem about it that ends this way:

Nor was I hungry – so I found
That Hunger – was a way
Of Persons outside Windows –
The Entering – takes away –

Hunger as the condition of a creature on the wrong side of the glass. Once it gets in and eats what it was built to eat, the hunger does not have to be mastered. It simply is not there anymore.

There is a whole industry, now, devoted to manufacturing the pathological kind. Food engineered in laboratories to the exact point where the wanting never resolves. Salisbury could not have imagined the scale of it. But he had already named the mechanism, and the mechanism has not changed: derange the body, and the body will ask for more of whatever deranged it.

Mind follows body

Then he makes a claim that will strike most modern readers as going too far:

Healthy intellectual and spiritual states are developed only in healthy conditions of the human system, while disordered mental efforts and moral fanaticisms are the outcrops of more or less deranged minds, which are themselves outward expressions of diseased states of the body.

Taken literally, that would make every bad idea a digestive problem, and Salisbury had plenty of bad ideas on a diet of lean beef. The sentence overreaches. A person can be perfectly fed and perfectly wrong.

But the direction of it holds. A brain that is poorly fed, poorly slept, and running on fermented starch does not think clearly, and a person inside that brain cannot tell, because the instrument he would use to check is the one that is compromised. The fog feels like the world. The irritability feels like other people. The flat gray dread feels like an accurate assessment of the situation. Fix the body and the assessment changes, and it changes so fast and so completely that the person is left wondering how much of the last twenty years was weather.

That is why the body comes first. Not because the body is more important than the mind, but because the mind cannot be trusted to evaluate anything, including itself, while the body is in the wrong condition.

One step, then the next

Salisbury then describes how a healthy person becomes a sick one, and he describes it as a slope rather than a cliff.

“One step in the wrong direction opens the way for the second, the third and so on, till the human organism soon falls a victim to the disturbances of a multitude of deranging influences that result, if long continued, in fixed pathological habits of organs and tissues.”

Nobody chooses the slope. “Surrounding relations, associations, circumstances, necessities, customs and fashions gradually develop morbid tastes within the healthy organism.” The culture does it, slowly, through what is served and what is normal and what everyone else is having. “These tastes, regularly indulged in, become by degrees confirmed, but cultivated, abnormal habits; at the same time they derange organs and tissues little by little, until they result in pathological states.”

When the organs “have become moulded to these morbidly deranged tastes and desires,” he writes, “the diseased states are thoroughly confirmed, and we have a well established chronic malady.” Moulded. The body has physically reshaped itself around the habit. The habit is no longer something the person does. It is something the person is made of.

Thoreau, in the last chapter of Walden, noticed the same thing about a footpath:

I had not lived there a week before my feet wore a path from my door to the pond-side; and though it is five or six years since I trod it, it is still quite distinct. … The surface of the earth is soft and impressible by the feet of men; and so with the paths which the mind travels. How worn and dusty, then, must be the highways of the world, how deep the ruts of tradition and conformity!

Soft and impressible. A week of walking and the ground remembers for years. Thirty years of a breakfast and the body remembers in ways that show up on a lab report. Salisbury’s whole therapeutic method, which the rest of the book lays out, is a method for wearing a new path, and he is honest about what it costs. The confirmed malady “can now only be removed by removing or stopping its cause,” and that “requires time, patience, resolution and a thorough determination on the part of the sufferer to get well.”

The craving was not a moral failing. The cure, though, is going to require some character. He does not let anyone off that hook.

Something we are doing every day

Then this:

It may safely be affirmed that all chronic diseases which afflict the human organism, aside from those arising from injuries, poisons and infections, have their genesis and development in something we are doing every day; or at least, in something to which we expose ourselves at regular and frequently repeated intervals. Occasional transgressions seldom or never result in confirmed pathological habits.

It contains two instructions, and they point in opposite directions.

The first is where to look. Not at the dramatic event, the one bad weekend, the thing that happened once. At the daily thing. The chronic malady has a chronic cause, and the chronic cause is, almost by definition, something so ordinary that nobody thinks to examine it. The bread with every meal. The glass of wine at six. The four hours of sleep that have been normal for so long they no longer register as a choice. Salisbury’s instruction is to “look to those states, conditions, acts, and things to which we are frequently, continuously and at fairly regular intervals exposed, to find the causes of nearly all our chronic ailments.”

He then gives the audit, and it is thorough. Drinks and foods; “the kind, condition and proportions of each used; the state and rapidity with which they are taken in; the intervals at which they are drunk and eaten, and the quantities of each consumed.” Then the nature and amount of labor and of recreation. The amount of sleep, and when it is taken. Exposure to weather. Bathing, and how often. Clothing. “The nature and degree of mental, moral and physical excitements.” And then, in case anything was left out, “all the necessities, gratifications and events which sum up the doings of a human life.”

That is a man who did not believe in root causes being hidden. He believed they were sitting in plain sight on the kitchen table and the bedside clock, unexamined because they were always there.

The second instruction brings relief: “Occasional transgressions seldom or never result in confirmed pathological habits.”

The pie at Thanksgiving is not the problem. The piece of cake at the wedding is not the problem. A body that is fed correctly three hundred and fifty days a year is not undone by the other fifteen, and a person who treats every one of those fifteen as a catastrophe has misunderstood where the disease comes from. It comes from the daily thing. It always did.

But the relief cuts the other way too. If occasional transgressions do not cause disease, then occasional virtues do not cure it. The Monday salad does nothing. The January gym membership does nothing. The one good week does nothing, because the organs have been moulded by years, and they are not remoulded by a gesture. Whatever the cure is going to be, it is going to have to be as daily as the cause was. That is the hard half of the sentence.

What he leaves out, for now

Three pages in, Salisbury has told the reader that disease comes from pathological appetite, that the appetite is a symptom, that the body moulds itself to habit, and that the habit is something done every day. He has not yet said what the daily thing is. That is deliberate; the chapters on alimentation are still ahead. For now the frame stands on its own, and almost none of it depends on anything he got wrong.

He is writing before anyone knew what a vitamin was, more than thirty years before insulin was isolated, with a theory of fermentation that will need correcting and a theory of germs that will need discarding. None of that touches these three pages. The claim that chronic disease has a chronic, ordinary, daily cause is not a nineteenth-century claim. It is simply true, and it was true before anyone could explain why, and it remained true through seventy years of being ignored by people who were busy treating the cough.

Read along

The book is in the public domain, and the Internet Archive has the complete scan free of charge, in PDF, EPUB, and plain text:

The Relation of Alimentation and Disease (Internet Archive)

Part 3 takes up Chapters I and II, on what Salisbury calls the useless expenditure of “nerve force,” where he argues that worry burns the vitality digestion needs, that nobody should think for more than ten hours a day, and that athletes die young. It is the strangest stretch of the book, and some of it is nonsense, and some of it is not.