A
MANUAL OF DIETETICS
r,v
J. MIEXER FOTIIERGIEL, M.IX EDIX
\F.\Y YORK
WILLIAM \V( )( )1) ^- e'OMTAXV
CONTEXTS.
PAIIT I.
CHAP. I. FOOD: Its Ohjret.
II. Forms of Food and their Digestion.
III. Methods of 1'reparin- Food.
IV. Condiments, ....
V. l>everaires, ....
VI. Stimulants, ....
VII. Fluid Foods
VIII. 1'ivsrrvt'd and Canned Funds.
IX. Prepared Foods,
A. Artitieial |);^esii\e Agents. .
I'A'iK
1
4!)
ti4
PART II.
XI. F>">d in Int'anev,
XII. --Food in Ad,,, I,.,, TII, v. .
X 1 1 I. F 1 in Adult I-ii'e. .
XIV. F 1 in Old A-e,
X V. I-'nod in .\<-iite I Disease.
X \'I. Fund in ( '(imalesreliee,
X\'I1. -Food in Castrie Ail'eetions,
XVIII. F,-.d in Strunia
XIX. F, Mid in An:eniia.
XX. Food in Constipation and hiai
XXI. Food in Phthisis,
XXII. Food in Chronic Heart and [.
\ ill
CUXTKNTS.
Cn vl'. XX I II. I-' 1 in I'.ri-ht^ I>is.>as<>.
\ X 1 \ . l-'i 'il in AHuiiiiinuria.
X.\V. I' 1 in i>iuU'U's
X X V I. !'" "i in ( ; Ivmsuria. ....
XX\ II.- I-' 1 in (iuiit
XX \ III.- ! i in N.'iirusa] AiTivtiniis. .
XXIX. I-'-,,! IMP t'l. runic Invalids, .
XXX. !' ! in Oboitv
XXXI. ! 1 in Indigestion
XXX II. I- i in P.iliuusnrss
X X X i 1 i. I-'. ...I I -i\.-M i.lliLT\visr than l>y the Month.
I'l'lU-ili-.' HI.
I'Af.K
. IS!)
Co
FORDVCK HARKKR, M.I)., LT..D., KDIX.,
AN ACKNi >\VI.KlH;i:n I.KAUKR IN Ml.DK i\l,
THIS WORK
IS AFFECTION AT Kl.V DEDICATED
I'.V
THE AUTHOR.
PREFACE.
The day of Dietetics lias arrived.
Modern advances in our knowledge of the physiology of
digestion have been accompanied by a like progress in the
preparation of foods. The value of predigested carbo-
hydrates in acute disease and nialassiniilation among adults,
as well as children, is now being gradually realised. 'Un-
digested albuminoids are making their way ; while oil
emulsions have, established themselves on a lirni footing.
The many evils of a dietary too rich in albuminoids are now
being generally recognised. The time indeed is at hand
when systematic lectures on Food will be a part of Medical
educat ion ; while the value of feeding in disease is admitted
to be as important as the administration of medicines.
;;, llKNHlKTTA STKKKT,
CAVENDISH SVCARK,
LONDON, \V.
MAXt'AL OF DIETETICS.
TIIK OIUKCT OF FOOD.
l)i-:i-'i>UK the days of chemistry, food \v;is in its pre-scientitic staue.
Then it was mainly :i question of the palate. Kinirs kept their
rooks, ami smaller personages imitated them. The rooks cooked bv
day and devised ne\v dishes bv ni^ht. In the pre.-cnt work, how-
ever, this culinary aspect, of food will he subordinated to that of its
sclent llic aspect.
Not that the cook is to he ignored, hv anv means. Without
proper cook in";, no food is palatable; and if the palatt the janitor
of the stomach -he oll'ended. no matter what is its real value, th"
food is useless. The palate must he consulted as well as the
stomach.
Of old the palate ran not. The Romans "were both epicures and
gluttons. The ovs'crs of llritain were convcvcd hv relavs of run-
ners to t he Roman villas. One epicure cast a slave into his tishpond
to improve the flavour of his lamprevs. The most absurd dishes
were contrived, up to a pie of n i^htinirales' ton ir ues. 'I'hcir tastes
11 r" r^
were not ours. Fowls \vere boiled in aniseed water, and served
with a sauce coin a; m nil" aniseed, mint . mustard seeds and asat'o t id a.
Nor were the middle au'cs far ditVerent. Charles \. of (ier-
manv was a notorious gourmand. liesidcs ordinarv meats he had
roasted horse, cats in jellv, li/ard soup, fried frog's, etc.. till In- '
\vhen asked fora new dish, could onlv surest a compote of watches,
-in allusion to that monarch's passion for such time-keeper-.
Animals were chased because it wa- found that the ile.-h o|
liuntcd beasts was nioi-c tender and palatable tliati thai <
killed without such preliminary preparation. Fo\v!< wei'e !:.ra- : :'-d
to death to lit them for t lie table; while one writer v;a\e ,
1' MANUAL (>F I MKTKTK 'S.
" HOW t'i n>a-t ninl eat a irni'se alive." No crm-ltv to an animal was
l<> Lrrcat 1" uTatifv tlic palate. It wa- merciless !
Tin' amount eaten. t<ii. was enormous. Tin- Unman hail live
nieai< a <iav: and at iri'eat feasts when full to repletion, the stomach
Wa- emptied ill order that the ]>|T)ee.-S (if tilling It llllu'llt lie 1'c-eulll-
IHcMced.
( 'harles \'. wa^ ijiute as hi;_ r a glutton a< he was an epicure.
At a ilimiel' of the Knights of the (in'alfll Kleeee linger Aseliam saw
him make hi- wav through .-od lieef. roa.-t mutton, ami baked hare,
after wh;>di lie fi''l full well (iii a capon. N'or did he forget lodnnk
with it all. " 1 1 e had hi> head in the ^lass li\ e times as l<mtr :ts aiiv
of thi'tii. and di'ank no le-s at mice than a i|iiart of Ilhine wine."
NO wondi-r he became a /"iiiv man.
Then views as to food \aried in the widest manner. The Km:-
li>h ath!et' |lae ( -d his faith in rare lieef-teaks and raw eu'Li's : while
the Hindoo wrestlers trained on sweetmeats. The Kmdish farmer
fce.i.-. hi- .-ervants on meat in oi-der that thev mav lie eijiial to hard
\voi'k: ju-t a- he add< some extra eorn to the dietary of his horses
when \\orkinLT hard. The hama of Stamlmiil earrie- meredihie
\\ei-dits on a du-tarv whhdi the l-'.iiLi'iish athlete would regard as nt-
ti-riv iiisiitli'Mi'iit to support life : and for baeksJu'i'sli is grateful for
a sliiv ' >f mi'ii '!i.
( 'ookery-lio(tks were written livnien of learning. l-',\cn Mr.
lohn^oM. i >f diet ionar\ fame, did not think t lie .-nlijert lie neat h him.
" 1 eollld write a ! .^:>-i' hook of .ookerv than has ever Vet heen
written." h'- boasted. " It -hoiild he a book on philosophical prinei-
ple~." >o importan' did he deem the ,-u iijeet that he said i-ontempt-
iiiiii!v: "A woman ma\ spin, but she cannot make a ^ood book of
eoo' K e!-x." I I". Kitelie!!' i\ the a ut I lop of " The ( 'ook 's < >raclr. " had
a l;b'Mi-\ of \\ork< de\otcd to food and eookerv. consisting of no
!-- than '.'"'" \olumc-. It eannnt then be said thai the subject ha<
tii 't ! - i-ci-;vfd dec at ; cni ion in a i i a^c~.
I' - oiiiv at r.e pri-~e]|i .lav. and from the teach HILT <>f LiebJLf.
thai f'Hid ha- arded fr'-m a .-i-ieiit ilic point of vic\v: both as
i.-: r\ '.'. ii -ii .- _' ; . , '.IT ' - t a rat ;"Ha! comprehension of t he ut il it v
i>:' :'..od. a :'. u :n- m cuts of ; h>' organism. I'.ct'oi'c t hat da v the
pala'e Hl'.-d. alei ia-:e- \;iry. /> <i*lll>nx I,,,H il!*i, nl,i nil n,,i !
The liurtti' - bui';, ihe;r i ; -!i until ;t i< putrid, in oriler to ^j\-,.
:i t'n,. Sandwiidi I-laiiders like i heir
-:i that tlc-v de\oiir ii-K a.i\e as -non a~ caiiirht.
THK OH.IKCT OF FOOD. .",
Europeans prefer ;i fresh egg; in Cochin China the people pre-
fer them "high." 'The Israelites t;ilked of ;i land of " corn and
wine" and of " oil and honey."' The Egyptians lived on lentiles:
while the Arab exists upon dates.
The Hindoo and the Negro l>oth delight in boiling rice and but-
ter. ( thee is clarified butter; and the Hindoo in praising anything
comestible, couches his highest praise in the phrase "as good as
ghee!" On the other hand, the (lauchos of the South American
pampas live solely on lean beef and water; and Sir Francis Stead has
told us what power of endurance this diet gives. The Eskimo and
the natives of Northern Asia eat huge quantities of fat, and drink
oil. This diet is a perfect contrast with that of the desert Arab.
On the burning desert little is required to maintain the bodv heat,
and a handful of dates is sufficient for the body-needs. On the fro-
zen Arctic wastes, fat, the strongest fuel-food, is required in consid-
erable quantities to keep the body temperature at a point compatible
with life. Cut oil' from farinaceous food, the Eskimo rejoices in the
liver of the walrus, with its glycogen, or animal starch: but to give
it a higher heating power, lieeats it with slices of fat. Instinctively
man has adopted the dietarv suited to his needs; and the Anglo-Saxon
who. on the plains of Bengal, persists in the roast beef and ale of Old
England, pavs -the penalty of his dietarv indiscretion in hepatic
trouble. Blindly and darklv then, instinct has guided man in his
choice of food, before the daylight of organic chemistry came to di-
rect his path aright. Light has dispelled the darkness: but the
palate is not to be dethroned. There are other things that cling to
us as well as original sin! The belief in meat is ubiquitous with the
Anglo-Saxon. No one can be strong without meat, it is asserted.
" Many people seem to look upon meat almost as t hough it formed
the only food that rcallv nourished and supplied what is wanted for
work. The physician is constantly coming across an expression
of tin- view. Undoubtedly, a greater feeling of satiety is produced
by meat than by other food. It forms a greater stay to the stom-
ach, but this arises from the stomach constituting the scat of its di-
gestion; and a longer time being occupied before it passes on and
leaves the organ in an empty condition.'' (Paw on Food and l>ict-
etics.)
This fallacy is disproved by the fact that the Sikhs of the Pun-
jauli arc pulse-eaters. The halian lives almost solely on mai/.c and
macaroni. The dreaded I roq uo is were cult i valors of mai/.e a.- \\ <!! as
ing Indians. The Spaniard munches his onion and dit
MANUAL OK DIKTKTICS.
mist of bread in oil. The Katlir, like the Kirirhis, lives mainly on
nnik: as diil the Cvmn. when l'a>sar invaded Britain. The Arab
has his tiates. The Hrahmin ]) refers t he banana. The Hindoo, the
rhine-e and tin' .Japanese, lind their chief sustenance in rice, which
with them takes the place of bread with us. liread or its farinace-
ous eijiiivaleiit is the stall' of life. But "tliou shall not live by
bread aione" tells that something in addition is necessary for the
I'm >d < if man.
What is that something? Milk; eertainlv ! Meat? Xo, emphat-
ically No! Fat. Yes! especially butter. Some lluid is. of course,
r.ece-sarv as water. Here we have all that is required. There is
stan-ii. body-fuel; there is albumen for tissue-repair in the gluten:
there arc earthv salts, too. especially if the bread he made of whole
meal: and then there is the fat, which partlv is burnt as body-fuel,
partiv cuira^cd in the building up of healthy tissue.
Let us trace the hi.-tory of a mouthful of bread and butter.
While it is heini: masticated, the saliva is brought into contact with
many of the starch granules (already cracked by the heat of the
oven and, not onlv that, but a step forward has thus been made in
its solution.) and the conversion of insoluble starch into soluble
siiL'ar i- he-j-un. Then it is swallowed, when a new action is set up.
The soluble <jrape sii'_:'ar of the converted starch passes through the
wail of the stomach into the gastric vesicles of the portal vein: leav-
ing 1 he undissolved residuum behind. The acid pistric juiee next
acts upon the gluten, the albuminous stroma, or framework of the
ma -and by dissolving it. liberates the rest of t he stan-h granules
whi'-h had escaped the contact of the saliva. When the softened
mass passes the pvloric riiiLT. and comes into contact with the bile
and the secretion of the pancreas, the most active part of the dip's.
five act sets in. The liberated starch granules come into contact,
w:th the diastase of the pancreatic secretion, and are by it con-
\ ertei] into ,-oiuble Lrrape siiLfar: the digest ion of the albuminous suh-
.-!;ii:'-e- i.s further earned on by the trvpstn: the fat is emulsionised
-i i- only digestion. The siiL r ar. the dissolved albuminoid,-, the
earthy .-alts, pass into the portal vein, to be dealt with by the liver;
wh.ie the fa; L r '"bides pass by the mouth- of the lacteals into the
ivmpliat ;cs. Sii'-h i- t he digest ion of a t vpical mass of food : 1 here are
hep', earl io-hyd rat' -s |st ;irc h and su_trar). albuminoid-, fat . and eaiM hy
.-ails. And !! nil th" art and skill of all th" cooks who ever lived,
co,!eet. enok and lla\oiir the various ed.ble substances of the animal
aiid vegetable \\orld, ///'-' arc the constituents of the food of Man.
THK OBJKCT OF FOOD. "
The carbo-hydrates are the body-fuel, the surplusage being
stored as f;it ; the albuminoids serve to re paii' t lie tissues as they war
out: the salts form the blood-salts; the fat helps t<> build up normal
health-tissues, the excess being burnt as body-fuel. That is tin- real
object of food!
Hut Nature bus veiled her object. She provides an imperious
palate, engrafted upon an imperative sense of hunger, and the-c se-
cure the nutrition of the body. Succulent vein-tables, luscious
fruits, sapid tlesh: such are the materials upon \vhich the cook exer-
cises his art : and such are the food of the savage. While milk, t he
natural food of the new-born, alone or in combination with (chiellv)
vegetable matter, is ever acceptable. Hunger compels the individ-
ual to take food to lill the stomach: the palate guides him in his
choice; it' the food be simple, there is little or no temptation to in-
dulge in excess. l>ut when the cook's art tempts tin 1 palate, then
comes in the temptation. The lirst temptation came through the
palate "the tree was good for food:" and Adam hearkened info
the voice of Kve, and ate of the tree and the history of human
troubles began. Xo\v. the man has hearkened to the voice of the
tempter, and eats in excess of his body-needs. lie must eat to
live: but that is not the true equivalent of to live to eat. The ob-
ject of food is the nutrition of the body rather than the irratitica-
t ion of the palate. It may be well next to examine these different
constituent elements of food in fuller detail both as to their diges-
tion and their destiny.
(MlAPTKH II.
KOIIMS OF FOOD --WITH TIIKIIL DKiFSTlOX.
Carbo-hydrates Albuminoids Fat-salts. Licbi^'s irivai
division <>f fin nl in! i ' hvdro-carbons. or " fu 1- food, "and albuminoids,
ur " tissue-food." though at one time subjected to much criticism
has. in tin- main. stood its ground. Modern advance in physioloii-
ieal clieinistrv certainlv lias told us that albuminoids are oxidised in
their retrograde metamorphosis and so contribute to the bodv-heat;
we know. t<><>. that fat is neeessarv to the formation of healthv i is-
sue -as seen in the rod liver oil so much in repute for the treatment
of phthisis- -and so to some extent is a tissue-food, as well as a fuel-
food. Kvcii certain salts, as the malates, the citrates and the tar-
trati-s are a fuel t'ooii. in that the malic, citric and tartarie acids
:uv oxidised, while the hase (lar^elv potash), appears in the urine
a- a carhoiiate or mav he a luhate. The muscles re(piire potash
and the Mood >oda: whv we do not vet <pute know. The hones call
for lime; and admitting that Liebijr's view is not preciselv accurate,
it i- true a- a broad division: and is well worth bearing in mind.
Wlr. !' l>e.-aii-e since the davs when ('ain kept sheep, and irave wav
to ungovernable temper and beliaved l.kc a carnivorous brute, m
hi- murderous instincts, man has been tempted to take meat to
i_ r rat:f\ his palate, to an extent far bevond his real t issue-needs.
Man i- i;kea .-team engine in that he is a piece of mechanism in
which - burnt. (Vrtainlv tlieiron framework of t he engine
ru-:- a slow oxidation and needs repair: and so do the tissues of
man \\var out. I he engine needs oil to lubricate iH bearings, and
>uiidr\ o'her matter- which ha\e to be cojitinuouslv supplied to \\.
'Ill-' animal >d\ ha- other wants than mctvlv "fuel-food" and
~-M"-' !. a : ' (or instance. The engine is a means of heat-
n:L r water into team. ' -in'_' that steam to put wheels
int" motion. >,i.. ;o motor power. When the eii-
-'o much more water and fuel. \\ hen
a mail ''\''!'t- liiin-el; he a .-o produce-: more heat !iv increased o\ida-
t'."!! a 1 'i '' <','. -11 Mi ; t :o!| of : food, Liebi^r i]o|llitles- \va- 111 error
'' a--M i! : : : ' ,.i : : :: ac % ;\ . t :. a dm mi noid ti.-sues art 1 consumed.
FORMS OF FOOD.
No more than the framework of a locomotiye when ascending :in
incline. An engine doing hard work will need more oil for its lu-
brication than one doing little work; and probably will sooner have
to l)e sent to the repairing shed. A hardworking man may wear
out his muscles at a more rapid rate than an idle man. But all
the same in the locomotive and the man, the framework and t he t is-
sues do not " burn," but rust, or undergo a slower oxidation.
(In forming conclusions from the amount of urea the body ash
the perpetual and ineradicable dilrieultv has to be met that urea is
the iinal soluble form of nitrogcnised waste derived alike from the
///,/ a* ni//\/i/ti]>tit>ti, or surplusage of albuminoid food and from effete
or worn-out tissue.) Just as when the body is at rest its tempera-
ture is maintained bv oxidation of hydro-carbons, so in activity the
combustion is the same; onlv greater. Consequently the tissue-food
for tissue-repair actually required is small, and more albuminoids
are usually eaten than are absolutely needed. Granting that the
general health of convicts deteriorates on an insufficient dietary; and
that the system sulTers when imperfectly fed; and that when work
is hard more food, especially of the stimulating nitrogenised charac-
ter is given, as the result of tin; teaching of experience; still the
main fact remains unaffected, \\z, , that the actual wear and tear of
the albuminous tissues is small, and can really be met by a dietary
far less rich in azotised matter than that taken by most persons.
Look at tin 1 lusty babies fed on '' Pobbs," consisting of bread and
water (with little if any milk), tobe seen in any agricultural district
in Lngland. See the huge navvy " Lincolnshire bred," reared on
bread and bacon, or dripping and potatoes; or the Scotchman built
up on oatmeal: and we can understand that the constructive [towers
of the human organism can successfully contend with great ditli-
ciilties. But all the same, when the navvy can procure snme
beefsteak he can do a harder day's work: and, I am informed,
that a Highland gillie, when lie shares the sportsman's repast a
dietary superior tit that to which he is accustomed waxes in
vigour and energy, in an obvious and unmistakable manner:
uhile 1'r. Kuiiruson of Bolton has told us of the improvement IM
< was added to their bread and butter and
S MAN I 'A I. OK DIKTKTK'S.
1. Carbo-hydrates:
'.'. . Mhiiminoids:
:;. l-'at:
With ;i small sub-class
4. Salts.
Water MO is essential to the body, but it cannot exactly bo
classed as a " Food. "
Carbo-hydrates.- I'ndrr the term Carbo-hydrates are classed
the staivhv, or farinaceous, or amyloid (as \ve choose an Knglish.
a Latin, or a (ireek term), and the saccharine elements of our
food.
Starch consists of Carbon, Nitrogen and Oxygen (having the
formula C,H,.(M and is found in all the cereals: especially in those
used as the food of man, wheat, oats, barley, mai/.e and rye: it is
also found in the pulse tribe, or legumes, as the pea, bean, lentil and
the haricot bean, as also the dalil of India: also in rice, buckwheat,
sago, tapioca and arrowroot, and the quino of IVrn. It abounds in
the potato, and other roots (which contain the germs of t he new
plant), in carrots, parsnips and turnips which first produce a root,
from which again a seed-bearing stem is developed ; and is part of
the unripe fruit, which becomes sweet as the starch is changed or
converted into sugar.
Starch i- the food of (he seedling plant. To take the case of a
grain of any cereal, it contains starch, albuminoid matter, and
earthy salts: while oa,ts and mai/.e also contain notable <|iiantitics of
fat. \\ hen the plant '.Terminates the starch is converted into sugar,
(as the liaby plant ret pi ires it) 1>\- the action of the diastase (an al-
bum iiion- ferment ). as the seedling grows. Insoluble starch is con-
yerted into ,-oluble sugar in the grain: just as it is in the human
mouth. The plant store- up food for its young: and that food man
take- fc>r h!s own use. \\'hv doe-: the store of plant food take t he
form of insoluble starch? I>ecause if soluble il would be liable lo
be di--o!ved liv water: and after rain the grain field would be bar-
ren. lii-enuM 1 th food elements wen- wa-hed awav in solution. In-
soluble -tarch can be stored.
A rapid germination i- artificially set up by the process of
malt ing": which wii! o.-ciipy our at tent um furt her t>n.
\\ In n man ate un >ked grain, as he tlid at an early period (as
tiie worn molars of graminiyorous men .-till tell us when dug up),
he ground i; slowly under hi- teet h ; and during t his t inie the starch
came i' contact with the saliva, which bv its diastase converted this
FORMS OK FOOD. '.I
starch into soluble dextrine (with the starch formula) and irrape
sugar ((' !!,..< >,,II,O). The action \vas exercised upon tin- outs id.- i.f
the starch granule; tin- remainder passing <n\ throiiLrh the stomach
till it reached the diastase of the pancreatic secretion, when it !><-
came fullv dissolved. (All starch granules however are not equally
acted upon, and where much starch food is taken a certain quantity
of them are to lie found in the t\eces. )
When man came tirst to crush and then to grind and cuok his
food, a new departure took place. The toil of grind im_' his ^rain
was done for him in a less laborious manner. Disintegration took
place in the mill, lie could cat, faster. Hut if no other change had
gone on. this might have been a verv questionable advantage: for
it would have had the result of filling his stomach with insoluble
starch granules (a fertile source of indigestion). The effect of
heat upon the starch granule is to crack it and thus to form a chan-
nel bv which the saliva could reach the interior: an important mat-
ter, lint another change goes on of which the knowledge is far less
general. The starch is converted, largelv into soluble dextrine.
(When a portion of well-baked Hour is subjected to the iodine test,
the conversion of the starch is readilv seen.) Consequently the fa-
rina is speedily transformed into soluble matters bv t he saliva. The
existing dextrine is carried forward to i^rape suiiar: while the
remaining stan-h is largely changed into dextrine. Such then is
the elTect of the act of cooking upon the starch granule, (irmd-
ing ynd cooking lessen the labor of the jaws and the salivary
glands.*
Disintegration and solution constitute the digestive act. The
comer-ion of starch into ^rape suirar is brought about bv the sali-
va rv diastase (an albuminous bodv whose formula has not vet been
determined), bv a process of hydration: and grape sii'_rar has the
formula) ( !!..<> ,.II..O). f.r., some water has been introdueei] in'.o
the molecule. The saliva is operative in the mouth and in the
LMillet, ami also in the stomach until it becomes distinctly ae;d.
The soluble ^rape-sit irar passes through the wall of the stomach into
the blood.
This removal of much of the starchy matter of the food al'ow-
the Moniaeh toad upon the other constituent s. \\'h''ii food
tilv swallowed, our mastication is imperfect from bad lee'.h, ;!),
Ill MA NT Ah Oh" DIKTKTirS.
stomach is hampered and embarrassed hy quantities of unchanged
starch, and its digestion is slow and painful.
When the stomach becomes distinctly acid, the conversion of
starrh is arre-ted. When the stomach has done its work mul gas-
trie digestion is complete the acidity seems pretty much exhausted,
and the divine (as the pnitaeeons mass is termed) finds its wav into
the duodenum, \\herc it heeoiiit'.s mixed with the bile and the pan-
creatic secretion. In this alkaline medium the pancreatic diastase
comes into piav. and the transformation of insoluble starch into
soluble dextrine and grape-sugar re-commences. As the more or
ie.-> disintegrated or denuded starch granules pass along t he small
int'-siiiie thev become 1'ullv dissolved into grape-sugar which pusses
into t he blood of the portal vein.
Mich then is the digestion of starch. lint before following up
the historv of urape sugar in the bodv. it will be well to consider
the ditl'erent forms of sugar. Sugar ntav be divided into crystalline
or cam- suu'.'ir ((',! I ,.( > n ) and glucose or grape sugar. The crvs-
ta'dinc sii'_ r ar is the object of the sugar-baker; and the fares of sugar
lioi!in-_ r . treacle or molasses, are the non-crvstallisable sugar. On the
other hand non-er\ stallisable. or invert sugar, otherwise levulose, is
theobje.-t of the manufacturer who supplies the brewer with sub-
stitute- fi>r mall, ('rvstalline suirar is found in the sugarcane, the
be^t root, other roots, the maple and t lie sugar grass. Hot hare
sweet to the taste; e rvstal 1 i ne siiirnr being more intensely sweet,
whi.e the flavour of non-ervstalline sugar is liner to most palates.
A- Migar i- the food of the seedling plant, so sugar is found in all
\ouir_r shoots (notably in those of the briar and the grasses, as all
rural diilil ivn kn< >w ).
Although eane siiLTar requires no digestion to tit it for absorp-
tion i! mav be eonsnlered probalilv that it undergoes conversion into
giMjii'-.-ugar. certainlv in part, if not wholly before leaving the ali-
incniarv canal. If cane siiLTar lie introduced into one of the vessels
re n la t ion, it passes oil' from the svstcm without lie ing
apes. still in the form of cane sugar in the urine. 1
';.j-;ir be introduced into the alimentary canal
it v. sav, I'oi- subser|ueiit assimilation, sugar similarly
. : j, U ] now in the form of L r rape sugar in-
- I_M r. " ( \ 'aw. )
i,,. -ti'j'iir \\hether dei-ived from starchv or
i||i ' . , '' ' ; ;J matters 11"! paSSCS lllto the pof-
to the liver. Mere it is dchvdrated, or
FORMS OK KOOI). 1 1
turned buck into glycogen, or animal starch ((' H^OJ. In this in-
soluble form once more it can be stored for the bodv needs. Carbo-
hydrates then furnish the glycogen or bodv-store of fuel in the liver.
The liver Mores up from each meal so much glycogen: and ghes it
oil' as inquired; otherwise life would be onlv one drearv meal.
(Any disturbance in these glyeogenic arrangements leads to the pres-
ence of sugar in the urine. These disturbances may extend from
the mere presence of sugar in the water after a meal, when the de-
hvdrating power of the liver cannot keep pace with the diastatic ac-
tivity, up to the dread disease diabetes.)
The insoluble store of glycogen is given off as required in the
form of soluble grape sugar: which is probably burnt upas lactic
acid ((',. H...OJ in union with soda, as lactate of soda. (.Muscles have
their little stores of glycogen; the muscles of the embryo being es-
pecially rich in it.)
Such then is the history of the Carbo-hydrates, our great '" fuel-
food": corresponding to the coal in the tender of the locomotive.
The surplusage of grape sugar forms the fat, or adipose tissue of the
body: a further reserve of '"fuel-food." The store of glycogen in
the liver is readilv got at, and so we may liken it to the coal-scuttle
bv the fireside, while the fat deposit is the coal cellar. In some
individuals it is spread over the body generally: while in others the
omentum and parietes of the abdominal muscles are its chief seats.
In some animals, as the pig for instance, the fat is wide-spread
and general, while in the camel the fat is stored in the hump, and
in the codtish the liver is the seat of the storage of fat. as well as of
glvcorjen.
This grape sugar is the natural bodv fuel, anil where it is burnt
up, the organism perishes of exhaustion: whether in starvation or
acute disease. This matter will be further discussed when the diet-
etic treatment of exhaustion is given further on.
Albuminoids. Albumen is a complex bodv notablv containing
nitrogen. This is t he cardinal matter which fits ii for the noii-oxidis-
able framework of the bodv in which the combustible hydro-car-
bons uiv burnt. "Of all t he elements of t be animal body, nitrogen
has the feeblest attraction for oxygen: and. what is still more re-
markable, it deprives all combustible elements with which it c"iii-
bines. to a greater or less extent, of the [lower of combiniiiLT w;: h
o\ \ "vn, tiiat is, of under^oin^ combust ion. " (IJebi^-.)
1 v virt ue of this nitrogen-factor then, the albuminous t ; --.MIC- arc
prevented from the body-combustion extending t" them. Like the
1'J MAM'AL ('!' DIKTKTK'S.
framework >f the locomotive they ru.*t hut lo not burn. Tlioir
composit ion is as follows:
o jiA.r^s,
From this we can sec that thev differ from the hydro-carbons in the
fact that thev contain some sulphur as well as a distinct amount of
nitrogen. The eg^r from which the living bird is developed contains
alliunien, some t'al. and water. Probably the shell furnishes the
iime. White of egg is typical albumen. Albumen is found in the
muscles or tlesh of animals; it is found in milk, as caseine, and in
all seeds, notablv the pul.-e tribe, whose seeds are rich in vegetable
caseine. A certain proportion is found in cereals as the gluten of
wheat . for instance.
It is as necessarv for the seedling to build up its tissues as it is
for a babv. The ferment of seeds which converts starch into ^rapo
su-_ r ar. is an albuminous body. Albumen in a iluid form as the white
of e^g. coagulates and, forms a firm Avhite solid on boiling. Vet
easeinc. as in cheese, softens under heat. Milk does nor, coagulate
on boiling: but meal juice does. Consequently if an infusion of meat
be rai-ed.to the boiling point the albumen is coagulated. Hcef tea
raised to the boil and strained loses (with its albumen), what food-
value it possesses.
Flesh cooked before the rigor mortis sets in. is readily masticated;
and the Abyssinian it is said cuts his steak from the living ox as he
wants it. Once the rigor mortis has set in the flesh is hard and
t"iii:h: consequently it is customary to keep it until this has passed
away before eookinir it. The cH'ect of cooking upon muscle is to
Ion-en the muscular bundles or fibnlla 1 from each other, so that
they are readily torn asunder and crushed bv the teeth. Insuffic-
iently < ked meat is hard and resist- t lie act ion of t he teeth : over
cooked meat is stringy. Perfectly cooked flesh is more savoury than
either underdone oi- overdone meat. \\dien taken into the month
the muscular fibre-; are torn asunder and crushed bv the act of mas-
tication: so that when t hev enter the stomach the gastric juice can
readily att; ". I f meat be not chewed but bolted, t he solvent
tiee can o] upon t he exterior of the mass: while "lumps"
I'lTi-nd tli' 1 : arrest the <rastric secretion, as was found in
tli' 1 case of Ale , St. Martin. Solution is at work under the inllu-
i-!iee oi pepsiin bv an acid. "The natural bundles of meat
a 1 d Vegetable- : [ []](> milSenlar fibre- Split Up into discs,
and the protop|a-m i- --. .!ved from the vegetable cells. *' ( M. l-'oster. )
Tiie a , b'ni. riot; - -ii'om o] bread or live]- is dissolveil and the
FOKMS OF FOOD. 1:)
starch granules set free; while the albuminous envelope of tin 1 fat
cells (adipose tissue) also is dissolved and the fat is iH't free. Th-
food is changed into a pultaceous mass. ' such pieces as most res;.-;
the gastric juice being the last to leave the stomach." The digest i\e
action of the stomach is exercised exclusively upon albuminoids:
carbo-hydrates and fat being untouched. The solvent notion of the
gastric juice in breaking up muscular tibriila- and vegetable matter,
is irreatly aided by the movements of tlie stomach, which mil its eon-
tents about. While digestion is proceeding normallv. a sense of
well-being and eomfort is experienced: a matter which has been
practically utilized by the Anglo-Saxon, who invites men to a good
dinner before asking them to subscribe to anv charitable object. So
successful has this been found that it is said. "The road to an
Englishman's pocket lies through his stomach.''
On the other hand, difficult digestion has a malign and untoward
eil'ect upon the temper and disposition, and a stomach-ache is per-
ceptible in jnanv of the sentences in Tom Carlvle's writing-. A
sudden shock will at once arrest the muscular movements and the
gastric secretion, producing a feeling as if the stomach and its contents
had been changed into a heavy hard substance. Ouietude is con-
ductive to good digestion, and an active man should .-;t or lie do\vi,
after a good meal just as his dog does! Animals Jill their stom-
achs and then lie do\vn not having the ambition of man. or bein^
interested in the absorbing acquisition of wealth.
As digestion proceeds the pyloric ring relaxes and t lie chyme find-
its wav into the duodenum. The aciditv of the stomach seems to
exhaust itself in the digestive act. and the divine is readilv rendered
alkaline bv the bile. In this alkaline condition albuminoids are
readilv acted upon by the trvpsin of the pancreatic secretion wind;
completes their solnt ion.
.1 u -t as we saw t hat starch is dissolved bv hvdrat ion. so is an albu-
minoid. An albuminoid previous to sol ut ion is termed a " protcid. "
When rendered soluble bv the digestive act it is called a "peptone. "
It has been rendered soluble bv hydration so that it inav pass through
the wall of the alimentary canal, and enter the portal vein. II;;: a-
a soluble peptone would a < steadilv slip out of the circulation '<
the kidnevs as it linds its wav in bv the portal venules. it is dehv-
dratei] and once more made a proteid in the porial b! 1. ( \\ !;.::
this does not take place properly the peptone appears in the urine
as " fa l.-e " albuminuria. )
When the albuminoid matters reach the liver, a certain proo.>r-
U MANTAL OK IMKTKTICS.
tion i- elahorateil into t he serum-albumen of the ?t'r/nnr ttfiHf/nini*
for the nutrition of the tissues. But as the framework of the loco-
motive needs little repair, so the albuminous tissues of the animal
bi ., iv iv< mire- little repairing material from day to dav. A suttic-
ieiiev can be found in a dietary far below what is ordinarily eaten bv
man. and especially eivilized men. For fifty years Lewis Cornaro
iued in health and strength and vigour on fourteen ounces of food.
mostly vegetable, and twelve ounces of liijfht wine dailv. I have a
su-['icion that the said Lewis Cornaro belonged to that stalwart and
.-"inewhat corpulent race of man of whom it mav be sai.l ''that the
le.-s t hev eat a nd drink t he better they are," and who frequently are
_:' \ "ci tsnrie. But allowing for this, it can safely be said that most people
gratify their palates bv consuming more albuminoid matter daily thai)
their bodies act uallv rcimire. This surplusage, is called the " In.riis
1-u/i.vi/iitfiftii/i." \\hat becomes of this litstt* t'OuxuMjitian? It is
burnt up. and oxidixed in a descending series as tvrosin, leucin.
kreat:ne, kreatinine. passing on to uric aeid and urea. It is uniiee-
es.-ary to ^ive the formula 1 of these different substances, except uric
aeid ((' ILVO,) and urea (MI.. .CO). '' The antecedents of the urea
in blood are in all probability, partly the kreatin Formed in the
muscle and elsewhere, partly the leucin formed in the alimentary
canal, a- well as in various tissues." (M. Foster.)
Thi- i- a piece of phvsiolo^v of which we have as vet but broken
h'_ r h;s. It i- cnoiiLih for the present consideration that tissue waste
and albuminoid excess are burnt up. (mainly in the liver) into the
abo\ i--name(! product, of retrograde albuminoid metamorphosis. And
wMli these e\ercinent it ions matters the physician has much to do,
e-pci sal 1 v a- \ car- ad \ a nee. \\ e all know tin- sen sat ions of well-be-
;v_r 1 1 rod need bv a u-ood meal, under t he act ion of a competent ditT (1 >-
t on; ei ation- which have ever had a potent attraction for the
A TI'_VO >a \on race, \\ ;: h whom //ni/t // rim nx ririt/Hifx ha- been largely
a rn'ei'!' conduct. But when the diirest ion of albuminoids is not
. then the case i< widely different. Mr. Lander
Brnntnii. I-'. U.S.. In- -hown that peptones in the general eireiila-
' "ii a- nii; and when the liver is deranged toxic
lV " a re fi irined which remh-r t he indi vid-
:;:u u rr i.-h-'-i. i ;i i ea-e.
;st L r a\e me a verv vivid account ojie day
"t !!:' i-;]'i . n her. ,\i lirst -he had the wnnted sense
two hour- after the meal lh:s pive way to
a t> -.(.[ v oppc,-;].- ci,.i,i;t ion of -n and sense of mi-cry and
FORMS OF FOOD. l.~>
impending evil. This condition is not uncommon, tin- '' liver stutTs'
or mill- products of deranged hepatic action having tin- oppo.-itc
effects of the normal products of digest ion.
The question may now he put: " How is it that nearlv all of us
eat too much meat, or its equivalent and vet onlv a certain proportion
sutTer, as beinir hilious or <routy ? " The question is a pertinent one.
The liver possesses a <rood deal of '' spare power " as the late I >r.
Murdiison happilv phrased it, and is, usuallv, equal to dealing suc-
cessfully with a quantity of albuminoids, far in excess of the body
needs. The answer is then " So lon<r as the liver possesses the power
of converting this hi.nis I'tnixii ur/ttiun into soluble urea ail is well !"
Soluble urea passes out of the liquor sanjruinis in the renal secretion
without anv difficulty. But not so uric acid.
I'rca belongs to the warm-blooded mammalia with a fluid urine;
while uric acid is the form of excremeiititious, nitroirenised matter
in the warm-blooded bird and the cold-blooded reptile. In other
words urea belongs to the animal with four chamliers to the heart;
while the tri-chainbeivd heart is found with uric arid. So loner then
as the liver can convert the IHSHS ronsinn/ittu/i into urea so lon*r can
man, yes. and woman too, eat albuminoids in excess of their body
wants: but when this power wanes, and products beloniriu<r to a
lower stratum of creatures are formed, then it becomes time to pull
up and diminish the nitnureni/ed elements in the dictarv. And if
this be not done, irout in some of its Protean forms will show itself.
Uric acid is the poison of irout: and when it is formed in any quan-
titv in the body then a condition of lithisis or litluemia supervenes.
As to the cause of this impairment in the functional power of the
liver, it may be said that loiiir continued over-work in dealing w.th
excessive quantities of a/.otised food is the cause /uir r./vW// -n<->\ It
may not be the act of the individual but that of an ancestor. The
father mav indulge in excess, and the son sull'er for it in the form of
an inetlicient liver. "The fathers have eaten sour grapes and the
chiidi'en's teeth are set on ed^c! " Verily, it is so!
There are, however, other mat ters of albuminoid descent and lin-
eairc. that must not escape our atlent mn; these are the bile acids.
I5oth contain nitrogen: and one contains sulphur ample pi'iioN ot
their oritriu! Clycoeholie acid has the formuhi (('..,11, N'O I: and
tan i-ocholie acid ((',, IL.XSJ)). Sonic persons sull'er from '
mia " while others sit tl'er from " ] itluemia " when their liver- are out
of order. Further some persons who are " hi i ions " m eari\ ii!e ; o.-e
their biliousness and become " polity '' in middle a^'e. I'holo-mia
Iti MANUAL OK PIKTKTK'S.
and litha'inia equally and alike are causally related to the albuminoid
elements of our food. Indeed, the products of retrograde nitrogen-
ised metamorphosis are fertile sources of disorder and disease. Dr.
(icorge .Johnson. K. K.S., has pointed out that kidney disease is set
up bv hepatic mal-products passing out in the urine and in doing
so irritating the kidnevs: and has written this trenchant sentence
" fii'/ut/ i/i'i/i //!'/(// in// /.v ii f<nixf'i/t')i<'>' of {lit 1 lout] continued eUininn-
tioii of j>rtnl in'{s <>f f<t nit if digestion //irony// tin' * kidneys."
There can be no doubt iu the mind of anyone who has had the
opportunity to observe and has availed himself thereof, that when
lithates abound in the blood one of two things happen: either some
remain in the body as gout; or the kidneys become inured by their
output of lithates (the common origin of Bright's disease), or may
be more or- less of both are found. Many persons pass turbid urine
laden with lithates for years apparently none the worse: but all the
same their doom is before them. Sooner or later mischief in the
kidneys is, set, up. We pay a price for pleasing our palates!
The ell'ects of food tell us that there are certain properties con-
nected with animal food lacking in other dietetic matters. The her-
bivora are widely different in disposition and build from the carnivora.
The beef of the Kngiish soldiers and sailors has played a part in
their exploits, it has always been said. Liebig has written '' It is
certain that three men, one of whom has had a full meal of beef and
bread, the second cheese or saltlish, and the third potatoes, regard a
difficulty from entirely different points of view." Dominie Sampson
was another man after some of the contents of the (iipsy's cauldron.
Refractory boys of old were subdued bv a dietary of bread and water.
(Granting all this, it is impossible to disagree with Dr. I'avyin
holding that, the advantages of a meat dietary have been much exag-
gerated and overrated. He points to the fact of the oatmeal and
milk of the Scotch peasantry. Certain reports of the prison diet-
aries are referred to by him. Dr. (Juy states. " That we possess con-
elusive evidence of the sufficiency of a diet from which meat is wholly
excluded : and even of a diet consisting wholly of vegetable mat ter. "
Dr. I'avv is careful instate that he does not advocate a non-meat
dietary, but H oppn-ed In the prevalent view that a certain quantity
ot meat i- nece-^arv to vigour; and. the outcome thereof of the prin-
ciple, that '' it i-' impossible to have too much of a good tiling." vi/. .
eating rimrc meat than is either necessary or good for the system.
There i- another a.-pcet of meat to lie considered, viz., the com-
parative digest ibi lit v of the various forms of flesh which mu-t be di.--
cussed at some length in a future chapter dealing with indige-t ion.
Dr. 1'avv lias given us a reasitn for tin- taste for meat, to tin- ell'ect
that t lie stomach is the seat of its digc-t ion, aiui t hat meat stays lom_r
in the stomach before leaving it. (Vrtainlv in the case of .\ie\i-
St. Martin, a Canadian soldier in the I'. S.A. army. who-e stomach
was laid open hv ;i charge of duck shot, at the distance of one yard,
at M ichillimackinac in IS .'.'. and who survived the wound. thi- was
the ease, For some months the patient sulTered terribly from ex-
foliation of the ribs, etc. . but t hanks to an iron const it tit ion he rude
out the storm. In a year the injury had healed, except that the
stomach wound did not close, and he had to wear a bandage over
tlu- wound to prevent his food from escaping out of the stomaeh.
A little later a fold of the lining of the stomach developed into a
valve which closed the orifice, preventing the escape of the contents
of their visciis. but readily pushed inwards by the linger, and so ad-
mitting a view of what was going on in the stomach. 1 >r. Beaumont .
his medical attendant, paid him the most scrupulous, attention: and
in return St. Martin permitted him opportunities for inspecting hi-
stomach when in action. The case created an immense attention at
the time, but is now disappearing from, our literature. 1 >r. Beau-
mont found that beef, mutton and pork took three hours for their
digestion in the stomach of St. Martin, and cheese three and. a half:
but for the latter a much longer time would be required with some
stomachs. 1 1 is broad results were that the ilc-h of animal- is no,
quicklv digested. His conclusions remind, mr of the heart v eater
who after an ample tish dinner remarked that " he felt <juite ivad\
for a beef-leak. "
Of albuminoid food, and especially the ilesh of animals, " li-h.
tlesh and fowl." it mav lie said that it is agreeable to the palate and
grateful to the stomach: and further that it is excellent material on
which the cook can exercise Ins -kill, and consequent Iv. that r, is a
tempt ing viand : that it is a stimulant in its character and i-ih'T<'-
fofe special! v su it ed for 1 1 lose who lead a i i !' of Lfrcat phvsical act i\ :i v.
But that it is not suited for I ho-e \\h" iead an indolent or -cd.-ntavv
life; and that most of th.e maladies which fa-ten on the bod\ a- .._.
approaches are can. -ail v 1 inked with the presence of an e\ce-s of a
miiioid waste in the blood.
Fats. 'I'he third LiTeat element of our fei
far inor>- carlion and much less o\\u'en than the e;irbi -.
has t he formula ((', II ,.< >. ) Fat can hardlv be -aid ;
but rathei 1 can be broken up into, a fatt\ aci i a'.<; :'i \ >->T\ >[.. The
MAM A I. <>K IMKTKTICS.
t'aitv afiils ;ir' t hive, stearic. palnnt ir. anil oleic. Stearine is the
lii'iiH-s: fat, ri-;ililv u'oiiii;' solid at a low tempera! ure. \vhileoleine is
.-till iiuite tluiil: anil palmiiis stands between tin- two. The matter
is ivaililv seen in a bottle of olive oil in eolil weather. Animal fat
contains a larp.T proportion of stearine. ami mutton and beef suet
iiuii-klv ^0 hard, liroadlv speaking, t lie digestibility of a fat is linked
with the proportion of steai'ine it contains, and with the tempera-
ture at whieli the fat pies linn. Thus beef and mutton suet an;
les< dip'stihle than butter or lard; while the best cod-liver oil has
its stearine removed by free/in^.
Fa! is derived from animals and vegetables, both as fats and oils.
Whale oil is too rank for food, at least, for ordmarv men: though
the Fskimo revel in the blubber of the whale and the seal. ('<><!-
li\ er oil is not attractive to the palate, though some persons overcome
their dislike to it. until they take it readily: and a small number
even profess to like it. Palm oil when fresh is palatable, and is
freelv eaten bv the negroes of New (Juinea. The oil of the African
LTi'iuind nut is a verv thin oil, used to thin down and to adulterate;
other ods. Olive oil is used in cooking, as frvinu' lish. and for sal-
ads; but then- are reasons to believe that rape-seed oil is larp-lv sold
as salad oil. Man v seeds are rich in oil. as 1 in seed : wh lie some nuts
abound in oil. The cocoa-nut and the Bra/Mian nut of commerce are,
instances in point. \\hvsitch quantities of a concentrated hvdro-
earbon should be requisite in the case of certain seeds in tropical
climates it is not easy to see. Nor is l he passionate liking for fat,
as ,-eeii jn t he 1 1 indoo's much-pi ixed '_fhee and the equatorial negro's
fondness for palm oil as readily intelligible as is the Fskimo's pref-
erence for blubber, which is shared bv the Ya knots of Northern Asia.
Fa; is a very concent rated fuel-food , and is t he form of storage of
.-urplii- food, ehieflv derived fnnii the carbo-livdrates. The hyher-
natini: animals retire laden with fat. and emerge from their hiding-
place-, pi u nt and emaciated like the pi"_- 1m r led under the chalk c! ilf
of l>o\i-r. which I >r. Mantel! lias mad" famous. Ilisstv was a cave
:n tli'' .-olid roi'k. under a <-haik ciiiT; so that wln-n a lar^e portion
"!' tin- e ' . ie \vas buried alive, lie \\a~ ''-tmialed to u'ei^h
about I i'ii i --. i- accident occurred: of course no hope of his
sun nti rta tied. \>\\\ \ In davs later tin- \vo]-kmen removing
the '. lie. and pit him out alive; hut old v wei^h-
;n'_ r I 11 . \ ' In- must have perished bin for tin- nioi-ture
win. li i ii the roek\ -ides of his cave. I hiring this i")!^
p, .;., i ii,^'j-\ nwii fat. 'I'he Tvroli-.-e chamois hunier
FOKMS OK Fool). l;t
lias found by experience that a piece of beef suet is the iicst and
least cumbrous food lie can carry with him on to tin 1 mountains.
His choice is a wise one.
Fat is not affected l>v salivary nor yet by pistric digestion. It is
onlv when gastric digestion is over, and fat conies into contact with
bile and the pancreatic secretion, that anv change is effected in it.
The change is not molecular like the hydration of carbo-h vdrat<s
and albuminoids; hut is merely an emulsitication, /./'., a division
into minute particles. These tine particles are small enough to enter
the months u f the lac tea Is in the uitest inal villi. which ma v be said to
" eat " the fat globules. l-'rom thence the emnlsioniseil fat passes
on to the lymphatics. The history of fat in the bodv after this is
obscure: we know that some of it is taken bv the tissues, and the
rest is burnt up as bodv fuel. There is no proof of fat beini: .-ton-d
up in the bodv as fat. Indeed. Kbstein has advocated the sub-titii-
tion of fat for carbo-hydrates in the treatment of obcsitv; and that
too with success.
The difficulty with fat lies with the stomach. A delicate fastid-
ious stomach is offended by the presence of fat in it: and this re-acts
upon the palate. Some stomachs will tolerate cold butter, which
promptlv and pronouncedly take offence at warm fat. Ifancid fat
is objectionable to all civilized stomachs: and compels the most scru-
pulous attention to all culinary utensils. With some persons, fat
turns rancid in the stomach bvthe formation of an a'-rid acid.
butvrii causing; heart-burn. There is a ^rowin^ dislike to fat,
especiallv animal fat. at the present time. Manv children will no
more eat fat than will the cat. They will turn with loathing from
the sweet pieces of fat on their plate-, yet thev will readilv swallow
the lishv cod-liver oil. Their choii-e is instinct ive, and evidently
linked with the fact that, thev can digest the one. but /// the other.
The fact remains; and 1 >r. KiiiLT Cham'-crs tells the Morv of a
phi hisical Scotch terrier who whined at til:- door of the cupboard in
which hi- cod-liver oil was kept, if ;t wa- l'ori_ r <>Men.
The late 1'rof. .1. Hughes llctinett of Kdinbiir_yli tir-t inlroduceil
the use of cod-liver oil into the treatment of phthi-;-. There
nothing magical about it. it. is merelv the mo-; digestible form of fa:.
Still, it is a mi^htv matter in dealing wit h wa~t inir d isea-o. Tiic . Selec-
tive tissues of stroma improve under I;. The phthi-ica! pa!:e-,
(pientlv linds in it the mean- of -^tavMiu' hi- ilisea-e. Tak'
an hour and a half after meal-; il ijUickiv parses out of ti!< ii,
and so Lfivi's that viscus little oil'cncc. Taken In-fore a !;:.- M
L'<> MAM AL <!' DIKTKTK S.
immediatelv lifter, it eructates and disagrees. H'H taken at the
time when tin- disintegrated food is passing out of the stomach, it
ouieklv reaches the point when fat is dealt wit h in the aliinentarv
canal. I>ut in some cases, especiallv when the bowels are the scat of
tubercular disease, the oil is voided m -//^/.v\r and unchanged. Here
the paiHTi as is clcarlv unequal to dealing with it; and it is useless
to persist with it.
From tlie fact that fat is emulsionised in the intestines, chemists
have heen led to mutate nature, and form fat emulsions. In milk,
fat exists in the form of an emulsion; and the addition of a certain
amount of milk to the dietarv provides fat for healthv tissue forma-
tion, in persons wit h the most tetchy stomachs. Or cream with a
little flavouring like maraschino, mav he taken about an hour after a
meal. P>v so do;iii, r in maiiv eases it does not become necessarv to
resort to cod-liver oil. Fat emulsions are more digestible, or rather
assimilable than unemulsionised fats and oils. There are many fat
emulsions in the market, of varving value, and various flavours,
lly drol cine and oleochyle are cases in point. Hut there is a difficulty
in keeping them, as sooner or later the emulsion separates. One
specimen I had for three years before, it began to part: but for sun-
drv reasons | have no intention of giving Us owner a gratuitous ad-
vertisement bv mentioning it here. In other eases the oil has been
mi \ed with malt ex t ract : and t liouirh this 1:1 ves an emulsion of coarse
oil-^lobnles, in time the oil gets to the top. Then in the (,'remor
I lordeat us of Leollnnd the emulsion form of fat is preserved; ami
Oleobyne is an emnlsionised fat. These last contain fat with soluble
carho-hvd rates, and are palatable as well as being capable of being
kept for ahv length of time in their tins. Such preparations are in-
dicated where the palate objects to cod-liver oil; indeed the fat in
both cases is a better fat than the oil; while the form of emulsion is.
favourable to assimilation. Thev form indeed vei'v complete fooiis
for in\;i!ids and travellers. \Vitha little farinaceous matter, as a
. ud a little milk, thev are well adapted to goutv persons and
tho.-e who -ulTer from Uri^ht's disease.
Fat-eat m'_ r amoiiLT adults is fort UliateiV on the increase at the
present day; if the valuable hvdro-earbon is in growing d:-fa\oiir in
the nursery. Intelligent person- ai'e now eating fat because ihcv
know 11 is ^ood for them. \\"heiie\ cr there is aii\' leiidenev to
tubercle, the individual should learn to eat fat. ju-t as a seafaring
man learns to ~wim. A-- a jihvsician to a Chest Hospital 1 have
learned to dread the announcement that fat is no longer taken. es_
FORMS OF Fool).
peciully if the individual is of shannons build, with :i small narrow
chest. In inv opinion the existence of a considerable an -a "I"
affected lung where the digestive powers keep up. is less fraught
with evil and less prognosticallv significant than intractable wasting
with verv little disease in tin- lung.
The statement often made t hat '' fat is hi lions," as he ing a direct
irritant to t he liver, is ineonvet.
Certain it is that when the dietary is improved in some eases the
liver is upset hv the ne\v demand upon it: but this can alwavs be
met by a cholagogue and a purgative.
Salts. -Certain nun-game principles are also essential to our
health, mainlv chlorides and phosphates. When certain vegetable
salts are lacking in the dietarv. the disease known as scurvy is in-
duced. The early navigators of the oceans which lave the shores of
the new world were terrihlv alllicted with scurvy, in consequence of
their dietary of biscuit, and salted meat. Anv vegetable matter,
especially " scurvv " grass (cochlearia ollicinalis) a member of the ( 'ru-
cit'era 1 , at once brought relief. Land scurvv is occasional 1 v seen in pel--
sons who abjure vegetables, as do some dvspepties. A cruel old I Mitch
punishment was to feed prisoners on bread made wit hunt salt. Much
obscurity still overlavs the 1'u net ions of t hese hod v- salts. " \\'e know
that t he various saline bodies are essential to health, that when the\-
are not present in proper proportion-, nutrition is aH'ected, as is
sh>,wn hv certain forms of scurvv: we are aware of the peculiar de-
pendence of proteid natalities in the presence of salines: but hcvond
this we know verv little." (M. Foster.) A vyood illustration of the
value of the body-salts is furnished hv watching the effects of arrest-
ing the night sweats of phthisis. A- soon as the out pop I'lnir of the
salts in the sweat is checked, the appet he returns and soon the pallor
"! the features gives wav to the hue of returning health. The
etl'cct ]s often almost magical. Chloride of sodium, our common
salt, is a palatable addition to our viands and especially to the tlr-h
ot animal-. I'robablv from it. is furnished the hydrochloric ac;d of
the gastric juice; while the soda goes to the livei'. as the alkaline
hascof theglyeocholates and taurocholates ,,f the bile. The ph,,~
[iliales too are eijuailv important. Phosphate of lime - iv.,u :-:> tor
the bones of the body, and is t'urnisliei] by the cereal- of o< ;: -
conspicuous for tin- tenacity with which It holds a larjv inian: :\ of
phospliatc of lime incoi'po rated with it." i 1 'a\ v. i
It i- found indeed in all the structural cl"in.".;- <>:
L'-J MAMAL <>!' I >1 KTKTK 'S.
I .e.-ithin, ilic food of tin 1 nervous system, is a phosphorescent fat.
Then potash is rcijiii.-itr fur the muscles, ami red (Corpuscles of the
blond. \\liv theff .-hould be phosphates juul potash in the hlood-
urpuseles with chlorides ami soda in the plasma around, \vedo not
vet kiinw. Indeed, this is part of the dafkness undispelled as to the
hod v -salts. "Although >o closely allied in t lit 'ir eh finical pro pert ies,
jiota-h and soda cannot be made to replace each other in the living
svsteiu. anil the same is likewise true of lime and magnesia.''
(Taw.)
\Vliatc\cr the peculiar part plaved bv saline matters in the bodv,
\\ekno\\ their importance, bv the consequences of beinu' Without,
them. The phosphates, the chlorides, lime, soda and potash, are
e.-seiit lal to iicait h and life.
"Water, \\ater uudenroes no change in the bodv. nevertheless
it is a most important matter. Solution is an essential part of diges-
tion. Our tissues are bathed in fluid: our secretions How. If
hunger secures tin 1 taking of food, a still more imperative sensation
provide.- for the neeessarv fluids. Thirst is the security for our sup-
plying our tissues with a sufficiency of water. When cut oil' from
food and drink it is thirst which drives the sutl'erer delirious, and
short iv closes t he scene by deal h. 1 1 linger kills more slowly. Water
is even more essent ial to life than food itself. Water too. bathes t he
tissues and wa-hes awav our waste and excrementit ions matter.
The \ a sen la i 1 svsteiu. like the canals of \' en ice. provide t he fond and
take a\\ay the waste and otTal. Water has, too. other properties in
the In. iv.
"\\atcr docs not it. -elf underL r o any chemical alteration, and
hence i- not suscept ible (f liberating force -does not in ot her words,
eon-i lute a foree-produeiiijr airelit . but it contributes to chemical
changes hv supplying u, necessary condition for its occurrence in ot her
Ixxlies." (1'avv. )
(TIAPTKR III.
METHODS OK IM.'KI'AIMNC K()()|).
IN the p re pa rat ion of food of vore. the palate has no doubt been
the threat ^uide. Still, a blind instinct set ins also to have been at.
work. Tin 1 cook lias been led to prepare vegetables with meal: to
unite uTain ami milk; to boil the hi^hlv nitrooviiised heans with
fat liacon: or peas and |iork. Kxperience at work through count-
ies-; a '_;<> has no doubt instructed Man. alheit darklv. what combina-
tions of food- arc ri-'jiiisiir for health under certain conditions.
Sillier-kraut was a \visi- provision oi' ve^cta!li' food during the long
winter, when salteil foods and cereals formed t he chief dietarv of t he
people. A Lenten fast of vegetables was a useful liv^ienic. measure
for clearing awav the maladies incidental to such a dietarv: as useful
as vegetables to scurvv-stricken crews ln-forc the davs of lime-juice.
No wonder people Ion ; a^ r o spoke of the anti-scorbutic properties of
certain Vegetables.
r,efoi-c pi-ocei-din^ with the preparation of foods, it mav be we'.I
to -i\e a Lei hebv Table of t he comparat ive value of various edible
articles as tissue-food and fuel-food, without anv pledge as to the
absolute acciiracv of it. J t. is certainlv useful, as ^'ivini: a u'ood
bi'oad idea of the value of various comestibles:
2} MAM AL OF I >l KTKTK 'S.
c. \iati IN. XITHOCiKN.
K'ye M-al W.W> .*(>
1'earl Barley '^.tiO .1)1
Barley Meal > - > 5.l>:5 .(58
Treacle. '- ) :!.S)5
Bakers' Bivad 1D.75 .S8
skim ( 'I se 11). 45 4.s:t
Mult. Hi I'.l.oo 1.*!)
Beef 18.54 1.84
Red llerrin-s 14.:J5 ~M7
Bull. ck>' Liver D.:!4 'J.04
White FNi 8.71 1.1)5
I 'lit a toe-, 7.1)!) .23
New Milk 5.11!) .44
Carrots 5.08 .14
Skimmed Milk 4.:',s .4:',
(liven Vegetables 4. 'JO .14
Tunii| -'.<>:'> . U5
In eon.-ideriii!_ r the methods of preparing food, it may be well to
commence wit h Meat.
Meat. l!'iHiinj. One of the most ordinary methods of cooking
meat is to boil it. Of old a piece of meat, a ball of oatmeal, and pos-
sibly some ".Teens, (when they are to be got), were all put into a huge
pot. which was t hen heated. The old Border rule was. " no brot h no
ball: no ball no beef." That is. first came a basin of broth; then
some of the bail: and after that when the ed^v had been taken oil'
the appetite, the beef. If the broth was not supped, there was no
bail: if the ball was not eaten there was no meat to be looked for.
In those davs. when the broth was of moment, the meat was placed
in cold water about a ipiart to the pound of meat. " Jt should be
covered with water during the whole of the process of boiling hut
not drowned in it the less water, provided the meat be covered
with ii. the more savonrv will be the broth." From fifteen to
t went v m :nut e< for each pound weight is t he ( Kitchener) t ime. But
fre~h!\ k ll"d meal. /.<.. while t he riu'or mort is is on. 'akes a longer
1 1 me t ban meat which ha- 1 been kept ! i i 1 i n cull narv phrase il is " ri pe.
M-at in.-' 1 - (rouirhh i about -I 11 per cent, of weight in boiling.
\Vhen the liipior." the fluid in whiidi meat has been boiled is
an obiei-: then the n icai must be put in co id water and all brought
to ;M>' ! 10 '; but ' ihe meat is the lir-1 coii-idi'rat ion then the
\\aii r mu-l : "' !io' "',- v In n the meal i- put. in it. " \\ hen M is
' In i j \\ ater, t he a I bunion of ( he lies h is i mined i-
; ' ' -. ; , 'face and to a certain dept h inwards, t bus
.MKTHODS OF PRKl'AKINC FOOD.
forming a skin or shell, which no longer permits the juice of the
meat to flow out. nor the water to penetrate into the mass. The
flesh continues juicv. and as well flavoured as it can po.-.-iblv become.
The irreatcr part of the savoury constituents is retained in the meat. "
(Liebiu-. ) Meat so prepared is very much more toothsome than
meat placed in cold water.
In boiling fish some prefer to heat the water, and add the ditfer-
cnt matters as salt and vinegar: then to take the pan oil' the lire and
put the fish into the boiling water allowing it to remain in the
water the same time that is given for boiling it. One gentleman
who lias his fish so " boiled " said the plan worked up to an h s 'b. sal-
mon. It is asserted that the flesh is more palatable thiswav than
after ordmarv boiling.
lioi'ed meat puddings are verv savourv. The ordmarv beefsteak
and kidiiev pudding is well known, but the contents of the paste
mav vary: in Suffolk pork is substituted for beef: in Oxfordshire
liver and bacon are placed in the paste. The best thing to do with
an old partridge is to let it hang till it is ln^h and then make a
boiled pudding with iu packing sonic pieces of fat and lean mutton
around it.
< ii-toin has settled the choice of joints for boiling and for roast-
ing. In the case of a ham it, is well to leave the ham in the fat till
the water has ^one cold; especiallv is this desirable where the ham
is a drv one. \\ hen dried fish is to be boiled it is well to steep it in
lime water first. This conserves the phosphoric acid as "bone
cart h " or phosphate of lime; otherwise the phosphorus would be
lost, and with it much of the food value of the li.-h.
AV/.V////V. 1'robably this was the earliest form of cooking meat.
The savage could put a piece of meat on a stick and have it kept
before the lire. I Jct'ore t he ila vs of the " jack." do^s called "turn-
spits" were engaged to keep the meat t urning before the lire. As
well as turn Mi".', basting is required to keep the meat from hurnnrj;.
The tiiuc for roa.-ting is a little more than for boiling. On the
who,e roast meat is more; savoury than boiled men!. Ifoa-tinu; ,s a
method of dealing with fresh meal: while salted meat is boiled.
True to his theory of coagulating the albumen of i he mea: at th-
exterior to preserve 1 he juice. Liebi"; advised that th"jo>>.; '
placed near the lire, and then after the -urt'are wa- hardened, to
ulihdraw it a little. I'suallv however, i he o!>\ er.-c - pra :
ha- t he .-auction of I )r. Kitchener. " The ha-t inir on^'h 1
forme* nke a religions dut v. A meat screen or rdlcctor ; '.'.
L>'. MANUAL OF IMKTKTK'S.
as it saves mal l>v keeping both sides hot." The fat \vliirh exudes
is saved as dripping, \vlnle the meat juice is sent up as gravv. which
gives relish to the vegetables eaten with the meat. As to whether
the meat should lie raw or well done is a matter upon whieh tastes
dilTer. When the mast meat is destined to appear on table in cold
form onlv it is well to avoid cutting into it when hot. Liebig's idea
of eondeii<in^ the juice in the meat is correct enough in this respect.
lliik'nui. The convenience of theoveii is a great toillptatiou to
its use. It issa;d meat loses less weight iu baking t han iu any other
cnlinarv treatment of it: but what it gains iu weight it loses in tla-
\oiii-. I >r. K ing ( 'handlers savs. " \o kitehen is complete wit bout
an open range. Il is impossible to have a properly roasted joint by
anv other means, as I learned hv visiting the private premises of a
' Patent Kitchener' maiiufaet urer; finding there an old fashioned
iireplaee in full operation. He cared too much for his diet to
employ his uwn works. "
An oven, of course, is indispensable to a meat pie. Meat pies
bear the reputation of liein^ indigestible, and probably they deserve
it, hut whether this is due wholly, or only partly to the paste, and
meat so treated is not itself indigestible, is a matter not yet deter-
mined. The addition of eggs which get as hard as leather mav he
sound practice from a cook's point of view, but t he physician and
physiologist can not be expected to be in favour of it.
lii'nili int. This is a verv savoury way of treating a slice of meat,
lie i! a million chop. ;i lieefsteak. or a veal cutlet (which is often
fried ). I >roi 1 ; nu; belongs too essent lallv to the cook's craft to he dis-
cussed here.
/'////////. l-'nr slices of meat, frying is an abuse except for bacon
or ham. h i-. however, an admirable way of treating lish, though
it may he ipiest loiieil if a fried herring is equal to one properly
broiled , hrandered.
The jlat tishe- are specially adapted for frying, and a fried sole is
savoury food. lint if the cook'- fat be not suiticielitlv hot it soaks
ml" tiie tibiv of the ti-h and few edibles are more indigestible than
a had I v fried sole. With looser-fibred tish this carelessness is less
the point of \ ie\\ of : he palate and digestion.
/"/. I'h;- - ihe most economical method of cook in^ r : it is
especially adapted to hou.-eholds where strict economy must be prac-
MKTHODS OF I'KKI'AIMV; F< ><>!>. L' ,
tisen. A> Dr. Buckmaster observes, " All ami cverv kind of iin-a'
will do tV)r a stew," and " All vegetables may In- cut int<> slice- and
cooked in a stew, except potatoes." All gristly meat and trimniiirj
with otl'a!. as sheep's trotters and pill's 1'eet, will do for a .-lev, ; of
course, as he adds. " the better the meat, the 1 tetter the stew." An
I nsh stew consists of unit ton. potatoes, and onions. ;ind un admirable
as \\ ell as economical dish it is. Indeed, such compounds of m<-at
and vegetables in a stcwpan and well moked would be must accept-
able to most households, but are comparatively neglected in favour
of joints. The Ion;: action of heat would ail'cct the staivh-^rains
favourablv and thoroughly detach the muscular tilirilla- from each
other and >o prepare the food for the action of the different digest ive
agents and processes. As orilmaril v prepared a stew is deficient in
fat. But care and knowledge are requisite for a trood stew and also
time. "Time" is what all skilled cooks hen- for in cooking. Ha.-te
in the preparation is the ruin of stews. I 'uriosit v. too, isa drawback:
the lid of t he stewpan should never be lifted until il has to be taken
otT. Then the savourv compound is sapid, fragrant and appetising.
It is also most digestible
This wa> written loiiir before science came to bear its testmionv
to t he truth contained therein.
Son /i. - -- Soup is alike a means of ^ratifviiiLT the palate of the
wealthy gourmand, and feeding the poor in times of famine. A
lijjdit soup is verv suitable food for the sick. Simplv. soup is an in-
fusion of meat, flavoured with a little salt and some condiment. A:
the rich man's table, soup is a very complex all'air. It consi-
stock (the simple soup) gelatine, which troes llnid on hcatinir.
often, cream an'l vegetables of all kinds and sorts: sometime- ;; .
thickened with broken biscuit, as is done in the ('hanncl Island-
and a verv nutritions food is soup so constituted.
In some cases, lish is the chief meat const it iient. In ot her ca-e-.
legumes take i he place of meat, whollv or partiv. e-peciadv wh
vegetarian-. Like stews, soups, looked at from their food value, are
ttnsat isfactorv as bein^ too poor in fat. \Vlicnevcr cream . i.-c/i,
the objection falls to the M-round. Soup precedes other food, and
ta!<c< the \an in a meal, as furnishing material for tin- forma' on o
pistr'c juice. A little meat-juice to furnish the pepsin (an a.!
oid lnp.lv) and a little dextrine for the lactic acid. ;
IN MANUAL OK DIETETICS.
stomach brews its own peptic solvent, while the viscus is filled and
the palate gratified. The French invariably take a glass of wine after
the plate of soup, "/<' <<>/<]> <!'<i/>/'?'x." Indeed, many soups contain
some wine. Old cooks over-season soups, which should not be too
highly seasoned in order not to deaden or dull the gustatory nerve-
iihrils: Really, the soup should just be seasoned sufficiently to stim-
ulate the palate. Nor is it good for the lining of the mouth if the
soup be served up scalding hot. On the other hand, cold soup is
very unpalatable. The meat of which the stock is made, ought to
be pounded and put through a sieve, in order to restore the natural
eondit ion and properties, and give the meat infusion a true nutri-
tive value. Then some broken biscuit, or some bread-raspings, or
boiled potato put through a sieve, should be added, to supply the
farinaceous element or conversion into grape sugar. In some cases,
line sago is used. White soups made with milk, and especially when
some cream is added, are very nutritive as containing a distinct
proportion of fat and very palatable.
/tut' 1 Mint Some physicians have advocated the use of raw meat,
scraped or pounded, in certain cases. The advantages of such meat
are not obvious to the physiological physician. Indeed, Dr. .1. II.
Bennett discountenances such practice in these words: 'To give
meat raw. however tinelv chopped, is to forego all the advantages
gained by judicious cooking, and to force on the digestive organs
double work." (Nutrition in Health and Disease.) Many of the
advocates of raw meat have had to deal with hysterical women- a
class so totally opposed to rational beings in every way. that it is no
matter for surprise that uncooked meat agrees with them. The
habit of eating uncooked meat has subjected those who indulge
therein to trichinosis; and other ento/oa are common in Kastern
Knropc, where this objectionable practice mainly obtains. Meat
juice ami cold drawn beef-tea have not. at least, this last, objection
to their use. In milk, we find an albuminous body, which does not
require cooking, certainly. Considering that all proteids must be
converted into peptones before they can pass from the alimentary
i 'anal into the blood, any advantage to be gained from raw meat juice
is quite hypothetical; and involves a lack of acquaintance wit h the
physiology of t he digest ive act on the part of t hose who resi >rt to such
raw meat.
In the cooking of meat, there is no clinical or even molecular
chaii"; 1 ' invoked in the proteid material. The muscular fibrilla 1 are
loo-en I'd by the act ion of heat , while the coagulation of the albumen
MKTHODS (iF I'K'FI'AIM N< i FOOD. L".
renders the fibres morr brittle. Conse<p.ientlv. cooked incut i- in"!-.-
easily mast icated than raw meat. While tin- further di~inte<_rra' '...n
of the flesh is facilitated by this change: -and disinte^ra^ou pre-
cedes solution ill the digestive act.
Starch. /J/VY^/ Mnkunj. Stareli is the cliaracteri-t ic cicnieni
in bread. " the stall' of life." \\heji wheat was first brui-ed in a
(jiieni. a species of mortal', or ground by the ' two women sittii,'_r ;,:
the mill," all the elements of the seed were in the Hour, [.on- }
fore chemistrv could tell them the follv of what thev wen- do;;;^.
e<ioks, led l>y the eve. bewail to prefer white bread. In order I" a!-
tain this (Mid the miller devised means to remove the external coat
of wheat as bran. I'nfortunatelv in this external laver lies the bulk
of tlie salts in wheat. l>y t his fateful gratification of the eve a cruel
wronjjf was intlicted upon the youni: and ^rowin^ creatures. An
erroneous taste dies hard, and the attempts to induce the proletariat
to adopt whole meal bread have met with little, verv little success a-
yet. Those who adopt whole meal bread have usuallv pas^e.l the
^rowin^ a^e.
Flour, as now made, is far inferior to that of earlier davs. The
destiny of Hour is the oven. Sonic of it mav iro another Li'ate. Imt
the bulk crocs to the oven. Mixed with water, a little salt and vea.-i.
Hour is worked into doii^h. is set before the (ire to rise; after whieh
in loaves it is placed in the oven to be baked. Yeast is a 1'enuent-
iiuj a^'ent (a form of lowly plant lift yeast fuiiLTiis). " The pres-
ence of veast in a substance containing sn^ar, or starch, which is
convertible into su^ar, and nitro^eiiisei] matter, induces certain
chemical changes, comprehended under the term vinous alcohol.!
fermentation. These changes in tlie nrakincr of bi-cad consist in the
conversion of thesiijiar of the Hour into <ilnji<> ! and <-<ir1><>,i!i- ^'.v;
the lat ter in its dl'orts to escape from the dou^rh in which n is mi \>'d,
distends it. forming vesicular spaces in its interior, and so can-in^ 1
to become porous or li^ht. M ucii of the alcohol is dissipated ;. '
process of baking.* hurin^ the bakin::, part, of the stardi ;
dotibtedl is convertcil into dextrine (A. Hill Ilassalh. This- '.
3d MAM'AI. OK niK.TKTlCS.
kent in the oven a longer time without burning, the conversion of
the .-tarch int" dextrine would be more extensive and complete.
From its vehicular or spongv condition bread is readiiv masticated
and mixed with saliva in the mouth. For delicate children, in
whom the saliva is deficient in quantity, or in qualitv, some guiding
principle led shrewd persons to use only the crust of the loaf, which
contains more dextrine than the crumb. This was a wise choice.
Then came the preparation of rusks and tops-and-hottoms. Finally
came " baby foods," of all kinds, a matter to he discussed further
on. The principle underlying all " baby foods " is t he conversion of
insoluble starch into soluble matters. Newly made bread is a poison
to most dyspeptics. It is moist and readiiv goes into a lump in t he
mout h : while stale bread is drier and of tinner consistency, and does
not readily lose its vesicular character in the mouth. Hot breakfast
rolls are toothsome but not digestible.
The reason whv boiled paste is indigestible with manv persons
is that it is not vesicular, but a solid mass. When flour has been
mixed with fat. as lard or butter, as is done in making pastrv, the
starch and fat arc so intimately mixed and incorporated that the
saliva cannot get at the starch granules. Further, too. disintegra-
tion is not MI easily performed as with bread, and between the two
the stomach is handicapped with masses of unchanged starch and
fat, upon neither of which has it any solvent, action. No wonder
then that it aches!
As the confectioners* wares consist largely of Hour and far. well
kneaded into paste, they are shunned by the parents and guardians
of children of tender years, from the ulterior consequences of eating
Not only do thc-e masses oll'end the stomach but thev load
the bowe]-; except when 1 1 ie i r i rri t a ii t presence set s u p d ia rrl 10 a for
The inhabitants of the I nited States are reputed a dyspeptic
race; and certainly a number of representatives of the threat 1,'epub-
bc ha nto m\ consulting room. suiTeriii'^ from
indige-t ion. In ; i ab.-eiiee of personal acquaintance \\ it h the New
World I an to rely upon what I bear, and upon American
cookery book-. In reading the instructions as to the making of
"corn bread." I lind "ISake quickly and steadily In a buttered
mon Ii i. i ,< I usually sutliee. " Th '- is not
loh;_< for 1 111] II ' . Then it i- told Pie ! iie.-e
cake- 1 1 le t line for t he s;di\ a to ac| u |>ou
the ,-tai'ch. In the name ot common sense ran \ve wonder if the
MKTHODS Ml-' I'KKl'AKINc; KMM]> :', 1
out raided stomadi sometimes protests? 1 Iain pep-d with immense
quantities of unehaiiL r 'd starch il cannot, perform it- work without
effort.*
If corn bread up cakes were eaten slo\viv initi-h of tin- re-niiant
dyspepsia would IK- avuiilcil. The albumen of mai/.e or Indian corn
is Hi it gluten. Consequently it. will not alone make bread. The
combination of inaixc Hour with wheat ilmir is what i- required for
a readily digestible oread. All boiled paste, all boiled pudding like
a suet dumplniLT. or a meat pudding-paste, ,-hould consist of a union
of the two kinds of (jour. 'Ail baked pudd in.'j's sliould be made of t he
two. espeeiallv when ep^s are used. \\liea! Hour and eii'i:- form a
compound not easily disintegrated, however palatable. Certainly
paste should contain the largest ]ira'-t ieal>le proponion of mai/.e
(lour. If the medical profession were only ^enerailv familiar with
the properties of gluten they couid L;'IVC a dii'ection to the d.etarv of
the Jiurserv of a desirable kind.
In the Xorth of Kn^laiul eakes of all kinds ai'e in vo^ue, and the
frying-pan and tlu' " girdle." or ni'i'idle is in constant request as well
as the oven. One form of cake is disappearing. \\ hen an audition
was made to the family <rrmip, a cake was prepan-d bv adding pientv
of butter to some ilmir. throwing in a few currant-, rodini:' the
paste about a quarter of an inch stick, and piae'm^ this in the frvin^-
pan if the oven was not available. While eookinu ; ' u '-~ d:\idcd
into s(jiiares, alioiit the si/.e of the palm of the hand. \\ hen cooked
it was still a -oddeti mass, but toothsome. The little .-qua res were
then split and but ter addeil free! v to t he warm cake. Old-fashioned
doctor- liked this cake, and drank it down with tea (said to have
been " laced " with rum) to prepare them for the journev home. It
is living out. probably because the le-s potent digestive orpin- of t he
present generation cannot deal with it. Paste roded out th;n in a
circie, with jam or fruit laid ove.rone half, while the other ha.f is
folded over, and the eil^es do-civ pinched together, la a eollimon
cake, or pastry in the North. Then there are Kcdes cake-, and
I>anbury cakes, comliinations of Hour, fa; . cm- rant- and eandied peel.
The early emigrants to \ew Mndatid took their taste for cake- o\<-r
witli tln-tii: and .-undi'v rolling-pins were in the hol.i of the " Mav
! lower." we mav depend upon it. The bane of all t he.-e eoiiie-t
is their mdiirestibilit v on account of the:;- form 1 . n ( _ r soiid ma--' :M
MAM'AI. (>K IMKTKTK'S.
cakes arc tempting to the palate, especially in early years. A story
is (old of a little <jr\\-\ who wanted more cake. " She was told if she
ate any more she would be ill, and the doctor must be sent for."
This effective deterrenl on all ordinary occasions failed in this emer-
gency ",lu-:t ano//.cr piece, and then send for the doctor," she
pleaded. Fat -'ind Hour sweetened form a good food from a chemical
point of view, hut the resultant product is unfortunately not diges-
tible; noj- are flour and eggs as in sponge cakes much better. The
addition u| mai/.e Hour to wheat flour gets rid of some of the difli-
cultie.- of pa.-trv: but not of all of them.
Starc'i of various kinds is in use for milk-puddings. For chil-
dren, invalids, and dvspeptics such milk-puddings are admirable,
unfortunately dyspeptics usually abhor them; a milk-pudding is
usuaiiv allowed an hour in the oven so that the time for the action
of heat upon the starch allowed is double that of cakes. The com-
bination of >tarch and milk is capital food. Unfortunately the cook'
will add eggs, which increases the food value doubtless, but detracts
considerably from the digestibility. The addition of butter is good.
If the various forms of starch, as sago, rice, tapioca, etc.. were sub-
jected to heat before being added to the milk the conversion of
starch would lie great lv facilitated. Act ing on this principle. I have
taught mv cook to put the farinaceous matter in a little pie dish in
the oven. drv. and bake it for an hour or two, taking care not to
scorch it by having the oven too hot. This docs not impair either
sightliness or the flavour of the starchy matter. The conversion of
starch is pn>\ed both by the iodine test, and bv artificial digestion
cit her wit h malt or a malt-extract. The most perfectly digestible
milk-pudding is made bv adding some ground malt to the baked
starch, when the warm milk is poured on, and stirring the whole
tnget her. aft er that set t ing it in a warm place for ten minutes before
putt , tig in t he oven. The diastase of t he malt ads upon the cracked
and changed starch granules, and the resultant product is lit for the
weake-i liahv. invalid, or dyspeptic. Indeed, ground malt is a much
bet ter a< id it ion than cane sugar wherever such sweet milk puddings
turn ac d in a fastidious .-tomach. (Tin-re is however one point on
whieh the conk mii-t be put upon her guard, i.e., not to add any
ordinary -ugar to a pudding containing malt. It is sweet enough
with the inalto- . Fspeciallv is this caution to he observed in
t IIOM- ease- \\ he|-r ordinary milk-puddings sweetened with sugar turn
-our in tin- stomach. ) Indeed, ground malt alone wit h a little milk
makes a very n'cc pudding, and is improved by an egg.
MKTHOPS OF I'KFI'AKIM; Fool) >
The principle of employing farinaceous matter which ha- a.rcadv
lieen subjected to heat (so that a considerable conversion of stan-h
has ^ouc on before the human salivary diastase comes into play), is
carried out in practice in the form of bread and butter pudding.
Slices of stale bread buttered are placed in a dish, some currants arc
thrown in, and then some sweetened milk poured over all: and the
dish is placed in the oven: or bread is crumbed and milk added;
but t his pudding lacks t he fat of t he lir.-t form. ( >r a milk-pudding
can be made of broken captain's-biscuit (which is baked at a hiirh
t em pe rat ure). The substitution of malt for cane su^ar. as described
above, is all that is required for an ideally digestible dish for delicate
stomachs; the flavour of maltose beinir also finer than that of cane
su^ar.
When milk puddings are served at table as a rule they lack fat.
If hot it is well to place a knob of butter in the middle of the mass
of pudding on each plate; it will melt before the pudding is cool
enough to eat. and mi \es readily. Very fastidious personages would
perhaps sav that such a practice is " messv," and object to " mak-
ing mortar," but these objections do not outweigh the real value of
the addition of the butter. If cold, like creeled rice, it is well to
eat butter and su^ar, rather than su^ar alone, to the cooked
farina.
'/'In 1 I'nlttfn. The potato lies midwav betwixt starch and vegeta-
bles. It is a vegetable neb in standi: and boiled potatoes ma-lied
have been used as an adulterant -well, hardlv that to Hour in pre-
paring dottu'h for bread. The object of cooking a potato is to trans-
form it from a firm indigestible vegetable into a ball of Hour. About
the cooking of a potato opinions ditTcr. Some hod. some .-team.
some pour oil' the first water; some pour otf the water when boiling
is completed, and leave the potatoes a little time m the pan. l>e-
fore the potato disease in the Irish famine of lS4i!. potal-ies were
commotilv boiled hi their " jackets," or skins. \\'hen boiled i; was
enough to take the potato in both hands, and with a ifeiitle pud oil'
came each half of the peel, and the llourv ball dropped into the 1 1 : ~h.
llard potato is utterlv indigestible, and potatoes cannot, like other
vegetables, be used, to stew with meat. Ma. -I led potato i- in;-'
tioiiable. The cooked potato is beaten up and mixed with cream,
or hot hutteraiid milk, until a ii^ht white product i- o'ota.n
is mo-t palatable if well made: as such it can be eaten ;o m<
mashed potatoes and sausage are familiar in all (own-, a-
hou-c luiiche-: or a wall of ma-hed potatoes - made foi
:'. I MANTAI, Ol- 1 DIKTKTICS.
meat, or ;i cot tau'e pic. Ma.-hed potato with salt ami pepper Jllld set
before tlic lire to tii-o\vn. \vilh a ^-ia.-s of milk. forms an ideal lunch-
eon, according to !\m^ Chambers. Tin- introduction of tin- potato
revolutionised the fare of Kurope in winter. Saner kraut the(ier-
nians had: and pickled gherkins were common over the most of
Mu rope, and in Southern climes some greens were possiMe; onions
too 1 1 iev had : hut, after all, their winter dietary was deficient in ve^-
etahle fond, and eolise' jilelit 1 V Scurw, and other scorbutic alTections,
were rii'e. The monks cultivated the wild ejirrot and turnipas lux-
uries: hut these were only for the well-to-do. The potato, which
keeps well with a little care, at once supplied the desired vejjfetahlo
food, and the winter fare of man was no longer without, the desir-
able element-.
I /I /.////< x. The vegetables in common use are mot sand irreens,
while celery is a stem like rhubarb. In roots as the turnip, carrot,
parsnip^, beet, mangel- wur/.el. also the onion, etc.. there are ijtianti-
t ics of starch and su^ar. while m greens the leaves consist of vege-
table pareiichvina of low food \aluc but mostlv rich in salts. The
most common art- cabbage, cauliflowers, broccoli, Brussels-sprouts,
spinach, lettuce, endive, salsifv. and other-. ( Vierv is an excellent,
esculent f 1. In speaking of the value of alkalies in our food
and especially phosphates. Liebiv; savs " The sure Li'iiide of man and
animals has taught us how to counteract the deticienev of veal, lish
and eiTLTs. in alkalies bv the addition of vegetables, potatoes, or salad.
Kit'-hcu vegetable-, m tins point of view, till up manv lilanks. The
I 1
(plant it les of salts of alkalies and alkaline eart hs. contained in manv
of these, excites astonishment. ( 'elerv contains from 1'i to -jo per
< -i -n t. , common salad '!''> to -.' ( per cent. , and cabbage-heads (l)iids) in
per cent. . of t he weight of t he drv plant in the form of incombustible
salt-." Of the value, then, of vegetables, there can be no doubt:
nor of the -ure-foo| d n line) which led man in the davs of voiv to
boil vegetables in th' pot with hi- animal matter. Tin- enicifera-,
especiallv cabbage. howe\er, do not -'o into this pot. but into one
of t heir own on account of t he oH'eti-i v e ,-meil " '^reen- water " pos-
'I'he cookiu'_ r of v c^-etatile- i-a _"-, n' art: more <-<peciallv greens.
' 'I'hev are !ie-t ." .-a v- I )r. \\ ' <-]\ in full -eaxui : " "u n ripe
v e^etable-; are a I a nd u n \\ ho,e-ome a-= linn pe fruit . " " I-'resh
Lfathered i- the motto tor vegetable product-. An orange or a
banana in London -r \< \\ York a diU'en-ni tiling from the -anie
fruit j lip-kdl tree. l.'ooi . ureen- and salads, are : he.
MKTHODS <>K I'RKl'AIMN'i; Fool).
same. Potatoes should be du^ out of tin- ground the la-t po--i
llionietlt before cooking, to '!" justice to tliein. With roots all. 1
greens when stale it is well to put them into eoid water, whi< h will
freshen them ii|> a little. Vegetable matters arc sueeiiient and !"-'
water rapidlv, wlneli impairs them in everv wav. Thev shoni 1 he
plunged iii the pot when the water is hoiim^. They are a tiek'i.-h
atl'air to cook. " Raw " vegetables are unpalatable; while if " ve-j-i-
taliles are a minute or two too lon^ over the tire, they lose all their
heautv and flavour." Fresh vegetables require considerably !>-
time for sutlieieiit oookinir than do stale vegetables. The advan-
tage of life- in the country is uTeat in the matter of vegetables. If
taken fresh, thev. however. pr<'serve well in tins.
After bein<r carefullv picked, greens should be washed in .-old
water and then drained, after that boiled \\-Jth a little salt: when
cooked thev should lie drained we]] and served hot.
Cabbages, as eaten in London, are an abomination. Thev should
be treated as in < Icrmanv and the I'nited Slates. When boiled,
''drain well, chop am! stir in a tablespoon fill of butter. w:t h pepper
and salt." Such cabbaire is also ^ood cold: and heated up next dav
it is excellent. Like soup, cabbage is better the second dav than
the tirst. lint served as thev are in the South of Knidatid thev are
a very pool- alTair.
In the North of England, in earlv spring, it is customary to
pit her the leaves of a wild let t uee with the vouti^ shoots of tin- com-
mon net t le and ehop them tine, then to mix some pearl barlev \\ . t h
them and boil in a bair. This is called a " herb pudd :nir " and it was
no doubt a valuable food in old dav- for scorbutic all'ections. Tho
'' nettle" beer of t lie M id iaiid< no limibt had a claim \ be regard' - 1
as anti-scorbutic. e<pcciallv when hoarhound was added.
^nliiils. I'licooked vcLTctaliles are usuallv eaten as salad. The
lettuee. the endive, the dandelion, mustard, cress, aii'i \\ ate:-.-) 1 ' -~
alone or mixed, are the mam constituents of salad. ( 'iietimbcr at.'
onion form a savourv salad. I'otalo salad i- r. ot mu'-h ;n n-e .M
Ln'j-land. Some like a little sorrel in t heir salad-: oilier- piv :':
tomatoes. ( 'eierv. radi-hes and watei-ri'e-- are as often a~
alone. Some person- prefer to dre-s then 1 salad on ti:- 1 i'!a*'-. "
other- prefer it dressed before it eomes to labie. A- to ;ii.
the old Spanish proverb ran to th;s ell'e'-t. "To mal\i' .
salad there should be a miser f"r oil. a -pcndt drift :'<: '
wise man for salt . and a madcap to st ir and mix a! i to-. : . . 1
irat herini: salaii. no steel knife should lie u-cd. A:':-
;}> MANTAI. (K IMKTKTICS.
picking ami wash i 71^ t hem, "let tin -in remain a while in the eolander
t<> drain; lastlv. swinir them Mvntlv in a dean napkin." then place
tin-in in tin- salad dish and prepare tin- dressing, and " pour it down
the side of the salad dish and don't stir H up till tin- mouths are
readv for it.'' So savs I >r. Kitchener, who adds -" \\'e recoinnieiid
the eaters to bo niiiidl'ul of the dutv of mast icat ion without the
due performance of which all undressed vegetables are t roiililesome
eoiiipanv for the principal viscera, and some are even danireroiislv
indigestible. " IJeetroot boiled in slices is coiniuoiilv added and
makes t lie dish look well. 'I hen cold meat is often added. The
Italians used cold chicken: the hutch, eold boiled turbot or lobster,
and in spring, voting onions.
As to salad dressing, it can be bought, but it is well to make it,
when and as wanted.
The following is Svdnev Smith's recipe for it.
Two boiled polatoi-s strained thi-oim'h a kitchen sieve,
Softness and smoothness In th<- salad u'ive:
( )f mordant mustard take a single spoon
Distrust tin- condiment that bites too soon;
Yet deem it not, tlioii man of taMe. a fault,
To add a double <|iianii1v of salt.
Pour times tin- spoon \\ith oil of Lucca crown,
And twice \\itb vinegar procured from town.
True taste requires it. and your poet be^-s
The i io nnt led ye| low of t wo bard-boil I'd i-!_; - i;'s.
Let onion's atoms lnrl< within lln- bowl
A nd scarce suspect e(l animate the \\ bole;
And laMlv in the llavon-d compound toss
A m a L;' ic S|M u MI I u I ol and 10 vv sauce! "
It will In- seen that he is not at one with the Spanish proverb as
to tin- proportions of oil and vinegar. He makes no mention of
suirar. which is indispensable in a salad m which there is sorrel.
Then the I-Yeii'di have'verv compound salads, and add black pepper,
eliervi!. and .-otiictimes a scrap of cheese. Kven the dissolving tin-
salt in tin- oil rai her t ban t In- vim-yiir is insisted upon bv some ^'our-
inands. There can be no doubt that the addition of a few drops of
Worcester Sauce is c_,- M od. ( 'aniiinat i\es arc ilesinible in salads, for
vegetables an- " u ind \. " It is needie-s to sav that salads an- un-
suitable for dvspeptie.- and those \\lio possess tender bowels.
As a wholesome article of diet, salad- arc too much necjfleeted in
maiiv hoiischoiii-. where thev mi'j-ht be atiopted \\ith advantage.
Fruit. - - l-'ru it - an- par; of i h" food of man. and in some areas a
MKTIloKS (IF 1'KF.l'AlilM ; FOOD. :;7
vcrv lai'LTe factor in the dietary. Thev are verv wliolesome. though
in some country districts, fruit is regarded a- unwliolesome and tend-
ing to set up diarrhoea. Certainlv. if a child is debarred from access
to fruit, it will take the earliest opportunity of L r or:_rin'_ r itself on anv
fruit which presents itself: and not be very particular or select about
the (piality either. If the fruit be unwholesome either unripe <>r
over- ripe, the best t hitiLT that can happen is for the aliment a rv canal
to Lfct rid of it as (puck 1 v as possible. lint sound, ripe I'm it is w hole-
son ie and u'ood : and if it formed a part of everv meal, child re n would
he pretty safe against indul^inir in indilTerent fruit. Cotton Mather
said: " houbtless (iod could make a better fruit than a strawberrv.
but doubtless he had not." Others mi^'ht prefer a jargonelle pear,
or a muscat irrapc, or a manioc, while others would prefer the
oral i ire. All fruits contain levulose suuar, and usuallv some acid in
variei) proportions, ranu'in<r from the pineapple to the lime. Thev
:ill contain alkaline salts, which are ^-ood for the blood. " This iu-
lluciiec of the alkalies is ,-hown in a decisive manner, in theetfects
produced on the salts of organic acid in the circulation. It has lonr
lieen observed that, after eat nil!" jnicv fruits, cherries, st rawbei'ries,
apples, etc., the nrine becomes alkaline. All thc-e fruits, as well
as the juice of edible rout-, tubers, and u'i'een ve^-eta-Wcs. contain
these alkalies in the form of .-ait- of the organic acid--'; n.-nailv as
malates (all kernel- fruits, pineapple:) ct t rates, (stone-fruits, currants,
potatoes;) tartrates (grapes)." ( Liebi--. )
The utilit v of such fruits in the iii'ic acid diathesis is apparent
and olivioiis. If iroiuv persons would learn to cat iVuit and teach
their children t" follow the example set. it would save much re-nrt
to medicine in later davs that ini^ht well be a\oided.
The Lrrowt h and decay of fruit is t h us described b\ I'aw: " I >ur
MILT its progress, it increases more or less ra pid 1 v in hu ; k. and weight :
and as it approaches mat urn v it lo.-es its UTCCII color, bee' mes bro\\ n,
vellow. or red. and no longer acts on the air lii\e the |ea\c-, ; >ut on
the coiitrarv. absoi'bs oxv^en and ^i\e- nil' carbonic acid. A- tin-
process advances, some of the proximate principles contained ;n the
unripe fruit, part ictilarl v the vegetable acids and tannin, .n !>art
di.-appear apparently liv oxnlat ion. and. ihn- ;i becomi 1 - -nnrand
ast r indent . At t he same t i inc. t lie stare h uiu ler^i ics t ran -for ma' ion
into -uu'ar: and the insoluble pectose into pectin, ain; otlicr -
substances of allied com po- it ion and ha\ in-^ npM-e r
timms character. The fruit in ihi- ua\ arm
tion for eating. Oxidation, [mwevei-. still aiivaiic.-, :n.
MAM AI. ( >F IMKTKTICS.
suj;sir and remaining acid become destroyed, pivin"; rise to the loss
of llavour which occurs after the full ripened state lias been attained,
and deterioration has set in." l-Yoni this \ve can readily understand
whv unripe fruit, as well as over-ripe fruit, is not wholesome and
sahilarv. " 'I' he vegetable acids and the pect in disappear in the bod v
sjieedilv after heinir eaten: while the alkaline base appears in the
urine as a carbonate:" though if uric acid be present, as a uratc.
Some fruits are preserved hv drvinv; them, like the ti^, raisin and
currant: while others art 1 preserved hv boiling them with cane su^ar.
as iruava jellv. strawberry jam, etc.. while in the South of I-'ram-e,
candied fruits are a Inrire article of manufacture. The addition of
the cane suirar in the two latter cases, "jives such fruit a tendencv to
turn acid in the stomach. Of old, fruits were bottled, and now they
are tinned extensivelv: and when so preserved, keep perfect lv
"_( ioil for years.
At one time, preserving \vas a household all'air. and preserves
were home-made. Now. preserving is 51 business. The introduction
of apple and turnip into marmalade, sent the best linns to Spain for
their manufactories. Then raspberry jam was adulterated with the
pulp of gooseberries. I >ricd tip's, of indifferent ipiality. with their
seed, otTcrAcat temptation to the rascallv manufacturer; and when
mixed with plum- that have seen their best dav. and boiled with a
cheap glucose (made bv boiling starch with sulphuric, acid), and tin-
allv llavoured with various essefices. the resulted product is sold as
" Family .lam. " Sii'di preserves Jive used for jam puddings, and are
eaten on bread. Thcv have a food value of their own: but are far
inferior to butter, for which tliev are too coinmonlv substituted.
\\ hen siiLfar is boiled with butter, the well-known toH'ee (a verv
excellent. livilro-carlon), is furnished. Tlie old-fashioned plan of
mak;n'_r toH'ee extensivelv in cold weather had much to be said for
it. Jt supplied an extra ration in fact, of admirable and concen-
trated fuel-food, to meet the external cold: while it also supplied
fat for healthy tissue-LTowt h. When delicate children object to fat,
and their stomachs \\iil not tolerate cod-liver oil. it is no bad prac-
tice to encourage t hem to take toffee. ( )f course, the mot her smiles
deri-iV'lv at. the idea: but the results arc often verv sat isfactorv.
And such union of carbo-hvdratcs and fat mipht often be utili/ed
with advantage with d'-lieatc eliildren.
Such then, are the various forms of food in common use with
man, and their niethod-of preparation. Their food-value and their
digest ibilii v vary widclv not onlv in the material it-eif, but also in
t he met hods of prepara'
CTIAI'TKK IV.
COXDIMKXTS. SAl'CKS.
Condiments. Condiments can he regarded from two distinct
and different points of view, vi/.: one. hygienic, and the other ^as-
tronomic. Salt is an excellent addition to our food, and in .-ome
parts of the world -where it is scarce, as in ( 'cut ral A frica. tin- saving
for a rich man is" lie eats salt, with his f 1." Animals will
often go long journeys in search of salt: and the ImlTalo mad" peri-
odic excursions to the '' salt -licks." Man is rarely depn\ed of
salt: hut animals frcHiieiit I v are from ignorance or neglect of the
suhjcct. I have read somewhere (though I cannot lav mv hand
upon the statement), that the hamster which lavs np larire stores of
provisions for winter, gat hers amongst the rest some leaves of the
gentian and the century, to ^-i\c flavour to its food; the hitters no
doubt acting upon the appetite. Certain agents, as carminat i\cs.
have a good effect as reducing flatulence, and in India some hirds
arc said to pick fruits and seeds containing aromatic oils to meet.
some craving: just as the Hindoo adds curry to his rice. When t ju-
diciary consists largely of vegetables, carmi nat i\cs are specially
indicated, particularly pepper. And \ e^vtanans find that carmina-
tives are essential, as 1 >r. Kitchener savs, to comfort.
Mustard is mainly eaten with meat: except, when added to a
salad. 1'epper, the Romans valued so highly that they exchanged
gold for it, weight for Weight. Indeed so much pepper formed part
of the ransom of Rome when besieged hv Alaric. Cayenne pepper is
st ill more potent and pungent . and has to he used sparingly. Of oid
it was common for persons suffering from flatulence, to make htt.c
pills of Cayenne pcpperand bread crumbs, and swadou them at tab'.e.
(linger is anot her excellent condiment, either added to a pm;.;; ILT.
or eaten in powder as is cii.-tonia rv \\ilh melon. K-~ent;a; "..- have
the same elTect m relieving flatulence.
The riu'ht, use of condiments and then- true proportion ami
lunation has formed a -'real part of the cook's art at aii Mm -
formed what is called a " rcii.-h." and the pauper \\
I" M AM'AI. OF DIK'I'KTICS.
eating a red herring with his frugal meal of potatoes u to give them
a relish." So an anchovy is added to a beefsteak.
And the condiments should tie added in the act of cooking. If
pepper he wanting in a beefsteak-pie or pudding, to add it after
serving is a poor substitute for the real article. Some persons prefer
hiirhlv seasoned dishes; and as a broad rule it niav be said the taste
for condiments irrowswith years. Children rarely euro for highly
seasoned dishes. Al-o as the palate flags, eond iinents and sauces an;
more in request : and tins is specially true of gourmands in hot cli-
mates. The eurrv of the Kast Indies finds its correlative ill "the
pepper pot " of the \\'est Indies. Paw says of them ''Through
their aromatic and pungent qualities they also assist digestion: tin;
//ii'i/ii* i'/n n/inli being by promoting the flow of secretion and in-
erea-Mii;' the muscular actiyifyof the alimentary canal. In some
cases they may lie further useful by serving to correct injurious
properties that may belong to an article of food." They are of vari-
ous kind-. I'ickles are eaten with cold meat, especially when fat.
Some are added to other food as a flavouring agent, as the onion,
or garlic. Many as vanilla, lemon, almond, ginger, and nutmeg are
used with milk puddings. Not onlv do they gratify the palate, but
they serve a useful purpose otherwise.
Sauces.- Sauces are combinations of condiments, more or less
complex. Some, as anchovy sauce, are used to add to or brinu; out
the flavour where this is latent or little, as in boiled white fish.
Some sauces a re made of various ingredients, as with roast duck for
instance, n is common to make a sauce by stowing the giblets.
chopped tine, and mixed with the gravy in the dripping pan. and to
tins some finely chopped ehalot is added. Such is a savorv sauce.
To some .siiices wim- i- regarded as a '.rood addition. />> i/nxl ilms
IK, n il i.- i,niii n<l n in . but a little plain "/raw is nicer with meat anil
vegetables than an elaborately made sauce including port wine. -
to my mind! Sweet -aiices are used to puddings: and rum sauce
was once in "Teal t'a\ > >u r.
Thc!i then- are prepared sauces. ( 'atsup is an old favourite. So
H India -oy. \1 M . and \ a ried a re tin- sauces and relishes now maii-
u fact u red and -old. I larvey's was one of t he first. As an all-round
sauce I. '-a and |Vrr n'- \\ oreester Sauce, " >uade from an old recipe
in a nobleman'- kitchen." i- as 'jood a~ anv. It is .-aid its peculiar
roNDIMKNTS SATCKS. 41
flavour is due to a certain admixture of asafu-tida: tin- exact
amount constituting 1 the secret. Of old. tlie flavouring a^ent was
added to the ragout: hut uo\v various sauces arc placed U|MIII the
tahlc. and each ^uest flavours for himself. There is no hroad rule
like that of mustard \vit h heef and pork: while it is never eaten with
mutton and sea reel v with hacon or ham. \o one dream- of eating
mustard with hoiled chicken, or for<rettin<; it with roust ^'oose.
( 'ond imeiits are ctiriouslv omitted from tlie dietarv of invalids.
There is a ireiieral impression that the plainer the food for them the
hetter. lint this leads to a ternhle moiiotonv in the dietarv. Salt,
is often forgotten in the meat hroths of the acutelv sick : and a little
Worcester, or allied sauce often ^ives a /.est to a palate which has
heeii palled hv plain heel' tea. If condiments do not possess a true
food-value, thevare not without a value of their own: and arc not
mat ters to he neglected in dietet ics. ( )f chloride of sod mm or com-
mon salt, its utilitv is easilv recognized; though its r<>/>' in the am-
mai eeonomv is not quite as clear as could he wished. I ioussinirault
made experiments upon o\en. l>v ^i\ mi, r salt to some, while with-
holding it from others, which told unmistakahlv of its value. As
to the food value of vinegar, it is not easv to lind anvthin<r po>iti\c.
Nodoiiht it is changed and oxidiseil in the hodv: and that it is
a^i'eealjli' to the palate as an addition to many articles of food; hut
hevond t hat it has a further ut i! 1 1 v. " It seems not improliahle t hat
as Niiie^ar powerfullv excites the secretion of the sali\arv glands, it
exerts a similar influence upon the stomach, augment IIIL;' the How <>f
gastric juice, and therehv increasinir the digestive power of the
oi'ifans." (Stille. ) Of its evil effects when taken to excess - as is done
liV some persons for the reduction of ohesitV- there IS no iple-tloll.
Condiments are atrreeablu to tlie palate, and, in moderation, u'ood
for the digestive oririins.
BKVK1IA<!KS.
Water.- As well us food, animals require drink: indeed the
necessitv for the latter is the more imperat ivc of t lie 1 wo. (Mir bod-
ics larirelv consist of water; and our secretion- daiiv entail a consid-
eralile quantitv of tluid: while for excretion a certain inilk of water
is essential. ( >nr t issues indeed, are hat lied in fluids which at once
liriiiLT nu! riiiient . and earrv awav waste matters. 'I'lie ^ood cll'eri-
of watering places are largely due to the itii-rease in the hulk of tluid
taken there, irrespective of any s eeial '|iiahtv of the water.
Especially is this seen in the ca.-e of ladies, who, as a rule, habitually
take too small quantities of fluids -for ohvioiis social reasons. Fur-
ther there is an impression abroad, that ;t is undesirable to liiiute
too freclv the LTiistric juice, (hi this mailer I'aw savs. " \\ 'hethi-r.
as the result of the inlliience of this notion upon the public mind,
or not , mischief is frequently occasioned. e>peciallv amoirj- the higher
ranks of societv. hv a too limited consumption of thuds. In-tead of
takinir a draught of some innocent and simple bevcraire. it is at
ma nv tallies the fash mn to sip fluid and t hi< a more or less st ron'jflv
alcoholic one onlv from the wineglass. It is a mi-taken notion to
think that when we drink with a meal, we are dilutini: the era-trie
juice. The act of secretion is excited h\- the arrival of the meal in
the stomach, and the ^a.-tric juice is not there at, the time of in^es-
tion. It happens, indeed, that the ahsorptioli of fluid takes pla<-e
\vith irreat activitv. and the liijiiid which is drunk durinir a meal,
becoming al).-orl>ed. mav \<c looked upon as proving ad\antaLTeou- !iv
afterwards eont riluit in LT to yield t he ^a-tric juice \\ hie h is required. "
So much for t he d iiut ion of the -ja-tnc juice. Tln-u there is the
(jiiestion of e\i-retion. ("rates especially are sparmirlv solnhle, and
require a certain amount of dihit:on for then- renio\al. (loutv
ladies certainly drink far too little Iluid. and more \vatei 1 is nnques-
t ioua I ilv desirable in t heir ease; and it the water con tai n some alkal-
ine matter it will he all the better for it. Hut whether alkaline
waters .-hoiild be drunk at meals or not. is a matter on \vhi<'h npin-
ions mavdiU'er. The digestion in the stomach inx-s on in an ai-id
I'.KVKI: ACKS. {:;
medium: mill too much alkali certainlv seems eontra-indieate i. ( >':
the other hand a draught of such water half an h'-ur bet'op-
is certainly desirable. To provide an alkaline hath fur the n~-n, .
an excellent practice, especiallv lirst tiling in the morniir.:
p'ttin^ out of hed. Hut it is also \vdl to lake a second ~;i n ; ;il -
draught before a late dinner. That is one a-pe.'t uf the .-uhject.
There is. however, another. Sidnev Kinder, in discussing a! kaiie.
speaks as follows: " \\ e wish to draw attention in this pia'-'- \
one important property of alkalies namely, their puwer to iti'Tca-e
the secretion of the ^as trie juici itself an ni-iil secretion. \\V
venture to think many facts warrant the following ".vncrali/at ion:
thai alkalies applied to the orifices of glands with acid secretion-
increase their secreting power: while alkalies applied in a corre-
sponding wav to glands with alkaline secretions lessen or clicck the
secretion." It is^'ood, then, to take alkaline lliuds before a nieai in
order to increase the flow of gastric juice as well as to wa-h awav
waste matters from the tissues.
I low far draughts of iced water at meals are injurious, either to
t he stomach itself, <>r to the digest ive procos. is a niuu;cd point . Iced
fluids have ever been sought for in hot climates, and arc certainlv
agreeable to the palate. About thai there is no doubt or ((iiestiun.
The All stria us love iced beer to their meals; nor do t hev .-nll'er from
indigestion therefrom: especially the female element. How far the
dvspepsia of Americans is due to their free use of iced water-.. i- a
matter on which some persons are insistent : but lam nut in a po-
tion to "jive an authoritative opinion on the subject. There a:v eer-
tainlv other factors in opci'ation in their ease.
The amount uf iluid reipiired dailv. is stated to be about ;i\e
pints, to meet the watei'-loss b\ the kid lie vs, t he skill, and the . \\ HL;-.
The^a-tnc juice reijiin'cs lliud. The bile secreted, the panciva;..'
flow, and the saliva ail involve a considerable bu,k uf water. !' -
vond t he matter of dilution of secret ions and Hushing of e.v ret ;o;,-.
there are t he re la t ions of water to the body tempera! lire. 'I 'he ,
in"; etl'eet of \vater passing from the fluid form iu tha ; uf vap"::r
the means of keeping down the bodv tern pe rat lire: \\ Inch oilier'
\vouid rise to a point incompat ilile. nut \\;th eapacitv for e\cr!,uM
bill with life itself. I to'j-s which do n<it pe'-spin- pi'operiv die
climate.-. \\' here there is u'l'eat e\halat ion of water, drink
at i\ c: whet her il be in the tropics or the heat of iron-work -. ..
lioie>. The woi-kers in foiinderics, and iron I'actur:.'-. a:.
measure t heir drink bv the^aliun. Hut taking per-i
44 MAM'AI. OF DIKTKTICS.
life, the amount of fluid taken depends ,'erv much upon what it is;
whether it is palatahle or otherwise. and whether or not it he
charged with alcohol.
Fluids are taken with our meals, and are essential to digestion,
and the secretions involved in the digestive act. Hevond that, most
fluids chosen for such purposes possess a certain stimulant action.
Alcoholic beverages were once the drink of all classes. Now tea,
coffee and cocoa have largely taken their place. Hut the actions of
these various stimulant I leverages as stimulants -will cii^avv our
attention in the next chapter.
Beverages as food-accessories.- As to the ell'ects of bev-
erages taken with meals upon the digestive processes. Sir \\ illiam
Roberts, F. H. S. , of Manchester, has recently made extensive ob-
servations. In his address on Therapeutics at the Card ill' meeting
of the Hritish Medical Association in July. !>>."), he LT;IVC the follow-
ing conclusions, as the result of his enquiry.
" In studying the influence of our food-accessories on digestion,
it is necessary to distinguish sharply between then- action on the
chemical processes, and their action on glandular and muscular
act iv it y. These two act ions are quite d ist met . and ire lie rally opposed
to each other: for while all the food-accessories were found to
exercise a more or less retarding influence on t he speed < if t he chem-
ical process, some, if not all of t hem. exercise a st i inn la t intx in ll netice
on the glands which secrete the digestive juices, and on the muscu-
lar coin ract ions of the stomach. It is also necessan to distinguish
between t he ell'ect s of the food-accessories on sal i va rv d ILTC-I ion. and
their ell'ects on pept ic digest ion. inasmuch as wide d i ver^encies were
found to exist in this respect. The distilled spirit- brandy, whis-
key, and irin, were found to have but a trill MILT retarding effect on
t he diirest i ve ] rocesses, whether salivary or pept ic. ; n the proportions
in which they are commonly used dieteticallv. Then- obstructive
etl'ects 01 dy become apparent when u-ed in quant it ies which approach
intemperance. Taking tins in conjunction with the st Imulat in <r
action whicli they exercise on the glands which secrete the diirestiyo
juices, and on the muscular act i vit y of the stomach, their ell'ect in
the.-e moderate dietetic proportions mu-t be regarded a- distinctly
p ron lot ive of d :j^est ion.
" Wine and malt liquors exhibited an act ion dill'crni: , -on -iderablv
from that of ardent spirits \\ine~were found to lie hLdih
ical to salivary digestion. Kveu very small quant'tie- of -
claret, hock, or champagne, inhibited 'he action ,,''
r,K\ KI;A<;KS. i;.
starch to :i very hijrli decree. 'I'liis i< due to t he con-:derai>!
which ail wines possess. When this m-iditv was neut rai i/.e ;
addition of an alkali, the inhibitors- ell'eets of \vine- on -tarcii-d
t ion was entire! v removed. It is a com mi in p;-a< ; , to m . \ v. . v -
especially sherry, claret, and hock with soda, -eii/er or sum.- ..; !,--r
effervescent tahle waters. These water- ail contain a ehar;j
alkaline carbonate, and it \vas found that, when wines were tin;
mixed, thev ceased to embarrass the salivarv act ion. Thi- practic
mav therefore lie looked on as hiLThlv commendable in the ca->- of
persons of weak digestion.
"On pept ic digest ion. wines exhibited a retarding effect aho^.-t her
out of proportion to the alcohol contained in them. I'mth th"
st 1'oiiLfei' and the lighter wines, except ;n \ej-v moderate proportion-,
checked the speed of the peptic digestion. In the eustomarv d:<'t-
etic use of wines with meals, there is. probablv. a douli'ie action: on
the one hand, a stimulating action on the secretion of gastric ju;.-'-.
and on the iniiscular contractions of the stoinai-h: and on tin- othi-r
hand, a retarding elTect on the sp^ed of the (diemical process. In
the ease of persons of weak digestion, wines should lie tak'-n s[iar-
in^ly. and the qiiantitv so adjusted as to hrin^ out their s' imiiiat in^
action without provokini: the retarding etTects which follow their
more liberal use. ( 'liampa^ne was found to have a distinctly .---
retarding power than an eipial volume of claret or hock. Th;.- 1
judged to be solelv due to tlie mechanieal ell'eets of t he elYerves. -eiiee.
and lilieratiou of ^a>, wliei-ebv a nnTe etlideiit stirring up "*' '.'c'
diLfcst MIL: mass would be elTected. I'ltTcrV'-^eeiit wines t heivfor.-.
other things lieini: eipial -favour the speeil of peptic digestion more
than still wines.
" The ell'ccts of tea. colTee, and cocoa exhibited some i lit el'e-t ; : ;_ r
diversity. It was found that tea had an inhibitory eU'ect on sai;\
digestion; even in verv minute propoi-t ion. ;t eompleti-iv pai'alv-"
the act 1011 of saliva. < hi the ot her ha nd. ci ill'ec ;i nd eoi-oa had >
a slight "11',.,'t on salivarv digestion. The inhil>itorv action of tea ..n
saliva was found to be due to the laruv iiuantitv of tannin conta ne.'i
in the lea-leaf. Sonic persons hiive supposed that liv mfu-:n^'
for a verv brief period t wo or three minutes -the pa --a if' 1 "
into the beverage could be avoided. This. howcNei'. is a
Tannin is one of the most soluble siih-ianees known, '
SH^I r in hot water. ( )ne ifent Icmaii of m\ acijiiaintanc- 1 .
ror of tannin, was in t he hab:t of preparing h ;- lea bv pl.-i
leave- on a paper- tiller, and simplv |iour;nu r "n tin- iio. T.
4i MAM Al. <>!' DIKTKT1CS.
In this way he thought to evade the presence of tannin in his tea.
Put. if von try the experiment, and allow the product, as it runs
through the filter, to tall into a solution of perchloride of iron, you
will lii id that an inteii.-e inkv-hlack coloration is produced, showing
that tannin ha s come t hrotiu'h in ahundunee. YOU can no more have
tea without tannin, than you can have wine without alcohol; and I
found, experimentally, that tea mt'ii-cd for two minutes had almost,
exactly the same inhibitory eifcct on digestion, as tea infused for
twenty or thirty minute-. If you wish to mitigate the ell'eci- of tea
on -aluarv digest ion. you should direct, the patient not to sip the
beverage with the meal, hut to eat lirst and drink afterwards. In
this wav time is ^iveii to the saliva to perform its functions unhin-
den^I. Another device is to introduce a pinch of carbonate of soda,
into the teapot; tins removes the deterrent ell'ect of tea on salivary
digestion; it is a practice occasionally followed in some households,
under the idea that soda helps to extract the virtue of the tea-leaves.
It was found that the addition of so small a proportion as one per
cent, of the weight of the dry tea. trreatlv mitigated it- injurious
ell'ect on starch -digest ion, and t hat twice this <piant it v (t \v<> per cent. )
a!mo.-t entirely removed it. This latter proportion corresponds
rouirhiv to ten grains of bicarbonate of soda to an ounce of tea-leaf.
" The ell'ects of tea. colTee. and cocoa on peptic digestion were
found to he as nearly as possible a 1 ike for infusion of e(|iial st ren^'t h.
Ail three exercised a retarding etl'ect when their proportion in the
digest m<r mixture rose above twenty per cent. The-e beverages
should, therefore, be taken very moderately by persons of weak
digestion. The ioiod reputation of cocoa, in regard to dip-stion.
Seems to lie who] i v d lie t o the fact that. It IS Used ill Weaker 111 I'll -ions
than tea or cotTee. The directions for the preparation of this bev-
erage printed on the packets of cocoa sold in the shop-, indicate a,
stren'_ r t h of about t wo per cent. : whereas a medium tea is u-uallv
made of a st ivniM h of foil r or live per cent : an 1 a im-d i u m ei 'll'ee of
a Strength of live to SeVell per cent. The strong coU'ee which It IS
eustoina rv ' o hand around aft IT d inner m u-t have a power!' n 1 retard-
ing" ell'ect on LTastrie digestion: and although tins practice may lie
saiutarv to robu-t eater-, it is not to be recommended to tho-e of
feeble peptic power. "
I have preferred to make tins loiiif ([notation ;n order to let I 'r.
Roberts -peak tor hiniM-lf. as an\' summar\' nnidn ^ive !'!-e lo -ome
misconceptions. \\ he t her his concl u-ion.- will be en 1 1 rely confirmed
by othei 1 observations or not. we mav feel pretty confident about the
main l'aets. The well-known eil'rrt nf"!ii_!i tea" '... iw.;
solid meal. seeiiH to tiiiil its explanation in the e!l'ee;~ of ;. a .:> p.
tardin^ digestion and espeeiallv salivary di_r<-t \\\. If tin- i;._-
of -taivh hr thwarted and ;i quantity of u M'lo'-t 1 ' ! -tar-
in t IP- stoinaeh. no wonder if pain and still more ila; u. ';,<' !, c\-
[M'Hi'Mrt'il. Tin 4 t'uiiil slimiM In- eat'-n sav \v;tii a htt!i- '-!l'<-r\ e-rcnt
watrr :unl then tin- tea drunk afterwards, liy t h"~>- who-, -diui'-; i"H
is nut that lit' the ostrich il-i-M'. Thf t'i>ii!:'!'-r <>\ " lii^h t>-a " \vas
ccrtainlv nut a hriu-fartnr nf h : s >jfi-ics: nir in.ici-.] IKI-- t !: i:. 1 r< ]}[>-
tioii of te;i t'rnlii Cliina -a stat n- i-i'iintrv. ;:i; Kn^.aMii. a '-"li::: r - \ >!'
ilistiiii't ailvaiiei ainl frmn t IH-IP-C v/hfi-i-vi-r I In- AiiL^o->a\'>;i has
sprca'1 hinisclf. hrcn an unalloyed ^i.u.l. Tea and datnin'r (a rake
of doti'_ r h \vit In HI t lea ven i >i' veast ) ina\ he a im-al "f sun i <.< i-hara'-ter
and easily prepared, hut nothing ean he -ai'i fur i: from a dietrtic
point of vie\v. No wonder that indigestion is as euinnion ainoii^
t lie >turk-rider< of A us! ralia a- aiiion-' those of \e\v Me\,.-o. Tea
inav he drunk as a refi'eshin^ stimulant lu-vera^'e: hut it is HOI di^ir-
ahli- as a food-aeeessorv. especiai'.y \vliei~e the f 1 is iar^e.v farinae-
eous.
As to wliat. Sir \\". Koherts says a! out the u r 1 elVeets of tiie mi\-
inir of clTcrveseinir water with wine, and theai-tion of the iiU-ratrd
earliotiie aeid 'jas upon the di^i'-tin^ I'oo.i. n ijui',.' t'al.~ :n \\ith n;v
own i-xperieiire personal and, pi'oics.-'.onal. in the niaii'-r '. ina.; .;<|-
uors. 1 had he^'iin to ohservt- that for invalids and eonvale-'-en'-. ail
niait r.i|iiors should he m i^ood eoiidit n in. < . . . \v*-ii (diaru'e'i w;: h . -ar-
houie a.-id; and that if " llat " or " deai'i " tiiey distinetiv d:.-aL r reed.
wlien a lii-n-e attack of si-arlet I'cviT left me in a position I" lake
further ohservat ions on mvself. \\ith the re~ult that inv impre ions
were eontiriiied. 'I'he hherated eai'lioiii'- aeid w;is a p"~.:.\'- uood :
while t he ai -etie acid of ' ' llat " mai t liijuor wa^ as ilisi ;iit ; , \ injuri-
ous. \\ e al-o from this eau understand the value of cl'fer\'e-i';n^
\vme< over still wines in t he siek room. I'rohalil v a lit tie pure -p;r;l
\\'it h an elTervesei'nt water is t he he-t drink for ;i dy>[>eptie or iinahd.
and is commonly adopted hv sudi [lersons,
l-'roni what has just lieeii said ahoiit thf etVeet of earl'oii;-' a>'.d .n
ih' 1 Hoinaeh upon dip'stniLT fond, \l\i- non medical r'a .'; :
run away with the idea that llatillenee ouirlit !o ai~; d;-'"-
iiotorions faet hi-inu r that llatillenee :~ a --real pur:
4S MA NT AT. OK DIKTKT1CS.
eludes his discussion on alcohol ''However little a man's purse
allows him to drink, let it be j^ood."
That winesand malt liquors have an action upon the stomach.
which is pleasant and irratet'ul. is a fact most people know for them-
selves. That they stimulate the trast ric flow and increase the mus-
cular act ivit v of t he stomach, is probably the underlying cause of the
sense of well-beinu; which accompanies their use. Consequently in
atonic dvspepsia. whether primarv. or secondary to a jjeneral con-
dition of debilit v some combination of alcohol and carbonic acid in
dilute form is indicated. But, <>f course, this is not to lie made a
rule absolutely to apply to all cases. There is a well recognized
form of indigestion which is intractable to all medicine and regimen,
except the avoidance oi' lluids. A dry dietary is. a swift cure.
ST I.MT LA NTS.
TIII< chapter rovers ;i vexed ^''"iiml a debatable land, where
views are in fierce conflict. SirouLi" feelings ha\e liccn thrown Into
the scale: am! liccl'-tca. vegetable prmeiplrs (as theiiie ami eall'e'.m')
and aleolmi have assailants ami supporters \vho ! fti-n ilo nut ^ive
cacli otliei 1 fair plav: ami use declamation m-tead of argument in-
deed, sonietinies the ilcclatliat Ion 1- Mi inverse proportion to the
argument, eonsiMjUentlv ! eanimi e\peet t<> please all b\ \v!i;.; will
lie \vritten in this chapter: certainly, not the e\tiviiii.-ts m eai-h
U'illLT-
Stiniulants divide tlieinselve< into; (1). animal and ve^etah'.e
snhstaiiccs of \vhich M H ro^vn is the cons|iicnous faetor ^as ,t i< o!' a!.
explosive coin pounds): and. ('.'). alcohol.
.1. Animal principles.- Ueef tea may stand as the typi<
representative of stimulants derived fr"iii animal f 1 at the pre-em
tune, and in the present >tate of pnlilie opinion. ^'e! ;i ; seareelv
a food a- seems so tin i\ ersall v ass tuned. 'Mi t he verv t hresliold of
tin- ehajiter it liecoines iiecessarv to slav a popular conviction.
\Vhen the relatives of a sick [icrson tell one in all earties:, of the
aniouiit of heef thi'v have converted into heel' tea. and ho\v tin-
patient has been sustained thcrehv. it is with dilVieiilty thai ihe
mnsides of expression are prevented from throwiiii:' a der;si\c >in;!f
over the feat u res. "There is no pain like the pai n of a new idea "
according to lia^ehoi; and to tell these i;- ! peopic that the\ are
siniplv talking nonsense that in faet the v do not nmier-iaip; \\;;ai
they are talk ini; alioiit. would ! to inili'-t iijion them a -,>: k;
and \vould prohalilv arouse a feclimj; of di-tnist rat her t nan an\ : :
else in I heir mind,-. In fad. n would seareelv he a >afe C\IM
ni most lioiiM-hoids. Still, all the same, to ^ive hei-f ; a a "'.'
,-iek person is to tjive him a st^ne ulien he asks for ' d. i'
not a food, it is a stimulant! (Jraieful and aeceptaMe a,.!
paiale and ihe stomach, possessing >; imnlat iic_;' pro;i.-i" -.
ha- it- \aliie. lint all the same, as regard.- it- foo.;-\a.i;^| .'
a jackass in a lion's skin.
.><> MAM AI, OF MKTKTirS.
\\"li:it can really In- said t'>i- it ?
It is a decided stimulant. \\ hen flesh i< boiled its albumen is
eoatrulated. That i> a simple fact. l>eef tea, as ordinarily pre-
pared, contains no albumen. The fluid so olttaincd is rich in ex-
tractives and salines. There are present t he phosphates of the flesh
in solution. The extract ives are nit rop-nixed bodies kreatin and
ki'eatinini the tir-t with the formula ( ' II N <> and the latter*'. 1L
N (>: which means kreatin is a hvdrated form of kreat 'mine are
found in meat juice and muscle extract-: hut t hev belong rather
to muscle as derivatives -as histolvtic rather than histo^enetic
matters. In oilier words, whidi can he understanded of the
] pie, thev are not material of which muscle can he built up: but
rather stand as eil'ete muscular matter ;n tlie road to urea. Albu-
men is material of which and from which tissue can be formed. It
is like the bricks which arc ^oin^ to form the walls of a new build-
ing. Kreatin and kreatininc are rather the old bricks and mortar
of an old !iu ; id mi;'. ( which have served their da v ) coming down to ho
carted awav as rtibbi-di. The liquor saniniinis brings the one and
removes the other: jnsi as contractors' carts mav be seen together
when build mil's a re beinir pulled down, and rebuilt, the one laden
with new bricks l'< >r 'new walls, tin.- other lii led with t he //<////> of old
walls. Now 1 tru-t tip' matter is unmistakable. These extractives
are not food-material for tissue 1 : but stimulant-. "Kreatin and
kreatimne arc products of the vital process and constituents of the
flesh of all vertcbrata hitherto examined. Human flesh is particu-
larly rich in kreatin." ( I .icbi--. ) It is easy from this to understand
whv sa vai_ r f'S at e the bodies of their eiieiii . !!<_; 1 MI man flesh to
endow them with courage. No doubt A did ,-timulate them and
make them feel warlike; ju-t as |tomin;e Samp-on felt exhilarated
bv sonic of the contents of the ^jip-v's cauidron. saving, " \ enlv 1
feel mi^'htv elevated and afraid of no e\i] which mav befall me;" a
\erv dilTerent mental condition from that in which he was when
MI-L;- Merrilies accosted him at the I\a;m of I )erncleuv;h. Of the
st i m u Ian t efTect s of meat extract ive-. of i he utility of the meat salts
in beef tea, there is and can he -..:-: ion. lint it is destitute
(practical! v ) of matter which can <-,, r form tissue; and is e.piallv
without value as fuel-food. : -' : As a food .: i- an impostor, neither
more nor less. A- -ome reader- mav fi-''l indignant a' this state-
sTi.Mn.vNT>. ;, i
711011 1. ami Mini: "lit that tin- import un- lies rather \vi:li the writer.
lot Sir \\ il'dam Robert^ once more be heard:
" l>ecf toa ami its oon^M-ners take rank as restorative- ami -timu-
lants. rather t ha.ii as nutrients. T he \ contain no album! mm- mat ter
in .-ointion. ami the small amount of gelatine contained in th'-m
cannot he of mm-li aeeoiint. There is a widespread misapprehension
aiming tiie public in regard to the nutriti\e value of 1 ..... f-te.-i. The
notion prevails that the nourishing qualities of the meat pas- into
the doeoet ion. ami that the drv, hard remnant of meat fibre \vhieh
remains undissolved is exhausted of its nut rient properties; and this
latter is often i{iven to the eat or do^-, or even as 1 liave known.
thrown awav as useless rnhhish into the midden. A deplorable
amount of waste arises from the prevalence of this erroneous notion
in the households of man v who can ill all'ord it. The pro; e id matter
of meat is quite insoluhlo in boiling water, or in water heated above
Itio Fahr. Tlie ingredients \vhieli ]>ass into solution ;iro the-ai>id
extractives and aslines of the meat, and nothing more oxeept s^me
trilling amount of ^v lat inc. The meat remnanis, on t he ot her hand.
contain the actual nutriment of the meat: and if this be heat'-n to
a paste with a spoon, or pounded in a mortar, and diilv flavoured
\v;th salt and oilier condiments, it const itut-es not onlv a hiirhlv
nourisli mjj; and agreeable, but also an exceedingly digest ible form of
food." Yes. |)r. Roberts, and thero is amit her ; * deplorable waste "
involved in this ei'ror and that is a " deplorable waste " of Imman
life: hundreds of our fellow-creatures are dailv dropping into their
graves, unfed, unsuccoui'eil, because beef tea is ^i veil as a 1'ood
^U'lven for what it is not !
I )o^s may starve on lixiviated meat, and even turn from it with
loathing: for this moat lacks t lie salts and oxtractives. Hut all 'he
same, human beings cannot sustain life on salts jiml oxtr:icti\e-; with-
out the ot licr const it uen ts of llesh. So i Jierc is a not her error I'iown
to [lieces, and a cherished conviction dest roved ! I.iclii^ himself knew
onlv too well that meat broth- liave no true food \aiuc. aici ad\o.-a;.'d
cold drawn infusions of meal . Such infusions are food ; and food of ,<
1 can seo sundrv readers !ia\m^ been driven pa-! the stau'e of
incrediilitv lv the hard lo-j'ie. of facts, wrniii'iim' tiieii 1 ha:.
anguish over t lie thought of depa rted relat i vos who have bee-
tically starved to death on beef tea. \\'e can fee! for:!i-!
oaiilio! heipiheiu. "let the dead pa-t Imrv its dead > -, , ) we
mav sorrow for them! Let us be wi.-er m the comn _ M
->-J M ANTAI. OK niKTKTICS.
Tile mistaken views about the nutritive value ot' beef tea have
been murderous. All the bloodshed caused b\ the warlike ambit ion
of Napoleon Ls as nothing compared to the mvriads of persons who
have sunk into their graves from a misplaced confidence in the food
value of beef tea. Asa food, it is but as the mirajje of water seen
bvtlic thirst v traveller in the desert: there is no real water. So
with be r f tea. it is not a food.. A traveller once requested some
chicken broth at an inn. when brought its quality was very indifl'er-
ent. Complaining that there was nothing of the chicken about it,
1 . i
the waiter assured him lie was mistaken " It was made from water
from a pool in which a chicken had paddled! " In so far as the fluid
was "' chicken broth " is beef tea a food!
What says Kin^ Chambers: "Make the cook understand that
the \irtue of beef teai.- to con t a i ii a! 1 t he contents and flavour- of
lean beef in a liquid form: and that its, vices are to be sticky and
stron if and to set like a bard jellv when cold. When she under-
stands this, let her take half a pound of fresh killed beef for everv
pint of licet' tea required, and remove ail fat. sinew, veins and bone.
Let it be cut into pieces under half an inch square and .-oak for
twelve hours in one third of the water. Let it then lie taken out
and simmered for two hours in t he remaining t wo-t hirds of the water,
the qiian'itv lost bv evaporation heimj; replaced from time to time.
The boiiiuLT liquor is then to be poured on the cold liquor in which
the meat ^'as soaked. The solid meat is to be dried, pounded in a,
mortar, freed from all strin^v parts and mixed with the rest."
Th:s last matter is the important matter, to restore the meat
fibrine to the fluid. That it is which udves food value to the meat
infusion. ,\t the Victoria Park Hospital we have recently had the
beef tea prepared on this plan wh;ch Mr. Chambers calls " whole
beef tea " and though at first the patients do not like it so wel 1, it is of
course much better for them. The nitron-nixed principle- derived
i'n 'in meat are a descending series which commence wit h k real in and
kreatinine and pas- into tvrosin and leiicin bv an oxidation towards
the final products, uric acid and urea. As -aid before, all explosive
bodies contain nitrogen, and these nil ro^en; xed bodies do not supplv
force in themselves, but thev liberate stored force, converting it into
' kinetic enerirv." Thev are hke the fulminat MIL:' mailer of a ear-
trid'_ r e which does not itself propel t he bullet, but which explodes the
fiinpowder whose decomposition is the real propelling power. Con-
Sei|llelit i V to u;i\ e t In Mil alone to a .-: 'k per-oll i- to e\ hat!-t the -t ored
up material the "potential ener;_;\ \vho-e oxidation produces
sTi.MU.ANTs. ;,:;
force. They should properly be accompanied hv some soluble carbo-
hydrate. To give them alone is as illogical and erroneous a- it
would be to thrust a bullet down a 1:1111 barrel and put on a i-:i|i.-
omitting the powder. These explosive nitrogeni/.ed bodies plav an
interesting and important part in the eronoinv. A carnivorous ani-
mal could never catch an antelope in a dear run. luit it can make a
supreme eil'ort and pounce upon its herbivorous pivv. And this ii
can do by the nitrogcni/.ed elements derived from its t',,,,,] Hesh.
(Ireyhounds are fed on meat, because tliev require to put forth im-
mense encrgv for a brief period. Sport in i; do ITS \vlio cover i"Ui: d -
tances in a day but at a less rate of speed, are fed on hrot h and oat-
meal. And the same occurs in the feeding of horse>. Trainers
will tell you that the hunter ami the draught horse reipiire to be
feil ditl'erent ly. The hunter is bred and fed for speed and carrv-
ing power: the draught horse for l)iilk and strength. In the hunter
is wanted rapid liberation of ener^v within a eonijiarativelv short,
space of time; in the draught horse is wanted a more gradual liber-
ation of enei'^v and fora longer period. To bntr r out I hese <mali-
, I
ties each strain must be fed appropriately. The hunter i> fed on a
concentrated and stimulating form of food ehiellv on the heaviest
and most expensive oats which if 1 mav so express it. is the " beef "
of the vegetable feeders; and unless lie is M> fed. he will not perform
satisfactorilv in t lie hunting-Held. The draught horse is fed on a
lower and less, stimulating diet on Indian corn and chopped hav-
t'ood which tends to increase bulk and weight, (Sir \Vm. Ilfiberts"
i Lectures on I lietetic- and Dvspepsia "). Not onlv is this so. but
when the ground is hea vv t lie hunter gets some beans or pea- ext ra
legumes which are speeiallv rich in nitro^eni/ed principles; ulnie in
plough MIL:' time, especiallv in spring when the hard,e.-t a^r:'".i!i ural
work is performed, the farmer adds a liberal amount of oats daily to
t he ord inarv food of his horses.
This rule applies to races. The conquering Auu'lo-Sa\on. the
master and too often t he exterminator of aborigines whose lands he
covets is a meat-eating man /xrr < t rrrl ... lli- carm\oi'ou> pro-
pensities arc linked in some subt i Ic manner with In- ma-tcri nine--.
/-'. Vegetable principles. Clo-elv allied i
position as well as in ph\siolo^ical action to the animal m::
stand a certain irroup of \e^eta!i!e principles. Tea. e, .;%.
and to a less extent, male, or I'arau'iiavan I' 1 ::. ;ire mad
sionswilh hot water and drank as food-accessories,
supplv at once llnid fur diireslive purposes, and a ci-rla.
.". 1 MA NT A I. OK IMKTKTICS.
eil'ect which has doubtless liccii t h' cause of their adoption. Theme
witli a formula ('.II, \.<> is the tvjic of these principles. They
are a considerable iri-onp. commencing with theine. calTcine and
t heoltrotniiie. and ending with hnicine and st rveliniui'.- a mighty
tonic of toxic proper! ie-. St rvchnine. \vit li a formula of < '.., 1 1 ,\ ..< ).. is
constant Iv used as a tonic of rapid action so as to come under the
head i ni:' of dill'usible st i umlauts. When the Resident Medical ( Mlicer
of the Leeds I'll hi ic Dispensary, where I could command an v amount
of drills of everv kind. hut where meat and drink were hevond
mv reach. 1 found in many cases of debility and convalescence
from acute disease, that ammonia and mix vomica in combination.
supplied the place of alcohol Very fail'lv.
'I'iie chemical composition of these vegetable principles, and the
similarity of their action was a matter which did not escape the ob-
servation of IJebi^. who wrott 'Theine is related, in composition,
to no organic nit ro^vni/ed base more closely than to kreatinine,
that remarkable compound produced in the vital process, and oc-
curring in the muscular system of animal.-: and to irlvcocoll. which
we ma v suppose to exist in gelatine, coupled with another compound,
a- mav l>e .-ecu bv the fol lowing formula:
' I ' i ! e 1 11 e . .
Kreatinine. .....
< i lycocoll (anhydrous).
Kivatin. .....
TheobromiiU', (in ( 'aeao i,
Tiiere arc no drinks wliicli in their complexity and in the nature
of ceria n constituents have more resemblance with soup than tea
and colTee; and it i- vepy pro'iaMe that the use of them as a part of
fond depends on the exciting and vivifying action which they have
in com n 10! i with sou p.
Tln-re are .~otiie discrepancies betwixt these an<l more modern
form ilia-, which mav or mav not depi-nd upon the MC\V notation: hut
which arc of comparative unimportance as compared with the main
fact uf t he st roni: similarity and chemical rc-emblaiice which exists
between t hese sub-tance--. I n I'usn MIS <if uic;it and ml'usiniis of cer-
tain vegetable prn - alike contain stimulant mare]'-;, whose
properties re-t upon the larife proport \\i of nitrogen they in com-
mon possess.
These vegetable principles are used largely bv race- \\dio do not,
take a'.coiii.il. The A rali and the Turk, forbidden bv their religions
STIMl I. A MS.
to taste alcohol, have found a substitute in eoll'ee: while the ah-te
mious ( 'hmamaii lias cultivated t he Tea-plant. The total abstainer
of Anii'ln-Saxon descent lias adopted the drinks of the-e races. 1;
is true that thousands ha\e lived without a k nou lcd-c of tea or
eolVee, and daily experience teaches us thai under en-tain eircuni-
stanccs. thev niav lie dispensed with without disadvantage to the
merely animal vital functions. l'>ut it is an error, eertainlv to con-
clude from this that tliev niav he altogether dispensed with, in ivfcr-
cnee to their ell'ects; and it is a (|iiestion whether, if we had not tea
and coll'ee, the popular instinct would not seek for and discover the
means of replacing them. Science, which ueeuses us of so much in
this respect, will have in the first, place, to ascertain whether it
depends on sensual and sinful inclinations inerelv. that everv people
of the idobe has appi'opriated some such means of acting on the
nei'Vous life. - from the shore of the 1'acilic. where the Indian
retires from life for a few davs. in order to nijov the Miss of intoxi-
cation with koka. to the Arctic regions, where Kamschatdales and
Koriakes prepare an intoxicating beverage from a poisonous mush-
room. " ( Licbiir.)
Not oiilv is there a widespread instinct for " these means of act-
ing <>n the nervous life," as Liebi^- happily phrases it: but the mn-
sc(|iience of excessive indulgence is seen in the various nervous
affections which we notoriously associate therewith.
The " tea-drinker's, heart " is a wcll-reco^nixed maladv. 1'eople,
especially of the female sex, who drink largely of tea. and still more
when thev do not eat a suHicirlit nuantitv of food, sutler from
manv nervous troubles as well as palpitation and neuralgia; and
present all the phenomena of nerve-exhaust inn. The nurse often
drinks tea to sustain her when there is no appetite for food, until
utter exhaustion is the untoward result; and a slate IiorderJiiL 1 ' on
the delirium trcmen.s of alcoholic excess is re\ealed. The " ten-
dril nkard " is a wel I -know n pal mi t at all hospitals; and is not un-
known in private practice. "The cup which dicer- but doc- not
inebriate " is not without a toxic influence, when taken to excess.
\\ 1 1 ile tea is in almost universal use with the A n'_do-Sa vn . eoiV
is eijiiallv in \"oi;'iie \\iih the (iernians. They ha\c the -anic -,{<'. \<>\.
to a u'real extent. ColTee. however, has M distinct eiTecl upon I !
heart: and call'eine wit h a formula of ( ' 1 1 N< is used as ;, in--
cine in eases of cardiac dehilitv. \" o'_;-e 1 has advocated I he u-~"
st ronu" coll'ee with cream as a tonic and food in the dehi: !\ u'ii
attends upon acute disease in children. No such u-'e of tea has a-
.">' MANTAI. OF DIKTKTICS.
vet found an advocate. Tea contains an aromatic oil as well as
tlicinc, and its effects upon the nervous system for <n>od or evil
may to some extent lie due to this rather than the theine.
So much then for those stimulant- bodies derived from the
animal and vegetable worlds alike, whose properties depend upon
the nitrogen contained in them.
Alcohol.- If the matter of beef tea is difficult of discussion in
consequence of ignorance and prejudice, how much more diilicult is
it to handle alcohol a matter bristling with difficulties, when fhe
pure white li^ht of truth can scarcely be seen clear of the coloured
rays around it ?
Alcohol has a formula ('. ,II,.O (better known, however, by the
old formula (',11,0..!. and is a readilv combustible substance out of
the bodv. A verv liu'ht. volatile bodv it. is. hiu'hlv inflammable.
All matters which arc o\idi/ahle in the bodv are " foods '" (Iler-
niann). Liebii^ held the opinion that ''Alcohol stands only second
to fat as a respiraforv material " while adding " Alcohol and alcoholic
drinks arc from their price most costlv materials of respiration.
The same effect could be produced in the bodv bv means of saccha-
rine and farinaceous art ides of food at one-fourt h or one- fifth of t he.
cost." A fierce war. embittered bv the presence of sentiment, has
raided around the matter of the food-value of alcohol. Readily
combustible out-ido the bodv. some have denied its combust ibi I ity
within the bodv. Kit'tv \vars au'o, the most advanced chemists be-
lie veil in the " spontaneous combust ion " of the bodies of drunkards.
In that thev were eertainlv mistaken. Then came the recoil of
opinion. Total abstainers are ranked in battle array on the matter
AVith ot her observers. The-e last, and their names are both numer-
ous and weight v, hold that alcohol is larvvlv burnt in the body by
oxidation and is therefore a ''fuel food." Personally, after very
considerable attention (IP the subject, 1 must sa v that 1 am amoiiLT
those who hold "that the chief portion of the alcohol injected, un-
dergoes consumption in the bodv."
P)iit t he quest ion of " alcohol ;i< a food" can never be separated
or divorced from that of "alcohol ,-i- ;i stimulant:" as a force-
liberator. Liebi^r reco^ni/cd tlnsa-peei of i he subject, and wrote as
follows:
"The use of spirit- i-' not t he caii-c but an elfeci of poverty. It.
is an except ion from t h'' rule when a well-fed man becomes a s|)irit,
drinker. < >n the other hand, wh"ii the laborer earns bv his work
less than i> required t" |>rovide the amount of food which is indis-
STIMULANTS. ;, 7
pensable in order to restore t'uilv ids working power, an un vie!di!e_ r .
inexorable law or necessity compels him to have recourse PI .-p.rit-.
He must work: but in consequence of in-utlicieiit fond, a certain
portion of his working power is daily wa-tin^. Spirit- bv their
action on the nerves, enable him to make up the deficient po\\vr
nt Hit' i .>/!! //.-.->' (//' ///> fin////, to con-unie to-, lay tha' nuantitv which
oii^ht naturally to have been employed a day later. lie drau-. -o
to sp r ak, a bill on Ins health, which must be always renewed be-
cause, for want of means, he cannot take it up: he coii-ume- his
capital instead of his interest; and the result is the inevitable bank-
ruptcy of his body. "
This mat ter of " physiological bankruptcy " made a deep im pivs-
sion upon me at the verv threshold of mv entrance upon medical
pract ice. and has been my jjfuide to the nsi- of alcoholic .-t i mu Ian*- in
the treatment of disease. If much alcohol be ^-jvc'i without other
readily oxidi/able food- while fiirnishini: a certain amount of iv-pi-
ralorv food in it sell' its etTect is to con- nine t he body --tore: in ot her
wnrds to produce " physiological bankruptcy." Kspeciailv i< ibis
matter to be borne in mind when there is danger of the system
sinking from exhaustion. There is a deep-rooted fear in mv mind
that many a case of acute disease (and especially in fevers running
a certain coitrse of so many dav-l ha- been sent into " a iiraye never
'in'.: by nature" (as II. ( '. \\ood pithily puts it) by over stimula-
tion: by "physiological bankruptcy." (ither hvdro-carbonace.,ns
food as well would have been preferable; and the di-piav- of energy
e\oke>l by doses of alcohol, were a- disastrous a- the di-piavs of
wealth manifc.-teil by a reckless youn^r sipiire who raises the means
for them by mort u'au'cs on in- proper! \ : each ,lispla\' rendering: ii;m
di.-t inct iv poorer.
'I'h i.- Lfn-at cardinal fact that .-! imn iai:t - a re " force- liberator- '
mii-t never lie forgotten in practice. If force mn-t be >ei free to
meet some emergency t lleU alcohol -Sllppi VillLT so 111 e fol'i-e ill l!-*i
we,! a- liberal MIL;' other force- mav I"- ui'^entix called for: but tiic
aftereir-'ct mi;-! not be left out of i he caiculat ion. In -vncnpe M
ci i!id it ions of acut e e\han-t ion fret.' resort to alci ihol ma \ be i n . \
IIP an- a! hand; aii'i ma\' lie, too. i; lieenme- nci-e<sarv to _ \
lill-l Illed ijliailtities to tide over the ini!l|ed:a!e d.'i'i'je"; ;
uho:.' of it- operation mn-t be borne m mind all the -ame.
A- to t lie ' f b value " of alcohol in h-nl; hit:
imi on i he -:cr\ m;- -\ - ; i-m. I .
5* MAM'AL OF DIKTKTICS.
lent of a fair meal in alcohol, lie would lie dead drunk. If lie took
it comparatively quickly- -as when men. for wafers, drink so much
spirits in a limited time the strong probability is. he would in a
very short time sink into eoma; which ere loni: would deepen into
death. Its "food-value" in health is such that its eonsideration
need not enirauv our attention for IOIILJ.
Rut in ill health and especially in acute disease the question of
its "food-value" as well as its value as a "stimulant." mav well
engage our attention at some length. As well as a force-liberator
it has some value as a " fuel-food." Indeed, at times, dilute alcohol
is all that the patient can take, or the stomach retain. Alcohol
requires no digestion; let that fact be kept in view. By its ready
divisibility it quickly passes bv osmosis from the stomach into the
blood. When the digestive powers are seriously enfeebled this
matte]- IK mi's very important. Alcohol provides some force, and.
borrows some from the system. How far can the borrowing u'o on?
That becomes the question. It mav be possible to provide the alco-
hol m unlimited quantities; but is the store of body force illimita-
ble;' That is where the shoe pinches. Whenever possible or
practicable the alcohol should be accompanied by some soluble
carbo-hydrates, which would supply the place of the borrowed force.
Say with some Malt Kxtract diluted; that would be a capital com-
bination; or in milk, excellent. Or with lemonade, home made,
containing a distinct amount of soluble suirar. The neglect of this
matter is fraught with disaster. This will be further considered
when the treatment of exhaustion comes to be discussed.
The ejfect of alcohol is to produce increased action in the heart,
while the carotid arteries are dilated, and so the brain is Hushed
with blond. This flooding of the posterior cerebral lobes produces
a sense of well-being. /./-., the patient feels better for the time; no
doubt, too. the alcohol borne aio]|M- m |j 1( . Mood acts directly upon
the cerebral cells. I'robablv a like continued ell'ect of increased
blood supply and direct stimulation goes on in all part- of the ner-
vous system the organic or sympathetic as well as t lie < ercbro-
spina'i. Hut this ell'ect is temporary and evanescent. Such st imu-
lat ion carries wit h it t he after ell'ect of exhaust ion. The heart ila^s,
the carotids contract below their normal calibre and the brain be-
comes bloodies-. If this lead to sleep, as often happens, then the
alcohol mav have been advantageous in everyway. P>nt the tem-
porary tune of stimulation ou-j'ht to be utdi/ed to assimilate some
easily digestible food. < M her\vi-c. \\ mav ha\e been useless: av.
STIMI I.ANTS. ;,:
wor-^e than useless. Kin^ ('handlers says wisely of a'.. -oh"': '
the alcoholic dnnk be limited to that i|iiant:t\ \\hich in^rea :;,.
appetite." lie is at the time speak in;: of its use in lii-art :'
Hut the principle is a irood one to hold to under ail eip-um-i a :/>;,
Alcohol is a two-edircd tool, not to In- used without iv;V.- T on;
and. like any other tool, all the more skilfully u-ed from fan:'!;;'!- tv
with it. Sometimes it is withheld when the call for '.\ i i.rj-eM.
At other t inies it is pushed recklessly, and alcoholic L. r :t-tr:t i-
up: the stomach rejecting it (jiiieklv, while the tongue is p-d :( !,.
irritable, and the bowels tilled with tlatus. This condition i
duced whe;i alcohol, commonly in the form of hrandv. is ^iyeii in
considerable ijtiaiit it ics. insuiTicieiitly tliluted. and at frequent inter-
vals. Here Nature is stepping in to limit that stimulation which
is thi'ea tenin^ the existence of the organism when exhaustion ;
close at hand, and " the beat MIL;' of t he w HILTS of the A iiLi'el of I 'eat li
are di-tiiictlv audible overhead.''
This condition of exhaustion is specially liable to come on when
alcohol, alternately with beef tea. is alone LTIVII to the patient, lleef
tea which (as ordinarily made) is no food: alcohol which i- a food.
carrying with it a ht-avv borrowing power! No wonder the system
is in danger of sinking from exhaustion. Ail that has been >a;d
here applies to acute coiidit iolis. as fevers, and also to conditions nm
exactly acute, as in ilropsy with a failing heart: or in acute eo:,.
tions implanted upon a chronic state, as in an acute bronchial attack
in a person the subject of chronic bronchitis. Here we \\i-h to -u--
tain the powers, and for that end we use alcohol. Hut we mu-t .-"
use it in combination with soluble carbo-hydrates that we do not
make it a mean.- of sinking the ship. If it be ;_ri\en al-'iiir with, or
alternately with, a meat broth containing some baked Hour, v,
milk, or diluted malt extract, then the power niav lie stistainei'i
the strength be kept up or maintained. Hut when aieoh"! :
is ad m mistei'ed experience has told us in unmistakable accent- tuo
end i- not far oil'.
\\"c are told " to u -c t he p;ood 1 hii'iTs of this \\-orld a- not abn-' 1
them:" and to do this with alcohol is feat of judgment. !'.:
conies the rcijii i-it e k now led L:''-: then t he judu'iiient t" n-- 1 t :: !\ -.-
ed'^c ariLfht. In tini'-s of acute depression alcohoi :- of in.-;
value. lint then the end mu-t be kept \\ell in \ iew. At;:
cour-e mii-t not be indetiiiite; must not indeed be pp. '.
|)rtip"rt ion as it can 'he combined \\nh other fmi r \\
continued. \\u{ when it alone can be taken the end
<><> MANUAL OF D1KTKTICS
measurable distance. So much for alcohol as at once a food and ;i
st iinulaiit - a " force liberator. "
\\lieii the subject of malt liquors comes before us. then no ono
can dispute, or think of d is put MIL;' 1 he food value of the maltose con-
tained therein. In the brewing process a certain quantity of mal-
tose is broken up into alcohol and carbonic acid : while a distinct
proportion remains unchanged. Consequently the well-fed navvy
who prefers to do the 1 st hour's work of his laborious dav on a pint
of ijood sound ale. has a hard solid argument on his side. Having
expounded mv own views at some length and as judiciously weighed
the subject as in mv power lies, some reference may be made to \\lia
ot her men have thought and written on this dillicult and complex
subject. Hrinton in " Food and its I h^vst ion " aftei- v,oniLr over the
pro- and cons, wrote- a f ter ^ivinu; the obvious drawbacks of alcoholic,
indulgence and how it blunts alike the menial edire and the deli-
eacy of touch and movement :
" ( hi the other hand, however, it is necessary to remember how
often the whole quest ion must practically be approached from a totally
different aspect: how often alcohol constitutes not the single feather
which distracts the sleepy savage, but the bed of down which restores
the exhausted man. It may disturb a balance exquisitely adjusted;
and yet, in the main, counterpoise a. scale heavily laden with disad-
vantages. If alcohol exhilarates, imparts comfort and energy, coun-
teracts fatigue, hunger and unrest, then it does in eiTeet. increase
the capacity for work of those who take it under such circumstances;
and atl'ords. in so far. a direct heiielit and ad vantage. "
I 'av v says of it as a food : " From a review of the evidence as it at
pre-'i-iit stands, it may reasonably he inferred that there is sullicient
before us to justify the conclusion that the main portion of the
alcohol invested, becomes dc.-i roved within the system, and. if this
be the case, it inav fairl\ he assumed that the destruction [.-attended
with oxidation and a corresponding liberation of force; unless,
indeed, it should undergo metamorphosis into a principle to be
temporarily retained, but nevertheless ultimately applied to force-
pr< idiict ion. "
KinLf Chandler- sums up his consideration of a icoliol so: " (A).
Let it be taken never as a stimulant or preparative for work, but as
a defence airai list t he injury done by work, whet her of mind or body.
For example: it is best taken with the evening meal, or after toil.
(|',i. Let the increase in the desire for and power of di^e-tin^
fond be the inude and limit to the consumption of all alcoholic;
STIMl I. A. NTS. '. 1
(('). Let the forms he siidi a- con; a i n the lea-;
fllSel Oil.
(IM. Let all with an hereditary tendi-n '.' t" h\-teria
functional disease of the nervous svstetn. refrain from it-
<ret her. even though as vet tlievare iii - i health. Ainoi-
hereditary tendencies must he clas>ed a procli\ it \ to .ie . ii r ht in dn;nk-
cnness. which reinarkahly runs in families. Children with -
an heirloom had hest In- kept to as late an a ire as po liile w.:':.-
last inir st rone- ilrink. "
Indeed, there can In 1 no question ahotit tin- desirah;i;tv of \\
holding alcohol from children under all circumstances hut tho-e,,;'
din- necessity. It is an injury to a eh; id, to sulijeet its t ,--ue- ;o ; ;..-
action of alcohol. ( diildrcii are in many respects like inferior ra-e-.
And of these Sir William K'ohert- writes: -" There are certain '
nor race- who appear to he altogether intolerant of alcohol. L ti;ei-
it does not suit their tvpc of nutrition, or thev lack the -elf-con; r.
which is necessary to its henelicial use. The Indians of North
America are said to he excited almost to mad lies- 1 . !,\ an\ ii-e of
alcohol, insomuch that the Colonial authorities i'orh !. under la-a 1 , v
jienalties. the i_riviiiL; or selling" "f alcoholic liquors to tiie nali\'-
ti'ihis. The Ailios of Ye/.o. a stihjeci mee inlialiitiKir the \o'" ; : ,
island of .Japan, appear to he wholly wanting in self-cont mi in ; he
use of alcoholic stimulants, for which the\ evince an irrepre--
pas.-ion. Whenever they have the opport unity, lioth the men and
women drink themselves to ;i state of inseiisihilit v. The defect
reaction of these races towards alcohol mav he compared to a -inn-
larh" defect ive reaction in certain individuals and certain fam;.:
ainoi!',;' on rselyes. " :
()n the other hand, just as strong men usually tolerate ale.
Weil, so apparently do the stronger races of mankiini. Kin:: Chan -
her- writes: "Ail nations that ha\e leil the van in the march .
civ ill/at ion have I icen addicted to drink. a\ . and add let ed to ijr:;:,.-\-
eiine-s. The .lews, the (i recks, the Ii'oinans. the lierman-. ;
Swi'd.es. the I>anc. -not to mention the l'in-'!;-ii all round the-
are amply atte-ted h\- their own native literature to ha\c hee]
i i IILI'U i-hed aliove their contemporaries in tin- wa\. 1'
some react ionary races, famous as coniiuei-o!'-. ha\e !.ee' a ; -
I' MAM'AI, OF IHKTKT1CS.
but they ami their t'aitlis arc ilyinir out. ami the coloring they have
Driven tn civilisation iscvcn iio\v fainter I han that left l>y 'he minister
races a thousand Years before t hcv were heard of." \\hiie Maudsley
ha- pointed inn that drunkards in socict Y are like t lie waste-heaps
of nianut'aeturiim industries thcv are so nianv \vitnesscs ot the in-
tellectual activitv ^oinL: on around tlieiu. The stronger the ra<-e,
the greater their enjoviueiit, of that exaltation which alcohol pro-
duces. As Burns savs:
John r.arlevcorn was a licro bold,
( if noble enterprise;
Fur il' YOU do but taste bis Mood.
"T will inako your couraii'i 1 ri^e.
"!' will make a man forget bi^ woe:
'T \\ ill hei-'lileii all liis ji >y;
'T will make the widow's lieai'1 1o sinu',
'rboii^'li tin; tear were in liei 1 eye."
This etVect it is which constitutes the danger of alcohol; ;nid if
the delight in sncli excitement cannot be kept within strict bounds,
the downward career of alcoholic excess ending in drunkenness and
degradation, is apt to beset on foot.
In concluding his contribution to " Tho Alcohol (^ue-tion."
which was discussed in the " Contemporary Review, '"'some fc\v years
:iU' (> . I 'r. Sam. \Vilks said: " In jud^in^ of the use of alcohol by
the ciiiiininnit v at lar^'e. \ve mii-t lie guided in the same uav as we
are hvother habitsof mankind. \VeseepersonsenjoYinLrtheinselves
in various wavs. eat HILT and drinking all kinds of food and beveraires.
occnpvin'_ r theuise!\cs with a in i tsciiie; 1 1 s of cYei'Y description, and
yet none of t liest- \voiilil be allowed in Vtopia. Thev ^i-t thnm^h
the \\'orld. althoiiL r 'h indulLi'iliU' in certain haluts. and declare them-
selves well where, then, is the appeal against their procedure? If
I. personallY. am consulted as to the proprietv of ordering alcohol
in any individual case, if there be no experience to ^uide me, I
am impelled bv the principle- I have enunciated. I believe alcohol
soothes a worried nervous svstem. and bv prevent MIL:' wear and
tear, actuallv -upports the frame; bul. discarding the notion of its
st iniuialinir proper! ies. I denounce its use in delicate children and
in women who fee] 'low.' I also .-trough- prohibit its use in the
carlv moj-nin^: in lact. those who then wish for it. have aln-adv
imbibed too lllllch. I alwaVS SllSpect people who I'e'plirc '
tiling ' about eleven in the morn mi:. Indeed, the man or won ia
STI.MI LAMS. .;:;
who has tin aonte cnnsciousiH'ss of the hour of eleven is a !,.:
phvsically and niorallv lost."
No doul)t there is much truth tis well a- force in the-.- p-ma
and there tire two mutters connected with alcohol, well worth bear-
ing in mind:-
1. Xever luive tileoho! in the brain when it lias work lo do;
'.'. A little tlleohol betwixt ;i lli:ill tllli 1 ;i pa-t trouble, is henni--
silile: but it is not well to put a little tueolioi in front of a eominir
trouble.
I may fitly conclude this chapter hv a quotation from the late
I >r. Murehison. whose hook on Fevers is so favourabiv known everv-
\vhere:
" What then are the conditions of the annual economv in which
alcohol mav he of positive use? That there are such eond!;;on~ I
helieve cannot lie denied hv anyone who has honestlv studied the
snliject: hut thev tire not the conditions of perfect hcaith. !; :-
espeeitillv u'lii'ii the circulation is weak or siuv;v;ish, that a dailv
allowance of alcohol mav do ^ood. 'I'iius
" 1. Alcohol is useful iii the cniir.-e of most acute diseases, when
the orpins of circulation lie-in to fail, a- they are apt to do. A
moderate (plant ity usually sulliccs. The Sar^e quantity './/..one
or t wo hott les of hrandv in twcntv-four hour- -till sometimes ad-
ministered, nitiv do htirm hv inducing' congestion of \arious internal
orpins.
" ','. In convalescence from acute diseases, or from other weaken-
ing ailments, when the circulation remains t'eehle and the tempera-
ture is often subnormal, alcohol is also useful in promoting:' i he cir-
euhition and assistini;' di^e>tion.
" ''>. In persons of advaneeil life t lie ciren hit ion is also often feeble,
and a moderate allowance of alcohol often appears to lie beneficial.
" All other conditions of the svstcin marked by weakne.-- of the
muscular wall of the heart, whether permanent or tran.-ient, are
usually benefited l>v alcohol. ''
Alcohol is"ap)od .-ervant. but a !>ad master."
The charge brought against the medical profession, that much
alcoholic excess take- its origin in medical ad\ ice ;s a i-iiai'^
preferred. It is undoubtedlv often made the e\cn-e |p.r ','.
1 eertainlv t hink (lie u't'catest caution ,-hould be e\erci
of neurotic women and their children, u here there
ni'_ r for alcohol, and the haliit i- uio.-t ea>i!v tieipi.r'
lllll-t never forget Its possible abu.-e.
CHAPTER VII.
Tin: type of " Fluid Food" is Milk the food Xature provides
for all young mammalians. It is a complete' and perfect food, con-
tainitig fat (in an emulsionised form.) albiuuen, (in the form of
casein.) carbo-hydrates, (as milk-sugar.) with salts, (phosphates and
others. ) all properly diluted. On this food life can "be. sustained for
an hidefmite period. In sicktiess. milk is really our sheet-anchor.
Hut there is one matter to be borne in mind, and that is this milk
curdles as the first step in its digestion. The light ctml usually
readily re-dissolves in the alimentary canal; but sometimes it does
7iot. Fsprciallv is this firm curdling liable to occur where there is
acidity present in the digestive tract. The hard, linn curd is an
irritant to the whole intestinal surface: and in conditions of ulcera-
tion, either tuberculous or that set up in enteric fever, hard pieces
of curd may rupture, or perforate the weakened bowel. The pieces
of curd 7iiay be seen in the stools. When such is the case the milk
must be combined with means which will prevent this hard curd
forming. At times it is well to stir some biscuit powder into the
milk, which mechanically prevents too firm a cui'd; or where ob-
vious acidity is present, some light carbonate of magnesia, which acts
ill two wavs. First of all it chemically neutralizes the aciditv: next
the carbonic acid gas given oil' tends to disintegrate the curd and
break it up. Milk is commonly given with lime water: but this is
often too feebly alkaline, and magnesia or prepared chalk must be
used. Usually as much as will lie on a sixpence (or its U. S. A.
equivalent) to the halt pint of milk is enough: or it may be iriven
with a mineral water as Selt/.er water, especially where the thir.-l is
considerable. At other times it is well to combine it with such
waters as Yiehv. Yals, Marienbad: and in some conditions of lithiasis
such combination mav be freely drank.
At other times some malt extract well diluted may be added to
the milk with advantage. This last is indicated in those eases
where the patient feels the long fast betwixt going to bed and risiu-j.
or either betwixt the usual hour- of bedtime and of rising: and
something is desirable in the small hour-: of the morn'mir. A : ,'>'.<-
spoonful of malt extract to half a pint of warm milk in a h"i-\\a'er
ju<_r (\vitli a liil) ]Mit on a piece of wood, or other non-conductor ..:'
heal, and covered with a tea eosev (the bigger and thick. ] ;h,
better), will be found a pleasant, palatable, and nutritious drink.
The tea cosey will retain the heat.
Then at other times milk is boiled with a little ground r:
flavoured with cinnamon: and this is an excellent food when tin-re is
anv looseness of the bowels.
Skim-milk is an excellent beverage in pvrexial state-, where fre-h
milk is too heavy. Buttermilk with its laetie acid is a irood hever-
iiiTe where there is much thirst and in diabetes.
Milk is sometimes too cloying and is preferred in the form of
whev. \\diev is a pleasant stimulant drink-f 1. It is made by
adding one or two wineglassfuls of sherrv to half a pint of hot milk:
the curd is strained out by a sieve. It is not in fa-hion at present:
but its day will come again. The milk-sugar in it u'lves it a certain
food value.
Then there are certain pleasant drinks with a low food value,
good in fevers, as apple-water, and tamarind water. They are
pleasant to the taste. A favorite drink is lemonade. The rind
should bo thinly pared (to get out the essential oil) and the lemon
be cut into slices, put into a jug and hot water ho poured in. Then
some sugar should be added or if this he apt to turn sour in the
stomach some malt extract may be used instead of cane snirar. Such
lemonade is grateful and nutritive: especially when made with ma';
extract or with Mellin's Koed. :;:
Then as a '"'drink-food."' oatmeal wafer is capita! where persons
are exposed to a high temperature as stokers, iron-workers and the
like.
llarlev water is a pleasant nutritive drink, and a capital vehicle
for bitartrate of potash. I'otn- Impcrialis sweetened is a capita!
beverage, ^ood in a cold with a deposit of pink lithatc-.
Rico water is a drink in vogue m India. It is a nutritive drink.
- and thereby hangs a tale. When ('live was besieged in Are
provisions ran very short. There were ;i few Knu'iidinicn a:.<
nn in her of Sepi iys. This is Macau lav's account of what ha ' ! ::< ; :
1 1 is invidious t (> n K 'Hi ion nann > in coin if. t ion with food-. I >
iin lias liei'n >nch a pioiii'i-r. tli;it lii-^ I'm id ni;i\ he >|ioken el a- ;ii.' i\
a niesl 1 1 ^et'id d;i<s of foods and as such it N sjioki-n ol' I rei|in nt iy. I '< _
his food Mr. Mt'Ilin is unkowti to nn-.
>i> MANUAL OK niKTKTlCS.
"Tin 1 Sopors came to ('live, not to complain of their scanty furo,
but to propose that all the irrain shouM be ^iven to the Kuropwins,
who required niorr nourishment than the natives of Asia. The thin
U'rucl, thev said, whu-h was strained away tVom the rice would suffice
for themselves. Ilistorv contains no more touching instance of
military lidelitv. or of the inihn-nce of a commanding mind." Lit-
erature eontains no more striking instance of a man, accurate bv
habit, tripping e^repously. Those \vho understand the matter
thoroughly assure me that the men who were satisfied with "the,
thin irrnel " ijot much the best of the bargain.
liicc water may be flavoured by any vegetable juice as that of the
currant, raspberry, apple, and mulberry. \\here there is j^reat
thirst in pyrexia. such drinks supply all that is required. In phthisis
however, it is desirable to increase the food value of the drink, and
this can be done by the addition of a mail extract, or soluble malt
preparation like Mellin's.
live which has been malted forms a capital addition to meat-
broths, as the stardi has largely been rendered soluble.
1 >e\t ro-saccharin. (?)or commercial irrape sugar, prepared for
the brewer, can also be utilised to gi\e food value to drinks
whether meat-broths, or made with vegetable material, as apple-
water.
Meat Broths. Beef. veal, mutton, rabbit, and chicken, aro
the materials mainly employed for the preparation ( ,f meat tea. In
the last chapter it is to be hoped thai the brains have been knocked
out of the superstition that beef tea. or any other meat tea. as ordi-
narily made, is a fond. The addition of ihe albumen of tlieiucat-
libre is required to give it a true food value, if that were done, the
amount or bulk of water to the pound of meat might be largely in-
nvased. Then too. a certain amount of salt should be added. In
invalid cookery there is a decided neglect of salt. Liehi'_:' advocated
the use of meat extracts. He deplored thcAvaste that went on in
the lar'je hordes of cattle on the plains uf South America and
Australia, where thousands of oxen were annually slaughtered for
their hides and tallow; and suggested the preparation of concen-
trated meat-extracts from the lle-h. lint Liebi^- himself was the
tirsi to recogni/c t hat such meat-extracts \veiva "mean- of invi^ora-
tion." rather than a food. There arc present the pleasant salts of
muscular t issue and the stimulant krcatin. which tempts the savage
to eat his vanquished adversary but nothing that is true food.
Ileef. or meat teas as ordinarily made, and Liebi^'s meat ex-
tracts stand on the same j>l;it form : thev an- not pr;i'-t i'-allv :'<>
But thev arc excellent vehicles for soluble earho-livdrate-; a:.d
the combination is a food a pleasant, nutritive, di;_'e.-t:h!e I'm
And at this point I fee! inclined t<> he dogmatic, e\eti inure th:
iisiiai: unnecossardv so, perhaps tin- hostile critic \v:l! sav: 'MI:
must lie done. "Whole hccf tea," tliat is heef t'-a t<> whi'-h tL>
meat tihre lias been restored after pounding, is no doubt a ^.".;
food. Ycrv <rood, nodoulit, in convalescence from acute
where wasted muscular tissue has to lie repaired. I'.ut in such
patients as I have constantly under eaiv at the hospital--, as phth:-:
eal patients either of ehroiiic character, -i \vith liectic in softeiiiv.i:
tubercle, or chronic bronchitis, or pleuritic elTusions. and in cardiac
cases, valvular lesions or weakened walls, cases seen in picntvof
persons outside hospitals it is open to question whether so verv
much alhiiin inous matter is cither L r ood or desirable. The heef tea
miiiht he verv much weaker and he flavoured with -ait. and some
soluble carbo-hydrate added. If the reader will at this point make
personal trial of what is heiiiLr said (an excellent practice with anv-
thinir food or niediciiu that has to pass the palate) it wi',1
well: and will make the matter perfect Iv clear. Add a teaspooiifiil
of anv haked flour, of which l,';il^e'< food is a tvpe, to a teaciipful
of onlinarv lieef tea, and tln-n add some salt: first look ;i; the invit-
ing soup so [d'odueeil that i- an appeal to one special sense, the
eye: then taste an appeal to the gustatory nerve. A- to it- palata-
hleiiess it. is unnecessary here to speak. Hut for the reader who ;s
content to read and not to taste and try. he or she mav take mv
woi-'i for it. Well-haked flour is larp'ly changed into soluble d
trine; ami beef tea containini:' some such addition, is a capita! fod.
If the flour be made from uiiliolted Hour. I,,-., where the bran :;;i-
not been removed, then some albuminoid matter is present a- wel
as the .-alts of the ii'ram. Such will make an idea! fluid-food.
The steam-cooked cereals, of which there are s<> manv varieties
pi-oduced, by ditVercnt makers in the !'. S. A., arc admirable for
addition to meat broths. 1'lain biscuits powdered arc a'.-o _,,<':.
The ('haiinel Islandei's alwavs add limken biscuit to their u:'-.
and thus ^ivc them a hiu'h food value. Soups are indeed :
lietterfor such addit ion. no matter whether made of -to.-k. :'
flesh, or of vegetable matter. Sa^o i< often added: ami
to heat in the oven for an hour before beiti^ added to tii' ;:, ;
all the more digestible. The same mav he said of :,.:
The stai'ch-transformation into soluble dextrine 1
I''* MANTAL OK PIKTKTirs.
about. Of course where cereals have been cooked by steam much
bettor thiiu boiling water this starcli-transl'orniat ion is more com-
plete. Whether the soup lie white or brown, cooked farina can bo
added \vith advantage as raising its food value.
Meat juice is of course a better food than a meat infusion, as
it contains some albuminous matter. Mr. Mann- Valentine lias
identitied his name with such meat juice. Others have followed
in his footsteps. Murdoch has mixed meat juice with the juices
of vegetables; a capital combination in theory. But such prepar-
ations arc not acceptable to the genuine Briton with his insular pre-
judices.
Then there are m the market " lactated foods." That is, com-
binations of cereal matters with milk, desiccated. These arc all
trood. And variety is us acceptable to persons who are put upon a.
''regulated dietary" as for other more fortunate persons, who can
eat what they please.
The stinir of a " regulated dietarv" lies in us monotony. The
palate palls at the restricted variety of food, and the person abstains
from food as much as possible hungers, in fact. Austin Flint and
Lander Brunton arc ipnte riirht in their criticisms on the elfects of
a '' restricted dietarv." Still, the dietarv mav lie judicious and ap-
propriate, and vet he varied -/.'.. if cither doctor or patient know
enough u poll the subject . That is where the shoe pinches ! Xeit her.
comnioiilv, are suHieientlv familial' with food m all its aspects, to
ret over the ditiicultv. It is want, of knowledge on ciilinarv mat-
ters, that makes the dietary so restricted. And as our acquaintance
with food increases, and familiarity with cookerv books becomes
part of medical teaching, the ditliculty will be e;ot over: and the in-
valid and dyspeptic be proportionated trrateful.
The seieiitilic aspect of food must lie united in the bonds of ho]\-
matrimonv with a practical knowledge of the cook's art. before a
man can discourse learnedlv of food. And another matter is-
nevcr take for granted that any cooked coinpound will necessarilv
l)c nict either to the eye or palate. Taste and try! That is the
onlv solution. I have been a judire at a food show, and ate some of
all the exhibits: the palate beiiiLr mart vred to a irreat extent. 1 have
tried most babv-fooils. I have hcid deep consultations with cooks
and housewives: I have experimented with loods to ascertain the
food-value in relation to cost for some articles, ("I-' 1 for the
Economical") in linml ll'o/v/>,- I have eaten everv vai'ietv of
tinned and preserved fruits: in faet. mv person.il experience extends
over the whole known lieM except a cod-liver nil emulsion. 'I'h.-it
is a fiTi'ii i /n-inj/i iln to inv jjftistatorv nerve fibrils.
Malt Extracts.- -The-c an- <]iiite a modern form of r i.
HoiT's first idea w;is a preparation oi' nuiit whieh should contain all
the qualities of beer, without the inioxicat mi: alcohol. Tin- malt-
ster malts the LTam, l>v which a certain starch transfonnation is pro-
duced: then the brewer mashes the malt with hut water, hv which
further starch-transformation is effected : and hi- "' w>rt " is a ,-wect
lluid. rich in maltose. The brewer then adds his veast t<> tin- \\ort
and then the maltose (or irrape-supir) is fermented into alcohol and
carbonic acid. The malt extract manufacturer stops at the won;
and instead of addmi: veast, evaporates the wort in a vacuum-pan,
into a fluid like molasses. A malt-extract is. however, something
more than either molasses, honey, or invert su<j;ar. It contain.-, as
well as carbo-hydrates, some soluble albuminoids and salts. In fact,
it forms a verv excellent food. It is not. however, as complete a
food as milk, as it lacks fat. Some advertisements of malted foods
talk of their lieinn- "substitutes for milk." That they are not:
and cannot be! Jut, a malt-extract is a lovely food all the same.
And when a stomach is in active- revolt, a teaspoon fill of malt -ext ract
every hour is an aliment which offends it neither bv bulk nor
qualit ies.
.Malt-extracts have been lauded for their diastasic power their
capacity to digest starch: but the diastasic power of a mall-extract
is far below that of ordinary mall. (ipMind malt lias a u'l'cal future
before it. As the digestive organs are enfeebled bv the advance uf
civilization, predi^ested starch mus! come more and rimiv to the
front. And ground malt added to baked flour, or baked farina in
anv form, before the hot milk is poured on. make- a nio-t lilies; .hie
dish. This milk pudding.' should, when mixed, be placed on a ii"t
plate, or anywhciv else where its heat will be main; allied, and then
the diastase of the malt acts prom ; it 1 v upon t he farina. Such a m . !k
pudding is verv fluid. It requires no cane -ULi'ar to sweeten it.
This is a trreat matter with stomachs in which ordmarv cane
siiLrar swiftly turns acid. An eu'.u' mav lie added or not, accor, im;r
to circumstances. Tin- is a far more eilicienl method of pre-
diu'cst HILT stai'ch than IIHXIHL;' a malt-extract witii a milk pud' ;:iL r
before servnii:' in the nur-crv.
<)n the other hand, a mait extract i-aii be ma ie a p
a^'c bv diluting it with a little water, (to make it of the
of a svrupl. and then adding an ai'-i-alcd water.
i MANfAI. ()K IHK.TKTirs.
Gruels. The admixture of farina \vith water or milk forms ;i
i^rucl. Oatmeal is tlic form of farina usuallv employed in the mak-
ing of ^ruel. lloiled in water with a knoli <f suirar dissolved, and a
piece of butter added, oatmeal LTUC] is reckoned a sovereign remedy
for a eoM. Oatmeal ^niel made wild milk is splendid food. As the
porridge of Scotland, and the North of Kn^land. this is the staple
of breakfast with the whole of the working population: which, in
thews and sinews as well as hones, can stand comparison with any
race on the earth's surface. An excellent sustaining drink for the
hav or harvest ticld. for foundries, stoke-holes, etc., is supplied l>y
adding a handful of oatmeal to a gallon of water.
Boiled arrowroot, was once in yo^ue for invalids, l>ut is not
fashionable at the present day. It wa- vcrv irood fuel-food; and
sweetened with sitLfar and flavoured with wine was not at all unpalata-
ble. r>u t it is inferior in every way to a "treacle posset." This
last consists of a pint of milk, a tables) loonfnl of treacle, a teaspoon-
ful of powdered -invvr. with as much nun as the drinker fancies.
Not only is this L r ood for a cold, but it has a lii^h food-value. Such
a posset last thiniron ^ettini; into bed, would cheer many a starve-
ling, and ill-nourished person.
Eggs. ---The e".-;_;- i> certainly a fluid food until its albumen is
consolidated by heat. AM eirjx. beaten up with eoil'ee, is a drink
re];>hed by many. Others prefer it with sherry. Some like it with
milk and brandy. With a pinch of pepper and salt, and a little
vinegar, an ev/ir form- "a prairie oyster." The white of an e^
addeil to liome-made lemonade, enables it to be frothed up. This is
a piea.sint and nutritive drink. I nder ot her circumstances t he yolk
i- the part preferred. It can lie taken with wine, or milk and
brandv. The yolk of an e^ is a constituent factor of the "rum
and milk." so famoii,- in the treatment of phthisis. Half a pint of
milk, the newer and fresher the better, the yolk of an e<_ r L r . a tea-
spoonful of su^ar, a suspicion of nutmeg and a spoonful (thesixe
varies) of rum. all beaten together and taken the tirst tiling in tin;
morning, has been credited with the cure of many cases of consump-
tion. Taken early, it will often prevent the exhausting sweats
which accompany tin- mornniL:' do/e. I'm- this purpose it should he
taken about six or so, and after it. the patient often sleeps protected
atrainst hvdrosis. < >r ;t may be taken Itcfore dressing, and often
enable- an invalid to L r < j t over that tiresome process without a sense
of exhaust ion.
Syrups. Then there are syrups of various kinds. The ( Icrmans
are fond of strawbcrrv svrup. and ra.-pl>errv syrup, to drink a-
aLfes; especiaiiv to breakfast, in hen of tea or roil'ei-. The-
arc vei'v palatable, and dce;dcdiv nutriti\e.
Svrups of all kinds arc in \ O<_MIC at present, to d niik \\ ,t h a> !',;; d
watej-s. Thev were in fashion in the pas;, with ho; water, and were
drunk for a cold. <ir when coming in from exposure to cuid. l-'e\\
middle-ai^ed persons cannot remember the eiderberrv svrup wluc
was made in every household: and verv nice it \vas a: lea-:
person t hiuks.
There are manv circumstances where fluid f'id is d''-;raMe.
\\"hat is most wantei'i is a knowledge of how to u'ive food-\ait;c to
meat-iiifusions; and on this section of the subject a murderous mis-
Upprehension prevail- at present, which may well be dis-ipate.
with advantage toad .-!<!< persons.
Koumiss.- A lluid food now becoming rather fashionable. ;
fermented marc.-' milk. Kari\ travellers in Tartarv sp->kc ..;' this
fermented mares" m ;tk as an intoxicat inu" di ink amon^ 1 lie Kalmucs.
Its intoxicating projtert ies are small as n-pi P is \\ e.-ti rn race-. The
casein of mares' milk forms the line, iloeeiilent cur,! characteristic
of woman's iin.k: contrasting \\ith the so,;d ciii'd of cows' mi k.
As a cure for phthisis, it ha- a di.-tinet reputation in the ea-
Knrope. I ))-. Cai'rick. of St. Petersburg, bad a number of ma:v
brought to Mi iLi'iaii 1 i and exbibitcl at South Kensington in 1-^1.
lie had studied, the matte] 1 thoroughly, and written a small i :\
on " Koumiss "( published by Iilaekwood and Son-). He showed
Koumiss made from mar"-' m i . k as on t he Steppes. 1 1 \\a- a pica--
ant drink with the curd in .-mail lloeeuleni ma-se-. \',\\\ . a- he ,
served to me -" I\oiim;-s is cumparat ivelv n-ele-- in a damp < .m-v
like Mnu'kuid, because a person cannot drink enii;jdi "f ;:. ( 1-1 '
arid Steppe-. wlM-i'e the evaporation of ;!u!d 1- ii'real, a <',< .--.i:--
per.-onean wit h i-asi- drink from lifteen \> < -.:/.-":i champagne o'la r; -
of Koumiss in a da\'. 1 nc,er tho-i' cireiim-iaiice-;
Koumiss are often very striking. " l-'rom tl'ii- ;; would -cei
is comparat ivelv useless to t rv Koiim:.-- cxcep: nn t i;e M .; . .-. i
fainlv in pvrexial state- :t may In- found a plea-ani ilr.'nk: a 1
esneciallv suited lo irritable eonditioiis o!' the -lomac'n. :,
interciirrenl gastric di.-i urbance-; of phth:-: ^vhci-e tii. :
rise of temperature. 1 n some ca-e- it - ^ i eil'e -; - a :> \ '< -r\ a i
CTTAPTET! Till.
I'KFSKKYFl) AM) CANNKD FOODS.
THE qualities and properties of foods arc n\ altered by the
moans resorted to for their preservation, at least to any material
extent, as regard s their food value. Still preserved foods rei|iiire
some attention in a \vork of this kind.
1'rohahlv the earliest method <>f preseryini; Food \vasa blending
of salting and drying. N (| t only was tin- pi_r so converted into bacon
and ham. luit the fattest o\cn were selected in October and salted
the rest lieinir turned loose to find their \vinier food as best they
eoulil. Mutton hams, too. were a delicacy. < Mi such salted pro-
visions the hulk of families in the country lived durini: the winter
month-. The piir. which could be fed on corn and the slops ol' the.
household, supplied the sole Fresh meat. IF the piir \vas no; at hand
(and in Scotland of vore the pi LI' was as objectionable as an eel) and
some fresh food was craved after, the cattle were driven into a
pound, and bled, and this blood was mixed with harlev. made into
a pudding, baked, and eaten. \Vheii the pi-' was slaughtered, the
blood was made into a "black-pudding" winch kept well for some
week-. Sausages were made of the fat and lean meat chopped to-
gether and Havored with saLi'e and othei' condiments. Uacon is a
f 1 of tlii- greatest value: the lean is apl to lie hard, hut the fat is
of the most excellent character. Il is easily digestible and agree-
able to tiie palate. It may be fried, as the rasher: and rashers of
bacon with fried or poached CLI'LTS is a stock breakfast di-li over the
length and breadth of F.iiLrlaiid: or it mav lie boi calen cold
with pickles. licyond that, too i';it liacon is used to lard fowls, nver,
venison, etc., to add to drv meat as ihe hare and rabhil (which
should always he ste\vei] w,th some pieces of fat bacon). ;ind to \eal
in a p:e. However, as a mailer of fact, it is if : . too little,
u-ed as an adjunct to other food. The inside fat of the pi^ is
" rendered " into lard, which is used in the making of pa.-trv. The
hams are a Favourite tood, and a slice o! eoM hulled ham will usuallv
sit ea-ilv upon the mo--t fa-! d <' -tomacli. In spi-akiuif of
Lfast I'it ;-." A:;-';n I- : '. aft' r recoinmi ndiiiL:' m;ik ami
PRKSKKVKI) AM) CANNKD K<>n|)S. T:',
farinae.eo s food, quotes Jaerond who was 1:1 favour "fa die* ,,
mal food. " He advises that the patient he encoura:_ r( 'd t" tak" *<<-
taiti kinds of food which arc supposed t" c\. ;;.. more than oih.-r
kinds, the secretion of gastric juice, and In- mentions boiled !;aiu as
part icularly eligible for that purpose." A thin -lice of tin 1 Van of
hoiled ham cut across the lihre. well mast icat ed , will n<> doiiiabe
tolerated hv a verv irritahle stomach.
Sausages are a verv toot h sonic form of food. As ord inaril v made
they an- known in London as ".-kin and mvsterv:" and the revela-
tions which come out at times about sausage inanufactorii's are cer-
tainly startling. Still on the whole they arc fairlv trust wori hv. and
their main adulteration is the bread crumb added. Ordinarv
Kntrlish sausages are a u'ood mixeil food.
Then there are foreign sausages as I'.olo^na. Strasburir. <lotha,
Leherwurst . and the toothsome (iui is Leberwurst made of the Boose's
liver. Thev arc all savoury ui a 1 manv of them rieh in fat. Thev are
suitable for persons with defective teeth, as the meat has all been
tineiv divided before heini;' passed into the skin.
All sausages which contain the tlc-di of the pi^. as will as baeon
and ham, are liable to contain the Trichina Spiralis: wh;ch is mdv
destroyed hv proper cooking. Trichinosis is speciallv found where
ham is eaten hut little cooked, if cooked at all in some cases.
Potted meats arc all savoury, from bloater paste up to /,
fun- <ir<i*. Thev are all liable to such manipulations as to allow "in-
to say of thorn, "am! things arc not what thevseem." /'</
<jri'.< often contains but a suspicion of goose's liver, for instatn'c. All
[lotted foods, whether iish, llcsh, or fowl, haw of course been thor-
oughly disintegrated, and as such are suitalile for dvspeptics. Tiiev
do not usuallv form the /ifi'n' </*' rt'sixtniif of a meal, but are savoury
accessories. Little tinv sandwiches of stale lu'caii, cut th;n and the
butter well I'libbed in. and then some potted meat added, will often
tempt a dainty appetite. Potted meats are u-itallv highly -ailed;
a mock jn'i/i' ill', /'oil' ill-it* made with larded calves' liver seasoned is
a very nice food. All these potted foods are '" reli.-hcs, " rather than
n latenal art icles of d let.
Pickled foods arc preserved by vinegar or hrinc. All kind
of Iish arc pickled in brine, especially herrings. They i'eot;:!'e 1
soaking in \vatcr before the salt can be -"; out of them. P.ck'.i d
l>ork is a ii'i'cat food with luiiiher-nien and ot liers who have to !av :n
stores of provisions. In the I". S. A. a winter with
with plenty of fresh air. exercise, and the fat pickled i--k. |
(4 MA NT Ah OK IMKTKTK'S.
to be a jrrand preventive measure in threatened phthisis. Mussels;
and ovstcrs are pickled in vinegar and are vcrv jiiras;int forms of
food. Hried ami smoked meats an- vcrv palatable forms of food.
Fish ivudilv lend themselves to tins process: kippered salmon are
famous, and so are "kippers" a form of split lierriiiLr dried.
'' /'///'/"// haddies" are \vcll known, and eijuallv so is the Yarmouth
bloater. The dried liaddoek is unobjectionable; Imt the other forms
are apt to upset the stoiuaeh. and can onlv lie sat'clv indulged in by
persons -who can trust their digestive powers. Kippered salmon
broken up small (after cooking) and mixed with mashed potatoes,
makes a capital lish pudding.
Pried lish of a common oi'dcr were one,' the animal food of
Kuropc in Lent. They require iiiucli soaking aiid have a low food
value.
Anchovies are hoth dried and pickled as well as potted. AH
anehovv 011 a beefsteak imparts a pleasant flavour to it. Anchovies
arc usuallv related to hot buttered toast, and hence arc not desirable
for the d vs peptic. ( 'a via re. the roe of the si uruvoii. is not acceptable
to all palates, but it has a hi^h food value of albuminous character.
Tongues are often dried, and when soaked and boiled arc -I'od
and palatable food. Cut thin across thevrain. toiiiruc is like ham
as regards its tolerance bv the stomach. The h'us.-ian tongues pos-
se-- unite a iramc flavour.
Vegetables. Sometimes vegetables arc preserved bv drviiiLT. as
seen in the vegetable matter prepared for .lulieniie Soup. Thcvare
sometimes also compressed as stores for tlcets and armie-. Thcv
reijinre soaking and then probabiv ditTcr little from their kind in a
fre-h state. Manv veirctablc matters arc p:i-kled as relishes to food :
notably the cabbage, the small onion, eschalots, jfherkius, cauli-
flo\ver, etc., all of which are trviuir to the digestive or"jans. \"e^c-
tables lend themselves readilv to the tinning or canning process.
Asparagus so treated has Ion LT been held in repute. The ////.* jmix
of !' ra lice are in i ilia t ure peas, not to be com pared for a moment with
the lai'Li'e marrowfat pea- of American production. These last onlv
reijiiire the addition of a little sui/ar when heating, to cnaldc them
toeumpete on fa i i'l v ei j ual terms with frc-h pea-. Lima beans are
also tinned and, keep well. Succotash i- a compound of the hiirhlv
nit roiT''iiiscd legume witli mai/.e and, rieh in fat. Mai/.c in tins as
" SiiL'ar ( 'orn *' is a beautiful ilitfc.-! ble dish, whether eaten with
suirar and milk, or with butter, pepper and salt. The baked beans
of New Knir'iaiid hold a hiirh o-ition as a food, no matter from
I'RKSKKVKD AM> CANNKD KOMI.-,.
what point of view they are looked at. Kach tin ,.,, ; .,
ol fat bacon bi^er than an t'L/Lr. 'I'll' 1 bean- an- so
cooked aiii! the fat intermingled \vith tin- material of tin 1 :.::
the hiu'h tempi-rat u iv at which tin-van- liaki-i ( wliii-h 1-
its etl'ect upon the stan-h). that they n-;nliiv di-inte-rat
month: while the fat is in a form wliich Drives iittie oil'i-n.-e
stomach, l-'or food value, for cost, tln-v stand \vrv hi-'ii. I-' 1 , i-; :..;.
they will come into votrue ere lonj; with persons who-e .-toinac;;- are
fast iilious aliout fat.
Vegetables are easilv stored, and a NO are easilv p;v-er\ ,.': ',.. : :.-.
us potatoes, carrot.-, turnips, beet, etc.
All .vv//.v c ;1 li |,c preserved lll'V, as those of the cclVuN ;il;d tile
legumes, and as such form a iarjj' portion () f til'' fond of man.
Fruits arc variously preserved. As prepared wi-h su^ar lv
lioduiu' thev have lieen spoken of before. The\ are a,-o bot;.cti,
and were at one time at least, lar^clv adulterated u,;h i-oppe]- to
secure a u r " () d LTi'een I'oloui'. ( )nee a ['!'u<ieiit man a! u a\ - |nit hi.- i !;-
knife into irret'ii pickles and fruit.-, to .-er \vlia' amount ,>: ,.;, pel-
was ilepositt-tl on the .-tccl. Olives ai'e la:'-jv,\ In.; ;;,. ;
usuaiiV eaten IM clear the palate before drinking ;';'. \\ .:.-. 'I'hev
are I'ldi ;n oil. lied fruits art- apt to be stained hv \"^\\ < <<\. Mi-
beetroot juice to impi-ove their colour.
Tinned or Canned Foods. Tinned fruits are i,,.
favour. Tin- apple, tin- pe;ir. the plum, the ^rape. the :;;:!:. ;
cherrr. the jieach. and u[irieot. all tin eapilaiiy. T
julilitiotis to the diniiei 1 tali'.e in winter and spr:n^. '
ai'e or cooked. Tinned cranberries are far super,": 1
astringent native, cranberries ol (in-at [SiMani.
Apple rin^s are also ^amniL;' favour with the !io;i-e\\ ;'e.
It ma\- be said as a rule that vegetable proiiu.-t-. tin o;- can moj-e
stieeessfuliv t lian li-li and flesh.
Tinned salmon, t hoiiLrh of -'ocd fond value, l.-^-k- : h-
fiv-h salmon. Tinii'-d, lobsters vary very much, n
to the length of time the ti-h has been in tiie can. A
lobster i- nut to be despised -when a fl'e-1 I,.:,--,
And tinned salmon will pot. or make a -.i,,, ; ; -
with ma-heil [lotatoes. (tther li.-h. a- ' !'bn'. cmi. n ,.
fi.-h. piiehanls. and herriiiL;.- tin. aii'i Him out ta r
The sanliiu- preserved in oil i- well known t| m
j^ood tish food, and mixed with it.- oil. \\ : a nrop
ter sauce, is ilecidedlv au r reeable to the palate.
7'> MANUAL OK DIKTKTICS.
small fish get mixed with the sardines, but tliis scarcely constitutes
adulteration.
There is one tinned fish, however, whose flavour is little affected
by the tinning process, and that is the shrimp or prawn. The
Barataria shrimp is delicious out of the tins.
Why the crab is not tinned not the small soft-shelled crah
which does tin Imt the ordinary crab, is unknown to me. 1'roha-
lily there is some technical dillicultv; also tlie eel, which would
seem a jinm'1 to he wdl adapted for tinning.*
In (Icrmany eels are pickled and sold in small barrels.
Tinned meats have established themselves over t he face of the
earth. Of course these tins of various si/es are most convenient for
stores. A small quantity can be used at once a great matter.
Whether beef, mutton, or pork, as a rule, it mav fairly be said the
meat is overdone and stringy. Minced meat is fairly Ood and nice,
and mixes well with mashed potatoes. Tinned tongues are really
very good indeed: the llesh of the tongue seeming to lend itself to
the preserving process very readily. Little .-beep's, tongues are de-
cided delicacies, and so are t inned sheep's tails. The hare and rabbit
tin moderately well. Turkey, goose, duck, fowl, and ^amc. come
out not amiss. Drawn is fair, and boar's head deeidedlv good.
I'ig's feet in tins eat capitallv.
Venison 1 have not had a sutlicieiit experience of, i,c., in tins,
to vent lire on an opmi< >n.
A . />'. One mat ler about tinned meats is never to be forgotten,
vi/. : t he i -MI it cuts of a tin ,-hoii Id be consumed as <m n-k 1 v as no-si-
. 1
ble after IM-IIIL: opened. \o food improves bv keeping after being
cooked, and this is speeiallv true of tinned meat-. The\- not only
beeoine mi palatable but even positively unwholesome: bv usin^- them
up at once the most is made of them.
Milk is now iargeiv preserved in tins, hoi h Swiss and other milk.
That sueli tmiieil milk is a great boon for town populations, and
SpeeialiV for vollllg children, there call be no doubt. K\e|| ill the
eountrv where milk i- not alwavs as easily procured as some mav
think, the tin of miik comes in very liandv.
Cream is more difficult to manage. I'artially de.-iecati'd --as
I )evon-lnre ( 'ream, it is well-known all over Kngland. ('ream is a
PKKSKKVKI) AND CANNKD FOODS. 77
highly nutritive bndy, verv rich in fat in an eiinii-innir-ed fiVjn.
Sonic tune a<:o 1 wrote to the .\V//- }"<///' //</"/'/ siiL r L r <'st ini: the
niiii;' of cream. An enterprising man in !<>\va sent me ma:.v -
pics; sonic tins turning out well, hut inanv until fur fond. I>u: ;h-
tiling could never lie relied upon, and so was cnmnicrciallv a fai.urc.
A Dutch linn seems to have been more successful liv an K.xhiblt in
t lie Inventories ( 1 xx'i).
The products .of milk, however. ;is butler and cheese, keen ad-
mirably. When luiticr has to lie kept, some salt is added, and how
lon^ salted butter will keep is unknown. It is a most digestible fat:
though of course, the object of churnim: is to uvt the fat out of ;M
eniul.sioniscd form. It is larir ( 'lv used eaten to bread, and is invalu-
able to the cook for her dishes and her pastrv. Melted butter is
eaten to li.-h. and adds highly to its nutritive value. Mutter i< de:ir
comparat ivelv; but it is an item of household expense that should
never lie Lrnidi, r cd.
It is a trrcat mistake to cut "' nnrscrv " bread-and-bntter thiek;
if the butter be sparin ir lv applied there is not enough of it ; if spread
l~.il 1
thick it revolts the stomach with delicate children of feeble dip'-ti\c
capacitv. The bread should be cut thin and the butter nibbed well
in. and then anv child can cat it ivadiiv vcs, and dip-st i; ton!
Bread-and-butter puddings arc capital fond.
Cheese is a form of food requiring some consideration. It ha-
the reputation of bein^ r most iiulip-stiblc:
This applies to the hiirhlv flavoured cheese eaten as the last course at
dinner. A nip of ripe (iorifonxola. or I'ochefort, or ('amembcrt. or
N'eufchatcl. or even Stilton, ('heddar, Cliesliire, or double (llouce--
ter, after dinner j)rovides a fatty a<-id which aids the cmulsion;-:n--
of fat in the alimentary canal. P>u; this is scarcely the consider;
t ion of cheese as a food. ( 'heese is largely eaten as a blending of :
and relish, bv persons with whom cconomv is a matter of mo:i.i-!i:.
It is either eaten as it is. or cooked. A: one time every I'anne:-
made his o\vn cheese, for home consumption at least. \"\v clicr-i
factories make, as a rule, so much heller cheese at a moderaie pr
that chcesc-makiiiLr i- no longer p'lieral with farmer-'.
A ski in milk cheese was a t<>tii:h all'air. but a hi^hl y conccir i
form of albuminous fund. A cheese made nf fiv-h milk, cni; 1 :
a lar^e proportion of fat, while "cream-cheese" coiit;
casein.
, s MANUAL OF IMKTKTK'S.
('asoin softens under heat, and toasted cheese, or Wi'lsli rarebit
are sapid and savourv morsels, soon falling awav if kept hot: indeed
it is \vell to wait a little for them rather than to keep them waiting.
They are reputed to he indigestible, and certainly are so with some
person-. Other stomachs, again, tolerate cheese; and there are horn
"cheese-eaters" as well as ' ' cheese-haters. " to t he one cheese is a
poison, to the other it is most acccptahle. To the latter even when
dyspeptics, cheese need not he forhiddcn. A great matter is its dis-
integration. Kinelv grated in soup or even hoded macaroni it is un-
objectionable. Macaronic cheese done in the oven, or lie fore the tire
requires stronger digestive powers. If hominv he well hoiled, and
then grated cheese with milk mixed with it. and the whole put into
the oven to brown, a delicious digestihle dish is the result. Crushed
cereals, shredded mai/.e. samp and broken hiscuit so treated with
milk and cheese, are admirahle food sol' high food value, savoury, and
tinallv. digestihle.
Cold cauliflower and vegetable marrow served up with cheese <iu
iiratiti are very good; wliile StalTordshire folk frv cheese with bacon,
and for this end prefer a crumby cheese not otherwise in favour for
culinary ends.
CTIAPTIvR IX.
IMJKI'AIIKD K<>nl>s.
]\\ '' prepared foods" here is infant the foods which art- sold f.>r
babies and invalids. To Lii-lii^, ainoiit; :< * min-li nioiv re|aiin-_; to
food, we owe t he i lit nxl action of I'm nU specially prepared for infa nt s
The food uf tlic newl y-boni is milk: but many attempts ha\<- lieeti
made to substit ute for it, mainly "i 1 in part, other I' Is; the motive
beini: in some cases cconomv. in iithiT rases the ditliciilt y ><l |ir<n'nr-
inu' milk in siitTidcnt ([iiaiit it it's. Smuct lines the niotin-r muld noL
Sllrklr tllf child, InMllU' ill, Hlld Si il 1 1ft 1 lilt 'S licad.
15 y what instinct |irrsms xvere led to i-hoctsc the ci-ust and -ule , ,f
the 1< iaf to Itoil for l>al ties' t'nod. i -an nmv only lie a inai ler oi' speenla-
tioti. Ai'tef t IIO|-OUL;-II liodinn' i he water was |ioui-ed \\ nii>i'e or ies.-
eoniplctely, and some milk added. The outside of the loaf i- the
part most thoroughly exposed to the baking process, and [herel'ore
in it the standi is most colliplelt'ly cuiiyerted into ,-oluliie dextrine.
SiH'h cai'bo-hydrate matter with some tVesh cow's milk formed ;i
yei'y complete food. lit it such " pobhs. " \vit h oni y a 1 it t ie .-ti^ar in,
is a poor food: ;ind the marvel is that such lusty infants eyer were
raiseil on " pobbs " as undoubtedly liaye been the ease in I he ai;'r;eiil-
tui'al districts of Kn^land and elsewheri', where miik is not ea.-ily
[iroeiireil. How, and by what means ine ^I'owinu' oi'L:'aii!>m has
secured materials for tissue-growth out of this improiiii.-iiiLr food, i-
a mysiei-y, when looked at from a seient itic jio.nt of y'u-w. Then
came rusks ami " tops and bottoms." all howeyer. maile unh tine
Hour, and lackinu' the .-aits and albuminoids of the lu'an. Then
came the introduction of malted [)reparations.
Something has been said before about the preparation of ma
extracts, and this need not lie repeated here. The \\-on is e\ aporaie
down to the consistency of honey, and is a sticky and iron-.!
f 1 to handle; albeit a lieatit i fill food. Asa mere food, v,
any dia.-tasic activity, a iii'\ preparation like Meiiin"-
way preferable. There are do/en- of siicii foods n the n,a: - :\
yery ^ood foods they are, too. They arc < specially . -
Si) MAM'AL OF DIKTKTICS.
to milk for adults as invalids and dyspeptics, and to a little milk
and water for babies.
( 'omliinat ions of liaked flour and malt are no\v sold by the hun-
dred as tallies' and invalids' foods. They varv somewhat in com-
posiiion. Some contain more malt than others: some contain some
desiccated milk. No doubt these last are the most complete foods,
as from the milk a certain amount of fat is present. They are also
most palatable.
I'll iv malt in fine powder must soon he a regular art iele in the
market. It is economical as compared to t lie malt-extracts, fluid or
dried, and contains much more diastasic activity. Added to liaked
flour in quantities vurvinji from one-third malt flour to two-thirds
of !>aked flour, up to half and half, and then hot milk either poured
on (for a pudding) or added for a drinkable food, malt can he made
most useful. (! round malt. too. contains the husk of harlev and is
rich in phosphates. Maltose, dextrine, soiuhle albuminoids, and
phosphates, all are there in a very palatable form. Only fat is lack-
ing. And that can he <rot too. in theuvmor hordeatus, and in
oleohyne: hoth of which contain milk-fat in eonsiderahle proportions.
The ordinary prepared foods in powder are legion. There is
one in MM! t him; about this, and that is. there is choice and variety.
One form is unpalatable to a l>al>v or invalid, while another pleases
the palate. The palate Arrows tired of one food, then trv another
fora change. .Monotony is the curse of all dieting, and should he
avoided as far as possible.
A medical man should not be wedded to one food, but should IK;
more Catholic-minded. This is a matter far too little considered,
and yet it lies across the very threshold of resort to prepared foods.
C'liaiiLTe about from one to another just as you expect your cook to
cater for yourself.
Say for breakfast the invalid has some milk and Mellin's food;
at eleven oV]oek some whole beef tea with baked flour in it; at,
luncheon a milk pudding, made with broken captain's biscuit, or
other biscuit: at tea-time some chicken broth witlt .-Invddcd mai/.e;
and at -upper a digestive biscuit and butter with a Lrlass of sherry.
IJv attention to these items but verv important items- -the invalid's
dietary could lie made acceptable instead of revoltinir. as it too
often is.
When I read of I >r. I >avid Vandal! fasting when ill with typhoid
fever. I knew -Mrs. Vandall's capacities as a housewife too well to
suppose for onu iiioiiieliL that monotony in food was the cause of Ins
fast MILT: and th;it his conduct would cause dire d<im< -;'- ^\- '. '. | ;
IIUIMV an invalid hungers, partiallv a! iea-t becau-e he ii'
vanetv. \ ariciv indeed isopnte as acceptable to the in\aild ;.:.'; :i..
d vspept ic as to anvonc else; and halne- IK, doubt ha\e tii'-.r '!:" .
about food just as much as their cider.-. l>e>-ause tiic poor
t li in:: cannot tell us what it thinks, it is nut therefore iin-r-si; \ '.<>
assume tliat it has not its thoughts, and these it communicate-: bv
its rejection of one food and its delight in aiioihcr. A \erv VOUIIL;'
habv can reason. I ri'ineinher once seeing a voiulit'iil mother uurs-
in<r her lirst hab\ . and put t MIL;' t lie tnout h pieee of her feed m^- iidt! ;
in the haliv's mouth and \vonderiiiL: whv ;; \\ouid not suck. The
bahv u'ot nothing hut air when it dni suck, and so ahandoiied the
ctTort ; it did not, want air; it wanted milk ! On directing her how
to have the teat lilled with milk In-fore [uittinir it in the hahv'-
Jiiouth. it suckeil awav famouslv. and developed into a lu-tv cli..-,
promisiiiLT to Li'row up into an ustutc ^'orkshircmaii. So wiiii ;iie
jireparcd foods, one Itahv likes a ^omi share of malt in the " food."
while another prefers a certain food in whi'-h there is little or no
malt: while another a^ain delights in a food in which there i> a
certain admixture of leguminous ilour. Tastes thev have, of cour.-e,
and preferences like other and older folks !
And of course the same individuality of taste and palate belong-
to d vspept ics and invalids. llccanse one form of prepared fnod .
distasteful, it, does not follow that all are. If there existed a little
more M t i vent ivciiess in nurses there would IKH he so much complain:
of moiiotonv of food on the part of sick persons. \\lu-n the /// ,
consols solelvof milk and sclt/er water, heel' tea and calves' foo;
jellv. is it any wonder thai the palate is palled ? And vet this is the
complete raiiLiv of invalid cookery in manv households. .\,>; id!.--
a^'o 1 was in companv with three Lfeiieral prad it loners two. fair
^ooil aN'erau'e specimens and one decidedlv far ahove l he ax'erai;' 1 '.
and they could ^o no further. It was txilv tK> clear that thev \\i-re
not in a position to all'ord much surest ion as to the dietaries <''
their pat lent s. Thev ail an, -we red "slops " to m v lead MIL:' '|i <<-;!<:;;
Inn t heir acquaintance wit ! i "slops " in concrete form- was i;m ; ed.
N i"et there was no reason to suppose them -pec, ally i;_rnrant U \ :
t heir fellows,
I'lvcrv medical man oiiLfht to trv the \anous prepared foot]
varioii- wavs, so as to pei--oiiall\ unilcr.-taiid nha* he
about when .-peaking of various fom';-. (Mhevu -e he v;'
dou;" on the subject. 1 \\i-h mv acijuaintai.ce u.:i. ;..
>'_' }IAM'AI. OF IMKTKTK S.
prepared |Y>< ><ls of tin- I'nited Stales was ativt hiiiLT like as extensive
as ii iv knowledge of tin- prepared foods of (livat Britain, for then I
could speak fivclv on the diU'erent form-. 'I'o ineiitioii those I
happen to know, \vould exclude iiianv of \vliieh I have never heard,
which inav lie etpiailv ifood.
All sweet foods containing malt :_ r <> best with milk: while plain
baked (lour suits be-t meat-infusions. l,ent;i preparations have a
strong llavor whatever mixed with. Tea llmir is best with meat-
infusion a- tlie " brose-ineal " of Scotland. The hiv;h!v nit ro^enised
character of all leguminous Hours renders them suitable rather for
the halo than the sick. And much the same mav be said about
oatmeal, as it does not airree as a rule with a sick stomach. Its
richness in fat has something to do w;tli this, ;i nd a fattv aenl is a])t
to be breweil therefrom in many stomach-. It is the fat in oats and
maize which makes them objectionable with manv. live is a pleasant
addition to wheaten llonr to the fancy of nianv. as seen in the pum-
pernickel of ( iermanv, and tin- brown loaf of the North of Knv;land,
especially in the farmhouses, where brown bread and skim milk
cheese are lai'LTe factors in the dietarv.
Prepared foods, which contain a certain proportion of desiccated
milk, have a hiifh food value, and require only water (witli a pinch
of salt) for their culinary treatment.
There is one form of prepared food which is, so far. uniipie. and
that is the eremor hordcatus of Loeniund, which is made from the
best cream from selected herds on the r,avari;;n Aips. depn\ f ed of a.
certain amount of water and prcser\ ed by malt extract. This highly
palatable food is excellent in its food properties. Ii contains somo
album moii Is. :i considerable quant it v of fat . and some ear bo- hvil rates.
It can lie eaten alone, and in certain cases where the stomach is
irritable and contracted, so that oniv .-mail quantities of food can be
tolerated, a piece the si/e of a ha/el ni;t mav be taken everv hour.
For an invalid in lied this is quite Mitlicieni to keep up the strength
until the .-lomach is well eiioirj'h to hold a larger bulk a! once. ( )r
it can be used to coll'ee or tea. and, i- especially indicated in those
rases where cane sii'_ f ar irives nsi- to aciditv.
( )f like character in t he mam, i- t he ni-u- food called " oleobvne,"
which as its nan e nd eates is a conipmiii'i of fat and malt. It also
is verv palatable, with a hiv/h food \aiiie. I;- fat !- in an emul-
-ioiiised form, and therefore very ili-je<t il'li-. x :: -ii food- are adapted
to per-ons who.-e 1 1 s - ii e - require more fat and vet \\lio dislike cod
liver oil. --;i very larirc coiiimiinity. l-'or persons of phthisical ten-
deney these f'onds are snitaMe. while tliev keep \ve!l. !'!
to lie thrown much i!|K>!i ;i meat dietarv. as mi huntiliL: c\p,-.,
should lliake the-e foods part "!' their -It ire-. 'I'll'-', a.-'
dicated for persons with incipient llri'j lit '.- di-t-a-e. a- :,ot i>. -.;
hi".'hiv charged \vitli nitrogen. Another admixture of oii and ma;
is " kepler," \vhere the oil is incorporated with ina',1 extra'-;.
Then there are coil liver <>;! eiiiiil.-ions ;,, !,, con.-idei-ed. Tin--.-.
of eourse. contain onlv fat. and that IP. tin- form of olcine :!,. n...
digest il>]e. luit otherwise. j m>l >a 1 d v. tin- lea-t valuaMe form of fa;.
(1 ..... 1 coil liver is fro/en to p.( nut tin- strarilie. aii'l a- 1 ni'ich of '!:'
jialiiiitine as possihle, the remaining ihinl linn^r MTV pur.' t.'.^n,-.
Such fai is often di^esteil \vheii other Fats, as animal fat and l>u:;er,
;ire rejected. Nolhini: is ea-ier than to make an eiiui!-;o:i u-;t:i anv
fat. suet, or oil. I>ut the ilitliciiltv is !<i make an emulsion ;li;,: \v'!l
keep an indefinite time. If a pancreatic preparation is u-ed. the
tendeiiev is, for the ferment to act upon the fa I. and .-p'.it some of
it up into fattv acids. matters vei'v irritant to tin- stomach and not
especiallv welcome to the palate. There are maiiv such prepara-
tions to lie lioii^ht: and when they are ivadilv [irocuraiiio i-ji-n !
hoii^ht as reipiired in a t'airlv new and fiv-di state.
There has deeii a prejndii-e. and a strong one too. alu'oad aliout
prepared foods. l-'irst announceil as " liahy-foods " and used for
infants, the pu hi ie did not seem to not ice the "and invalids." wii.'-ii
in manv instances follows the " hahies." Advancinu' k: owicd^.- !-,
howe\-er. hreakiiiLT down this prejudice, aiheil sj n \vlv. A more
^enei'al recognition of the value of soluMe carlio-h vdrates. ..-h,.;-
than cane or licet su^'Jir. on the par! of the medicai profe--;on. -
desirahle: and u'heii svsteinatie lectures on foo ! and d eie;
u'lven, everv voiuiu' medical man will understand the \a;;;
dip-steel t'ai'inaceoiis maiter-. and I heir litue-sas food ;n all
weaklv digestion, (irape siiu'ar is the food of the hodv an.d mu- 1
.-ulied to a certain extent evi-rv dav. 1 !id:u'ested starch !:an:>:
I'rejiared foods wit h pre-d iu'ested March mu-t '-"me mo
the dip'-t ;ve powers fad under the mental -; ra ;n of ; ;,,-
and the si ill greater -train of the future. I'l-fpar--,!
kind- thai have heen suhjeeted to a h:_ ! i iempei-ai iii'e.
loods ot farinaceous origin, must lari;'eiv iai\e the p.a'-i
in the kitchen. Soln'nle preparation- of meat, ilia:
mii-cnlar liln'e ha- hei-n I lioi'oiiLi'h!'. d> 'Crated, a
sideral'lc ouantities of solul'le cari'o-liv
Si MANTAI, OK D1KTKT1CS.
Hy varying the soluble meat and the carbo-hydrates, variety can be
_U'ot, it' not a very wide ratine. Then where the stomach resents fat
floating about in it when at work, the fat ean lie taken when the
gastric activity is over, as ereain. or emnlsionised fat artificially
prepared. Such a selieine of dietary is not very attractive; but
then we all know that we must cut our coat according to our cloth
not according to our liking.
CTLVPTKH X.
ARTIFICIAL IUCKSTIYF. .UJKNTS.- ARTIFICIALLY HI-
X KtT.ssiTY is tlic mother of invention, savs tin- n'-d saw. Ar.d
failure of the digestive powers has led i \ he adopt inn of artiticial
digestive agents. First the chemist sei/ed HJH>H the diastase of the
seedling to help our human saliva. Thru In- appropriated t In- dip-s-
tive aiient in the piir's stomach and utilized it for the needs of man.
Hence pepsin in its various forms. I'inallvon discovering the func-
tions of tlie pancreas, that visnis was enlisted as furnishing a m<i.-i
useful recruit to the ranks of the artilieial digestive agents.
( If the act ion of diastase upon starch, enough has In -en said, hot h
as to its action and ho\\- to make use of it in practice. \<> more
re<piircs to le said. The diastase, or rather the matter containing
it. can he added to the starchy food: 1. he fore hein^ taken into the
mouth: or. '.'. while lieiiiLT taken into the mouth: or :!. ;mme iiatelv
after the .food is swallowed so us to ud liefore the stomach hecomes
too sti'on<r]v acid for its operation.
i\'e qualities upon al liiiminoiii matcna s xuetv. I; ;s put
up in a lluid form, in the powder, in pills, and in tahlets. li ;- ;m-
possihle to express anv opinion upon the resjiective merits of t he
liill'eren; form-. Tin- matter is to secure a ^ood anl poteji! prepara-
tion. The pill- and taMe;-- have the advantage of iieinir reai'mv
swallovvcil. The [lalate is not oll'ciided. [hat is one matter. '1 ii^n
t hei'e is anot her. There are maiiv iiersons \vhose diu'c-tion need-; a
little help, who are vet \vel! enough I" visit and dine out. a!id ;t is
under these circumstances that some artilieial digestive :; .. ,- n;o-t
neccssarv. A hollle of till id, is out of t he ijUe.-t Ion here. '.;;; ;
pepsin pills or lahlcts can easilv he cai'ried ahoii! : and o;ie -r more
taken at t he tahle wit houl at t i - act in^ at tent imi. l-'or -uch : <~'.;\
pills and taldets are adm;ra!>;v adapted, and ai'e a>-. ';
patroiii/ed. Iiideed !iv such, means and nica-n ;- n,;i
e n a hi ed to d i n e i n com pa 1 1 \ without a t ; r - a t : : i ^ a : :
i he rejection, of careful selection of their food, or ii
M- MAM'AL OF 1>I KTKTK S.
i<> digestive aids: both exceed ili;/iv unpleasant for nervous persons,
\vlid arc verv liable to In- dvspcpt ic.
Where a meal is taken alone, it is a matter of comparative in-
difference in what form the pepsin is used.
Then coiiic jianeivatie preparations of all kinds and varieties.
SD far. we have Keen most familial 1 with tin- lluid preparations
recommended liy Sir William Robert.-. I-'. U.S. . <.f Manchester. The
pancreatic lluid ha- a larp' ran;_ r e of dilative activity. It trans-
i'onns stareli into ,rape su^ar: it digests albuminoids (in an alkaline
medium): it curdles milk, and it emuisioni.-es fat. The ilitHculty
about it is. h"\vever. that it is inoperative in an acid medium. The
acid stomach lies betwixt the- mouth and the duodenum the area
where the pancreatic secret ion exercises its action. I >r. Roberts met
this ditVieultv by placing his Liquor 1'ancreat icus under the protec-
tion of an alkaline Lruard, in the form of li> or '.'it Drains of bi-
carbonate of soda. I Jut the soda has a tilthv taste, and renders the
draught most otl'eiisivc to manv palate-. It has seemed to me. in-
stead of soda and water, it is well to ^ive the pancreatic ferment in
a iriass of milk with as mucli prepared chalk, or li^ht magnesia as
would lie (Mi a sixpenci about tin- sixe of a male thumb-nail. This
is a far less outrage on the palate. It i< a preferable form of alkali
to mv mind. 1>\ waiting until the aciditv of the stomach is ex-
hausted ere j/ivinir tliis draught, less a'.kaii i- reniiired. and the
result is more certain. The aciditv of the stomach wanes as gastric,
digestion reaches its completion; and there is little acid left to neu-
trali/e aliout an hour and a half or two hours after a meal. Thi- is
the time to select for the artificial pancreatic digestive a;_rent to help
out t he nat nrai |>ancreat '.< secret :on.
The -ante principle of action must 'nude us in the u.-e of pan-
1 > I
erratic agents whatever their fonu: and other than lluid pn-para-
tiotis are aireadv beini: manufactured.
Combinations of ; ; :" several diirest ive airents on t he " shol-^tin "
principle are iai'^elv sold. I'liplivsioloLfica! a- they appeal' thev cer-
tainlvare often useful. "If the . - misse-, t'other hits." That
is the principle. If the contents o! the -tomach lie still acid, then
the ])cp-in come- in u-'-ful. If the fooii be pa--:iiLT the ]iylorus, and
eomil:^- into eolil ' ' ; '. : le- of t hi' bile, t lie|i the
pancreatic product- arc ready for action.
Such th''ii are i '.'. the artitic ; i] _ - ve avfent-.
\o\v a- i" [iredi;_ r e>ted 1'uods. Mnou^h ha- been .-aid about piv-
a rui-. a iv !,au.-fii;
fill, i'Ut inv i-xjM-r.
nit ;:ivui\ th-- i 1 "!.
]i;<>r>- I'avuraii!.' t"
u''ijr.-u<i!;a!>.''. i", :.
': ii:a<i' |ia.ata:'!'-.
I'l-ln-ral .-ta'f < :' \v--aK '. .
lift\Vc.-:i ra ---- V,':..-! '.- lii.- -'. .Ili
hvt-r is t'i :>".ai::--. I :: .-tat--*
SS MAM AL OK HI ATKTK'S.
Sonu' description of them becomes essential, as there are eases
where they are required. Hut whether great gastric irritability
existing is an indication for their use is a moot matter. 1 am not
aware that it is pleaded that peptones sit more easily upon tho
stomach than proteids, though it may eventually turn out that such
is the case. Here it is rather a <|ucsti<m of hulk than of anything
else. Small quantities at once of whole heef tea. with some baked
Hour, malt extract, or milk with or without some soluble carbo-
hydrate, should be tried. Kspecially in gastric catarrh is this desir-
able. If anything approaching solid food be taken then, as it is
rolled over :n the stomach, it becomes coated with mucus, and so
forms an utterly indigestible mass. Here peptonised milk niav be-
come useful as no longer undergoing or requiring the curdling which
might transform ordinary milk into something of a solid. In gastric
nicer predigcsted food would pass readily through the stomach and
occasion little movement, and would do away with the pain caused
by the muscular contractions dragging on the base of the ulcer. The
presence of the acid of the gastric juice irritates the raw surface,
and vomiting relieves the stomach at mice of both acid and move-
ment, and so immediate ease follows. The circumstances, under
which resort to [in-digested food is indicated, can only be broadly
spoken of here, and must in each ease form the subject of private
judgment upon the part of the medical attendant. After such cau-
tions and qualifications, some account niav be ^iven of the means
of preparing them: following upon the lines laid down by Sir
William Roberts
In peptonismg, or partially digesting fond by means of Liquor
Pancreatielis, it is important to remember that the liquor must not
be added to food of anv kind at a higher temperature than 1)0-'
Kahr. This temperature can be estimated with suHicient accuracy,
should no suitable thermometer be at hand, bv last MIL:'. If too hot
to sip without scaidinir the mouth, it would entirely de.-trov (In-
activity of (he liquor panereat icu-, and mu<t be allowed to cool to
that, point before ,-ueh addition is ma le. Tins rule will hold Li'ood
with oilier pancreatic preparation-.
Peptonised Milk.- A pint of milk is diluted with a quarter of
a pint of water, and heated to a temperature of about 1 )ii Kahr.,
(Mi ( '. ). Or the diluted milk mav he di\ ided into t \\ o equal portions,
one of -i\h:ch may be heated to the boiling point, and then added to
ARTIFICIAL D1C.KST1VK A<,KNTS. ^'.1
the cold moiety; the mixture will then be of the required tempera-
ture. (\\earenot told what is the temperat lire of the cold portion.
but we may assume it is below M> l-'ahr.) Two or three teaspoon-
1'nls of liipmr pancreatieus. together with ten or twenty grains of
bicarbonate of soda (about half a small teaspoon fu 1 ) are then mixed
therewith. The mixture is then poured into a covered jiiir. and the
jitir is placed in a warm situation under a cosey to keep up the heat.
At the end of an hour, or an hour and a half, the product is raised
to the boiling point for two or three minutes in order to arrest any
further digestion. It, can then be used like any ordinary miik.
The object of diluting the milk is to prevent the curdling which
would ot herwise occur, and greatly delav the peptoni>inir process*
The addition of bicarbonate of soda prevents coagulation dnnm-:
the final boiling, and also hastens the process. The purpose of the
final boiling is to put a stop to the ferment-action when tin- has
reached the desired decree, and thereby to prevent certain ulterior
e ha Hires which Would render the product less palatab'c. The de-Tec
to which the peptonisinir change has advanced is bc-t ascertained by
the development of a bitter llavour. The point aimed at is to carry
the changes so far that the bitter taste is distinctly perceptible, but,
is not unpleasantly pronounced. The extent of the peptoni-m:^
action can be regulated either by inereasinLT or decreasing the dose
of hipior paiicreat iciis or by increasing or decreasing the time d tiring
which it. is allowed or permitted to operate. liy ski in mini: the m ; Ik
beforehand, and restoring the cream after the final boir.n^', the
product is rendered more palatable and more milk-like ;n appearance.
Peptonised Gruel. (iruel maybe prepared from any of the
numerous farinaceous articles which are in common n.-e, wheaten
Hour, oatmeal, arrowroot, sairo, pearl barley, pea or lentil llour.l
The irruel should be well boded and made thick and strong. ''
is then poured into a covered JULT and allowed to coo] to a tempera-
ture of about 14" l-'ahr. Li'pior panereat ieus is then ad'ieil, :ti the
proportion of a tablespooiiful to a p;nt of ^ruel, and the jn L
warm under a cosev as before. At the end of a couple <
the product is boiled and finally strained. The action of the pan-
creatic extract on irniei is twofold; the starch of ;
: Ma v i ioi i he mat ter e-o 1'ar to expla in I In- i < M> iy o ;_- i : ,,
dilute,! \vit 1 1 an alkaline \vatei' as coin | >a rei I i o | ii.o n mi 1 1\
t In accui'dallce wit li \\ I i;il li;i- 1 u ;i i I a ! 'iiu' in-i-!'-il 1 1
h;i- aii-eaily b-rii expo-eil to a liin'li li-ni|n-ral lire i- tu !, .'-n
here.
9< MAM'AL OK DIKTKTK'S.
verted into sujrar, ami the allmminoiil matters an- peptonisod. The
conversion of the starch causes the jrucl. however thick it mav have
liceii, at Martini:, to become quite thin and \vatcrv. lVptoni/,ed
Truel is not LTenerallv. by itself. acceptable food for invalids, but in
conjunction with peptonised milk (peptonised milk-Lrrnel) or as a
lasis for pcptonised soups, jellies, and blanc-maiii^es it is likely to
prove valuable.
Peptonised Milk Gruel. This is the preparation with which
Dr. Roberts has had the most experience, ami with which lie has
obtained the most satisfactory results. It mav lie regarded as an
artificially digested bread and milk, and as forming bv itself a com-
])lete and highly nutritious IViod for weak digestions. It is very
readilv made, and docs not require the thermometer. First, a ^ood
thick irruel is prepared from any farinaceous material. The irruel
while still boiling hot. is added to an e<|ual (plant it v of cold milk.
The mixture will have a temperature of about, 140 Kahr. To cadi
pint of this mixture two or three teaspoonfuls of liquor pancreat ieus
and t went v grains of bicarbonate of soda, (half a small tcaspoonfnl)
are added. It is then kept warm in a covered jui: under a cosev for
a couple of hours, and then boiled for a few minutes, and strained.
The bitterness of the digested milk is almost completely covered in
the peptonised milk-^ruel, and invalids take this compound, if
not with relish, without the least objection.
Peptonized Soups, Jellies and Blanc-manges. l>r. Uob-
ert- has sought to _tri\e variety to peptonised dishes by preparinir
soups, jellies, and blanc-maniU's, containing;' peptoniseil elements.
These contain a larire amount of digested star<-h and iilbuininoiil
matter, while possessing excellent flavour, and which the most deli-
cate palate i-ouid not accuse of ha\inu' been tampen-d with. Soups
were prepared in two wavs. The first wav \\'as to add what cooks
call "stock " to an eipiai quantity of peptonised ^riicl. or peptoni-ed
milk-L r niel. A second and lieitcr \\'ay was to use peptonised lyruei.
which is (jiiite thin and watery, instead of simple water for the pur-
pose of extract! HIT shins of beef and other materials cm ployed for the
preparation of soup. Jellies were prepared simply by adding the
dm- quantity of p-chitine or isiiiL f la.-s to hoi peptoni/ed u'ruel. and
lluvoiinntr 'he m i \t 11 re accordiiiLT ' o taste. Dlanc-ma n^cs were made
bv treating pcptoni>ed milk in the same way. and then adding
cream. In prepannuf all thc-e ili-he- ,t i< absolutely necessary to
complete tiie operat ion of peptomsinu' the ^niej , ,r milk. e\ eu to t he
lina! boi'inLr before a'Mini: the stilTeiiinu inirredient. I-'or if Honor
Airi'iKK i \i. !>!<;KSTIYK M.KVIX. :]
pan>Teai I'Mis l)c allowed to act on tin- Ll'elat 1 lie. tin- '_feiat '',">
undergoes a process of digestion, and its power of -cttMi'j' <>r
iiiu r is nt tcri v abolished.
Peptonised Beef Tea. -Hail' a pound <>!' tin
beef is mixed with ;i pint of water and twenty grains of bicarb,
of soda. This is simmered for an hour and a ha.f. \\'ln" :
cooled down to 140 Kahr. . a tabicspoonful of ; he im M. .) pan- n-at ..
is added. The mixture is then kept warm under ;i cosey for tuo
hours, and occasionallv shaken. At tlie end of this time, ihr liquid
portions arc decanted, and boiled for live minute-.-. I'.eef tea pr--
pared in this wav is rich in peptones. I: contain- about J.'i per
cent, of organic residue, of wli;ch more than three-fourth- eoii-i-
of peptone^, so that its relative value in regard to nitro^eni.-ed
materials is about, equivalent to that ot milk. \\ hen seasoned with
salt it is scarcelv distinguishable in taste from onlinarv beef tea.
Another way. One pound of tineiv minced lean beef j~ mixc.i
with one pint of water, and simmered for an hour ami a half. Tin-
result MIL: beef tea is then decanted oil' into a covered jiii:'. The un-
(lissoived beef residue is beaten With a Spoon into a I'll, p or pa-tc,
and added t<> the beef tea into the covereil ju^(wlioie beef tea).
\\"hcn the whole is <-ooled down to MU i-'ahr. (or when it i
enouirh to be tolerated by the tuoutlf) a tables] nfui of the ,
paticreatieus. is adiU'd, and the whole well stirred together. The
covered jii'_r is then kept wai'in under a i-nscv for two hour-, at the
end of tins time the content- of the juir are boiled brisk Iv for t \\ o
or three minutes, and (inallv strained. ;; is then rcadv for u-e.
The extreme solu!)ilitv of digested product-, whether r-tarch or a.-
htiminoicls. detracts from their acceptability |o the heaithv. T
them tiiev a|)|iear thin and waterv. tln-v miss the scii-e of .-uli-!:in <
and solidity, which is cliaracteristic of their ordinary food. Ui; 1 '
the weak in\ a! id wit bout appetite, this sense of -ub-taiice or t ii \- -\\>-'
MIL;' is generally an objection, and they take with more ea-c a M a. :-
lias beell lliade. then the Si
reli-hed.
The Use of Liquor Pancreaticus as an Addition to
Food shortly before it is Eaten. < crta
useii i\ invalids, farinaceoiis j-ruci-, m;,i\. !ii - c:l4 ;'i
tla\ on red with tea. or ci ilTee. o
MANUAL OF DIKTLTM'S.
up with the warm food as soon as it comes up to table. And such
is tlio activity of the preparation that, even as the invalid is enpisjed
in eating if lie eat leisurely as an invalid should a change comes
over the contents of the cup or basin: the Li'ruel becomes thinner,
the milk alters a shade in color, or perhaps curdles sot'tlv. and the
pieces of bread soften. The transformation thus he^un s^oes on for
a tune in the stomach, and one may believe that, before the iiiistrio
acid puts a stop to the process, the work of digestion is already far
advanced.
The food should be cool enough to sip before the Liquor 1'nn-
ereaticus is added, else the ferment is killed.
Peptonised Enemata. Such peptonised milk-irrnel as has
been described, is adm irably adapted for cneinata. Here the palate
has not to be considered, and monotony is not distasteful. IVp-
tonised beef tea. with some soluble carbo-hydrate may he used at
times. l)iit the fat in the milk makes the milk-uTiiel more desira-
ble, in theory at least: for how far fat can be taken up by the larsjje
bowel is a matter on which the writer knows nothing personally,
nor. on enquiry, can lie lind anything to favor the view of fat-
absorption by the lanre intestine.
There lies no objection to peptonised preparations for enemata
on account of their taste. and%an enema of peptonised beef ten,
with anv of the prepared foods consisting of soluble carho-hvd rates,
would be easily prepared in any household, however humble.
There are other preparations than tluid pancreatic preparations,
and the following are from the instructions furnished by Messrs.
Faiivhild. This form has its pancreatic preparation in the form of
a powder I'J.ft rui't a ni I'd n/-/-riit i<. It is sold in u'la-s tubes, each
containing live grains of the Fxtraetum, and fifteen grains of bi-
carbonate of soda. (Thev are sold in boxes of one do/en). The
contents of one tube will digest one pint of milk in half an hour.
The procedure is simple: " Into a quart bottle pour \\ pint of
milk, a (jiiarter of a pint of water, and one peptoiiisinir powder.
Let this stand for thirty minutes in water as hot as the hand can
bear, and then boil for two or three minutes. It is then ready for
use. and should be kepi in a cool place. "
In-tead of testing the temperature by sipping. - I >r. Roberts'
plan Messrs. Fairchild prefer the hand: either is a trood ;1 |id ready
test. From the evidence Messrs, l-'ain-hild have lieen alile to collect,
t hey are st ronirly of t he opinion that peptonised food is more readily
borne and tolerated by the stomach than food not prcdinvsted. They
n
s;iv (if peptonised milk- "It is retained
cspeciallv of the digest he tract. when e\ervt hiii'_r -
jeeted." Time will tdl if this sanguine \ ieu :- wi-j founded. 1 >:
tile peptoniSIDM; of llleat their direction- are; "To h:iif ;i I'!,
whole beef tea and half ;i pint of water. thirt\ ^raii:-; c-f K\; ra--' n m
1'ancreat is. an<l twentv grains of bicarbonate of -oda. ai.d ke.<p :
warm place not over Ho* I-'., for three hour-. ai;'l the:, in I,.,;;
kill anv remaining activitv in I'ancreat;'- Kxtract." Nida - '-m- a-
essential to the action of trvpsin a- aei(l is to the action nf p.-i.-m.
Tlie use of peptonised fooils became vcrv extensive, soon af;<
Sir \Villiam Roberts introduced them t<i the notice of the puii/.-;
but the demand is now much less. Whv is thi.-l' l'roiia!i!\ out-
matter is that those practitioners who love to dal>l>!e in the \erv
latest novelty, had ]>eptonised food pi-epared in manv eases wtieiv
onlinarv food would have served eijiiailv well, and so LZ'ave i!:--
friends and nurses of manv invalids a "ffeat deal of uniiecessarv
trouhle. Then other novelties cropped up and liu-t!ed pep;. .M /.- -d
foods out of the memories and minds of the said novei-lnn:t :n^
practitioners. That is part of the explanation. Another part :
tliat the resultant products were not palatable, because the in-tnic-
tions were not rigidly cai'ried out. A tine in.-trumeni in the hand-
of a careless fellow is soon put out Vf working order; and the finer
the instrument, the sooner disaster is induced. The method of
peptonism^ food is a matter of precision, 1st. the n^\\{ \ mperature
liicrh enouL r h to permit of the ferment readily acting. :md vet ...;
too hi^h to kill it. If too hi.L r h i"' peptonisiiii: i> possibh'. if too ;.\\
the iliifest i ve a^enT is inoperative, and no peptonisin"; follows. .':.
The neglect of raisiiiLC the lluid to the hoi; at the proper time.
''The hotter the oven the shorter the time." is an axiom in co, .k:: _.
If the lluid was kept warm under the eosey the time to raisi 'o
the boil comes earlier than it does when some ( ..... line; < ..... ur-. I:
the time to raise it to tlie l>oil is delayed, t hen the bittei- ia-
coinplete digest ion is brought out. aii'l so the resultant pi-oiin-'l .'
oiTen.-i Ve to the palate.
It is easy to see how earelessne.-s. or perhaps to be ni,.r.
how the want of careful exact it ude led t" ii'-ii-e of pepti
If these were only used when it is understood t hat t he en-
it would follow that pi-oper care win;!' ' taken. \ : --
follows upon use. and dabbling in pep'-misin^ food
eurio>ii v or keep somebody nit > >'i \
valuabie measure intu disrepute, aand con-dpi. ,
'.i-l UAM AI, OF MKTKTH'S.
Iii ordinary cases, prediirestod carbo-hydrates, arc enough with
whoie-meat broths, and mills with selt/.cr water, in small (|iiantitics
at onrc. alternating \vith malt -extract for varictv. If such dietary
is insuilicieiit. and life i- (jiiivcriii^ in the balance, then sonic re-
sponsible person inu.-t he put on to do the peptonisinir, \vitha full
sense and consciousness of the ^rave responsibility of his or her
action. If this were done, then the practitioner could rclv upon
his weapon as bein<: well forced and tniM worthy. l!ut to set a
nieddlesonie fool to work peptonisiiiLT food, is |o inaugurate a solemn
farce, and if the case he ivallv a irravc and serious one. such pro-
cedure is little less than manslaughter, and deserving of the most
severe censure. If a medical man does not possess sullicient acumen
to discriminate his agents, he is not tit for the post he has a.-s.umcd.
And if he cannot exact military ohcdicnce from his subordinates,
he should dismiss them from the service, as a ( leiieral does an in-
competent soldier: and if be cannot do that, lie should dismiss him-
self from the irciicralship of the cast and his resignation would bo
the hot plan f' T ail concerned.
With propei- care and precautions, peptoniscd foods arc a most
valuable aid in manv cases, especially where there is anv morbid
condition of the >tomaeh pre.-ent. Thev require little or notiiniL;' of
natural digestion, and sit easily on the stomacb: but then such food
rcMiures to be made with as much can 1 as is rc(|iiisitr m putting to-
gether the work- of a watch- if it has to ^o well.
An attempt to provide a peptonised preparation which only re-
quires -omc hot thud, and so dispense with hou.-ehold peptonisin^,
has been maile in " Solu lile Kood. "
With this last remark. whi"h indeed applies hroadlv to ail culi-
narv preparations, but specially to pcjitonised foods. Par! I. of
tbi.- work lit 1 v I'oncludcs. A knowiedu'e of \\liat food is. of what it
consists cbeinicaiiv, of its destiny ill the body, of the ctTects of i-ook-
in^'. and the d.lTereiit poi'iions of the digestive act. must const ilnt(!
the I i;i--is or fou nd at ion of all dietetics, and m u.-t lie t horou^hi v mas-
tered in detail liefore t lie aet nal liict :._;";' a -.!< [ler-ou can besafelv
ajiproachcd. It . - the \\ ant of -'iicb km >\\ cii^-e as hit hci'to
iiamperci'i the profes-ion in dealing \\ith the mailer; lea '.HILT each
practitioner sinu'lc-Iiandei] to |o o\vn experience an experi-
ence often leading h;m in a manner \\'h:ch remind- me of a cicr^'v-
man's answer when a-ked if a certain parishioner followed his con-
science. "Oh \ e-. " wa- the |'epl\ . " c foi ows ll IS cimscielice Very
much ; n '.lie \\ a \ - 1 M ma \ be -aid to o. ;o\\ [ \\'ben he dn\'e-
it in front of him!" A man, to some extent. mak<--
as h"' pics, tentat ivc] v, on certain line- laid down. !,;;
how!' The fashion- which have swa\ed i he dietarv <'.
room. demonstrate that no iruidiiiL: |irinci|ile wa- :n a.-i
matter. \'cal broth and eel broth had vieided to calve.-' MM.- '.-.,..
when inv professional experience first be^an: then tha' i_-;iv>- \\a\ :
milk and seh/.er water. o\ er \\ hn-h beef tea u-urped ;t bane!''.il ; . ran:
\vhieli it still liolds. I5ut the facts are -iowlv underminim.: it- <.;'<.
and common sense, illumiiietl by scientific knowledge, i- hombard-
iiiL;- its fortress, and. before lon;_r. \\ c n.av fairlv hope, its ;;',-'..! ;, .
]iret(.'iisions to be a snstainini:' fooil \v,ii \- abandoned, and a -afer
and .-onndcr jiosition takeii up. vix.: that it is (a- ordinariiv pre-
pared ) a stimulant vehicle, plea-ant to the palate for -oni'tile <-arho-
hvdrates no mean position l>v anv nu an- for ,; \ hold 1 Mrior '.:
knowledge in the making, and " ki!(\vied^e LTI'O\VS. but \\v-iiom
lingers." as is evinced in a piece of instruction in a medical journal
which came under inv notice, while penniiii;' tin- chapter. >he. ;
ti.-h there is a<lvocated a- a food for the diabetic, and e-peciai.\
ovsti'l'S. ?\d\V the ^'I'eat lillik of the oVStel 1 ( like >oine other -he.!
ii.-h). consists of its liver, which is crammed with Ldyco^en. or animal
starch. How such a curiou- and [lernieious error could ha\e foiini;
its wav into a respectable medical journal, is one of those th.nu-
whi<di Lord J )u nd rear \' decided " No fellow can understand. " \\ hen
dietetics are properlv taught in our medical schools, an>i each ineii;-
cal ,-tudent is made to understand the chemical compo-ition and
utilitv of each article of our dietary, a- careful!) as lie .- laii^h; the
action of each unit of 'he Pharmacopeia, he w.ll hannie h:- HUM! .-,-
skilfiillv as he wield- each medicinal aiTem. Aip't ihen. wii--n :,
can iio this, lie will achieve results which mav an'reealnv .-ni'pr
ot hers as well as him-cl f.
M\ erv ,-ick per.-on is a dvspcpt ic i'^r t he t ;me bein'_ r : and . h-
it :.- the dvspep,-;a of a'-ule di.-ea-c. or ot chronic iii.-ca-c.
trouble collected with the stomach it-e'.f. llie |uc.i;,-a
ha- ilai'iv to encounter impaired litres! ive p. i\\ei- .-..
pa' lent- at all ! A lid a knowledge of d id c; '
ouaintance witli Materia Meclica; and Tiiei - apeu':c
neglect one u!' the other, than a ladiier can cun.-i.-i u! o:.
and ruii'j's.
PART II.
CHAPTER XI.
FOOD IN INFANCY.
HAYING discussed tin. 1 subject of Food, in its entirety, it now
becomes possible to enter upon the practical application of this
knowledge.
When the babe is newly born it was, and in sonic cases may still
be, customary to put something into its mouth; commonly some
sugar and butter.
The child had had a long last, it was pleaded, and the welcome
to the little stranger could best take the form of some nourishment.
The motive was good, at any rate. " At birth the stomach and
liowels. not having been used for the purpose of digestion, contain
a C|Uantnv of mucous secretion nieconium which requires to be
removed before they can enter upon then- function. To effect this
object Nature has rendered the first portion of the mother's milk
purposely watery and laxative; and on the part of the infant nothing
further is required than to allow it to follow its natural instinct and
suck it in.' 7 So savs I >r. Andrew Combe m his famous treatise on
"Digestion and 1 )ietct ics. " Laxatives, other than this, a IT not re-
quired. He has some more remarks whieh seem to me to be worth
(jUotat ion.
"At birt h the stomach is feeble and as yd unaccustomed to food.
its era villas are consequently easily sat istied. and frequent 1 v renewed.
A healthy infant seeks the breast with avidilv. but sucks little at a
time. It leaves an interval for thoroughly digesting t he lit ! le which
it has swallowed ; after which its appetite revives, and a fresh supply
is demanded in language which no mother can misinterpret. I Mir-
ing t he lirst MlOIlt h appet ite ought to be the mot her's M-n ,!,, |], oll'er-
iiiLT the breast, and if she know how to read the expression of her
infant aright, she will want no other. .\t that early age 1 hen- uu^'iit
to be no fixed. t;ine t'or !_rivMi:_ r noi i 111 ','. 'I he stomach cannot
FOODS IN INFANCY. '.'7
be tints satisfied. In one child digestion mav be slow, an 1 i
tcrval IK- c()lisc(|U01itly too short; in another it may be 'i' 1 ' 1 ' k. an 1
the interval too Ion.;. But the active rail of the infant i- a .-'/.m
which need never be mi-taken, and none e|.-e ouirht to lie listened (<>.''
Overfeeding i-'. however, the danger in' r 1. 1 1 -'.he hi. Ms: and
mo-t of the troul'les of early infanev are clue to tin-, a- en!:.-, howel-
irritation and diarrho-a. The earminatives, aroinat i*-- and antacid-,
so frequently u'iven t<> infants are required niainlv in consequence of
errors in feeding. \\'e must not put out of >i'_dil. however, liie fact
that any derangement of the maternal health, anv ,m proper food
on her part, even a mental emotion ma\ .-o all'cct the mhk as to
alter its qualities. This is a well-known fact with mother.-. |-"ur-
ther. if a child is const ipated. the [ileasantest method of correct ML:'
the liowels is to ^ive some mineral la\ati\e to the mother: and of
ail these the phosphate of soda su^csls it-elf on phv.-iouiLfical
grounds. The dose to In- !_n\eli to the mother which i- siitlic;ent to
inllueiice the clulil isusuallv not so iarj'e as to alTf-t he 1 ,' mii'di.
The mother's milk is usuallv ((tiite sutlicient for the iir-1 nine
months of existence. \oi - need the mother he specially fed for the
purpose of stitlicient lactation.
Of old. if the mother was removed hv death or from any iea-oii
rendered unei|tial to sticklinn' her liahe. a wet-nurse was procured.
I''or the purpose, a mother in a humhie po-;t:on of life was u.-uailv
selected. lint "the health and usefulness of country nurses arc
often utterly ruined liy their transplantation into the families of rich
and luxurious employers/' said ('omhe.
The "wet-nurse'" is now almost a tiling of the p:i-t. and ln-r
modern substitute is the " feeding-bottle." Hut as much care is re-
quired \\'itli the one a- with the other. IVrfc.-] clean! ; tie-- i< reijiu-
site; scalding wit li hot watei- con tainiiiL;' some -uda .-In MI ,> i ! i ;:!': ;-,.d
after each ll<e of the bottle the hot! !e. t he tube-, and I in 1 n ':;' ''.
piece. The milk i- usually furnished bv the cow; and
matlcrof indilTereiiee how that cow is fed. If li'iveii breui'i -.
lush 'jra-s and othei- fund which lend- to a lai'u" 1 ' ou:r
the milk of cows MI fed is apt to disiu'ree with tiic ; ;'aiit. t
(ptentlv in most dairv-\'ards a cow i- >jtei-ia':\ fed for ;h'
of milk for baliie-. Sometime- the mnk of one eo\\- i, .-
a babv I'm 1 no apparent, or o-|i'n-ibie rea-on. and \\.< :
change the milk a- it i- impossible to chari^e ;:ie \r,v>
In other cases tinned mi;i\ is iic- : -ab e, Sw:-- n
a special reputation for t he infant '- fe> ; ' n-'-bo: ., . [
( . ts MAM A I. OF 1HKTKT1CS.
peculiarly wholesome from the heritage \vliich forms I In- dietary of
Swiss cows. Tinned milk usually contains sonic added sujjsir, and
consequently onlv requires a certain dilution with water (about one
third) to simulate human milk verv closclv.
This leads us toasuliject which has been threshed out au'ain and
apiin. The curd of human milk is lighter and softer than that of
cows' milk. The milk of various animals is used as a substitute for
human milk. (According to Dr. Thomas Do Ian. con.-iderable dill'er-
enccs. sutlicient to trive the subject a practical value, occur in the
milk of dill'erent women). On this matter Dr. I'avv savs -"The
milk of the cow. accord ills' to above analvsis. (I'aven's) the most
closely approximates to that of women, but it is rather more hi^hiv
charged with each kind of solid constituent. Next follows the milk
of the iroat, which, taken altogether, is auain rather richer. That
of the sheep is characterized by its marked richness in nitrogenous
matter, and butter. The milk of the ass and mare present striking
differences from the rest. The peculiarity consists of the small
amounts of nitrogenous matter and butter, and the larp 1 amount- of
laetine or suirar. "
There are variations in the composition of the milk in dilferent
females of the same species of animal, just as there are in dill'er-
ent women; hence the variations in the analvses and estimates made
by ditTerent authorities. The milk of the Aldcniey co\v is the rich-
est of all cow's milk: and 1'lleretier found the milk of a lintiiflli*
richer that that of a 1>l<nitl''. a conclusion borne out by the further
observations of Dr. Dolan of Halifax. while Dr. Hill llassall found
that the morning milk of a cow is not so rich in cream and casein
as is that vjiven in the evening. Looking :tt t he analvses of milk.
it would seem tfiat a small addition of water to cow's milk, brings it
down to human milk: while some contend fora small addition of
suirar. Nor need necessarilv the su^ar be eaiie su^ar: a little mal-
tose siiL r ar is easily procurable, a- in Mellin's food, for instance.
The advantage of maltose sii'_ r ar. in whatever form, to the milk is
that maltose su^ai' rather undergoes lactic acid fermentation, while
earn- siiLi'ar under',:"" 1 '-; acetous fermentation and acetic acid is far
more irritant than lactic acid, whether free or in combination with
a base.
For some months milk is all a child requires: and. if it can ^et
a siifliciencv of milk, nothing else is desirable. i'.tit amongst the
poor the amount of milk is apt to fail short of the infant's needs
and then some substitute must be tumid. I p to a recent time the
crust anil sole of the wheaten mat' were boiled i'ur -..:i : .- ;i
the resultant product " pobbs." mixed with -uni'- niHg
compound was nut objectionable: lint when a i:t : ie Mcj'ar <;.
added to the " pohbs." then partial -tarsation wa- tii.- :v-i>.a- 1
ha\e stateil before. The addition uf a !iltie butler wa- a:; imp!
ineiit: but even that did not provide tiie silt- I pho-phate- and ch'.o-
rides) whieli are su desirable. Speciallv prepared bi-euits wefe . ,f
much the same fond-character; till at ia.-t the subject attracted ;:..
attention uf the chemist wlio started ;u prepare sjiccial "Infant'-
Foods; " uf which ^eneraliv ;t niav lie >!ated tiia! lliev '.-.^ k fai.
This last can scarcely be said uf "lariated" foud~. thai :-. f i-
contain inu' a ] import mn uf tin', k. ( >f t he ininurtaiiee .if fat tu haliii ~
no unc can entertain a dottlit, after witnessing theetTects uf ,,'!
unctions upun an ill-nourished child. It niav Ke -aid of a'nio.-t a.,
the [tivptired Infant-' I-'oods. thev are intended a< adihtions \ nn,k
- -not as substitutes, for it. I'ntil the teeth are cut. and in the act
uf making their wav thr<ni^h the inim. arou.-e the saii\arv L;'iauds
into activitv, the infant has no means uf deai;nu' \vith stai'di. hefure
it reaches the jiancreat;' secretion: anil raw unchaiiLred .-tar.'h is
not acceptable to the infant stomach. Numerous disorders of the
alimentary canal can fairly be laid to the charge of unchanged siarch.
The length ol' time a child is kept t.i the bn^^t is u-ua.iv nine
months. There inav be reasons for weaninir the infant earlier;
there niav be reasons (in the maternal mind) for euntinu;i!u r '"
suckle it. But considerably before this time is reached a certa.n
amount of food othei- than the mother's m;!k is usually ^i\cn to :;_
Panada, or m nnrscrv lanirtuiire " poblis." is well enouirh in its wav.
but its preparation is somewhat ti'ouble.-ome. The diiTeri-nt pre-
pared foods have been discussed before and need not occupy u- [on--
here. Thev consist of admixtures of bake.! jloiir and ma. ted, \,<- <. a-
rations as a rule: some containing dr;ed ini.i\ (aiidin^' tall .-"me a
certain proportion of ground legume- (^ivin^ nit ru^eii ). \\ !;;. o\.
should be preferred, and the circumstances under wh;>di o:.e
wuiiid seem n,u!-e suitable than another, mu-t, ;n the pre-.
uf our knowledire, be iei't for the private jU'i^me": u! ;
in eaeh case. Too lun^ continuance witti an\ o;;e ;.'o;
pall on the palate. A varietv of food is as ae.-epiabic '
as to an adult -that is of " artificial " ;' :. 11- ,
matter t horou^hl v entertained in the work of m\
Mustai-e Smith, on "The I )i-ease.- of I 'hiLiren."
There is one drawback to Hi' 1 -'' prepared
MANUAL OK niKTKTICS.
mastication, and but little digestion, which may as well he considered
here as at auv other point -though not coining into operation till a
later period. It i- a d iv.Tession. Imt one of such practical importance
that it niav he as well entertained now instead of hein^r postponed.
It is the relation of rooked and prepared foods to the development
of the teeth, and the prevalence of dental caries. The jaw is im-
perfect! v developed and the teeth are crowded. A small mouth and
a liirht, pointed chin art.' now our ideals of beauty. "Muckle-
mouthcd Me<j; Murrav" the ancestress of Sir Walter Scott, would
iind her chances less now even than thev were when Scott of Harden
aliuo.-t preferred death to marrvin^ her. There is. too. ;m imper-
fect development of the teeth; to all appearance thev are <|into
riirht, but their dentine is of inferior qualitv. and when caries sets
in. this inferior dentine is readily eaten up by the tiny organisms
whi'-h arc at work in dental caries. A biirvvr jaw and teeth of
superior structural (jualitv would be an advantage. The causes in
operation in t his imperfect development of t he mast ieatorv appara-
tus is now attributed to a combination of two casual fa 1 -tors.
1. The fact that all food is now so prepared that there is little?
need of that labour of the jaws which was involved in cat hit:' a piece
of hard crust, whether bread or cheese. There is, in fart, compara-
tive disuse of the ma-M icatorv orpins niid that is leading, bv an in-
evitable law to degradation of the organs: the jaw is ill-developed,
and t he tect h of inferior <ptalit v.
'.'. The furthi'r fact is the higher education of the vouiiLf. A
child is taken earlv and tTaincd as hi^hlv a- its powers will permit.
The brain and tin 1 dental apparatus alike jire b'd hv branches of tin;
common carotid arterv: to encourage the l!ow in one branch is to
depletr another: when the blood -current is tlowin^ free I v to the
brain its llow is diverted from other branches. |)i~use of the jaws
starves the areas supplied by the ma\ii!ar\ arteries; and then when
the demand of education comes these arteries seem specially to feel
this depletion bv derivation to the encephalic vessels. The brain
is fed at th |- expense of the maxillarv area, in fa^i.
The lack of mast ic;i tor \ 1'il'orts is t ! I irl : LT 'point of tin- morbid
depart lire. 'I'll is ;i matte! 1 liol t' he ovel ookei] in the ft-ei i in"- of
[
children, and a hard crust (which is highly digestible) is a v;ood
t hinir for a child- wh^n it has pit tip' teet h with \\ hii'h to chew or
jrnaw it.
\\'hen a child is weaned it has panada and milk (oroii^ht to have
this last) in lib<Ta! ipiantities. Nd\\ :t 'j-d- miik, when this is feasi-
hie, uith more or less of tin- mvriads of prepared f<">d- .
ket : and if it is in danirer of lieim_ r nndiTl'i'd in i r hi;-
I'll us an ftjiial risk of heinir "\erfed in t he mir-i'ri''- of ii,.
For a considerable time the infant is so fed. until
to wield a spoon on Us o\vn ai-< < >n nt and -ha re 1 lit- i i< >ri" ,
or Imiiiiny of its older brothers and >i.-ters. Oatmeal p"i
the staple breakfast fond of 'the N'urth of Kn^iaiid a:,' :.
In the more Southern areas, bread hobcd in m'd\ lak---
The dietary of the American Continent i- ri>di to a derive in fa;-':
ceous (trrjianttions suiialue for the nurserv lireakf;i>i-ialile.
Then for dinner c-onies the milk-inhldin^. preeedeil \<\ in.-it-
hrotli. thickened with some farina us matters, which should ha'.e
maiie the acquaintance of the tire hefore hciiiLT added to the inea;-
infusion: 01- [icrhaps hv some potato" tineU liroken up \\.tii -nine
ijravv or meat-juice. Too much of this latti'r is apt to pro'iiiee
1latu!ence. colic, and diarrluea. Ktirthennore. \\dn-n there i-\>i
jiny looseness of the howt-ls. this will scarcely lie controlled i>v niedi-
<Miiai measui'es. so I on u" as meat-infusions form a part of the dietarv.
Neglect of this fact, too little known, has had its etl'eet upon infant,
mortality. On the contrary, when the child i- con>tipated. ,; may
he well to !_dvc some meat -infusion ; as well as the liu', prune, or
manna, common! v u'i veil.
Too much food brings ahout mal-:is~imilation. jn-i a~ miiidi as
defieieliev of food. " Amon^ i he wealthier classes, imperfect nntr-
ti"ii most (jeiiemllv arises IVom exec.-- in oiiantilv. or a too >t;mu
lat im.: 'jiialit v of food: hut am<>nirtlie lowei' classes from delic:en,-v
in (jiiantitv or (jiialitv. addc<l to scantiness of clothinir. \\ani of
cleanliness ami im perfect vent da t ion. " (Comhe. )
In his treatise on "Scrofula and Consumption" the 'ate :
James (lark pointed out 1'oiviMv, how imperfect nutrition
mismanagement of diet in early days, lay at the root, or \vr\ i <-.
it. of that imperfect tissue-nutrition which, as we .-hall see later n-i.
is the essential condition of the.-e morbid states.
The milk-pudding in the nurserv used t<> precede meat in ar.\
form: and this matter hecomes of more importance as
he^in s to eat meat. The starchy matter- of the t' i. \\ h;.-li i
vSilivarv digestion in the mouth, the gullet and the -
it hecomes acid), ou-'ht. on scientific and phy.-:o|o-'i :
precede those matters \\'hich arc digested in ;
nur-i'i'v rule would lie a --ond one for invalid- and
larger ^"I'owth. Such milk-puddini:.- arc madi
1"L' MAM'AL OK DIKTKTK'S.
hominy, semolma. vermicelli, shredded mai/.e, samp, SULT<~>. tapi-
oca, rice and bread and butter, as their ordmarv cons! n units. For
delicate children tlicsr ditVerent farinaceous materials need some
predication hv heat. I>ut for healthy children it perhaps is enon<rh
to educate them to take then- food slowlv. so as to bnnir the starch
into Millicieiitlv lonir contact with the saiivarv diastase to ensure its
conversion into soluhle matter. In avoiding Scvlla let us not, run
upon ( 'harvl >di>.
'I'he dietarv of the nurserv is ample in quantitv if restricted in
materials, and this is ^uod. The appetite of healt hy VOIHILT crea-
tures rarelv needs stimulation, or temptation b\- varietv bevond what,
has lieeii pointed out above. 1'iaiti. wholesome food is piod for
children. " 'I'he same kind of food ou^ht to he continued till after
the appearance of the canine, or do^-teeth. When these have fairly
protruded, a portion of soft-boiled e^ mav be ^iven as an introduc-
tion to the use of a mure completely animal diet. In Lfcneral. solid
animal food on ^1 it not to be allowed in any quantity till all the teeth
have appeared and t he digest ive powers be fullv adequate to assimila-
tion." (('niiibe.) This authoritv holds the opinion that to<i much
animal fond leads to (1) imperfect t issue-nutrition, and delicacy of
constitution mi the one hand: and ('.') to mental irritability and
peevishness of disposition on the other: and that this combination
impairs the resisting power of the organism. ( 1 onse(|uentlv, such
improper! v fed children present lessened resistance, both in catch-
ing and succumbiiiLT I" the ordinarv maladies of children, as the ex-
anthemata. whoopin^-couLrh. etc. The stronger the food, tin?
stronger the child, is erroneous I'ea.-onin^: and strong meat is not
o- ( ,,,,l foi- babes. Milk and farinaceous foods are the foods of the
nurserv, /"/' i-.n-i Ui'iiri .
As to wines and alcoholic drinks, thev have no business in the
nurserv under any circumstances, \\lien a child is so ill as to re-
quire such stimulants, it is well to lake it out of the nurserv to a
room of us o\\u for i he time. To ^ive an ill-nourished child M'ine.
is an act of weakness in mtcl i^fenee or morals. If LT'IVCII to please
a foolish mother, it is a sin a crime. |f I aiise the medical man
does not know better, then it i-- hi^h time that he be referred hack
to his smdie< there is some lee-wav to be pulled Up ill his case.
< >f far mure im portancc is it to insist u pon a sutlicieiicv of exercise.
The n ven i mi of 'i i- perambulator i ot been an unai loved ;j'ooil
for our i tl e folks; ;i ma\' be a r-adv mean- of v.vttiiiir fre-li air.
but rid ;i ; eramhuiator i- not " exercise.' The waxing limbs
\v;int unrestricted iiioveineii! for their development. A',<n8
short df faii^ue >hou;d In- lakni e\erv 'lav.
Fat is essential to liealtliv tissue; and lio\v is fat in !n- \-. :,'.
into t lie juvenile organism ?
Tins is a verv important mailer at the present iiav. and "!,< of
p'owni"; nnportanee. I was once illiberal enough to ho'.d tiiat ;;.
present distaste for fat in the nursery was nothing more than wa:.t
of tinnness on the part of nurse, and mother: hut thai po-:;;i>n ha--
had to lie abandoned. There is a waxing inaliilitv to t -a! fat. Fa',
in a visible, tangible form, is simplv repul.-ive to manv chiidivn,
and as such is loat lied. It niii.-t he " snr.'.^led " into t hem. a- old
matrons put it. The hunch of lnvad with a stout laver of hu;t"r
over the upper surfaet nurserv lnvad and hutter for main chil-
dren is utteriv unsuitable. The bread and butter should be cut
thin, and the butler spread liLrhtiv over the snrfaee ("eompanv"
bread and butter), and then this should In- doubled upon itsed':
sueli is {lie rational bread and butler for the nursen with ilelieate
children. Then a ^-ood piece of luitter should be added t" eaeli
"lielp" of milk-puddiiiL;'. and so mixed therewith as to be l>\ to
the eve. Uai'on-fat is especial 1 v in demand in the nurserv. The ; ;.pi ;d
fat is most di"v>tibie. and easily tolerateil bv the juvenile r-toinaeli
Ureail erumhs mav lie mixed with it. or some tlourv potatoe. The
latter with some liaeon-fat and a li^ht -boiled e--^ poureil over it i< a
verv pleasant form of fond. Then the more solid fat of the baeon is
also ivadilv taken b\- most children; and a bit of " papa's baton " at
breakfast is a wcleoinu treat to mo-t voun^sters. Hominy fried \\ th
fat pork is a form of food in favour in the I'nited State--. The suet
puddini:' with the suet tinelv mineed is an excellent uiethod nf m-
t i-odiiein-- fat into youthful stomachs. If a little treacle be mixed
therewith, the pudding is ail the better -both as to the palate, and
as to its own food -value. Such puddings should be eaten \\\\\\ Mi-_;'a
best eaten wuh butter and .-u^ar."
llo\\'c\er ii is [tract icall v inanaLTcd. a siilliciencv of fai -ho:;
supplied ill order to luiiid up t horoiiLrh !\ hei!th\ t:--uc-. ]\
>liould never be spared. The father or mo| her (u ho ean a:'
\\dio does not ;diii\\- their children a siltlie .:: \ of Initrc!'.
I" 1 I MAM'AL OF .PIKTKTICS.
pav the snrireon's bills of a later dav for operations on joints, and
scrofulous Clauds; to say nothing of bills for the t reatment of maras-
inus, tabes inesentcrica, hydrocephalus and phthisis: toget her wit h
the bills for hoard and lodging at seaside health resorts. There is,
sneh a tiling as '* penny wise and pound foolish: " and this is a ease
; in point. They niav not grudge the cost. but recoil from the un-
pleasantness of insistence with their children hut. depend upon it.
this is infinitely less Irving than that, which ihev will endure when
disease has fastened upon their hapless oll'sprin^r when regret is
unavailing. I'nfort unately. too, it must lie admitted that it is just
t he children who reject fat who most require it. There is something
more than mere fad or fancy, in the child's, rejection of a piece of
sweet fat on its plate, and its readv acceptance of a spoonful of lisliv
oil. It is impossible, indeed, to insist too earnestly upon the supreme
importance of an abundance of fat in t be food of the nursery. It
is all very well to talk of jams and preserves. They cannot take the
place of butter. Thev are palatable adjuncts to butter; but they
never can be substituted for it! If a child can be induced to eat
bread and butter bv spreading some jam over it -----iiood and well,
.lam, pins bread and butter, is a very different mutter from bread
and jam.
When a child is old enough to handle a knife and fork. i.e.. be-
tween four and live ordinarily, it is allowed small quant it ies of meat.
I ut milk and puddings ami sweets are preferred till much later
vears hv healthv children. \\hen children get too much meat,
under the mistaken idea that this will make them strong that the
meal of the ox will make the child as st roni: as an < i.\ as ^rc:it a mis-
take as that of calf-lvmph in vaccination being followed bv the
growth of horn- the end aimed at is usuallv defeated. The child
(Iocs not grow strong. It is indeed, ill-nourished and liable to all
kinds of trouble, from colic to boils and ecxemu. In Yorkshire,
where t he fat her likes to see his little son eat "a bit of meat," it is
quite common to lind gontvskin affections, with the urine deposit-
ing ;i sediment, in children: a condition at once relieved bv a suit-
able dietarv. ('hildren who, from a mistaken view, are given too
7i inch meat and encouraged to eat it . and who do not t hri ve t hereon,
are soiiietitiies recommended so much \\'ine. It is needless to sav
t hat t he reined v does not lie in this direct ion. but in one ilia metrical Iv
opposite.
I'robublv children are allowed too little fruit. A liberal amount
of sound fruit is nut only good in itself but. ii is a prettv certain
protection, or insurance air-iinst the chiMivn L r or_ r iuL: ;h>-!i
t'niit -no matter what itsipiaiitv at tin 1 lir-! opportunity. \-
before, " line of the most pernicious ha!>;t- in whii-h children ran !
indulged, is that of almost incessant eating. Manv mot hri-s iMieonr-
aire it i'miii the facility with which, for a time iheoilVr of ~..me-
l liinir nice ' procures peace. Kvm from infaii'-v. the chll* i-u^lit to
In- Lfraduallv accustomed to cat onlv when hi!ic_rr\. ai.'l \\in-u fo"d
is ivallv reipiireii. After two vi-ars of ap 1 , an interval of f.uir hours
lictweeii meals \viil rarclv he more than enough; and to ^i\r b;-euits,
fruit or bread, in the meantime, is ju-t .-ulit rart inir from thediircs-
tive power of the stomadi. Like almost cvcrv other or;_ran of the
hodv. the stomach rfijiiires a period of ivpo.-r afti-r tli'- lahour of
digest ion. and acconiiu<jflv, in th' 1 hfaithv state. \\\i~ sensation of
appetite never return- till it. lias for some time ln-cii emptv. To
jive food sooiiei 1 . therefore, is analogous to mr.kinLTU \\'earv traveller
walk on without a halt." (('om!<e. ) To e^- on, or tempi the
palate to almse the stomaeh hv otl'i-riiiL;- slices of seeil-cake, luins. ;i!nl
sweets of ail soils, lietwi.xt meals, is ;i cruel kindness. Old-fashioned
people, \vlio used plain words, used to talk of a " surfeit " when too
miieh had lierii eaten. \Vearetoo polite nowadavs, tou.se siieli a
lilunt u'oi'd: iuit tiie tiling for which it stands remains iinehanired.
A sudden rise of temperature, often accompanied l>y vomiting and
pur'jm^. is common with children after some undue " indu!c;enec.''
the euphemistic modern siihstitute for "surfeit." I: is nothing
more than a natural expur^atorv process, accompanied !>v a honlire,
(the pvi'exia), to evt rid of the surplus matter.
" Children should have four meals a dav: hut meat onlv at one,
oral most, two; the latter when onlv a small portion ai once is al-
lowed. When in health, lliev should have no wine or hccr, e\i-ept
a- a festive treat; no coU'ee, strong tea, or other exciting drink."
(Chamhers.)
( >nc rule mav he 1 rusted : a healthy child requires no tempt at ion
through it- I'aiate. It is ipiitc rcadv for it- meals when tin- run-
comes. Nor, as a rule, do children need anv ciicoiira^'cmc!; to
[icrsist m eating. Thev will t:'encrallv cat till lliev feel fu.l. I'm-t
a child for that ! Its plca-urcs as yet are few, and eat n
plea-lire. //"/' r.ri-i llr iit'i 1 . of childhood,
As ri-Lrards the dietary of school, it is now fairly liberal:
in some schools i he d let -table i- iniidc at t rad : ve in in vrr-e
to the intellectual dietarv provided. Some mothei-s ,;,-:-
iilierai table as a >//// ,jn/i nun. \\'here childn-n [>ia\ a iriva! deal,
Idtl MANUAL OF OIKTHTH'S.
food in liberal quantities is ventured. Hut as to the vexed question
of plentv of \vork and little food, and little work and mueli food
in other words, betwixt the well-fed dunces of rich parentage ;nid
the half-starved, bright child of poor parentage. 1 am not called
upon to decide. Work, play, and food in nice proportion, will he
lound to p'ive satisfactory results.
M. Met'/, of Mattrav. the philanthropist, found <:ood food, and
even wine, necessarv with weak-willed hoys, to enahle them to form
a resolution and stick to it. AVhile of old. bread and water was the
dietary of refractory children until they couid obey discipline; and
was effective.
( '(t't'-ri* jxirihx*. 1 would always back a u'ood breaki'aster from
a bov to a u'amc-cockerel. A ^ood meal to heir in the dav is a u""od
foundation !
When children are ill. they require to be fed according-. A
child will often abstain from fluids to an extent that would be \erv
painful to an adult, without apparent inconvenience: hut when ill.
it requires more tluid. A child is rarely indisposed without more or
less pvrexia. and then more tluid is necessary. Sometimes lluids are
pnrposelv withheld, on the impression that they would dilute un-
dnlv the gastric juice: this is a gratuitous cruelty. No child will
drink cold spring waterunless when overheated by effort. In ill-
ness, its thirst is the measure of its needs. Home-made lemonade
is usnallv enough of meat and drink for a child in a febrile state,
with the addition of a little milk and lime-water or selt/.er water,
or the equivalent of the latter. AVhen tinned milk is used, whether
to a sie]< child or one in health, it is well to remember the rule laid
down before about tinned foods, vi/.. that thev should be used up
as quickly as possible after heim: opened. Tinned things readilv
become unlit for food after the tin is once opened.
When a child is convalescent, nsuallv its appetite is keen, and it
takes !' ': eagerly, and even greedily. All sorts of milk puddings.
rice-milk, plain broths with baked flour or broken biscuit, and -tewed
fruit with cream, are ^ood and proper. At this time a child is very
liable to take more than it can properly digest . and acute indiges-
tion often deiavs convalescence. Its u'uardians are <jdad to see it eat,
and it relishes its fond. lint to quote a plain nurserv a \ioni some-
times. " Its eves are hi^er than it shelly:"" which, beinir translated,
means, that it lake- in.. re than it can deal with. Then a " surfeit "
follows. Some cli Idi'ei are ijfrnss feeders: -nine are daiiitv feeders.
These latter need tempting by various viands, served up \\ it h ,-crupu-
Ionsclea7ilinc.es. Little neat sandwiche- made with potted ini-nt-, .:
a thin slice from the thickest part of a tongue, or of lioiled
ami nicely arranged on a plate, will often tempt a fast id ion- pala
and a halting appetite. One golden rule there is in fee.lmi: an
invalid or sick person, child or adult, and that is never ^ri\e them
too much on their plate at once; this at once impair- the />-;.
Ilather it should he on the short side, so that the inclination i- for
more. Further, little appetising dishes are often devi-ah'.r.
" < H't en a child will eat a small bird, as a lark or a snipe, when he
turns with disgust frmn beef and mutton." (Kustaec Smith. ) !:;-
deed, with delicate children, their tastes must he eoiisiitted, ju-t as
in an adult. "(Jrown-up people are permitted to ^i\e their like-
and dislikes free plav. and judi -iou- wives and cook- studv the tastes
of theii- lord and master, and see that he is dulv furnished with Ins
favorite dishes: hut the poor victim.- of nursery abstract principles,
are often forced to consume things which thev ubhor." (l-'arou-
harson," School 1 1 v^ieiie. ")
(Mi the other hand, there is "bulimia:" which is not nien-lv
the u'luttonv of .John Ueed in ".lane Kyre." "John liccd was a
sehoolhov of fourteen vears old. larire, and stout for his ai:'e. w;:h
a dint, r y and unwholesome skin; thick lineaments in a spacious
visage, lieavv linilis atiti iarire extremities. lie ^or^ed him-c!f
lialntiiall v at table, which made him bilious, and irave him a dim
and bleared eye and ilabby cheeks." Such is Charlotte Uroni.-'s
tvpical sketch of a juvenile glutton. Such a bo\- \\a- -tutT''d at
home in a most foolish fashion: but no doubt, boxes and hamper-
containing; rich cakes and other toothsome comestibles Wel'e re^n-
larlv sent to him at school, till a nio-t unwholesome product i<li\-,
eallv as well as psvchieall v was the result. There i- "bulimia"
not infreijiient 1 v met with, after some of the maladies of childhood.
and in mv o\vn experience ('nainlv, after measles. There \\ould
seem to be some low j ii tla n 1 1 nat or v condition of the miicou- hn;: u r
of the alimentarv canal, some sub-miico-enterit is ,-et up. \v In-
tensifies the normal senst; of liunu'er. The child lie^s p;teon-',v :
fooi! ilnriiiiT tlit 1 intervals bet wi xt meal-, it - I'eijne-t ;- complie.i \\
with the result that no portion of the food (or \ery little) :- diL;
the i-hdd remains practically unfed: it- seii-ation of ImiiL: 1
onl\' not relieveil, but it waxes stronger. In -iich case-. IIP
amounts of food at proper intervals are csseiit ;a! to reco\ e
the bulimia mav be relieved by ,-umu .-cdativu fur an >
sensation is really pain.
10> MAM'AI, ()!' 1>IKTKTK'S.
Ill inherited syphilis, the babe is not only cachectic, lint its
mother cannot feed it properly, as her own milk is thin and \vatrrv.
ami comparatively innutritivc. Here Kustace Smith, and others,
have found malted foods, after the manner of Mellin's, verv satis-
factory.
Then there are chronic conditions of t issne-de^enerat ion, as
scrofula and rickets, one of glands and the other of hones, not rarelv
found together, which re(|U]re their o\vn appropriate food. lu
scrofula, starchy foods, even if rendered soluhle. are insutlicieiit : es-
pecially \vheateii Hour, which has been deprived of the bran, -rich
in phosphates. Here "meat, fresh eiru's and vegetables " are desira-
ahle. ( Kustace Smith.) \\'e have seen hefore, what Liehiir had to
sav ahout the larirc quantities of salts, especially phospl-.ate of soda,
which exist in vegetables. Much the same mav be said of rickets;
where phosphorus for stouter bones is urgent Iv demanded; and
where the svstem is unequal to breaking up the phosphate of lime.
If a laxative is indicated, then phosphate of soda may be j/iven,,
which is not onlv a laxative, acting, too, upon the liver, but also a
true tissue- food. Indeed, if phosphate of soda took the place of
castor oil in the uurserv, it would be well for infant economies.
In the feeding of infants, a <rreat matter is to hit the happy
medium betwixt too much and too little. The results of over-
feed in- ." ;ts of "under-feeding''' are much the same; there is im-
perfect nutrition in each case.
CTTAPTHTl XII.
IX Yor'l'll AM) ADOLF.SCKXCK.
FOR our prseent purpose infancy m;iv he taken to cease at the
pommencement of the second dentition: usuallv aliout tin- eighth
year.
\\hentlieniilk teeth are hein:: shed, and the permanent teeth
arc taking theil 1 place, a like change ",'oes on 1:1 the palate, and >!!-
eulenf and sapid meats are more craved after. Not onlv that, hut
t liere is more extensive % irn>\vth Lifoin ; on, reijuiriii": a plentcnu- -upp'.v
(!' lissue-huildinu; material. The change of taste conies op, <_yra> : i:a '.', \ .
and it is not till after pidierty that the full eravinir for the ;V-i, ,
animals is ordinarilv developed. Kin-- Chamliers, whia
maintaining the need foi- plain wholesome fond. -a\- " K\; ivme
monotony should he avoided." lie also condemns " t'auii'.v u-h:m<'
ahoiit food. '* It is astonishinir." he Li'oes on, " ho\\- in^raiiieil soim 1
of tlie>(! acquired idiosyncrasies hceome, and indeed after full man-
hood IS reached tllt'V may he concealed, lilll are never (jUlie o\.
come. Yet fe\v of the minor thorn- in the roselmd are so ve\ai "<
to one-elf and others. I shall not sonn forget the annovanee (<:'
taking a VOIUIL;' man to a (iivemvich dinner, and iindinu" that he
never ate anything \vhieh .-\varn in the \vater-." It i~ clear, nuieed.
that he wished that that voting man was ea~t upon a de.-ert :-!and,
wit h only deni/.ens of the sea for eiioiee, \\hen he penned the
tence. I-lveii adinit'.ii!^ that the dietar\ of the yoiin^- - : :.-ii'i
simple, he think- it a u'ooii plan in view of future !'-ii -'].:.- i; |
world, if vomit;; persons \\-nnld learn local what is ,-et liefore ti,. ,
.-o tar a- t he\' a re ahle !
Then comes the (piotioii of -chool !.;'.. I" (.'real I'.r . M .:
[ti'e.-ent dav no sidioul has ativ pi'o-pect \ ,-i;r\i\al 'A:.
[irovide a liheral dietary. Mr. Npieers of I '- the-!
lind it verv diHiciili to make his selieiiie work at the
'I' he institution of the IVnnv 1'o-t ha- !>;;;;; the -
feeding at schools, at ha-f for \>\~. A:.< : Uigj M
! f a ~e|| ( ii i! Hi ;-t re-- \\-i mid -ce an v of her
her , k kept a t iny v, a! "!': ::^-<-a :: \\ /
110 MAM: AL OF JMKTKTICS.
t he toast with water t<> economize butter. An old Xortli Country
vcomaii used to tease me when a schoolboy bv telling me " There
are onlv two creatures that will j>av for starving- school children
and wintering sheep." (In both eases the pay was forthcoming if
the creatures were handed over alivi no matter in what condition.)
All t hat is changed now.
I >r. Fanjuharson strongly condemns (lie habit of eating confoo-
tioiierv and sweets betwixt meals, which he terms "gastronomic
nipping;" in allusion to alcoholic ''nipping'" or drinking betwixt
meals. lie also protests against the svstem of hampers from homo.
King Chambers delivers himself thus ''The gorging themselves
with past rv and sweet stulV at the confectioner's, as practised habitu-
ally by schoolbovs and often by girls when they get the chance, lavs
the foundation not onlv for indigestion in after years, which is its,
least evil, hut also for a habit of indulgence which isa curse through
life." It is indeed a survival of the practice of supplementing the
scantv rations in the old semi-starvation days, when some such extra
food was really required. lint at the present day. it has no valid
foundation: some cheap sugar or sweets for the ill-fed children of
squalid neighborhoods is another matter.
I>r. Farqnharson, who was medical olVicer to liiigby school, lias
had both the opportunity and the inclination to study the school
regimen. He says authoritatively "Little children, probably, do
not require meat once a dav. but growing lads working hard both
with brain and muscles, require a liberal allowance of nitrogenous
food, and will hardly be satisfied with the old-fashioned breakfast
of tea and bread and butter. To the.-e must be added something of
a more nourishing character, and actual llesh may be frequently
varied by fish, bacon, or eg^s, which need not be in large quantity,
but good of its kind and well prepared." (Like King Chambers he
is dead against, a stilT lesson before breakfast.) As to dinner, he
observes. " It is not of coiiivo an easy mat ter to provide much variel y
under the ordinary circumstances of school life: but the perpetual
roast joint may sometimes he boiled, or baked, or stowed, meat pies
and Irish stews and various hashes may lie given from time to time;
and the opportunity should not be neglected of proving how e;<>od a
thing cold meat really is, in spite of the social obloquv to which it
has been for so lonir subjected.'' At this point it mav be said that
the great objection to stews and hashes lies in the suspicions of tin;
children and their parents, that they are made of inferior meat.
As to cold meat, in hut weather cold meat with potatoes, (old ones
IN Ynt'Tll AND ADoI.KSCKM K.
71 1:1 si i dl and new ones boiled) and other vegetable ; >:;:;'-. :,
I'oi' instance, or greens, forms an excellent nuddav mea,. |>..-
tor goes on. " We have aln-adv spoken of the great die-.
taiye- of vegetable soups and Mewed frui:, and of -!.:, .
which keep up tin 1 balance, so important '" '"' maintained. ; ,
nitrogenous and non-nitrogenous food." He hold- that a ;' n-m of
Clplellt >eur\'V IS apt to develop I!) schools where the Vegetable eie-
nient is defective in tlie dietarv. " The major f.irm- of lh;~ terrible
disease are rarelv met with nowadays, but miniature tvpes occur
much more frequently than is generally supposed: and. when bov-'
grow pale and ilabbv. when thev readilv bruise \\hen struck, and
when their gums an- spongv even to the smallest decree, then our
suspicions should be aroused, and \ve mii.-t direct the treatmiMit ae.
cordin^'lv. and this will not. be bv di - itL r s a'oiii'. but liv ordering; the
consunifition of such things as will sujiply the veu'ctabjc acids which
keep Up a healtllV OjUalitV of the blood." (School Hygiene.)
When boys are but day scholars and otdy dine at school, thcv
share the familv fare; aud the walehi'ui maternal eye sees that thev
L;'et both sullicieiicv and vai'ietv.
Tea is a liu'bt meal, whatever its composition, and is followed bv
bread and milk, or perhaps brca 1 and, cheese and some ii^ht beer
as supper.
" Then something mav be said of athletic trainin--. Absurd old
whims of the prix.e-rin^ still linger as traditions. .Meat all but in-
nocent of the tire is preferred to cooked meat, contrarv to ail phvs.o-
lo^ical teaching, (ireen vegetables are t'orbiddi-u.' 1 1'ies. puddings
and sweets are eschewed rigorously: despite the fact thai llnnloo
wrestlers train on sweets, as Sir .lo-eph l''a\rcr. M.|)., \\.( .S.I.
informs me, "while strong iile or port take the p. ace ,,;' other
bc\ "erases. " "A ScllOolboV who gets ple!ltV of sleep ill good ail'. IS
well-fed and not overworked, .and plavs at iranic- vigorouslv aii the
year round, mav be said to be in a perpetual state of training, and
liardlv requires to adopt anv particular system: bui he ;- sure to
have picked up from books or ignorant, people some fantastic 7!t .or;<
about diet, and these should be dispelled as -piickly a- po-
( Farijiiharson. ) He admit ~. " It mav be ueee-sary to enfoi-c
diet rc-'imen on professional athlete- who tend to lead ;rre_
live-." In the diet-table- of boating men which King ('!
copie- from Maclarcn's "Training in 'I heory unu in 1'raci. :
is. nothing reiiuirkiible, lei alunc niysteriuiio:
1 \~2 MANTAI, OK DIKTKTICS.
CAMBKHHiK SYSTK.M.
St'MMKR RACKS.
A DAY'S TKAIM\<;.
Uiso at ? A.M. HUH 100 or '-.'00 yards The old system of nin-
Exereise. as fast as possible. ninjj; a mile or so before
breakfast is fast p>iii
out. except in the case
of men who want to u'ct
a p>od deal of flesh olL
Breakfast at Meat, beef or mutton. Underdone.
8.:!0. Toast, dry. Tea. two
cups; or towards the end
of training, a nip and a
half only. \Vatereivsses
ocetisionally.
Kxnvise (fore-
noon). None.
Dinner about 1 .Meat, beef or mutton. Some colleges have
:' P.M. I'rrad. Vegetables bakeil apples, or jellies,
]iotatoes. irreens. Beer, or rice puddings,
one pint. Dessert
oranges or biscuits or
\\'j>. \\ me- -t wo glasses.
MxiM'eise. About .").:]() start for
1 lie I'l ver .and row to t lie
starting |'osi and back.
Supper about Meat . cold. Bread.
S or !'. X'e^'etables lettuce or
watel'eresses. Beer, one
hint.
\v
A Day's Training. The only ditlVrenee is a
meat at one P.M.. " with half a pint of beer, or bisniit with a irlass
of sherrv. perhaps a voik of an CLTL: m I lie sherrv " instead of sup-
per; and the rowing exercise at two P.M., instead of half-pa.-t live.
The dietary ist!i:it of a well-fed prudent na\vv. \vho .
self so a- to earn tin.- best wap'S he can.-- -xvh:!' 1 '!!
far ,-hort of his work: then- heln;_r thi- dilYeri-i.cr. the i;,-i . -,\.,.
hard aii'l steadily for maiiv hours, while a raciii'j; '-r< \'. ha 1 ,'- N> u..:
a supreme ctl'ort fora liiuitetl time. eerta;nl\ under '..< i ur. A
highly nitro^-eiiised ilietarv. a- we have ~een In-fore aUi-w! tu^SBfi I
essential to ilie rapid liberation of force the oarnivorou- panther
can pounce upon t lie deer, which would soon leave the pat it he;- | ),,...
lesslv behind in a fair race.
I'lirsuinv; the subject (with hcalthv voutrj' person-: under con-
sideration at present), soinetliin^ mav be said of the reiriui'-n >!'
,L r ir!s. The i-e^iiiieii of ifii'is is plain 1 '! 1 than that of liovs. llvi-ou's
" bread-'ind-hut ter misses" remain niU''h the same. Kleo-ance in-
volved fraLrilii v: and foi- a boarditi^-sidiool ^irl to look robust ; ( nd
a p pie-cheeked was to call forth the deri.-ion (if her sd ..... i mat >-. with
t lie crude- sat ire of the younu' and, allusions to " dairvmaids. " After
speakinir <>f the evils of overfeed 1 1 IL:' ati' i the mal-a>-imiiat ion -o in-
duced. ( 'oml ie wi-oti ' The op posit i- error of not pi'o\ idinu' a -;i:!i-
eieiiev of noui'ishinir diet for the voting is. from mi-taken views.
much more pi-evaient than it ouLfht to be. particular! v in female
lioardiiiLT-si'liools. where th<' >vstem of diet is often msullie;.-:;t :',ir
due stistenutiec and ^1'owth: and where eoiiseijuent lv the natural
expression of impaired health, if m>t actual disease, ;- a marked
feature in the jispcct of mo-t of the pupils. So defective indeed ;-
the common school management in tin-, and other respects, that \\'e
have the best authority I'"! 1 eonsiderim:' it as a rare exception for a
p'irl to i-etiirn home in fui! health after speiidinLf two or three years
at an Knirlisli hourtliiiir-sclionl. h is ti'tie much of this i'e-iii;
owin^LT to eotiiiiiement . iiciflect of cheerful exercise, i , i-\ en; : .;;; "d
that of an insutlii-ietit dietarv must often be a'iiled. and \\ heii .
exist it aets with double force from the impaired di^'e.-t ;on. \',II'.CM
seldom fails to ensue where the laws of health arc -o v
raired. "
I >!'. I'.ai'low on ' Physical Kdtieation" in the "hie!
I'ract jcal Medicine " think- that of error- of die; a -pare ;-,_
more deleterious on the whole than a nutrition-; one.
of casual repletion are less prejudicial and more ea-i!\
those of inanition." To an imm-rfec! d:eiar\ ;
digestive power from visceral eonuv-; :on and :nact.\ '
due. part!v, to lack of outdoor exeivi-e. partly to .,'!!:>
1 1 1 MAM'AL OK DIKTKTK'S.
viscera in order to secure a graceful figure. To appearance, inaiiv
sacrifices are made l>y girls. In order to acquire pallor and get rid
of tin- hue of health some girls take an excess of vinegar, and attain
their end by dest roving their digestion. Others attain in order to
acquire the desired hue eat, r:i\v rice, until by setting up confirmed
constipation tliev ruin t heir sanguiferous niacliinerv. It is difficult
for a schoolmistress to \vateh and detect the vagaries of her charges,
no doulit. or discover the amount of slate peii'-il. chalk, etc., de-
voured in secrecy; and with this aspect of the subject \veare not at
present concerned. Then the dietary of school girls is loss highly
nit rou'enised than is that of boys; and this is desirable so IOIILT as the
physical exercise is so limited as it at present is.
Breakfast usually consists of bread and milk boiled, or porridge
followed by toast dry, or buttered, Avith rashers of bacon or meat in
some form. Then at midday dinner there is meat Avith vegetables
and milk puddings of all kinds and varieties- excellent food, as Dr.
Beaumont found with Alexis St. .Martin. with stewed fruit. A
suflicienev of this latter is desirable where there lurks a tendency
to constipation. Tea is a light meal, and supper consists of bread
and milk. The dietary is apt to be deficient in fat, and butter
should bo freely used. Cod liver oil is often requisite where the
assimilation of fat is defective, or the palate abhors it. So much
for schoolgirls.
The broad rules of the dietary for an active outdoor existence
indeed are followed in a vague Avay. With more physical exercise
would come a taste as well as a demand for more meat in the dietary.
So lon;_r. however, as the exercise taken is restricted, so long it is
well to have a dietary arranged accordingly therewith.
And in connection Avith this subject of feeding young people,
two matters may be considered of much importance in early life.
Of all the food taken into the animal body, carbo-hydrates, al-
buminoids and fats, each ami all can he found in the vegetable world.
Pnlv metabolism and oxidation the one for tissuc-buildinir. the
other for the production of heat and force LTO on m the animal
world. The plant builds up. giving olf oxygen: the animal oxidises.
The plant has no temperature, it is alleged (but where molecular
activity is going on there must be production of heat ).* while ani-
mals vary: the lower possessing some heat while the higher animals
have a distinct body temperature of some inn l-'ahr.. derived frmn
combustion \vithin tin- organism. The plant i- mot joui. - .; ;!,.-
warm-blooded animal is active. These t wo matters lm.lv ina - a:,
mot i lit v. U-loii<j t<> t he animal world. ( 'insc(|iie]it Iv die an: ma
sesscs for these ends a circulation and a ner\ous system.
Carbon and hydrogen unite \vitli oxygen, hut the blood imiM
contain an oxygen carrier for this combustion. Tin- rvd blo'.d-
corpuscles hear the carbonic add to the lun^s <_rivin:_r it oil' there;
and take in oxvp'ii. The venous blood laden with carbonic acid ;-
dark in hue. The arterial blood charged withoxviren is bright in
hue. \\ hat is it which curries on tins chemical interchange I' Ii ;
the luvnuurlobin of the red blood corpuscle. I hemoglobin
a very complex substance with a formula scptnethin^- like this
( ' , 1 1. X ,,.( >.,So ,!"<),., witli o or 4 percent, of water of crvstalli/ation.
This compk-x body has to be built up within the animal econoniv,
Ix'inir essentiallv an animal substance. The plant has no require-
ment fora blood-corpuscle. Its eirculatiii'jf thud corresponds to the
liquor saiiLruinis. Consefjiiently luemoirlobin cannot lie taken from
without. Nor can it be introduced into the svstem bv il'MiikniLj
l)lood. It consists of a union of luematin ((' II ,\ !'< I with a
proteid, and that proteid must bu cunverted into a peptone ere ;t
can ]>ass into the blood.
Amemia is a dearth of red blood-corpuscles, which H not curable
merely by furnishing iron to the system: though of course, iron i-
part of the cure. At pubertv. es| iallv in ^ii'ls. there is a di>tin>-;
tendencv to anremia. Sometimes there is even chlorosis or LTreen
sicklies^, with a positive breaking' down of the blood-corpusc]c<. and
discoloration of the skin from lirt'inoirlobin: ju-t as a bruise change-
its hue to p-reeii. as the elVused hlood is absorbed. Kor the cure of
aiuemia and also for its prevention j/ood f I. containing a fa :
amount of meat, and fresh air. is as essential a- iron itself.
So much then, foi 1 one maladv linked with the later veai<
growth, whii'h rcfjuires its dietetie as much as its medicinal mana'je-
Animals possess a nervous svstem: also a matter not ivoir.red bv
the vegetable world. This nervoii- system has its own want-. ;
it- food seems a phosphorixed fat. known as " Lee,: hut."
formula ('.,11 ^M'* ) . It, too, i- a eompl
t he or^ani>m. When the brain i< o\crworked fora lon-j 1
fii ml ion a 1 act ivit v i- impaired, as seen in " o\ cr^t ii'i v. " V a n-M
of fact, however, the voiui 1 .;' man \\lio ha-
1 1'"' MANTAL OF DIKTKTICS.
;i person with a ii;itur;illy feeble brain, which lias been found un-
equal to surmount ini; the usual educational tests. Recent Iv, when
compulsory education has caught in its net all our wails and strays,
or social Ara!>>. it has lieen found, as a matter of fact, that " over-
studv." leading to lira in collapse, is quite coiunion. \\ hen the poor
little tilings can p't enough to eat and feeil their brains, then these
last arc quite equal to what is deinandeil of them. \\ hen the dietary
of girls' schools wa< notoriously insuilieient, a break-down was far
from an infrequent event. Rest from work, change, and a more
liberal table, brought matters ri^ht in time.
\\ e may suppose a failure in the supply of lecithin as the
material factor of this brain exhaustion. As phosphorus is a con-
stituent of lecithin, this element should be supplied in any form
\vhichcaii furni.-h it.* Our assimilat ive processes seem ordinarily
to possess the power to break up phosphate of lime, or phosphate
of snda. and so provide the free phosphorus required for the nutri-
tion of the nervous system. P>ut under the unfavorable circum-
stances of under-nut rit ion. the power seems to be more or les- com-
pletely lost, and then it becomes necessary to furnish phosphorus in
forms less stable and more easily broken up. 'The hypopliosphites
arc available for this end: and may advantageously be added to the
dietary when the demand upon the brain is i^reat and the assimila-
tive powers arc feeble, or food is supplied to them in insuilirient
quant it v.
Iron then, for ana-mia. phosphorus for brain exhaustion: -but
hot !l wit ll a Sllfliclency of food.
Indeed, in youth and growth, the maladies are mostly (except
the contagious diseases and the results of exposure to cold) the out-
come of insufficient nutrition. As was pointed out before, the
consequences of over-feeding are much t he same as those of under-
feeding: because, in each case it is a question of defective a^simila-
t;ou. T'i swallow food and to digest it, are not one and the same.
It is what i- digested. not merely what is eaten which has to do
with nut rit ion.
The appetite of youth needs not the stimulus of food tempt ini:
to the palate. Plain foods arc quite enough in most cases. \Vith
invalids some temptation may be desirable, or even requisite. P>ut
of that anon. A suHicieiicy of plain fnod. meat puddings, etc..
should be provided : and when this is done, eat in;_r bet wi xt meals at
IX YOIT11 AM) ADOLKSCKNCK.
confectioners is not neressarv, and is eertainlv unde-iraMc for \oii'
peoj ilr of eit her se\.
I'ntil u'rowth is completed, aleoliolir drink- should lie avoid,
and oidv in ven \vlieii there is a verv deal 1 indication for their i;-r
and this is nut like.lv to ueeur in a euuditiuu of health.
rUAl'TKU XIII.
FOOD IX A DIM /I 1 I.IFK.
AViiKN" the period of growth is completed, the dietary chosen
varies with the individual, the occupation followed, the opportunity
for acquiring food, and of course according to the appetite and
palate.
Some broad rules, however, may be laid down. In the first place
persons of square abdomen and large viscera prefer a good sub-
stantial meal at not too frequent intervals, while persons of thin
ilank usually find small quantities at once, and frequently repeated,
suit them best. It is just the difference seen in steam-engines, or
rather locomotives. The express engine, running long distances
without stopping, has a large capacious tender to hold the requisite
quantity of fuel. Locomotives which run short distances, as yard-
"Ugines for instance, have small tenders; which, however, will ac-
commodate what fuel is required in their case. If the engine with
;he small tender were to attempt to do a long distance its fuel would
run out: in fact its tender would not hold enough fuel to enable it
to do the distance. So it is with human beings. A wife of slight
phvsique (with a small tender) tries to accommodate her meal-times
to the \vavs of her substantially built lord, and fails signally. She
must have one at least, or more meals betwixt his solid breakfast
and his late dinner; she could not hold enough to carry her over
the long interval, if she tried her best. She makes the attempt to
do as he does, and utterly fails. She is not built on the same funda-
mental plan, and cannot do as he does.
Men ditl'er too; the man of small viscera requires his meals at
comparatively short intervals, because he can take in but a small
quantity at once. Some savages who have to cat as they can procure
food, eat enormous quantities at once, when they get the chance,
and then fast accordingly. They break their fast when they get
the opportunity. Our word for the morning meal is "break fast"
because it breaks the fast of the ni^ht. This matter of eating, and
the large and small tender, is far too little considered, where a
number of persons are living together. Jf it received due attention
much discomfort, if nothing more, would he a\oided. " \I;i:.-,
female- ami delicate persons injure their powers of digestion hv de-
la\ MILT their exercise till the system is too much exhausted |., pr.,:i;
liy it." (( 'oombe. ) \\'hen I was in country |n-:ietiee. 1 noticed thai
certain fanners' wives were alwavs ill after attending market.
'I'hev were all o f the " small temler " I vpe. 'I'hev hreak fa-te, 1 earlv.
hustled about at market, took no mitlilav meal la- usual), ami >o
had a racking headache lie fore thev ^ot home, ami \vere " jiast
eating" to use t liei r own lan^'iia^e. Too loti^ delay destroyed the
appetite when the opport unit v for food came. Manv person-; i-an-
not eat then' lireakfast for this reason; the \<n\<j; fast lietwixt supper
and lii'eakfasi is too much for them: such person- need something
in the middle of the ni^'lit. Some milk, with or without mail ;n it,
in a juu" with a lid (so as not to acquire ; mv taint of the room), am!
if t he weat her is cold, kept warm under a " teu-eosev." is a ivadv
and handv form of food for such persons. ( >r some heef tea and
baked Hour may lie used instead. "('hronic invalids ami persons
of a delicate liahit of hodv, are also familiar with the fact of t he
animal heat and general viu'or diminishinu' towards morning. I>ur-
in^' the prevalence of cholera, both here and on the continent. ;;
was often remarked that a lar^e proportion of the at lacks occurred
earlv in the morning, in persons who had u'one to lied apparently
well. " (( 'oomlie. )
There can too be no doubt that digestion is much (pucker witli
some [x'rsons than with others. And this is a matter which does
not permit of more bem^ said. It is a matter of experience with
each individual.
In old davs after a hard ti^ht on a lonu" march, or a (lav's hunt-
ing, came a Li'ood feast. lint in our degenerate davs we cannot do
this. And with persons of weak digestion, it is a piod rule to eat
les.s, and to be pai't icular about the food bt-ln^ easily digestible when
tired. Perhaps, to eat less, and take a little extra wine, is the be-l
plan to adopt .
Meals must vai'v according to the individual. The A n ^ !o-Sa \
prefers a substantial breakfast. The |-'rencliman and the Au>:r.a:i
like a cup of cotl'ee and a roll on ji-tlin^ up, and then take a -
stantial meal about eleven \.M. Tliev take a second ^ood me:
the evening. It is Well to have some fooc 1 earlv. e<pcc;ali\
who stmiv, or work for hours in the eai'lv moniitiLf. I he ;
rum and milk lirst thimj' in tin 1 mornim.:' reconnncnded
lives, often is of the greatest utiiitv. and enables them to ea' a :a;r \
ll'o MANTAL OF DIKTKTK'S.
good breakfast: which otherwise they could not do in consequence
of t lie long fast. Times for eat ing must depend on the 1 individual
requirements. Families usually get on well together, because of
family likeness to each other. \\ hen a stranger comes among them
then .-omebodv is apt to suffer.
The difference in individuals as to their food requirements has
been noted by .lames Henry Bennett, who savs. " In some persons
the digestive process being very rapid, frequent meals are required
even when abundant. For want of food at comparatively short
intervals, for instance, four or five hours, sensations of sinking and
i'aintness come on, and if the desire for aliment is not gratified, the
appetite disappears, and general prostration with headache and even
nausea ensues. In others, on the contrary, the digestive process
appear- to be very slow. When hunger has been appeased, tin'
desire for food is long in again making itself felt. Such persons are
generally satisfied with two. or at the most three meals a day. They
are often not larire caters, do not require so much animal food, and
can bear much better than the former, accidental or forced absti-
nence. " Elsewhere in discussing t he same subject, he writes " The
food requirements of adult human beings vary according to climate
and temperature, and according to the activity of their organs; they
also vary according to individual peculiarities. Some persons, even
in health, digest rapidly and imperfectly the food which they con-
sume. With them a considerable amount of it pas.-es awav undi-
gested through the intestinal canal, and escapes with the fares.
With persons so constituted, hunger soon returns, owum' to the
demand,- of the economy having been imperfectly supplied, and a
fresh supply of food is required; it is as if half the coal placed on a
tire had fallen through the grate. With others, on the contrary,
the process of digestion is slow, and the elaboration of the nutritive
material- contained in the food is complete. Such persons both
require less food, and that food less frequently, inasmuch as they
extract more nourishment from what they take." And such indi-
vidual peculiarity is by no mean- confined to human beings. All
who have had mii'di experience of horses, know that some can do a
Lrreat deal f work on moderate supplies of food, while others "eat
i heir heads oil' in no time," in stable language, and vet are no; capa-
ble of much work. And t his seem.- to hold v;ood of breeds of horses.
Once I ha'! two out of the same marc, which were just like their
mother, in the small quantity of food they required, to do their work
and keep in -ood condil ion.
FOOD IN AbU.T I.IFK. !_'!
It is also eertain. that the temperament of tin- in dl \ 'id i;al
ences tin- ta-te I'll' and tin 1 amount uf fond taken. ( n|i 4 T,_f! <
"tiic following imperfect remarks " which, however, -in u.
of n.imtatmn. " \\ lii-i'i 1 the constitution is of a mixed iia:nr-. <T , L
compound n f two or more temperaments, a <iiet eompi>-rd of animal
and vegetable aliment in nearlv ei|iui! proportion- i- uiuirr nr.;li.arv
circumstances the l>est. ilnt where any one temperament predomi-
nates, the diet onu'ht to he modified accord hiLrlv. \VlnTe, fr c\-
ampii'. the sanguine const itution pi'evail-. and is ehara'-teri/.i'd !i\- a
tlond complexion, ^reat activitv. .-trmii:" action "!' thi- ln-ari and
Mood-vessels, and a consci|iicnt lial'iiitv to diseases of exciti iip-nt
and inllaminatioii, the food oii^lit to \>f lialiit uailv of a k;ipi calcu-
lated rather to soot he than to .stimulate. Red meat-, spices, \vines,
and fermented liquors oin:lit to lie n-ed spariniriv: and the prinejpal
sujiport to lie derived from refreshing >oiips. ii>h. mucilaLriiious
vegetal ties, acidulous fruits, and diluting drink-. In the case of
lymphatic person-, on the other hand, where the circulation is u.-ak
and slow, and ail the funetioiis are feeble, the system is bein-iited
iv the stimulus of a larger propm-tion of animai fond, e.-peeiads red
meat and ^ame; while vegetables, soups, aiui tluids nf a.l kind-
prove relaxing and hurtful. Aromatics and spice.-. howe\cr. are
useful, as is also wine in moderation, and conjoined \\;:h aiieiaiate
'\eri'ise. If aLi'ain. the individuai presents a h,!_rhiv nervous teni-
peraineiit. chanieteri/.ed by delicacy, unusual sensibility to impre.
.-ions, and ^reat cxeitahilitv. witluuit proporl innate strength, -ueli
as is often seen in females and :n men of genius, care on^iit in i'C
taken not to make use of a heating or st imiilat in^ regimen. \\'IL;C
meat, sueh as li-h or fowl, are more suitable than ihe k;nd-
nar\' us". Siijer- arc also hurtful, but farinaceous and mue:.a^',!;i'i;.-
aliments and ripe fruits, are LT l 'iierall v admi>.-ib!e, alwa\.- .-upp"-^
IIIL;' that moderation in Muantily is attended to. and that the m...;e
of life is in ot her respect- regular and rational. \\hen tin- .
bilious temperament predominates, and miieh bouiiv i-\.
the open air is ciijovcd, more latitude in the eho.n- c.;
ad in :--;! lie. than in anv other constitution." \\ ;th th:-
mn. however, I can not i|iute a^'i'ee, as m\ i-xiier'i-ne.
ill ; he din-el ioll t hat liiliolis people do not do U e o"
of aibuminoid food; a mallei 1 that will be di-eu-^d 1,1,1 ;
ter. Utherwi-e what \>r. Ctioinbe say-'iii,le
I'ieliee.
The haliits and food cu-t< 'in- uf t he
ll'-J ^lANL'AL OF DIKTKTICS.
culated. and form a matter of some importance, which those \vlio
meditate foreign travel too often neglect.*
Or. I>ennett writes, ''Just as the stature, features, and bodily
proportions assume a characteristic peculiarity in each individual
during the period of growth, so the organic system also receives its
stamp, the result of earlv habits which usually last throughout life.
The habits of organic life, if we mav so term them, are partieiilarlv
marked in the digestive svstem. A man who has been brought u[>
to the adult age on a very animali/ed dietarv. in after life requires
such a dietarv more than one who has lived principallv on vegetable
food. Again, the one who lias been accustomed until middle age
to eat often, mav not with comfort and advantage be able to supplv
the wants of his system by two meals only: and yet this system of
feeding may perfect ly agree with his neighbor carlv inured to it. Thus
it is that the Herman, the Frenchman, and the Knglishman become
habituated to the food and food hours \vhich obtain in their respec-
tive countries, and that their digestive powers often give way when
thev change their residence, and endeavor to conform to the novel
habits of their new place of abode.
" These facts were well illustrated bv Avhat occurred during the
Franco-Herman War (180970). .Many thousand French prisoners
were put on tjie usual dietary of t he Herman soldiers sausage meat,
coarse bread, and beer. The common soldiers, peasants, and artisans,
accustomed to a coarse and spare dietary at home, did very well,
throve; but it. was not so with their officers. The latter became
dyspeptic and ill. and in manv cases their health was broken down
and ruined. 1 have attended at Mentone several in whom the seeds
of fatal diseases, principally phthisis, were then sown."
To a slightei degree the same thing was seen with the Anglo-
Americans who were studying in Vienna the winter the writer was
there. Himself, a hardv North-countryman, got on well enough;
but neariv every other one complained of the food being indifferent,
and were more or le-s out of sorts from it, if not actually ill.
On the oi her side may be quoted a case which ( 'oomlie took from
Jleidler- "A v mug woman of healthy constitution, brought up in
* Wh.'ii -i in it > i if i||.. inliMbitaiits of St. Ki Ida's, a u ild n>ek in the Atian-
tie far away In tin- \VI-NI n|' iln- 1 {ebrides. emigrated to Australia, it was
1(/uiid " 1 hey ei MI Id i ,n I v in- |<i-|)i iii IHM It 1 1 liv an <x -rational meal of 1 IK- rank
'L:'u's and dried pullin^ 1 ln-v earned with tln-m." While I'"inn recruits in
Ku^-ia nii th'' Imvli-liark in tln-ir brown liread on leaving home.
FOOD IN AIH'l.T I. IKK.
all tho simplicity of country habit-. pas.-ed at once on her m, '.'.-.t^-
to a less active mode of life, and to a much mop- c;.-^;ii!i ta'> . I\
a >hort time she he^an to complain of irritability, la>- itudc. \-,r..
spasmodic sensations, ati'l habitual con.-t ; pat ion. 1 1 \ p< ichon>ir
was sonii adilcil to oilier symptoms; her hope of hcci>miii'_r a
mother bciiii:' always deceived. An additional i;!a-- of wine, hark,
and other tonics were ordered. The evil increased. The pat ;,;.
liecame melancholic, and believed that she was ahvavs swallowing
pins. In the course of the year she became so emaciated and vel-
iow that her mother, who had not seen her for eleven month.-,
could scarcely reco^u/e her. After an eighteen month-' emir-e
of purgatives, and two courses of .Marienbad water, she entirely
recovered. "
The same thniLT is commonly seen in country cfirls connnir into
towns to sedentarv occupations: and yountr fellows abandoning an
active life to wait behind a counter especial! v in rooms inditl'ereiit ' v
ventilated. "The operation of the same principle is c((iially con-
spicuous in i^ir Is sent from the country to t lie work -rooms of fash ion -
able miliinei's and dressmakers in the larger to\\ns." \\ith little
exercise they rei|iiire less food; but if the appetite keeps up. head-
ache, sickness., biliousness, indigestion and constipation are apt to
follow. Strong and healthy fellows who conn- up fruin tlu- country
t< sedentary trades and occupations also require and -jet some un-
pleasant experience before thevcaii adapt themselves to their new
form of life with its novel needs and requirements. The same is found
bodily labor comes to luxury and dines out. while he settle.- down
to a sedentary life to put his book through the press. He -oon
linds that his new life makes new demands upon huii. with winch
he must comply, or pav the penalty. l.iii'ht fond of a kind likely
to keep the bowels open (see a later chapter for this), is the a.iment
which wil 1 keep him in heal t h.
Then comes the relation of food to climate. In tropical coun-
tries tin 1 carbo-hvdrates form the staple of food. In temperate
climates a mixed dietary has been adopted a- the result o] c\
cnce; while in Arctic regions the concentrated fuel-food ha- been
found the only food that will sustain life amidst the inten-e cold.
The stomach of an Ksijtiimaux couid not hold enough o! ">
hydrates to preserve him against star\ation in the low surroun'i ; nir
temperature. Liebi^ pointed out that the carho-h vdrate-
tropics contain only some 1 '.' [icr cent, of carbon. 'I he
ll'l MANTAl, (>!' DIKTKTICS.
of the Ksquimaux. blubber ami oil. contains from i>0 to SO per cent,
of carbon: consc(|iu'iii 1 v AVC can readily understand the preference
manifested for fat in Arctic regions for heat-generating material
indeed. There is no taste for sweets in these Northern dimes, and
Sir Anthonv Carlisle found that even babies there had no taste for
sugar, spluttering it out of their mouths, "while the little urchins
grinned with ecstacv at the sight of a hit of whale's blubber." All
Arct ie voyagers have fotiml the necessity for following the. Ksquinuiux
in the diri'ction of eating;' fat in liberal quantities.
The importance of this matter of climate and food require-
ments is illustrated !>v the need for varied stores when bodies of
men are sent out on expeditions. According to the temperature
so must their food supplies be furnished as to qualitv and quan-
tity.
And closely linked with this matter comes that of the relation of
food to work. It has been pointed out before that both with men
and horses more nitrojjenised food is required when active exertion
and hard toil have to be endured. We see the farmer raises the
allowance of oats to h;s horses at ploughing time. The Aral) gives
his horse barley and camel's milk, and if great elfort be required,
even camel's llesh. The horses used in Sahara to course ostriches
get camel's milk and dried beans. (Paw.) This is a very highly
nitrogriiised food material, but the excess of nitrogen enables the
horse to make rapid movement-. The muscle itself does not, wear
out in exertion, as was once supposed. Traube held that the muscles
burn up hydro-carbons, as fats or carbo-hydrates. Possibly the
store of glvcogeii is the fuel of the muscle when at work. "The
muscles appear to stand in the position of instruments for effecting
the conversion of the chemical energy evolved by the oxidation of
combustible matter into working power. While admitting that
hvdro-earbons are the fuel which produce heat and force, the neces-
sity for albuminoid materials for hard exertion has also t;> be recog-
ni/ed: a~ albuminous food produces firm muscles, so exercise makes
them hard. To .-um up. science intimates that a liberal supply of
nit rogenised matter is necessary to produce and maintain muscles in
a gin" ci nil for work, and the result of experience is to con-
firm it. " ( Pa \ y. )
This brings u- face to face with exertion in cold climates. The
maiix consume much lean meat with their fat, without in-
\\ e '' undcr.-tand oxidation being very active in Arctic,
<. me-; and a- \\:\< been >aid before. MJ long as the liver can convert
t lie waste or surplus albi
well.
If the muscle itself .Iocs not weai' out. what is the rca-on :h,v
nitronvntsed food is essential for severe exertion:' It -ecin- ;., nic
t he answer must lie found, in the stimulant eiTeets of kivatin and
kreatinine.- the stimulant, factors of beef t,-a. Thc\ are f, ,.-,.,
liberalors. and so enable the system to ^vt ai it- stored force mo;-,-
rapidlv and reaililv. And a certain proportion of tiiem :ses~ent;a;
to active cll'ort. Navvies, lightermen, and others who work very
hard have found t hat a considerable octant it v of meat in i heir d ietarv
is essential to enable them to undergo tlieir toil. 1 >r. .lames ll.
Bennett, in discussing this subject . savs" 1 was told by a n eminent
railway contractor, that when some of his navvies were first taken
to work on French railroads it was found that they could do in the
same t i me double the amount of work 'ot through by the French
workmen, who lived in a much more sparing manner, and princi-
pally on bread and vegetables. The French sub-contractors wcr-
obliged, in order even partly to efface this dilTereiice wonndm-- to
their national pride, very considerably to increase the dietarv of
their workmen, and more especially to nit ro^'einse or an;maii-e it.
By adopt ins; this course, the French workmen very soon increased,
their muscular powers. The materials for greater muscular devel-
opment bemii' LTlven, and the lliuseles at the >anie time freelv exer-
cised, the organic nutritive flianires became more rapid, the muscles
increased in compactness and volume, and the work power increased
in proportion." This reminds one of I'avv's story of a farmer who.
when asked " how it was that he paid his laborers so well I'" re-
plied " that he could not afford to pav them less, for he found thai
less wa^es produced less work." The old Northern farmers alwav-
kept a liberal table, say 'MILT -"* Work <foes in at t'mouth."
Sir I .von I'lavfair some years au'o took up the subject "On ;';.
Food of Man in relation to his useful Work." He found tha:
'' Subsistence diet " for persons who were not doin<i anv work ran
about as follows:
\it roLi'enous matter, .... '-'. "'- o.x.
Fat. ' I'.-l
( 'arbo-hvd rates,
I vnamic value in \'< <\ tons. '.'. \~>'-\.
ll'ti MAM" AT, OF DIKTETK'S.
Nitrogenous matter. ....
Fat
Carbo-hydrates iS.tiiU) "
Mineral matters 0. ; 14 "
Dynamic value. 4. (I'M foot tons.
Diet of active laborers, including that of soldiers in Avar time:
Nitrogenous mutter, .... .\41 o/.
Fat -1.4] "
Carbo-hydrates 17. '.Ml "
Dynamic value. 4.4.">S foot tons.
In this last it will he seen that the force-liberator the nitrogen
is considerably increased: and that the concentrated heat, or
force food (fat) is also notably increased, with a fall in less concen-
trated hydro-carbons.
Dr. 1'arkes found the food of the English soldier on home ser-
vice to be:
Nitrogenous matter, .... :>.Si> ox.
Fat !.:;<> ;>
Carbo-hydrates, ..... K.:!4 ''
Mineral matters. 0.808 "
which is very close to Sir Lyon Playf air's estimate.
From these we can form useful broad rules as to the dietary of con-
victs (not doing hard labor) and persons in workhouses. While
comparatively short rations will do when no labor is exacted: a more
liberal dietary becomes necessary when work has to he done; and
when verv severe exertion is expected the dietary must lie still more
1 literal hot h as to force-liberators and force-producers. The capacity
of ihe Fnglish soldier in war has ahvavs been looked upon as closely
linked with Ins commissariat. Prowess and food go together, of
course the cpiestion of food can never be separated from that of
clothing in cold climates. the more that is required for the heat
tin- less is left for force-production. The native of Arctic regions is
clad in furs in order to reduce his heat loss, and so lessen the demand
upon his fuel-stores, Fven then lie needs liberal quantities of fat.
(the concent rat I'd fuel -food ). About twentv pounds of meat and
b, libber per dicin is the ordinary allowance. And Sir John Ko~<
found t hat a 1 afire con sum pt ion of " ( ireenland food " was 1 lie road
to .success ni fro/.en countries. " The 'plant it v of food should be
FOOD IX ADl'LT Lll-'l-:. l'J7
increased, be that as inconvenient as it may;" and of ci.ur-e
economise food l>v suitable clothing as far as possible.
On the other hand the Knjrlishman who will persist in tlf dietary
and especially "the roast beef of old Kn^iand " in tropicai e,imates
sooner or later falls ill with some hepatic trouble; I aii-c hi- liver
cannot deal effectually or successfully with the albuminous food
which he consumes far in excess of his bodv-wants. 1 n ( I iv-nlaud
he would hunger to death be entirely burnt up "stork, lock, and
liarrel ''-ill two or three days on a dietarv aniplv siitlieient for the
plains of Bengal, or the (luiuea coast. And fire n-rxi'i, a (Ireeniand
dietary would pall on the appetite in tropical climates.
"There can be no doubt that a lar^'e proportion of the disease.--
i I 1
of the digestive apparatus which are so fatal amon^ Kuropean iv.-i-
dents in India and other tropical climates result from the habitual
inirestion of a much larger quantity of fooil. and this especially of a
rich and .stimulating; character, than the svstem requires. The loss
of appetite consequent upon the diminution of the demand for com-
bustivc material, is set down to the deleterious elTect of the climate;
and an attempt is made to neutralise this bv artificial provocatives/'
(Carpenter.)
Taking his statement ''' that about two pounds of bread and three-
quarters of a pound of meat are amplv sutlicient to compensate
the daily losses of the system in a healthy man" (in a temperate
area), we can see that considerably less than this is enough for the
hot! v wants in a tropical climate; and that much more will be re-
quired to maintain the bodv heat in the Arctic regions, especially if
considerable exertion is also entailed.
Women as a rule eat verv much less than men. They lead an
indoor life, usually in warm apartments; they arc smaller in frame,
and lighter in weight , and consequently require less food. \\iicn
women are out much in the air, either as ladies hunting or field
hands, t heir needs are increase! 1. and substantial meals are
and usually are taken bv the ladies at least.
i/.ed tribes, women often perform much of
probably take food accordingly.
The clerk, cooped up for many hours daily in a warm otli
(often up lo it)' l-'ahr. ). requires eomparat i\ eiy small quantities
food : the same may be said of the miii hand and the ar!,-an.
haudici-aftsman working indoors. \\\\\ for the field liaiid.fi
and tlie lighterman, and the soldier on active service, a i
\vnrkniL 1 ' eniiiii
ll'^ MAM'AI, ()!' niKTKTK'S.
persons performing litiic pliysicjil toil the food should consist largely
of earho-hvdnites in the form of farinaceous food, with sonic nitro-
gen such as a tish diet could supply, ami a little animal food. Of
course. where tlu-rc is aiiv tendeiicv to tissue degeneration (phthisis
or sci-ofula), a certain quantity of fat is desirable. lint, with all this
calculated, we nui-t still reckon with the disturbing factors, the
"palate" and the "appetite." which will rule the roost with many
persons.
In a vegetarian dietarv, the legumes (rich in nitrogen) take the
place of meat, while oil supplies fat: and mineral salts arc furnished
bv vegetables, as cabbages. No doubt a great deal of excellent work
has been done bv vegetarians; ;ind a great manv people would do
wisely bv becoming seiti i-vegetaria us. at least, especially in warm
weal her- t he \\ n; er's o\vn personal practice, lint then there are
to be heai'd so many other voices, including those' of the housewife
and the cook than that of Science on this topic !
Then comes the matter of the opportunity of acquiring food.
This is a matter which can scarcely be discussed at length here. It
is a well-known fact that stockmen and miners have very often to
live on undesirable food, as "damper." Flour cakes are indigesti-
ble, and pancakes have been the ruin of manv a stalwart fellow, who
ate them because he could not get anything else.
The subject of the food requirements of adults may litlv termi-
nate wit li soi ne oo n-id era! ioiis of the tendency of the a ire. \\"e have
not :_ r o t the internal arrangements of our ancestors, and cannot deal
with the quantities of food they ate apparently without ill clVect.
And this is .-peciallv true of meat and alcohol. There is a wide-
spread movement towards ''Vegetarianism" and " Teetotalism "
ainoii'jr the Anirlo-Saxon race at least; and this must have sonic act-
ing agent. Ina little work published some time au r<| . ("The l-'ood
we Mat ") the writer speculated as to the dietary of A. I), .'ono.
\\ hat H put there in a li^ht and jocular manner is however what he
seriously believes will be the ease, and what we are COUIHIL;' to. Hut
of course the spirit of the axiom, ''the future must take care of
itself" prevents anvoiie from taking any steps for their potential
descendants. For the bulk- of persons a lighter dietarv consisting
largely of cooked farina (otherwise predigested starch)and milk will
probably be found the bc-t. Hut for tho-e engaged in literary work
some doubt mav be expressed. " The irnm old millers of the tongue
and pen " were caters of meat and drinkers of wine; and Carpenter
states:
*' . \iiil while on tin' other hand il mav !>e fivi-lv eoneeded to th-
ud vocal es uf 'Vegetarianism' that a well selected ve^'taMe die!
eapahle <>\' pruiliicin^ (in tin- iri'iMtn- iiiMiilici- <!' i!nii\ ili;aN) th.
hiirhfsL phvsical <lt'Vfl()|iincnt nt' \vhicli tlicy ai - f rapatih-, it IIKIV !
on tin' other haml aHirnu-il \\ith ci|tia! rcrtaintv, that the suh-ti-
tution <>t' a nTtain projioi'tion !' annual llt-sh i- in \\<> \\av injiinmi- 1 .
\vhili' so t'ara-onr cviili'iirc at present extend-, this serins raih'T
to favor the highest mental development."
So much then for the food wants of in'own man under tin- various
(nvumstaiieer-. of oeeupatioii and eii\ iruiinieiit.
CHAPTER XTV.
FOOD IN ADVANCED UFK.
"A MAX loves the meat of his youth that lie cannot endure in
his avv. "
So said that most remarkable observer. Shakesjteare. Ib>w he
ever found time and opportunitv to observe all he did. is a marvel
to ordinary mortals. This observation too is perfect Iv accurate.
There arc a <jood many reasons for the inability in ap' to cope
with the dietarv of vouth. AVe saw in the last chapter the relations
of the food to the individual, his work and his environment; and
can applv its lessons here. As aije advances the energies wane. The.
capacity to take exercise or undergo (oil is enfeebled, and the in-
clination to do so also lessened. A man pleads he " is not so vouns^
as he once was." His limbs are stilfer and his wind is not so v;ood.
Some certainlv retain their vipir till a verv old air* 1 , and with it their
digestion and their gastronomic ardor. In mv davs of earlv practice
in the North of Kn^Iand. there was an old gentleman of the old
school, and the habits and practices of the Iiep-ncv. 1-Yoin earlv
morn till dewv eve he sturdily walked throughout the dav in order
that lie miirht cnjov his late dinner. His bell was his ^od ; and he
was an earnest faithful worshipper! It was not a lofty creed but,
it could inspire conduct: and that is the highest terrestrial etTect of
a creed. He walked, he ate and what is more, ate with impunity;
and died a nonop-narian. After all it was a piteous si^'hi to see the
old patrician tramping a Ion <r in all weathers with his dinner before
him-- an object, however, which could hire him to undergo ail the
inconvenience of exposure to bad weather in a tempestuous locality.
1 1 is ambit ion. such as it was, was irrat iticd.
At iir.-t " llie turn of the hill " is scarcely noticed, and perhaps
the oldv diH'erence is that the individual doe- not come twice to the
joint. I'rohahlv, too, the once cherished draught o| ale is no longer
so keen'v reli.-hed. A slighter excess of alciihol is felt next morning
than of voi'c. I'erliap- LTout ba i ; h:m to leave oil' jiort wine.
Hut as years cree]) on the alteration In'comes more marked; the ap-
petite irencrallv is impaired : tin- palate lose-; its once k , ed :: a
thr skill of tlie conk is no lunger so successful in lirkiin^
and tiie appetite; hut as tin- latter fails so the ^"nrmand
more particular about lus dishes.
The teeth, ton, fail: ami tin- strong meat " ^iviiiLT a L r| ""i
IS lio longer So easllv IlUlStieated. ( 'oliseouent iv <//'/'>- take t:
place of the joints, the steaks and chops, on v so eau'erlv de\ouiv>
Spoon-meat is found more acceptable in evi-rv \vav. More eond
incuts are i'ei pi i red. ami hitrhlv seasoned dishes find favour for iu!
reasons tlian one. Flatulence is the ham- of advancing vear.-: a;:
for this the cook can do much. There ;.- a tendeiicv to constin
tiou: and that too is a matter I'm' which much can be done in ti
kitchen.
1'iefore proceeding f 11 ft lief i L Ilia V 1 ie \\'ei 1 to (plote frotii "T!
Diseases of A'ivanced LitV'" hy Dr. .Mcl.achian. on the anatomic
changes which -jn on in the viscera in a^e. " I'art icipat IIIL: m '1
general wasting of t lie organs and tissues, the stomach and iutc-t iin
lose hulk and hecome thinner in oid au'e. Their glandular appar;
tits is also atrophied. Many glands seem to ha\ ' cut irel v d;.-appeaiv<
The \vastinir n i' the tunics composing the stomach and iniesiines
moi'e obvious in the duodenum, jejunum, anil ileuni. In some ca-
it is carried to such a decree as to admit of the contents of the i:
test nies beiiiLT (1 >ist met Iv seen through t lie attenuated structure-. 1
striking contrast, the larger intestines oceasionally [>n-serve the
natural thickness, dnetlv throii'di a compensating hyp'Tt ropiiv >
the mu.-cular coat. The miii,-ous niemhrane i< usuailv paler than
t he ad ult . and, general 1 v aeipti res an ash Lfrav colour a- life an vane.'
In the .-toinach it is often traversed hv eniar^'ed ve;n~. a.~-ii!i;;-;^
varicose character, \vhich heeome more Tiumcrmis m the lo\v;- po
tions of the intestinal canal, and are part icularlv conspicuous to\van
the termination of the colon and rectum."
Such anatomical details tell us thai the 1'iinct ainal ac;:v::v
digestive organs mu-t he much impaired in au'c. The a 1 '-
act:onmtist he cripjiled bv tlie stairnant current in the.-\vo].en
The glands of the small intestine are atrophied. Co 1 ,-
initrition must In- less perfect, an^l the ; ! miisi o;
readily annullable character. No \\onder
MANUAL OK niKTKTK'S.
: :..<! the a'-:ion . :' :'.- l...v. d- ren<lere.l -"__--':. Th<>'i the
:' ; . . \vi r -: favor piles, an i nther maladies at
or i " v.>.
T: ni'iral of all :h's is. that the as.similative orpins a- years a<l-
van arc M< ; " '. t" [rivat lit-niamls in >n thcni. T<> fas: t" t-niov
;.;.::. :;r.: an- 1 takt-y. a I n: ' r - > '. :. _' ir.t-.-rva'.s. " < hire a nia:; an<l
" .-ay> ':. n.i] mlairc. A:. ; tin- ilii-tary of T:.' 1 very nM
;- '. n. or./ the nursery. l\-rhai'.s nmn- eondinn'iit- are
: ' ::a:i "f yore: 1-ut tin n tliat ajrain is a return t" early .lays.
Tile ' ' ei of Ir.faivy returns : :. a-lvaii'vl life: an.] the !'<>."!
must In- i're]iare.] a ":;:?. _ly. Sni; 1 nieals i-fi rtM-eated iie.->me
Wlu-n any riinsi'lerable luilk 'f :' 1 is eon~ume>I a; i>nce
_:::; - r ,':":' the a! ;ir.entary _ s se: up. Tlien- :> iliarrhu-a
?'.v. _-.' : :._ m; - ; _ in-' li-
nn: rir tin-re - "iisT nate i-on>:;i ;'.-.. when ;:. ; "We! :- un-
..:._ ::.--.' >u \. [n eitlier - is ;r. <i :o
v - : . rious ki 1 is. : ro\v!^. ;!.:.: whit", thi 'k a:. I Irar. 'i :'. sh
or i'.-h. _ : ' ' ' !in ! .: n !>i>.'u:t. nr s. ane .;n : \';(-
.::; nn !:< i i-urt'-r. ( '. n > >.;' far
:.- ras.' any U!": 1 '-
: :?iv : U. P. . nr ;, -
.;.-::.- >.::. < .r eauli:: v--r
nr - .:: ' ' ' : -':.'.> -. 'li. ' '- ' I r < Iil'.O-t.- ':.i'
'_..-'-":' :i .-!na!l
. !'",'l'li:;u r .
: L'h' -'.-:' a l'<iij . .-I ' . ;:- : . !". .; ; ;-.-.ik-
_ . . ' - :.". !' -"!u far.i - ' .'.is :'. .< ' 1
: . . '_'. Stale
,-. ! \v 1 1 i
:--. (.'- in :!':-.. ur '.; -i l-:f;i-r.
':..!/.; : -jf v.-.-li ; .ut:<-re i
M L,.- : ii::t!i L> ,]>:>.] : . :'.. ' M
vr-_'.-:;i;.V^ ..- ._v- ry k::.'I. :.:. I v:.:.
r.u-a.s. A !!.: ;;-.:" ;:.;:. ..:_ -:":
Th- >;.'.!- -I u-j- ::;':.:. -:;:v "\v
ma::<-r : ir.":r.t-:,: \\\::i i-Mi-ry :
a.]..:o-I. Mi'.k sir,-!.:
t.c ;u* n::iy .:i\r ;:: >-r..., lii
ii< ;;::. _ r tin.' !:;:!. : - ;i". \v;it- r.
< '; \vin-v may ' !!:::;. :i::I a
i!iL r ' !: 11. !ik si'.:- a;,'i i:. . '.k sr,-'a
A:, .:h,-r ;!;;>; !.,-\rv:i>i- \vi::-!
i'-'fi' ; a (;-- r<\ ,:.ari'.v i!:ai!r '. T
('!' a- a -ii':; .;:;; :'t>r :> >.';. :-.;; a
'-a a \ ITY ;._r^' a:>.i-
li.aiii'. \v;:;i a littit 1 '.'fi >; "; a:. . .
l: 1 . t
MANUAL OF IMKTKTICS.
Then attain, a return to nursery food is food in the form of
stcsvcd fruit. Tin- toot hless j:i\vs cannot deal with tin- linn apple
as ean the sharp unblniited teeth of youth, and consequently it.
niu-t l>e liaked or stewed: and verv irood such fruit is for elderly
pcrsi >ns.
There is a medicinal niattei- connected with stewed fruit. \\ hen
earn- suirar is added hv the cook the resultant product is apt to turn
aeid in the stomach with manv persons of middle aire and advanced
life. Iii such cases it is well not to mask the acidity hv adding
commercial suirar, bin to neutralise it hv an alkali. This leaves the
natural sweetness, due to the levtilo.-" suirar of the fruit, which is
Mifito pronounced enough for elderly palates. The amount of bi-
carbonate of soda, to he added when the fruit is put into the
oven, is as much as will lie upon an Kn<rlish shilling, or a (Jerman
mark. or an American <|uarter dollar hit. to the pound of fruit.
This 1- quite enough even for unripe irooscberries. Such stewed
fruit is excellent, and will often a^ree. where stewed fruit as ordi-
narily prepared (/./'.. by the addition of cane or beet suirar) turns
acid.
This matter will be referred to a^ain Avhen the dietary of the
u'ont is considered, only there it is well to substitute the bicarbonate
of pota-h for t he soda.
Such stewed fruit with cream forms, or oujjfht to form a regular
staple in the dietary of old a ire.
1>\ keeping the principles whidi should H'liide us in the selection
of food, well in \ lew. much may In.' done to preserve the aired organ-
ism in health. These matters of mineral salts, fruit salts, ami vege-
table or meat salts, arc of much importance; and more attention
mav be paid to them with advantage.
M;lk puddings of all kinds and made with Hour, maixe llour.
broken biscuit, rice. saL r '>. tapioca, and semolina should form part of
the dinner, at least, with all old persons. I'orndire. or some similar
dish of oatmeal, h^niinv. or any prepared cereal- should alwav- be a
part of breakfast. The rule t hat all farinaceous matters should be
exposed ton h;irh temperature for some time before bemv; used for
the cniik's purpoM^ .-hoiild no more be foi'i;-otten \\-itli culinary
preparations lor oid folks, than it should be omitted in pi-eparin^
lllll'SerV t'ooil.
The diirestiye fei'm-'iits (like the rest of thebodv) are not so
aei \ c iii aire. ai:d -o a :' 1 -hoiild be carefully prepared: and pre-
di"'ested r-tarch is easily oiitai liable. A- t here is a ditlieult y often in
maintainiiiir tin 1 bodv tern pc rat lire \\nli oid pcop> ihis n::i:
soluble carbo-hvdrates must never be forgotten.
There is a pro-pect nf milk .Miirar sunn bein^ placed upon - h'-
market, and this \vill supplv a need \<> delicate children and o,d
people which is \<TV dcsi rable. It ran he added to the miik and
mineral water, or be prepared MS a lemonade, or I-M-II ! ;i'M'-il t a
iin'al tea. luU hcinir t( s\vccl to olTfiid ilic [lalatf wln-n !ak'-!i
Slli'll rnlllpailV.
\\'ll('ll chlcrlv JX'l'SiHH ilillr nut tlli'V dt'ti'll flllil tiM' cillllrst ililcS I't'
thru- hosts ili'tii'iciit 111 condiments t'i>r thi-ni. ai;d ctuiscijiii-iit 1\ th'-v
arc troubled \vith llai ulciicc. 'riic\- miss their \vontcd i-ariniirati\ -.
A ^'ood old-!'ashioiicd plan of adding condiment^ I" food without
otVctid i ML;' the palate \vas lo make a piii or two nf liiH-ad-criindi and
cayenne [icppcr at tahlc; and, >o guarded, the rarminativc worked
well. Some o-u[irinets used i<> carry a small bottle of Ncpanl
pep]ier with them pcrpctuallv. so a- to lie prrpared for anv ciner-
i'cncv in the wav of lack \' flavour inu' when dining, where mii'-h
scasoniiiL;' is eschewed," (The hiseasesof Sedeiitarv and Advanced
Life.)
All soups and all fish (except perhaps salmon) arc suitalilc food
for the old, so are OVSUTS and dams; hut lohsters and jointed .-hell
tish are apt to disagree, proljuljlv because iinpci'fectlv mastica'cd.
lleavv solid meats should be eschewed to a vreal extent. Livjlit
food as chicken, and rabbit, sweetbread, giblets and .-mall birds and
gallic are u'ood. Sheep's head well cooked is admirable. Tripe .>,>
i- excellent. Meat prepared bv mincing or hasliinu," (fiv-h meal
beill^ prefci'Mble to eold meat) is also n^ooil. A nice di.-ll is prepared
bv stewniL;' some ha- lied meat and add in L:" a little llou i-\- potat oe \\ :: ; !
some pepper a ud salt : which Drives vegetable mailer as well as annual
food in a rcadih digested form.
As the taste for sweet- does not return with ap 1 . in the ca-- oi
inanv old persons soinelhiliu' of the kind of a rcli-h is ile-:ra ; - -.
I'ottcd meat.- of ruanv kind.-, beef, name, venison, arc a;
/'///c ili tn'r tii' t i^ \< excel lent . and 111 1 L!' 1 1 1 be lllorellSed \\ltll a-l\
tap- to say not hinji of (lieu-ratification of the palate much n>.
than it is. Livers indeed, larded and roa.-led. inav In- u-ed f-.-i
or cold. The Leberwnrsi of (icrmaiiN rich in fat m:v;
inanv a table and fiirni-h a varielv of food too mu^n gflg
('a\iare ha- it- claim- to iifitice. The roes and n,
fried on toast mav lie 1 ried.
( h'.-t cr .-on p. a red mil 1 let , a sweet bread , a part r,d
1 :)!'> M. \NTA1. OF IUKTKTK'S.
millet, followed by a digestive biscuit and butter with a trlass or two
of p-nerous wine as Bucellas or Madeira, would form a '" company "
dinner for old folks, to which the writer would have no objection
to be invited.
Or a basin of whole beef tea with broken bi-cuit, followed bv a
milk pudding, forms a luncheon not to be despised.
cn.vrraj xr.
FOOD IN AITTK DISK ASKS.
"\\IIKN life seems passing a\vav under their eves, the friends
will often shrink from torment HILT, as it seems to them, tip' .
111:111 with i'oud. Let them not despair: nianv a one ha- recovered
after tlif doctor has taken his lea\e with a sad shake of the head,
and without making a fresh appoint nient. And let them ai-o he
stimulated hy the fact namely, that tin- pains of death are a^Ta-
vated. if not mainly caused hy the failure of the nutrition. Kveii
when apparentlv insensihle, the living siill'er much increased distiv--
t'rom want of food, though thev cannot express their suiVenn^."
( Kin-- ( 'haml>er-. )
A ";ivat man\' sick persons are allowed to drift into a critical
condition when ill- from which manv never railv. heeaiise the\ arc
not fed n -it furnished with such nutrithe mat'Tiai a- their en-
t'eehled powers can digest. That is not a pleasant eon>iderati<m.
either for iiiedh'al men or the hereavcd relatnes when xiine \alucd
life has closed:
le'Li'i'et is unavailing when the deed is done, and the scene is eio-cd.
I)epctid upon it. mvt'iads of our felllow-eivat uivs luive pi-r:-hed
liecanse those around them did not know how to feed them: and
either withheld food altou'et her. or u'avc innutritions food, under a
m isa pprehension.
\\dieiiii person is ill. the (litest ive organs are implicated, am;.
prohahly, the digest ive ferments arc inipaii'ed, or scarcelv forme.
all. To pour food down tho^nMet and to have it assimilati-:!. :"<
two totally dill'erent tilings alto-'et her. All that can he
that the food must lirst u'o down the gullet", else no
po-ihle.
I.et us take a person who is laid prosirate. say hy ' ; i-
an accident, whei'e there is a hrokeii ihi'jh, while h';i
- nri'-ent . 1 h-i-e t here is not I he t hi
I:)* MAM'AL OF DIETETICS.
ami so there is not the acute craving for fluids. The food may
consist of (whole) beef-tea, \vith a little hroken hiseuil in it, or milk,
or milk ami selt/.er water; or milk-puddings of malt extract, of
stewed fruit and cream: and later on. anv kind of soup. Then a
little tish. a sweet-bread, or chicken, and so on gradually until tin.'
ordinarv diet is ultimately regained.
Hut with fever present, as in the exanthemata, typhoid fever, or
acute inflammation of the lungs, something more of the nature of a.
drink is desirahle. The temperature is high and the fauces are drv,
and the thirst is urgent. Consequently what is wanted is 1'otus
Imperialis. Apple water, or Tamarind water, or Apple Toast water,
or Apple Kice water, or the juice of fresh fruit as the red currant,
the black currant, or the mulherry, diluted with water; all pleasant
refreshing drinks; the nutritive value of all being very small. Kice
water and hurley water give something more nutritive than plain
water and mav he flavoured with any of the above. Home-made!
lemonade with a thin piece or two of the rind to u'ive flavouring is
excellent. Where cane sugar disagrees it mav be made with malt
extract, or Mellin's Food, or if the malt flavour is disliked, with
milk sugar or levulosc. Malt extracts with effervescing water are
jjfood. Thev supplv maltose (grape sugar), soluble dextrine, some
soluble albuminoids and some salts. Consequently they form an
admirable food in pvrexial states. Then come the meat-infusion?,
a- beef tea (as ord inanlv made), mutton broth, veal tea. and chicken
broth and eel broth, all pleasant stimulants, but lacking in food-
value; and. unless some baked flour be added, not to be counted as
food, but as pleasant beverages.
.Milk mav be u'lven as whev. or diluted with Selt/.er or other
water. A 'jTeat matter to be borne in mind with milk, especially
in the ease of tvphoid or enteric fever, where the bowel is weakened
liv nleeration. is that it curdles as the first step in its digestion.
When it curdles too firmly the curd docs not fall to pieces, but
travels alonu r the bowel, a hard irritant mass, apt to lacerate the
Weakened bowel. This is no imaginary danger boi n of apprehen-
sion hut a L.TIIII fact. At the London Fever Hospital a glance is
alwavs east at the stools in enteric fever, and i
milk-enrd arc .-ecu in the motion, measures
consideration. It i> tint enom.di to irive n \ ;
title-;, judgment is also ivijnired 'o .-,,- th;
harm.
1 1 o\v much ad ital food is bein'.: n'i ven with ;!;
(jiiii'kiv be pithered fr-.m a glance over 'In- nur--
LT!\en. ami tliis ii-t should alwa\- In- <> <rr>''-\ i\ keui,
There arc other lluul finds which can lie \\~t] :.. ;t fgHM
tlicrc is uTtiel. or oatiiieal and water la verv piea-an: r|f; k !. i*:| a;.:
farina may lie u-vd ami lie well Imiinl in \va',er. A .
r-'t-i'Veil .-uha'-id fruit as Ua<-k or rnl eurraul jeilv ma\ \- \>\\<
\vatcr.aml on cuolin^ furnishes a |i!ea-ain chaiiu'e. A i.nle .-u^iu-
<ir milk sii'j-ar mav I'c adileil ID -'ive sunn- moi'e i' l-va!ue in ill-ink.
J">\' n n^'i n 'j; t lie < -hull Lifrs nil the aiinvi'. ami L;''\;li'j.' -'line 'jTai -,
or otluM" easily mast icated fruit, when ;u .- ;\-\i. all that :- m d;!iav:'v
rc'iuireil is fiiniishcd t<i the patient. I: ;- Lrraj>e-^u^'ar thi- imniia!
j'nml of till' ln)(l\ \\-llieh lllUSt 1 i- ' - 1 1 I 1 1 1 1 1 1 ' i tUllleet t '. , C U \ \< la t i"! i " !'
the hi "/I i ! en i ] ic rat urc.
]\\ >uitalili i al;meutati"ii the \va-tinu' ;- le-s, and tlie patiei d
ll:it lie.'nlllc SO reduced, alld CnllSei jUellt 1\ llie !> in\ a!''-ei':. ce ;- !!...;
rapid. \\diere liccf-tf;i (as ordinarily made) ;- -''\'''i alnne "'. tie
niisapitrclietisinii that it is a sustaining f"nd. the >\-;em ha- in e\ -'
on its own rt'sources, and t t'ten the patient sinks intn a ^r:(\--
not dii^' fnr him hv disease, hut h\- the ignorance of tlm-e \\ ho .-nn-
stitutc the nurses and attendant-. Ilui this matter will he ta.ki
of im i re t'u llv furl her i in.
At this pnint something mav he said as to tin- as-:milat i'i'i <:'
food in acute pvrcx.al conditions. \\ e have --m.d ri-a~"ii f'-r !:".'!
that tlie (litest i\-(> ferment - are enfechlcd and pi'e.-i-nl hu; in -ma.
(juantitv. ( 'oliseijiieiit 1 v \\'e 'j'ive saccharine matters and lartnacco'i^
matters which have lu-eii preiiiv.-ested into a sn'.uhle fnrm. T::
relieves us of a n \ a 1 1 \ let v a 1 'ii t the saliva heimj- innperai : \ -. \\
can furnish to the liody its own fund proper (Lrrape--ii--art. \\,;
dilliciiltv: what is pert'eetlv soluble presents no i: .tli.-n . \ ; ;md
foi nl t he hud V mu -' ha \ e.
l-'at is never rel ished hv t lie acute'\ -;.-k . a nd
so that it is earefullv skimmed oil' the top ..;' ail meat
supplied in the milk which is the |r-t atid ,ea-t ' 'i
fat, and in a hi'_di state nf subd i\ i-mn. ll"\\ iar .
we do nut k now. N ' i h;m_r may I
ject.
The!! ci.nic- the sillijed of t he a.--:m a' "'i ..''
1 }<> MANUAL OF D1KTKTU 'S.
bumiuoids for histogenesis. This is a dillicult matter and must be
judiciously considered. 1 lippocrates insisted upon nut rit ion in fevers,
and used harlev gruel. Then came other views until the French
medical men went to the other extreme and actually starved their
patients to keep down the fever. Anything more abominable can
scarcely he conceived. I'mler-feeding patients in febrile states
however continued till Dr. (i raves of Dublin set his fact 1 against the
plan, and insisted upon more alimentation being given. The
" feeding of fevers" was what he taught. This plan now univers-
ally obtains. "The great art of duly nourishing fever patients
consists in giving a frequent, almost continuous supply of liquid
nutriment, containing very soluble aliments in a dilute form "-so
savs King Chambers. And now a very unpleasant task must be
performed, and that is a searching criticism of what the worthy
] )octor savs next. " The physician sees that a large supply of nit ro-
genous material must be wanting. The nitrogenous tissues are de-
vitalised and drained away in a disproportionate excretion of urea
and other organic compound*, and nothing is taking their places.
Shall he act antagonistically and try to stop the pas-age of urea by
the kidnev? 1 do not know exactly how he would set about it: but
I d> know that if he succeeded he would do positive harm: for the
worst cases of fever are those in which metamorphosis is active (as
shown by the heat ). while the excretion of urea is arrested as shown
I py the ligl it ness of the urine), t hev resemble cases of unemic poison-
ing from diseased kidnevs. The other principle of treatment which
I noticed in my introductory lecture would not perhaps be so directly
injurious, but common sense would still allot the palm to restora-
tion here. Let it be your chief aim to supply that which is passing
awav- nitrogenous tissue.'' NOW the first sentence and th" last
sentence of this quotation point unmistakably to this, viz.: supply-
in L; to the body matter for histogenesis, for the repair of t he wasting
tissues. < in P ferring to i he lecture from which lie quotes it M-CIIIS
he advocates " I wo or three ounces ( ,f milk every hour." lie is not
as lucid on this point as he usually is. bin \ve mu-t take the state-
ment as it .-land-. \ ;/.. : i hat I he " chief aim is to supply that which
you el earlv see is pas-ing a wav- nit roge nous t issue. " In the absence
df context i hi.- means if the sentence moans am t him: at all that
we ouirh; to supply nitrogenised matte!' to take the place of that
which is i missing a \vav.
Now to this I demur. The tissues are melting down under the
h:i:'h temperature, and the cancer to life is that the b,ood is IM-CUIII-
in<: sure harmed with nit ro^eni-ed \vaste. iint:l a i-n'i-iitiuM
("till 1 tVpllnid cond It lull ") IS Set lip. It ;> ll|.' ;illlit| !:!
AVaste ill tlir IP! 1 Which is till' danger /"/'<. ' . T'i hy'.i '
we trv t<> lower the tdii] 'era! 11 iv. 1" reduce tin- \\a-tin-j
:un! keep tlir kidnevs in actimi \<> ^c\ rid of thr \i-i i i i !i:i"i '
tn\ir matters. Now to ".'ive ample supplies nf iiit i-i >_:'!!>;: - ','><>:
to iiifft tin 1 \vastr ^'OIIIL:' mi. i- a distinct Iv dan^erm;.- i <\-;i< '.,-,..
appears to me, as tending t increase tin- amount of nit r< >_'<:,.-..,;
matter nf cxcrcint'iuitious cliarai-tcr in tin- s\stnn. 1 'm. ;:,,;- <>:
retrograde nu'tamorplKisis are not snielv l'ni'n;-lieii from t --:;.
waste: 1 1 lev come also from t lie ///.</'><<.,, ^n i/i/ ////,./ i if < mr a! lui mini >' > ;
food, and to ^ive ample (|iiaiitities of alliliminoids is t" inerea^e th'-
evil. ( >f course it is possil)le to contend that th-'Se pi'ote'.d maKer-
are never {leptmiised, and that thev mereh drift aloiiir the :u;nn-!i-
tarv canal till thev reach the point of exit. \\\\\ then \\v an- nn -
certain that sncli is the case. Certainly if peptuni-ed fund In- -"i'.e:i
th.cre is no such escape. If pi-ptonc- reach ihe !i\cr : ma\ ;
tmned, and pertilielitlv (picsl i<>ned. if the li\er at a hi^h teni!"':-a-
ture- -can curry on metaliolism and comci't any of ihc pri.ti--'
matter conveyed to it into serum-alluimen I'm' t;--ne repair. A
downward career into krealin. kreatinine, letiein. ivrn-iti and the
other products of rei ro^rade metamorphosis (some i winch arc
toxic) seems inlinitelv more proliaMc. To p'i\i- ail'iiminoid- or
tissue-food in amjilc (plant it l'es for !n-t< >-vnc~;> during pyrexia 1>. I
opine, a mistake. \Ve cannot lie certain al>out it; l.ut to mv min
it is ail 1 ,011 1 1 ia I'd Si reel to a ( 'lima oraiiLi'c that in -lead of eiicmiraL. r -
mu r histou'ciicsis we onlv increase the risk "i nra ni;a. or the typhoid
condii ion.
It is a matter which cannot lie demonstrated : it niii-t reman; a
matter of opinion and conjecture at lea.-l in the prcM-nt slate
on r kno\vlcd M 'e.
( l-'rmu some nliservat inns made li\- I >r. (rd and I >r. Itroadl'.'-
the i.pei i in-- meet MIL;' of the Medical Snciety of I .\ t ,\,.\ \. (),-,,;,,.,
!>>."). it \vonld appear that there i- a certain a ];'M'J'I :-m '
histoLi'enesis and pvrexia. \\here h i~ii>--ri;c-
lo\\-ered teinpei'atnre. This alisoi'|it mn i if hca' i- ai'i'e-i ;
and the heat lost in hist o;j.'eiiesis is added !othchc;^: ol
processe-;; and sn swells the [ivrexia. The lirill oi ;h -
is no histo^enesis Li'oinu' nn in pvrexia. \\here an
process is oil fool. TllC subject isolieuh.cii \\ ; ,
m\ c-l ii;'at ion. )
14'J MAM'AI- OK IHKTKTK'S.
I'rohablv 1'r. C'hambcrs lias failed to express himself elearlv: for
all the men with whom I have interchanged ideas on the suhjeet see
il in l lie liirht in which it is put here. It is now widelv recognised
that the estimation of the hulk of urea passed in pvrcxial states
once regarded as so important is fallacious: because there exists
no means of telling which of the urea is tissue-waste, and what pro-
portion of it is derived directly from the nitro^eniscd elements o|'
the food which have never passed through the sta^'e of tissue.
Of the importance of " feed in ^ fevers" no one no\v entertains
any doubt; but of the desirabihtv of larger ipiantities of albuminoid
matter in pyrexia the gravest doubts mav honestly he held and
expressed. \Ve know that the muscular struct lire wastes and breaks
down into </<'f>ri* in pyrexia; we know that subsequent repair takes
place by thi; development of voting fusiform fibres wit Inn the sar-
colemna: but this last is a matter of convalescence when the appet ite
is keen, especially for animal food. There is the pulling down of
an existing building, and the erection of anew one on the same
ground: but the pulling down precedes the buildiiiLf up the t\vo
cannot u'o on together side by side at the same time. Ilistolvsis
and histo^enesis <, r o together in health where balance rules. \Vheu
the normal processes are perturbed, upset by pyrexia, histolvsis is
augmented, to be followed in turn bv rapid hi Slovenes is. Hut I
maintain, a rapid histolvsis is not accompanied but followed bv a
swift histo^enesis. or tissue-repair. It is the difference of a pair of
Imr-es side bv side and tandem.
It is well for the reader to determine in his own mind what aro
the facts- -or perhaps rather the probabilities of the facts other-
wise in well-meant endeavours to do the fever-stricken patient
L r oml \\ e mav be but reducing the chance of survival: and but add-
HILT fuel to llame. bv .-til! further ladintr the blood with nitrovvnised
waste.
i >r .lames II. Dennett has something to sav about ''Defective
N til rit ion from t he Ivxistenee of Acute I (isease." to t his elVecl - -" In
acut" disease the functions of nutrition are partiallv suspended, the
digestive powers are weakened, or even for a time arrested: hence
the lo.-s of appetite, or even the absolute loatliini: of food which
ensues. The digestive orLfans beiiiLT unable to transform and elabo-
rate food, an all-wise I'l-ovideiiee preserves them from the labour
tliev are iiiii'ijiial to perform, bv dest roving;' the desire for nutri-
ment, and rapid emaciation I M] lows, the more ra]>id the more eom -
piete the iiiabilitv to digest fooil. 'I'he process of organic destruo
tion or disintegration inseparahle from tin- use \ our u :_': r -
it-eif a condition of life noes on. accelerated perhap- hv :.-
hut tin 1 material ti) repair the loss not Iteiiiir all'rded io {].*> _
satioii it wastes in voiunie. Moreover, as the material- <>:' ":_..
comhii-tion foi- the generation of heat are not elaborated
digestive organs, t lie eeoiiomv isohh^ed to re-ahsorh and eon--;
its own fat. -deposited, no douht. ill its cellular ti-Mlc partly a- ;
kind of reserve tissue. Thus it is that after an acute iSlne of two
or three weeks the emaciation is .-ometnnes extreme, more e-pe, .a.lv
when from tin- nature of the illne-s it has Keen impossihie for the
patient to digest any kind of food.
" In continued fevers, in which the iliahiiitv to take and dL r e-t
food is all hut complete, and which mav last for weeks, it i-of'en
found alisoluteiv necessary to <, r i ve win;-, or other alcoholic !K-\ erases,
in order to alYonl to the organisation the i-lements t'oi 1 heal-'_ r|> iiera-
t ion. or organic comhust ion. and to retard the process of de.-tnic-
tive metamorphosis of tissue. In the ahsence of -m-h aid. the
extremities and then the l)ody <n;nidualiv heeome colder until deatii
ensues, as much from cold as starvat ion. In th;- case ihe human
lire sini])lv p>es out for want of fuel: like a coal or wood lire li, at
lias exhausted all the materials of whieh it is compo-dl. and which
expires for want of their renewal."
But ;lll uIoiiLT it is " fuel- food " not "tissue-food" for which hr.
lieiiiict; <'ontends so eloquently, and what >s aliout to he said is a
content ion on the same lines.
Imperfect supplies of " fuel-food " to the wastint: organism have
the effect of permitting: u'l'cat emaciation, which more iiheral sup-
plies would prevent: and on the present plan of treating acute
pvrexial maladies we eertainlv do not prevent \va.-tiniT. and uilh ;t
coiiseouent lal weakness, as we mi^'hi. ISccf tea (howevci' made)
contains practica'lv no fuel food, while milk contains hut a com-
parative! v small pro port ion of rnilk-su;ar. ( 'on-i'ipient Iv our i -a; .<.
are apt to dit a- thev did under the l-'reneh ph\>ic;an- who :
[irived them of all food and called the stai'vali'Hi |'ian '/
opeiilv <tarv ed them to deal h : while we allow them to die hv '_i\ :n-_
them in-ulTp'ient food. The dilTereiice onh lie- in the, \~\i\ <>:'
the Krenehnieti. \\ e stand hv the d\ . ni;' patient's
hevvail t he failing strength, talk ^ravelv of i he t hreale'i.'.u" ,-\
t ion of the power- and do nothing t" pre\eii! the o:,
e\ ha i i -I , on. \\ c see the wa.-t mi;' L:'OI ][_; in., and la men
we do lit ; le. or nut hini:. \\'e leave t he pa: j :.; \<j -
144 MANUAL OK PIKTKTK'S.
;uul unaided. \\ e certainly inve some alcohol a rciulilv oxidisable
fuel-food- hut we do not act efficiently. If the subject of cxhaus-
tion were only more fully and completely considered, we would
know how to hel j) and succour t he sinking organism. At the recent,
annual meeting of the British Medical Associat ion at CardilT ( 1.V)
I read a paper entitled "When a- Patient dies of Kx'huustion what
does, he die of ? " lie d les hecaiise his bod V-storo of fuel is exhausted ;
because we do not supply to him the j^rape-su^ar which is the normal
lioiiy-fuel. and his rcserye stores of fat cannot he trot at sufficiently
rapidly. \Vestarveour patients into exhaust ion. ami bemoan the
fact: and then lca\'e them to their fate, without doini; anything to
sayc t hem from it.
It is a irravo and serious charge to hrin^ against ourselves, and
the matter, as the President of the Medicine Section (S. Wilk-) ob-
served, the matter is one of the very pv.itest importance. I >o we,
or do we not allow our patients to die from insufficient feeding?
\ot one person present at the reading of the paper disputed my pro-
position. It is true then that we do not feed our sinking patients as
we should. \\ e oiiLi'ht to supply to them ^rape-siiLi'ar in free quan-
tit ics in order to conserve and economise t he body stores. 'The becf-
tea ouirht to contain well-baked flour (much of it soluble dextrine),
or even milk-suirar or maltose, which is not too sweet for most
palates. We should irive lemonade made with milk-suufar. or le\ u-
lose. Acidulated drinks wit h uTapc-supir. or its equivalent ouirht
to be 'jivcii. Water is wanted to allay thirst, and drinks should lie
so made as to have, a distinct "food-value."' If the patient cannot
take such drinks and will only drink water, then of course we are
not to blame. But when the patient docs not p't the chance of
such nutritive drinks then that patient is a victim to ignorance- a
sacrifice .-imply. It is not a matter for demonstration, it is one
which reason can determine: and if after this outspoken protest any
reader of ihi- work does not feed his patient properly by the li^ht
of science he is a murderer! There are sin-; of omission as well as
Kins of commission, and to allow a poor patient to die unfed, is like
allowing a man falling overboard to perish by not throwing him a
life-buoy, or a rope when those are ready to hand. \\hat should
we say in thi- la-t case which would not apply to the lirst ? Of
course --o loni: as \\"edid not kno\v wha; it was the sulVerer needed
there was no blood-LHiilt iness. So loni;- as the dill'erent form- of
LTape-siiLfar were not to hand we were nol blameworthy. I5u: now
that we know what is required, and, further, have the materials to
liaii'l tin-re is no palliation of theolTcr.ce: no rv-u--.' ! A
tin' outcomes cf svstemat \<- lecture- on dietetics oiii/h: '
proper and ct'iicien! feeding of put ieuts in aeuie di-ea~e. and -i ;;,; ,
in pvrexia! maladies: so that thev .-hall not hceume wa-'i-d .. ; ,-\
hail-ted further than we ran pos.-ihlv he!n. " Knuwlcd;
luit wisdom lingers" and now that we realise the importune.- uf -
plviiiLT u"rapc-stiv;ar to tip' ecuiiomv in its dav of trial. we ean !'',:'
etlicient, ai'l tothesiek man halt !;::_:' wit h ilisi-ase, ami sueciiiiih: 1 :
to oxhuustion if \vc- do nut intei-fere.
\\'liat \vas written !iv !\.iii^ ( 'liamhei's and (pioted at th-- cnin
nienceiiimt of this cha|iter should hnrn itself into every reader's
niemorv, \i/..: that inanv sick persons pass into a i-ritieal ^-la:;' 1
fruin whiidi inanv never rallv heeause thev are insnlTieieiit Iv fed.
\\hat was the denuiu-iat ion on tho-e \\dio 'ave no fum! to the
hunu'ry. no drink to the thirsty? " hepart tVom me. ve enr.-e i.
into everlas! MIL:' lire." Aiu! everv man who has allowed a pa tie!.!
to die of exhaustion without havini:' maiie a stout iMii fur him.
deserves like ( 'a in to carry the hraml of murder un him fui' t ;> re-i
of h.is days.
1-lveii wlieti the loathing for fond is pronontieed, it stiil remains
possdile to ad m mister em -ma! a of ^rape-suirai 1 \\ it h meat lirot hs eon-
tiiininjj salts and the stimulant extractives uf meal, or when the
typhoid condition is pronounced ,--iieh feeding nuu'ht stdl ! e.ei-
tinued. The patient must lie supported in the hour of trial; and
if this he proper! \- done we mav fairlv expect a Li'ood pcrccntai;' 1 ' of
case- to rallv which now u'o on from had to worse till death !>v ex-
haust ion closes t he set-lie.
I now add the hictaries in use at the London Kevcr Hospital,
from which it is clear that the patients there are not starved hut
have ample allowances uf food provided for them.
The whole snhjeet of the feed Mi'_;- of persons acutclv ill and ::
critical conditions is one un whieh some histruct ion is desirahlc.
Milk does not aii'i'ee with all. Iiecf tea is a stimulant and not a
food. What the patient needs is soluhle carho-hvdrates, whi'-h can
he ^'iven in vai'iou- forms, which arc not particularly expens;\e.
\\'hat the hu.-tur wants is information on the stihject uf t'efdini:'-.
And if the K'oval ('ulle^e of IMtvsicians of London could for um-e
its historv put it- hand to a ii-eful work and ^ive the wor.d -o".,.-
evidence uf ns ntiliiv. some cxeu-e for us existence, m-tcad o;
14-) MANUAL OF DIETETICS.
it seems the fittest liod v to undertake such ;i \vork. If it would
onlv have one <|iie>tion on Dietetics in its examination for the
superior qualifications; of its Membership it would lie hiking a, step
in the riu'ht direction.*
'' From a nmnlier of experiments jtci'fonni'd of rcc-dit ynirs it si'dus Hint
thi' dit^vst ive tin ids and their several ferments uro gravely impaired in acute
disease. This Uiet adds stivnyth to the views advocated in this chapter.
CHAPTER XVI.
FOOD IN COXVALKSCKNCK.
'' Ix the management of convalescence tin- patient should never
he permitted to sit out of hed till the .-t ren^t h In- consideruhlv ad-
vanced. It is hetter that iv.-t rift ion -hould lie imposed a little too
loni;- than that rtnv risk of relapse should he run.
' The next point is of still <rivater consequence i he proper regu-
lation of the diet. In our experience. hv fa i- the ^reater uumher of
cases of relapse take phiee from indiseretion in diet. It should al.-o
lie st roiiLi'lv impressed on the convalescent that il is us iieecssirv t
LTuard against the quantity as the qualitv of food, particular, v when
tliere has hcen irastrie irritation in the progress of the fever. Tiie
stomach mav he al>le to digest and assinnlate a limited proportion of
food, hut the indulgence of an extra ounce or i \vo mav induce op-
pression and a renewal of the fever. This or^an in convalescence
partakes of the external mu.-cular dehilitv. and the convalescent
mav as well expect to he ahle to carrv a lieavv load on hi.- shoulder-.
as to diu'e^t an undue fjiuuititv of food, even of a suitahle kind."
(Tweedie, Article '' Fevi'i 1 " in the Cyclopedia of Practical Medi-
cine. )
When the worst is over, and the critical period passed, the pros-
tration is liTeat. Care in the administration of food and the e\h;h;-
tion of stimulants is still required. lint shortly the sorde< d;-
appear from the teeth and lips, the hrown fur dears oil' the surface
of I he tongue, and with these comes some return of the appetMe,
and a relish for food. The weakened condition of the organism,
hot h in its whole and in each component part, must he home ,n
mind: and in all illness and dehilitv the .-tfiuaeh is invol\ed. and
is functionally impaired; in other word-, all .-ick and weak p T-on-
are dyspeptics.- and must he fed accordingly. Small ipianni
milk and seltzer water, of whole heef tea, of meat infusion- with
sohihle carl)o-h\'dratc- are rcijiiired at freqiieiil inter\a',-.
And there is one point to he attended to HI the feeding of early
convale-eence. and that is, not to rai-e the patienl up a!'rup:'\ in
order to lie feil. The heart >tructure is exteti>ivelv -i !-op_ya:i - hv
H s UAM'AL OF l)li-:TKTR'S.
acute and still more l>y sustained pyrexia. and a great many of the
muscular bundles are reduced to a mass of ili'hri* in the histolytic
process which has gone on, so that the heart-\vall is weak, and to
raise the patient suddenly is to throw the weight of the blood-
column in the head and neck abruptly upon the heart. Under
these circumstances the left ventricle' is unable to bear the weight
so thrown upon it. and comes to a standstill in diastoit flaccid and
distended with blood. Kven after the patient has recovered suHi-
ciently to walk about the room this danger of heart failure is not
fully past; and after the high pyrcxia of relapsing, or famine fever,
it is not unusual for the convalescent to drop suddenly to rise no
more ---the weakened heart having stopped abruptly.*
The appetite for food steadily increases, and must be met. Small
quantities of milk puddings of very digestible character may be Driven:
such as those made with broken biscuit, or with shredded mai/e,
or cooked hominy, or jndeed any farinaceous matter which has been
already exposed to a high temperature. Mi'k or cream with cold
cotl'ee forms an admirable nutritive beverage. There is often a con-
siderable amount of thirst lingering, and this calls for beverages,
which can easily have a food value given them either by some form
of maltose or grape sugar, or by adding some baked cereal, (iniel
made with baked flour, or baked oatmeal is -rood. The lactated
foods can be used, and if need be. may he flavoured by red wine of
any kind, or by some other flavouring a^ent. Lemon juice SULTU'C-LS
itself as a pleasant acid assuaging thirst effectually. Sairo and rice
milk mav be added, and oatmeal and hominy porridge make a
change. Blancmanges suggest themselves, but should not be made
of raw or uncooked starch. The salivary glands'still feel the storm
which has s\vept over the organism, and have not regained their
capacity to digest starch. To forget the fact is to run the risk of
filling the enfeebled stomach with undigested starch just about the
most effectual means of upsetting it that could be devised. |)r.
Tweedie warns us against errors in alimentation in convalescence,
and this is one of the most common. A little later on. an overload
or surfeit is apt to occur from the appetite being too keen, and the
quantity taken at on>-e too much for the stomach. A greedy feeder
is most liable to this last risk of relapse; hut all convalescents mav
experience a " back-cast " from a quantity of undigested starch find-
in L: it- wav into t lie stomach.
Then the patient advances to some white fish boiled, to a sweet-
bread, to some chicken. It ;s nut necessarx to tempt the appetite
liv condiments, the palate declares fur simply div-sed !' i. Ti.
]il:iiner the food the hetter. The palate ivipiiivs no tick^n^ 01-
St lllllliat HILT: tile desire for food is kecll. and eU^er enough to do
without any whetting. It i> no; like the invalid's ea.-e where ;he
:i|i|tetite is small and fastidious. ^ oiiir^ convalescents from acute
disease, can generally eat anv t hini: oiTetvd to t hem ; and consequent '.v
those in attendance upon them should exercise jud^im-ia in the
selection of the viands supplied to them. Thev eat and L r o to >'.ecp.
to waken up with a craving appetite.
Tliere has been a severe demand upon tlie ho.lv stores of ;'no,l
which have to he huilt up apiin. Tliere has heeii extensive dest in; -
lion of the nuisenlar tissues hv a rapid histolysis, tlic tissues melt-
ing do\vn rapidly under a lu^li temperature. Ad this has \<> be met
and repaired; and the appetite is keen. and the digestion active mid
rapid. Nevertheless it is \ved to c(imm;t no error: as all persons
familiar with disease and convalescence know thai a relapse is fol-
lowed by a slower rale of repair. Once a "hack-east." and the
pr 'ss of repair and the progress .if the convalescent are a'.ike
slowed. A maxim with Sir I'Yederiek Kolici'ts in liis A t'L. r lian experi-
ence was. " \\ hen voti have once ^ot an OriiMital on the run. keep
him on the run." If his Ili^ht was not kept up he mi^'hi rot -ome-
where where it ini^ht not be so easy to dislodge him: consei|iient ;v.
it was best to keep him ^'oin^'. So it is \\itli convalescence, u is
best unbi-oken and uninterrupted. Once a check, and the onward
progress has apun to be initiated. And all initial movement is >.ou
even in a (ireat Northern I 1 ! x press. I-ivei'v stop involves a I're-li
start. ( 'arefullv t hen. and wit h cant ion 1 iberal supplies of fond ma v
be ^'iveii ID the convalescent. \\\\\ it must be borne in mind there
ai'e convalescents- -and convalescents. Tnerc is the robust hardv
vouth who has had a .-mart attack of enteric fever: as soon a~ h.-
ap[ietitc I'eturns he can eat anvt IIIUL:'. a -heep in its wool aliuo-;.
lint there is too. a delicate u'lrl recovering slowlv from an atlack of
scarlatina, witli kidncv complication-. She is a very ditlefenl eo;i-
va icscent : t here is t he in jurv done to t he kiilnevs to be kepi in .-._; ii I ,
and never forgot ten. The kidneys are a 'j'real factor ;n t he ehniina-
tioti of nitro^eni-ed waste. \Vliilethcyarestill I'cehiiL:' the ejects
of the disease which has pa-.-ed over them, thev are not e<jua. to
^feat demands upon them: and this t'uiiet ioiial deluliiv iiiu-t :
overlooked or even underestimated. Small ipiantit - oi a:.;mal
food alone are safe here. The hunirrv vouth who IM n .-caive, \
til! the sheep is skinned wouM be tort ui'ed and injured ;.\ ; ; : ,
K.I i MANUAL OK IMKTKTK'S.
meals, sparingly composed of animal food, which would be proper
in ilif other cast 1 , -wlulr alinu'iit suitable enough for him would
lie fatal t<> tin- Li'irl in ail probability. " \\'liat is one man's food is
an< i; her man's poison. "
The importance of bearing in mind the function of the kidneys
in the dietetics of convalescence is illustrated l>v the following ease,
lu mv earlv davs of village practice in \Vestmoreland, a case of
nephritis camo under my care. a typical case of acute Urip'ht's
disease, not post -scarlatinal. l>v suitable measures convalescence
was secured. 1 \vashutayounir practitioner, and though the case
was doinir well somebody thought it might he doing better. So an
older man was called in. who thought I might allow some more food
and administer some steel. Accord inglv. this was done, and for a
day or two all went well. Then came a change sudden and rapid: in
spite of nil that could he done uraMiiia set in. and the girl perished.
That case has been one corner-stone in the building of my medical
experience. Itegret was unavailing: and I went on a sadder but a
wiser man.
In like manner after enteric fever it is well to remember that
there has been ulceration of the bowels, often extensive, sometimes
deep, and t hat hard pieces of food as unripe apple, or insufficiently
< ked potato nii^lit readily cause a perforation of the weakened
lio\vel. My repertoire contains no warniuir case telling of forgetful-
ness he'v. which could be placed at the reader's service. A medical
experience involves a certain element of patients sent to their doom
by Slime sin of omission or of commission, and mine is no exception.
l>ut in v experience can tell of a verv instructive case anent con-
valesceuce; and the recital mav help some reader in a difficulty. In
my earlv davs an old peasant woman was ser/.ed with complete sup-
pression of urine. She was a hale old dame, and after three days or
so of active treatment, the urine reappeared. Of course a careful
examination of it was made, and sonic tube-casts were found. Tak-
ing what Sir Thomas Watson said about tube-casts as my guide. I
nave it as mv opinion the old crone would not long survive the
attack. Tin- coining t,, ]|,.j- ( . : ir- made her verv wroth, and she at
ouce transferred her professional confidence to an irregular practi-
tioner in the neighbourhood.- -who was always in demand whenever
the regular practitiniier's opinion was unfavourable, or }\\< advice
distasteful. Hi- opinion was thai she onlv wanted something to
cat and drink, and she would do well. This jidvice was promptly
followed, and carried out with the most satisfactorv results to the
patient. Sin' glowered at me with e\i! eve, whi-M. .. I huiM-'
1" ride past her cottage. :md held tin- poorest p.. --;!,;, opinion ,,' ..-.
professional capacity. And well -hcmi:_ r ht. for ei^ht'-.-n \.-ar- : IT.-
passed aii'i 'jri'iic since then, and sin- -till li\e- to bear in-r tc-timonv
to ihc crronei>n<nes- of inv opinion HI her ru-<-.
A vcrv common cause of interruption i the JH-IILTC-- ; :i cuii-
valcscciicc is an excess of t'"i'l. 'rin-rc is iHscuml'urt w:th a -harn
n-c of teni|ierat ure. sutnet mies yi>iiiitiiiir, coinnmnlv sunn- j>iir:_ r :nLr,
with the i-.-snh i>f cleariiiLT tlie system. In strmiL: '>r L fan;-ni< the-^e
intei'dirrent ileran<xeinent.< ]>rn(hice lit t !> i>r n<> etl'i <; : Inn with Meli-
cate individual- thev ai'e fi'aiiLrht with a certain risk t" !:l'e. and tin*
often havt a very malignant etl'ect upon tin- onward |H'i>i_ r res-; nf the
case. In tlms" wh.o have l-cn Verv irravclv ill. and in :h<>-<- \\h
have any constitutional delicacy m- special gastric intiniiltv the \- ( -ry
Create-;! caii; must )) tak'-n. Such a case cam>- under niv notice
lately. A delicate ^irl had a slight jiiieunionia with, a ^<l <{>;{] \
pa-trie ii-rita'iilitv. I!v very careful dieting she went <>n very satis-
i'actorilv and seemed likely to weather the storm: luit ju-t as she
seemed "out of the wood " an injudicious meal inaugurated a 1'apid
downward pi-o^-i-ess.
Li^'lit fooil. as ehjeken. ral'liit. pime. and small hirds mu-t pre-
pare the wav for chop-, steaks, and a cut from the joint, together
with suitalile yei^etahles. The dietaries of the London Fever H.>S-
pital mav be adopted until the whilom sick person is out of t he doc-
tor'.- hands.
The amount of food a strong and previously hale vniini: man will
cat in a dav, after an acute attack of fever is something siirprisni^;.
We hear of ei^'ht <ir ten meal- a dav. and pretty i;ood meals too,
he in IT taken under such circumstances. In fact, the convalescent
wishes to be back to hi- place in the world and to hi- work, and he
c\pe(lites his progress thereto to the best of his ability. I'.u: thep-
is an old ada-v which says " The more ha-te the less spec. 1 ,." a".';
solliet illie- tin- i- t he case.
It is not always desirable that the plentiful dietary of the con-
valescent be too rich in albuminoid material-, \odoub: there !:a-
bei-n tissue-waste, often extensive, and material is needed for
paii'. Hut this end is not always served by liberal .-upp'>'-
sharp at lack of enteric fever in India, wrote to me to ;. ;
His heart wa- con-iderablv weakened l>\ ! he ', ;->iie-de-i i-;;." ... M
ha.| "'.'lie oi, iii the pvre\ia: and he made hi- \\'a\' a- -:" ;.- in 1
i .
l.VJ MAN I' A I. OF DIKTKTirs.
cnuld t:i French cook, whom lie found in Homliay. Here he went
in for liberal meals supplemented by generous Burgundy. Hut to
h:s threat disappoint nieni lie did not improve as he had anticipated.
On arrival at Aldershott . lie found a friend deep in the perusal of uiv
\vork on " Indigestion and Hiliousness," who ilrew his at tent ion to
some remarks therein. a< to the dilTerenee betwixt meri'lv swallow-
ing food and its digestion, and the importance of li^'ht food where
the liver cannot deal with a large quantity of proteid matter. Ilis
own ])lan having failed egrcgiously, he determined to accept my
suiTLTi'^t ions, lie put himself upon farinaceous food and iish mat-
ters his liver could deal with forthwith, and the results were so
satisfactory, that he made my acquaintance iu order to report to me
the (to him) wondrous results.
Where the liver is weak it is not well to overload it bv an ex-
cess of albuminoids, for the burden only deepens its mobility to
carry on the metabolism of protcids.
CIT.VITKi: XVII.
FOOD IN GASTRIC AFFF(TK>NS.
IN this chapter it seems desirahlc to commence \vii li the .-'.
forms of trouhle. and to proceed, later on. with the considerati
t lie graver forms. Indigestion will lie deal! with in a later ch
at full length; t hi' present eonsiderat ion licine; devoted in po-
d isea.-e of i he stomaeli.
The mam maladies of the stomaeli are eutarrh. atrophy o
inland-. Li'asirie nleer. and linallv cancer. In the l!r-t tii<-re
<|tiaiititv of rupv mucus ^iven oil', and a> the food m the stoma
rolled over and o\ er it liecomes ^radnaliv covered wit h a wrapp
this mucus, upon which the ^a-tric juice is impotent to exercise
dl!_re-t!\e elfeet. The fooi 1 Wllll Sollle ^astl'lc JHIce i- ! . k e ;i pnd
iii a ha^r, and feels like a dead weight in the stomach. It is
oli\;ou< that in such a case all solid food mi;--: lie reliL r :"ii~!
jureii: and such food onlv lie taken a- can not 1><- so ciifoide
mucus. I-'luid food alone must lie taken -that is o!iviou~.
Atrophy of the glands of the stomach involves functional
paeitv, and onlv food of tlie most diircslililc nature should he ta
l-'oo.j which is not acted <m !>v the stomaeli so much a- l>v the
creas is here indicated, and that means that miik -hoii d fo
laru' 1 ' portion of the dietary. Farinaceous matter :- ii!ijeet:iH
hut not ~o pred iLi'estei i. or so! ti 1 tie i -a r! >o h vd I'ah'-.
In gastric uleei- t here is little or no lii-comfoiM while i he o
is at rest, luit as sunn a- loud enter- it pain i- se! i;p. T!
part ! \' to the acii I iyasi ric ju ice irritat inu' t lie raw HI r face , ,f the 11
partlv to the dr.- 1 '_;_; in",' upon the has" of the ul-er cau-ed !'\
inu sen ia r movements of the stomai'h .-''t UN i>\ the nre-euec o! :
Vomiting at once ^iM-s relief from Imth cause-; of H!tl'er'!:'j - .
ail\aiie~ are indicated, and milk coin ;I;IU!!L:' -ome alka! - :i ! '';
oidv food that can lie taken without sntTerinu'.
In cancer of the stomach pain is ~et up l>\' mo\einen' > >
hu; i hei'e is a 1 si i pain \\ lien t he -tomach ;- empt v. ( 'o" - .
cancer is M-aled ai I he pvlorv r:ii'_ r . and pa:n - can-'
sai;'e o! food iitit of the stomach. Here on.\ :';. n.
1.V1 M. \NTAI, OF JHKTKTK'S.
foods can lie taken without suffering, and towards the end all food
airirnn ates t In- sull'ering.
'I'o show what inav In- done l>v a suitable dictarv. the following
case is instructive. An old lady at lirixton sufl'ercd iniieli from pain
and sickness caused hv cancer of the stomach. A liini|> as bi^ as a
doulilcd list could he distinctly felt. Yet l>v putting that old ladv
on a strict dietarv of lluid food and prcdi^vsted carbo-livdrates the
stoiuacli quieted do\vn. lliere was no sickness and no pain, and at.
the end of a week the friends asked the regular inc'dical attendant
if tlierewas not some mistake in the diagnosis. So great was the
relief ail'orded that the patient lived on until cancer broke out else-
where; indeed it was some months before she succumbed, when she
had onlv seemed about a week from the inevitable end when the
change of food was begun.
The great matter about any disease in the stomach, anv gastric
irritahilitv which mav crop up as an intercurront trouble in the
course of ot her maladies- -as phthisis for instance is to introduce
but a small bulk of fond at once into the stomach. That is the
fundamental matter to be kept ever in the centre of vision, and not
onlv that but well focussed. It is too, the central affair round which
all the rest turns. Metaphors awl similes might lie multiplied in-
detinitelv, but no amount would be too great for the subject matter.
" Bulk " is the first thing to attend to.
Small quantities of meat broth thickened with baked Hour but
so thickened that the eye can detect no mass; milk with \'idiv or
Yars. or other like waters, these are the staples of the dictarv. To
t hese mav be added malt-extracts (marvelous food in bad gastric cases)
where the patient does not dislike them. Small (plant it ics of the
svrnp of stewed fruit are often grateful to the patient. But in the
milder cases, some boiled while lish mav be borne and forms a
change. Sometimes a very strict diet, with the patient in bed to
economise the powers and reduce the body-expenditure to a mini-
mum mav In 1 enjoined for a definite time, as a curative course m
ulcer or catarrh. Such a severe regimen, eked out bv nutritive
enemata. will do much towards a cure, even in verv bad cases, and
achieve one 1M >I lirhter case<.
\Vheii then - a i:reat excess of acidity, vomiting gels rid of
much of tin 1 olTending acid. Milk is returned in firm curd: and
mu~t be ^iven with some fixed alkali, as prepared chalk, or liu'ht
inaL'iic.-ia a- much as will lie on a six-pence, or sometimes even a
shiiiinir. to the bait' pint as lime-water or aerated alkaline waters,
!'< M i|) IN ( JASTKIC Al'l r.t 1 |i >NS. \ .',.,
are not strong enough to neutralise the acid. ![:.-. HUM:
enou-h tn secure I he de<nvd end are e->en t '.a 1. M'-a! infu-
|ire|iarccl carho-hydratcs, m;tv he exhihited. i 'an-- -u".a: -
nation in llioe cases. \V hdi .-li^hi hut chp : ; acj.ii; \ -coinp
of. cane Miirar niii.-t lie abandoned, and other form- of suirar
lielllLT '"'''I SllllSt it llted for it. llli'leci!, hl'ieflv. Sllei-p i.~ ( -s nr e I' V -I"'?.!
lisaoie sugars. which readily undergo acetous t'ermei.ta; i"U. m::
lie u'ivcii uji. ami ^'1 iii-"Si's, i T uncrvstallisaMe su^ai'. takf!'. in th":r
str-iil.
In those eases where thirst prompts the siitTere;- i ^u!p ilo\vn
a ^'ooil ilrauirht of tlui'l. \vhieh the stoniaeh pruiupt'.v rejei-t- ai.d
ejcets. it is well topve the patient .-mall [licees of i-e to silek. The
melting ice cools the drv fauces; ami. int i'oihiee'1 in thi- -'':''
iiiatinci'. the stoniaeh tulei'ates the presence df (luiil. It i- jid--:!/i'.
hv the use 1 nf ices containing t'ru:; svrup or cream, to intr<nluce a
small ((iiatititv of ndurishiin-nt into an irrilahle st.iinach. \\ !;.-ii
the stomach is in m-tive revolt ar.'i ohjeets [n ali contents, it ;s ;i
matte!- tif life or death, vcrv often, how far food can | . introdn'-'-d
into it. Ilunirer and thirst Imth are cxperieneeil : while in manv
case< the pat;ent manifests an intense dislike 1 to feeilin^ // / - ' //.
\\diei-e the latter is well l>orne. the dillieu'.tv i< small; hut where the
olijeetion to eiiemata is insuperahle, the Create-; diHieultv may he
encountered.
When t he (piant itv or hulk of food which is tolerated a; on .
is small: the meals must he the more frequent. If t hcv are sutli-
c-iellt to he called llleals. t hcV slloll Id 1 ..... f the fill! UUIliher -hi'eak-
fa.-t . eleven o'clock, luncheon, tea. dinner, and supper. Half a do/en
hv no mean- too manv. When oniv two or three ounce.- of ;!';:';
food can lie taken at once, then the feeding times -hoti'.d niiinher a
tolei-ateil. cverv hour is not ton often. The smaller the hulk. ;!
shoiMer the interval else the patient w:;l starve.
Sometime- the patient luathcs the onlv food which is suita'>
hatc-s heef-tea. cannot take milk, eii'irs disagree; (and oflei: the \
of an c^-j; is --ood. where little can he horn' 1 at o;;ce. i \\ !:a'
hedoiie;' Ti'\' a t caspoon f ill of malt-evt ract evcrv hour. ! '
new food, not handicapped hv mc-moi'ies of nssociationy.. ;t _
fair trial, and, often succeeds, espec;aii\ with fema '-, t > :
piece, the -;/.e of a !ia!Velolia IlUt, of ('ft Hl'if II '.>, I! .1
ti-iecl hourly.
The resources of the | ih vsiciaii are oft en ta\c.!
i:><; MANTAL OF DIETETICS.
troublesome sloiiKicli cases, but success often is the reward of ex-
tensive acquaintance with food of all kinds and qualities. Hut
then, this acquaintance is onlv possible bv long, watchful attention
to the subject.
The principles of feeding in gastric cases are the same, whatever
the form of disease, though in minor points some variation mav be
siiu'iresied bv the individual exigencies of each ease. The digestive
act remains the same, whatever the precise form of disease. Small
quantities of readilv digestible food at once, is the secret of success.
Knemata of soluble carbo-hydrates and peptonised meat come in
verv conveniently there is no palate to be oil'ended in feeding /><'/
red ii nt.
Of course, there are always the individual likes and dislikes to
he encountered ; as also the fact of certain foods disagreeing with
the patient: t wo mat ters which often tie one's hands very awkwardly
in dealing with cases. And it is in women in whom, as compared
to men. assimilation is imperfect that these disturbing factors are
encountered most frequentlv. When the assimilative power is very
small, the patient must be put to bed and the room kept warm, to
reduce the body-expenditure to a minimum. The amount of food
which will "sustain" life under these circumstances, is surprisingly
small. And after a period of comparative rest, the appetite and
power of digestion return. Such a case was put on record by I'ro-
fessor See^ens. where for thirteen days, but thirty-live grams (.") 15
grains) of milk were the sole food. After that, the appetite re-
turned, and considerable quantities of milk, an egg and some arrow-
root, were taken dailv. It is possible, too, to give some food to such
patients bv having them rubbed with oil. Absorption bv the skin,
even if small, is of priceless value in an emergency of this nature,
wii'-n. indeed, every litt le helps.
Sometimes violent and irresistible cravings for food of the most
apparently unsuitable character are experienced. It becomes, at
time.-, a matter of no small dilHculty to decide upon whet her these
cravings shall be ^rat i lied or not. Kxperience has shown that fre-
quently the food so craved I'm- has agreed, despite all a /irmri objec-
tions; and consequently furnishes an argument for yielding to the
patient's desires. (irantin^ these exceptions to the rule, the broad
rule remains of small quantities of liquid food at frequent inter-
val- in all eases of disea-e of the stomach. Of course, this does not
thru-t out of .-iLfht the fact that the stomach requires its own inler-
\ai-of physiological rest: but the smaller the meal and the more
digest ihle its nature, tin- less this interval is.
(MIAPTKK XVIII.
F(M)I) IN STIM'MA.
Tins is u very important matter al tie- present time, vrun:::
is tin 1 Word IHi\V ill use 111 lieu of scrofula. Scrofula u a- ai'M '. \ In
that suppuration of the cervical glands which followed upon eularire-
liicnt n! these ^iand-: ami 'jnl it- term from Scrnfa, a -ow. from
t In 1 porcine appearance of the neck. This it \vis\\hii-li caused tin-
1'niice Urgent to adopt thosi' voluminous lu'cktii's \vhirh wen- \voni
in tin 1 rarlv part of the pivscnt centurv. li \\a- vul'_ r :U'lv kii"\\n a-
"the Kind's Mvil" liccause it was lu-lii'vcil it \v;i- ciiralilc !v tin-
roval ti'iii'h. I'rolnililv then 1 \v:is souirt liini; ;u tin-. Inn ni'iii'fi-; ,\ ,
lint ilin-rilv. Tlli'i'lllM U'llii'il SUrrtM'ili'il 111 ^''ttlllLT Id-fiv-s to tin-
royal (ouch \voiili! proha'ilv after t hat u'' 1 ! tli- supi-rinr frc'iin:: aii'l
n-^inii-n whi'-h i- so ii-cful in stninimH, or si-roi'iilmis all'i-et ;I>IH.
St ruina is doselv linki'il \v:th. if not rrallv a lii'pravr.i urL r an:-ni.
with tissuc-dt'Lrrailation. Then 1 i< a i-crtain ciilarp-nient of tii, 1
epiplivscs, often itotici-jihU 1 111 the kt:ottnl iiu^t-rs, larii'e al the jn:::t-.
the liniH-s as a rule heinu' small and iiLi'ht. The musi-li'-s an- small
and apt to In- llahliv. The lips ai'e thiek and sn are the al:i- of ih,-
nos". The t'Vebrows are often \vell-inarked. and either straight "f
hi^lilv arehed. The little fairv child, ii-ualiy a \i\r\. with li',o>i,i.-
hair, wrll vaulted, fondiead. elearlv ill-lined e\elirow>. pniil:u^ p.
and ai'eliness of expression, with IOULT ilken r\el>i-o\v-. - a -
niou- ehiid: and will nsnailv not survive did lliood. I;
t I'ast to t he heavy plain child of coarse 1 ; MI >a i iii -nt -. thick up-. l>rok>"
or stunted evdashes. enlarged eervieai Lrlands. and i-;iinis\ f'U-iM.
not iinroninioidv seen: i-oih are alike, if not t-i|iiai!y >!ruiii";-..
The -TC;M Icvieo^i'aplier. Sam .lohnson. had distinctly st i-iiuicr;-
tun-s. with the knoMiv hand of i-oiilirnied -irtima. lie \\:i-
the la-i \vho was touched for the " Kind's e\il ": and i IP >!;_
nut serin to have henetited much therefrom wa< a hi-'ote.
promising: trne-lilue Torv all hi- day-, l'rot'f--or I.ayco-k -
person- of the striimoiis iliathesis. lha: tiieyex!
vllal force manife.-ted l>v defective n u; i' : t :!;. impi
and delii-u-nt function." And ai-o o! tln-.r !"m\ de\e.oi'n:i
1.".^ MANTAL ()!' 1 >1 KTKTH 'S.
it is "df a retrogressive type towards the infantile or a lower ethnic,
form." Of the nervous system it is " irritable, feehle in tone, mind
precocious, hut mental powers impel- feet, or if good, soon ex lia listed."
a "lower ethnic form " of individual marked l>v precocity and
ear! v exhaust ion. In its slighter forms stnima i:'ives us ourtvpe
of heauty: hut it- is an unhealthy type. The precocious fairy child
will never make a strong healthy woman, lit to he the mother of
children.
Of what may he called the cause of the strnmous taint, the de-
terioration of the pliysii|iie. the following illustration is fraught with
instruction. In mv early davs of practice in Westmoreland a family
tainted with stnima were among my patients. The father was a
man of fair physique, of the nervous diathesis; while his wife he-
longed to a moderately strumous family. In their early years of
married life they were prosperous as working folk, and their first
children manifested little of the strumous taint,- -had indeed just
enough of it to give piquancy to the expression. Then the father
took rheumatic fever which injured the valves of the heart, and
crippled him so that he hecame very poor. The' children horn dur-
ing this time had more marked stnima; their noses were stnhhy and
their eyelashes hroken and defective. Then the father had some
money left him, and their circumstances hecame easier and their
regimen hetter. The two children horn after this improvement in
t heir circumstances resemhled the lirst-horn children in the slight-
nessof their strumous taint. The family group was a most instruct-
ive one.
( )ne curious matter there is ahout strumous children, and that is
the amount of uric acid in their urine. ThcvaLsoare liahle to acid,
or .-our perspirations.
Stnima is a departure from the normal in a downward direction,
hoth as to development and nutrition; and. consequently, has to he
met hv good food, fresh air. and indeed, everything which will tend
to rai.-e t he />////*ii///r.
In i he tirst place, it is very nndesirahle that sudi a child he
suckieil hv the mother: especially if the strtima come from her
side. When a wet nurse is sought she mii.-t first lie a perfectly
heaithv woman, and tlien l>r. ('omhe (" 1'livsiological and Moral
Management of ('hildren") lhmk> "that the nurse should I'e-
.-emhle the mother in ail the characters in which the latter can he
coi - dered henithv: she should ! nearly of the same height ami
huik. for it has heen noticed that the chiM of a tall, thin woman
Ft M M> IN >Ti;i MA.
rare, ,- thrives upon the iniik of a woman of -
thickset. It is also a( -Teat importance th..-
hcen delivered as nearlv as possihle at tin' .-ante ;.me ..-
a lieu-horn rlnM nursed uj'oii niiik ;i few ino.ith.- o-i is ', : >
\-i\v thai the wet nurse is ^oinijc out of fa-hiou, attention ;.i h--:
is less necessary than ii was. lint I he nii.k supplied to the . d
-hould lie of cxeellent i j lla ', I h \ , a 1 1' 1 if |mssihle Hot that of -; a h.e-le.;
cattle ill t<>\vu dairie.-. " It is a curious fae| that iiie miik ><\ a
tuhcivulous eo\v an annual \vhieli i- \erv stihjeet \ i nheivuious
ilisea>es, \vlieii confnieil ;n ,-talnes. as tlp-v fi'euiieni , v afe !ii laf^e
cities- lias heell tulHlll to contain SeVell tllll' 1 - a- [Illleh j i] 10- j iM;i . nf
1 in ic, I he main in^'i'e'lient, of scrofulous tuhercie, a- i he niiik o' a
heah hv an iiual. " ( IJaudi'loctiiH' (|iioicil hv Lu^oi "()n Scrofu.a.")
'I'he niilk .-houM lie from a countrv-feil co\\. li\:u^ 1 ;n u ha; ma\ 'ne
tcniictl a imnnal manner, and leading a naturai i.fe. Not oiiiv
should such children he eaivfuliv fed. hut thev -limiid he reared ,M
the coiintrv under circiiiustaiiccs the most favourahn- for rne, .u:-;i_'-
ini;- development. And without this Sir '. < lark though; "ad
our etl'orts to improve their health w;ll fan." 'l"ne -ood foo, mn~;
he hacked u[> hv everv oilier advantage. " The -.-]'o;'u ,,,u. eiid>i
should not, uierelv live in the coiintrv hut should he a- much a-
possihle in the fresh air. 1 have fre<|tietii i v had ocea.-ion to iioi;,-e
the extruordiiiarilv irood elTects which an out-ofdoor l;fe proiiucr-;
upon scrofulous d i -ease in t he ease of i-liililrcii who during i lie per.od
of IT lean i HL;' are m the tields i rom sun rise to sun~ct for da vs ; o_;-et !,.;'.
Scrofulous glands, as well as other form- of sti'iinioas iii-ea-e, ;Ve
(jiieiit i v uiii teru'o a not al ile aiiU'lioral ion duniiLT I in- t -me. " < I .';jo.. )
The ad\anta'_;'e of setidilm" such children to ihe -ea-;dc. wlie|-i-t in-
whole iiav is s|ient in the open air \\hen I he weather perrufij :
ol i\", oils. " The seaside and eml-l 1 \ er oil " i - tile |-i 1(1 1 . !ie pre-
tion for such children when aU'ected with sonic -.rui'u;. .;i- ;:-o\
in t heir joints.
There is in strum on- children much tendene\ io ii.-ea-i 1
hone-. The I'll H have thickened eplphvses a! ':,e'r ':ir: :._
i-xt re unties; " the rachit ic ^a riand " ..- the name - ,\> '.
of en!a PJ;V< 1 costal ep; ph\ se.-.
]/,,,/,,'.< m. iii/-/ //.v i- also common, from -onie -:i..e A . .,
a con-i'dei'ahie liei^'h;, hriii.-in".' either ;h-e h.t--ad .
clip of the hi [I- hone-. I i.-e;He , , f I 1 , e , '. : ,, i \ ; , ! ,
(silent. The .-pine i- ant . too. io lie a :;' .
Jt'-i> MAM'AL OF DIKTKTICS.
single or double curvature, or even caries. The music-stool ^iviu^
no support to the l>aek 1ms been held largely to lilatne for this. In
the old starvation davs for school-fjirls, the inipert'ect osseous dcvel-
opuieiit of struina was verv frequent. In a lareje school visited bv
Sir. John Forbes, not line of the fortv jjfirls was free from some crook -
iu^ of the spinal column. And of these school -^irls Sir. J. Clark
said " \\ hi le the nat ural form of the bodv is dest roved, the general
lieahh sulVers ... In short, all the requisites for the produc-
tinii of strumamav lie found in a larvje proportion of boarding-
schools when the svstem described was pursued. 1 " I>ut anv such
expression of opinion ahoiit boarding-schools at the present day
would lie incorrect and unjust. Still the matter of feeding delicate
children, and especially girls, is a verv important one. in the matter
of L r irls more than hovs. because the advent of puberty and the in-
rush of new ideas consequent thereupon seems to affect more t he
palate in them than boys. Slate pencil and chalk seem the articles
most craved after lv the depraved appetite of school-^irls; and
neither have a food-value, while the chalk locks up the bowels.
Consequently, irreat care and supervision is requisite to prevent ir'fls
caiiuLT what thev should not have: as well as to see that they eat
what t hev oiiLfh t to eat.
Strumous children, from an early a ire exhiliit a strong tendencv
to form an excess of uric add. * It is seen in crvstals in the chamber
utensil-;: and LTIVCS i'isc to sour acid perspirations. (It is not asserted
that uric acid i< found in the perspirations, onlv that thev arc sour.)
I'robahlv this has something to do with the orood Hl'ects of potash
upon strumous children, to which I,u:_ r "l bore his testimonv. He
oli<cr\'ed that the administration of potash had a <_ r ood ell'ect upon
tin- maladies when present, "'without in anv way lessening the ten-
ileiicv to a lVe-h tubercular deposit."
\\ here it seems desirable, to administer potash (which is not verv
palatalilc), it mav be ^iven in the following mantier, without olTence
to the pa, ale. 'I'o eaeh pound of fruit when put into the oven to
slew, add a~ much potash-bicarbonate as will lie on a dune or a
quarter bit (in Kniriish. a six-pence or a shilling.) This will
itdit rali/'' the excessive aciditv without the taste of potash he in;:
present. Then some su^ar mav be added. Such steweil fruit with
cream, would form a desirable factor in each dav's food.
Then collies the (jlle-tlon of fat. I-'al is Heees-ar\ :'""
lion of healtliv tissue; and when there i- a di-tinet ;<'.,
tissue-deirradalinn fat becomes even more imperali\el\ i i,; .. .
Hut then t he st ruinous child turns awav from fat with !at :.i !:_. [
revolts from a piece of sweet animal fat : ;; 1 11 rn - a \\ a \ from n 1 ; :
bread and butter when a stout slice of hread i- co\r|-ed h\ a i;
laver of hiitter. How then is the requisite f.;t to he introduced
the organism ? I' v means of cod liver oil ^tveii an hmir after eaeii
meal ! Certainiv: hut is end liver oil the lies] or the mos; de- : raMe
form of fat y Tliat mav In- questioned. 1'rnfcssor ,lohn Hughes
Uelinett ill! rod llced t 'tie Use of cod liver oil; hut Luu'o] had Ho ex-
perience of it. he savs. Its n-c soon lieeame general ; n ad scrofu-
lous ainl tulierciilons atVect ions; and \\diat i- more, ;t ha- st 1 the
e'rim test of time, and hold.- its ground a< lirmi\ a- ever.
The iisliv oil IS relished hv lliailV children whetl on a /'/''
grounds it m i".'! it lie thought the child would di-Td<e it. ( >n the
contrarv, it is taken hv main delicate chiliireii as ivudilv a-
piece of \\ hale hluhhlT hv all K-killlo Ii;il)V. The fa i si-elll- t" Hie. t
an inst inct i\ e wan; . I 'r. 1\ ; I: M ' ( 'ham hers tells i he ia;e of a pht i; .-.
cal Skve terrier who whined for his cod liver oil if forgotten. O;her
children take ^reeililv the nil from canned sardines: a form of fa!
Then there arc other wavs of introducing fa; without <!;' nd.nu'
the eve or the palate. (if these, milk stands !ir.-l and, forcitio.-t ;
cither jilain. or as mi'k puddings, or as an adjunct t" porridge.
Then cream mav he eaten with .-tewed t'rn:;. ('ream too mav he
served up at tahle as cream moulds variously thnoured: cotitainini:
cream wi'h sonn- farinaceous matter: or as nierin^'iii'S. A- \\hipped
cream it is a pleasant acconnian i men t to man \ cold pud dinars,
i i
there is luitter. which can he added to hread. and some potted meat
in thin sandwiches, svheiv somcthii;^ tasty is relished: or it can he
adiieii IVei iv to mashed potatoes, or eaten \\-\\\\ milk ptuld, m-j'- eitlier
hot or cold. It is to he found in olcohvne. Wln-n- ecouoim js :)
matter of momeiii then suet puddings SU^LTCS! i hem-e,\ t -. j 1 ,,,;
cracked and .-tewed \\lth rice arc an exceilent fatly '.' 1. eh
haked heaus of New I'iii'j'iatid furnish a :ar;_re proportion of :'at n
a plea-ant form not likely to oll'end the palate. Th- a!-o
t L- I
economical toou.
Then there remains one more food, ran iv looked at
value point of \ iew. and 1 hat : - " '['> 'll'i'c. " T.h C.III.H.
lt'>l' MAM'AL OF DIKTKTU'S.
and siiLrar is acceptable to the palate of most vou Masters. The old
original totl'ee, made when butter "U'as elu-aj) and su^ar dear, is the
form to lie adopted when it is desirable to all'ord fat to the svstem.
The increasing price of butter lias reduced tofl'ee (in most instances)
t"the level of a mere carbo-hvdrate: \veil enough as a fuel food, hut
inoperative for tissue const ruction. In my experience many a little
stnunous child whose palate revolted at cod liver oil has been saved
from death bv liberal supplies of totl'ee: though its mention usuallv
provokes a smile of derision and a sceptical remark from the
mother. She soon however sees for herself the beneficial ell'ect it
produces. Incredulity u'lvcs wav to j^rat it iide: just as of old those
who came to scoiV remained to prav. There is other conversion
than religious conversion !
In struma advantage can be taken of the ready absorption of fat
by the skin. Children readily admit of cutaneous inunctions beinir
applied tn them. In a warm room the child's trunk and limbs can
easily be sponged over with warm water and soap so as to cleanse
the surface, after which oil. which has previously been warmed, can
be applied. It should be rubbed over the skin freelv. This can be
done one or twice daily. Cod liver oil probably is most read ilv ab-
sorbed, but its smell is objectionable. Then comes neat's foot oil,
also an animal oil: olive oil is less o (Tensive than either. Such in-
unction in eold weather forms a ^ood protection against cold.
After a suitable regimen under favourable circumstances, as an
outdoor life at the seaside, the system will often ^n-atlv outgrow
its strumoiis tendencies, and a fairlv heultliv organism be attained:
where if no steps are taken the svstem simplv gravitates deeper and
deeper into conliriiied struma: and sinks ultimately under some
tuberculous or scrofulous disease. The preventive treatment of
stnmious affections is a ^reat matter. \\hen some joint ha- been
e\ei.-ed or mischief .-hows itself in the mesenteric glands, or the
hi!i">. I he nbove scheme and regimen, have to be adopted as a cura-
tive measure.
The ".Teat food for the strumoiis is " Fat."
CTIAPTKU XIX.
K(M)D IN AX. KM I A.
TIIKKK is a t nil In icy in youth and especially \vitli irirls t> ln-com,
ana'iiiic. or hioodle--. \\ hv tin.- should l- is m>t \ITV clear: in;! .
seem- prohahle that the demands, of growth, of puhertv. and i.
work, school IT other, made upon tin- organism, lower the capa'-ir
for .-aiiLruitieation. N<> donht in smut- casr.s inhci-iti-.l >\'tih:!:
factor. TiifM i-xpfisun- to nialai'ial inlliifju-i-s inii'i-fi-n-: witii t;.>
Format inn of hloiMl-corpuscIi-s. as wrli as, pruhaMv, li-adin^ to ;:,
rapi'i il i-inti'^rat ion, or \vrariii'_;' out of thr.-i' I'nn 1 Innlirs. Ati\ !I[OM
poi-dii i-arrii" \vith it a tcmlciicv to aiia-m :a. aii'i ul'ti-is to nrtira'^la
" I'ain :- ill'' prayi-r of a nci'vc for ln-ait hy Momi." ,-aM li'oin!"'i'_
ami pain is t'ouml, cspri-i illv m-ural^ii 1 pain, \vhcri-vi-r tin- iii'm.i
impiiri-. or lii'tirit'iit in (piatititv. ( 'oiiscipn-ntlv, \vc tiii'i in-Mi-a -.:
nii'li'i' tin' iiio-i opposite ciri'iiiiistances. \i/., MOO,! impuritv on \\\,
one liaml. ami poverty of MOO.! on the other. Ana-mia then ma'
he simple from det'eetive lilooil-fortnat ion : or complex, \vheiv t!ie:-i
is a hloinl-poison opei'atiiiLT injnnoiislv on lilood formation, p-r'.
even also destroying the re' 1 , liiomi corpuscles.
(It mav In- .-aid for the instruction of non-niedicai reader-: tha
the Mood corpuscles do not feeil the tissues, tllevarefcd fl'olii l!;
serum, or //'/'""' s '""'"'""- v of 'he lilood. Si;,!, \vhen -a:.^i::ll>'al ;:
is ii'ooi) t he u'eiieral nutrition i- not amis-.)
It \\:\< been pointeil out in a previous chapter that the ord,::a:'
nutrition <>f the Kodv is hut metaholism of materials funi:-h' >1 i
the food, except ill t \\ o matter-: 1 . t lie ha ma^'ioliin of i he ':,,,
and, '.', til-' lecithin of the nervous sv.-iem. lla-ma^loh n a a \
complex lioiiv ;n \\di;ch iron is a factor. 'I he treatment of
is not iiieivlv the administration of chalvheao--; tii"iiL;!i !:
essential part of t he I real meiil nsuaih'. If some spr'-:i"j.l..-
pi'eseiit in th'' liloo.l, as svphilis, inalai'ia. mci'.'iirv, LI'OI;!.
Una, i! !- USejc-s to '_^l\'e ll'oll Utltil tile ' ! : '_' 'c-t : \ i ol'-'av,- ;
order (as a rtile to \vhich lio\\~ever. th' r> j are -om>' ,
The S peel tic po!-ol| mu-t he Diet hv It - o\Vll all! 1' lot e i li or ;
the orirans m\olved :n sann'iulicai ;oii a !a.r lic.-i. I :.
It', I MAM'AL OF DIETETICS.
ivadilv seen hv the inutility of steel ami <n>od food in a cast' of
aiuemia in which syphilis is a factor, until the proper treatment of
the taint is superadded : and then the dilTerenee i- noticealile at
once. The treatment of an;emia often fails from ignorance or lor-
tretfulness of this fact. It is not uncommon in eases of pint and
hiiiarv distnrlianee to lind that weak ana-mic persons have lieen tak-
ing steel and quinine most earefnllv for some considerable time
without anv LTOOI! result: and vet. as soon us the pun p<uson is met.
liv ]iotasli, or the liver put nirht hv hepatic stimulants and ehola-
CT"irues, improvement, at oner sets in. \\hen ;i certain point has
been reached, then the iron comes in most usefully.*
These matters. lvin<^ somewhat outside pure dietetics, must lie
pointed out in order to prevent disappointment. Valuable as a
knowledge of dietetics undoubtedly is. it must be remembered that
feedinir cannot do without medicinal aid in manv eases. A man
who has lost both le^s would do little with one erutch.
Puntvof blood and iron to enable ha-ma^lobin to be made are
essential to the treatment of ana'mia: but proper food also is requi-
site. The food should consist to a considerable extent of animal
food (except in puit and ehola-mia) at least when the ease has made
some prou're>s. At first in amemie cases in nirls it is well to send
the patient to bed. The assimilative powers are feebler and cannot,
digest enough to feed the svstein, and meet demands on the bodv
a- well at the same time. To send the patient to bed to lessen the
body-expenditure is the tir-t step. 15 v so doin^ even a very feeble
digestion can suppl v the want- of t he organism, with a little to spare
for improvement . ' You cannot eat voureakeand have your cake "
savs the old ada^'e. No more can a starving organism use up each
day's income and expect to store and Darner strength. A few davs
in bed i- the proper start in marked ana-mia. e.-peeiallv with '_;ir!s.
Tin- is a lesson experience has taught me \vith some liumblinir of
ride. Pa ;n is of various kind-: and wonndinir of the se] f- pride
mav make as enduring an impression ;i- the inllietion of physical
pain -as \vhen they !lo^,_,- r d certain healthy lioys in order to imprint
the locality on then- memories in the old rude method of " rid HILT
the boundaries." Sn<-!i a ease occurred to me \\hen attached to the
West London Hospital. A pallid iiurse-Lfirl was an out-patient
every oiuuhination of iron with tonics, made no pro'jre.---. ),..,
",<>!![- through tin- wards, there wa.- MiV illtractahie patient
on I'amouslv in lied mi the nrdmarv chalvhcate mixture. So !"'.j a-
she wa- doini;- her work fating her cake- she made no pro- -,...;
as >oon as .-lit- was placed a! rest in hcd the l"lv e\p.'nd;tniv ;''.'.
In-low thr hodv income, ain! impro\ ement hecaiue |iossih!r.
\\ liciT tiic assinuhltivc ]HI\VCI-- arc I't-clilc n is <>\ i\ u~.' in |.i-ur
in lilicral i|uantitic< n!' animal funil. It is not wliai i .-\v;d!n\si-d
lint what is dii:rstcil that iri\vs stn-n^th. Animal lu'utiis (Miitrrii,,
111^' sniiic of the muscular :il>rr) with sunn- t'arinai'ciius ma!"i'.:i'.-.
often all the liettef :t' |ii'e\'inu.-lv rcmicn-d snltiblt', mu-i aiti rnaii'
with meat. As inipp'Vrmrnt troes on the dietar\ mav !>e made n.'.re
lilieral. A 'jreat matter is not to over-run the powers, and hase ;,>
turn hai'k and >tai't airaiit. \\hene\ir the tongue i< seen to !.e
covered with a iu-own fur then the eliaivheati- must he withdrawn
till the inutile clean?: wlieii i! mav lie iv-nmed in smali '.nan'.! es
and its I'H'ccts carefully watched. 1 lowever anxious in i;-et on. care
aiiii caul. on must lie |n - ai-t ised. In simjili 1 aiia-mia after the iir~t
slow initial |iro^i - e-< it hccoiiies |ios.-ih]e to |.ush on with I 'literal
sn |>|>1 y of fund. containiiiLT a fair pro IK >>;\ '> m of meat . eomhiiied with
fresh a:r and exercise. A waik sliouid |tri'ccde the iioont ;le meal,
whieh should he !'(', lowed li\- an hour nn the .-ufa or couch: and : f
sleeli can then he secured all the hettef. After that a wash, a I'.nie
of sonietliinu 1 to eat. and then another waik. drive, or ride. P>\ such
mean- the assimilative processes are encouraged and aided. A ^<"id
,-u pplv of oxyu'en rcmoviiiu- waste matter- i- often verv servieeaiilc.
I have known very judicious ti'eatmen; of ana-m:a fail to alia n the
!e>;red ;ind wonted results on aci-ounl of a ha^ilv \eiir, i:iiv
room; removal in a more desirahle liedi-liamher he.ni: at "ii
lowed !i\- ini]irovement in the patient's condition, and >al >;;'i'M*|3j
progress IlKI'le.
Another [Idillt i- to keep the hnWeN npell. (If n;d p!'\~i
were verv careful to enmhine ehalvlii-ate- wit h !a\a!:\''~: ':,
aiding in the ah-nrpt inn of ; he iron, tliev he;d. Aii'i
c\ [icrieiice upholds this vie\v; while at the -an.e t.ine
hoWels opell is to <f>-\ \-\i\ o ]' cerlai.Il o|Tell-i\e Ilia!'''!'- !'!'
hv tile lower howel. which wliell I'e-a h-oi'hi-d Illlo the -y-'- r
a mahirn and pernv n !; , iiilluein'e upon sanuiiiiica: "' . \\ '
howel< a-.-;mi!at ion ;- ever inn crfi ci . There 'm;:-'
tion, el-e the ti'ealnient of ana m;a ;- : l!iwar:ed.. ;
It!*') .MANUAL OF ]>1KTKTK'S.
be of a character to keep the bowels open. Oatmeal porridge, dishes
prepared from maize, vegetables, fruit, fresh and stewed, and meat,
and meat broths, or soups. These should all be given according to
appetite and palate and body-wants.
There is a ditVerence betwixt jiiurmia and convalescence from
acute disease. The latter is a case of quickly down quickly up again
verv often. In aiui'inia there is more chronicit v. a slower fad tire of
the powers and a slower recovery. A person regaining ilesh and
blood, and with them, strength after ana-mia. has not the recupera-
tive powers of a previously healthy and robust adult laid prostrate
bvthe stroke of acute disease. The appetite is not so keen, the
digestive powers are not so vigorous. The regimen appropriate for
the one will not tit the other. Circumstances alter cases. Certainly!
And li^ht food of readily digestible character should in each cast;
precede the solid meals which are appropriate later on. while it
is almost needless, to say all body-outgoings should he reduced to u
minimum. *
('ITAPTKi; XX.
!(><)!> IN CONSTIPATION AND Pi A KIM !< K A.
IN disorders of t he a iinentarv canal the dimce of fund - sear. -c', \-
less important than In affections of the stomach itself. Ti;.- i' i ,-
ofleli .'lliilit' .-Utliclent in produce i'!' relie\e the i\V oppo-if' con-
ditions i if constipation ami diarrlm-a. Th" f-ndt-nev f r;<-e and
\\'lii';i[i'!i iliuir is to hind tin- l)ii\ve|s; that "!' oatim-ai \ opi n them.
\\ here the orilinarv \v!iiic u lii'atrn ln'rail lni-ks r, 1 . in.- !i<>\vrN ii i<
fi'iuiil in inaiiv cast's tiial rrli'-f is at nin-t- alT'>r<li-'l !i\ i-i^m-t iiii: t"
Illl ! M i ((!, ii!' " \vlliilf lllr;ii " lil'rail, (.(',. iil'ca'l ci il il;il !l! 1 ILf til' 1 \vll'i]i-
<>]' I In 1 i-niist it iicnis of \viicat . t lie lira n as \\v',l a- tin- i-ni'H. I >a: im-ai
deserve it. \VhetinT t h is act ion is d ue t o t he tai the-,' tv., forms
of farina contain, or not. mav n<>! lie aHirmed.
Then fruit is regarded as a laxative, and for inan\ adult- as we.;
as children, a \\<j. two or three prunes, or some stewed apple- are
enough to correct the howds when correction i< re.jiiircd. This
ia \at ive etl'ect of fruit mu-t not he confounded w.th liie [nir^at:\e
con. -eij uences of a sui'feil of unripe, or overripe fruit. Here diarrho a
i- Nature's process for :fet t inu' rid of a n o'Teiid i iiu' ma-s in thea.i-
meiitai'v canal, and is a sain I a rv process. ( >i\ the other ha nd . usidei:
certain circumstalices, fruit is a corrective of a loose -tale <>i the
howois. In nrie case kno\vn f> me. a luhous liiarrh'ea i set up
summer, \vhii-h is corrected l>v eat ini:' a ipiant ;t v of fru,;. 1: \\o:i.d
seem t hat hv introducing;' a uiiant : t v of vegetal ile matter to m: \ \\ . -,\
the |,ij,.. the compound ;- more toleralile t" the Liwei than tin-
eel; ; ra i ed hiliarv matP j r. At an\' lime a oiiantiU o! api'.e- (
and ail) will put a stop to (his l>i!iar\ diarrlnea. Th;- n-- "f
i- almo-i unknown, hut i; i- \vorth h.-arin^ in n::n'i. Th"
l he.- is here put forward as an e\ pla nat .on o : t-hw [;;>; ss ' je' ..;-,
lint can s.-arcel\ lie .-aid to he e-t;i!>i;-hed. A ,.,, n !
i- ac.-,.ptahle to the -ton a.-'n. a 1 d t he ! >ark of i r> - - >.'.'
time- than t ho-e of famiin . . ' . , when o 1 . ! \ .
a\ a; .a! lie. \\ he;, ha v ha- tier n wa-hed o\ :! i, <;(< :
i:\ e cat ; -. it ha- lieen f. mud thai \\ ! -'na\ in:
l',x MANI'AI. ( F DIKTKTICS.
were readilv taken, and that the animals so fed. did better than
those who u'ot no shavings. A certain amount of woody tihre
in their food seemed essential to their health. (" Fruits and
Farinaceu 1 . ")
Conlliot mu; vie\vs are held about the dietarv of eonstiltation.
Some writers advise' avoiding food which will load the bowels as
vegetable parenchyma, while others au'ain discountenance such food.
'I'hat the bran of win at is ^ood there is no doubt. I5ut if thehvpo-
thesis put forward to account for this. f.r.. that l he mechanical ir-
ritation of the brail-seales excites the vermicular act ion of the bowels,
is true and well founded, then it would seem the bran, or much of
it is not digested. Certain it is that the coarser the Hour and the
more bran it contains the better it is. as has been the experience of
sundrv manners. And the custom in \\ estplialia of eating bread
made from unbolt eil Hour lias been introduced into K upland ( Liebi^)
with advantage to the bread-eater. The addition of treacle (which
is largely levulose. or uncrv.-tallisable su^ar) to brown bread is
credited witli increasing its aperient, elVect : and, "brown bread and
treacle" is in vo^ue amongst the students of tlie impecunious class
whose sedentary habits clo^- the act 'HILT of their bowels.
It mav be .-aid as a broad rule, that [l--h meat, and meat in-
fusions have a (list i ml tendency to keep the bowels open : while milk
and farinaceous matters tend to constipation. Cheese lias a reputa-
tion of its own in this respect: while e^s. especially if hard boiled,
also bind the bowel-.
As to the peculiarities of individuals thev cannot lie discussed
here. One person i- potentlv affected hv a small i|iiantitv of food
which in the bulk of human beings l:a- a purelv negative action.
For such persons abstention from the articles which d satire c with
them : - a: I I hat can lie advised.
Th'.i- -oine persons ai'e readdv acted upon liv iVint. especiallv
fresh t'r I. ever t liev indulge in it: whili- neai'lv all are all'ected
liv I'h u hi. ii ' ; r-: eat en in .-prin- .
I'nder c-i-rtain c;rcum.-tances foods which ordiuanlv lend (o ]o(d<
up the bowel-, -et up active purgation. Thus milk, onlinnrilv
bindiii'j'. when the stomach i- acid so as to set up excessively tirm
curd . ts a sliarji iea: a nat ural ehminanl | HMCCSS \n -j-ei.
r;d of the jieccatit mailer. In the ~;i ine \va \.other like ma 1 1 ers act .
(>.. at the Leeds I >ispen-ary. a \\oman brought a child ill \\ith
o-a. On beiiiLi'a-ked what she had iriven. -lie replied - Hard
j- ." and Seemed io feel hel'self decidedly ill-treated bv
I'rovidetlce ill that tile child wa- til'- Wo|'-e. and !:' 'if ; " "
!]'!' I feat II iellt. Slleh c Till If, Hll per feet I'.-; i -,,'.;-;- , ,' .'a:!' - II..
t!i:l!l Sullll 1 . \\ lio 1'eal IV k ll"W .-' >llle! ll l!l'_f ill' fund and !'':.:._. II
tllllik p"--lhie; nlilv iheV 'in li<>; cnliie illt'i enntart With '.'. .
Siiii more important i- tin- fiHiil. \vliiT'- the o] iii. '-;.- -
diarrho'a is established. One limad rule ni:iv I"- iai'! down. ;,'.': it
i- t hi-: - " SD lon<_r as ainiiia! hrot hs a IT permitted. - i 1 >?!_' wii! diar-
rhiea !n- intractahle. " A'_ra;n aii'I a '.rain has t'hi~ Itfi-n iiri\''-!i . -," a
sjiikc int'i my nidiKiry. < >f cDiirsi-. I have li-anii-.l tin- !--- <>M t'. >r
jnvsr'if: hut 111 inv IHKIIIOII ;is a I'misn Itanl . ;' cutni 1 - ut;'!<T mv i.u' re
in rases treat' 1 '! hv otlie]->. There is anvthii!-' hut a ^eti^ra! ivei ig-
nition "f th's t'art: aii'I few nf our '\::.>al re-i'li'iit - a! \'i''."ria
I'ark Ifn-nita! have tmi t his U-SSHU ;., l.-ani. M"k \v;;li !'ai\!ia''e, ,us
niatiei's. fiinns t!ie i'niiil in iliarrlina! i-oiiiiit i"ii-. Arp'UT'Mit . ir;t\v)
i-- the I'IXM! eui'e t'u]' 1 1 iai'i'liira anioii ( _ r rhiMren. in the utiiniu!! \'
linti-h mothers, Stat'eh certaiiilv snittlics tiie aluiieritai'v '-aria!.
aii'i a -a'j'i. ni'eveii lietter, a taiiinea |iii'!ii:!i'_ r . t'"fiii~ suft ua-i'i ',rj
fur a :">\ve; \vith an irr:;a'>:e iniic'nis meniliraiie. A,! hari. ;rr.!ant
matter i- uhjeetinnahle. ainl a^i;Ta\ ate- the mmi'ii :<IM. A liiari'lm a
(if hari! potato, r nf earmt. of a irreeii staik. or a t> ere uf nti' ..... i\'-'l
ceierv; <>r of an unripe apple: anil i~ eerlainU a^'^ra \atnl !.\ -:: -h
nieehaniral irrnant -. .Mnk lioile.] \v',:h ri'-e i '"-; >j:\-<>\\ ti'i ) l:a~ a .'; --
t iin-t eiirreet ive aet ion. Milk \\ith liiseuit piiu-iler i- e\.-> lien;. I'..
sii'-li admixture, tun linn rui'iHinLT i~ avui'ieil. T" pu! :n a '.
cinnamon cassia is to au<! a flavouring a^'ent \\ h ;-ii at t lie -a me !;
i- a 'jooil a'lilitioii as acting favonrahlv on lim^e Im'.ve!-. In ! : a
tli" fruit of the |',ae! or Bcniral iniince (A^le Marma'."-)
repute for the Ireatineiit nf iliari'lio-a. A 1 the -a me tini'-. :: :
in cun.-t ipat imi. " It is an ineomprehen-:!i,e reine'i\. ha- !.):'
aroma imr la-te. aii'l eertaiulv HO astrinu'enev." (( 'hr>l;-'" : . i x '
it liea ;- a L"O' .'I I'eputa! ion.
Al! V'/etalil" aiji I'm;' juires enMain;:;^ !an,!;,n. are : ' '.
Til- 1 ari.rn and the clie~t! m. when dried and L:'''"'.:: '. tjj&K
uliieh has (li>tinctlv a-t r. i I'j'eii t proper! ;'-. A Lf'Sffl |
from t h' 'in. or a n int'n -:i>n. ( Miehcika ll'ee, )
! n acute d :a rrho a t he !>e-t f ..... 1 i~ m!!k \\ ': h . '"
\\' ia -at i !! I!'''. ir (\\'iih cinnamon) in sma , >. ! ;a'.' '
1 1 "i '.I. d nor ton warm. M ;ll\-pudd in-j'* mad.
or ta pio.-a. ai'e 'j; ..... 1. * >r. \>< iwden-d a rr> .w r ' I
in in. ! 1 1' sueii TO. >d lie i ier-i-! -d w;: h, ma:
170 MANTAL OF DIKTKTICS.
without calling in the aid of strictly medicinal agents, liut fre-
quently these last arc indispensable.
In more chronic conditions of looseness of the bowels, milk and
farinaceous foods are still to lie made the staple- of the dietary. St ill'
puddings, as suet dumpling and plum puddings, are held to lie con-
stipating, anil thesa.me is said of pastry: but if such is really the
case, certainly ne.ther ai'e smtahle for conditions of intestinal irri-
tability, whether catarrhal or otherwise. In chronic conditions of
diiirrlui'iil character, some olijection lies against annual liroths and
meat infusions; and it is well to give them, or soups with sa^'o.
biscuit-powder or vermicelli.
Creeled rice is a very good food in such conditions; and t he juice
of cranberries is useful, as there is some Astringent (tannic) in cran-
berries. The juice df the pomegranate is also pleasant and good in
ailY looseness of the bowels.
Then come the astringent wines, rich in tannin -as Claret.
Carlowit/ and Catawki. These maybe drank undiluted; or mav
be made into a nutrient food bv adding them to solutions of urape
or cane sugar, or even to lactated foods. In many cases the small
amount of alcohol is desirable.
Ii mav be laid down as a rule, that farinaceous matter is useful
in diarrluea: the soft starch being not only non-irritant, but actually
soothing to the morbid mucous membrane of the bowel.
No doubt in manv cases of diarrlura. acute or chronic just as
in constipation the resort to medicinal agents is often necessary.
liut. L r rant in;/ t his and admitting the numerous remedies in our pos-
session for tlie relief of both conditions, still, their action can be
potently aided or thwarted bv a suitable dietetic regimen. Indeed,
in the milder cases, regulation of the dietary is sullicieiit to keep
the bowels in a satisfactory condition.
In the diarrhiea which belongs to travelling, it is well to take a
ose of rhubarb whieh iir-t opens the bowels, and then locks
them up as a secondary action the dav before travelling': and after
this to take n i:l k and farinaceous mat ters only till the journey is over.
(In consequence of tin.- second a rv binding action of rhubarb, an
art ; tie ia 1 const i pat ion is fa r from uncommon. |5v sub.-t it ut in;x sonic
other aperient for the rhubarb for a time, the bowels commonly
come to move naturally and of themselves. Rhubarb is indeed of
all aperients that least lilted for habitual use.)
CIIAI'TKI! XXI.
F<HH> IN PHTHISIS.
\\ A --TIM; disease is eon.-iim !>t:<'M. wh.'-n mav IT niav not h- pui-
nmnary. Of ( ,] ( 1 this was Spoken of a- a " weariv_r " '...:! w. a:\nif
out. or exhaust imi of thehodiiv \>\\<T- vvitli emaciation. \\ :.:. a
jiersuii was spoken of MS " liriir_r in :i i-on-umpt:o:i." : t meant i:.a -
In 1 or she ua- emaciating: hut ii;d \\<>' !n\"'i!\' an\' -i"-'-:,-il iviii-'- I'ui'
tin 1 wasting. I >;. ( '. 15. \Viiiiam- h"j - that phtiil-] - 'he u-ua!
niala'iv w,;h persons who il;e " In-iik'-ii-hi-art'-'i." N'nw liif :-!:; ;-
almost entirely retrieti-il to pninninai-N- plith,-i~. ot- i.ii'Ji '. ."
Th:-~ pi'iniit ; ve eoneept ion <>\ " i-oiisii nipt ion " <>r " -,\ .;!::..."
worth lu-arin.ir in iniinl in relation to ph; h'-'~: \\ : ' -ii ; ; - : ; ; .> pri--.'! ; :
<lav is ton exi-lnsivelv rr^ii ri in 1 as a inei'e local n.n.a'iv <'' :!n- . ;:._."
In realit v jHilinonarv plithisi.s i- -as a rn'i- ' .11: a . 'a I'Mu-c^inn
of a '^i-nrral wiiiespreail alpl eon-t ;; u! iojia! '-,.;; '.'.;'.,, :, : a! 1 i !-h.- '.' :
\\-lii' 1 ]! nin-t I)' 1 kept wrll in si^'ht in al! treatnu 1 !;. p!--\ '.: :\ o;-
cu rat i vi'. The very 1'aet that i: run- in err: a in !'ai :::; i- - \\ hii. ,...
ai 1 '' euuallv exempt from it, i< a ino.-t -M'J'L c -~'. .\ < fa 'i. \\
linki'ij with (iisease of the ^iainl- an-l scroll- nicin'iran''-. 1'
hooil we li'i'l the hidden taint shewing ii-e'f in lii-'ra-e i,f ;h,. m,.
terie glands, " pot-helly." or 'I',*!, < 1A - /. a:i> \ in 1
meningitis, otherwise :ieiite livdroeephaiu-. A- \eai'~ a'isa:.' 1 "
find the ti'iidetiey to disease in tliese area- Lfi\e wav to -;;!:.";;-. ..
lai'Li'emeiit of liieu'lands of the neek. and d:-ea-e mt
Serot'idosis and t nliereiilosis av as nearly related a- i\\:::-. a
not inerelv have the same pai'enta^e. In the piv-i-n; > -\\ v
attention ha- rieeii so stroiiiriv di'awn to ij;.
are found with pnlmonar\ phthi-is we are a'.'' :' l-e
eon.-t .tut ,onal rehtt ions it- niori.id k:ih and i\.n. T
I , L' MANUAL OF D1KTKTICS.
resistive power to the tubercle bacilli inspired h\- all;" or to state it
thus "Certain families manifest a U'lulenev to lung-changes in
which the tuherele bacilli lind a t'avouraltle nidus; " we must con-
front the t'aet that there is a something in some families which ren-
ders its members liable to become phthisical, which is not present,
;:i other families. Taking a broad view of phthisis, it can be hon-
est 1 v atTirmed that the families which exhibit this tendency to tuber-
culosis are those in whom the st ruinous dial hesis is existent. It is
the "lowlv ethnic form." which carries with it the tendencv to
tissue-degradation, which gives us our phthisical families.
Laennec laid it down that tubercle was a neoplasm --a new in'owt h
of tissue. unknown in the healthy organism: and when it was found
the case was hopeless. To such d ismal view has succeeded another
and truer one. viz. that there is nothing in tubercle no histological
element- -not found under other circumstances. Tubercle is a rapid
proliferation of connective-tissue corpuscles the lowlv basement-
membrane. or packing material of the body the more rapid and
excessive the production, the more huddled together the cells, the
more liable is the mass to die. The sparser the production and the,
nearer the, new growth to normal tissue; the better its chance of
survival.
This pathological disquisition is not the pursuit of a, side-issue of
Lfrasp if he. or she, is to have a correct and vigorous hold of the
dietetic management, of phthisis. \Yhen the ceil growth is rapid
ami extensive, the crowding of the individual cells upon each other
means deal h to them. It is like crowding a host of individuals upon
a Smiled area so closely that it is impossible to feed them: those in
the centre die first from starvation. Rokitanski speaks of this
"central softening'" and of "the ocular proof that the softening
commences at the point most remote from surrounding textures''
i;i i ubercle. Such so ft en i n 'j or ca scat ion of t he muss is accompanied
bv hectic fever wlii'di mav. or mav not exhaust the powers; and
wear the patient out m a shorter, or longer time according to cir-
cumstances. If the softened ma-s can be expectorated a cavity re-
mains, which mav include the whole morbid area. leaving the in-
dividiial short of so much lung, but otherwise little the woive. At
nlher times i: vpectoration of the softened tubercle i- acroni-
!. Hi- fo'. lowed b\- a new development of tubercular n'l'owt h
doonie ; ;,, Joficii and die: and the IOIIL;' continuance of the hectic
f< :. haust- the powers.
Hut tin 1 course run is not :il\v;ivs -o L. r '""iuv. Th-- tv
growth mav Hot lie so five ;i:ii! tin- ceils <!n M"t crowd ;...;, .,.
another so liercclv. and .-o some nutrition of tin- new _':< iv, :
lie po--;l>ie; in which case death de> M.,; fo'i'nv. " Va-
in truth, beloni:-; as little tothe nature of t uin .!> a- or-.-,:.,
it -ell' " ( le>k itansk i ). I Jut if enough of nut rit ion can 1 " a: v < >rc..'d !o
the mass of lowlv texture it inav niaintain life, at.d, wither u;i. !:.
some cases only a ma-.- of lime salts (like a piece of m"rtarl <vma:!;-
to tell of the hv-]);ist tuliercle; which mav Mav in \ /". or h.- , \
]iector;ited IOULT after al 1 evidence- of in n^ mi -eh icf ha\ e pa-sed a\\ av.
Such is the hi.-!orv of tuliercle. I Jut what does the eminent path'i-
lo^'ist tell us!'- "The cure of tubercle mav take pla-'e in \ar:"i-
wavs. l-'.ach of the Ilictliniorjilioses of tubercle ma\' heconie ill\c-l'd
wit h t he e!i;ir:ieter of a healing process. Mill, neither I he decadence
of tuliercle. nor its ejection ihroiiLi'ii the meilium of ulci-rat [:;. a-
local heal in 1 -: processes, ai'e fraiiii'lit \\ it h an v value for ; he indi\ id ua .
n n! c-s a c con i pan led hv the extinct ;on o! i he t undai iient al i u ' "!.'
producing era-is. " This is the uTeat matter to attaiii if po->il/.c.
Opinions ilill'er as to when the term "tubercular " can be applied to
the mi-chief in the liuiu'. Some hold i! max be n-ed when i-oiiso 1 ,;-
dalton of t he Iniiu' is on foot : and in cei'tain case- this is so. as when
luiii: consolidation is found in a person of tubercular familv hist"rv
who has been wastini;' for sonic time and had ii:i;h! sweats. <>'!:';-
hold that a mere consolidation of the lunirs is not enough, and, thai
it is onlv wiieii there is evidence of softening o;i f"o: there.!, iha:
the term '" tuberculous " ean be trnlv appl eil. In the lan^ua^e of
Xieiuever '' we have no hesitation in stating that the ^reate.-t dai^'er
for the majority of consumptives is ///"/ lh< >/ nr< "/</ fn f > <
I' II 1(1 IIS, "
He >avs too " Prophylaxis a^ain.-t consumption require- ii; tin
iirst place, tliat when an individual show.- si'-rns of defectivi' \\\\'.r'
lion and a delicate constitution, i-speeially if he have L:":\CM p..-:
evidence of niilHlial delicacy wil h a tendency to di-i-ase.-
in eaSCOllS product-, //'' slinlllll // /i : ih-,il // y/n.v>//;// , //
rillriiLi!,',! In i ,, I'i ijui'U t<< UK' n))l*t i I H 1 1 it . "/"/ '" f.< t < >i <l n i *!,
1,1,1 1^,1, ,,,."
The proph vlact ic treatment of tubercular alTection- .if a ! !
i< to prevent, or remove that dvsera^i-'. or general con.! - :.of; <'
bodv and its tissues winch Drives the ti'in:cn,'v
degraded connective tissue corpii.-cle- joo 'ow!\. :
or urbanised iu live. There i- a L:v:'.'Ta',
171 MAM'AI, OF DIKTKTICS.
tlir inherited constitution is a ^ivat matter. F.vd surround incfs ;m<l
tin- mode of life tell mi the parent-organisms, and what is acquired
bv the parent becomes inlicritcil l>v the chiM. l.im'ol said the
population <>!' Pans of his day was eaten up hv scrofulosi-:. vet their
ancestors three or foui 1 generations hack \veri' liealt hy people from
the eountrv. I >r. \\alshe. and still more receiitlv .lames Cantlie
have pitinted "lit the degeneracy (f the populations <pf !ar_ro towns.
VOL:V! savs "''hildivn hriii"; no existing tubercles into the world
with them." though " there is no disease so positive! v inheritalile as
tuberculosis. " < i rant m.'j.' this he i^oes on to sa v " The following arc;
U'enera'dy considered the external causations of tuhereulosis; had
air. eontinemeiii in elose. imperfeetlv ventilated, dustv moms, damp
hdise- and had food hv which living exclusivelv on rve l>read and
potatoes, and the deprivation of animal fooil, is understood."
\\ ith the oilier matters than hail food we cannot deal here; hut
with it we can deal to some purpose. If the tendency he a matter
of inheritance let the phvs;eal links hetwixt parent and oitVprinil he
severed as soon as mav he. The mother should irive place to a
healthv wet nurse (chosen on lines and principles laid down he fore).
In households win-re this cannot be accomplished artificial feeding
must he whollv or partlv carried out. In the matter of struma
insistence was laid upon the nccessitv for fat for the formation of
sound healthy tissue. Phthisis is an outcome of t he st ruinous ha hit ;
and to improve the strumoiis hahit is to reduce the nsk of phthisis.
Kat is re(|iiisite for t he huildinir of heal! hv tissue-elements. Milk
Lfivesthat form of fat which is most desirable. \\y.. : -t he emulsion.
I-'at in milk exists in a very line emulsion, the fai-u'lobule beinn verv
Milk is mo-'t acceptalile to all VOUUL:' ei'eatures, and is
as to iiu-lude a Muantitv of I'at-liearni'j; milk. TO this mav lie added
some prediLTested starch if needful. I Jut as soon as the infant can
chew, and ha- some organs of ma-tication i! hei'omes a iMiestion
how far ' not - 1 poliev to LTJve it some food on which ; t can
exercise IN jaws. A biscuit, or eracker, or piece nf hrea'l munched
would lead to thirst calling for a draught of mdk. Siii'h starchv
matte!- \\-> i <'! would develop the jaws and their aecessori i s.
Too much si ft food, whether of insoluble, or of prediufestcd starch.
leaves out of ~i'_dil the natural mean- of developing the salivarv
Is. Th' 1 LrnawiiiLT which a child delights in is started hv the
'.'., set up by the teet h con i i 1 1 '_;' 1 1 1 H ' 1 1 -'! i the i, r um. I hirinir t h"
time of the growth of the primary ij\- milk teeth this irritat ion
OXHtS and serves an IIS. -fill plirpo-c. '\\< rciii-ve 1'. tile,
sonict hinLr. :iii ivorv or india-rnhher mi'/;, "'' pad: th- 1
run- down 11 - In!) tcl hie 1 ; of t he ad ivit v "!' tin- -a , , \ ar
;lc! ;\ e ll|o\ ellient of the jaws If t il< J I lit'; Hi: c (1 ;t!d he ".i
;i p!c,-e of hread or hiscuit. il wouid he \vr,i. \<> douo 1 \
di'jv-: ::i is active in early life, and salivarv a. -linn >inc- into i.!..--a-
lioii w;;h ma-t i'-;i I ;i >>,\. Aiiinial< \\'!i:'-h rln-w thc'r 'Mi'i art- 11 ' -:>'.'
from t iiliiM'i-ulosi-' ( to \vlii. 'h nxi'it arc c'-rtaiiilv sn'if'-ri I. I'. ; :ii.-
cvcri'i-c nf ilic-jau'< is ^UM,! for ilic ili'vi'lnimn-iit <>\ tin- ni-^a:!- "f
;ii-alivation : aii'l tin 1 iliasta-i' u'lii'-ii tin 1 -aiiva cuntaiiN :!- uo>n
t in 1 stan-h. ('hinlrt'ii \vin> irna\v at a cm-: arc ilmiiLf a ^ i t!r.:ij.'
f"r the ilrvcIojiMHMit of their ja\vs, ;nnl \vit!i that tin-i! 1 j 'cniia'i'-Ji'
teeth; ;in'l a!-n hrin^ii'iLT out their ,-alivarv ^'lain!-. Arnl iijmn ::i-
sa'nvarv iii'^e.-tiuii their life or death mav turn MI me I'litiu-e :': t \-.
Surplu- .-uir.'ii' i> storeil as fat ; \vherestarcii ili^^tioM ;- ':!' -<-\ :
ciuaciat Mil set - in.
Tin- >i i ft fnoil -i) much ^iven \ eln'nlivM niav he in maiiv ca--i'- a
inat'er unavoidalile: hut in mir ile<;re to feed the eh;M ,n ;!ic
present. <! not let us prejudice it- future. Tin- eiicmtra^enien; uf
the saliva rv u'lai ids hecomes then <>\' importance ;n the die;";.c- .,;'
i'liildreii who have a tuhetvttlar i'arnilv histnrv.
Then t lie re i- a not her point to he at t cm led '".and i! i- t it;-, \ '.,:. :
the ah-encc ,,f f ; | t in mailed prejiaration- or haked llmir-. A'i-
inirahle as Mellin's food is as an addition to milk, it can no' |d,esp.:e
(he advertisement) take the place of milk. 1: lack- the c--,-n!.al
factor fat. The same ohject ion doe- not he aLi'ain-i l:i'-:a!'-d i' i-.
win-re milk enters into the eomposit ion of the!' 1, or wh.eiv tip-
yolks of c--- arc us,.,]. The hread should he huttcivd. or
used. Some iu-lv fellows have heen rai.-cd mi a dn-tarv cn:.-.-i m^-
of nothing' more than a lump of hread and some dr;ppi:iL. r . <>'.' I h '
of hacon. The hread should he cut thin and tin- hint"! 1 weii
in for delicate children. \\'here the u-ual fan v f 1- arc :
taken t lien of course resort to cod liver o;i h^rom, -
The .-i -ant v rat ions of man v a 1 it t !e mile are el<i'd out \>\
oil from t he hospital or t he dispensary. 1 ! mem '..: a .-a--
Soiue eiiiplovci-s at l.eeds. went oir on -trik-
plo-.-i-r-. an-l had to " i-Ii-m " (starve) in con-'-.j-M.-ii''.-.. M
cmaciaiei] child was suckled l>v it- ninth"! 1 wi o o 1 \
little \vak tea and drv hread. Mverv ari :cle of :
pos-sihlv he -pared, had pine to the " hoii-c
halls. " s^ line cod liver uil and si eel wine ! mv,
1 t> M \\r.\l. OK DIKTKTICS.
wonders for that lit tie starveling. It is not uncommon in the Xorth
of .Knijfland to see a child fcil on pap for its meals with a little l>a,u'
to suck or chew betwixt meals, containing butter and su<^ar, called a
" sno-ar-pap." 'I'his is a capital plan when milk cannot be obtained,
and supplier an excellent form of fat. The utilitv of ordinarv
totl'ee. as an admixture of carbo-hvdrates with hvdro-carbons pos-
sessing a liiu'ii nutritive value, has been pointed out before.
Such then are the various modes of introducing fat into the
vouthfiil organism. There remains the inunction of fat to fall back
upon.
Then most authorities advocate a supply of irood vegetables for
children not in lieu of. but. in addition to other food. These
supplv phosphate of soda and other useful salts. The same end
m;e-ht be met bv animal food, if it were not for the fact that in
children of strumous or tubercular constitution, thev are </i\'en to
the formation of uric acid in larger quantities. Potash, a uric acid
solvent, is advocated by all authorities on tuberculosis or scrofulosis.*
Phosphates must be supplied freely to children of this diathesis, as
tliev readily escape bv the urine; and. of course, if voided in the
urine, are not available for the tissues where thev are so needed.
\\ell-eooked vegetables should be allowed and form part of the
dietary. For the supplv of other salts, as the eit ratc-malate. or tar-
trate of potash, for instance, fruit in various forms should not be
forbidden: indeed, the eating of ir should be distinctly encouraged.
A heaithv child can extract what its svstem needs from verv un-
promisini: materials; but not the child which comes into the world
with an impaired physique. It mav not brinir with it into the world
ready-formed tubercles; but it brings with it the tendency to their
formation. And with a thorough knowledge of this fact, we must
do our h".-i to condiHt the inliorn tendency.
Tlie milk of the Alderney cow is best. Then that of* t he black-
polled An^us breed; but the milk of any healthy, properly fed cow
;: There is a curious and interest in-- point about the forma lion of uric acid
hv children of s-t ruinous or luliercular family liMnrv. I'rofe-.v,,r l.avcock
pointed out t hat the -.keletoii of t he st ruinous is of ]<iwl v et hnic form. I
have elsewhere pointed oui |io\v i he formal ion of uric acid l>v a mammalian
liver is a i a^e ,,f reversion, or turnine; back of the liver to the form of
nil rou'ciii-ed \\a-1e found in the birds and reptiles who have a solid urine.
The mammalia have a llmd urine, largely composed of the soiuhle urea.
We vrc 1 hen. ill the -I rii ini 'Us. o>scous de_ radat ion as \ve| ] a-- he pat ic d<--Ta-
uli; liolli of \\luch inu-1 lie home in mind in t heir d ietei ic regimen.
FOOD IN PHTHISIS. 1 , 7
will <!<>. Mixed with tin- various farinaceous ni:it>-r- :i- a iri'.k
pudding, milk should be a staple of the dietary. I'.nUer-
freelv supplied. 15 read niiil butter pudd MIL;' is L: i. lJu'i'T c-:i:
lie ;ii 1 1 led In milk pudding :it tin- table wit li ad\ anta-'f. Kai-ca' '
must be encouraged: and suet puddings an- _LT 1. The baked beans
and pork of \ew Kiiii'land form a capital food, rich m fai. l';.-i:..<-
.-In 1 11 Id tic well luit tnvi't ; and i'i >r a chanirc, some milk wa nil-- ! u , ii
a knob of hlttttT incited in it.euuld he served at table with pia : n
boiled potatoes. I'astrv made of l-'reuch pail' pa-te mav be allowed
(when it dors not cause ijidi^i-stion). in rea-<mahle ipiaiit :t ;-.
\\'liere lllc appetite 1- eapricioil-. evell i huriilate el'eaillS have a
\'alue. Sweets mav lif esseiitiid; hut su far as possihle the raim^ nf
sweets betwixt meals .-hniild he avoided. Ii mav lie neces-afv to eke
out .-mail lileais hy sweets; hut a watclifui and evi n siispieinii< eye
should he kept on the practice in order to avoid the emu- of spuiliirj'
the apjietite for meals hy sweets. Indeed u H unlv in rare ea-e-;
that the plan of "uiiv food rather than none." is necessitated: and
( >f course toll'ee ( ' 'ontai n HILT hut ter ) is t he he-t form of swi-et : and 1
know at least one eomely dam-el who owes her life to toll'ee in tii- 1
ear! v \ ear- i >f pul icrt v.
In some of the Nort hern parts of the I'.S. A. a cure for phthisis;
in vo^ue is to u'o Itimherin^ whei-e pleutv of exercise in the open air.
t he sharp chill air of wilder, trives an appet ite for fat pork. Such
a plan is only suited for |>!i! i]i-i<'a! put icnts with lar^e and capahle
frames. The principle is sound, and, the practice mav ! imitated
in a les.s severe and gentler form, hv main VOIIUL:' persons threatened
hv phtl;is:s. 1'ientvof exercise in the open air. with homiuv and
pork for victuals, would save manv a life; cspeeial'v ;iuioii^si ;!iat.
wretched ; own-populal ion doomed to live in small lil-veiitilated
apartments, where the air is I'mil and laden with mechanical irri
tants; who foi'iii a lar^'e proportion of the phth:-ie;il pa; ent- wh. -h
ei'owd the waitini:' rooms of nl| hospitals for diseases of the che-t.
And now a few words a ho ut the use ol' rod 1 ;\ er o: !. A- p'>; ; vd
out liefoi'e, lish-oil is no; the iiio-t dcsi ral i'e. or the 'nest form i' 1 fa':
hut i; has the ad\anta".v of hein^- the most di^'-si ilt'c. I' -
taken after food : and in order not to needles- !\ provoke t he - :.
the interval should he ahnul an hour if po^-ilije; ~o ih;t; it ,-ai. M..
with the food passing out of t he stomach n.to i he d uodeuum. whe-
the digest Jem of f;i| he^ilis. A- pointed out before. ! : .
fat does not commence tini d ; he food has l,.i'j i ],,. ~',,\,.,,
^lAM'AI. OF IHKTKTK S.
y if iriven before, the oil only swims about the stomach,
otl'endiiiLT it, and causing spasmodic contractions, or excitations.
Whenever the stomach resents its presence, it is we'll to administer
the oil at a distinct interval after meals. In other cases it is con-
venient to take it immediately after food (as in the case of workiiiij;-
people LyoiiiLT to their work), and if it does not disagree it mav ho
taken then.
After ten years' experience at the City of London Hospital for
Diseases of the Chest, and mv other experience at the West London
Hospital, and at the Leeds 1'uhlic Dispensary, to sav nothing of over
L L
twentv years of private practice, in the thirty years which have
elapsed since I was hound apprentice (as an apothecary) to mv father,
who was in general practice in West moreland. I mav say that in en-
counterinu' phthisis mv greatest, dread is a distaste for fat. \\here
the nutrition is intod. the prognosis is, as a rule, favourable; even
if a larii'e area of lun^ is implicated. \Vliile on the other hand, in
those cases where there is slowly progressing emaciation with a dis-
taste for J'at. tin 1 prognosis is as dark as Lrchus, even before any
lun^ complications set in: which commonly enough is not till an
advanced stau'e is reached. Whatever may have, been the teaching
of the experience of others, that is the lesson my experience has
taught me. When a patient is steadily wasting with a tainted family
history, and a personal history of a loathing of fat intensified of late,
then the forecast of the future of that patient presents no difficulty;
it is. indeed, onlv too easy to tell what it will lie. The practical
outcome of this i< the insistence of fat in sonic form - beinir taken
without waiting for Innir-iniscliief to show itself. That, lock which
opportunity carries in front of it (b'sni:' bald behind) must lie ener-
<reticallv grasped; and to be forewarned is to be forearmed. If the
patient can be induced to take fat for the tissues, all mav vet be
well. The absence of tat (somehow or other) leads to a dvscrasis
which favours the product ion of tubercular i!;ro\vtlis. Kven when
tubercle ha- developed and softened, cod-liver oil has snatched
manv a patient from the 'jravc va \vnmi: before him. or her. If fat-
can lie take!; Ill SllHiclCllt < | lia lit It le<. llCaltllV tlS-lle ea II be built Up
around t he di>easfd area, and the ravaires of the invader arrested.
\\ here the absence of fat leads to a depraved t issne-'_ri'owt h and repair
for a considerable tune, then a condition of much danger exists.
1'rof. Laveoek callei] this "the [iretnliercular stan'e of phfliisis."'
Anv tnbcrenlar !_ r rowt h then formed will certainly start on a down-
ward progress in the least possible time. '|')ie impaii-ed tissues
FOOD !\ I'll TIII^I^. ; 7;i
around it oll'er little resistance, and th>' neeros;n:_: tuhep-!i!a:' ma-'s
\\orks in no time tin- ruin of the . .ivani-m a.n-adv -ai>i [ and
undermined.
IM all families where there exists a tubeivular ; :
ilren ouirht to be taught (almost as a reii^iou.- du: vi ! ,;'.
some. Hi 1 ;IMV i'onii a< tin 1 ea- mav In-. 'I'.. mv mind ;M;I; ,
inosi efl'ective insu rain against phthisis tha; ran If -,\. ;,,>,../. ;
is unwise ami .-hort-.-iiriited to let tin- rm-mv In- upon one, : .-:m
IM- fcprcseeii. Iii sninr cast's win-re coii-iivcr <>\\ cannot !" ta \>-:i.
mutton surt rhoppcil tiin- ami boiled in milk secures tin- di--:: - i'd
end. Thi- |ian is in ^''i-at favour in Loiiilon. Imi exists i-vi-rvu in-ri-.
I'rohahiy the mo^t digest iltle t'at next I" i-n-l-Iiver oil is ill.- ii-jnal
fat of j'rir.i hacitti. Tin- rardv up-ds tip 1 siojiiacli. Iliva'i frum-
lilc'i ihtu the fat eiiatiieM it to lie ivaililv taken. >th'-rs like fa;
liaenji hoilcil. anii samhvielies ma-le therewith.
SIP iiiiii-h I'm 1 the feeding: of the pi'tentia! '. v phthisieal. ai.'l \vhaf
I'i'rm- of I'IMI, 1 <iu-'!it to lie taken !>v them. N'ou soinet hintr mav '"
Sli'l i'f ill' 1 feeding nf the sick consumptive, Wlleiv the appetite is
feehle and ea pi'ie ious, and the digestive powei' weak. Sum.- ! ;'
tea with Kidire's food, or like foud. a ^!ass of milk \\itli snme
Meilin's nr other lik'- fomi in it : or sonn- malt extract witli an
aerated water; a vulk of an e^-'j in a little slierrv; or a luseu;! with
a cupful of (onlinarv) lieef tea. or chicken broth: ail are suitable
as interludes betwixt meal- the more serious pi-tronmuic per-
formances. The meal- ,-liould be small, so as nut to " out face " t he
appetite (tu us,, a provincialism), and just enough M-nt up a; onec
to make the patient think a very little nu>re could have l.e.'M eati'ii.
Then it >houid be served with the utmost I'leanlitics- and .-eriii' ilmis
neatne.-s and daintiness, so ticces<arv to seeui'e appetite. I'ln'tiii-r,
the patient is never to be a-ked what food must !.. pr-'parc.-.! a
nur-e wlm can do that, is not tit for the pn-;ta>n. iuii jn-t -ntue-
thinir nice ma !< and sent up so as to secure that agreeable .,
wh;eh whets tiii' fastidious appetite. A small bird on tua-:, a :'
sandwiehe-;. -mail, thin, and m-at in appearance. ( M:e 1-. . .-\. "i-
one !eii'_'th of sausaLT' 1 . An CU'L;' with -mne l'a;r\ -
blltt'-r. A -llia' % Clip i'f ^(.nd eiilVee a!,d Cl'eaill. '" i'll"e
/
cocoa: '':' even ti'a \\';th cream. Ad served "ii a e.eaii .
pa : r of hand- clean a- We!; as wi,,inu'. \v:d i!i'!ii<-e the pa'
when lllliier Oilier eireUlll-tances the faee ;- a\e!"|i' ; !
di-'^u-t "n :i- features, and appetite ha- turned n- la i\ ;. !--d.
Such a meal a- di'senbcd mi^ht form breakfast.
TSII M AM AL OF niKTKTICS.
In manv cases it miirht well and fittingly be preceded bv sonic
milk with a little supir and a small (|iuuitity of nun. or brandv (and
a suspicion of nutnici:') in it. about T A.M. Once this "ruin and
milk " was a far- fan icd and sovereign remedy for con sum] it ion. And
there is no dou lit t hat with many persons such " hivak-fasi " is <Mod.
as breaking the Ion:; fast of the in<jht. after which the ordinary
lireaktast can lie enjoyed: where \vithout such preparation the
stomach would feel itself unequal to a heart v meal. Put in scien-
tific phraseology this furnishes to the stomach the matters requisite
to the formation of the pistne juice known as '* I'epto^ens. "
At 11 A.M. ill ii: lit come one of the lit t le interludes just spoken of.
For lunch a cupful of white soup, or vermicelli soup, with a
digestive biscuit and a small sweetbread, or a small lish as a sardine,
or anchovv on toast. A Lrlass of p-ood red wine would not be out,
of place. Then a rest on the couch would not conn- amiss. At 4
l'. M., a cupful of chicken broth with plain biscuit broken into it. or
some milk with Mellin's food mi^ht be taken. I (inner at li P.M.
mav con.-ist of a whiting or soim' llat lish. followed bv a chicken or
some irauie, a little bread and butter pudding and, if fancied, a little
cream cheese or a nip of other chee<e. A iz'lass of miod port. Bucel-
la-. or Madeira, or Marsala (according to the purse) mav lie taken.
At bedtime some treacle posset (milk made hot with treacle and
some i: i n <JT< r ) mav be taken on u'cttinu' into bed; and the rest be
put in a jiiir with a lid (under a bi<r tca-eosey) for the small hours
of the iiiorninL:'. Such would form a liberal dietarv during the hec-
tic of softening tubercle: and as soon as the fever abates, some cod-
liver oil mav be added.
The fond when the patient is confined to bed should never be
allowed IK remain in the room one moment more than can be
avoided. Perhaps grapes are the onlv exception to this, lieiii"; cov-
ered with a stout impervious skin, the sweet tlesli is kept from taint.
Onlv just as much fool should betaken into the room at once us
the patient is likelv to consume and no more! The contrast to
this i< a weak, wasted patient with a wan. worn face, and a hand
almost transparent, ian'juidlv looking at a table on wh:eh stands a
cup half-fuil of milk : a saucer with some canned apricots in it : half
an apple with a cut surface ^oinL:' brown: a :_dass with some half
melted ice floatni'j 111 water with a metal spoon in it helping to
the ice; half a L lass of port, which has been there ;m hour or
more; and Irving to fix the resolution as to which of the ^I'mip he
try. Xo wonder I he appetite is languid, and that choice is dilli-
The physician in; iv l>e dnMi'j; aii t iiat lit-- in ii - p- >\\ . T v. ii ::.
en II--. nia\ arre-t t he ni'_ r ht sweats, cnnt ml t he fi-\ -r. k'-< ; '.!:
r<"_Mi ,ar. ami the stoinaeh in ^m>d ,-nnd ;i ;< <}\ : \>\\\ \\itlmut th- 1
a nurse natiirallv i_rift>-d and eaivi'uilv t ra neii, uh und'T-t.i:
!'cedim_ r as well a.- niir-,nu'. the results are un-a: .-fa*-'. .r\ . I',;: ;: ; .
physician must I'Vereise a general supervision, aii'i have a \\.e-, ;
praise I'M i- the irood nurse, and a word of another kind I'm- the ;; -
eapaiile "i 1 run-less nurse; aihl fur thi- he ton mu-t i e>< ii :^;-M.:I-
tion.
\\ hen thn-e times of 'jastrie irritahiiit v eume as enine th>'V \\ .
ami >lo 111 ||lo>t eases of ehl'ollle |>htlli>;.- -tllell the feeilinir I'eenlln -
a eanlinal matter. Sma.i ijiiaiit it ies ,<f i;.jii;il f ! a; t'reijiietit in-
tervals are essential. After some stinlv n|' these intereurreii! attack-
of irasU'le irritalii ii! \" the eoiielusion arriveil at is th;-. the Miore
extreme aibl riui'i'l the ilietai'y the niniv ipiieklv 'lie stomai'li re.-n\,'r-
its tone. ( n a vi TV strict ilietarv this ma\ lie aehieve.l in from i w.-n: v-
I'mir to seveiitv hours: whereas on a niuileratelv raivfui [Lrinien
onlv it mav l.ie a week or ten ilavs liefore the gastric il:>turliaiiee .
i >\ ereoilie.
A .-mall nutritive enema o!' treaele ami warm water iha.f ai,i
haif) or a s\'rup of miik-sii'j'ai 1 or ^Tape-suu'ar ma\ he ^u^n thrive
ilailv, to help to maintain the general nutrition. ( )r the Unly mav
lie ruhlied with oil - -;.> a make-iiift.
\\'ith moileni kiiowieil^-e of digestion and hodv-reijuiremen! -.
\\ith a more perfect irnp of the essential wants of the pht!n.-ica! "f
the importance of arrestini;' all out^oinu's. a- well as thai of the in-
troduction of fond at once dip'stihle and nutritive, ;he pi-n-pe :
of the phthisical arc much Kn^liicr than lhe\ were ai the he^inni!
of the [ircsent ceiiturv. A suspicion thai then- i.- a diiVerem-e
IWlXt lllel'eiv 'Jet 1 111-' food (loWll lllin tile Stolliai'Il and i!- >\ L't'jf ""<-
is ah road : and that a tahlespoonful of milk and Men in'- f , u :.' ii
is digested, is reallv liettci' I'nr tin- patient than a ! ><< !'--! < M 1\ w iJ.': MI
simplv passes thrnu-'h the aliinentarv canal. T<> -uppra B he
much-tried nru'uiu-in il 1; ,t whi'-h it reallv ivijitiiv-
etliciellt help In it. |-'a! for pl'e\ etl I "lot i ; fat l'o|' cure I'.'.;'
tin re is pistric iri'italiilit v mi foot, ii is a ca-e of m is ;.'''; '
oH'crcd to t he consuinpt i\ e and which I he ;n\ ,-!;'
tn swallow have m> advantaLT' 1 n\er ihe IIMU.I'; . . o ; . :, -
iiiii'-h ha- lieeii -aid in tin- t real i~<\
All aioiit: the line, whether during the periods of comparative
health, or times of acute peril, with patients with a phthisical ten-
iieiicv. thetz'reat cardinal matter is the nutrition of the organism.
To Imild up healthv tissue is onr aim; and for that, fat is essential.
And nsuallv. fat is loathed and avoided. Imperfect nutrition is
what we have to contend with, and the side from which danger
is ever threatening, more or less seriously. Cod-liver oil. oil emul-
sions, preparations like Cremor Hordeatus, and Oleobvne. all
strengthen our hands, as regards the [icrmaneut treatment of the
plithisical. In t hose periods of gastric disturbance to which such
patients are liable, prepared foods are invaluable. " The subjects of
pulmonary phthisis resemble in one respect, hand-fed infants. Like
them, thev are liable to repeated attacks of Castro-intestinal catarrh,
which trives rise to indigestion and flatulence. These attacks, bv
the inlluence they exercise upon general nutrition, may produce
verv serious conscipiences. " So savs Dr. Eustace Smith, in the
art icie on Chronic Pulmonary Phthisis, in his classical Treatise on
the Diseases of Children: and his experience at the Chest Hospital,
Victoria Park, agrees with mv own. that intercurrent attacks of
disturbance of the alimentary canal, and with them, failure of the
nutrition, are amonu; the most serious complications we have to en-
ei'iintcr in the treatment of Consumption. And this is even more,
true of children and verv vomit: adults than of older phthisical
patients; but even with senile phthisis, the dilVicnitv of maintaining
the nutrition is. the threat stumbling-block in their treatment.
CTLVPTKT1 XXTI.
FOOD IX CHRONIC IIKAKT AND l.l'NC DISKASK.
SDMI: critical reader may fed -urprise, or be inclined in s.-niT at
tin- distinction made herein. 1< not I'hth;-;- a lunu'-disca-c !' }\<-
may ask. Certainly pu ini' 'iiarv coniplicat ions are \ crv common with
phthisis, aim 1'ivijUriitlv fni'in tin 1 main trouble ami tin- i j au-c of
ili-ath: but all the same, hut admitting this. |iulniniiarv phthl.-l.- ha-
no )-i-'ht to he classed as lunir-diseasc in tin- proper sense at ,iA.-t.
That \vuiilil he niislcailiiiL;'. I'lilimmarv Phthisis is imt a pivtuarv
lunir ilisca-'". as chroni Mroncliitis and l''.in j'li\-rina certainly an*.
1'ldii'it ic disease mar certainly exist in a jM-rsnn \\itii phihi-ica. ten-
dencies, and then a condition ivscinlilhiLr />/tt/ii*ix jii'/iinniirii.x, uiih
the same indications I'^r treatment, mav lie sei \\\<. l!ut uhat ;<
meant hv the a hove heading arc cardia'- aircctuins and inorliid slate
ot tin- IIUILT. u'hi'-h interfere with the t!o\v of hlnod t liroK'j-ii th-
|udinonic cin-uiat ion ; and the obstruction, working liackwards,
proiluces conire.itioii of the portal circulation, and the viscera con-
nected therewith.
(Acute picurisv or pneumonia requires t he dietet ic management
laid down in t he ( 'ha pter mi " I-'m \ in Acute Disease:" while a con-
dition of pleuritic ell'usion. or eiiipyt'ina. would rather he lu-tter met
bv the line- laid liown in the pre.-cnt chap!'T.)
\\ ha; i- deal! \\';th here is a condition which mav broad! v be siii
to be the oppositeof (or antau'onistie to) phth:s:<. Mot 1 1 cardiac (valvu-
lar) iliscase and chronic bronchitis and emphv-cma are ir.compat h'c
with tuliercle. Tu I ici'i'ii lar disease of the [un^ mav. and tiocs -o" !( .
t inie< co-rxi>t w;lh val villa r di-ca-e of t he heart . or w;t h emph\ -ema :
but so verv rarelv that tin- very fa>" ha- been called in ijiie-' on.
M' ith IJokiian.-ki and the late Dr. 1'ca- k held that \a<cif.ari n-o -c-
ineii! of the !un-'. which follows upon mi-chief at the mitral \a \e.
wa- iiieom pat ilile with tubcrcic. \\'hilc i; ha- bc.-u pro;...-c.l 'o -ri
ii!' art ilieiallv a eoiiii.tion of eiiijihy-cma a.- a pi'oph\'!ac! . n:ea.-:. :<
in ihreateiied piilmouarv phllii-is onlv nobo.i\ k; e\\ ho\\ \\-a-* ;o
be done.
1^4 MANUAL OF niKTKTK'S.
offered to tlu 1 How of h](K)(l through the pulmonic circulation, and
the etl'ect of this upon tin 1 blood-current ami blood-vessels behind
the obstruct ion. A certain damming of tin- current, is the result,
and with that, congestion of the liver (impeding and impairing its
functional activity). and 'behind that apiin congestion of the portal
vein and its venules. The elTect of this venous fulness is felt ill the
stomach and intestines: and feeble digestion and, si uppish bowels
are the consequence. The condition of the mucous membrane is
favourable to tlu 1 production of pis, pviiiLT tlatulence. Flatulence
is one of tlu 1 e,Teatest troubles of persons \vitha crippled heart or
chronic limp-disease. The pressure of the elastic ^as prevents the
descent of the diaphragm and so further embarrasses the breathing.
So pronounced mav t he ditlicult v of breathing, so set up. become,
that the term "asthma" is applied to it by t he sult'erer. The dis-
enpiu'cmeni of pis in valvular disease of the heart is sometimes so
pvat that it. pours np the (esophagus producing loud noises, and
continuing for some time. The term " heart- wind " 3 is applied to
this explosion of noisv eructations.
Another eonset|ueiice of this venous .fulness is that the patient
.feels " full" even when the stomach does not contain food. It is
neeessarv to _;-o over this pathological ground as a preliminary 1" the
discussion of the food appropriate 1 thereto for the instruction of the
non-medical reader, in order that he may the better uva-p what is
here said.
From the venous congestion of the whole abdominal viscera
impairment of function follows. The stomach is enfeebled, and
pr;marv digestion is lowered, while the working of the liver is em-
barra.--ed. and much of the proteid matter which reaches it is never
carried forward as the albumen of the lii/nur X<IH<IIH ntx for the
nut rit ioi; of the tissues, but proceeds on a downward career toward
uric a'-id and urea. The condition of the urine, more or less laden
with Inhale.-, tells of the faultv assimilation. It is impossible to
feed the.-e persons up bv ^ivin^ liiein lai'^'e (jiiaiitities of animal
food: this simplv add,> to the li\'er embarrassment. The amiable
intention mei-eiv link- a condition of hlhiasis to the pi'e-cxi~t m^
; rouble. It is well to bear tin- in mind in feed MIL:' persons with
chronic disease of the liin-js and heart. The more severely ill the
|e.-s the jissi m i hit i \ e eapaeitv, and the solul'le ca rbo-hvi 1 rat es. all but
"'.]''.' of tin ve act, form almost the only food that.
i! ' a : isi H'bed.
\\hcii lairlv well persons, with old-standing valvular disease of
tli- 1 lii'art. >}' with chronic bronchitis ami emphysema, or
einphvsemu alone, can share the family meal, pc'-hai'- tL'->.
out liiat certain food- di-a",Tee with thrill and e-.-hew pork a: d '
(and some i-vi'ii pi^eon-l. he MILT scn.-ible ari<l rational indi\ idiul- :
but bevond this it is nut necessarv for them to --0. '1'hev pivfe-
hi;_rhlv .-easoiieil ill-he-, a- the carminative pepper ,- ^mid for th'-.r
flat iilence. Mustard ton thev patroni.-e. and thev i ;ke a _" >"d iiea
of LT.HLVr Wltll tliell' llleinll. ('llUtliee theV fill'! -Ill'-- them; ;i!l<i
tiiev aiwavs weleomt 1 niuiliL r atawnv soup, aii'l sn:tT u;th an air of
sat i-i'a<'t ion when a curry appeal's on the seenc. l-'i-h nn nrnti/i
SUMS them, e.-peeiallv \\llell We'll .<ea.~Ol|ei 1 . ( 'a ! 1 i 1 tl i > Wi V ali'l Ve^fe-
talrle marrow in/ //ri/fi/i ran lie treateil in the same manner and !>e
on intimate term- with the pepper eastnr. A!i smips and male
liislle- to which Seasoning eail lie a'1'ieil are ill Vo-j-ue Ultll them,
and all kinds and varieties can lie made l'r tln-ui. 1'utato^- can
lie >ervril up \\ith a liu'ht boiled e'_;~'_ r . and peppered to taste. l-'i'e-li
meat minectl. and seasoned with a wail of ma-hed potatoes. woii,il
form a lit: in u r di>h. .M inced col lops would not conic ami: while a
Sco'climan wouii'l doulitlcss uilvoeute ;i hau^'is. or a >heep's-liead pie
wliii-li can hardlv he over peppered. Kntreesof ail kinds could
he prepared to meet their requirements. An Irish stew, or pepper
pot. or hotch-potch, would not he rejected hy such persons if \\vll-
sea-oned. I'rohahl v t he\- will prefer pepper and I (Utter with a 'naked
apple rather than .-nu'ar. I'l'^'s feet or tripe could lie ppepareii to
their mind. A fat little pi IT'S cheek ciil in pieces and, served up hot
with a saner piquant would form an excellent d;-h. esp'-eiaih where
there is anv Li'outv eomplicat ion -a vei-v common oecuri'ence. Thev
would prnl. alii v he more likelv to pav t heir at tent inn to '_nii'_rer snap-,
eoriani'ler cookies, ilian to cranberry tart-, or huckleberry cake, or
jumbles. Mullinsand " mot lier's cruller- " thev wmild be like-U '<>
pa-- iintouchd!. but their eves mi'j'lit rove to a u'inu'er brca-i loaf.
( 'hocoiate cake and marble cake would not excite t heir CM ! in; - a -in.
of Ll'iti'Jef or llUtlne-j-. ail'! cloves could be Ut.llseii ul'I'
oppvrt unit v occurred. Cinnamon i- -"""d m a r:<-
mulled claret i.- a comfortable drnk in cold weather. Sn
admit- of a _< >od deal of pepper, and, inn ili'jrataun v \C L -I
e-(ioi| in;- ilatuleiit jierson-. Mushrnnni- can !" eoo^i ;
wav- and readilv lend I hem-elves to i he cook'- ;"' a-
!':-;: pii'idin-'- ami pa-le could le speeial'v -:!- *ll' ..
ma 1 .- nnai-c would nroliablv at their hand- be (!'
IM'I MANUAL OK DIKTKTIOS.
tional pepper. Totted fish should be specially prepared, for added
pepper cannot ai\va\s take the place of seasoning put in at the
proper time, as in meat puddings and pies for instance. Their
whitebait mu.-t lie devilled, and their prawns lie served as a curry.
Not that their stomachs arc- to he made a perpetual spice-mart, hut
their wants as well as their palates must he consulted.
The three things to he aimed at are. readiness of digestion, a
proper proportion of carminatives, and ;i suitahk 1 hulk, the latter
heiii::' a matter entirely under the control of the individual. Small
meals at no long interval should lie the practice; and a light supper
is essential to a good night. A substantial supper is very liahle to
he followed hy an attack of dilliculty of breathing in the night, and
is a mattei- of certainty with many persons suffering from disease of
the heart.
As to the amount of alcohol such persons should take, t he answer
is a dillicult one. Kin*; Chambers says of alcohol in disease of the
heart " Let the alcoholic drink be limited to that quantity which
increases the appetite. In a great many instances this quantity may
be verv shortly written down 0." No doubt this is ipntc true of
some persons, especially those persons to whom alcohol is a poison,
no matter what is the matter with them, whether it is their heart
or their liver. Some generous wine \\ill very commonly be found
to aurive well with persons with old-standing heart or lun<_ r mischief,
and will help them at meals. In attacks of dyspno'a some alcohol
as a stimulant is of incalculable value. As cordials alcoholic com-
pounds are excellent. Ali'ohtil (/*' Men/he has done me excellent
service.
When the condition is marked and the patient gravely ill, then
a dietary of liquid food is necessitated and meat infusions, predi-
gested starch, and milk, become imperatively called for. King
Chambers also points out. that with some persons who have dilated
hearts a " sloppy diet " does not always agree. ( 'ertainly t here are
persons who can not get on with liquid food, but they are the ex-
ception and not the rule. The observation is the outcome of the
writer's exten-i\ e knowledge on the subject of dietet ics, which makes
him more observant of the except, on than the rule.
When a verv advanced condition is reached then the admixture 1
of alcohol with the food becomes imperative. Milk with some
brand v: a little beef -tea, or " invalid's soup,'' also with some brandy,
not Ujru'et t 'ing to add some soluble carbo-hydrates. One caution
airain must be observed, and that is not to push the alcohol when
svmptoms of acute ^astrir disturbance appear. Sometimes :; '.
yerv d ill ic ult, choice In make in deciding what is M'-t for : In 1 pa: .1 : =
<;<!( it i. when to risk the withdrawal of alcohol, and uhcii to remem-
ber tin- irritable condition of tin- stoinai'h. The introduction of
solid ilt' carl HI- hvd rates into common use is he! piiiir to sett le t he ipie--
tion. \\'hiie it was a case of choice betwixt food that required
diLfe'tion. and the alcohol which passed readilv into the Mood and
was luinit in the organism, then the alcohol had the preference,
lint now, when so inanv preparations of soluble carbo-hvdrates ;uv
at hand, it liecomes possible to limit the amount of a'.'-ohol to the
reijuireinents of the svstem as to stimulant, other readiiv combusti-
ble hvdro-earbonaeeous; mailer beinir sulist ituted for it as a food.
And this is a matter of cardinal importance when conditions
threateninir exhaustion are present. As for instance, when some
fre.-h acute bronchitis is added to old-standing bronchitis and em-
jihvsema. or is super-imposed upon a condition of advanced mitral
di.-ea.-e with permaiie:it congestion of the pulmonic circulatimi. I:
has seemed to me that when the capillaries of the lun^ (whii-h an-
normally of comparatively lar^e calilnv) liave for IOM-- hcen ilisteinU-.i
liv a Mock, at the mitral ostium. tliev i-eadiiv ^:ve \\av. of vieid
uhen some ne\v force is in action. IIe[tatisat;on of the iun^s is very
apt to spread and extend where there is old-standing: mitral di-ea-e.
and then a condition of acute danger is devcli.ped. reijuiriii'j t h"
most watchful care, and calling not onlv for appi'npriate medicinal
measures Mit for skilful measure- of feed HILT. Tiie svstem and with
the general condition the digestive organs are in no condition to
meet anv demand upon them for assimilative purposes. Sma.i
(|iiantities of readily assimilaMe foml mu-t lie supplied to -ii['port
the sorely taxed organism. As to the assimilation of fat. it i- very
douhtful how far it is possible at all in these conditions. A :/,an'V
at the urine, hi^h-colourcd and laden with lithates, tells that the
liver is in no condition to deal with lanre i|uantities of albuminoids,
even if the stomaeh could digest them. Then the paia'c has to ! H-
considered: fat is loathed, and predi^estcd album;noiil- are no! en-
joyed. How then, and upon what is the patient to feed;' The
needful p'l'a pe-.-iiLI'a I 1 must be Mipplied to it. else the or-'aiu-m Will
burnout like a lire imperfectlv supplied with fuel. There arc no
doubt medical men to be found, who regard with iuditl'erence the
matter of food and its di^estibilitv. and \\'ho order "-'.ops ' w;'h
bin very little discrimination as to whai the-e shail con-'-; of; b;; 1
the-' 1 are, as a rule, men \vho have n..i: dee.plv I'on.-idered the .
MANUAL OF DIETETICS.
ject <>f dip-si i<m ami its processes. The advanced physiological
knowledge of the present dav is deinonst rating what it is the body
requires when in straits, and ho\v to supply its wants in a form call-
in LT for the in in in nun of the digest ive act. They remind me of t hose
persons who could not see the advantages of ( Jeopjv Stephenson's
invention of the locomotive: and onlv held a railroad to he inimical
to the coaching interest and the breeding of horses. These persons
will inevitably become rarer and rarer, as man is mortal any " rarity
is the precursor of extinction " as we know- to make way for yonnp-r
men mure intimate with the i'acts of physiology.
OTLYPTK11 XXIII.
FOOD IN r,i;i<;iiTs OISKASK.
ON CT: more a certain amount of pathological consideration mti-t
precede tlie sultjcct proper, this bein^ e.-peciallv uecessarv I'm' non-
nu'ilicul readers.
'" Hriirht'ri disease" is a disease of tin- kidncvs. it i- comnionlv
taught: and its evidence is to tie found in an aibuminou-: urine.
This is about as accurate as to sav thai the llierian peninsula ',
K u rope, and t he K tiro t lie chief river of Kurope. I', right's dis>-a-e "
of the tuhular nephritis, or lanr 1 ' white kidnev tvpe. and amvioM
<>r lardaecous kidnev varietv. niav fairlv lie spoken <>\ a- " k;di;e\
disea.-es. liut of the granular, eirrlmtic. cotiti'aeted. red. LTo;it\'
kidney l>y far the most common form of r>riu'hf- disease, it is im-
possible to spi'ak as a mere localised "kidnev" disease. It H a
matter of widespread change, in \vhieh the ein-ulaturv svstem ha- a
marked share, and in which the kidnevs arc also involved. Ttie
eondit ion. is one of waste-laden blood : where the lilood i< surcharged
with nit 1'o^eniscil waste. There i- impei't'eet action of the iiver,
wliich fails to convert the alluiminous matters into scrum albumen
(for t he nut rition of the tissues) and urea ( the so! tittle form of rr.tro-
p-nised waste). Instead of the latter there i- a. distinct tendency '<>
form uric acid, the primitive form of nitrop-nir-cd waste. Mam-
malian livers normallv form soluble urea: but when the
developes a tendency, or rather and more correctly, rc\ erts or !'a!.-
hack to uric acid formation, then the kidneys suH'er secondar;.} .
I'rofessur (Jc'o. .lolinson. l-'.K.S.. put it happily in his well-kin
Wurk on l)i-''a.-e~ of the Kldliev.- -" I'l'lliti '!> ',''///'"' '"/'
ifin ii'-i' nf /n, /(/-''I, ilfi/l I/I'd , llmi il''ti"H nf / ./'"' I u," v nl' t',/ n't it <!.
tlii'inii/li /In- /, ill iii-i/*. " As allmminoid matters a- proteii
enter the blnoil. this faultv dip-stion doe- not lie in the a;:men
canal. Soluble peptones alone enter the portal ve;n; ati'i
" fault v digest ion." we now k now. lies with the liver. I he
point of llri-'ht's disease, then, may lie said to bi-
llow far natiiraiK inetlicieiit kidneys, or kidney-
a- -carlet fever, liv their inadei|iiaey to -. ;-.d .;
I'.IO .MANTAI, OK DIKTKTK'S.
Hrates. help to the condition of the blood. ;uul to accnmnlation
therein df excrementitiouH mutter, is u subject on \vlnch opinions
inuv dill'er. 1 Io\v fur tlic first departure from health is mental worry
or overs! rain \vliicli notoriously all'eets t he liver ami the assimilat i vo
organs injuriously \ve do not yet know. ClilTonl Allhutt regards
line-lit 's disease as having t're(|uently sueh a mental origin.
\\ hen these mal-product s are formed, and exist in excess in the
blood, two things may happen:
1. The kidneys may become injured by the output of these
lithutes: or
'.'. The excremeniit ions matters are retained in the blood, ^ivin^
rise to lithiusis, or u'out in its widest sense.
Frequently and not uncommonlv more or less of "both is found.
Certainly, polity persons have ^outy kidnevs. Hut a well-marked
condition of Hri^ht's disease niuv exist which all phvsieiuus would
class as Hri^ht's disease, and not as ^out. In such cases there is
p-nerallv a certain pallor, (sueh is the Hriirht's diseuse seen so much
in (iermany) while a polity aspect is more common in Fnu'land.
In this widespread change the urine mav or may not lie albu-
minous: or onlv albuminous at times; or it mav not be albuminous
(.Mahomed). Manv hold that in this chronic ^ranular condition of
the kidney albuminuria is not essential to the diagnosis, and that,
when certain other changes are notable, the absence of ;dbumen
from the urine carries with it no comfort. Hvthe overwhelming
importance attached to one symptom and the neglect of the other
scnic'a. a uTeat deal of error, confusion, and misapprehension. ave,
aii'i it is to be feu red much unnecessary mentul discomfort. huve
been occasioned. Surely there is enough unhujipiness in the world
without adding to its muss unnecessarily. Albuminuria, too, has
other ussoeiut ions than Hri^lit's disease.
Such then is I Jriu'ht's disease as ordinarily encountered.
I am old enoiiLi'h to remember when the teaching was -meet the
drain of albumen hv liberal ipiantities of albuminoid food. This,
it is needless to say. was an outcome of imperfect ae ( |iiaintance with
the nature of the maladv. and a superticiul conclusion. It stood on
the ,-aine chronological platform as the advocacy of the llesh of car-
nivorous animals for diabetes. It was at that time thought that the
threat matter wus to keep the albumen from pus.-in^- out. of the bodv:
and, when this could be successfully done, to introduce plenteous
supplies of it.
.\o\v a Lrivat change has come over our views. The teachimjf of
(ie-o. Johnson has had a profound mtluenee upon tin- :>:->
t'on. and tin 1 in"-; recent work- <>n the subje,-t ho..; n;"-
tln- vii-u" nt' nit roirenised wa-to in ;he hi i ] . '.}, ^ i'ii'-.-
I!ri;.:ht's ilist-asi-. 1'nuit did - 1 w<>rk am! so .i'i.! i.;,r-d.
t lie voHm_:er men of t his LTenerat ion an- a'i fam;l lar \vi; h : ..
of rhniiiii' l>ri:/lit's disease to the albuminoid cii-iii'-nt - -if oui
manv eases a mental factor plavs a prominent pan m ; he -tar; :n_r
of the morbid condition. In other eases the -tar .:;_; P. .in; ;- ,-\ -.---
sive indulgence in animal food. /./.. beyond the bo iv-ii-.-.-d-. \\'i;.'!i
t here e\ ists evidence of renal lliadeijliaeV, then ;I bei-olue- !iee.-<-arV
to limit the work thrown upon the kidnevs. \\ ha: amount of evi-
dence would be accepted as conclusive, and wha! a- HUT'-lv -
picious. but not proven, is a matter upon whi'-h opinion- mav. a:,d
nio-t probably would ditVer: and I am hv no mean- i!:c'.ine(l to :-P-p
out of m v \vav here to attempt to settle the point. If anv doubt
I'.xists. it will be well to err on the side of caution.
In the lirst plaee. then, it i- well to iv.-tricl the amount of lean
meat, con-umcd. The lle-h of the larger animal-, bee!', mutton,
pork, no matter whether a- adults or juveniles, must he taken in
st ri'-t mode rat ion : and with due regard to i he needs of the hod v and
its tissues, and not to the cravings of the palate -nor \et the -tom-
aeh. whieh leans to meat. The joint is best avoided, miles- it be
the fat of it. Made dishes arc often permissible, and entrees .-an lie
made which pratit'v the palate without taxing the liver. Liver and
bacon, for instance, is a suitable di-h. though some would lake ex-
ception to the albuminoid element in the liver. Stews, with plen:\
of vegetable matter and fat. are preferable to joints. I; .
that, legumes, which are rich in nitropMi, should ii"t be a lar^v co;i-
stituetit of the stews. Hashes with plentv of \e_uvtable mailer, a-
turmps, carrots, eelerv, onions, leeks, and \\ith a limited amount of
lean meat, are irood and palatable. A vegetable entree -hitild f^rm
one course at dinner. 1'rovided t tie d i'je.-t ion beLT'ii'd. pas;r\
contra-indicated, ('akes. crackers, biscuits, swei-t corn, arc all
missible. Salads should form a distinct element in lhed:e;ar\: a
fruit, raw or cooked, mav be taken bv ih"-c with whom .'
( 'ertaiidv there are SOJHC cases of lir^h:'- i:sea-e \
proiiouneed aiia-mia. to which the abo\e dietary :s HO; a:-i -.
ami where a more distinct animal ilc-h dieiar\ i- :",. ; ,>;!< ;. ?.:.;; :<
the bulk of per.-otis with I Jri^'lit's disease, where I he nn: r.: on : ;.
t hese remarks apply.
l',ll> MANUAL OF IHKTKT1CS.
Fish in all forms. ;ill kinds and however cooked, are admissible.
Hut here again we must remember that fish is albuminous, and that
unlimited lish even may be harmful. Shell tish and molluscs form
an agreeable change.
Soups of all kinds mav be taken, a preference IK-HILT Driven to
those where the amount of "stock " is small. Those prepared with
cream, and those thickened with farinaceous matters, are to be pre-
ferred. Soups can be made thick with vegetable matters, and such
soups are good.
Persons with liright's disease will do well to learn to eat fat.
Thev should [nit cream (as understood in Kngland) in their tea and
cotTee. eat plentv of butter on their bread, should be given to bis-
cuits and butter at lunch and dinner: should have real melted
butter to their lish: and should not be niggardly with the oil in
their salads. A basin of porridge, either of oatmeal or hominy, fol-
lowed by a rasher of fat bacon, or tish with incited butter, would
form a suitable breakfast. Soup, us described above; some well-
mashed potato o]- lish. followed by a vegetable entree, with biscuits
and butter, would form a desirable lunch. Then dinner might
consist of soup, tish, an entree, pudding of any kind not too rich in
eggs, milk-puddings, blancmange, pustrv, or creams are permissible
when they can be procured; again, biscuits or crackers and butter,
with a nip of a savoury cheese to finish with. 1 )essert might be
liberalthough 1 am afraid some of the older practitioners will not
approve of this indulgence. Then if some food were required later
on. a plain biscuit and a glass of milk, or of wine, would be sufficient.
()f course much would depend upon the features of each case.
As has been pointed out be.fore in these pages and mav possiblv
even be refenvd to a^uin it is not what is consumed, but what is
digested, that is the measure of nutrition. It may be found that
even where some meat would seem indicated bv the amemia it does
not attain the desired end. I have at the present time a patient at
the Victoria 1'ark Hospital, who has other evidence of Plight's
disease than mere albuminuria, in whom this is well seen. She is a
well-built, strong woman, but pale. So sure as she cats anv animal
food, so certain is she to put in an appearance, complaining of not
being well, looking ill. and with a <|iiantitv of albumen in her water;
while she restricts herself to farinaceous food, vegetables, tish and
milk, she is wed. Again and again -he is tempted bv some foolish,
well-meaning person to take some meat, and, bein^ a good-natured
o ..._ ng woman, airain and again has sulTcred for her compliance.
< >< >i> IN m;n .in ->
Indeed 1 have fiiuii'l \vnli a certain da^s of \ e-.ni- in I'.r
disease llial a milk ami farinaceous dietarv | -n i ip''-m>"iied I
hath-) has not only cleared tin- urine "f aditimen. !>nt ha- mad'- ;iv
siek persons feel hfttlT.
Stiii then- niav occur cast's \vln-iv fn>m special circumstance-;
dietarv niav In- relaxed with ad\ atita^e. luit llie lilieralitv -inni,d '
strictlv watched. And i!' there lie continuous nie!:ta! M ra M this
idionid lie [nit in alievance. Then a modified dietarv nia\ ''>< e\-
cusalile: ainl imlerd of advantage to i!ii- individual. Th-'n a- to the
use nf alcohol in I'.n^ht 's disease, opinions dill'er. Sonic twelve
year.- airo the matter of the part plaved hv alcohol in the production
of 1 5 1'li;' lit 's disease was hot Iv discussed, some verv eminent ant ltor:t i--s
takini:' sides, I >f course it nia\' lie laid down as a general propn-i-
tion that alcohol has a liad elTect upon ihe liver (no one u'iil dc"v
that i. and that then-fore when th'- working "f the liver i- impaired
al'-oiin'i is cont i-a-ind icat'-d. lint tln-n sometimes a little aleohul
ha< a heiietii-ial ell'ect it[ion tin- sv-tem u'enerally. and it ma\ lie
(jUest iom-d how far it can 1 >e \viselv wit hhclii. especial Iv if no nii\ .mis
e\ ii I'csuli fp 'in its use. Any alliuminuric can lind out fur him-" If
if h'- cares to make th.- experiment. that a certain amount of alco-
hol wid send up the proportion of al'unmen in tin- urine: though
proliahlv few Will lie temple. i to test t lie ;lecll l';ic\ of the Statement
in their own persons. Much person who i< the snliject of liri-'ht'-
disea^e must studv the matter for lnm-elf or herseif. I am not of
opinion that it is well to makea hard and fa.-t rule to the etl'ei-i that
under no cireumstanees should alcohol he taken by a person with
chronic renal mischief. This would lie umvise, lint as a liroad
rule, it mav he said thai when genuine liri^ht's disease is on I'oo' i;
is wed to keep a strid watch over the amount of aleohul taken.
jn-l as it i- kept over the amount of animal food consumed. The
ma'adv is found amon^ water-drinkers, and therefore h;i~ n! nece--
sariiv an alcoholic oi-iLi'in. All the same, alcoholic ind nlu'eiiee wil:
a^-'jnivate the state of matters when it exi.-ts; and there are few
pei'Miiis who lake niiieh aleoiiol who do not. in the end. ha\e m 1 -
chief iii t hi-ir k idneys.
\\ ithmil iie^'at i VIIILT other casual relation-. ;i mav lie si d t!!;i !
the dietetic and drinking hahit-i of the ind i\ id tin] com moi \ 1 \ p.a\ an
importani part in the production "t' chronic liri^iit '.- .': -ea*e.
\\ itii ,-onie per.-ons a m;ds dietarv is ellieient in ;';;:;,
to the sxinptoin-. and I he remo\al \ a, i m men fj'"ia
M , i is cures and -jra t >< >", ; P-- a re ;n \ o'j'iie on the ('>:;;:.' as m I-.-; P i -.
11' I MAM A I, OK IMKTKTlrs.
To remove tin 1 albumen is not, however, to restore tlie kidneys to
:t normal condition. Nevert heless. it is (juite possible to stay the
progress of the kidney mischief, and to arrest its march by wise and
judicious measures, of which a careful, regulated dietary is a factor
of cardinal importance. And in some cases it is possible to make
the advance so slow as not to be measurable.
CIIAPTKI! XXIV.
Fool) IN ALIU'MlXriIIA.
IN putting albumiuuna into ;i chapter t>v itself inv design is to
emphasi/e the fad thai it, and Height's disease are not sviionvnioiis
or convertible tenns.
Albumuuiria is eonunoidy enough reallv the escape of peptones
bvthe kidnevs. Instead of being converted, or turtle 1 '! l>ack into
proteids in the portal vein, aquantitv of peptones lind then 1 wav
into t he general circulat ion and slip out of it l>v the kiiinevs. just
as ivadilv and as easiiv as thev found their \vav into it l>v I he portal
venuies. In such ease the system is ill fed, and the individual is
pallid: and a condition closelv simulating true ISn^ht's disease is set
up. Such, indeed, usually are the eases of Uright's disease which
are "cured;" for the real disease (as spoken of in the la.-t chapter)
does not admit of cure. Conditions of acute '' I>ri^ht's disease"
are, however, compatible with recoverv: leaving the kidtievs eit her
free from permanent injurv, or in a more or less disabled condition.
Thus the consequences of scarlatinal nephritis are most varied.
Kveii more permanent states are compatible with considerable
length of days. But wit h conditions \vheivthe presence of albu-
men in t he kidnevs is not accompanied by co-existing evidences of
perturbed health, the prospect is i'ar less grave.
The following is an illustrated case in point: A patrician youth,
who like manv others of his class indulged a good appetite, had
albumen persistently [iresent in his urine. A hastv medical opinion
to the ell'eet that he had " I >right 's disease " was ai'i'e[ited by his
familv; and in so far he was an object of interest to a large circle of
friends. One dav, when riding in a London park, he met with an
accident, and. breaking a limb, was taken to a neighbouring hospi-
tal. There he was put upon the ordinarv d let arv. with ihe iv-n't
that he lost his albuminuria. The case was i^reatlv discussed in
polite circles as a " wonderful cure of Bright 's disease." This is an
instance of the loose, inaccurate gossip that u'oes on about diseases
all over the world.
\Vheti a diet is too rich in albuminoid matter the urine is apt to
J'.M'I MAM'AL OF DIKTKTICS,
be albuminous. \\ hen such albuminuria exists, it is but reasonable
to suppo.-e that some modification of the dietarv is desirable. First,
however, ascertain what the precise facts are. and if the dietary is
really too rich in albuminoids. If this be so. it is well to reduce
the amount, and, put the patient upon farinaceous matters, fish,
fruit and fat. The whole matter wa- too thoroughly ^one over in
the laM chapter to nerd repet it ion here.
If. on the other hand, there is evidence of mal-nutrit ion present,
it mav be well to combine a liberal dietarv with a course of tonic,
and hu'inatics.
Mi-re albuminuria, as differentiated from l>i'i gilt's disease, is not
a bodily trouble which calls for special dietetic treatment, beyond
what has just been said above. If too much labour m the digestion
of albuminoids has been thrown upon the digestive organs, then we
mav find the nitro^enised matters slipping away in some form of
albumen, just as they may lie cast out as some imperfect Iv oxidised
form i if urina rv prod net.
I udeed the whole t feat iiieiit of a case of album iniiria. alike medi-
cinal and dietetic, will turn upon the diagnosis; ;md for accuracy
greater pains are desirable than are ii-uallv bestowed upon it. too
commonly the worst, benr_r rashly luss.umed.
CTTAPTFJi XXV.
TIIK I-'()( )|> IN DIAIJKTKS.
IF tin- dietetic indications in mere albuniinuria arc compara-
tively un mi port a nt. I In- case is widely dill'eivnt in d la betes niellit us,
where they are of the gravest importance.
In diabetes the patient Wastes hecause the ^rape-si i 'jjar. the food
of the body, is slipping awav livthe kidneys and so is unavailable
for the hodv-needs. It is not t lie presence of t lie stiLrar in the urine
which is of importance, though it would seem like it from the atti-
tude of a considerable section of the medical profession. The
his hodv is starving, and he is tortured by the symptoms set up by
the presence of an excess of ^rape-suL r ar in his hlood. An urgent,
thirst impels him to drink copiously to wa-h this excess out of his
system. There is some prospect of success in dealing with a .salt-
thirst by drinking: but with a suu'ar-t hir.-t the ease is widely dill'er-
ent. jus anyone who 1ms had experience of it well knows. The dis-
teiition of the vascular system adds to the blood-pressure in the
hepatic arteries, and so increases the output of siiu'ar from that
viscus. The sutFeritur patient drinks and drinks, and UTOWS worse
and worse too frequently: and unless some impression can he ma<ie
upon the functional disturbance in the liver, the case --oes ,>u
from had to worse until the final end. In other eases the pi-o-ji-os
is less disastrous, and by proper dietetic arrangements the patient
keeps the maladv at bay and lives on. a harassed and much : Ked
creature. In other cases a better career is found, the "diabetic
storm " passes over, leaving a comparative cairn behind: where then-
is more or less siiu'a r in the urine cont in uou s; y. hut rarel v an v SVIH p-
totiis ,,f diabetes. In such eases aiiv disturbance, a- a shock, or an
access nf \\-orry, mav hnni: on an acute diabetic attack. Such are
then t he variet ies of what mav fairly be termed " I liabetes " a- com-
pared to mere " < T ] \"eos|| ria. "
It is well to hear the distinction in mind when ..;(! . r h :tnv
individual ca.se u hen- stiirar is present in I tie u r: nc.
In the manau'eineiit of dialietes proper the diciarv
I'.'S MANUAL OF DIKTKTK 'S.
cardinal importance. Bv indulgence in anv food -which will form
UTape-suiiar. or rather from which grape-sugar can be formed, a
distinct aggravation of the symptoms is at once set up. All carbo-
hvd rates must lie earefullv avoided. The consequence is that 11 rigid
dietarv must he laid down hv tin- medical man. and observed hv
the patient. Indeed the latter is only too glad to secure relief from
the torturing thirst endured. The dietary preserves the organism
from perishing of exhaustion until the disturbance which sets up
thediahetes isahated. if ahatement he feasihle. U\* supplying food
material which does not form grape sugar, two distinct ends are
served -
1. The organism is fed; also
'.'. The sull'ering caused hy the presence of sugar in excess in
the hlood is relieved.
These are great matters, truly. Hut thequestion may lie raised:
Dot's a strict dietarv exercise anv curative elTect over the malady;*
Does it merely keep the patient alive till a cure is wrought? Or
does it tend directlv to that end?
If we believe in '* physiological rest " to anv organ impaired or
injured, or functionally incompetent and such a hroad rule is
recognised in medieim -then the non-carbo-hydrate dietarv lias a
instinct curative tendency. Physiological rest as regards its glvco-
geiiie function must favour the regaining of its lost or weakened
power li\- the liver. It is at least a reasonable assumption, even if
it cannot lie demonstrated as a proved fact. Such assumption falls
MI with one's experience on other matters medical.
\\here carbo-livdrates are eontra-ind'.eated, then we tind the
dietarv rest ricted to hvdro-carhons and albuminoid with the alcohols,
a- ordmarv alcohol or spirits of wine and the alcohol v;lvcerine.
The chemist has striven to give directions to the baker in this
matter, and hv depriving wheaten Hour of its starch, a gluten bread
is made which can be eaten with butter, (iluteu bread is not par-
ticularly acceptable to the palate, still with salt butter it is not very
objectionable. Some gluten biscuits are the most unpalatable food I
hav ever ta-ted in a wide raiiLfe of experience. Nothing but a
mo ust roii- fear of deat h. or some ti'em end on sly strong mot ive to live,
could enalile ativ one to get th''iu di>wn.
Then the od of the almond i.~ utilised as formed in almond tlour,
and, -till more in almond biscuits. These are palatable enough, and
KIM )| ) IN DIAMKTKS. I'.i'.t
which throw- a strong ii'j'ht on the ^niesis of diabetes. Talking
one d:iv with .Mf. \ an Abbott, who is so we'd known in concretion
wall almond food t'nr diabrte<, I a-krd rasuallv -"Who an- vour
chief cu-!oniers. Mr. \'an Abbott?" His face assumed an earne-t
look as lie replied. gravel v " ( . iv\ . worn, business men look i MIT > >'.<\<-r
tlian tln'ii- vears."* The alnioinl liiscuit is rich in nil and tlifivl'niv
i'lirms an iidiuimhlc " furl-food." 1
Thru of course 1m Ik ;s grateful to t hr stomach and musi lie
sought in the parrii'-livma of vegetables.
Defoi'r proci'i'ilint; to t hr practical discussion of the food of the
diabetic, h, mav be well to irivr \)\-. 1'avv's table of the vai'ious food-:
HutcluTs" meat of all kind-, except liver, ham. bacon, or other
smoked sailed, oi-cured meat-. 1'oultry. ^ame. -hell-fish and !i>h of
ail kinds, fi'esh. salted or cured. Animal soups not thickened, beef
tea and broths. The almond, bran or gluten substitute for ordi-
nary bread. Kirn's dressed in anv \vav, cheese, cream cheese, but-
ter, cream, (ireeiis. spinach, turnip-tops. French beans.* ] > ) ru--el-
sprouts.* turnip-.* rauii (lower.* broccoli,* cabbage,* asparagus,* --a-
kale/ :: vrirrtalili'-rnun'ow,* mushrooius.
(Those marked with an a-tcri-k mav onlv lie eaten in moderate
(jiiantitv. and should be boiled in a lar^e (jiiantitv of water).
\Vatcr-cress, mustard and ere-s. cucumlier. lettuce, endive.
I'ailislies. celery, vinegar, oil, pickles. Jelly tluvonivd, bin not
sweetened, savou rv jel 1 v. blanciiui n u'c made with ci'cam and noi m ,1k .
custard.- made without .-u^ai 1 . Nuts of anv description, except clii-s-
nuts. ( Hives.
kinds. uicr, arrowroot, sairo, tapioca, inai'caroni, vermicedi. [iota-
toes, carrots, par-nip-, beet-root, pea-. Spanish onions.
I'a-tryand puddings of ad kinds. Fruits of ad kinds, fresh and
[.reserved.
'' i 1 1 1 he a-,- 1 n i,i t i, ,n I iei -,\ i \ 1 | ii -i -1-1 1 -ii 1 mental -! r;t i ii a ml .. . a* . . . \ :n
rrea^iiii: el ia: -l e-. \\ e ;ire i >._: i 11 iim_' to have -. -;i ! Ii irnii-,1 , . | -i i: :, i , -. - - , . .1 ;m
all'eaiK' rxi-t Ili-tWJXl -''Hie -Miili'll --Illli-k allll llie iJllieK lleVeji '|i!ll.-|ll of
aci lie ilia In 1 ! ic -\"h 1 1 it < 'in-.
1'fio MANfAl, OK DIKTKTICS.
MAY Hi; INK
Tea. mlTco. cocoa from nibs. Dry sherrv. claret, dry Sauterne.
Burgundy, ('liablis. hock, brainlv ami spirits that have not been
sweetened, soda water. Imrton bitter ale in moderate quantity.
M I'ST AVOID DIM N K 1 No
Milk, except spannudv. S\veet ales- mild and old porter and
stout, eider, all sweet wines, sparkling wines. Port wine, unless
sparinu'iv. Liqueurs.
Such is a fairlv complete list of foods forbidden or permissible.
()f course all the pivdiu'ested carho-hyd rat es as prepared foods
are contra-indicated. However valuable elsi'where. thev must be
banned from the diahetie's dietary. On t he ot lu-r hand, all oil emul-
sions can be cordially accepted.
All fishes preserved in oil form admirable food.
With Dr. Taw's material to hand, it is possible to construct the
diH'crent meals of the day. it not bcin^ necessary to have all the
articles mentioned upon the table at once. A variety, of course,
mil.-t be provided.
HIM: A K FAST.
Tea. coil'ee or cocoa with cream, gluten bread and butter,
a 1m 01 id biscuits, tish. with oil or melted butter, caviare, mutton-chop,
rasher of bacon, cold meat. ham. pi me. pressed, beef, tongue, water-
ITess. salad.- pickles.
LfNCll.
Soup, lobster saiad. potted trout, celerv. raw or cooked, radishes,
scrambled ej^s. cream clieese. ('iaret. hock or sherrv.
DIN N 1:1;.
Salmon, with lobster sauce, brill, anchovv sauce, coil, shrimp
sauce, herrings, suuec tartar, plain white fish and incited but-
ter, troul with parsley butter (not ilour (la-te). stcxved mushrooms.
pi.irs' feet. A joint of iinv kind \\'ith spinach, caliba^-e. catiiillowcr.
|Jnis-e,- -pro',, 1 . . celerv. endive or encumber,
/;'n/r 1 1*. Sweet lil'i'ad-. pi^'s" or calves' check boiled, then cut
ill pieces and served up with a since piquant. Mavoiuiaisc. (lame
of all kind -.
>a,ad and cheese, cream . ; lekles. ('reams (unsweet-
I ilnten bn-ad. 1 chec~c. al tuoiii 1 liiscuit -. claret, hock.
FOOD IN DIAHKTK."
Piv such means, variety so essential t<> the [lalate can lie -e-
cured, and an ample suHiciencv for the nutrition of the Unix-, too, is
furnished.
And no\v to some criticisms of the ri^id dietarv:
In the lirst place. I )r. 1'avv bans liver: vet he allows shell-tish.
though the oyster and the mussel consist lar^elv of liver. This is
ohviouslv onlv an oversight.
'I'hen do not turnips contain some supir? He states thev do.
That is another oversight.
The more serious criticisms are these: Is it ahvavs desirable to
subordinate the dietarv to the diabetes;' Are not sometime-; slight
diveruvn-vs from the rule permissible? Though milk docs contain
suu'ar. is it alwavs advantageous to bar it? Of course when the
patient is Bravely ill, any addition to the su^ar in the blood is otl'en-
sive and objectionable: but when the condition is less pronounced
sometimes milk mav lie allowed freelv. and the >anie mav be said
about ordinarv bread. In one case latelv. where the patient chafed
at the riu'id di-'tarv, a little bread came in advantaireouslv. The
relief it u'avc to his stomach more than counterbalanced the extra
su^ar in t lie svstem.
lint of course such deviations from the rule should be narrowlv
watchi-d. and with a full consciousness on the patient's pan that the
cha Hire is an experiment which mav, or ma v not . turnout successful I v.
\\"hat the writer desires to put clearlv. if he can achieve this, ;
"That whde it is neccssarv to adopt a riirid dietarv in ixrave cases
of diabetes, and when acute svmptoms ;ire present, is 11 necessarv
or desirable to pursue sueh dietai'v when the svnipumis are ijuies-
cent :' Is it. or H 11 not. the fact that manv persons, fairlv to tie re-
garded as diabetics. siitTei 1 much IIKU-C from tlieir ilietarv than their
malady, and that manv break bounds without apparentiv ^ulVerin^ 1
m I'onsefpience thereof? The histories related bv various patients
\\'oiiM |'a\iur this view in numerous instances. But. all the -ame,
-ivat caution should be exercised, and the etl'ects of each foi-b;dden
art i'-!' 1 be narn >wl v wat '-bed.
The patient mii-t be dieted in order to be kepi ;iii\ unti. the
livei 1 can regain its iost power as regards it- ^-!\i-o^i-n:e
possible. Hut how i- this I,, l,e attained ': It i> i;ot merc,\ bv t he
a\'oida nee of suLi'ar and \\ ha ' will make -u^'ai'. '1 he plan , n \ '_'' ie -o| ne
\ e;i |-s ; i -, i. k nowi; a - "t he sk im -mi i k t real n lent oi d a i '>-. ad \ oc;i 1 1 -d
"2(1'2 MAM'AL OF DIKTKTK'S.
vigorously l>y I>r. Scott I'onkin, had ;i lar^e measure of success; and
vet the milk su<_ r ar was nut removed in the cream. The actual
amount of suirar had something to do with the result. I feel certain.
A u'lvcosunc patient of mine recent Iv sent me a sample of her urine
for examination which was absolutely free from sn^ar. Vet at
that time she was Imnv,' upon vermicelli pudding and arrowroot
two farinaceous matters most likely to have produced an excess of
suu r ar. There seems some ground for holding the view that the liver
can deal normally with a certain amount of su^ar, and a certain
amount onlv; and anv excess beyond this remains in the blood,
Lfivinir rise to diabetic symptoms. Hut. the subject, is one on which
li_rht is coniinir in slowlv. and time must elapse before we can see it
in the full day-liirht of complete knowledge. Some years a^o a
retired armv medical otlicer of eminence consulted me for severe
attack- of angina pectoris, and on examination he was found to have
a ^oiitv heart with disease at the aortic valves. On taking down
hi- history it turned out that some years previously he was (in India)
tc-tinL: the urine of a patient for suvjar. lie was in perfect health
and strength, and wishing to be sure of his tests he determined to
examine the suspected urine side by side with his own. To his
astonishment he found his own urine heavily laden with suiiar. So
alarmed was he that he made all haste home to put himself under
an eminent a ut hority on t he subject of diabet-s. ( Mi this his health
soon he^an to fail in reality, and after some months he pvw so weak
and ill that he be^vd for some raspberry jam. a- lie could not be
worse than he \vas. His re<|uesi was complied with, and he felt the
better of the carbo-hydrate: and the result was lie pive, up his
dietary, ate and drank what lie pleased, and ^'ot well: ultimately
losing his ^Iveosuria entirely. There was no grounds for question-
ing the truth of his narrative; lie \vas a man of known probity, be-
loiiLrinir to a distinguished family. It is a curious fact, that several
brothers of this family have at times passed .-ULrar. They are all
Vj 'lit V,
Iii what has just been written it is not intended to cast doubts
upon the value of a nun-saccharine dietary in diabetes that would
be absurd: but to point mit that we have vet much to learn about
the conditions under which siiLTar appeal-- in the urine. Of the
\aluc of a suitable dietary, not onl\ as ;i mean- of fnnii-liinu' relief,
a stcppiiiLT-stone towards cure :n man\' ca-e.s, there can exist
lid doubt. Indeed m diabetes m> .. .::;- we see one of the nio-t
marke : instances of the value of dietetic-, and of tin. 1 fool treat men t
CIIAPTEK XXVI.
'FO()I> IN <; L V COST K I A.
TIM: mum reason for the existence of this < > h;ij)tcr as a separate
chapter rather than us un appendix to the last chapter -is to keep
(rlvcosuriu well apart from true diabetes. There exists such an un-
fortunate entanglement of the l\vo. not only out of the medical pro-
fession but even within its ranks, that a complete divorce of the two
is most desirable.
( i Ivcosuriu is oolite common with corpulent persons, especially
where Millie ";out IS present. Ill such persons, indeed. It Seem- a
species of waste-pipe runniM"; oil' the surplus carbo-hydrate-, and
without which the body would become embarrassed with an accu-
mulation of fat. Indeed the laying' on of fat from the surplus of
carbo-hydrates, while 1 a condition of ^Ivcosuria is co-existing, is not
unknown.
A marked instance of this came under my notice about a year
airo. when a series of experiment - with prepared funds (consist HILT
mostly of prediiresled starch), inslead of increasing the out-put of
suirar. resulteil in a marked increase in weight.
\Vhat the relations of "/out and <rlyeosuria are we do not precisely
know. The one is a disturbance of the idvco^vnie function of the
liver, the other of the second function of that important viseiistiie
metabolism of albuminoids. There is sonic linked association ev;-
<leiitiv. though what its nature is still shrouded from us.
On the other hand, one of the ".Teat dangers connected with the
abundance of animal food allowed in cases of diabetes and i^lveo-qir.a
i- the production of interstitial nephritis, or I!ri";ht's disease. There
is no proof that siiLfur in pas-m^ out of the kidneys doc- any injury
to those organs, any more than it does to the portal vein by \\li.cii
it enters the circulation at every meal: but the lar^e amount of
ai! Hi in inoids not only allowed but positively forced upon t he - , \ ci >--
uric patient i- certainly destruciiye to the kidney-. Tli:- i- ihe
ot her asjicci of fond, vi/..:- seeinu' that we do not do harm \\.ih it.
It is not wed to engraft a slate of permanent injur\ to i he kiiitievs
iiiion a condition of Li'lvco^uria, which, as vet at lea.-t. is not con-
-'"4 MAM'AL OF DIKTKT1CS.
victed of evil, even if it have been under some suspicion. That is
the substitution of a morbid certainty for what is so far nnproven.
There are not onlv the lienetits to he derived from a correct
dietary in certain maladies; there is the harm whieli may accrue
from dietetic error. The kidnevs are far from being hevond sus-
jiieion in goutv persons of middle ago, and if a liberal meat dietarv
IK- adopted there is a distinct and measurable danger of a Cravat ing
the renal trouble a most undesirable matter. The patient must
choose (under medical direction) what he will do, whether lie is
more afraid of the pint or the glveosuriu; and if he is a prudent,
thoughtful man he will choose the glyeosuria as the less evil of the
two.
If the teaching of this chapter be mainly negative, it is not,
then-fore without its value.
CU APT E ft XXV IT.
TIII-: !" < < > i ) i.\ cor T.
BFFOKI: proceeding to the subject-matter proper of this chapter,
it niav he well to clear the ground somewhat as in what is meant hv
the term, "gout." It once IKH! a definite meaning, and was applied
onlv to the deformities of the small joints of the extremities cau-ed
hv the deposits of urate of soda in the articular cartilages of the-e
joints. 'I'liey were produced r/m/f/r fii'i" t/nt/f/i\ that is "drop by
drop. " So long as our ideas of gout were restricted to t hese ohvious
morhid changes all knew what was meant hv the term.
I5i it when t lie chemist discovered that the said deposits, or " chalk
stones," consisted of urate of soda, the word hegan toha\e an ex-
tended meaning, (lout was seen to he a blood-disease, /.>.. that
uric acid (as unites) circulated in the hi 1. and wherever the bloud
circulated there might gout follow. For instance, it was found that
goutv deposits were laid down in the valves of the heart just a-
much as in the joints of the lingers and toes. 1 rate of soda H com-
monly formed in nodule- on the pinna' of the ear I < Molite<. ) 1 5 run -
chilis lias heen found often to have a basis of gout. Certain -kin
diseases were recognised as having goutv associations, 'Then various;
disturbances of the action of the heart have been discovered as heni'j;
outcomes of gout. Thus the range of the term was found to be
constantly extending. From uric, otherwise lithicacid, bein'_r th"
iiiiili'i-ii 1 * i ii "I'lii of i^out . the terms " lit hia sis " and " 1 it lia-mia " have
been used to de-ignate t he gout v condit ion. They are more accurate
terms, hut it will take smnc time for the public to become familiar
with them: whereas the vagaries and internal complications o| gout
are fairly generally known.
Tiie various foods of the hodv, whether Fuel-food or t ;-sue-food.
undergo within ii an oxidising process which produce
I'oive. The fuel-foods burn easily: the t issue-mat ters o\i.
diHieultv. Worn-out tissue and surplus tissue-material undergo
ret ro^rade changes which tit t hem for e \cp-t iou by l he kidiie\ <. and
to a less extent by the skin. These changes take place to a irreat
JHt; MANUAL OF D1KTKTICS.
extent in the liver (lie furnace of the body the resultant products
beiuir cast out liv the kidnevs.
When kidneys first make their ;i})po;iranco in tin- animal world
\ve liml the form of nitro<renised waste to he uric acid. Uric acid,
as urates. belontr '" aniiiials with a t hree-ehaiuhered heart and a
solid urine. /'.'.. hirds and reptiles. When the mammalia appear we
find a t'our-chainliered heart and a iluid urine.; the form of nitro-
trenised waste beintr the soluble urea. There st ill remains, however,
traces of the primitive urinary product, uric acid. So lontr as the
liver can convert the waste and spare albuminoids into the soluhle.
urea all is well. As the soluhle urea the excrementitious matter is
trot rid of without difficulty, and albuminoids far in excess of the
hody-needs can be eaten with impunity. Hut when the liver fails
in the formation of urea, and reverts to or falls hack upon the
primitive uric acid, a change conies over the scene. The compara-
tively insoluble uric acid lingers in the blood, finds a habitat in the
articulations of the extremities, in the valves of the heart, on the
pinna- of the ear, while it irritates the air passages and teases the
skin. A certain proportion finds an exit bv the kidnevs, and worries
these orpins into interstitial nephritis, known as the cirrhotiu or
polity kidnev.
At other times the condition assumes ;i complexion which en-
titles it to be designated Chronic Britrht's Disease.
When urates are formed bv the liver one of two things bappens:
1. the urates are cast out by the kidneys, which become injured bv
this out-put, and chronic kidney disease is set up: or '.'. the uric
acid remains within the svstem. trmntr trout (in some of its many
forms): or, as very frequently happens, somewhat of both occurs,
as has been said before.
From this we can understand what is meant bv "the trout v
habit" or "a trout v man" or "latent trout," and realise that the
individual is the subject of hepatic reversion, with a tendenev to the
formation of uric acid. We can also comprehend what is-meant bv
"vjuitv families." and whvCiillcn railed trout " .!A./7///\ ll>T<'dit-
//">." \\hi'ii iheiv has been trreat indulgence in animal food for
generations tin- liver becomes more or le.-s worn out bv its toil, and
t he M' ion of such a familv starts li 1'e with an insu (lie lent liver. " The
children of trouty parents ou-ht, more espeeiallv to follow the hv-
Lrienie and dietetic, laws laid down in these patres ( \utrition in
Health and l'isea-e") if thev wish to escape much suH'emur. Asa
rule thev ou'_rht to be wat er-d ri n k crs throughout, life. Thev have
to pa V the penaltVof their pro-Jet i 1 1 ol'S* excesses Of dietetic effoi'S.
FOOD IN <;<>r r r. I'M 7
If tin- <>utv diathesis is stronirlv niarki-d. thev should In- mo-:
moderate and abstemious in their fund habits, and l< ad a- active ai.d
nnisi'ular a life as possible." (.lames Ih'nrv l>eiiiiett). Whiie. on
tin- n! her hand, the huiidily born alderman who -tarti-d life with a
liver in all its inteirritv. cats and drinks with impunitv into \>l a^e
before his Nemesis overtakes him: or. perhaps, himself escapes
free to leave a tendeiiev to pmt aloir.: with his wealth to his descen-
dants.
l!v sueli consideration of irout (in tlie widest sense of the word
we can all the better understand t lie food-rec|iiirenieiits of persons
artlicted with this tendencv to form uric acid. What, the relations
of uric acid are to " lilue blood " it i< impossible to sav deiinitelv.
but both run in the veins of lon^-deseended patricians, (iout has
had a history of p>od eatinirat some time in the historv of the in-
dividual or his race. The liver has become impaired bvthe labours
it has had impo.-eil upon it for generations. And this liver-failure
brings with it in its wake all and sundrv of tho.-e di -agreeable eon-
sei jiieiiees. the various and numerous forms of u'oiit. It also points
out to us in an unmistakable manner the food to be adopted 1'or the
relief of this tendency to form an excess o f U ric acid.
LOXDOX KKYKi; HOSPITAL.
DIKTAKY TABI.KS.
ADULTS.
l. -'.
Milk, ','i Pints. Milk, -Ji Tints,
liivail, Ki.^ht Ouiic.-s. Bread, Ki-'ht Ounces.
:}. 4.
Milk. Two Pints and Half. Milk. Two Pints and Half.
Beef Ten. ( )lle Pint. Beef Tea. ( >lle J'illt.
Two K--S. Two E--.--S.
Ice. lee.
"). li.
Fi^li, I'J^lit Ounces lUlieooked. Fisli. l-'ive ( Minces i I'ncookcd. l-'rc>ii
Fivsli Fisln. Fisln.
Bread. Twelve Ounces I'.read, Twelve Ounces.
P. >1at< "-, Six < )i a ices. I 'ot a toes, Fmir ( liinces.
M ilk. Two Pints. Milk. T\vo Pints and Hall'.
Milk I'liddin--. Milk I'uddinu'.
Tea. IlairOunce, oi'( 'ocoa, J Ounce. Butiei'. One Ounce and Half, or
Sll^a I 1 . (Ill' 1 ( (mice. Tl'i ';|c 'le.
Bu1 !'T. One Ounce and Hal!'. One K^L;.
On.' !'._
L'"^ MANL'AL OF I )1 KTF.TH S.
AITI.TS. ( 'iiihDKKN (lender Ten )\'<ir>t o/\ !;/<).
7 S,
Meat, Six Ounces (Cooked, and Meat. Three Ounces (( 'ooked. and
wit liout Hone*, wit liout Hone).
Potatoe-, Fiulit Ounces. Potatoes. Ki.u'lit Ounces.
Hivad. Twelve ()iince>. Hfead. Twelve Ounces.
Milk, ( )ne Pint. Milk. Two Pints and Half.
Two KU---S. One F<ir.
Pudding. I'uddiiit;'.
Tea, Half Ounce, orl'ot'oa. J Ounce. liuller. One Ounce and Half, or
Siiu'af, ( )ne Ounce. Treacle.
Hutter. (>ne (Jmice and llalf, or
Treacle.
('I se, ( )ne Ounce.
!. 10.
l-'jsli. Ki^-lii Ounc'es (Uncooked, Fish, Five Ounces (Uncooked, Fresh
Fresh Fi-h . Fisln.
Brend. Twi-lve ( )nnces. ]'>read. Twelve Ounces.
Potatoes. Six Ounces. Potatoes. Four Ounces.
Milk. Two Pints. Milk. Two Pints and Half.
Milk Pudding. Butter. One Ounce.
Tea. Half Ounce. Coffee or Cocoa, Two E-'-'s.
;. < >unce.
Su^-a r. ( )ne ()u nee.
F.utter. ( )ne Ounce and Half.
Tw,, i;- u >.
11. 10.
Fish. Four Oiuiees i Uncooked, ^leat. Four Ounces (Cooked, and
Fre-h Fi-ln. without Uone'i.
Meat. I-j-'lii Ounces (Cooked, and Potatoes, Four Ounces.
without Hone i. Hread. Twelve Ounces.
I'otatoe-. Ki.-'lit Ounces. Tuo Ivu'.u's.
Hivail, Twelve Ounces. Milk. Two 1'ints and Half.
Milk. ( >ue 1'int . Piiddinu-.
Puddin.u-. l^utter, Unc Ounce and Half.
Tea, I lalf Ounce, ( 'oll'ee or ( 'o< ( >a.
,' < )unce.
Suu'ar. ( (in- < )uuce.
P.utter. I )ne ( (mice ;md Half.
Two K-.u-s.
1:5.
Meat, Six Ounces '..oked. and
\\llllollt PHI lie '.
Potatoes. Ki'^ht I )llllces.
P.read. Twelve ( Minces.
Milk, < hit; Pint.
Ann.Ts.
Two Kirirs.
I ' 1 1 1 i 1 1 1 1 1 u\
Tea. Half Ounce. ('oilVo or < 'ocoa.
( Illllrr.
Si IL;-;I r. ( In,' ( Illllrr.
I '.Ml Iff. Tw< > ( Illlirc-,. or Treacle.
( 'li. .>.'. < )n.> ( Mince.
I !, ,'!'. ( lin- 1 'in! a ila v. i ir I J.-.-r
Mone 1 - a \v.vk.
I!' if T< ii, 1 lli. of l.'an MI. Ml \viliioui I ion i* lo the I'ini .
Sli'i,,/// Hi,'/' Ti'n.'2 Hi-. . !' Iran in. Ml without hone to the I'int.
Clu'i-l.-i-ii /.'/"//,.--( lin- < 'hi< -k. -li lo -aril I'int.
< iiir Fo\\ I. _' lli-. I'or Three I'.-r-ons.
Mill/mi. -\.<-^ an. I ShoiiUer (loin ami hi'st .-ml ol' n'ck, sjn'cial order).
I!' i l'. Sail Si I N'.'i'.-i.l.' lotlii'r |.iinl^. S|n'i'i;i| .ml.'!' 1 .
/,'//. 1'ntliliutj. -()n,.( inn,-,' Kir,-, guartfi' I'int Milk. Hail' Oiim-f Siiu'ar,
( ..... l-lu'L;- for Thrrr IMulilillii's.
>'(/,/( i i t >uartrr i'ini Miiis. 1 (iiuirr Sa.u'o, Ounce Su-_ar. ( )iir !;-- f,,i-
Till',-,- 1 'ii.i.lnij.-..
< 'iisldi;!. T\\ ,i KUL:-. llalll'inl Milk. 1 lai I' ( luiir,- Su-ar.
/i/-<iiil /'/<////;/. : , .>/.. Su-'ai-, I'li-.-a.l. OIH- F.iru for Four I'u.lilinu-.
When the poison of L;'"HI \\-as liiv-t discovcrt'tl to '" an arid, a
curious in.-:tan<v of cureless ami slovenly reasoning was funiisheil to
us. 'I'hat su^ar will fri'iiieni . aiul turn into an arnl. is a notorious
fart. 'I'he poison of ^-oiit i> an acid. '1'herel'ore supir iuu>t \>c
eschcweil. 'I'lns illogical conclusion, however, lii-nvt'il a certain i'/'m-
xi'iiililn iti'i', or colouriliLr of reaiitv, from the I'aet that with some ufotilv
[lei-sons siiLi'ai 1 docs turn arid in the stomach, and verv ijiiicklx too.
lint hecaiisc sii'di is i!ie case with certain dvs|)e|itir ^oiitv person- it
is not wcil to lav down a l>n>ad rule thereupon appl VHIL:' to ail "joniv
person-. Asa I'uie it mav lie aiHrnied that polity |iersons arc not
partial to sweet food, and pa-- the sweets at dinner with \TV
few exceptions. liu! ail the same, uric arid is not derived from
the -aeeharine elemenis of our food. The old school who :'></
lad,- sii'^ar arc ^ivin^- wav to voiurjfer men. who f,ii!o-v the
eliemieo-nlivsiolo^ical idianu'es in the nitro'jreuised element- of on: 1
In the prc-etil eon s id era t ion I he u'outy d\'-pcpt ic \\ ; i I he left out .
and \\' ill I'eeoi vo a ppropria t e ni ten 1 1< ill when ind ii;'e>t ion :s dea It \\ ; l h
in a laler rhaplei'. T" imdude him. up her. would render ;h:- chap-
ter moi'e ronipl irat ed t hall i- de-i ra 1 de.
MAM". XL (>K DIKTKTU'S
Then airain some persons object to fat for u''>utv people. On
\vli:it their objection is based is unknown to me. For mv o\vn part,
niv experience, personal and other, runs mi all fours \vith Khsfein's
directions to eat fat. (Mice fat has passed the stomach, all trouble
connected with it is apparent ly over. It is burned readily, nor can
tin- objection lie in the tendency of fat to make fat in the bodv.
For we have every reason to hold that fat doc-- not make fat. and
that the fat in the bodv is derived from the surplusage of carbo-
hvd rates.
The food element which furnishes u rie acid is. then, the albumi-
noid, ur proteid matters. The flesh of animals H i he main source
of ^ont-poison. It is not possible to dogmatise on this mailer: but
on comparing notes with a number of ^-ood observers of extensive
experience. | lind there is a considerable agreement as to the llesh
of the larger animals beinu' li'oiiiv. The white meats, as chicken.
do not seem to possess the same strong tendency to pass into uric
acid as is found with the brown meat-. Caseiiic. whether in its
animal or vegetable form, seems verv free from this teudeiiev to
uric acid formation. Of course what has just been written must be
taken for what it is worth neit her for more nor for less. An im-
pression mav be t'airlv correct ;n the main even if it cannot lie
represented in ti^ures. A diet of lentils, if ri^idlv adhered to. is a
verv \aiuable matter in cases of conlinned ^oiit. Hut this fact does
not rest solely upon the comparative freedom of cascine from a ten-
dciiev to uric acid formation: there is another important factor at
work. Such food doc- not tempt the palate to excess; and thus
the livej- ^ets that physiological iv-i as regards iH function in the
metabolism of albuminoids winch is so important in the recovery
of impaired functional capaeitv. No doubt, maiiv jjfourv pi'rsons
would :_:'et urea! relief from their tormentor if thev could anhere to
a ilietarv of lentils: but then human endurance fails under such a
gastronomic trial. The late Farl of I >erbv, it, is said, once had some
sherrv sent him. which, it \va- averted, "would not make v;oiit."
lie returned i; to the wine merchant, saving, he " preferred the
irout." So it is with a. dietary of lentils, The llelircw I'at i-iarehs
had lloeks ami herds, but thev lived on milk and lentils and I'arina-
eeoiis matter-^. Indeed !-aae marked an important familv ceremony
bv tirst partakiii 1 / of savoury meal. The Zulus, who possess a most
magnificent phvsi<|tie. live on milk and " mealies." or cooked
ma i/.e.
When we come to the praet ical details tif a ._:"<> uty person's dietary.
wcmn-t eep te carna
well in \ iew.
Soups need not In- forbidden, as tin- amount of gelatine ;- no!
verv Li'ivat. and possibly little of it passes mil of tin- alimeiitarv
canal. \\hiie soup- made with eivani are L;'"<H|. \ e^vtabie .-.nip-
are excellent, though a caution may lie retpiiivd alioiu tho.-c made
from legumes, allieit the alluiliieii is easeine. Fish soups art- per-
missible. All soups niav lie thickened with broken bi.-cuit. or
contain quantities of vegetable mailer, as Julienne, hoteh \>\ -h.
Spring soup, and u'l'eeii-pca soup, asparagus, soup. corn. soup, pea
and tomato, turnip and potato soups. .Manv persons prefer a (juan-
titv of onion, and others celerv in ilieir soup, both of \vlndi are un-
tihjeet lonable from a food point of view.
As to sauces there is little to be. -aid. l-';sli forms a lar^'e por-
tion of the dietary of the u'outv. Ki-h does not diil'er fi-oiu the He-'n
of animals in chemical constituent- so much as in its eompai'ativelv
small fond value. The amount of actual proteid matter in li-h is
calculated at about one fourth that of animal t]e-h. The r oii-c-
(piciice is. a comfortable, sat ist'v in meal of li-h dues not overload the
liver with albuminoid material, as would be the rase with an diual
bulk of thelleshof warm-blooded animal.-. The ditTerenee lies in
the proportion of water, which is very larii'e in the lle-h of li-h.
.Manv soups are made from lish. |-'irsi comes the attra<-ti\e
erav-lish soup, after which follows at a short interval (pistronomic)
ovster-.-oup. Lobster-soup is ",'ood. A white soup is prepared
from anv of the white lishes down to the eonpT-ecl, and iiotaliiv
the haddock, which is atlmiral)lv adapted io tlu 1 liodv needs as Mril
as t he pa late of the ".-out v.
Then there are cooked tish. the whitiiiL;'. the hadiioek. jhe cod.
the turbo! . the brill. 1 he skate, t lie halibut, the -had. I he john-dorv.
the L;'nrnel. and lesser known !i-h. The coarser lidi are the iini:.
the hake, l he chub, the bream, and of course the pike. The iroin.
the salmon trout, i he sewin of Somh \\ale-. the lake inml. the
salmon, t he p,Tavlinu'. and t he white lake t I'out of tlieSt. La \\n-ni-e
are all excellent. The mackerel, t he herrinu'. the pilchard. : he eel
are t oo rieh m oil lor nia n v stomachs. I MI I ot her\\ ise are perm;-- MI-.
The.-e li-h mav be boiled, or baked or fried, or made up into \\~\\
ba.lls. tisll-cakes, etc.. with potato; or served up i"i 'li'ii' a. The
smaller llat lishes. the sole, the llounder and the plaice are --,,,,,!.
but if fried should lie prepared with care; and fc\\ thiii'j'- thai are
eaten are more oll'ensive to a tetcliv stomach than a l>adh frie.i -o 1 ..-
}1. \.\TA1, OK IMKTK.TK'S.
with the tihres soaked in fat. This is the sourer of manv ;in attack
of aeute inditrest ion. or "even :_:'out at the stomach."
The shell tishes. a- the ovstcr, the rlaiu. the mu-sel ami the
Scallop. ;il'e ail excellent. So are the lohster. the eraV-tisll. the
shrimp, the prawn, and therrah. Manv othei 1 shelled tithes, uiol-
luses ami segmented lishes. are eaten in dill'i-rent part- of the ^lolie;
\vhlie the Chinese |iri/.e hl^hlv the sea-slui;'. The edihle snail has
it - \ otarics. !ut this is MI >\ "a ti-h. "
'I'" a LTouty mail of perfect il ivv.-t ii >n a loh-ter-salad is a tvpii-al
f 1. It- food-value in nutritive material i< not hiirh. \vhile of its
acceptability hv the palate It IS needless to speak". i'Vh 111 lliailV
forms It-nils ii-elf ea-dv to eiirries: ami a well-made lish currv \vith
pletit\ of rice is au excel lent ilish for a ijou t v individual.
As to the llc-li df animals, the L r n-at matt'-i 1 to ivmemher is that
tliis is a verv concentrated food, rich in alhuininoids and therefore
t" he eaten sparinu'lv as regards the lean at leas!. The ijuestion
o!' dip'stiliilit v is nut hein^ consitlered here, hut t he dilTeivnt fornis
in eciiimon use mav he arranged prett\' much as follows, mutton,
liecf. lauih. veal, pork: the last two U-mijf partaken of cautiouslv.
Iiacdii and ham seem less ohjeetionahle. When these concentrated
animal fuods are eati'ii thev should he in eompanv with a fair store
of fat, and a liheral supplvof ve-'eta hies of all kinds. The raliliit
furni-hes a capital chaii!_re. e-peciallv wlieti conked with a ouantitv
of fa: i " >!'k ( >r haeon.
The same mav he said of the llesh of fowls of all kinds, those
with white ilesh heinnf to he preferred t those with hr<>\\n meat on
their holies. Thu- the chicken is hetter than the duck or ^foose.
Til I'K c\ -eetn- 1 1 ' lie 111 ',< ! \\'a \'.
T ii. a- in M-;nne. t !H- same mav he said of white and hrowii meat .
her : " u fur or feathers. A little ^ame \ tini.-h otT a meal
i- ohj -ti d i" liv the imps! I'iii-orous I'ood-diseipliiiarmn.
l' ' .: _ ' . : . ' ' ' I i if hulk, ami 1 it t le m u~t he taken.
Tiieii a- in - II T- as sweet hreads and niher Clauds: ti'ipe,
1 1; IT'S I'ei-l. , d. oi- as hrawn, liver and haeon. thev are
; of fat . ami t he small ouan-
t it V of lea 111 . ( ' - Hot oiljeet ionahle. \ ('Ll'e-
lahir- form a ' di-rali!'' faetnr in the dietarv of tip- L T 'OUIV.
S'lllie ohjcetloll II I 1 1 hi III I isi I rooms a IK 1 < >\ ll e !' f U 1 1 H'i he-
o| lhc|' llieat-!lke C(illl)l0-it :n||. \ e^'et a ! ile~ ci ill t a 111 i ll .' a
' t\ of o\a e acid disagree with manv -joiitv person-, who
avual rl in ha rli. -oi'i'd. I' itna toes, asparagus and even
broad brans. ISut for ordinarv '_ r <>utv prr-on- potatoes in aii form-,
carrot-;, turnips, parsnips, beet, broccoli. IJrussels sprouts, eabbairr,
spinarh. endive, li-ttuce. bran-, pra-, harirots. ^p-eii corn, ami -u^ar
corn. kale, leeks, onion-, -al.-ifv. sea-kale, samphirr. lavrr. celerv.
vine .-hoots, euriiinbrr. L^'lierk in. vegetable marrow, anil oilier !---
LTeiierallv used vegetables, arr I'Xccllciit. Manv admit of brine; \ari-
ouslv pivpared so as to furnish that desirable matter, v;/... vari<-;v.
Salads should lie freeiv eatell.
Puddings are to be measured by the amount of CLTLT- :n '-.'fii.
The (","; is rich iii albuminoids, and therefore object ionabir to ;i:r
<n>utv. All miik puddings a- rice, tapioca, sa^o. semolina, roru-
llour. malt-pn-parations. and other farinaceous matirr should '
prepared uith"Ut CL^S. oral most only the vlk should be u-rd.
Suet dumplings are not to be forbidden, or bread and butter
pudding, if the cook \viil make it without ce.'i/s. Ilu: custard- and
omelettes. sweet or savourv, arr to be shunned. I'a-trv is not j.rrr^-
sanlv to In- forbidden, nor vet cakes, if ;he ainounl of CU'LT be modrr-
atc. All kind- of creams are pi'rmissd!e, but blanrmaii'_;"es. -iiap"-.
jellies, lemon sponge, and articles of food containiiiL;' much ^c,aiine
are to be avodicd.
l-'niit- of all and everv kind, raw or cooked, arr -uhable, \vhat-
ever \ie\vs mav oii'-e have been h<v! about -11'jar. And pirntv of
dessert fruit is desii'able, except for those ^oiitv pel-sons \vit!i \\hom
siin'ar disagrees and turn- arid. Indcrl lemon juice, lime ju;rr,
oraiiLre-. shai'idoeks, and the like sub-arid fruit-, are at [irrseiil raihrr
in Millie \vitli persons \vitii a ^'ouiv or rheumatic tendency.
Thru, as to cheesr ami cheese preparations. Kveii tiiou^-h i-on-
s;-t:nj' of i-aseine, <dii'csc in larire ijiiant it ics H not parti'-u'.ariv 'ii--
sirable. Sltch dishes as toasted cheese. \Vel-ll rarrbit. rhrr-r -ouill.'r.
or ramekins. con<istin^ of cheese and e^'s, are unde>irabir; but
macraroiii rhrr-r and cheese strap's mav be eaten in moderation,
l-'or those who hankrr after thr tlavour of i-ooked clieese a rhrr-r
pudding i- permissible. l[oiuin\\ sa^'o. or rice \\rll boi'.rd i
and mixed \vitii eliei-sc liiirjv LTrated, mav be prt into th" ..-.. - <
brown: and a verv Lfood and di^estilile dish is so furnir-hrd. Nor
should lar^e i|liailtities of llllcookeil chre-r be ratrU. ll!i'.e.--
rrram cheese, whirh contains onlv a small proportion ,,'
l>i-cu:i-, rrarkers or pulled bread, with huttrr and a '. :< "''
cher-r. shouid form a part of the dinnt-r of ;!: ~j:><\\'\. No -
bu; a 'j'lut ton \voii M rat too hear! : 1 v of sii'di chrr-r a- 1 r !,'; ..;:.
( iofj-. iii/i i,a. N'riifc-hat i-l. ('amembi-rt or l!r r.
I'M MAM A I, OK DIKTKTICS.
The small pTeen Swiss cheeses mixed with In-rlx and grated on
bread and 1 nit (IT a IT unobjectionable. Tin- poorer skim-milk cheeses
are cigitra-indieated.
As to milk itself, it should lie taken in moderation, unless it is
taken as the sole food a regimen which agrees witli some indi-
viduals.
As to des-ert. nuts and fnuts, fresh or dried, are permissible
for those \vith whom tliev a^ree.
And now as to !>e\eraTs. Few <routy persons ort on well with
malt liquors. Alesand porters brewed after 1 in- Knirlish fashion are
so niueh ] 101 son to ^oiit v persons of thin Hank. I in Ik v, trout v persons
can on lv indulge t heir liking for sue h malt liquors by a compensating
a bst inenre from the llesh of animals. No polity man can drink malt
and eat meat at the same time without paying the penalty for such in-
diseret ion. Beer brewed after the (Jerman plan, as hiorr beer, does
not upset the liver to the same extent as Kn<rlish ale; and manv
LToutv and liilious persons ran enjoy a draught of lau'er. whether
liaviere. or Milwaukie. without suil'erin^ therefrom. In mv opinion,
indeed, the lavrr system of brewing will ultimately prevail. at least
unions persons who have to be careful as to what thev eat and drink.
Wines, too. dill'er in then- ((Utilities. All u'ood LiTnerou- \vines
must be Lriven up. Old ['ort. Madeira, brown Sherrv. Tokav. ( 'on-
stantia. Chateau ^"(plem. liuedias, all must be abandoiUMl. 1'ort.
old i;i wood, is less pernicious than old bottled port: but mo<t "-oiitv
1 1 ."
iiii'H eschew p'n wine .-mine!' or later, no matter ho\v fond of it.
< 'hamp:c_nie. Moselle, [[oek.aiid liur^undv are scarcely less harm-
ful, and 1 h:>.ve seen Li'oiit simplv bla/.e out in a few hours after
Ma ivobrunner and llii-ter.
A p' ior. t Inn wine, as t he poure-t claret, or correspond inu" I tai ian.
Spanish, or Au-tralian wine (I do not know the wines of the Western
I lemisplicre and therefore cannot speak of them), is all the vinous
drink- a i-onlirmed L r outv man can take \\'\\\\ impunity. lie mav
,-t iii pri'ie h in; -elf on hi see liar but it is \'r hi- quests, not him -elf !
A little spirit, brandv or whiskey. Seoieh. lr;-h. I'ourbon. < Md
K've. or Monoii'jahela. with water, i- the be-i d; - ink bevond iloubt.
Mineral and aeraled waters mav be taken freely, and help to wa-h
the uric ac'nl out of i he 1 issues.
\\ hen a ^outv maii's palate fa ;ls him. it is rather a fortunate ac-
So |(>i!u r a~ the pleasures of I he table are [-"irarded a- amoni:
01 hi tllitl'_ r - of lit' 1 '. SO loliLT 1- tl " h II lenev to t'ol'lll lll'ie a'id
fo-ierei and favoured. An old clep_:'vman wa- known lo sav " l'\';
been a dvspept ic for liftv ve;irs. Thank (Jml I'm' \\ '. " The cause
of hi- [ii.)us ^ratitiule for \vliat most people regard as a plague. \vas
the fact that his brothers had all peri-died from LT"ii! v ail'cct ions.
while his dv-pep-ia had prevented him from overworking hi- liver.
\\"hen the liver manifests a return to a reptilian condition, it-
owner must alter his dietetic and gastronomic performances, or
sulTer t lie conse'itlelices.
Then- is no nice \vavof liavin'j' (lie ^'"iit: and. what is wor-e.
there is no pleasant \vav of avoiding it.
CHAPTER XXATH.
FOOD IN N LfROSAL A FKLCTIONS.
IN dealing with all'ectious of the nervous system there is one
point which must never be forgot ten. and that is the supreme im-
portance of t'at. For IOUP; the < lermans ha\ e recognised this Fact.
< speeia'dv ill reference to t lie t real nieiit of neuralgia liv eod-liver oil.
This matter of the relations of fat to the nervous system receives
an i i ic i-cii lent of interest from t lie physiological fact t hat the nervous
svstein is rich in a certain phosphoriscd t'at kno\vn as Lecithin with
a formula ( '. ,1 1 , ,\ I'< >, X : >I I. O. As pointed out he fore, in the chap-
ter dealing witli ana-mia. there are onlv t\vo bodies actually made or
(a- M. l-'oster puts it ) " ma nu fact tired " within the animal organism,
and which are not found in the vegetable world.
These are linked with the function of the Mood -corpuscles and
with the nervous svstem. two matters with which vegetable life has
not hini: to do. The one is Ila'ino^lobin. which enters into the com-
ju is it ii m of the red blood-corpuscles; ;md the other is Lecithin, "a
conspicuous component " of the brain and nerves. .lust as under
certain circumstances we lind some persons IICCOIUIULT ana'iuic. and
the red blood-corpuscles cither arc nut made, or break down, or
ma\' be somewhat of both: so m others we lind the nervous eiier^v
waning. lb',\ far this is due to exhaitsti m of the .-tore of Lecithin
is a matter on which as yet we can only speculate. lint the hvpo-
thesisthat such i- the ease stands in a curious and .-u^cstive re-
iationship to the clinical facts thai fat and phosphorus are so ser-
\iceable in the treatment o| atonic conihtions of the cerebro-spinal
.- \'s t e n i .
In tip' ini-v struiru'lc for exi-'tcnce of the pre-vnt dav. when, as
Sir.), ('nchtoii |')ro\\'!ic da- pointed out. "the battle of life is no
, on;_ r er foil L:'! it wit 1 1 1 1 lews and smew* bii ; ! >\- the brain." t lie demands
the iierviius svstem are < ,ce-sive. " The spirit indeed
is willing but the tlcsh is weak." ( eiMainlv the spirit is -o verv
willing t hat t he lle-h must trh e wav. e\ en wh^u not weak. It is all
very well for ( Tilford A SI but t. |-'. U.S. . to charge his neurotic pat ienls
witli a lack of endurance. \\ liatever powers of endurance the bodv
FOOD IN NKIKOSAI, A FFKCTI* )NS. L' 1 ,
ma\ pos-ess the restless tenant would exhau.-t tliem. The sword
will weai' out the scabbard ! And especially is tins true of tho-e
small or sliirhtly built persons with well-vaulted foreheads and -mail
viscera the Aral) tvpeof beings of the neurosal diathesis. Their
ivsile.-s energy brmirs about, sooner or later, a break-down. 'I he
assimilative organs cannot supply the nutritn'e pabulum of the
nervous system in sullicieut ipiantilv. the. -tori- becomes exhausted
and then the brain-power irives wav: the work that mice could be
accomplished with ease becomes a rricvoiis task, and a little later
on the capacity to discharge it is no longer present. There i- a dis-
tinct brcflk-down ; ami the j r palient. bereft of his whilom power.
i- sent awav for rest to do nothing but recuperate. Such a -tory
is sadlv freo,ucni at the present time, and threatens to become even
more common in the future. After a luiiir rc-t and appropriate
f i the brain is once more e<piai t" its labours.
In such a case the individual ha- distinctly drawn a bill upon
himself borrowed S o much of his intellectual capital: and th" dav
come- when that bill must be met: after which follows a lonir slow
process of pavinir back into the liodv-liank till the work inn" capita.
is once more sutlicieiit for competent action. There has been a
body-expenditure in excess of body-income, and so the reserve body-
capital has been heavily drawn upon, until indeed it i< too small for
successful enterpri-e. ]5v redm-mir the out iromirs to the minimum,
and raisiuir the incominirs to the maximum, a new balance or capi-
tal is regained. It i- ju.-t. like a man who exceeds hi< income; he
ire's into debt, and then he has to live on verv little until he has
cleared oil' hi- debt-. and then he can <^> on airain. When the
pabulum of the brain i.- exhausted a lon^- process of reetiperai ion j<
lie -(--itatcd.
I laving secured for such a pat ietit t he requisite re>l, and nervne
tonic-, the next (jiiestion arises, viz.. How i- he to lie fed / Kxperi-
ence ha- taiiirhi us the fact, before physiological cliemistr\ con d ;el!
it- ihe wliv. thai fa I and ti.-h are the foods specially imiicated. l-';-h
i.- rich in phosphorus. A pho-phorised fat has to lie t'urni-hed to
the m-noiis system. Hut lo supply in liberal <pianiitie- food
taininir phosphorus and fat. is not necessarily lo re.-tore to the im-
paired assimilative power- the capacity to build un lecithin from the
raw material-. It is one ihinir for the contractor \<, collect his
material- for a house: there are the ma-ons and brick, a\er-. ine
carpenters and plasterer-, ihe .-later- and ida/ler- io iui Id up ihe
ediliee reiptired for it- erection. I;' iln-e i '.-\\ ihcii liie work
1_M^ MAM AL OK 1UKTKT1CS.
of const rurt ion will proceed but slowly, no matter how much material
is to hainl. So in t he bodv. 1 1' the constructive powers are but feeble,
then time is essential to the accumulation of a sutlicieiiL store of
lecithin for working purposes.*
There are the capacities of the assimilative and constructive
powers to be calculated in each case. When they are fairly vigorous
comparatively rapid progress is possible: when thev a re gravel v im-
paired, and still more when the individual has but small viscera, the
recuperative process is and must be a slow one. The digestibility
of the food must not. then, be lost siu'ht of in the calculation.
Small meals of suitable food at short intervals are the line of feed-
ing to lie taken. Then lish with butter should form a conspicuous
factor in the dietarv. .Milk puddings are p>od. As a beverage
cream with sdt/.er water, or other aerated water, is capital. Cold
coil'ee with cream forms an excellent combination. ('reams of all
kinds are u~ood. Cod-liver oil and oil-emulsions mav best airree with
others.
The voik of an ein^ i" u little sherrv would make a little change.
Salads with oil surest themselves. Stewed fruit and cream ouirlit
to f< inn a staple dish.
\\ hen we consider that the pabulum of the nervous system is a
phosphorised ).,;_ u - ( , ,..,,, eoniprehend why the ]>lan of treat HILT cases
of cerebral exhaustion by liberal quantities of lean meat has turned
out a failure. Albuminoids do not supply the requisite material for
the intended purpose: while in their metabolism thev furnish matters
which mav be called hepatic mal-prodncts, or ''liver stulTs," which
possess very irritant or toxic proper) ics as regards the brain. Con-
sei|tientlya highly nitro^-eiiised dietary is not only without advan-
tair 1 '. but actually possesses positive drawbacks. The brain is not
fed thereby, but 11! i ! - Wea k eiled condition is a 11 lloVed a in 1 ye Xei 1 by
t hese " li\ er-st I! tTs. "
Tliis mailer of t he toxic etTect of liver-stulTs has. another aspect
wh;<-h is well worth consideration. An American patient told me
that, after the perusal of m\ work on " Indigestion and Biliousness,"
hi found that lii> 1"-' hi- bilious headaches bv st rikiu^ out of his
dietarv the lli'-h of auiinals except lish. lie lives on a milk and
naceou- dietarv. with butler, plus the li-h. < >n this restricted
ri'LTini'-n In 1 ha- e\ee ih. feeiinif <mite well. I)ii t anv diver-
FOOD JN NKi'KosAL AFFKCTIUNS. -!:
in'iuv I'roni this (lu'Uirv ln-in^s \vitii 11 it- own puni-hment. I >r. A.
I lai<4\ our ol' the casualty-physicians at St. liarlhoiomew's I IOM i;i;il,
has put on record a similar experience of h;s own. arn\ed at. ipiite
illdepelldentlv. Loll^ n^'o. when attached to tin- \\est London
Hospital, a patient came to me whose expression told of haliitnal
HI ll'enne;. Shi' was torilH'llti'il bv severe and aliiio-i rver-pre-vnt,
hiiiou- headache. She averred she eoniil otnv take a link l<-a!i
meat, ilrv bread ainl tea. She wa< prevaile'i upon to j^ivc up this
ri'Li'iiiH'H. not \\'illioiit coiisitleralile d MTn-ult v. and trv I'anna'-i'oiis
matter and fat. Much to her surprise she soon \va- con-iderahlv
lieMer. 'I'eii veal's later she iunie>! up a'-eideiitall v, \vhfii it was
found that the iiuprnveineiil had heeii maintained, and her face \vas
free from the 'pained" look it hore when tii'-l seen. 'I'he theory
and the clinical facts hanix together at anv I'ate. if a more positive
expression of opinion is not yet warrantable.
Some per.-, ,11 s. ;ind es pec Kill v women, of lii^hlv developed nervous
svstem and small digestive power, are liaKie to reeiiriviit storms of
neiiraln'ia, speciiillv- facial neuralgia. Sometimes ;t is fae;al neurai^'.a
(a- ordinarilv umlerstood) at other time- thei-e is intense pain in the
eve ha 11 with hem i era n la.
\\dien the storm is Mowing they can lie ^ot to lake medicine,
hut food thev cannot lie induced to take. This i< a .rival mi-take.
"Tain is the prayer of a nerve for healihv hlood " said lkoml>T_::
and this cxijiiisite sentence is well worth hearing in mind. The
hionil mr,-t lie e-ood in ipiaiitv and sutlieient in ipiantitv, else the
nerve ^'ivcs out its 'mart ie u late cry. < Mie sulTerer of t his kind came
under mv notice latdv. Miik was ohjeeted to and meat infu>ions
aioiie wei'e availahle. lint sueh infusion-, a- pointei! out elsewhere.
ha\e (pract icaii v) no food-value. Some " lactatcd fooil " was avaii-
:ih|e, and l>v the addition of it to the meat-infusions the strength
\\a.- maintained. Not onlv did the svstem derive support from the
food to hear the sull'erin--, hiif the nerve liein-' better fed it sooner
ceased its wail. Short 1 v the opport un it v olTer> 'd :! -e. f for t h ;s pa; .ent
to pre-s her new convictions upon a friend sull'eriULL' ,n i;ke manuei-,
and w:lh the same satisfactory result. \\dien the pain is on. the
sniTef'']- can onlv ohject, to everv propos:t ion. and hc^s to 'nc ., ;':
ill'il'.e. Tile patient, however, when so SUll'erini:'. i- not a en|i|!"-!e;:t
jud'j'e of what is he.-t to In- done, and mi;-; lie iirmi\ resisted. llotii
pa;. en;- sulTerod si-verelv from a sudden eold -pe!i of weather. Ti.e
cold. ;iir of tin- niL!'ht. caused them to waken in ;i;e morMiiv; \\ ;ii
L'L'n MANL'AL OF D1KTKTICS.
neuralgia. Some food in the small hours of the morning warded
off these mornine lace-aches in a most satisfactory manner.
(The ell'ert of roid air in t lie prod net ioi l of t liese 1 an -ai 'lies seems
as follows: Cold causes the cutaneous vessels to contract, and the
cutaneous nerve-tibrils thus liave their Mood snpplv cut down, with
the eonse(|uence of iieuraljjiti in the starved nerve. 1'roteciion
apiinst cold is. of i-ourse. one preventive matter; u hilc a snfliciciit
suppiv of nutritive Mood ;s another. <>ur ancestor.- in dranti'htv
houses had bed-curtains and wore meht-caps. No doubl this saved
manva face-ache. Their descendants, wit h eiirtainless beds. and ie-
norant of nielli-caps. suil'er i'or their advance in taste. The facial
neuralgia which has its origin in a cold drive is a similar case of
ner\ e-starvat ion. )
This view of the relation of food to neuralgia, and especiallv
superficial neuralgia, is well worth bearing in mind. Such nenral-
i_ r ;a lii'lon^s to persons with small viscera, and who can only take
small ijiiantities of food at once. Thev cannot endnre the lonir un-
broken fa.-t of nieht. and should have somet hinir las; thinr on iret-
tinir into bed. and also something Hrst tiling' in the morning liefore
commencing to <lress. In cold weather, beyond this, they must have
some food in the small hours of the morning- This mav consist of
m.lk with some malted preparation: or of a meal infusion with
on i predieested food. Tins may be kept warm under a tea-cosev:
or on the hob. if the lire lie kept up. or a .-pint lamp mav be
used.
And. by attention to the matter, many neura Uric snll'e re rs will he
e. if not to rsrape their plague altogether, -till to avert much
<>' tin ir pain. At times alcohol in >ome form mav lie indicated as
an addition to the food ju-i mentioned. SoiuetMiie- indeed a little
alcohol seems necessirv to digestion in the small hours of the
m or; i ir_ r .
{ >;. K me Chamlicrs de-eribes a eiirHMis n enrol ic condit ion. linked
\\ th an erroneoii- dietarvthu " Tliei-e is a pc"iii;ar form of ////-
\inilrinxi.-i \\lii' 1 ]] ari-e- from eating too little vegetable- and too
Ilieat. It i- di-t ili'_ r ui-heil by the h i '_d I ,-peeilic -Tavilv of the
( 1 .<).'.") to I .n:;."i | ilepe d< ire-eiice o!' urea almie
i'ja r. Thi'i'e i- in t he i-a-es often a remarkable lassitude,
ippai'eiit paraly.-i- of the i m!i- -uddcnlv occurring after e\er-
i o!i. So met inie- tin i'e i- emaciiM :on, 15ot h t he-c -vmptoms n-ua 1 1 v
:';!' ei nite t he morbid state to m-
rit ion. and tn i !<; mori and more t he i iri >i n MM ion
FOOD IN M-:ri;<sAi. AFKKCTIONS. -_'-_M
of meat iii spite of the aggravation of tin- ailment. A rapid ci;r<-
allend- tin' ilimiimiioM of tin 1 meat meal- In one ilailv. and tin- ~ui>
plvniL: their jilai-rs \vitli plrniv of porriilir' ainl ^I'n'ii vc^i-tali!i'-."
Tliri-r i- aunt her |>ifcr of evidence, that \vhilf the I'rcliiiLr- |'i'n-
(liii'-'ii liv normal digestion are ajjfrccahle -lie!ire the praetiee of
charit v-dinners wlicn there is an excess of albuminoids in the
dietarv. 01- the liver is nneijiial to it- \vork. inal-prnihiets are formed
which possess a toxic cll'ect u[ion the nervous >v>lem.
CIIA ITKU XIX.
Fool) I'OK ( URoMc INVALIDS.
A< Tiiiirlit. '' ////"//. lie expected, tin- dieiarv of a chronic invalid
dill'cr- materiallv from that of persons in robust health. Yet this
obvious matter tines nut ahvavs receive the attention it merit-, and
the invalid has often " tu take what is u'"in,i:'." and \\ hidi is adapted
to the ! K ill v- need> >f t he rest uf t hf fam d v. Of course this due.- nut
occur in thought Inl families: lnit is apt to he tin- east- where one
meinlier uf a ruhnst familv returns to the family jjroup in hruken
health. It is all vt-rv well fur a familv tu enjoy unbroken health;
luit lack uf fainiliarit v with illness carries with it certain draw-
back-; and of tliese. ignorance of what an invalid requires, is one.
There is no intention to neglect the sick ineniher. or disregard his
or her rei|iiireinent s: it is simplv a case of want of knowledge.
\\hei-eas. uii the (ither liaiid. in families where illness is nut un-
knuwn. an acquaintance with the want- of sick persons is fuiind.
This is. in the hmir of need, the silver liniMu' l>< the dark cloud of
iilnc--. I-'ew phv.-icians ln-t have had the above facts forced upon
' attenl on fi - oin nine tu time. ('alleil to a sick person, in one
v to lend t heir services, hut the will i HIT vol-
unteers are an 1-dr noli, destitiite of anv k no\\'icd^e of \\~haL
has tu lie dune, and how .t has tu he carried <nit: while in an-
inily the phy.-ician tinds the dilTereiit inendicrs readv to
fa ;. :: In of In f place ke Wei 1-d isci p] ined soldiers. IIow
rcl:a-ed their knowledge it mav In- well not to 111-
(|ture: Suit M ;- there when it is wanted- and that is something.
With the chronic imalid the position is sonic\\hat dilTereiit.
That OIK of tin female- of the lions. -hold which has the kindest
heart, tip- lic-t head, and the nm anils, lake- upon her-elf
t he task of tend tr_T t he sick mem 1 n-r. lint no a nion tit of willintf-
ness ca n com pen -ate for the Jack of act nal in format ion.
N'natTectiull I'' at'd "'T the i-Vll elTcct- of lil'ead
criitid'- in the lied, whi'di -nun iiecumr hai'd. irrittv particles readilv
of l.e.l -ure~. [Jead \ and a ll'i c a- she is. t his de-
voted woman ha- h>T le.-son to learn, and prohaMv learn- :t as
!'()( >l> !'()!; < lli;< INK I NY \|.||>s.
mii'di utlit-r knowledge is acquired thr"ii'_:h much erri-;- aiai m.- - -
taki 1 : hut all tin 1 >amc n has us disadvantage-. The -eif-apii:!:!ed
nur-e iiiu>t pore over her cookerv- book. and ponder n\.-r w:,:i: -he
tiiiils there. If some ul the details >erm uncalled for. -oin>' :
untiecessarv, she will do well i in! to exercise her ri;: lit of prisate jnd'j-
ineiii and make modifications of IHT o\vn. h is ne\er weli ;o
|iro|iheev ahont viands. The proof of ihe pudding i- the eating!
And it is not well to assume that some eooked jirodiie! will he tooih-
.-onie. It mav turn out far otherwise. Taste and trv. I'aulV ad\ i<-e
1" the Thessalonians to " Prove all things, hold fa.-t that wh>h is
Ll'ood." applio hei'e Verv l "Tt nieiil i v. >i:e should make a private
trial of eaeh d..~ll liefol'e SiT\iuo- j| up \, t ;| lr |)i\'aiid. She lliaV lie
pn/xled what dishes to select. Il will lie well for \\<>r to irive he]-
alUMitiop, to li^lit rathej- than solid food. The nnaiid is nut emtai
to iinie'n exertion ai;d therefore does no! require the snh-lantiai
repa-I whieh is desirahle for the hale nieiidiers of the fannlv. and
which thev enjov. The Itoilv-requiremeijl.-i are smaller. ( >n tin-
other hand la<d< of exercise leaves the appetite impaired, and the
y.c-\ for food is not so kt en. Something tempting is indicated a
small liird on toast, a daintv sandwich, a herring's nuiiet. or a
hit of cod's me. a sweethl'ead or a little lish, a .-mad qnantitv
of a milk puddinir* or a little stewed fruit and cream, or a i-ustard
in a crlass. something small in aniouni and tempting 1 ; in eharaeter.
Very often the cook dislikes the trouble of these iittie odd-
ments." Ill which case it is better to trv to prepare them Mldepeil-
dentlv of her than to persist, wit h her. No woman vet ever made
a dish palatable \\hich she prepared un wi 11 invjlv. A cook nin-t n'ive
her mind to her dish if it has to be a success.
If the volunteer experiences a dillicultv in her selection she mav
lind considerable help in a little bonk " Food for the Invalid, the
( 'on valescent. the I )vspept ic, and t he < lout v," jniblislieii I iv Ma MII ;i-
lan and ('o. . containing' some three hundred ciilmarv preparations
selected from \arious eookerv-books and compiled bv tile write]-.
She must learn, too. to prepare small quantities at once. |-e\\-
I'oods improve bv keeping, and fe\\ bear \\'arm i m_;' up without ,''-m^'
much of t heii- toot hsometiess. Sometime- the famiiX nieai \\,!1 in-
clude a di.-h of \vhich the invalid ma\' fanev a lit lie; but as a rule
something .-peeial must be prepared. The invalid canno; h\i. ha\-
HIL:' bill a feeble appetite, or even beill^ dallilX. I 1'ei ; : i e n 1 , \ . no
doubt. I he in\alid bears much quiet Iv \v;thoul .-a\;n^ anvihinu'
about it. I'tM'haps !]< is peevish. Illne i.-a trxiiiL: mailer!
L'l.'4 MANUAL OK DIKTKTK'S.
As the amount of food which can be taken at once is small, the
invalid must not be restricted to the family meals, but have little
gastronomic interludes. A cup of milk, a cup of beef-tea with some
prepared food in it. a little custard, the volk of an ejjftr in sherrv,
or some chocolate, or possibly even some sweets. P>ut here we have
to confront a ditlieultv. vi/. : How far do such minor meals destroy
the appetite for the regular meals? This must i'orm a matter for
private judgment in each individual ease.
Sometimes the invalid may like highly seasoned dishes, but as
a rule plain fare with condiments in moderation is preferred bv sick
persons. As Sir \\ m. Roberts has pointed out, the taste for savourv
fond i- diminished in sickness, and simple food, unattractive to hale
persons, is relished bv those who are not well.
In consequence of laek of exercise there is always a tendency
towards sluim'ish action of the bowels: and this can usually be met
bv a baked apple, a 1'ew stewed prunes, or liirs occasionally. Kspe-
ciallv is this necessarv where milk forms a considerable portion of
the dietarv. Meat-infusions have a tendency the other way. Ac-
cording to the state of the bowels, milk or meat infusions must be
resorted to.
Then another matter is the avoidance of fat by invalids. In all
illness fat is objectionable to the palate. Whether this is an instinc-
tive avoidance of an article of food which cannot be digested or not,
mav not be atVinncd. But of the impairment of the pancreatic
function in acute disturbances there is much proof. This, however,
is certain, vi/. : that the necessity for such concentrated fuel-food as
fat is much diminished in the case of invalids. Confined indoors
to a uTeat extent, and incapable of much exertion, there is not the
demand for livdro-carbons which is normal in health.
(of course this statement docs not applv to strumons and
phthisical persons, who require a eertain amount of fat to build up
healthy tissue).
Salted and dried meats arc rarelv relished by invalids unless it
be in the case of bacon and ham. Tinned or canned meats must
be used at once, else they turn apiinst them. All irreasy meats are
disliked and drv meat preferred: thus a chicken is in request, while
a succulent duckl'mi: is rejected. Boiled or baked ti-h is preferred
to fried fish, as a rule. An evfir is a favourite food with invalids
n-ually. I'lain boiled, or boiled li^htlv. and turned out into a warm
cup containing a little knob of butter melted with some pepper and
salt, either are attractive. Or a ILdit boiled ci:?, turned out upon
sonic nice mashed potato ;unl mixed therewith, form- ;i dish \ ( -r\
:iccc|it:ili!c to t lie palate of ;in invalid.
A- t" drinks and heverap's it is impussihle to sav anvt him;: -n
much de] lending upon t he likings and di~iikin^s of different persi ].-.
and so iniicli upon the actual requirements of each individual ca-e.
(Jreat clcanlines- and neatness in the serving of food arc
tial. otherwise the appetite flees at once. \o attractiveness in the
viands can compensate for a dirlv plate or a soiled cloth.
15
riLAPTKR XXX.
!()( )1.) IN OIJKSITY.
CONTKARY to \vli:it llli^'llt lr expected. F;lt eaten as food is not
deposited in the body :is l';it. I'art of it is utilised in t issue-forma-
tion, while the rest is huriit. The fat of the liodv is the surplusage
nt carbo-hydrates heyoiid body-needs. ()f course it is ohvious that
if tlie dietary lie rich in fat fins \viil burn to maintain the bodv-
lemperature. and thus the demand upon the carbo-hydrates con-
sumed is lessened, and the more remains oyer for adipose tissue.
Fat is deposited in the body in an irregular manner: sometimes
evenly distributed, at other times certain localities are selected.
The eye lies in its orbit with a packing of fat around it. The salmon
has its fat in its tissues, the cod locales its fat in its liver. Some
persons are fat all over like a fattened animal: \vliilc other- carry
their fat in a thick pad over the wail of the abdomen. The came!,
the dromedary and the bnll'alo have a lump of fat on the back'.
The Kin:: of Dahomev's wives are fattened on rice and butter,
pre\ious to i he nuptial ceremony. A certain plumpness is admired
!i some animals; and a re-er\e store ol lat is often very convenient',
carrying with it a certain stay; nil' power. A sleek, well-fed horse is
an i nst a nee in point .
On the other hand fat may be a burden, as many obese persons
kno\v fiiji well. li certainly may be .-o excessive as to be unsightly:
and fat person- are regarded as legitimate objects of j'idieule b\ the
vulgar. ( oiisefjiient Iv, many and divers plan- have been laid down
for the reduction of redundant corpulence.
Le\vi> Cornaro. who \vas a corjuilent. ifoiitv man, put himself
upon a spare dietary, vi/... twelve ounces oi' food, mainlv vegetables,
and fun;' ice 1 , ounces of I i'_dii wine dad\ : a i id on t his li veil in ^ iod
health for over half a century. |-e\\ per.-oii-. however, could undergo
such a severe re'j; men. A not her <>hcse ma n fed la r^el v 11 1 ion a ppies.
.in which he reduced himself considerably. The LTi'eat idea in the
ditl'crent plan- uf treatment is t he a\ uidancc nf carbo-h vdrates in
the food >(j far as i- possible.
There are two plans before tin- public at tin- present tini": (!)
JJantinunstn, ami ('-' ) Professor Kb-tein's plan.
h \viil In- well in take ill' 1 plan advocated by Mr. Planting lir-;,
because it must lie crit ici.-ed rat her than ivrommriiil'''!. lie cut <>:]'
carbo-hfdnites; no sii^ar, ni stan-h. Su far so p>od. \\\\\ on the
other hand lie allowed unrc.-tricted indulgence in albuminoids, as
the tlesh of animals for instance. Tin- reduction of a hitman IKMUL:
to the .-talus of a earuu onms animal has Keen attended with un-
fortunate results. Ail aloni: in thi ; treatise the danger of an e\ve-s
of a! buminoids in the fond has Keen steaddv insisted upon. The
dangers involved therein ha\.' been planted out. e<pecia!lv in the
chapters on " liriirht's I lisease " and on "(iout."' And t his danger
of kidnev injui'v is no mvth 01- imjii'.'iiKri'v ri-k. Not lonir a'j' 11 a verv
illustrative case came under mv notice. A man of sixtv, \s~hose
kidui'vs were pri ilialilv ii"t ahovc suspicion, was advised to reduce
his corpulence, he then hciii",' in i;' 1 health and feeling weil. ll
was \\'eil to take oil' a couple of stone-. ln~ medir;il man .-aid. ami Mr.
P>ant in^'s plan of reiiuction was recommended. The desired re-
duction was accomplished Imt at what co-t ? No susp'cion of anv
impairment of the kidiievs seems to have suir^ested itseli' to any
one, to put lliciu on their ^iiard: and the untoward result was. a
condition of lithiasis was established, and in a few month- P.ri^ht'-
disease had claimed Us victim. \\ henever anv reduction in a corpu-
lent person over middle ap 1 is, contemplated, the possible condition
of the kidiievs should never 1 ie forgot t ei i. There is much tva.-on
to iie!ie\e that main' persons ha\e fallen victims to their desire to
reduce their corpulence, and the adoption of IJantinu'ism fr t'nat
em!. It i-, realiv. a very dangerous practice.
Professor I'llisteiu's pian is free from the dauber- which lurk
around Mr. I5ant m^'s method. The ( lot t lU'j'eU Professor, who ha-
_i:'iven much attention to. and has written a small bunk on. :..
subjeet. sum- up as follow.-: "The pei'iui-.-iou to eiijov certa.:,
succulent thinii's. alwavs of ctturse in moderation, a- for in-lan^e
sal UK in. pale de i'oic p'i'a-. and .-itch l;ke deiic;n-ics, recondi,--
corpulent gourmet to hi- other saeriiiees. 'I'lie-e consist in ihe c\
elusion of the carbo-hvd rates. Sifjar-. sweets of nil kinds, potat^
in everv form. I forbid uneondit iouallv. 'I'he ipiantitvof lu-eaii .
limited ,-it most to :; to :'..', ounce- a dav. and of \ e^-ta i'le- I ad"\v
asparagus, -pinach, the \arious kind- of cabbage, the legumes.
who-e \aille as CHUN e\'er- of album ell. a- \ (Hi ob.-el'\ e-. , - k :,ou '; I o
few. (If lllea! 1 exclude nolle, and t he fa! in [lie ;!<-: !'.:;
MAM'AL Or PIKTKTIr
Ill
to he avoided, hut on the contrary. sought after. I permit bac
fat. fat roast pork and mutton, kidnev fat. and. when no other fat
is at hand. I recommend marrow to lie added to t lie soups. 1 allow
the sailees ;i> well as the vegetables to lie made juiev. as did Ilippoe-
rale.-. only fop h;< sc.-am oil I substitute butter." This is a suin-
niar\ oi' Kb>;em's creed. which is a distinct impnn ement upon the
regimen advocated liv Mr. Banting. Some modilieat ions. however,
mav lie SH'JU'e.-ted. such as I'll rt he I' lie velopme) 1 1 o!' lish 111 t lie d let a TV.
F'i-h of all kiipU, fresli. dried, and canned, should lie largely taken.
Then a caution abniit the amount of lean meat and legumes i> desir-
ahl '. as heiii"; albuminoids and needed in small iniantitv. Salads of
various kinds are ^ood. The lettuce, the endi\e and celery iua\' lie
added with advantage to his limited list of vegetables. The onion,
kale, .-ea-ka!e. turnip-tops, do not contain so much saccharine matter
as to exclude them. As to the potato, of course an objection lies
airain-l it theoretically, hut when t he stomach has to he ill led a small
< ptant it v of potato will help to do this in a sat is factory man net-. 'I' lie
palate iiiu-t he consulted, and so must the stomach; and a small
quantity of forbidden matter mav in many cases he desirable. Onlv
of course more time for the desired reduction is then essential.
Piread, biscuits, crackers, corn cakes, milk pudding.-, other pud-
dings. all must rutldesslv ^o if the reduction has to he successful.
Malt liquors of all kind must lie t'oivsu urn, and a li^lit \\'ine or
spirils and water alone lie indulged in.
As much e\c)-cise as ptjssihlc should also lie taken, as exertion
counts oil' so much \'< id.
Hut do imt Id the new regimen to lie [no -evere, or so riii'id as
to atTect the Lreiieral health. If ill elTects are heillLT experienced,
some i'e!a\at ion for a while mav he advisable. \\ here ohesit v is the
outcome of indulgence m rich food in unlimited quant it ies, comi lined
with ^enerou- drinks and halntual la/.iness. the regimen requisite
for its I'eiluct ion will be lieiieiiciul lyenerallv. \\~.\\ where a person is
v corpulent and vet well u;ih it. ;t is a matte)- for deliberate
thought a- to bo\v far an v sudden chan^'e of regimen is desirable.
Some faun ies are norinallv -imil ji ' : others ;) |-,. | ( .;in, And as it
is impossible to fatten the latter, so it m;i\ nut be wise to trv to
reduce t he former.
The i real incut of nhe>it\ is the axoidanci' of carho-hvdrates;
vh.ie in emaciation carbo-h vdraie. n theii- mo-t diu'est ible forms
are w'nat is required to -.-,. n -. - , i id ties- or enibonpoint.
'1 here ;-. however, a ci rta : .' -- -ecu in females al. or
about pubert v, ami then ajiain ;it tin- menopause, <>r tin- cha!c_:c
of life, which is linked with aiKemia. liirls r women, they bee., me
pa HP I. the blood goes thin, ami 1'at accumulates upon t hem : H n-cia, i v
t lie subcutaneous 1'at. \\ it h u'iris a < plant it v of iv< \ meat ;- a- i-- -CM-
tial for mre as are chalybcates. \\ ith women at the change of life.
an excess of albuminoids mav tell upon tin- kidneys. The fatne.-s
may depend and docs depend evidently in .-oine eases, up'>n the .;.-
liciencv of red blood-corpuscles, leading to impaired oxidation, and
from that apun to the deposition (as fat) of the itncon>uined earbo-
hydrates. This inipoverishiiient of the blood mav be due to the
pressure of sonic poison in the blond bi-cak .IILT do\\ n the I'l-d bloo ',-
corpuscles, or hindering their formation, and in Mich cases the re-
moval of the toxic clement is the tir.-t step to lie taken: after which.
the cau.-e bi-m ; removed , all ^ocs \veii. Such a case cause under
mv notice sonic nine au'". <o'tit here \\':i- the underlying can-al
factor: and t he cicai'in^ a\\ av of t he to\ ic ap'iil by uric acid s< >\\ cut s
\vas in one case followed, and (piicklv too. by the re-formal ion of
red blood-corpuscles, and a reduction in tin- adipose ti-Mie. I.nt
the reduction of the fatty tissue in ladies at the change of life -
especially if >oiue malnutrition of the nni>ciilar wail of the heart he
a!s_o present is not a matter to be lightly undertaken, and reijir.i'es
considerable jm l^menl.
\\ lien a person is naturally stout and leads a rational life, taking
exercise and eating in moderation, any ".Teat reduction in hulk is a
questionable advantage. Hut where obesity is the outcome of glut-
tony and la/ine~- . iheti a change all round is certainly desiraiiie.
lint even then a sudden reduction in bulk is not without certain
drawback-, and entails an exercise of the judicial powers.
\Vhen a reduction in bulk has been achieved, persistence in the
dietary i- neec.-sarv in order to prevent increase iu weight: and a
regulated dietary an irk-uine matter to say the least ul' it muM
become the rule of l:l'c.
('IIAPTKU XXXI.
TIIK F<M)I> IN INDICKSTIOX.
I'KOP, \ IM.Y none of the topics in the connect inn of t'ooil with ill-
ness is more interesting lh;in the one now to lie considered. It \vill
lie neeessarv t" u'o into some detail in the matter, as " indigestion "
ciivers a iar^e Held.
The tirst matter in this consideration is the physiology of divfe--
1,011. \\ Inch has lieeii spoken of he fore. I tut must he glanced at au'aiu.
First so much far;naeeoiis matter is rendered soluhle bv the action
of the saliva. The sicrliarine elements of our food and the soluhle
outcome- of starch pass readily through the wall of the alimentarv
canal: and so the stomach is relieved of their presence. What
starch remains untouched l>v the saliva passes through the stomach
(nnalTecteil hv gastric action). ;uid tinds in the intestines the pan-
creatic solvent. In the stomach the ail mminoids of our food alone
are acted upon. That is the second section of the digestive uct.
The third and last is the pancreatic digestion, where starch, albu-
minoids and fat .all are dealt \vit h.
( iastric indices! ion then mar be due to
1. Too much undigested March in the stomach: or
''. Albuminoids too hard to be dissolved; or
:!. I ; at lloat in-- about in t he stomach. olTeiidin^' it and interfering
wit hit-] iroper \\ ork.
In t he.-e cases the stomach inav be eipial to its dlitie- if the diet-
ary be adjusted properly.
Then there is indigestion ba-vd on the >;omach having more
food in it, {.i:, a larger bulk of contents than n can deal with. Here
smaller i(iiant;t;e- of fooi'; must be taken at once.
Finally the stomach it-eif ma\ lie at fault and be uiieipial to its
duties. This will take two direct ions.
1 . I)etie ; ,elleV of ^ISl fie JU lee;
'.'. I >efeet JVC JIIU-ell',;i r 1IIO\ el)l' ' ' .
The late ])r. Arthur 1. cared held that pain is the proof of the
fir-t: and a sense of distension (with flatulence) the evidence of
the other. In manv cases the two arc combined.
These last catl.-es df indigestion lnav he due to or^'a!^' dd-a--.
lilll I'V 110 mcailS IlcceSSarilv SI). l''llM''l;li;tl illeapaeltv j ;',-
stomach mav, and often does. e\i-t \v!lli<Mit oi"_ r anie eiianu'e. I' laav
or inav not he followed l.y siruetural IT ^ross alteration-:.
\\ hen tiic stomach is at I'aiiM then sunn- nicd:e:nal niea-nre- are
ralli'i] fur. whieh (.annul he con-idered here. l-'re<iuent 1 v a little
arntieia! pepsin in addition 1<> the amount furni.-hed hy tin- ineai>a-
!'!i' sTotnai'li \\ ill < -nali! i- t he la hour! i it; vise us to vj t over it - d ;!l;.-:i'. v.
< M''en t lif ad i i it i "ii of rarinmat i vi'-: and cond iment s to t he t' i will
relieve the flatulence. Mill, tyrant ::iu' all this, and imt ati'-ni ntiiiLT 'o
underrate its ini|)ortanee, the main mailvr with priinai'v or Lf:i>t rii-
indigestion is the fond laken into the stoniaeh.
In the lirst j'iaec n must lie (if siieh eharai'ter that i; run he
properly disintegrated hythe teeth, and he so red need lv mast ;ea-
tion as to In- in a til state fur the stuinai h t" ;iei upon it. If such
dental preparation has nut u'one on, then the \\,<n\ reaelies the stuni-
ai'h in an unlit condition: and conseqiienih" that visens is iiu-apahle
of deaiiii-' with it. Defectlvt! teeth, the lialiit of hoitin^ the f. .od
uii'-hewei i. and unsnitahle character of the via;ul>. are the main
causes of thi- fonn of indigestion. Cei'tain things, as pastrv. win-re
i'at and llonr are kneaded tou'etlier inlu a mass not ivadilv d;-:n-
te^rated: cheese, nut>. hits of hard meat or ^i-istle; hard pi-ces <if
]>otato. cahha^e or other vep'tahle matter: all ve\ the stomach.
In the case of Alexis St. Martin, I >r. IJeanmoni found t iiat sn-ii
ai'tieles oU'eniled the stoiiuieii, arresting the ilow of the gastric jn.ee.
and cati>iiiL;' the ImiiiLT meinhraiie of the stoniaeh to \,<- drv an-l p-d.
I- roii i this we can nnder-tand the notorious clinical faet of the a'io\ e
mentioned artieles provokinii' indigestion m a delicate, sen-it ivi-, r
1'ceh.e stoniaeh, Persons \vlio can eat m o-i articles of fo<id \\.IM
eonifoi't tind these hid iifest ihle ariieles to cati-e them sn tTerinu'.
('oll.-ei jUelll !v tlli'V should he SCl'tl pll lolisl \ avoided.
\\'here ma sti eat io ii i- defect ive owin^' t" the lo--s of teet h or t :;eir
(ieeaved ciijiiiition. the :i;d of the dentist must lie imoked. After
!!: teeth ha\e been put ri'^'h; and are m working o rile r tin- simnaeh
is no longer out raii'i'd hv lumi>- of food upon which it can c\ere;-e
no -oj\ -ill aet ;on.
\\"he!-e the hahii of eating quiekiv olitain--. and I lie I'M, . Iiolted
or !la pdrai;-om-d. and thus the >|om;i,-h olTen.ied.a more rational
met i 11 >d of ea l ; ]\'_' \~ the en re or at lea -I a _;'! ea t pa ri o; : : .
Mailer- inliltrati'd \\ilii fai are provoeanH of i'a,nful and imper-
fect dl"-e-'t;on. A hadlv fried -ule :- a notorion- o';,--,der in ;'.'-
MA NT A I, OF DIKTKTICS.
respect. If the cook do not have her fat properly hot. it soaks
through the fish, and tiie muscular fibres so becoming coated with
oil are bcvond the reach of the gastric juice. l-'attv meat, as the
ilesh of the goose and duck, are avoided by dyspeptics. Such fat-
swathed muscular matters are as burdensome to the stomach as
quant ities of undigested .-larch.
These are gross and tangible matters, obvious even to the un-
educated eve: matters which merelv require to be pointed out in
order to lie comprehended. Hut bcvond these there are subtler
matters, such as t he difference betwixt veal and chicken, pork and
rabbit.
Meat hard of fibre is indigestible, as pork and veal: then beef;
then mutton and lamb. Kven parts of the same animal varv. A
piece of hard neck of mutton is much less digestible than the loose
fibre of the meat: on the sheep's head. A veal cutlet contrasts with
a sweetbread. A salmon steak contrasts with a whiting: though
fish arc as a rule more digestible than the flesh of mammals. The
fle-h of fowls is widdv different, as a succulent duck compared to a
part ridire. (ianie is vcrv digestible with its short fibre: while goose
is not otilv rich and greasy but its fibres an- longer and coarser than
is the ease with game. A leg of a chicken is less digestible than
the breast.
Articles that are flatulent cause indigestion, and consequently
many persons of feeble digestion have to eschew the legumes as the
bean and the pea. 1'eas bear an evil reputation: and especially in
the drv form. Vegetables as a class are regarded a- "windv."
I'li'-ookcd vegetables are to be avoided bv dvspcptics Udt onlv on
l his account , but because uncooked vegetable matter does not ivaddv
undergo di-iniegrat ion.
The presence of starch granules in considerable amount in the
,-'maeh i- a fertile source of gastric sulferinir. This is an aspect of
the subject .fa i 1 t no ] i 1 1 le consid eivd : and vet it is a matter of great
importance. The gastric juice ha- i o action upon starch granules.
This is quite a different matter from mere masses of farinaceous
matter like pa-trv or [Me crust. The disintegration mav be perfect,
or fairlv so. still the starch irranuic i-; a- indigestible in the stomach
a- so iiianv minute particles o! _ as-. < ommonlv. however, there
;- a combination of causes in action, a- more perfect disintegration
bv ih" teeth would iiecessarilv briiiir the stai'di granule into contact,
with the saliva. I'.ut putt:nir this mailer a-ide for the moment,
aia en, -iderinir the farinaceous matter .-imiilv as an aggregation of
staivh granule.-; these last, it' sutlieieiitlv nuni'Tou-. hamp'r and
oh-truct the action of the >tomach. 'l'lie\ ah-orh tin,'!: they
to the hurdeii home hv the stoniaeh a.- \ its mu-cular iuo\'ii,. :<-.
'1'hev incommode it; and therefore are obstructive and unde-;rah!e.
In order to u'et rid of an v superabundance of -tare h '/ran 11 !- t he
dyspeptic ou^lit to take the farmaei-oii.- articles of food lir-;. and
adopt the rule of the nurserv. vix.. pudding hefoiv meat. If tip-
niiik pudding he taken lir-t. then the sah\a can act upon the -tardi
in the month, in the gullet, aiid in the .-tomae'n he fore it hei-on.c-
acid. I!v so doiiiu r the stardi \vonid he rendered -oliibie land -o
e.-cape through the wall of the stomach), and wonid '_:''! out of the
\vav. leaving the -tomach free to deal with the meat which coinc-
after it. That is the comiiion-sen-e \H-\V of the subject; and a fol-
lowing of the natura; order of digestion. Hut cii.-tom ha: 1 - the
adoption of siieh measures. The dyspeptic mii-t rise ahove en--
tom. That i- all that can lie said.
Then t here comes t he <|iicstion of dealing wit h I he March granules
previous to their be HILT taken into the mouth. A- ha- heen pointed
out liefore. exposure to heat not only cracks the -'arch granule, ''in
render- much of it .-oluhie as dextrine. \\ here the appiicat ion of
heat ;- made hv the maltinir proee-s there is a;-o the action of the
diastase upon -tarch. In eases, then, where the presence of raw
.-tardi granules oll'ends the stomach, cereal matter- wlndi have nti-
der^-one a preparatory iliire.-tiye coui'se mu.-t he chosen. I here are
many in the market; hefore IOIIL:' thei-e will he many more. In the
meantime the cook can put her farinaceous mailer in the oven hv
itself for .-onie time lie fore proccci 1 m<jf to heat ;t in the ordinary
manner for a milk pudding. Or staivhv matter.- whadi ha\e un-
dei'Li'one some pri '] i in i ii a r\' d I u'e.-t lol i can he used for soups or hroih-.
Of oM. hi'ead well hoiiei'i and put through a >ii've was n.-eil < th.-r
a- " hread jelly." or added to milk or soups. Pv so iloin^". aii'i t i!\-
MIL:' the-e matter- as the lii-st course at dinner, a .-titVicieni -upp,\ of
LiTape-siiirar woiiid he furnished to the hodv for eomhii-t.on pr.r-
po-c-; while the stomach would he left iineinliarra-.-ed to p:-o.-,-. d
\\ ; t h n - o\\ n \\ i >r\\.
li is ad \'ei'\ well to point out ho\\ much tronhle aii'i expi-n-e
tin- wiil entail; hu; then 11 is it na \oida hie if the -\~-ti-m - to ;,-.-i
up to working point. The d\ p spept;e ,- an nnfort una;-' n
mativ \vavs to he sineereh pit iccl.
\\'here | he stomach i- ofVerided hy the pre-eii-'i- of :'a\ a!,d i-s-
p"i-iahy fat en ma--e. or in the laiiiruair" <'' the :. ::- r^ 'do'
MAM'AL OK DIKTKTICS.
lops." such source of otTence must he avoided. Very often, it' the
fat lie hidden from sitrht. the olijeetioil to it is lessened. Where
fat ;s not well tolerated it is prudent to conceal its presence. The
stomach if left unprejudiced may he more lenient as to its presence.
It may he necessarv to eschew the fat of animals and compensate the
want of this hv hntter. Hutter mixed with potatoes, hutter hidden
in milk puddings. Imtter melted withiish: these are comparat ivelv
unoliject ioiiahle. \\'here no such compromise is possible, then fat
must not he taken till the work of the stomach is over. If the meal
he of digest ihle character, in from one and a half to t\vo hours the
fat mav he taken as cream (with maraschino or other liqueur), as
cod-liver oil. or as an oil emulsion.
What each individual can do. or must do in order to come to
terms with a tetdiv stomach, is a matter of experience in each case:
and oiilv to lie ascertained hv trial, and indeed repeated trials. \ oi-
ls the stomach a 1 \vnvs the same as to tolerance. What can he en-
dured at onetime is intolerable at another. Whenever the system
has heeii taxed or upset the stomach hecomes intolerant. Thus \vhen
the system is wearied the stomach is hereft of miudi of its capacity,
and food ordinarily well-horne disagrees: and wliat. is more, the i:a--
trie revolt tends to hecome chronic. An American ladv-patient.
with dyspepsia, traced ]HT woes hack definitely to a certain dinner at
(Jenoa. After a Ion;: day's joui-nev she and her fellow travellers
arrived at the hotel just as the tahle d'hote was being served. They
sat do\vn and made a hearty meal. This outrage on a weakened
stomach in her ease led to persisting indigestion. She had then
sulTered for seven months: and hy the greatest consideration had
attempted to atone for the original outrage. OlTonce and repen-
tanee are neeossarv with an injured stomaeli which may he as un-
for^;\ inu r as a ( 'orsiean.
Then a'_ r ain anv mental perturhation may make itself fell either
as hv io-s of appetite or hv indigestion. Had news, received diirinLT
or shortly after a meai. substitutes for the usual eomfortahle sensa-
tions that of a stone in the stomach as the food lies motionless in a
palsied viseus. There is no douht that the di;e-tive powers of the
A ii'_ r lo-Sa xon are waning. fMir eai'ly ancestor.-; \vei-e e(|iial to a feast
aft 'r a hard day's mare hint!" or ti^'ht inir: hut not so their nineteenth
century descendants, who when their energies are taxed find the
stomach impaired in digestive eapai'ity. I >i-. l'a\y says that thi-
fact i- recognised hv experienced sportsmen.
Then a'j'ain there are stoma'-hs \vh:e!i re-ent the presi-nee of
lluid-. and. contrarv to what i- usual in indigestion, o; '.
agrees. In most eases of dvspepsia liquid or semi-iiqnid fo. ;. '., '::<
meat -infusions or milk with some carho-hvdrate-. sjjsea-ii
the -tomach. I)ii t in the-e exceptional ca-e- all tlu;d a- far ;
]iossihie has to lie avoided. If th;s he niridl v done then diLf''-':"n
goes on normallv and without discomfort.
Ha\inir thus iv\ icwed the causes of indi'_ r f.-t ion. and its form-'
and varieties, it mav he well to consider MS ijuanr.tv or extent. In
some cases the defect is so slight, that if the more notorious of m-
dia'c-tihle foods lie avoided ail is Well. Pa-lrV. Ulieookeil VCLTetahleS,
nut.-, arc to he eschewed : hut not hinir more under ordmarv eircu in-
stances. (Mhcrs airain cannot take pork, \'--a!. or cheese without.
su iTerin-j' for their indiscretion. Then come those \vho mav not eat
cold heef. or a hecf-stcak. hut who can inaiiair 1 ' mutton. !'! all
these, ai'tilicial pep-in may he enough I" g'-l them over their ditli-
cnlties. 1'ersons who are no worse than this have not mudi \<>
complain of; thev mav he put to inconvenience HO\\- and then. . -_
]iee;al 1 v when 1 ra vei 1 : ir_:'.
Then come those more irravelv alllicted. and who tva!!v have to
he \ cry careful al"Mit t heir d'u-tarv. They mu-t pa-s ; he ve^-eta' >]<-
as a rule, take verv little animal f i at once and that oniv of the
most d iL:'c.-t ihie character. Ki-h. especiailv white ti-h. and honed
or haked rather than fried: chicken, rahhit. or a sweethread. are
theeh.ief articles of food with them. Thev arc rest ru'tcd to miik-
ptiddings: and other puddings ha\e to he foregone.
\\;thsuch persons mailer- an 1 irrowinir serious. Thev can ire!
on I'airlv well at home with a cook trained to meet th.e.r -o> ,-;al
needs; \>\\\ ad diiiinir out is next to impossihlc, who ' hotel ,,;'.
hunieii-onie to them. It is we'll for them ne\er to forget to have
some pcp-;n near a! hand \\dicn eating;' a meal a\\'av from liotiic.
The indi'_;'c-t ion of males rarelv M-OCS he\ond this except ;n the
ca-e ill coll-ll 111 pt l\ I'S, or pef-oliS With Some all'ec'loll o| til' 1 stomac'l,
or ,-ojne acme d ist urlianee o!' a naturallv irritahle -tumach.
with females a further limit is no! uncommon, and then the <i:;cs
tlon of a Stltliclencv of food to SUStaill life hccnllleS fea ! 1 \ !_'ra\e,
(Mil\ liijiiid and semi-l hpiid food can he endun-d h\ the stotua'-n,
and that too in hunted quantities at once. Smal, ijuant.l.c- ol
meat -in I'n.-iiins conlaimnir some predii;"e-ted .-'arch. m:'i\ \\:'ii or
Without some malted [ireparat i>n, a haked apn!e. ..: the of
some .-; e\\ cd I'm it : such form t he d icta r\ . I ' - no; an IM-V matter
to " r'nir the ehanires " when the clmicf i- -o re-tr;ctc.i ; and
I':' 1 ' MANUAL <>F DIETETICS.
1'ossiblv. tlii' appetite is small and the palate dainty. 'Tin- hndy-
i:iconie is neces-ariiv sni;t'.i. and cannot In- raised. Then let the
Modv-cxpenditure ] - reduced to the minimum. The patient must
_T" l" '"';: aii'i. surrounded !>y bed-clothes in a \vanu room, the need
:'<>r fuel-food is i'roti^ht dwn to tin- lowest point: while perfect
',;.;;'! rcduc.-s til'.- demand for food to supply force. Ki^iil economv
,s neces-arv \\ it h ~!, r ;;:.. means: aii'l tins has a w.iiiT application than
:-: i-'iMiinit;: ' - t. 1 1 ai'plics to t he Imily piivsii-aiiv as well
a- I" M-:al un '- ". A -mail ine..Mie is iiieimipatihh 1 with
!:iU'-h fe. I)'-'_ r L:a:'v is the alternative. The same with
th>' !nt.i\ : tii > :'_ 'iiiir> exceed the ineumin^s. then exhaustion of
t :: ' . - i- :ne\ itaoie.
Tlie -inaii'-r tii" I'liik of the foo.l whieh can lie taken at nnce the
-:.". r i-rval mu-l !" ht-twivt nieais. Kven when the wonted
fan- ' ' . . :; nnlv in limited quantities at on^e. a small
amoii!.: of :'--: '> '.'.;-;* meals is usually a irood praetiee. esjiei-ially
er. \Vhen the patieiit is reduecd to the condition just
<"-: >!. the inti - ' ,'ixt nieai.s must oe mailc verv -hort.
1' >-;ii / it -houM not e.\i-eed two hours in some cases. The t'a-t of
. - ' n -. Then.- is a wcll-rceo; ' lency t a iower-
ti e fiody-eiier^ies ''. th" -mall hour- of t!i" mnrniiiir. Some
: A.M.. is. ino.-j iic-ira!ile. \Vith man; ladies ,,;' -mail
i-apa'-itii'S sii"h nocturnal nu-ai- a<id materially to their
. . '.'., ; . / r,f ' . Such per-ons of i-iiurse arc readilv
: . ' >' ; - liv ai -'. : ,-. :.;:". ji >ne of t hose
ics are so mad as to ne'-e-:-!tate their
'. .:._ ier ;' -'-'.. ' ' an A-v i m; :h u -h ifoud ejl'cct- that
; h"V arc . rime -an" :'ii to !. at !;i :'_. i 'ontn lilcd. t hey
(:" !"'._ I.- '!. -<i - . A-yium restrain! onet-
luof". A :,' ; t h'T" an- p'-r-on- who-i- st oma"hs f"-" ml tie these eraxv
', Id v-i iepsia. feijiiir-
: :._ r a -' r. ' : . , ( ' .-.' improvement is
ma :- / . tii" \vo; ;. -- ;- i-.-a.-i cil; n drfore lon^r -oni" upset
'."--.':'-' . \ I Sll'-h i~ til" lli.S-
.-,.;',,,.,,.;, .. \ cs^iti il teaches i- t he
. P'I t !!"V \\ ,o! . c. . . '"in" watchful-
."--. . . ' . : <:, , !!::.'_'. :- i he onlv pi'otection
l'i-o of .->,. 'S furiii-hes more pa: i<-nts t han
. . - . ' . if Hot pi i^cs-crii (if
: ' iot"iit ;a 1 hod v-
income muM never enable t hem t" TO;!. Th'-v are '':'
te.d'jvnt in e\ eru hnii: 'mi their food-reouireme:.;-. K .
thev are very careful, their politeness i>ft>-!i ; ':--'._-
inducing them to eat something which ;he\- k:,"\\ l:'"iii <-\, ':'.
disagrees witli them, luit which llicv do ii"t like * '.'n~<\
Of till- class of person I>r. Pavy speaks a~ f'l!"\\- "\\i.'"
chronic impairment <>f power exists. a- in ordinarv d ;-. - a. '
patient must lie i_'ui'!ed liy what i; i- found liv c\;i-i'ic!ii'c \ . a_r--c.
\\'hilst a void in-- that \\ hidi i- known to !n- nf an i i : i :--.-: i'...- ;. a ::;..
ainl whatever, through ii'.iusynerasv. n:av happen in par: i ;':!! i
stances to up-ej the stomach, th'- ina\iin of management >iiou!.i '>
t" keep tlie (iiei a- closely to what i- natural a~ the eiivinnstan'-.'S
df the ea-e w ! ! i permit. I''i'i'i|iie!iri v. ln-eaii-e a per-on ;
from livspepsia. he is recommenun! tn lea\e u;T t!i:< a:nl tliat article
of f i. and mav per!iap< i;i the c.iur-e nf time !,, re luce.! in ;akiii'_ r
xcli!>.vely. or almost exelu-iveiy. liijuii] uourisiime!:!. S:ich in
it.-elf i- sntlicieiit to lower the aireadv enfeehlcd puwer of the <;.'m-
acli. 'I'he oi'Li'ai!. Lfettinir no einplovment. lieciime- \\eaker and
ueaker. and is also prejudiciallv intluenced !>y the dcfcctivc'iv ':\\r-
i.-liei! state of the system. The aim ( if the.phvsician in thc-cca-cs
.-hould lie rather to raise liy appropriate treatment the di-v-::\e
capacitv to the level of digest inp: li^ht but ordinary food, than to
reduce the fund to an adjustment with a low standard of digestive
power. "
This aspect of the matter i~ here well put. Instead of eui;:nu'
otV one bv one the diiTrrent articles of diet, it wou'd lie !ietieri:i
cverv wav t" ! able to tell the unfortunate dy-pcptic of some ne\\
article of !' i which can lie taken safei\. \\'h;ie inti-oduc;i,i;- ;i,;.i
the stomach the food requisite and, indispensable for the bod\ need
in anv po-sdile shape, the aim is to ra:-e the digestive capac
appropriate medicinal measures as well as suitable food. \\herc
the system at lar^e is badlv noui'ished the stomach >hare< in the
general enfecbletiient. I'reii i^oted food, mav be una\o;c,abie to
rai-i. 1 the general tone; not to relieve the stomach of ail work. T"0
rea'lv resort t" peptonised foo^i- mav tvailv t;il fnrllicr loucf tiic
ea[iacity of the stomach. On the oilier hand, anv iiidi- :v;:ic, n;a\
throw the ease back and all the lal'onr be thrown auav. > d a new
start be necessitated. ( 'onseqiirin Iv. thr trcalmen: oi -: mi
is not a matter of o|l : -hand direction-;, but of deli :! o\er
each ,-ase with il- individual reijuin-meiit <. T.HI '' '.iiieiiiix 'he
livsitentie leaves c>!l' otic article of f. >nd at'ler anoihcj- :. the palate
MAM' A I, OK IHKTKTirs.
loathes the t'c\v remaining articles of diet, and the starving civat ure
oft. -ii fasts sooner than eat them. The hod v must he fed untd the
diu'er-tive capacity is regained, if possible. That, Itv a judicious diet-
arvaud proper inciliciual measures the digestive organs can lie n-
stored to a fairiv capa'ole condition, is a mailer of fact. But in had
oi 1 continued cases the loval co-operation of the patient must hack
U|i the wise counsel nf a competent physician: anv defect in either
be HILT fatal to success. \\ lien dyspepsia is linked with clironic con-
si ipai ion--a common occurrenci this matter must he pointed out
to the patient elearlv and forcihlv. Such patients rarely possess the
perseverance indispcnsahlc to success. If the [laticnt noes persevere
courageously tiie reward comes. \\ e vvt what We deserve in life to
a \erv "Teat extent, and the maxim certainh holds v;ood nf per-
>ons of weak digest i ve power.
There are two mat ters dvspeptics must ever attend to. (1). never
to touch meat that has heen twice cooked, though this liolds less
against lish than other meat: and ('.') fat which is rancid, or which
has heen exposed too lon^ to heat, or to too hi^h a temperature.
(hie American patient could e;,t cold hutter in anv quantity, hut a
fried whiting was an outrage to his stomach.
\\ hen a dvspeptic is reckless (as was in all probability the ease
with tin- late Tom ('arlvle. the philosopher), lie endures a ".Teat deal
of avoidable sulTerinLT. But many dyspeptics arc of this class, and
especially intellectual dyspeptics. They perpetually commit outrages
on their digestive organs, and sutTer for them, hut all the same
they hold on their own way. Kxperience 'iocs not (cadi them.
They are very unsatisfactory patients.
<>ilpTs a^ain cotiuuit these recurrent outrages no 1 , from \\-ilful-
ne.-s hut I'mm forget fulness. \\h:le ihesuhject is iieinij discussed
in the [ihysieian'.- -tud\ they a: - e alive to ail that is said, and endorse
it all. But \\ lien their minds are occii pied hv other mat 1 ers a 11 this
- forLTotteii. and the indiscretion committed; and it is only when
the unpleasant consequences put in their appearance thai they he-
conie coiisi-ioiis of 1 he; r foi'--et I'u 1 ness.
The nio.-t unfortunate matter is that one such act of forget ful-
ness ma \' u tii in a OIIILT lahor o| careful d iciary. and t hi'ow the pat ii'iit
hack to chmh [he painful ascent. It is the -tone of Si.-vphus mice
llli ife.
1'iut one curious well-recognised fact there is in connection with
ind _' ~tion, \'i/.. when the crav;iiL r l'"i' a. certain article of diet is
very stroii;.!'. even if it 1 f a mo-i ohjeet lonahle nature a- regards
dyspepsia ijpncrally. it commonly happen- thai ;; doc- ;;.,
linn- and when it is safe !'> permit tin 1 _ 'rat ili'-at ion <>:
is a mat ter vet hidden from us.
Mill, ail the same, modern ehemico-phv.-io!o";ica' km>\\.,
do';c milch to cnalile 11- In help tin- il V-pept .! ill il,- troll'li.
c.ailv when tlic patient is resolute almiit Ix-niLT reiie\ed.
(,'uti/i/ /)f/x/irji.it/. AVliateVer the i i i Hi, -il 1 1 i> -' 1 ' ) lie e! i-< .1 ; : : ; - r- ',
a!ui overcome with the ordlliarv dvspeptic. ihev ai'e enliam-c.i >. ;],-
ea-e (>!' t he p)U t_V I lyspe pt ie. Tile re.l'ief \vi:! 1'etllelll I ief what i- -;!,-;.
in the chapter deaiiiii: \vit !i ;j-"!i' . a 1 - 1:1; hepatie ri'vi'simi aiiii 'in-
i'i ii'iua! .mi of uric aeui. \\iie;iiei- mv :i-".-l lin-i.-; its wav intn the
irusti'ie secret inn. or not. is a inatter ^in'oiiile'l in ilarkiie--. (''-rtain
it is that the U'ollt V (1 \ ,-pept ,. i- tl'oul'ieil \\ , I !l ai'liiiiV. I'Hi- aei.i
siiivents are ilist inet lv iiniieateil. aii>i withniit tiiein mere i;.e;i>i^'.
however eai'i't'iill v eaiTied mil. is !i:;i partiaiiv sueee>sl'ii!. Tin-re .-.
too, ill tllese (h'SpeptieS a llceitlcd telldelley t, i'ui'lll 1'aMei'i l'a : t V
aeids ill the stoiiiaeh fro] 1 1 anv fat t hat ha- iiad [no lutieii nf : in- i'n-r.
( 'n:i-i-i(iieiit iv ail fried meats are to !>' a\ <>.'if !. e\ >!! itn\\ :i [n ;i-:i.
Their lish should 1"' hoiled, or haketl. and u hat is left. e..id .-ho'ii i
lie served up as lish |iie. which mii-t ii<>! lie iuo IIIM^; :u the o\i-n.
Then an'ai n t he v til id sweets IIHI n ad , , \ t urn ae.d in t m- .-ti>inae!i.
and e-peeiall\" the eaiie .-u-'ar addeii hv t:;'' conk to fruits. ,\- a
1'iile a u'outv per-on is not a " s\vect Lout h." ami -\veets are a'ljnreil
hvtheiu. Still many would like to take .-tewd Iruit, if thi- eii!d
lif iloiie with impunity. As much luearhonate <>\ pntash as v. . .
on a HiniiiiL:', or a ijtiarter-hit to each pnund of fruit when put in:<i
t!ie o\fii t'> ste\\'. \\'iil neutralise the aeiditv, and lifiiiu' 1 1 ui the nat-
ural sweetness of ! he i.evulose suirar in the fru.i which is ma-k' d
li\ the tVee acid. Sii'-li st"Wcd fru.t \v.ii no! oniv not "ead.i\ ::;rn
:ic;d. lei! it provides an uric acid solvent in a verv palata'o.e and un-
i '! iject iona! lie form. Hv usin^ canned fru.i in winter and -IT:._'
Mil MI' stewed fruit ca n l>e had all the \ ear mu mi. < >r a I laketl a p;
rail lie eaten ill-lead.
Milk [imldin^s made without eir^s should form a lar^' 11 p"
of the dielarv, and the.-e should not lie sweetened I'V cane >UL''a: - '>:;:
li\ othe!' sii'^ar, as milk suL;'ar or he\ u,o-c. An adm:\iurc ..; ma.;
with farina perhaps ^ives t he Ix'st re-uit. l-'ai\na--i'ou~ ma: ti-r \\ :i. -h
ha.- pl'e\ loll-i \' I iei -n e\ I m-rd to ileat , as -I :rc'ided Ilia l/.e. cooki ! i I' 'Ill-
ill V. Ill all ed nee. or lirokell liiscltlt . etc. , ,-iioii d 1 >e .-; in'ed i, 1 1 U " h an
eijua; ipiantitv of LTround or crushed ma.! in a puiidii'.LT .4i; ::
tiver this should lie poured milk li"t c:i"ii^:i !:;; i:"'. i"" !:; '
M AM'Ah OK IHKTKTH'S.
sipped. Thi 1 dish should lie placed when 1 it M'lll not <^et cooler
(iiiul not much hotter) t'di- ten niiniites, after which it can he put
lllto i lie dVell lollLJf enough to hcci uiie Sl^li t 1 \ . Such [>U< 1' 1 1 HIT < Iocs
in M require to lie kop; in l lie oven t ill it is " enouirh " -as is the case
with puddings inaile with farinaceous niaiters which have had no
previous aerjua in (a nee with heat for t he materials have a 1 read v lieeii
cooked. Such puddings will not turn sour with most <iotitv dyspep-
tics, thouLi'h the opposite uiav he the case with a small proportion.
Then a staple article of the dietarv will he soups of all kinds.
thickened with hrokeii biscuit, malted rice; or cooked farinacca- as
the A. I!. ( '. cereals, the farina coda, shredded mai/o, baked hom-
inv. etc. If sa^o or tapioca be used, either should be placed in a
d i-h in the oven for an hour or two hours, care hcmu,- taken t hat t lie
farinaceous material is not scorched. Or the sa^'o, rice, or tapioca
should be well boiled ere adding them to the soup. liv so doin^
the n-k of lining the stomach with quantities of insoluble starch
W'liild be avoided; a matter which has been discussed in the earlv
[tart of the chapter.
Farinaceous matters- supplying the essentially necessary <n';ipe
su'_r;ir to the bodv--must forma verv laruv portion of the dietary
with iroutv dyspeptics, and must be so treated as to ^rive as little
trouble to the digestive organs as possible. The more such t'arina-
ceous matter ha- been cx|)oscd to heat the better, and the lessdi^es-
t ion t hey I'eipl 1 1'e Wit hill t lie bud V.
Soups made witii cooked farina, boiled and baked fish, milk
puddings prepared as directed, baked apples, and fruit stewed with
potash, grapes, bananas, and such natural fruit as agrees, carefully
masticated so as not to oll'end the stomach by tangible lumps, must
form the staple dietary of I he 'j-outv ilvspeptic when the stomacl)
is yerv irritable. \\"hen a careful curative course has led to a better
state of atl'airs then some chicken, rabbit, tripe. swcetl)read and like
d iLfest i hie ma ttei'- may be cat en. \Vell-liiashed potatoes with cream,
or butter and miik warmed tniM't her. put duwn before the fire to
hmwn (better than hein^ put into the oven), in order that heat and
tiM'i-tiire mav .-till further modify the starch granule, will form a
desirable change.
Cold fat i- less apt to t'"i'iii fatly acids than warm fa!: and bis-
cuits t he plainer the better and butter should furm a considerable
portion of ea"h uieal. Ail sweet bis'-uits contain i-ane siiif.'ir. aiul
.-o are apt to turn acid. Tho-e which are made with malt are less
objectionable. ('ream with stewed fruit is al-o a suitable fat.
FOOD IN INDH.KSTIuN.
As to beverages, a little claret or wine of like character. u!;!i
8oii ic alkali ne water, (better if effervescing), i >r per hap- alone, ma v be
desirable. Or a littU 1 pure s]iint and much water mav in- preferred.
As to tea, coll'ce. ami cocoa, there seems little objection to tiiem.
unless one or the other lie found aetuallv to ilisairi'ee. 'I'ln- eai.i 1 -
su^ar aildeil to sweeten them is the cause of iniii'h of th* 1 ari
(.'iToneously attributed to tlie beverage itself, it seems to me. \\.\k
with eijiial parts of some mineral water, a- seltzer, it' m;M alkali he
ni-eded, or Vichy, or X'als. if mure alkali be desirable, forms a .-tiit-
able beverage.
Like all dyspeptics the p;outv dvspeptie must ufi\v his m;nd to
t!ie trcatmeiil of his own case. If the dietary is restricted and the
reu'imcn irksome, t he sutVeivr must remember that he is the person
beiietited; and that it is only by the observance of strict dietetic
rules that relief is to he obtained. The power to help is limited to
the patient's determination to be helped a matter the dyspeptic
must not forget or overlook.
CHAPTER XXX IT.
T1IK FOOD IN IJILlorsNKSS.
1'uon AISI.Y tlii' contents of this chapter will excite ktH'iiev criti-
cism than any other in this book. The vic\v taken traverses the
ordinary opinions on the subject; and yet an increasing experience
hears them out. Some half score Years a<_n> a consideration of the
chemical composition of the bile acids led me to reflect upon their
derivation; and from that a^ain to raise a practical issue, viz., the
proper food for bilious subjects.
The bile acids are t\vo. The one (Jlvcoeholic acid with a
formula ('. ,,.!!,, ?s"O r ; the other Taurocholic acid, with a formula
( '.., 1 1 1: XSO,. l)0th contain nitrogen: ; md one, also, some sulphur.
And these two constituents point to their origin in the albuminoid
elements of our food. Then comes the further consideration that
persons who are bilious in their early years are apt to become ^outy
in middle aLfe and advanced life. The \vhol<> subject was one of
deep interest. Instead of bile benur derived from starchy, sugary,
and fat ty foods, reputed to be " bilious," it evident lv had ot her asso-
ciations. The dietary of lean meat. . Irv bread and tea. without
Mii;ar or milk, in favour with the bilious, seemed erroneous in
theory. Hut how about clinical facts? Th' 1 proof of the pudding
is the eat inir, after all. One confirmed bilious subject . of the bil-
ious d iai lies is. and wear HILT a !o->k of persistent sulTcrinu'. came under
mv care and seemed a most suitable subject foi 1 experimentation.
"\\ ith some didiciiltv .-he was induced to ^ive up the meat, bread
and tea. and take to farinaceous matters and milk puddings, and
much to her siirpn.-e soon felt very mu<-h bettei- for the change.
II' 1 !' case has heell aiillded to before III the chapter Oil F<)O(1 111
A ll'ect ions of t he X er you. s System, and -nice writ i HIT that chapter an
opportunity for ^oin^ over (lie facts (as i here stated) has oil'ered it-
self jiud contirms them. The clinical facts fitted in with the theory
so completely that further trials were made. The results of these
further trials have pointed unmi.-takably in the direction that much
albuminoid food is not desirable for bihous pei'.-on-. despite the fact
that they jind such food sits well upon the stomach. Such food
FOOD IN nil. lot SNKSS. i'|:',
innv be agreeable to the stomach, hut it ccrtaiulv taxes th-- liver.
The analogy used in " Indigestion and biliousness s a- follows:
"A vouii'4 man mav linil favour in a girl's eves, but her parent- mav
not lie satisfied with him. Acceptable enough to her, tin- MTV
(|iia!ities whicli wei^rh favourably witli her mav he those on which
her father specially founds his objections. That food wliieh is
acceptable to the stomach mav be the verv matter which disturbs
the liver." Five years' further experience bears out what wa- writ-
ten in ISM, when the book appeared.
The function of the bile is, so far as we know it, the emul-ion-
isiiiir <>f fat. If fat be abjured t here can exist but little necessity
for bile. If a disproportionate amount of albuminoids In- eaten,
the material for excessive bile is provided. There is a disturbance
D{ balance in the ecoiiomv. If fat cannot be taken the excess of
albuminoids can be avoided at lea.-t. And the praefieal result is
relief to the bilious symptoms. In the present stale of our know-
ledge it is impossible to lie more explicit. Some dav it mav be
feasible to u'ive a more satisfactory and complete explanation. Our
acquaintance with the functions and operations of the nver is re-
cent, and incomplete: but 1 venture to think the rational outcomes
of the above consideration will warrant some practical conclusions.
The food of the native inhabitants of warm count ru-s as i :t k,.n
fim l^r. 1'avv is as follows: The Mexicans are "accustomed to
uniform nourishment of an almost eutirelv vegetable nat uiv: " wh.ie
the inhabitants of New ( 'aleilonia " subsist eh ictlv on roots and li-h
and the bark of a tree; " while in Ilindostan:- " I-'rom the earliest
period the most general food in Imlia has been rice, \vhieh : >r;ll
the mo-t common food of neariv all the hottest countries of A.-:a.
I'uise. root- and fruit, are also larirelv eaten." (iliee is in Lrreat re-
ijiiest. In (. 'ev'.on they ea! " rice seasoned wit h sa ! t . and a t'e w \eire-
talilc-." In K;_rvpt " vegetables form the principal food of the 'ouvr
orders." In the Sahara desert "all live on dates." IJiiiter and
['aim oil are also m demand in various par;- of Africa.
Tiie Spaniard has his bread and oil and onion-. The l:a.:an,
mai/e aipi macaroni. The Turkish hamas ;< a viLforou- man. \et
hisdictarv is almost eiitirelv vegetarian.
"The attention of Herodotus was called, to the fad that :he
I'er.-ians. the manliest and most sport ini, r nat ion in the o.d world,
had at meal- not onl\ .-cverai dishes, but sc\eral course-; of ve^etabie
food, preceding a \'erv moderate allowance ol so.i.i meal. ' il\:n^'
( 'hamliers.)
244 MANUAL OF DIETETICS.
Set against these facts the other fact that when the Anglo-Saxon
persists in his home-dietary on the plains of Bengal he becomes the
subject of biliary trouble, and not infrequently of actual disease in
the liver. Whereas men who adopt the dietary of the natives suffer
comparatively little.
Indeed the relations of hepatic trouble to an English dietary in
tropical countries is a notorious fact.
Regard being paid to what has just been said, the great object
of the bilious, like the gouty, is the avoidance of albuminoid arti-
cles of food, or the taking of them in verv moderate quantities.
How many persons, who, when dining out. indulge themselves in
meat and drink, lind that a calomel pill and a seidlitz powder en-
able them to escape sundry unpleasant after-consequences? That
fact throws some light upon the relations of the food taken to the
function of the liver. Loss of appetite follows any excess in food;
and what does that tell us? When the liver has more material
brought to it by the portal vein than it can deal with, loss of appe-
tite is the result: and by a period of abstinence the liver works
round, and all goes on again as usual. The stomach can reject its
contents. The bowels can sweep out objectionable matters. The
liver can do neither. If not protected by anorexia the liver would
have rather a hard time of it with persons who think that the regu-
lation four square meals a davuiva part of the Divine Scheme.
Loss of appetite comes to its rescue. 'The bilious disturbance caused
by a surfeit, especially with children, is another contribution to the
subject. The liver is the furnace in which the waste' and super-
fluous albuminoids are burnt, we are told bv physiologists. When
there is an accumulation, pyrexia often comes and helps on the oxi-
dation, or in other words '" Nature holds a bonfire." P>y such means
the not readily oxidisable nitrogenised matters are burnt up.
1'ut briefly, with bilious persons it is well to reduce the amount
of food taken to the body-needs, or as near this as can be attained.
And especially is the moderation to be practised as regards those
nitrogenised elements of our food from which, obviously, the bile
acids are derived.
Bilious persons. th>'n. should avoid the solid joint at meals.
Joints, chops, and steaks, indeed lean meat in every form, must be
taken in verv small quantities, if at all. Fish, as a less concen-
trated form of albuminoid material, is to be preferred to flesh.
Vegetables should be larii'e'v eat n. Fruits do not disagree. Eggs
and milk have an evil reputation for encouraging biliousness. Fatty
FOOD IN lUI.IUt/SNKSS. i'j:.
and sugary matters arc reputed to be bilious: but if this be sn (and
the vie\v lias a basis of fact) it must be indirectly ami not directly.
If the readily o.\idisal)le hydro-carbons attract the oxygen of the
bodv. the less oxidisable albuminoids will be left over, the a-ln-s
or cinders of the body-combustion.
Farinaceous matters and vegetables should form the staple diet-
ary, accompanied by a certain amount of fat: the amount \arvinir
with the season, climate, and locality. In temperate climates a
certain amount of the concentrated fuel food, the hydro-carbons, mav
be required. In tropical countries the dietary cons.sts of carbo-
hydrates only, with advantage. The ^astronomic proclivities mav.
however, u'o in another direction: but reason must be brought to
bear upon them.
This view of the dietary appropriate to bilious persons will strike
manv readers as heiiiLr novel, and so antagonistic to prevailing opin-
ions as to savour of unsottndness. The testimony furnished bv mv
limited experience may seem insulHcient to warrant it bein^ r put
forward so contidentlv. If the experience has been limited and
recent it has at least been convincing so far as the writer is con-
cerned, h is one of those matters which can be reasoned upon
rather than demonstrated. And if the reader remains incredulous
tin-re seems to the writer no means of convincing him. If he him-
self be planned with biliousness let him p'ivc the matter a fair trial,
and note the result. There are manv matters which, if they had
had to wait till they could lie proved to a demonstration before they
were launched into the world, would have remained unborn. On
t he other hand a sweeping change of opinion and pract ice must have
some solid foundation before its propounder can expect the w<>rid
to accept it. The arguments <; - i yen in this chapter seem deserving
of attention, and the verdict of the world can be awaited with some
confidence. My experience has iroiie in the direction that what is
sound in theory works well hi [tract ice.
The bilious person should avoid the e^'irs in the traditional
breakfast - bacon and e^s taking the fat of the bacon by prefer-
ence. Then if there be anv tish some of a should be eaten. In
summer some lettuce or salad mav lie added: in winter some fruit,
especially t he apple. There exists no real objection to some cream
and siiLrar l>ein'_ r added In the tea or cotl'ee. Then the much should
consist of some s'Uip <r fish with weii-mashed potatoe- or other
vegetable, and " pulled bread " or biscuits. I)inner should consist
of some lish or chicken, a vegetable course, milk pudding, and bis-
L'4o' MAM'AL OF DIKTKT1CS.
euit anil butter. Such \vas the dietary on which :i gentleman whose
liver gave him niueh trouble got well, after being under several
physicians of repute without avail. On his usual dietary, \vhieh
embraced a considerable quantity of lean meat, he grew worse and
lost tlesli. This is a common story. \Vlieii the live! 1 cannot carry
on the proper metabolism of proteids into the serum-albumen of
the lii/niir xniirjninix, but breaks them down into bile acids or urine
solids, the tissues go unfed. In fact the albuminoids consumed
" o-o to feed t he d isease and not the patient." to use an old-fashioned
and time-honoured expression now getting lost sight of too much.
Of course it is well to raise the tone of the liver bv resort to hepatic
stimulants at the same time. Hut by reducing the demand upon
the liver as regards its function of dealing with albuminoids it can
perform its work, and normal metabolism goes on. The conse-
quence is the bodv is once more fed and the biliousness relieved,
i.e.. the proteid matter is going to its wonted destination the tis-
sues, and less bile acids are formed. licee.ntlv a well-known writer
of fiction came under my care with a tongue covered with a thick
fur deeply stained with bile, and lithates in her urine. She too
had been losing llesh and getting Worse on a meat dietary with some
alcohol the proper dietetic means to get strong in popular belief.
She adopted my suggestions with quick and prompt relief, and got
well most satisfactorily. When the liver is out of order the ordi-
nary dietetic means for gett in^r strong are rather mischievous than
useful. It is not what is swallowed but what is digested that is the
question. Primary digest ion goes on in the alimentary canal, and
secondary digestion or elaboration is performed by the liver. Food
niav be taken and digested, but if the elaborating action is defective
nutrition fails, just as much as if food were withheld in the first
place. \\hcn the bodv is starving from liver inadequacy, to force
1 .
down liberal quantities of generous food is to overtax the liver and
hamper its action still further. Food rich in carbo-hydrates, and
containing but a small proportion of albuminoids, is that which is
rcallv indicated and required. Th'' appetite may be feeble ami
capricious, the palate mav be daintv and have its preferences; these
mav be met, but after all the function of the liver must be remem-
bered: and with it the true body-needs.
( i rape sugar, the fuel food of t lie body, must be supplied in sutli-
cient quantities. Albuminoids for tissue repair, too. are required;
but the amount actually necessary for that end is but small. All
beyond the bare necessaries are superfluous and only hamper and
K()()|) IN mi.KH SNKSS. _' 1 ,
embarrass tin- liver: and increase the amount of In!.- acids, or urn:''
solid.-, as the case mav In-. That i- tin- lc.--on taught us hv inoiii-ni
advances in phvsioli>".-y ami clinical medicine.
This is all rank heresy in t!ic opinion of the people at larjv.
\\'lu-!i a person is below par. plentv of animal fooil and. jj-uo-l \\ine.
tonic- with iron, arc the things to jjvt him up certainlv in 1110-1
cases; Itnt when the liver i- involvci] there i.- an error m the e.jiia-
tioii. So lonir as the liver is competent to it- work, .-o Imi^the
eijiiation is correct; but when the liver i- uneijual to it- w-irk this
regimen but further embarrasses it. The number of stones i-.M
one of the failure of this plan to vvt them strong. bv different
patients, is conclusive. A number, too, furnish .-nine curious corrobo-
rative testimoiiv. Thev hrin'_r a specimen of urine for examination
in a bottle: and not infrc<|Uently that bottle has on it in rai-ed let-
ter- " (Quinine and Iron \\iiie." It has signal! v failed m their cases.
A look at. the tongue and a few well-directed questions soon lighten
the matter up: and on a different regimen, dietetic and medicinal,
improvement set- in. Hut tlfse persons are often hard to convince
At !ir.-t siu'ht it does seem an odd way to increase the strength.
\ i/.. cutting down the food, and especially the animal food. 15iit
the alteration is soon felt. ' She stoops to r<iii(|Uer." And tii.s
mano-uvre can be [iractised witli satisfactorv rc-u!ts in hi'pat;c in-
udeijiiacv. No chain i.- stronger than its weakest link. The appe-
tite mav be fair, the -tomaeh ("ipablc: but the liver is weak. The
nutrition is defective usually when the liver i- incapable, and til--
appetite fads. That is Nature's wav of a! taming a new balance b\
" levelling down." Hut an appetite is held to lie a man".- inalienable
ri'^ht: and so lie tries artificial means to create one. lie defeats his
own end-. He is thwart inir and traversinv: nature's provisions, and
s.o i he plan fails.
\Vheii ih-- liver is incapable it is we'll to reduce the demands
upon it to its capaeit ies.
S'> much fur the dietarv in biliousness.
Now about the drink. A naturallv feeble liver cannot L r -'t on
with malt li'iiior-. \\ h'ther it is ch-'Ia rnia or lith:emia. malt l:-jiioi-
i.- pernicious: e.-peciallv uilh jiersons of the "Arab" l\pe, /...
hii;'hlv developed nervous sv-tem and small vi>ccra. Malt li-jiiors
prepared liv the ! ; .n'_;-i ;-h sv>tem of brewiiiL;' are speciailv injurious
to an incapalile nr sen-itivc livci 1 . The beer- breue.l upon the (it r-
man or lair-T system are le-s objectionable; and mans ' li\eri-h"
pei--on- can drink beer on the ('ontincnt \\'h" cainiot toudi it in
MAM'AL OK D1KTKTICS.
Kngland. Generous Ay ines too have an evil influence. The wine
must lie pooi- for most bilious persons. Often even wines must be
foresworn and some weak spirits-and-water form the sole beverage
or food adjunct.
Abstinence, both as to meat and drink, must he the rule with
persons who possess an insufficient liver.
This may seem a hard conclusion, but it is a simple expression
of the facts. How far people can inherit an insufficient liver, is a
matte!' about which there is not much doubt: we know gout runs
in families, and so docs biliousness. lias the advance of eivilixa-
ti"ii a deleterious effect upon the viscera ? Does the heir of all the
ages ilnd amidst his rich inheritance a waning capacity in the liver?
It would seem so. at least, in many in.-tances. There is no apparent
impairment in the physique of some families whose history is known.
as, for instance, the reigning family in Kngland. Uut while this is
([iiite true of some families, there is much evidence, and accumu-
lating evidence too. that when the fat hers have eaten sour grapes
the children's teeth are set on edge. Dr. .Murchison follows Dr.
P>udd in thinking most persons have competent livers, but "in
other- the liver scons only ju>t capable of performing its functions
under the most favourable conditions, and it at. once breaks down
under adverse circumstances of diet, habit or climate. This innate
weakness of the liver is often inherited. The person is horn with
a teudeiiey to biliary derangements."
\\hen a person, man or woman, inherits an insufficient liver,
gastronomic indulgence i.- thereby forbidden under a penalty.
('II. \PTKR XXXIII.
FOOD (JIVKX OTHFRWISF THAN I5Y T1IF. Mol'TII.
Tn KKI: are certain morbid conditions in which it becomes neces-
sary to f red the patient otherwise than by the month. Kspeciaily
does this becomes necessarv in acute disturbances of the stomach.
There arc. however, other circumstances where such alimentation
becomes desirable. Sometimes the appetite is so small, or tile dis-
taste for f 1 so stroii-;. that the amount taken bv the mouth i.- in-
.-iiHicient for the wants of the system. I'nder such circumstance-
it 1 tines desirable to eke out these scuntv meals by some t',,,,d
ofiveii // /'ii'ti/ni. I'nder other circumstances, especiallv with
marasmatic children, it is well to use inunctions with oil.
Before proceeding to describe nutrit ive enemata and tlieir con-
stituents, it mav be well to consider some anatomical and phvs'.o-
lo^ical facts which will piide us in practice. \Vheu food i- iriveti
bv the mouth it meets with the (lip-stive ferments; tirst. the saliva:
.-ecoiid. t lie gastric juice; third, the pancreatic secretion. Tin- lar^e
intestine has none of these. The seeondarv digestion in thecoion
i- somewhat of a misnomer, and as such misleading. " ' >f the par-
ticular changes whiidi take place in the larvv intestine we have no
detinue knowledge, but it is c \ceed in^lv probable that ill the volu-
minous ca-enm of the herbivora a lars/e amount of digestion of a
peculiar kind jnu-s on. ^Ye know that in herbivora a considerable
ipiantityof ci'llulose disappears in passing through the canal, and
even in man himself some is probablv digested. \\eare driven to
suppose that this cellulose ditn-stion is carried on in the iarp- in-
testine, thoiiLfh we know nothing of the nature of the a^eiicv bv
which it i- ell'ecte,!. The other digestive idian^es ;i re probably of a
fermentative kind. 15 e that as it mav. whether (litest ioii, proju-rlv
so-called, is all but complete at the ilio-co-cal valve, or whether im-
portant chanp's .-till await the chvme in the larger intc-niic. the
chief characteristic of the work done in the colon i- absorption."
l.M. Footer. F. U.S.)
The only matter we arc certain about is the ah-m-pl inn of soluble
matter. Staridi must then be converted intn soluble ju-o'luct s for a
id" MANUAL OF IMKTKTIC'S.
nutrient enema. IVoteids must lie converted into peptones for the
same reason. ('./'., that there is absorption certainly. As to fat. it
is highly questionable how far it is of use in a nutritive enema.
Fat is emulsionisrd in digestion and in minute globules passes into
the mouths of the laeteals in the intestinal villi; which, as M. Fos-
ter puts it. mav he said to '"Cat the fat globules." lint the intes-
tinal villi cease at the ilio-co'eal valve; and therefore the fattv mat-
ters of nutrient enemata can he of little nse. Tins is an important
matter, on \vliidi it is \vell to have clear ideas. Bidder and Schmidt,
in a case where t here was a duodenal list nla. found that " Fats intro-
duced into the lower part, where they could not be acted upon either
t>v the bile or the pancreatic juice, were but slightly digested "(M.
l-'oster). There must, however, exist some other m<>de by which
fats can leave the alimentary canal (probably as soaps) for " the por-
tal vein during digestion contains more fat than the general venous
blood." the same authority tells us. It can, however, not, so far,
be shown fhat fat can pass through the walls of the larp- intestine.
The same authority quotes from Bauer "Absorption from the larire.
intestine after injection /'/' annul, or through a fistula, has been
observed not only in the case of soluble peptones and su^ar but also
in that of the white of et^. caseine, and starch." Hut there is no
mention of absorption of fat. Consequently we may sty that fat is
practically useless in a nutrient enema because it is not absorbed;
and that when the svstem needs fat it is of no avail to MJIVC it by
enemata.
Of old a nutrient enema consisted of beef tea, the yolk of an enir.
and milk. Of these difl'erent materials prohably the extractive- of
the lieef tea and the milk-supir of the milk alone were absorbed
to any extent at least. If brandy were added, probably it. too. was
absorbed. Of the other matter, as the casein and egtr albumen, some
were po--sibl v absorbed.
The bowel really is adapted only to the absorption of mailers
which have been digested above in the small intestine. If matters
be introduced into it from the other extremity, they ou^'ht to have
been subjected to a like action previous, to their occupation of the
lower bowel. The dio-eo'eal valve bars their entrance into the small
intestine \vhere digestion -as dilTerent iatei] from mere absorption
take- place. If not prediLTested they arc not fitted for absorption.
Nutrient enemata then can conveniently consist of soluble carbo-
hydrates and peptone-. The disagreeable L, r lue-like flavour of most
peptone^ constitutes no object ion to t heir use here. I ndeed peptones
FOOD (JIVKN OTHKKWISK THAN I'.Y Till! MolTH. i.'.", 1
and peptonised ^rui'is, arc excellent matters for nutrient e>i<-mata.
Malt. preparations, mail foods, and malt c\ira<-;~ arc admirable
material for ciicmata. ( )r inilk-su<*;ir, or dextro-saceharum, or ,-\.->i
hevulose suijar, especially as treacle.
When acute irastric disturbance is on foot, then the nutrient
enema should consist of soluble carbo-hvdrates, meat peptones, and
if necessary a little hrandv. \\lien there is anorexia and a febrile
state co-existent, the utility of albuminoids is less certain: as prob-
ably no histo^vnesis then ^oes on (as pointed out in a previous chap-
ter). P>ut of the utihtv of matters ftirnislnnir Lrrape-suLrar to the
system in its hour of need there can be no epic-lion. hVceiiKv in
a case of chronic bronchitis and emphysema the appetite dropped
I LI II
dangerously low even for a ladv in lied in a \varm bedroom. Here
a nutrient enema of .Mellins's Food and pcptonised milk niirht and
morning just made the difference betwixt slow starvation and im-
provement. I could have liked to have something I" say about the
utility of nutrient eiicmata in the attacks of acute ^a-trie distur-
bance in phthisis; but unfortunately am not in a position to say
much. ( n n nriuri grounds there is a irreat deal to say : but lio\\- the
actual facts will turn out is not so certain. If readers of this work
Avho try nut rient enemata in such eases would put their experience
on record we should soon have a body of evidence which would be
highlv valuable, whether for or against. If favourable, our hand-
are strengthened in a vcrv Irving crisis. If it turn out but a broken
reed it will be well to know it. so as not to [nit faith in an untrust-
worthy measure at our time of trial.
A larirc tablcspoonful of soluble carbo-hvdratc as malt-extract,
or .Mellins's. or other malt preparation, or milk su^ar. or a small tea-
spoonful of meat peptones in an ox. of warm water, would form some-
thing like what is rci|uired for a nutrient enema. Such a small
liulk would probably lie well tolerated by the not verv sensitive larue
intestine. And repeated twice, thrice, or oftener daily would make
a substantial addition to the body-income.
lhw IOULT nutrient enemata mav be continued depends upon the
condition of the anus. If tins become very .-ore and sen-iti\c they
mav have to be discontinued after a short trial. (The utility of an
opium suppository in such anal sensitiveness surest s itself, or -oine
other local application). If the anus remains insensitive the
nutrient enemata can be continued for a longer pei'iod. < >n !:;
matter we have much to learn. \\ hen we ^ive an enema to t;;;-h
out the contents of the lai'LI'c intestine We |V<|Uire bulk to di-tclid
th" pouches of the colon in wllieh the t'ace< lod^r. I',;;! for
L'.VJ MANUAL OF DIETETICS.
nutrient enemata a small hulk is desirable iu order that it may bo
retained and not he cast forth.
\Ye can sec a great future for nutritive enemata no\v that tho
proper materials for them can readily he procured; and increasing
knowledge will teach us many minor points to he attended to, of
which probably something can be said in a future edition.
Very recently '"rectal alimentation" by nutrient suppositories
has been advocated; and in some cases has been found useful. The
component factors of nutrient suppositories will be limited by the
anatomico-physiological facts of the Avail of the colon and its capaci-
ties (pointed out in tho early part of this chapter), (-specially
what is said about the non-absorption of fat by the bowel. That
nutrient suppositories of soluble carbo-hydrates and peptones may
come to have a high practical value seems eminently probable.
.Kven if these nutrient bodies have but a limited scope, this may
still be enough to give them an incalculable value in times of emer-
gency, when life is quivering in the balance and a triile Avill cast
the beam. And it is in our capacity to provide these apparently
little matters in the nick of time which constitutes a great part of
the utility of the medical profession. Sometimes a practical grasp
of the exigencies of the case, and the knowledge how to cast the
quivering balance, far outweigh in real value an elaborate but
sterile diagnosis of minutia 1 in such hours of need. Kmergencies
are indeed often the test not only of the possession of knowledge 1 ,
but of the capacity to make use of it. A nutrient enema at the
proper moment may have life or death hanging on it.
Of hypodermic injections of nutritive fluids little can. bo said.
Accounts of such methods of feeding have been published doubtless,
chiefly by foreign physicians; but they appear rather to belong to
the curiosities of medicine than as part of the working apparatus of
dailv practice. For matters of small bulk, as potent medicines,
the injection syringe is of priceless value; but of concentrated foods
adapted for injection purposes we know nothing.
Transfusion of blood scarcely comes under the heading of die-
tetic..
Then come inunctions of oil. How fat is absorbed by the skin
is a matter on which little is known; at least, nothing about it is
known to me; but about the fact tin-re can be no question. \\ hen
attached to the \,Vest London Hospital numbers of poor starvelings
wen- amon^f the out-patients. \Aith manv of these mites the addi-
tion of some cod-liver oil to their scanty fare caused much improve-
ment. "With others, however, it became necessary to resort to oil
FOOD (JIVK.V oTIIKKWlSi: THAN i:V Till! Mot 'Til. 1' .'.:',
fnnnctions.. The eiTects varied; some babies be^an in improve at,
once and rapidlv, while with others the proirres-- wa- nni<-h .-lou,;-.
Dili mi tin- wh<>lr the results were sat isfactnrv.
I u some instances such inunctions have been found useful \\i;h
adults where the assimilative organs W<TC uuenua! to much Wi.rk.
It is imt unusual l'r phthi.-ieal patients t<> appiv cod-liver oil to :he
chest when it is not ivadilv taken liv the in OH th. The nil i- absorbed
and does p>od, Imt the plan H an un-avourv one.
When oil inunctions ai'e indicated the rn.nu shouM lie made
warm and all drauirhts excluded; else the exposure mav he injuri-
ous. (A pooi- little infant ivadilv 1'eels nnylieat loss). Then lip-
skin must, he made perfect Iv clean with hot water and soap, with a
piece of llanui'l or a sponge. Aftfr this has ln-en done the oil <-aii
tie applied. It, is well to allow tin- oil t<> u'ei warm hv th<- iii'e while
the preliminarv operat ions are LT'ii"^ on. Aliout, half an ounce ia
tahlespoont'ul) is emui^li at once. Ahoiit, a teaspoonful should he
ponreil into the palm at once, and this should lie ruhhed well iu over
the trunk and 1 mil PS. 1 low much of this is ahsorhed I do no; k rmw.
The undergarment of course hecomcs oily, and how much ahsorp-
t;on ^-oes on after the I'lilihin^ 1 do not know. I5ut. ho\\c\cr it
comes ahout, the process i;ives sat isfaetorv re-nits.
Adults, or children of larger growth, who i-eiju;re od inunctions
are usuaiiv or ouirht to he- in hed. (in order to reiluce the liodv-
expenditure). A\'ith these it has been found convenient to anoint
one half of the bodv at once; taking the other nmictv in turn. In
certain cases this method of feeding proves verv useful. Ini-oid
weather such coating of oil is fouii'i verv comfortable. It is not a
cieanlv method, however, and has nothing to he said lor it except,
its utilitv in t itncs of need.
Such, then, are the methods of feeding otherwise than bv the
month. Thev are all oliject lonablc and repugnant to the feelings.
and to sensitive pei'soiis sim[>lv intolei'aliie. Still there arc c;rc:;m-
stances under which these methods are advar.ia^eous. ami ;
to know of them and about them when the emergency arrive-. As
to the choice of o;l. [ iroba bl v an ani ma 1 oil is more eas;i v ab.-orhe'i
than a vegetable oil. Of these neats-foot oil is the lea-; o!Teu- : \e.
\\ hen this is oll'ensivc then olive oil can lie resorted \. l':'o ; .a''.v
t his was the oil useil bv the earlv Christian-:, who whin -;ck \
anointed with oil and praved over bv the elders f the Church, ac-
corii i n^ r to St. ,lame<.
Iiuim-tinns of oil are less fre(|uentlv called for than nutr.i;\e
enemata, which arc often <if much service.
roxcLrsroN.
Tin-: perusal of the foregoing chapters Avill. it is bolicvecl, con-
vince most readers that there is inueli more to lie said for food and
feeding in disease.- alike in acute maladies and mere chronic affec-
tions. than at first sight seems probable. To kno\v what food is
required in eacli morbid condition is a matter too little attended to
in medical teaching. Medical teaching is conducted in hospitals,
and in hospitals for obvious reasons the dietary is arranged in scales
of varying liberality. This unavoidably leads to routiiu hard and
fast lines which are not elastic. Consequently, dietetics are matters
picked ii}> by the medical man mostly from his private patients; and
probably his first real lessons come from some intelligent patient, or
friend of a patient. P>eef tea he knows from the hospital, and milk
ami lime-water or seltzer water; but the rest he acquires as he can.
Some men pick up a great deal, others but a little. The Professor
of ( > rvalue Chemist rv tells him little or nothing about the food -value
of food; the Professor of Physiology describes digestion to him. but
docs not describe the various forms of food; the Professor of Prac-
tice of Phvsic gives him directions as to the choice of medicines, hut
probably never mentions food except when discoursing on diabetes;
the Professor of Materia Medica gives a careful account of the dif-
f' TCI it members of the Pharmaeopo'ia, including their actions within
the bodv. but as for food, he has no word to say; while the Professor
of S;;n;vrv mav speak of a bread-poultice or a beef-steak fora black
eve; but t hat is all.
If some systematic lectures were delivered, even if only of an
elementary character, tin- student Avould have some broad rules to
guide him in his choice; instead of being left prettv much like a.
ship without a rudder. It mav lie thought bv some readers pre-
MimptiioiH fora person n.it actually engaged in medical teaching to
criticise the existing silence, or to make surest ions: hut it does
seem to me t hat instead of getting up pharmacology mid the appear-
ance of crude di'uu's it woihd be well to substitute some account of
foods and feeding. When the medical man hail to choose and
select his raw material, from which, as an apothecary, he prepared
extracts, tinctures and infusions, then such knowledge certainly had
it > value.
C< >N( I.I'SH .\.
lint no\v-;i-il:iys a medical man trusts his chemist and drm-r'-rl-'
for his medicines, and rarely even makes a fresh inf'i-io:,. (,,..,,..
(jiU'Utly, this part of his stmlii's is uselc.--. anil merelv hiirdeii-ome t
tin' .-indent, and an inroad upon time which has manv u'emand-
upon it. and which is too precious, in every wav. to he uasted. If
tliis time were devoted to some account of food in health atid -i''k-
ne-s; of the preparation <>f fund in relation to its digest ion; of pre-
pared f 1 for infants and invalids and those aetuallv ill: of the
p reddest ion of foods; of the relation of various i'oods to sundrv
niorliid conditions; it would he much hetter.
Possihly the ahseiice of sudi lectures ';- to -ome extent due (o
the fact that a text-hook availalile for such lectures did not exist.
I>r. 1'avy'.- hook is most interest inv; and iustnietive; and the same
mav lie said of Kini: Chamhers's Manual of I>iet in Health and
Ihsease; hut neither form svsteiuatie treatises suitaliie f^r lecturing
piirjioses. The \\iMter lias some hope that the present work has
so i HC claims to lie such a honk: hut this may I.e no more than the
vanitv which is sud to clini;' to autliors.
Lectures ;av delivend Vearlv hefore tile Koval ( 'ol'e^e of 1'hvsi-
eiaiis of London, and we mi^ht have thought that the authorities of
tile College Would have foil lid Some one to lake Up tile Sill'jecl
teaehiiiL:'. When a lish smells about the head it is useii ss to look
for fre.-hnes< at the tail, savs a Turki-h pmverh, and so lon^- as this
niiinj; hodv in mattei-s medical maintain- an att;tud,e of hiatik and
supine indilTereiiee on the mailer of fund, so Ion-- nothinir w;:l he
i joiie. A- an exam in MIL;' hod v a change would at om-e he inar.Lnii'ated
if a (juestion on I >ietetics were asked at the higher examination fuj-
the ineiiihership: l>ut of this there seem- as vet no pro>pi-ct.
There is a hetter prospect ill tile I'llited State<. w!|e|-e the Hlhject
of 1 >ietet ic> is in a m uc ii more advanced coin i it ion. ' The .luurnal
of ii'eeoiistniel ives " ; . ;1 step forward which ail inu-t ha;, with
satisfaction: wlnle the ettorts of the enterprising tirms who prepare
various form- of f i are \\-nrthy of ail commendation. A- -oun a<
the knowledge of foods and lio\\- ;u use them com,'- ahrc:,-; tiie
various ['reparation- in the market, then a revolution ;n ;iie fedim^
of the .-iek and inlirm w.ll he wrought. And liie
eluding: sentence is the e\]ire-sion of Ins lielief that that much-io-
he-de.-ireil rc\olntioii is close at hand.
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an. I -np.-rlily illu>trate,| with niue:\ r!:r-,e ilr;nvi:i-s <m the >tou.-, ;rt. .;.:-
full- an-l iloudle ]..i4e pi.-ites. The au;:ior's i!ra\\ in;;s, phnto^: api:- o!' - : .. :
olij.et has lie; n to ileM-rihe asi'l liuiin- :. r..| lit;. ' of t !n .~e h! : ;~: ralions is i
iiiisiMte lesions of ili>e;i-e f'lfiTu tli" iiiai -rial '.vhi!.' th-'ir e.\"riitio:i in the uiv.
.vhich lias fall, n ini-l'-r his own ulisvrvat ioi;. ;i':'niileil tn make t hem -p. .- f : . -
In 'hi> re-p-et t h Look 1, a-; a peculiar value. The sulijeets specially l r. at. ;
in repre-eiil 1 1 ; ^ 1 1 1 1 1 v 1 1 i i , n 1 uork in a \\i'i" aii'l \oluiue are phtui-l-. p. ri"
c'U'.'t ull v cult ; val "il tic-lil. Tne re-ui' .- o'' t in -e pneumonia, < mp , in a, .,::'
la'io|-s are pr. -"iiteil for w:iat they ai'e \virt!i e!iit:s. til' rer."i!o-i ,. '!'!: :
as <ii monst rate,] l ,et^. not hin.; moiv aii'l not h- one ..f tins,. , li-. ;i- > i - : - '.
i':.. i. <-. A- very iinnl. s:ly >t:it.-,l l,y niir ai; h. nsn-. '.v iie~ ril- ! i:i c
t.;..r. hi^ plan of ^! ''.'iy i.'iipl v in\o!\ ,-.( tiie pi at -. 'has ^ivii;.,' I ! r. i : : '
foil .win- of Nat :r,- wli.-rev. r she mi-ht lea i. of clinical as w. i! a.- pariaO
( '. .n-e.|iiei!:!\ . in viewing th.- a.lmiraliii- pres- .iili'i-ia n' le -ions
e';'atio,M ,,(' inieroseopieal appearances, \\ . are "We ea-.no' coji_--;.[ ,1! . :
pr.vi!e_;. ,1 to -it. as it wire, lii.-iije t i,.- ina.-ter \varmivon l'i- r. -ii.lT-
an. i a! most vi^w t he speeirn. n- wit h in- "/'-. n. .r e,, n -,\ .-...-, .::ir:- :
A' 1 . 1 ! : !"t ::,s -ay th:'f pfohalily in no -^i:nilar tn t lie pru^re^-ive - :.i. n'
-..rk ev.-r In-fore p'ihli-h. il are th,-r. eolle-te.l p-,t !, ..'o L - 1-:. Tli. >.!;
i n;.ii:v 1 -vitii'iM "li'l -,a!-::tli|.' rep:-.-i-!i"iti..n, ri-t.tM'.y l..e: M l. -.| I -.-
ol [iat:io logical lesion- t iia;i in tile on. 1,, i ,re m. -ri' - is a : i i : ; h oi . _ . ! i :
::-. Tiie processes !iy which the-e a.i-uir iMe '/'(, .If <.'-. ; /,
Hilton, John, F.R.S., F.R.C.S.
I;HST AND PAIN. Ar-mr- .-:' i,- -MI-.S ,.., th.. i M t'J m - M.
I'l,\-i. '... -i ,! II. -t :;i the T- : - ;:1 . ..'
Dia. :i...-!ie \'-.;\n>- of |':i' ;i . I -i : - \
-1 PUBLICATIONS OF \YILLIAM WOOD COMPANY.
Wagner, Ernst, M.D.,
A ^lAM'AL OF <;i:\Ki;AL I'ATIK >I,O< ; V. For tin- t'so of Students and Practi-
tioners nl' Medicine. Translated t'r.'in tin- Sixth (I.Tinan Kdition tiv JOHN VAN
I)i VN. A.M., M.D.. Professor of Anatomy and Histology in the Medical School
! Syraeuse I ' ni \.-r-it v. N. V., and I'. C. SI:IM IN, M.l)., Clinical riol'e-sor of
I>i-"as' s i if tin- Mind and N'ervoii- System in thu Colleue of I'hv-icians and Sur-
L'e..i!>, New York, ('in' volume, Svo, <'"-'* paC'-s. Price, muslin, *~>.~>(> ; leather,
!*'!.. ~iO.
'\'>l,ook in the Kn^lish lan^nau'e Drives such the ;:re'itost C,erman minds. Thehihliojrrapln
n thorough ft'siimi ui 1 the elements of medi- nf tluMvnrk lu-fun- n is VITV rvjilcti', anil t-viiK'i's
i-i'ic. Tin- work. cnntJiijiiujj OVIT M'VCII ln:n- a rc-e.ircli rarely entered into d\ authors. Tl;,-
d:i:d cl'.M-lv pi intrd iiairfs. i* a storehouse nf work consists of four putts, (It-voted resjier-
earel ; :ily sifted and \vell-arraiiired information lively to ( leneral Nosology, (leneral iMiolo^y,
in :i!i depart inents of patliolo^\ . Unlike many (Jeneral Pathology, Anatomy and I'hysioloLiy.
t:;\t!~iation>. the text is lucid and pleasant and J'atiioio^y of the Blood." 1'i'ni iixitliir
rtvuiiM.'. ami tie work is altogether one of the ./o*/ /,..// nf M, ,li, ',,,, .
nio-i va'iialiie which has hecii issued in the " The work is on which will ani|'lv rejiay
Knu'is.'i ia^^'iaue. It \v ill lie in valuable to the jieru-al : iufact.no physician should neglect
-tudetit of pat liolo^v. and should lie in every to read it, niid the student should make it one
|ihy-ii-i:in' ii!.rary.'" /'A//,,,/, //,/,;,, .]/. ,!;,;',/ ,,f his most el cri-hcd text-hooks. " />'//V<>
/',, v M, .in;:! ,,,n! Sn ,',j[,;i\ J,,nninl
'Ii is a liook full of knowledge for the "Clear atid cotici-e statements, short and
praetiti. INT. A medical student could not simple sentences, pre-ent the condensed
liettei commeiico work than liy reading this thought with which this vohnne is tilled.
)io<ik :::! i,_:h. It has all t he modern doctrims This is as it should he. Those who desire
and di-coveries." Tfn I 'J i)i if. more than carefully ai ranged results will find
"T::e views i:ow held liy jmi^rrssivc inves- in the copious liihliojjraphy and alumdant in-
tiu; toi-s i'i this liranch of medical science are teicalated references the sources from which
_;i\i : in a marvellous mass of well-arranged t: e infoiiuation has Keen deiived. An index
;ui(i eurefulh digested facts, cmliiaciutr all de- ol authors and another of subjects lender in-
j ii'; :' -\ pathology, and furnishing minute valua'oie aid. \Ve <-oiisnicr this Look as one
and oe: ;i ill- 1 information on everv siilijt'vt per- ol t!'e mist valualile of the manv medical
ianii"_' to the uiorl'id state and disease in all v. o;k~ ir.inslated fi'oiu (ierniau into l-inirlir-h.
its p oteiin forms. U'a^ner's systematic ar- 1 i - ;< ppiicat ion is general, I'oi it will l.e found
i --kill in classification arc ad- rot oiilv uj on the sl:e!\ es of the surgeon and
miraMe. part i'-ularly elucidating the l'eanni;s phv dci.-in. 1-ut al-o in the hands of the medical
"t I'-iets i;;ii.n the processes of disease."-- student, vvhoeanrelv upon no safer and srrer
. I :,:;,.: J, ,,,,-, ,,il ,.;' ,',. \{, , / ;, , , 1 S,'n ,<>. i:uide t i:rom;h the ol'iseiirity which surrounds
M. ;-. Win. Wood A- Co. have place 1 the tie causes and phenomena of disease. The
pro!e~-io'i ,,)' t hi- country under re::e\\ ed oiili - niodei n explanation of ' catch inu cold ' may lie
'_;.)*! i'i- !.\ the pve-i \i\ -it ion of thi- intmitalMi' situ, as uell a.-- the more elatxnvite theories
v\oik. The tiMist ]'opular text-hook in C,er- witii iiL:;ird to fever. Ahove all. it contains
IIKIM v . -inii !'a .'itr.,- pa- -i d 1 1 iron:; 1 1 -i\ e lit :m:- \v hat i- to l.e found in no ot her single volume
in tin' i-ouiit M . t he oidy woTider is that it ha.s - it i- ti'h d \v it h a complete and com pi e-
ll'i' I ei-n .;M.M to t. ! .e profe--ioii of America I.elisive -CMC- of -\stematicaliv arr;in:;ed a!i-
hefoi'i this. The nio-r cni-'-orv ijlance through straets. which form an epit ome of L.'em-!Mlpa-
it i.s -nthcii'Ut to con\ incc (,ne of the ex<-elletice t!io]o.;y." />nst<i,, M, i'n,il niitl >"/\'/e'cc'
t the w,.rk. v. i.iej] hears the ini] n int of one of /-
Longstrcth, Morris, M.D., etc.
tUllj MATISM. COfT, AND Sn
I ' v - 1 1 i '-en ] it Ii '11. See pa _'e ..I.
Bnrwcll, Richard, F.R.C.S
MATISM. COfT, AND Sn.Mi; n|' Tin: ALL1KI) IMSKASKS. Si .id mly
- 1 1 i '-en it Ii '11. See a _'e ..I.
Lynian, Henry M., A.M., M.D.,
i' M.M:I ; , iii tl.c '.\ miicn ''.
AIITTI'H l\l. AN.KSTHKSIA AM) A N .1>TII I'.TK S. S.,!d ..,,! y l.y -ul'-cription.
S OF \VILMVM WOOD A m>II'\\>
/>/*(. <7-S( 6' of <>1<1 -I;/', .tilf <"t !(<;* tf.
Index Rerum
I'm- tin- l".-c (if IMiv-iriaiis an. I otl.. i 1 -. "M "H\y l\y .-u!>~'-i i[>' : :i.
Charcot, J. M., M.D.,
Till". I>ISKASI-;s ()]' OLD A<;K. Traii-'.ai.-.l l>y I.. HAKUI-ON Hi vi. M I'
nmiu-i-ous additions l,v A. I.. LUUMI-. M I >' . .-t<-., I'n.tV.-oi- ,, I'.vi
I'ra.-ti.-al .M.-dirin. in fin- M. d;.-:<: I>. i',.! -in. -lit ..f' tin' liiiv.-r.-i;
N..\V Vurk ; (\uiMiltiii- I'll v>i.-i.i:i in M 1 ,.- haiity H..-]'ital ; '.- >; . !!;
Out Door U.-ii'-!' ; to tin- Ci-utral I >i-]..-!isai-y ; YUitiii.: l'h\>it ian t.. !! I:
Hospital ; tu th.- Mount felliai !! -.-]. tal, tc., i-tc. Su!J uim
Beard. Geo. M, A.M ., M.D.,
l-VU,,\v .,f ti... \,-w Y..rk Aoa.l.-!!i> i.f M-.!i. :!!:
UT ..!' ::i.- A:n.-r:.-:ui N -:,!-..:, --I.M! A-s-r.u: ..
Rockwell, A. D., A.M., M.D.,
A I'U.V'TK'AL TRKATISK O\ Till-', MKDK'AL AND SI'KCIi VI. r>K- i>|
TION; I.DCAl.'l/.l]!) AM) i'MNTUAl. < . \ l.Y AM/ATK )\ ; Kl.Ki 'Tl;< I.Y<lS
AM) UALVANO-CAl'TKUV. F-'irtii Kditimi. lu-vi-,- 1 l.y A. 1 >. l; . i i .
M l>. On.- vohnii.-, ^\-n, >^ ;.aj.-. ..',.- Inindri-d a:i 1 .-: . l.'y-;.::.-- w.-.d-. -
in.'.-. I'rii'.-, uiu.sliu, s.'i.riu-. h-atli'-r. .<o."in.
./
lli'i-tva 1 '- 1 wit ;i won i r its in a \v:iy u hicii .-an- " \I. .r. iinjuirluilt as-i-i IIH- 1-1
nut r'-i:l T.I li.- nmst us. -ful tu st ..!< nts. <-n l.y tin- illu>t rr, iuu.-. I., tin- rlia;
"Tin' mart -i- of t!i-. vulr.Mn-. :i;_':iin. i- ;..]- i !;< n; i an-ii, %\ !:.-fr t!i.- va;'i.
rnira 1 '!'. an-:i;i_'.-.l : li. tt--r than in any li"..k ..(' ut' a|>j.lyn;^ r tih- aj.jia: atn.- i: '
thi- kin I wliii-li I Imvr K -i-ii. t :ii' liitt'.-rcnt atl'ri-Muii-- is i-xjilaiin i
" Kcf.-n-iii-.-s ruv ijinuri-.iiis ami sicc-nratc. Jmn-niil uj' I/. '.;' ,s. ,'.:,.-..
a'l'l w<- .in- i|- li.;';.t.' 1 'u liavr tint \v:,ich \v.- " 1 1. is uiiqurst iuiialil\ t!i.-l- * :
la--k s.i :H irli i'i filinns' all othi'L" >Mi-li )nink-. authority "U this .-irii.vt ai ].r. -i:.
iri:u>-l\ . i'uiii|il''tc in l.-\.-s. l..if'i \i-rli.il ...'. 'l'i:..s.. \\iin \\a:.t 1:1 ::,i> i-."-.
l.ilili.'jvainn.Ti!. 'I'jii-y liavi- ]> -rl'i- -t !, it't:..\ al>ri-a-.t ..f t ; :.- linns r ui (.:::.
ill i nut u! i_':na'.-. a in.-l :i. .-1 ..f rii-i't m -tiit-ra- wnn'li \vill 1." in. '-t s-f i -t a." v. ;.'
].;. wliii-h Tili'y rail L,'i-lii-:-:il I'as'a ii/. iti.ni. - /,'>,,/ / !/ '.,-,' ./../' ( -.
" It i- a pi -.-i^iri.: t'. -at in; in tin- pn-si-nt \nl- "The i-urnpiii-at'-.i inr:i:i..ls ;ii.
nn,.' :lvit til.- i in si i,' .(.s^l'ul casi--. ln-ai- t !n-ir ju^t t nr. - that, hav.- dish, ai f.-ii". i t ' . :
J.:.'ii -it in 11 tu 1:1.- siii 1 'i-s-it'ii!, a ii 1 1 t n at in otluT . .|' j>r.-\ ni!is ant in .1 - nil Mr. - i.; :r..-
-' i',.-. - \vh !! s-; .-;-; w.is i :. -n:n]> ] t t ;. r- i; i\ .- l.rrii [.nin.- 1 <>( 1 1 I : n- 1.' ' '
i- n" aM--'n:i: totiiik" t ; ).- r.-,--iIt- in.ir.- sati~- :'<.in.iin^ s\ imn \ MIS. " .1
f-i.'t ,rv r-ian t:i.-\ n-all, :<-." -/,'/-,'.'.v ; < ,/ . r.
/'.,- i'i )[!. , < 'i, ,'//////.' /,' i'i'i if. "hi ;ii.' arvanu. nifi." "' "'
' \V>- ran i-.-;illy L,"M' : I!II.- Mrs. Hai'.l th- pr.-.'iitat i.iil nt' th.-;r
:IMI| i;.i.-kw--ll nn t in- jn-.i.lu.-t Ion ,.)' ;i v.-rv i-\- thr M-..|- ,,(' t!n-ir st-i.!i.>
iii'istiv,' work, t liorniu;hlv nj. t.i th.- tiin..-. t l ..Mu'h nm ! --t n.ann. i u N\ .
a M. I . vini'im' an intiinat . taniiliarif v \vi; h 1 1). ; h r o\\ n > i -.'. -. an i in ' i. ' '
l.'i- ! -ml t'op-i :!t \vnt--r.s, :,-il a h.i.i,, .] .J. - D:-.. |!,-; ir .i .-. i K
si-'-- t i :-iv.- an !nin---t ;ii'i'o;:nt of th. ir i-:i-.-s, inrnt. .1 a - ' i\ : .. I .-.-:;..
Ho' 111 i.'iiit'vin^ thrir snci'i""..-s nor i-nni'i-a'. a>:.i i n ~! i n.'t 1 . \v. .: i; ..;i i.,.;.. ,
r: ..' 'hi'ir t iilur.--. " -Iiit>,'in o-/. //-,' ,-.'., ./. ., :, i ll!; , v \ j.j h ,..':!. j. ;;.,,; -. r t \
i|-;ii-.-ini'nl - of t .,,- l.';~\ M ,, it
" S ipi.'irs a loiiL,'-fxistin_; want in .!-. i - ; . :.-.n\ -in-',. -,....;!,. .11 !.-
" \\ i- k> . ..'." of no ot ',i r work on t ':'..--:'-. I i' i from a I- ! . I.::. l.u;_ ,-. ' .
t:: it u'ivi's. a-iytinn^ like ti.c [.r.u-ti.:al .:.-. .r- .!/ / - /,'<. ..//./.
<' I'lT.LirATIOXS OF WILLIAM WOOD X- CCTMPAN'Y
Jf(-ct/'j<'itt/. JM((ss(t<~i( : .
Rockwell, A. D. ( A.M., M.D..
LEtTI'UES ON ELKOTUICrTY (DYNAMIC AND KUAN 'K LINK') IN ITS RE-
LATIONS T> .MEDK'INE AND slU<;ERY. On.- volume, . s vo, 12? pa-e.s,
i',!>i:-;rated, iiiii-'.in. Trie,-, si.','-").
1 i. iin> al: that is practical and useful on "Tln-i- lectures embrace the more imj or-
nii ' tn th' pract itii'in r ; it i.-. concise taut . praet ical mat ters. ;i- the inanipuiai ioii> , t'
.-ill ' i- , v-t ::i_ !' ' i.ad, and should In' in til'- apparatus, and t he fields of disease when eicv-
hiii. -ofe\en practitioner." ll>.v/ ( r/( /.i"(--,f. tricin will pnnnis.- tin- most y 1. " < il,^, t,-:,
" I'r.-ii-ntiniiiTs wi-liiim tn clitaina kimwl- Vn'-ll'.
, I:.. , |" tin 1 nii-tiiii'is i't' apjilviiiL; aini itniica- "At tin- olusi' <if tlii 1 Imok llnTi 1 arc a si-rii-s
: . . _' . 'f.-t ; i'-it \ in tin triMl Jt.i lit \ of pit !iy piiia^raphs. <{iviiii;. in pl;iin laiigua^i*,
fii^ - t liml mutv i.M-t'ul inl'iiniiat it'll tiic prai'tii'al applicatinns nf tli>- ilillc-rt-iit fir-
than i-- ct'iitaiiii'd in thcsi- r.'iit.- in \aiimis atl'crtioiis, a> slin\\n Lv tin-
! ( .1 ~. \Vc: take i>lcasuri' in I'Diinncndin^ it, prr-niial i/xpi'rii'iiei.' i>f thr writer, and tlm-i- of
t'i i ir iit'ticu." <.'>.iH'.('i'i Juitr/i'i! ij' M<_ (/(../; utiii-i IM:::J Ltfiit f-i'cci;Ui.~tti." Mli<-<il /{'-
.* i . f. vi'd.
Gin ham, Douglas, M.D.,
\V i-iiiinni . i tin- work in those who avf until in>w. will li.- fo'ind in Dr. (Ivaiiarn'^ cv-
HIM . unrits of friction. kncadiiiL;. cf!i'-ir volume." /,'/''///,<,/, .^HH, ])f-iinlnr
in:: ; ' ii ''t ::...'. r"lint;. and pci-cu.-sidii of tin li. 1 >S 1.
xti . tissues of the liodv, with a view to "Tile -ni' ; .'.-t of tiiassa<,'e lias lie<-n ono
th . iti\-e. ji.iliiative, or hytric'iiic elfects." toward which the attention of thi' jrolessioii
I ' '^ ".'.;,: .^ :,,-:'.' J> :,:,-.,.,'. > ', ~ i I I I I j I C. ' t . ' d 1 ! a lid IliM t V ,,f hlte \. ill'S.
i :: '. :. t'i in the liands of a ineiiicnl Asatheiap ( ic mea>':rc, it has ln-eii ^rowiliij
1:1; ' ; itati'iM. the wi.rk may lie a. c li'\ in fa\ .>;"-- .I/, ./.'.,;/,(/,,/ .S(//y//, ,,//,',-
: in evpiainiiiLT tins I'e-.nscita- t><trt< <. ( )ct..ln r '.'n. IN^.}.
and as .1 _ r uide to it- pract ic>-. " "Ti:- i- a valnalile [irofc<K]onal liook !>.r
-/>'' ' / /' ' ^ /' ^ /, Deo.-mhei IJl, wlilcli. and I'oi t,. siiliject to \vlncli it i.- de-
\.t ii. v\i' vent ri' to ['!.. diet di>tiii i i,Mii>liL l d
:.,': history, from th.' l.e^'iKr.inj -t.<v - 'ih- A^ .''..,-, .January 1 , 1 1 >^">.
Morgan, Chas. E., A.B., M.D.
I-:i.i:i 1'HO-lMIVSIOLOOY AND TIIKII AIM'.T'TK'S : I'.l'IN*; A STI'DVOFTHE
KI.KI T!;h \i. AND <>TII:-:K i'ins!i-.\i, IMIKNOMI-INA m-' TIIK Mrscr.
!.\i; \\D o'l'HEii SYSTEMS DTIMM. HEALTH AND DISEASE. INCI.TD-
!\, THE l'l!i;\n.Mi;\A OF THE ELEi TKK AL Elsl(i;s. One volume. Svo,
'. ' ' . '. ' tt'-d \\itli liiie s, iniislin. I'riee, sii.rii).
T '.: i~ a mine of knowU-d^'e to tin "There i~ not nim{ in tin- |-liiL;H~h lani,'iia^i.'
n :i t he d'']iartment of scieiu-' to /. .. , ,. it all approach,-^ it as regards the M-ieii-
(t i-- a most thon i tnn nt of the whule snliject of elect ri-
ive tl'.'.tti.-e i,u ; // ',-,,,/ /,'. ,'J, ( r,.( J/; ./('((//. ,i,i,l j'/,*,'-
" ' .'.' Ii, Ul>. :
Eib. Dr. Wilhelm,
" vei :v ..f I..
PUBLICATIONS OF WILLIAM WOOD \- COMPANY. 7
Seguin, E., M.D.
MF.DICAL TIIFK.MOMKTRY AND HUMAN* TKMrKTlATCIM:. O:i- v :,;iu, ,
Svo, II") ].;i -,!>, illustrated with diagram-, mu.-liii. I n< <. S.;.."i(i.
"Til-- "-'abject-matter of this Milimi'- is of i-xiiiliitin-.; tin.- ttMi]i'-:at:;n- in v:i:-io-is d'.ivi----..
I'M- hiu'de-; irni'ort.-ii'i 1 '-. and tin- i.rol',-v-.i,,ii ; s .\nioii_; tin - :ir.- I);- .1 - |.h .I..:,.-' i< \ . l-
nii'l.-r .']'. it oliii /at !"iis to its ui.thor for the low Fever,' win ri- t h-- ti iu(>- r;il in ' is cit-d 1:1
/ al h :.a- iiialiltc,-t -d in l>! iligmu 1' lo our no- two cases which t' 1 :::!; at < l l.it...i\ :it l!o ,
t .1 <. The book is worthy of can-liil study liv The ilin-trat ior.s. t. -in j-i lit in i- ci.ait-, i*c..
.-ei-\ mo iic:il /! mil-lit and ^Tinlioii> practi- an- -ijlity-t'"iir in iiuinU-r. UM! :u > \ <: \ liaii'l-
l:->:n-r."f>'tr<i;t/i'>-;>:i.'ij'.]ff/i,-in,,ii,ilSi<r- s.nii^N i-xcruti-il. \V. i-.r.li:ill\ i-oii.m' n,| C;.-
,',''','/. wyrk t" i'U r ri :nlri'h a- ;i highly v.i! ) >.i lilt rim
"This ili'iorritf. cli t,'.-intlv jiiiiiti-il. ;nnl il- t ri'.ntii .11 to tin- st u.!y a-nl i.-nlti\:it'o:i o! !.'..-
l':>rr;if.-'l Worli i-uTit:iins a full ili-sri ;pt ion of n;osl iinjmi tan! ai I I < iliaL'r.o-'- at'"'-: 1 ;iii--i--.l-
i-\ i ryt hinj: l" Ttaitiini;' t" th.-nnoiurtvy t!.r lationainl i"-ivi;--ioii . :,ow -i dally r! i.i'.i-
i-harartcr of tho inr-tr uiii-i'ts. tin ir valiu-, \isrs, ii,^ ami ri-w.-u-diirj tl.i- at'cntion of p!.\~i-
rt,-. NUMUTOUS t.-tl-h-s :in- -ivL-n from various i-;aii.s ." r/ tl irt,.-t'>iL J/'i/iV-i! J, ,-,,.(!
Ai.i'-'i'ican and t'lirci^ii authui's and \\ritvis, Ji'ii'i-n:
Gregory, George, M.D.,
LK<"!TUKS n\ 'I' in-] F.IM'I'TIVK FKVKIIS : As ii.nv in th-- C.MII^.- .'f D.-liv.-ry at
St Thi'iiiiis' I!o-].it:!l. in I.on.loii. With \ot--s and Ajipfiidix. -MI i- -ly in. Mi--
nio>t i-i-c.-iit iijiinioiis on i-xaiitln-iiiatic ]'atlio',o_'v, and ril>n >t;iti>tiral tal>li->a!:d
color.- d plat.-s, I iy II. I), lit I.KI.KV, ,M.I>., l'h\>iciall of thr N.-w V-rk iL-j ital ;
Follow of tin- Now York Collr.;,- of IMiysiri.-ins uu-l Sur_'.-on>, ,t,-., , t..-. I'n..-
vohnii.-, Svo, :;?', jia^os. nnisliii. 1'ric,-, ^:>.(U.
Wilson, James C., M.D.,
A TIli'.ATiSi; ON' Tin; rO\-I - I\ri:n FKVI'.I^. Witl, an Tiitn>dnc-io!i l.v J M.
l)\ CIXT\, .M.I)., I'rnfi-ssnr of tin- I'ractic,- of Mi-dicin.- and Clinical M'.-d!c::i,.
at tl'o .li'lVi-rsuii M.-dical ('olh-i,'c ; Diy-ician to th.- l'onn>y I vania H >-|'ital ; < 0:1-
snltiii- I 'liyMriitii tut In- Children's Ilo'<],it:il ; Fc'.hnv of l }>' i 'o!ic_.' ,-[ I'hy-: ;..:.-,
1'hiladolpiiia, Ltc. Sold only 1 .y .-ub.-njri]'tion. See pajc ,V.
Murchison, Charles, M.D., LL.D., F.R.S.,
CLINICAL LKCTTHF-S o\ DISHASI'.S <>F Till; LIVKK. .lACNDICK AND
AP.Dn.MI.NAL Dltol'SV. Inclndiiu' tii.- Croonian I. .-cm,.- on Fm -timi:,! It,-
raiu'. ni--nt< of tip- l.iv.-r, doliv.-r.-il at tin- lioyal Cull...;.' of I'hy- ,-ians. N. \v
i- ! it i 1 si jii-'-piiriiiL,'.
' A lin.'k \v'ii'-!i siirpussi-- in clinic-d useful- thoroughly scic-nt illc i". 'li>' prinri;>lc- .'' w!-.!.-ii
r..--s ,-v. ry work i.:i iiisr;i.si-> of the liv.-i- vet it i> ha-.-d. . . . \\'c coiinii. iid I r. M;ir-
j.u'.li-i.i- l'." If.'/:.,, < '!,;,,< , -,;;,,, i /;,,;,,,. ' chisoii's volume in tlic lm;ii. -si t. rms of j.i ai-.,-
" It i- tin- mo,t instinctive, the m.-t t, ,i<-!i- to tin- not ic- of n-ir i. .-1-1. r- 1' i- a 1 k fi:ll
('/'. work mi its Hill ijt-.-t n: oar 1. -111^11:1^1'." >'/. of f:;c|-,, clearly arid f.ncilily writ I en ; and t-in-
/.,-,',\- )/: ./;...,/ ,,,,,/ .s,,,. (/ ;, . ,/./,,,.,,,,' imlvin-^ t-i,- iat.-t re-nits of -cienfifc -ti..l
" A inono'.rrai'h on ' Liv.-r A ll'-ct ions,' which cdinical r.-^earch. It nm-,: he".c. t.,i t h oc.-ui'y
T:iay '.i- j.rotit:iMv read (,\ the -.tndent ; and in n ni^li rank amon_' v. ..ik- of let', r.-nc.- ..M the
which tin- [ihy.-iciaii will tii:d a ^y-teni of tliaj- di i ;iio-is ,-nni t r.--,! ti,. :,! .( atl. c;:o::.i of t!;--
nojis hoth practical 1:1 its a;'i'licat;o:i and lisvr." /'.'/ /'/." ''' /.
PUBLICATIONS OF WILLIAM WOOD A COMPANY.
/VXM/.SV.V of the Jjir<r, Practice of 3l< J I chic.
Murchison. Charles, M D., LL.D., F.R.S.,
ox rrxrnnxAL DEUAXOEMEXTS OF THE LIVER: Beinu tiio Cn.unian Lc<'t-
llivs delivcivil at tin- Royal ( 'ullc.Uf of. Physicians, i n .March, 1S7-1. One volume,
1'Jni". 1 s - j>ai:es. illustrated, muslin. Price, Xl.7">.
'' Tills monograph is :i!l cxc lii-nt cinitrilpu- ^ivt'il ill tills little book, tin' reprint nt" the
t "ii tn medical ht'-r.ttuie. ;nnl is worthy of a Croonian lectures, a de:ir and comprehensive
place in every medical library. "--(.V/i'(N<(i summary uf the present state nf ineilieal
/.-'it'-'t "ml < >>it, 1-1,1-. knowledge concerning; the iclation of I'niic-
" There i> lint a physician anywhere who tiuual hepatic disorder- to the various vital
will not ivad with aviiiity ami profit thisad- processes." lS<>*t<>n M'"/i,,il mnl ,V///v//< -,<l
Inir.iMe expnsiti in nt' this classic and nm-t iin- .ln I'mil .
Jim t 'int siii.ject A,nt i-ii'i/i M, >li, ,*' \\',, U/i. ''This a'hniralilo volume, the work of a
"This work iloes not in-i <1 special criticism ]>ract it inner who lias brought to t !;.- invest i^a-
at our hamls. t'or its author i- known tn be a tion of this .subject, all tne li^ht of mode in
ilistinmiishi'il master of the subject on which physiological science will exert a ilerHrd in-
he has discoursed. His name has lon^ heeu ttueiice on the minds of mi'dical meii. and
identitled with careful oii^mal researches in awaken nnev.ed int'-rest in the complaints of
tlii.s J'jpartn.i nt of pathology, and lie has Vikichittiv&tis."Tht;AiHU'i<'anJ.'riti-(iliiiit<r.
Frerichs, Dr. Fried. Theod.
A ('I.IXK'AL TKKATISE OX DISEASES OF THE LIVI'.ll. Translated l,y
CiiAiii.i:- M I i;> ii i-i >N, M.I). In three volume-.. Svo. Illustrated IIN- a fuli-
]>a_'e plate and jiinuei'oiis wood-ciigraviiigs. Sold only by subsi.-riptioii. Snj
Bristowe, John Syer, M.D.,
An ' nthcrs.
DISEASl-;s OF THE IXTESTIXES AND rEPJTOXErM. r.-iniirisiii- Articles on
Ent.-raL'ia. by .lniiN K n ti ,\ i;i i "\Y \ i;i>i-:i.i., ,M.1>.: Enteritis. Ob-tructiou ,,f the
ISi-wi-N. rieeratioii of tin- Howcls. Cancerous and other <li-owtlis of tin- Intes-
tines, Dise-lse.-. o| the Creetlin and App'-lldix \"el In i f oi'li i is. by ,ln|:N N x . i:ii l',!;i--
TOWK, .M.I).-. Colic. Colitis, and I )y-eiitei-y, by, I. \V \ i: i;r KT< IN HI.I.HII:. M.D. ;
Disea-es ,,f the l!i-ctlHii and . \lills, by T:ii>M\S I'.l.l/./.A I! n ('! Kl.INC, F. U.S. ;
Inte-tiiial \\'orni.s. by \V. H. It \NSOM, M.D. ; i'eritoniti-, by ,biii\ I{ICIIAI;I>
W \ i;]ii-:i.i., .M.I). ; Tnberele of tin- I 'eritotieuin. Cai ci iioni,-; of the IVntnii.-inii,
Ail'e.-ti.ijis of tin- Abdominal i.' in phat ic (Hand-, and Ascites, by JOHN SYKU
])j;[-Tnwi., M.D. Sold only by Mibftcriptiuu. Sec 1'a-e 07.
Bennett, John Hughes, M.D., F.H.S.E.,
CLINICAL LECTCRES OX THE i'K I\( d PLES AND 1'RACTICE OF M EDK'IXE.
Fifth American from tin- Fourth London Edition, With five hundred and
thirt v-soveii illustrations mi \\nod. One volume, Svo, Id','',' |iaires. Price, nius-
lin, S.'I.IHI ; 1, atlier, sil. ni I.
' We recnliiliiend this volume with the i e pome over the practice ofim-'ii-
u!:i|'ndit:. d pr.-ii-e to the att- ud f..r this, more than for anythn-;
atii.n nf the practitioner and .students. \V, i U,., we value him and the bonks which record
ha\e m.-t \\ith no work of late yars on tiie hi- vi-ws ai.d cas.-s. . . . Tnis i- a must
pn: .eiph - < ( lie -dici: mm e li';e'.;. to advai ' nk. a ml records work and oi'i-inal
and i i.-i:i f-d study of our art." M"l ' ' v '\ i'. ill .secure for tin- author a hist-
in, I ',. i., I!,. :,!.'.- ri-plltation !IS a phvsinln^ist
Wh. n :il k -especially sn lari"- a b, i, " /,,,/,,, /.,,/.
a- r>ii~ -r--aeiii'> ;\ f.,uit'i edition, it m,-iv be "(i most valuable books whii-h
i . be pretty independent of r-- have - nati-d from the nn-d i.-al pi e^s.
. i.-ws ;,nd i> vi-wers. No o-, d.'vot. d to the profession will tali tn
It would ''e .scarr.-ly too much to <-ay that per-:-, th-ve lectures and acquaint himself
I: F'-m.-M marks aneia in the scienci' and v.ithtli' di-cn , rj )' sn ardint an e\ilnfi-r
: - - nn Ii iii.- To him us much as to in th-- ti'-ll of jjicJiuinc." -\> .' Yvrk Jv"i'iMl
. arc ilm.- ti.u ti.an-,'es <!'.}! '/c'/o.
ITBLK'ATIOXS OF WILLIAM AVOOl) \ (OMPAXY. :>
Cede of Medical Ethics
AUol'TF.n I'.V Till-: A.MKRK'AX MKIHCAl, ASS(t( 'LVTIi ).\. i:
();i..- volume, IJ'Jimp, I!',' pa-i-.-s, iiiii.-lin. I'li.-.-, -Id:.
Bigelow, Jacob, M.D.,
I51IIKF KXI'OSITIoX OF KATIoNAL M F.I >M 'IX!' TM whi.-i, i- ],i-. ;!
I'ara.li:-.' of Doctors. A F;il Jf. On*- Vuluiuf, 1'Jinu, i;:i j. ....-, n ; :i-.::i. I 1
Hooper's
PHYSICIAN'S Y \I>F MF.iTM : A Manual of th- Pnn.-i;.!. -s an.l !':.! ::.-, ,.' I'l.y-
\\\'\i an Outline ppf (J.-n.-ral Palli..!,.. v. Th. Talent if. and I ly.i.-:,, . T. :.::.' 1M--
:i..n i;.-.-]-. .1 i,\- Wn.i.i AM A i in -ir- civ. \i.i; . cai,-: K. r.i: > . ,.:..i ,i..j ,
H \Ki.KY. . M.D., i.on.l,, F. I. S. V,.!,iiii,-> I. an.l II. KiuMrut.l l.y n , -i-. :;-
LT.r.' i;i_>. Si.M unlv 1'V >ulir-rri[>tiuii. Sec ]ia_v r>'2.
Curtis, Edward, A.M., M.D.,
MANTAl. (F CHNKHAL .MEDK 'I \A L TFi 'IIXOI.Oi ;y, J\( T.rnTVi ; ri?K-
sdlll'TION \VIMTIN<;. OIL- vuhuiii-, :]-Jui., :J:J-1 p:u...s iin.- :u'.;-'.i:i. I 1 :; .
Si. (in. \V 1's I'.M-k. t Manuals
"Tiii' !!i':trii' ~ysTi'!ii i> cxpi:iin>Ml in ;i in;ui- jiatieiu'". It is \v'::at :n;iiiv wav.' a: 1 .'! . -'
Tier nt niii-i. liu-iii an.l aitrartivi', ana will no ni-fil," >'. L"tti.t .\f.-,':,,r/ .],,, , ', ,l;,ii iary.
<l,nihf a. inrlUh nrifii in tiif \v:iv nf r.'n.li-r- ! x ^l.
i:u r t:ii~ nu-tho.l l-'s-i liista-teful to thimt- who " A v.-ry iir.Tv.rt-int f-atuiv i.f t' 1 \v. k 's
Irr. . _'iv.-n it Kut litrlf at tcrit ; oii "Tin \f- /'- it-t i-lt-ar cxt'ii^it : ini . ]' r ':.. r- ' \ '..:> :' : :.. ]'. _'-
<./' /,' " '.'//. I'iiila.ifii'hia. Pa... .Tannarv. 1 -^ ! lisli a pi 4 h- vane-;' \vci_'i;f . aii'l :; r :- :; >- t. i!v
" Ti.is lirt !' manual is a tersely I'niiipOM.-d m.-t i ii'al fnriu?. iiu\v sn i.t'ffti ~i <:. i:: I !:>:.> -. r
tr.aT.i-- 1,11 thr Mil, j-rts rHVrn-.l tu almi.., in a t.-xt-l ks an.l in-. lira! j.. r:. .iu-a!~." 7 :
c'uiivfiH.-nt ;iml antinirifitivf xirt 'if way thai .!/ '!'' //-/''/, Luiiisvi'lo, K..,, Fc'iruui'y,
ifiuKTs it a i.ainiy ci)ii.-crvatnr !' tniic an. I l s ?l.
Roosa, D. B. St. John, M.D.,
"Tin' L.-xii-i!i TI;. a :]- ('ir.-f iir.il nno- 1 .-n- iv.. I."\ ; . . .n A-
fi.iir'ii i''..' l i.'~ in Ii-i!L'tli, l.y twn au.l thr. ,- n. -t !. MI ul . i:. :!; \.
r ..-l.t 1 < in li'.'railt ii, a'.il i^ tliri'i' t'oiirt h< of an who \\-oi-, M )!;... t . ,
iin-h hirk-. Tin- wh. .!' work i- u-.-l! itmu-." liirMoria TV .. : . i.-.
"'l'.;i.- i- tin- .-:i.al'. -t of Knok.-,, aibvil ail i:.\- / i:'.
!'" PUBLIC ATIOXS OF WILLIAM WOOD \ CO3IPAXY.
Tidy, Charles Meymott, M.D., F.C.S.,
LEGAL MKDiriXE. Volume I. With two coh> red plates. Contents: Fvidenco
Tli.- Si_n> of Heath- Identity The Causes, of Death The Post morK-m. S<il<l
l.y Mll.-eription only. See ]I;ILTI- -Vi.
LEGAL MFIMCINF. V,. limit- II. Contents: Expectation of Life Presumption of
I'.-a'h and Survivorship 11. -at ami Cold P.urns- - Li-aturim,' -Kxplo-ives
Starvation Sex -MoiiMroMties ]Iennaphn>dism. Sold hy sul'scription oiilv.
See pa_:e ">4.
LEGAL MFDICIXE Volume III. Contents: L.-itimacy and IVernitv Preg-
nancy . Abortion Uaji,-. Indecent KxjMisure Sodomy. l!e<i iality - Live ]',iii!i.
Infanticide Asj.hyxia. I >ro\vninu Jlancin.:, Straiiuulation Suil'ocation. ,^oM
by -ul'.-.Tiptiou only. Sec pa^'e oij.
Castle, Frederick A., M.D., New York.
WOOD'S iiorsKiioLD rrtAcTici: OF MF.DICIM:, ITYOTFXF:, AXD STIM-FUV.
A I'l'aciica! Ti-eaii>e for the 1'r-e ot' l-'amilie.-, Travellers. Seamen. Miners, and
cthei's. P.y \'ai'ioiis Anthni>. In two voliiines. royal Svo. MM and !)-}'J panes,
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Ziemssen, H. Von, M.D., Munich.
CYCl.nP.F.IHA OF T1IF. PI1ACTICK ( >F MEDICIXE. By Various Authors. Coin-
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6 :.
Peabody, George L., M.D., New York.
Sl.TPLK.MKXT To XIKMSSKX'S CYOl.OP.KDTA OF TITF PKATTICF, OF MKD-
I<'IXIv P>y Various Authors. In one royal svo volume, S 1 1 ]%!_'.>. hoiind to
corresj'ond. Price, in cloth. Sli.(H) ; in leal her, -<T.IH); in hall' morocco, !<S.(ni;
a!.-o exti-a muslin not corres])C)iidim:!, sCi.llli ; and in red leather, sr.lilt,
^ - '" Tl.r aim of \\\\-. \\ ork i-; t" t:ik>- up <-ach ^nhjrcr 1 reati'i! of in Zicnissi n's ( 'yclop.-ruia,
and tn l.rinu' it do\\-n TO date. Mirny of the articles will, therefore, cinliracc the pi'o^r.-s of
t : v \.-ar-. I ut some. n-latm_r to th>- lati-r volinncs of ZicmsM-n. lie-in at a more ivccnt p'-riod ;
tic vhnli-. iiowever. forni^ a complfti- 1'i^unie' of thu proi, r n-ss of medicine mostlv for the p>a>t
ti\c years.
Carpenter, Wesley M , M.D.,
,\-- : -;'i!.' I'.n'-, ..'.. '-!. I 1 ., u.'v:, H , -t.:r : ; : In-inirt,,r in tin I'.u l i '. -.'' .~-.\\ T.:il>. .-:il . >ry "f t )..- Tir v. r-ity
. .. i ;; . . i N. -,v Y. rk >.-ei-.-t.iry "I It;. Mc'.li'-.i! Sncii-t> nf tin- (.'oniiiy uf .N.'W Y..rk . Secicuu'y
111- N. : Y.T'K i'.ch,.; ,/. n - < .'!;., -.
AX INDF.X (>F 'I'lli: PPt.\<.TICE OF 31 FDK 'IXK. Sold only l,y subsorijitinn.
Flint, Austin, M.D.
ro.MPKXDIT.M OF I'KIK KSSloX AXD ATSrl I.TATTOX AXD O]' Till' IMIYS-
[' Al. DIAi.XosiS OF DISKASFS AFFF,<TIX<i Till; LUX(J AM) IlKAUT.
On.- volume. iNii". -1:1 pa_-os, muslin. Price, ."id cents.
Paul, Dr. Constantino,
Prof.-- V A.T -' ii. rhi. Ka'-ti'ty . Me.ii.' ; nc "f I'.-iri-. . t<\
D1ACXOSIS AXD lHSI-;\sr:< o] 1 Till'. HI:AI:T. Tllu-trat.-d l.y num.-rons fhi';
\\-o,...l-eii'_ra\ in_'- So; i only l.y sul.-criptioli. S.-e pa :. r,l.
PUBLICATIONS OF WILLIAM \vnnn \ COMPANY. 11
Loomis, Alfred L., M.D., LL.D.,
A 'IT. N'T T.I M >K (T I'liACTK'AI. MKIMMNT:. On- liaM.l-.'in.. -vo v. .'-.....
1 . inn ;M_-,-, iilu-trat'-il l>y two li!i:i<liv< I un<l c!.-veii en.Tav ii;---. 1'r.. , :..
S'i.nn . I- atln-r, S?.IMJ.
"'I':,, v.-. rk ).,-fore us is a cornpl.-te rompre- wit h ev: !enr,-s of K-n-h unu-iia! ii-,-- . ;....
h. >.-.s. f.'-atis.- 1,11 i-!icral pathology an<l skill a t.. pii'-.-nt t:i.- -i;l. . ,-r 1-1 -, fi.--:. !u:.',
p- |.,1 i:;-"Iicir.e. Thi- :irr:i:i.:<-:n. lit. aii'l :i:i I t' ..-!. -1 i' ',' .1 in..-' :i.-.-. ptni.'.
ei i--i''e lion i> that which the author ha. s oi.- t" in. . heal lit' :ati;r, . 'J'ni i!l-i-r : .it :. i.- ..:
s. ;,. ; -,-, ti'a'-;.'.ii_ r . an>l islia-i-'l "ii ;i. i \ a::, e-I aor.Tiilai.r. ori.'ii.al. ;inl. a- a I'll--. i:>a"!v
r,- .,.._-. -ai kno.vl ,U,.." /..0,/w,", J/,. /,.,,/ .irawn. :,:i,l w,-:l illu-t.at-- t:> I. -XT u. :.-
A -. ,\,,\ iniii i '."^. l^^t. ih" sul.jrc's an- ili.-M-u-.-.'.i in [:; li_:.r ,i'-:.--
A ."ir'-fu! fxaiiiiiiatiuii uf thi- hodk iTi-iiti-s n;<i>t r.-c.-nt a.i.liti'.i.s t,. .,1:1 kn..u!< i-jf.- >.;'
T.' :.. !!.--! 'ii rhat it i< ih.' v.mk of our \\ ho j.atii..!. ^y an I t :.! .it .t ,.--." /'- 1 /'
.; ak-.'tii.,t wlii.-h !:< hii;i.-.'!f klu.w-. It is \,l.-., \f '.' ,' T 'l >,-,, -n.l,. r U'T. >-i.
i, it. a^ is t ,o of'fii Tlii- ra-'- in s u-!i works, a " [ is an rlal.!at" \v..; k ><: i , ! i"j j,a_',-~. \v.''i
i:,--:.- 1', van. j'iiij "f statrin.7its which ha\f lirrii ii fuil imli-x, :ii-il is is~ii.-,l in tin- ;nM:-!i,:'s
ji i;i-t, :-,-i- 1 Th:oii,;:i a loii_; s,-ri,-s of 1 1 ,-at i>-s !,r-t -lyl,- Ii ii:':^' 1,.- iat.,1 a- .:,, ..I !:
i !. L, | : a." !' "t' jiii-.lii'iiu'." .}[< ili<-'i.l. .I'i', staii'iar.l works dii t (:. tin- .rv airi juMftio' ol'
I > !.(>;. i 1 .. r '.'."). !~-^4 ni.-.lii'in.- in t:ii> country, a::.! .-;.,,;.'! l.avi a
"Ti.t \\,ik 1 1 ,i\ I'l'-i-s tin' usual tirlil of in- |irrfi - ri - iir>' IIVIT tim~t; I'liiaiiiitiiii; finiii !'jir.,j.i-,
? : a. i, alii 'i'>.;v c.iiisiii.-r.'.l in ti-xt.-lio.iks . \ > n n i> i-.iit.-.l in tin- coiiiit i \ " 1':, '!'', r-
r;, : t':;' p-.u-ti <_ of nn-iUcine ; lr.it itdors.su u/ >' (''!.:> tt< , No\ csnli. r, l^^l.
L!JTT-RK> oN DISKA^KS OF Till' 1IKS1M HATi >UY oRflAXS, Hl-AKT AND
!\H)\i;VS. (>:, v.-hiiiu-, Syn, .V.U i':i'.'. .s. J'ri.-.', mn-,;:i. S.'I.IMI; 1. ati.. r,
11. 1 HI.
"I - :-.!. ar in -tyli-. cr.nv. niriit in arrnngi:- '' \\".> I,avf> r.> h.-itation in t-v -.;; !::_ :
I:..-:.', v.-r. i!--tiii!t'- an.l ].; a'-1 ica! in itsti-ach- on.' of iiiucii vain, to tin 1 \*\ >: r-- i :.. ;'....!
ii - -I'",:'.,,!. ',,',; , .If../;.,,.' T.,,, ,,. la-lily ..iv.lital.k- to the aiul:.,:-." A- )'. ,
Wi- Ilk'- the .-\st.-iiiatic iiii-tho.l in whicii M, ,;,,.,' .!,,,. ,,,,,/.
*':- !' I-T ,;i-i-- ;i;-i- aiTai:;_ r i-'l. an.l n 4:111! lln-ni " \VhiV tin- \ irw.s JMVSI '.it.'.l arc ful!\ i;;,;i
;.- i-X'-' HI-HI in ..'Very way." <_'; , ' , ,-<it '> /./,- \\hat is ac!':all\' kiiou;: on ihe .-;;t- : ,r;^
.-' ' "'>- /'. t:, -ii'i-il. tin- iloct: -iiu-s ai.- ; ;:.l;ri, .i;~ a:..i -a!-.
"h. ;. I;L. '.i-t'iifi- v.s tli>- r. -til'-r may look Atth' ~a!ii.' t inn- t h.-y ar.- j.;-. -n; i\\i'.:-.:i
i :.":.!!'*!;. for T!ii- last wor^ls mi tin- su'.j. -ct, usual c!. nn. --, an.i v.nh -.i;tt:ci,-:> ;. --ti-..-
!\ i ::.a\ iv-t :i-~'ir.-'l that what tin- author ni-ss to connnan.i con!;, |.-nc. . " A- ' "
1: -:..-!. i- !!.:..irt-.| to ti,.- pros is tin- l--iilt .I/../.'.,'.' "// / >- ,.;.', ,'./,.. ,-,,,:.
of i . :. !.-.i' :ii:i_ r . soiiii-l ',uil_'in--ht. an.l thor- " l!y all luran-. l<i.y l,oi .:ni-' \vi -rk ana -' 'y
\\". ha v. I., for.- us, thi-ri-fniv, a '.ook con- i-!ra*ion of <in_'--. It i- a ] k t ;,:. : v. .1! w. '1
\i'ij -i;r. nn-:i- uf pract iivil la. -is relating n-;,ay can-f i:l stu-h . " -H'. .'.
'. r ::.'. 'no i,- o:' origin, aii'l ],r.,pa^ation. ainl will he iis.'ful an i ai-c.-j t./in. < ',,-;.. -.-
-, a- t . IN- .M-i'v '-omp!cli.-n.i.-.i i|. nt ami !: ac: '.: io:.,-i ."_ \ } '..' '
..- ;:: ' -! l.-nt. W. a[, . lu-li.-v. they ./'-/-
i- i \\it.ioii! -,',,- i: in- -, l.y the 'la.lv " 1 n 1 i! is i t.t.'i-.'-t in^' vo!-:ni". u h: 'ii r..::t ail. ^
I; cciiir.iin- iniich jirac t:.,- Ii-ctuics :. f.-\. is ! ii 1 .. '' i ' '. I'i. '- r
.. -V!.-.i,[ ..ttion ,,(' ! ii,- in.-.lieal prof. ~ ha\ i- a e. : i-i-e :i".I i!iij>:ir' 1.1 l -. i. . ! t ii- i:'-
i .-.::>. stat'-:i.e'.! . ! ta -I- u it h i r.i* ur. i - <.iie. i ni: ^ |.-\ i s i ' . - I '. ; '
i'. .'. - * -,o ; ' . rl'iiij. i in _' p.-r-.pieiu( \ o! i- r 1 ii" -k-. ' ! - i-a .-. t '.- v .- : -i"! '.: (.::'_, '.
]]}_: )Vv. r- ' l-i t : i- a- > iiil'-ii i:- i 1 :.. : - -',1's
-T-V ,"'; of p. ,,f,. --or Li M, in is' is a of t ::i- a-'th ,r's , I-.M. . \t r.-Hi- . .:,.! \: r-
.-.-:' ' ion to :u- -l|."i! ir i at 'i ' .-. r .'-in -, \\ nii-ii n.-is 1. i ; : i n, ;..;..',::. . . : ::>.. i. - -. :i
'-.,'.'.:'. ,-u : j.-." i > t-,.i"i i \ prai t ; - .-. r' !'n r.-.-i.<-e* - a ' \ -n i .:: w it !i :..-. , ,\
:i'; . i - i :. -: i ,.. |, i nut -,- with wirit I !] -otm oM:>T i ii.-<T> i - : a: 1 i ' ''. .k p- :',t- -I
: ...i- !;:!.-> l' oli- l \. '1 a! 1 in- l<i-. Is iile. t ' i - ar. i in . e - -t pi . . I e -A In !..v. , i.i.t,
, i _ 1 1 . ; 1 1 . . f f \ . r i - i : - 1 i -, : . s : . . i ' : , - 1 ,'!::-. i -
] % 2 Pi I'.LICATTONS OF NYILLTAM WOOD & COMPANY.
7>/>v </.v, x of Throat <tn<l Cluxt, of tin Juct
Corson, John W., M.D.,
Ingals, E. Fletcher, A.M., M.D.,
I.KI -ITI;KS ox THK DIAGNOSIS AND TRKATMKNT OF DISKASKS OF THK
CllKST. THIJOAT, AM) NASAL CAVITIKS. \Viih en,, lnm.lr.-.l and tliirty-
liv ilhiMrations. One volume, Svo, 4:'>7 jia r e.-, luu.-lin. 1'iiee, S-1.UO.
"In briiniini: within one pair of book covers student ainl practitioner, in the -ti; ly ..f its
a c ii.-i-t' epitome of affections of the chest snli|ect. It. is clear and conei-e in st\!e, s\ --
. , !,in-.- iv-piratory tract, Dr. In<;al.- has tematic and th iirli in the coii-idcrat ion of
/., : ui,' int. r.l,-].rn.I.'.,t jvlations of a -:n-h >h-iMl."f/,ini;/-i .)/- -i',, ,,l .!,,,,, !,,
^iciiiji nt' a'.;it"inn','il rr^ions falling to^rtln-r /:'j'>i>tilin r.
i!-it:;r:i!lv. Imiii in hi-t < lioLry aii'l jiatlioin^y. ' Both a.-> to the matter anil arraiiirt'in'-nt of
] 1 ;~ \ i >!i ; nil- aims I i:rivhy at an oljjn't ivi- coin t lie Imok, it niu>t '" o.t j^real ser\ itv t<> tin- <ir-
: !i ti : ' -,-i '.' liicii ha- nut hithei-to liccn attain'''!, ilinarv j'liy simian MS well as to t he sp-ciaiiM."
tui .- wli'ilijc, i'i any single work of jiiiy>i -I ir;/i>ii'i .\fiiHi-nl !A. /<,'//.'//.
c.il ilia^no-i-i, or on any disease of the cliest " Tin; work is of the most prai'tical eharae-
and air- i.assa-cs.".!,m //.<(>< Journal f th, ter ; i; avoids theoretical and i, n-et il.'d - r ,e- -
s (ions; the subjects aiv ple.-elited in a 1'ieiil
" l-'nr L'ood. practical, and correct teachnur. and compact .-tyle. \\'e piediet !'..r t!i:- '.vo|-n
I! -;,i-,.r There is 110 Volume a wide licld of u.-el'illl;ess lieeanse it >eiT.i-'.|
would lie nioie usi'l'i;] in the general us t n I ^e exactly ada|ited tu 1 he H-e of The p!i\
: titioiier'n daii\- li t'e. " . I //< ri'-nn Jf-'/ifi! ,-ieian in act ive prat t.ec. " . I/. ir>/''ii'-l M.i
II , Journal.
"This I'unns a valuaMe. aid, but'.i to the
Kclscy, Charles D., M.D.,
Till: l'ATIloI,o(iV, lil.\<; \osis. AM) TItKATMI'.NT OF DISKASKS i)F Tin:
III'." I'I M AM) AM's. One volniu.-. NVO, |:;d pa:.-. iUu-trat. 1 liy t\vo
i hr-iii iili" npiiie plates and inan\ v l-i-nuravinirs. I'ricr. in cloth, ^l.(!i>.
" Th" aiin of tli IH --it. make " ! fonnsthc l. -t re -enl uo,k on a , lass of
this I !: ; t s-,f. _MI i tiident and > . din se ,vlii. , althonuh claim, d I.y sni-.-rv.
or :.l pr.e't iti' n.'r. aii'l to fni-ni-h t hat int'ornn ha- more im dical r. 1 1, -it ion than n.o-t ph\ -i-
. me!: i- -o ilith'cult to olitaiu with ul i;i in awiue."- '/''<' '"..,'/. ,/.,/,,./'"/;,,,, /;, .
:tdvanta,'.'S, such ns arc ol.taimd liy ",-,/.
cla.ii--, .te." " The \vork is ;ui excellent oi-e. and will !>
' In , nclii-i-in. will add - appi - : it. d." 77,. /'/,//,/. ;.,..
ha- -nee, , d. d adiuiraliU in -i\ii ' ' />>, .,t! : ;, .?,,,:
will u'f'-atlv advance tin- domain df ri-e Th, tinleiit and lni-y pract it i< .n.-r :\\]]
v. and eneonra^'e leans a praet it ion. r liml i;. re in a condensed f,,i m all t hat i- ] o-i-
- heieTofoi-e -!;n:nk f'oi ,1 tin- disi ,-(,.. tivi.-ly known, and much that ha- not he''ore
Pii and uni-ati-1'act..ry l.rain-h of sin::.-]., to . . nl, d, cone rnin^ di-easi s of t!:,' ;-e,--
a_-a:n \vitli 'r-i:eweil contidellCc." t -. a i. 1 a- i: -."---/'/,< ,]f, d'vil. /;/<''. M/'. 1'lii]-
A ' ' , -,./ M,-r,<-al .I,,,,,,-, ,<il. ad, >! ia, 1'a.
DISI:\-I:S <T THI: HKITC.M AND AXTS. s ! \ o:.!\- i .-.- -iii.-eri, .: -,:,. <,>.
I'lTuMCATlONS OF \YILLIAM Wool) A COMPANY. 1:5
!>/'*, /is, .v nf tfn- J'iirfnin <///</ .!////>, 77" 1'iij"
Bodenhamcr, William, M.D.,
TKL'ATIM: o\ 'run IIKMOUKIIOIDAL DISKASK. civi-i
('..;-'. |':ttli"!n_'v, l)i:i>_r:iii>i>. an 1 Tivatnifiit. <>!n- vn!niii'-
;'.!;-]. i'i ! Lv t\vu rhriu"-!i: !i.'_ raj'hi'- j'laU-s aii.l many w
iiAiTicAL TI;I:ATI>I: o\ Tin: .I:TIOT.OI;Y, PATHOLOGY. ANI> TIM:\T-
MK.NT <r Tin: CONGENITAL .MAI. FORMATIONS or Tin: KIJ TIM
i'KA'TifAL or,s!-:i:vATio\s ox Tin: .i:TioLO(;y, PATIIOI.IH.V.
SI-N. AM) TI;I:AT.\II:\T oi' ANAL n^si'itr. r.ii^nai-.i \< : - -..'n^-i-..-,
!-.;--;,. it -{in:: ii;_>. ( >n.- vnluilli 1 . S\-<i. ! I 1 '. 1 { - -. liril-lill. I'li.'t'. S'J.'.'"i
' T:.- t: 1 . ati'-i- i> r'.V" i_-h,,;;t ( -:,:vt:;i!y ]n<- st" >: il" ir-. \VM.-M t M a*-- 1 i:>. :< ~. i.;ir.i'' v. ib: -.:
....i. ii: i \\-- r- I't.'.in::--!! I ii :i^ a valuaiili-. u < >^,-t t In.- Mibjirt in an i-xini' l--'i a;i'l iniuul
k. u.'i! i :! (.la.-.' in a!n \vurk- I'nnu." v . /.""' .\f"in" ! j\'- ,.'<,,.
-I.'.' .'.,'../ s- ...,/..,' /.'." ,,.-,>,/. It v.-il] I,,- j,, ni-,.,| \VMI. ;jit. P--T aii'i ['i-.iii'
'I'..:- 'i- '!..- :. ,- r-;i, !>!.!. airl rx'trns: v l.y all. " ] t, t ,;<> /,' ,,,,.'' If. /
..- . t:.:~ . rv painri 1 aii'i iniiiMi-oMii- " U'c ln-lii-v tiiaMln' -uli-i.-T i.;,- p-.-.'iv. .
Ringer. Sidney, M.D.,
'! i '-. - ul' liir- i:i'ii!f> r!i;it \vr --a::']-,! \,i;i;, : V
'i-' .' 1 I i :!- i i Iirirli lai'jrr I i,i i :,p -u: i.--. I
':':.:.!:' ilisca-' -v >..:><!' wit ;i n: T.-I'I--: ;.!,
'. !! r.. nun. n. I' 'i MI .-I run :!., v.'ill '. !.;;..! . i
'. :. I ; i t.. ..iv I'H ". : t :; r. ":-: . 1 y I ', ;,: -, f , . .
!' ! !:.:. V : -i- ,),.-. I'i "ll: I ill i^I' 1 ,1> i- , . ,.;', i . I t !,
.l',<lr. M I1V-T l,:i.\i'ir.| I.. . ;i i , - ,':, :, ,-.. .... ,
- i :^l.i.'' .^ . ";v ii. i-iT ii ,;i in fiii.ti 'i-t ii .n r. ,M t \. i.. .,o
tli..- N.JV. ^'l.:K J )l-.|"'U>;irv all'. :; .ii.. i in- l.-ii<::i.
1 i I'tT.LICATIONS OF WILLIAM WOOD & COMPANY.
M<it< rid Mlicn, Tin ra]
Fothcrgill, J. Milner, M.D.,
iNiM'.r.snnv i;n.itrsNi-:ss. AND cm T ix ITS IM;<>TI:AX ASI-IJ T<.
I',!-! 1 I ;idi_. ~:io:t a:id Mi!idii-!iess. (.'no vnluni'-, 1'Jni". ;!'Ji) i>;u> -. in;;.-i;n.
1 T ]'...'. if li -tion to Imliits (ifl'ifi-, four chapters aiv duvdted to it" functions ai.d
.;. and t<" the perfect niitrt- their di.-turtiatices. lit n t'errin:;' in ti.' 1 in-
!;..;: , ,|' ti;. Kodv, a:e t:. ! it! ;i i-ia-i.rh Iliirluv uf mental xt ruin ami \\orrv. Dr. l-'-:h-
m-im;er, and .i!iomid \;\ ]ua.-t ical hints oftiie IT. rill s:iys : 'Talkm.: one il.-iy with Mi \\-.\\
^.T'-att -t I - -!!'! i;ulii v in the p-.u-t IMII:; pli.v- Alilmtt. wlmsr litMviil - l'nr iiial-nc.; h;i\i- -licit
Mr, :IM. Al!"L,i-thi r. tli'-wnik .~:i 1 ' :u:i : k;i ! .1 y a wi l!-<I.'>i rv< 1 1 ivi'.nw i:. I a-ki.l iiini. "\Vi.o
<.'-[".; ! ':. !-i: ^i \ - ;i'lv i>f i - ' '.vlm-h i< tmi :irc yc-ir dinli.'tirs must ly V ' '!'!:' '.' {'ly \v;i-
II:T!>- i:r. iT-t", -1 l>v T nriin! ity nf i:it.-<llral \>-ry siu'iiitican t. " H ;(-iiH'->i ii.''ii. 1-1 Ti.pa; ;i-
!:::." \ )' ' I/./' -' /,'. /. tivflv c.l-l ;iii(l '_'r:iy fur tlnir yi-:ir- ; iiii-n '.v!).i
1 >:. ]''!]. :.:!.- Kv:iys cmiuniiinl l.',,ka-, :)' tln-\ hail :i d.-al 1.11 lici: niitnU.''
; I ami rl! i't' in- Tills was tile iv,-i|in-*'. I' >t.ii;.l- ii: -':u^'' >-
farfs. dr.iwi !iin.tly fmrn his n\vn tivi- n.-liitiditsliip to t!^ fact ()' ;irntf 'ti;il'i-!is
' Tlii-i viiliimc i- wiiit.-n \>. in:;- si-t up by slioc'k or other nit'iilal ]MT'::r-
f: '!! , I lit, and K". 1 n i > li-it ic in. ur df its artificial jirndiu 1 ! ii) i >\ 'he
\ .' . . ;ic I'tiMt >'f natur.'il (liL'^stinTi, l>y w;iv puncture ot the fldorot' the I'mirTh vi-l!t i iele. '
. ! : . di- ;i!iti'lif>is tn the Titiiiu tdj.'n: Tlie \\ln.le )v;uk is pi-;.ctii;;il and iiimv-'.iii:;
\ ill ivi i 1 is t!ie _r''at store- )va ii;i_'."
i - ii) -':;':'- for the use of tit- system,
Phillips. Charles D. F., M.D., F.R.C.S.E.,
Garrod, Alfred Baring, M.D., F.R.S.,
: re ;i lui, f , , ;' :..:,:. , . :t
If li;i] pai (s !i.-ii,_- :,.;-TI !.
' : ln>- I I .'. -1 a Cdllill.elltar) r-n t i.o I'i,:,y-
: ' ' W"tk t . -.innc-whril n' in'il" - I'i.i'lii -'
' ' ' I : ' >' ' mi I lie 1,, .11 ion 1'liai III;M-. ! i !'i,
' ' ' ' : ' " I jh mm < \\' ndi-d in it - di sei ij.t jdi. i.; t "."
'.-. :' ' mother i ill and uses of I't-iiii dl-'h." /:'<<''''< '! -
' ; for.' ' - - ,/ .<u-n.il.
Trousseau. A., M.D.,
. . ' : ' . ' ' f - (ho ril't." Pio:;, .
Till:!; \1M-'.I !'1< <. ' , l> I'. I.IM m \. M I)., fv in ' ... Mat-rin M.-li'-a
: i:ii::- M. i i . !i(.-d. V..!.i!,i- I.I!.
; ' Tr -- 'in T'. '! , : '-i.f. ss:-n - !: ; - t.'-'.f.'M.d
; . ' . a - 1 l.i - d'-Ii::i,! T.i -l \ ! n-ii.ii;. i:d
i Tiii - u. 1 1. i - -aid '.. In- Hj'ji'-ridr to -iT.y
_. n t:,oru'.ig:dj, i- vis" d a:el c iit-.M h\' Dr Paul, ai.d 'oro-i_';it
PUBLICATIONS OF WILLIAM Wool) A fOMI'ANY. 15
T/ur<(j)t~uti<'S, C/iol< rd, J tniijno.-*}*.
Binz, C., M.D.,
IT'ifi'ssor of I'liarmnrolopy in the University nf Bonn.
TIIK KLKMKNTS OF THKUAI'KrTICS. A Clini.'al ( HI! ! ! . !,. \et! : \\.\\-
ciuos. Tran-lated from the l-'it'lli (iermaii F.dition, and Kdited, \\\'A, \ i : ;
iu conformity with the British and American I'hai n, ie..p > :,,-, l>y l!ir.\ \KI> I.
S!'.\KK>, MA., .M.U., Ox.m , .Meial>er of tin- lloyaln.! of' Phy-
London, Ollicier <lt' Santu i Alpes Maritime.-- 1, Fran< , i> rm.-r!\ IJ:i l.-!i > T:..
liiii: Follow. In one handsome 1'Jiuo volume, '.>\~> pa_>-. Pound in \!ra ; .
lin. I'ritv, ^.(M.
''Fully UTI to ttio timc^ as a therapeutic vance the movc-mmf tu f-talili-li an u:avi:-. ; l
pui,i,.."_l7',,/,,/,i M,di<-'d mid Siti-ijii'nl .!,,,(,- I'iiannafo]xi'ia." A" /,'-/../
/(''. "'I'iif wurk a[i[-:irs to li;ivi- !>. in -.vrf :i
" \V.' art 1 much mistaken, howovcr, if th<> with m\ -cat run-, and in-ar-* tiii' iniiir ,,i .,._
\Mirk in its prosi-nt shape does not lieeomr a lialiihty. and IM a vuluine that \vi-i io :.>: .,;-
t.''-neral favorite with l>oth student-; and jirac- tate to ri-eoinnieml in tau rti .in_;i.-.-t n.anne:."
tituiiu-i-.s. It will also help, wo think, to ad- Tlu Ml(' <d U-n,-<l..
Wendt, Edmund C., M.D.,
A TRKAT1SF. OX C'HOLERA. Edited and Pn-paivd in Association with J..ii\r.
I'KTKISS, M.D., New York, JOHN 1',. HAMILTON, .M.D., Sinvt-ou-c.-n.-ral i'. ^.
^larin- llo-pital Service, and Ki.v Ah ( 'i.Ki.i. \N. M ])., Sur_'e-.n I'. S. Ainr.-,
Illustrateil with maps and eii,ni.vin_'s. SoM oiilv la- snl'>er:pt ion. S..->- paj>- ">1.
J .-"' Availing themselves of the history and exjierieiit 1 " of cholera ejii.l.-mics to the pr.'~, nt
day. together with the new li^ht. thrown upon its mode of propagation, ypn ad. and Tie-un nt
tin.; pa-l year thnniLrh the investigations of I'rof. Kocli and others the kiioulcdu'e e MC./I inj
preventive measures, quarantine, etc., so recently acquired in France an i Ir-ily- th. !..!:. 1
authors of this work aim to proiluec a hook which may at least serve to prepare tile pi"!, --a n
of America s:icces>i'nliy to comhat this dreaded scourge, should it unfortunately _:a:!i .1:1 i :i-
tnince into imr country this year.
Burrall, F. A., M.D.,
' 1' i< n special merit of Or. I'.urrall's timely achieved this chief cud of medical rcs,':>.r<
volum--, that it so .-tat.-s facts as t<> in>t ruct For t l;is n a>on. no le<stha;i fi .r t he -.:;, ,! i ;
ti:e i-i-adi-r most i'liju'essively and acceptaMv exei'lleiu'ie-, ( ,1 this ln-oeh'ii'e. it ]~ ,111 ! o c-
in all r ha' n iat. - to preventive measures and maud the utteiit ion and r< _ra''d of t' c pi> :'.
prophylaxis. \\"e irive met witli no writ in^ on sii.n." .\T'il : <.'tl // C'n'-l.
ciioler i iii oiir language that has nnji\' happily
Brown, Harvey E., M.D.,
KK1'< >KT ON" (.ir.MlANTIXF, on the So,ith<-ri and Culf Coa-fs of t!ie [.'nit. 1 >;;.' -.
Oil'.- Volume, Svo, 11? 1'a^eS, luuslill. Price, Si '.'").
Dclaficld, Francis, M.D.; and Stillman, Charles F., M.D.
A .MANTAl, OF PHYSICAL DfAi i.XOSlS. Illu-fraU-d uith si:; r!-., t - 1 .:: I
trali~par,'iit litliouraplied plates. ()n,_. vuluiii--, It--, '.111 pi .:;:',:
S'J. (ill.
'' Tin want of coueisi-ricss in th or 1. nary lv \\Y canii"! iina :ine a?i\ \\-\\ \\\ -\:\\<\\ ;
n. annals on ]iii\ ->ie-il diagnosis ;itrc< - t- t hi- aver- practical .-,tud\ of pin -p-il d: i ::,o-;- ca:: '
a.;i j student, and they never learn it until com - mad.' more . asy thanl,\ ''" ai.'i '.' *i.- - ;-
j'e'le I to. 'l'iii^wii:k is an t \i\ ptioa to this ]> rli \\ . 'rk. "- -l'-i- Jic -!/ ; . . -i.l >M',et^
rule." ohm Jf'.'.lic.u J L \'-<ji\ifr. ' J-j>u',^a : ..
!> ITULICATIOXS OF \YILLIAM WOOD \- COMPANY.
Ranney, Ambrose L., A.M., M.D.,
V PRACTICAL TRKAT1SF. ON STRiilCAL DIACXOSIS. DKSICNKD AS A
.M\M \l. I'oll IMIACTITIONKKS AM) STl'DKNTS. Third Edition. One
\.'.,;in. iif ii'.' x |i:u. -, iiluMrated by ;!1 ]>l:itrs. handsomely l>oniid in muslin.
1'ii.-. . Si. ."ill.
"t" - (";' i'i) a.'i'o'.mt of it< systematic ar- and in this country, in 1 V 'U. this is, so far as
ran.-. :ii.-iit-"- ' m .,"fi /. ' nul I'linti; we know, tin- tirst monograph ever ISMICU on
" \\ aieat a !>>- tn see h'.w more iiilWina- >in yical (liagiui.sis." I'liilinhljitiin Muliini
f.oii onii.i ItaV' 1 liii-!i oni'ii'iisi-.l in tV\vrr Tiimx.
\\tir\- ''.'.'' ! / <iil iin'l 1 ..>'- "Tlic cliii-f wmrco of perplexity in the jirac-
ti^-c of iin-dii'ini' and surgrrv is to tind out what
1' . s\>ti-;i and cnl of tiir vol- is tin- matter with ilu- pjitiriit. rncoinfort-
r.:i..- .-,:.- i.i.;i:I\ i-o-i ; . an i tin- author alilc, indr.'d. is tin 1 ictlcction uf a ]i actit icn.-r
li.i-.'.i , ^'H'/i'i-i, J'i;t,-- \vlieiili.-liaslrftacaM-l.anda.ucdaiiddivs.-rd
for a f>'it'-t'tr> \vhon, perchance, it may IM> a
"A \M-\ _ i id .: ; to -.'ir-ic -il di,-iL. r no^is for flinlni-ntinii. Dr. Humify has given us a look
I't.n- anil licj;iii:ii-rs. Asa to assist us in ali such stati-s of unrrrtaint v.
- il is ijr.iti' \al- and ho has done well ; for in I.IV.M ntin^ tin;
i II . syini'totus of dinrasr in niaikcd rontr,,st. it
"\\\-: th -\ ].:.:. of .Mad.', id's 'Out- makes the diagnosis of similar tronMes really
; -..id Minuitdiioouaiv in Enuland easy." Tv(> <.!<> Jful. un<.l bury, .limritiil.
Guttman, Dr. Paul.
A HANDl'.OoK ol" PHYSICAL DIAGNOSIS: COMPTJIsTXf; TUK THHO \T
TIlnltAX. \\H AIIHO.MKN. Traii>lated from the Third Ci-riuan Kdiiioit l.y
Vi r\. \\i-n. i:. M !>.. i ". '.'..v. ul' I'aenlty l'!i\ sieian- and Suri.'eoii>, (;la>-
'i llditi.'ii. uith a colored j.!ate and iniinei-ou.- i.lu.-t rations.
Loomis, Alfred L.. M.D..
-'' ' ' ' : ' , i, ,,, lilish,.,!." /;, -,-,;,' //,.
Ti -i- a uork air. ad\ Well and l'a\ oralilv
[uote.-sion. ' In th. | .re.-, i,t e.ii-
i text i,a- lie, 11 elit " IT ! \ I'evJSi d
|f '' " i d 1,\ The addil ion ot ti\e' n, w 1.
. :. .i/, ,/,-, /;,,;,,..
M id. -:t ol in, dii iiie and pnirhtioTK r
tin work to n. e, i their
-iiKi, ets of wl.ieh it t r, afs II R
i , . . ;,- d . >.-,-!. I' I ' ' \' , , '
i--' i.--i,.: !), |,revio l; - ,ditio]i* of the uoik, crn-
' ' '\'-t net 1:1 ,-,-. ; . .... x . ., ,, ]t ,, ,., ,/ t j ;i . ,,,.l,' r ,. r ,,f , | : y-i-
'!' ' ; '"' ^ ' : i:-tl..i, of t!,,- eh, -t and'al.doli ,11' we
' 1 :[ '' i-'i-a. :!:.. r ; i.-,ve .-.r.i.-i ;.- runonyti., vi-ry l-t v.oi ks
;'' d'.- !-:a-r. r :- eon- i.-ji., ir. . -I .-xtaid :.!:r| h- !!. r-' rointm ndi.-d
PUBLICATIONS OF WILLIAM Wool) A COMPANY.
llutilluj, (' I i inatoloijij, anil /'//_//.-/"" < : /y.
Johnson, Laurence, A.M., M.D.,
Bell, A. N., A.M., M.D.,
CLIMATOLOGY OF TIIK TNITKI) STATICS AND ADJACKNT Cor\TUIl>
ami >(' siii-h F"i-i-i_rii l'nrt> ami I'la.-'-.- as ha\ < ir.tima!.' Coimn, Trial 1!> . a':,.:
v.ith lli.' I'niti-d Stat.'S. with sp.-rial r.-t'i-r.-iK-,- t.> Il.-altli li<-s-n;-. aiM th'- I':
t.-.-timi dl' I'ul'lii- ll-:i!ili. S.iM only l.y sul'Srrij.tion. S,-.. j,;,..- :>\.
Fothergill, J. Milner, M.D.,
Till-: I'HYSIol.OGK'AL FACToll IX DIAGNOSIS. A \Y..i-k iW Y- _ Pi
ti.in.-rs. S i.l .-.litinii. Sv<>, ,'.")(; t.:i_-i--. r.min.l i:i mii-lin. s'J.'-'"i.
Ashby, Henry, M.D.,
S-i: :iMiis 'I'lv- a.i' .:\ v.;.~ in.|;i,-i..| (.1 l.rin^ n.'vs. Tlir |)ii.-tl -- (liap.i-.Nrr-,
til :. o'!t i" | :!!:. ill t : . !miu t l;:il t :: v mi- ii' T!i. S. n.-. ~. >:. .-.::. :ir , I < I: ^.\i.- . I . ' . I .'
|.t... . :-.:'.) tu . wi.j.T "cl:is nf -ti.<i,-ut> HM.l t!:.' Ai'i . M li\ ; In.;, -t mi;.! I'!. . -' M.
(.^ i-iin'- :npl (ifnv's Aiiatoinii s airi l''o.-t .'i''s Sy-tcin. an.l Tl.c: nn;!iii-T,-i .-
i.; >: whi.'li !niu'L ol' t ln> i:il'innati'.u r. iiit ai :'..'! l M.iv r.-a 1 ii! v a . ,uia !>!'.. "
i:: '..- v. i.fk \\a-i I'liuii'lc i. 'I'no n.-v.'iitft-n nt\'-
Comstock, J. C. ; and Comings, N., M.D.,
riT.I.irATIoNs ol- 1 \YIU.IAM WOOD & COMPANY.
/ '// txiolot/tf.
Kirkes' Handbook of Physiology.
11 \N !>!'. >< >K <>!' HI Y~-I< >| < M ; Y. 1'v \V. MiWKAXT BAKEH. F.R.G.S., Sunjpon to
St. Hat'tli.. l"ine\v's llo-pi'.d ami 'oiisnltiii;,' Smx'eon to the Kvelina Hospital for
>i, k ( hil ii ii . I. eel in [' MM 1'h;. -:.':.._ v at St. I'.art h. 'li'im \\ 's Hospital, ami late
Met.. Hoard i't' Kxai'niners' of the Royal Colle-e of Stin.'c'<ms of Kni;-
1. in. 1. an. I VIM INI i>i'K\ii:i; ll\i:i;is, -M.l>. J."inl , I >. nionstrator of IMiysio!-
o_ \ at >t l'>ar:h. 'loniow 's 1 1 . ..-pital. Kleventh edition. In one volnnii 1 , with
.iii. I livr hundred illustrations. Price, muslin, -l.(HI; leather,
S.'i.tH I.
-. . 1' li\ ;. . tlii 1 lit"-' developments " As a jjnidp for the student, ami ready rcf-
.- : it treats. The illus- rrenrc lor tile jiractitioiier, tliis work is not ox-
. - . ui ! ii-eti'.l an-l will lie found relic. i l>\ any oilier in the IMI^II>|I laii^Mia^e
I I., tin ' ; i. 'it in his rtinrt- To for the eieanir.-s of statemt 1,1 ..!' e-tal'lislied
i inaster eVi-n the inii>t inlri- farts in tin- si iriiei- of \\hieh il treat-."- T/u
, ." '/'/',, ///,,- S.i,,;!,,,-',,!!,. X, w York. April. INX,.
. !' da 1,-lphia. I'a., July. 1 ^.\ "Tin- Messrs. \\'ood uo not intend to ior.uet
'!!;.' ord.-i of Milijcel -. and arrange- t lie juniors and i;ive tlu.-ni th^r.-lon- tin hest
: : i:oii1 th. \olii in. are -.vorks at a nominal prier. Tin re i~ i ardlv ;i
I 1 ...- ' i. ;i- M handhook. the ah- j.iaet it KHUT ol s. inr \ears who oid not It-am
I aru'iinii nta'ioii on the piinriph s of physiology from Kirkt-s, and
I litioMal reeoiuini'iulat ion any work \vhieh n-achc> an i 1. -\.nth i-diiicni,
I'll, illustrations cm har.llv !. show- it ^ intrin>ie value." '/'//' ,\ "/'// .li/n >'-
; . . P- \\vll diawn'und i>'"'< .In,-i<,il ../ //..//,., ,, t ,, ,(/,/. I 'hilaiielpliia,
thi-, is the chief end of a j.iet - Ma\. I ^S.").
. . ; . :,-''. ; '" .!/'./- "Kirk. >' Ifandliook has IM.-II a popular
. I. ->!!:. K.V., JiilH', 1-S.\ t. xt ook of physiology for >o many \eais
"T .;!' us i- a revi-ii'ii and im- that its flcvt-nth edition hardiv calls for an
I ' ' \\ .- - I '; \ -r ... I ' ] - a ext. ndi-d no' 1C--, much h -< a I f\ iew. It is
. : i-vc.il. ; i.vk. . . . To tiio>e i.f us enough to say that, th.- editors, wiai are n.,\v
vs. paid n-v. n ne. to praeticaily I h.' authors, have maintained 1 1m
: ' ; Kii k.>. this hook com. -, as ;i iii^li eharaet. r ol t he work, and Inn e kept I id-
: : . . i ':'!. a:. 1 p.'.- 1\" lip t o t he t lines in t he si'iein'e oi' | ii . vsinlo^v,
: . made -in h \ast pro;;i'e.-s uitliin ti.e
: . which liav, '.,n . . - 1 :'. \v \ . ar<. " '-./,'//,, ,;/* .]/, ,/;,,,/,/,,,,, -/,,,/ (
P'.c i.t time. \\ , ;. o; ,M. \ . 1 -:>.
- i - ik.' /'',. >-,'',,'., On i lookmiMhroniJi the last edi-
\'a , Ai ril, 1 --.".. tion of Kn kes' 'I'hyi-ioloiry. which is. Imwevi-r,
' i \\ork has I -en tl lor- rea v K - . - it si-ctn- to us, <mlv t hroii^h the
ipto tiie tim.-s. co',iri.->y oi tin- editors, we can tin. I scarcely
I' . . i,,,,!, |',, r iin\ i him_; to criticise. It seems thoroughly n;)
1 , n ' , i he lime, /nid u'lnle moot poin'- in plnsi-
iins I i-ii ei in : not h. -i n entirely om ii t.-d. they arc
' tun .ei rated in -neli ii \va\ as t,o nnder t hem easiiv
- . ' ihe t<xt ha- cempreheii-ihle to the youim.-t -indent of
V- / Tl,- I-H'IH /it!,' I,.,.:, /! . May,
Lambert, T. S., M.D.,
;!M\i:v -v- i KM \T!I H i M\\ iMiYsioi.ocy. ANATOMY. \\D nvr, n:\i:.
- and el a-silieat ion. ln.t h -im j.'.e and
t.-d to tli-. ii.-. of yoiniu scholar.-, due
- . : l'i ice, 's.'ie.
Brodio, Sir Benjamin. Bart., D.C.L.,
PUBLICATIONS OF WILLIAM Wool) A COMPANY. !'.
Harris, Vincent, M.D.,
Power, D'Arcy, M.A., Oxon.,
Mi ail.iT nf tin- K'-vnl Ci.ilt'Ki- "f Siiru'i-nn.-- ; Lit.' . \.--i-tant IViii.'!!-: r;ar "i" }'.,-'. ''.- :' -
MANTAL Foil THK I'll VSK >!.< )( IK 'A L LAI'.olI AT< >Il V. OIL- v...;m . - : t
].ri_--'S. !'"i-t v ilhistra'ioiis, m'i-lin. I'rir.-. Si. ."><).
"'I'll.' pivs .'it littif volume. r.h!n>u<:h of -.TVC tin- ix-oil* of any who may <i.--iit-, t'-.i n.-li
me I' .-t pit t'-n-ions ami narrow in -oopi', i- a nianipuluUs'f study, to familiar;/' \ '.!<:,-< \\ -
rcli i!i!f ^uiile-lio.ik for thi- stmli-nt, who tlt-siri'S with flit- .-ssi-i:tial> of hi-tolo^y. h:-t" <
tn l.'-ira s.im.-thiiitf nf tin- ni'iiint-iits of hist>>- i-try, ainl physioloL,". ." /.,,//,V.r
h.jirai m.-tholsan.l liist..-rii mi.-try." -Me//- .Wx, Octal.fr"->, 1 ^Vj.
, ,// /,'. ,.-./, S..-pt'-m'o.T ". 1 vs l. " Ti.i- lit t!i- liook i-- a 'i-j-ful ai-! T.. >s, rk 1:1
" T hf prommt-mv Lfisvli to 1 a 1. oratory work the physiological lal 'oratory. It - main - r- !._rtli
in all well i iiuij. ;('! m.-'lu-a! srt.o .1- Iris fro- li.-s in t;ic .lir. rtion- iris . n f..'-r. .'.!,. iu_ :::i-
ato-i a ili-:riai.il for surii i" .ok.-, as r >, vohnnc ci o-ooi 'ic c xaniinat ions ol' i :>-i;i-s "_./'', './-
utnlvr iiuiiri-, wi.ich is in i vrry way titlnl to tl-'jj/i"i .!/" '/.'-".' /';'<- v, Ooioljcr. !^ x l.
Satterthwaito, Thomas E., M.D.,
A MAM'AL <iF IHSTOr.OC. V. F-Mit.-l nii'l Pr.-]>:ir.MM.y TimM \- E. S\TTI-:H-
|-iiu A i n-:, M. i>.. i.f Ni-w Vurk. In a^sm-iatioii \\ itli Di-s. Tin .n.:,.- |)w:_ht. .1 . Col-
lins Warn a. \\iliiaui F. \Vliitin-y. ( iaivnn- I. I51ak.-. ami t . II. William.-, of
l',.,-to:i : |)r. .1 11,-MrvC. Siin.-s, .'.f I'liiia.l.-l |.!i ia : Dr. llfiiiamiu !'. W. -ri..",. ,k.
of Ui-onklyn : am! D'I~. K'lmmnl C. Wt-n.lt. Alu-ahain .May.-r. It. \V. Ami. Ion,
A. It Robinson, W. II. Uir.lsall. D. Brysoii D.-invan. C. I,. Dntia. ami W. II
I'orti r. of Nt-\v Vockcity. N.-iv .-.liti-.n. \vitli appi-'iaiv. hii.ii-- !,:.:. !s. .m. v vo
Voluiii.-, jirnl'iiM-ly illii>t!- :i {,.,l. -iiiii [la-i--, luuslin, I':';.-.-, s!..~.n.
'It '.viil tiii-1 a ivn-lv wcl'-om,. f:-, m ail iiion- ncc.-ssar\ to pliV-iria': - v. i:o w.iu". I K.-. p
\sorki-v.~ HI this .Ifp-.rtnit -lit. as h.'iii;; a tr'i-t- aori-a.-t. uith m.-iiical p:o_: r --.. Ti.i- oi'k is
worthy iin t \alualilf fpitomc ot t,:.f s-.lijf t, all 1 :.- cruilita'iK.- to the .iit'.i as !. ispl.-i-nl
ai-i-or .linu to t;.c lijht of t In- most ivi-t- i in- to (i iil hiniM-lf- hi> collalmrai or-. ;.:.! t i;-
v.--;L'ati -us. ami a- ln-iu^ l.y f.n t!.c ! c-t m liral (>rof,-<s:i.!i in tii.- I'nih ; M-;t-.s
Knjii<h t'-xt-'.ook. a> a'iapti: i to t'.r want- of '/'',. ^-i-i-l-n-'i-in, N.-w ^"olk('ll
f,, -'!!. :t a-i'l ti'.-> ;>:-ai-t tio-,,. : - ; a-, su.-li Wf "Wo woiiM rfcoiu:i:i-!:.i tin' ' MaT.'i il ol
hnrtilv n- -oMiTin-riil it.." --.In. ri--'ir> /'(r,"l : Hi>:o'.o,'y' to any ].!:> -:.-i in or - :!.:
,.'///. '(/ : :''> S'- .''"' i S. . l''>iri s | .,!,,. ],i-, ,|' U . j, ;il :'.!..!, 'Mr;,: ...;,;,-
Tui.- hook i- what it |,ur|i,,i-ts to 1..-, a - < '>, ;..,., )f, .;;,: J ,>, ,...;!;..
iiiaiiiiai ii. l ! .- ti"i-- -I-M-- ">f I in- wi if 1, an I wi.l " Ti.i- i- r. a:!\ a s.ip. : ' . v . .;k . . . ;
ni'--t t hi- W.IMI -' ol I .'.< ' ' :--\ pra"' it imn-r. a- .-01: .!.' for I is t iio-i i \\^.,i _< \ .:.
W- II a.- tii-- .-:: I lit sv!i i I.- : i-- I . . .!: m ---iciii ; \MI k. Si irli a u n'k !i - t '. is .-!:.-,'. i ' . : . !
r-t'i 1-. in tin- i:n;Hi! Ian 1 il.-[i-ir! :i.i-iiT." -.)/ .// in coniiinct ion with phs -i .!o.r\-. -. . r ,.-
,.,' 7',,,. .v. -Mil. -lit isa'.lr to follow al. n.: v. . ... -.-. n.
":,,*,>,
i . v m i 'ir r ,;i,. ; ji. -is a tr MI,' .-!:, s in.- lie : on.' "It nn\ !,r --ii.| t lv,i >ati.': ri .v ,i . \I ,n
f j - f i !_' of i.i ,|-iv ami !' ni'i-. : 1 i
In . ! -. ..--:.. ,-! i! i- :, ...': -V,' sv, can . ':i 1 -1 ..... '.: >',: -".,|,n'- .-. I i ,
I,. ,-:;. -H'.r'i- M-l to a:! v. !i .i- r. t , -i nis \f- < /:,-,> /.: . , r-l
t .1- i -i..- an 1 i:s fi.i l.i-an.-i. of m. ill- "Tin app. miix .-..! .r - :: '.
\' ', :: .1 ,i , ' :.' ., ,<,-! r-.-.-n-'s a H. i . i .:-'.-
Thudichum, J. L. W., M.D..
I'l T.LK'ATTONS oF WILLIAM WOO!) ^ COMPANY.
J^JnxioIoii/, I'<ff/iolo(t <iii<f Tin /'<!
Strieker. Prof. S.,
D: V: i. n ,. Angina.
A .MAM'AI, <il' HIsTo|.oi;y. Written in en-operation with Til. MKYNKKT, F.
\.>N l!i:< Ki.iM.HAt SKN, .M \\ S< in I.T/.I:, W. WAI.I>I-:YI-:U. and others. Trans-
-, II i M;\ l'owi;i{. of London ; JA.MK.S ,1. I'i TN \.M and .1. OHM-: (JKK.KN,
,: |io-ti,n ; Hr\i;v<'. KN>, TIHI.MAS K. SATTKHTHWAITK, KI>\VAI:I> c. SI-.CIIN,
1.1,11- 1>. Hi I.KI.KY. KI>\V\I:I> L. KKYKS. and I-'I;.\M-I> K. DKI.AKIKI.D, of
N,-.'. Vork Ann-rican translation edited hv AI.KKKT 11. IlrcK, Assistant Aural
Siirj.-oii r ., ! ; ,- V -. V,>rk Kve and Far Intirmarv. One voliinii', imperial Svo
l.'ni'i [,.,_,-, four hundred ami thirty-cmo illustrations. lYi,,-, muslin, ^'.'.00;
! atleT, if in. i in.
A' ;teiided and valuahh- phv-iciain and surgeons who would pursue
tr, it ; - on 1 li-:olo % which ha- yet aiipcared." their depart me-ifs witli all t he li^ht of modern
_ 1 .. I/, ,/,>; .S,/, ,-,.<. science ' /'//,/,/, /,,/,, M. ,/;,;, I Tun , *.
T uf Mr. r,,\%. is covers -llH'i " The need of a work of this kind has he, n
present edition; hut the remain- felt for some time past. The last edition of
1. i h\ the American Kolliker contains points which he himself has
^. !]' named. Nearly two thirds, altered in hi- lat. r eiitioiis, which have not
tin: U,ok an- tran-lated hy Amer- heen translated. The pnhlieation of this %%-ork
: vsiciaiis ^specially interested is ile-tim-d to ^iv,- increased y.c.-t to t he st uily
,\ have under of minute anatomy, a study which i.- l.ccoin-
I ; ;i:cie i- e\i lei t advantage, as in^ a in-ce-sity to any one who desires to he a
1\ familiar with a sii!,], ct is thoroughly educated physician.
. rasp nhscure jioints, whicli \Ve I.elieve tins li,,ok to lie indispensahle
.-.;-. d st ill more oh-cure hy lie- to any physician who desires to understand
loieiirn idiotn. There is .-d-o the pr, si nt ]io-ition of medical science, and
ahont an article to kno\v, it' not to tind out for himself, the
'i - - ,- - ate i than if it form, in the original, present knowledge of thu minute anatomy of
iniher, and l.y different an the human hody. The author.-, as remarked
. : lividnal : for the liefore, are men who have <l--voted them-elves
must n. ce-sarily jjrow ujioti to these studies, and do not limit themselves
i~ not re- to communication of the- facts, hut in many
: ' ! -iiniliarit % %vliich he places tn at of t he met hods of olit aininu' eood
i. . ('lire if t in- papei s an.- all hy t he same s] ecimens for self-study.
A.- tot- the I'ook it'-elf, it has heen pnh-
I - i ;,- of papers, edited um 1 in many li.-hed m jood -t\le Tin- tvpe i- char, the
.:: ' n 1,\ 1 'i of. St rick, r con-ti- %vood -cut - are e, pial f o t ho-e of the ( lertnan
.,, extend. : i most iditioii and there are l,ut f.-w typoirraphical
i ':-, on Histology M int. And errors ' '/' >' /,'',,,,/.
- !l -. \ i- a suteject, \vliich " ]-]\ ery medical student and every soientifio
' - and mo-t accurate in practitioner -honld -tud\ this %vork, as. hetter
;- dd. ihiswork musi n.-cessa- than anv ot h.-r in t he I'lnirlish huiu'iiaire, it ex -
i , r- It Incomes, therefor.-, hihit- what has !,,. MI demonstrated respectnij;
i e\.ry ld-tol,,^i-i fli, miii'ite -t rnct lire of tin- hod% . " /> !r,r
, ,vor! !. i- N',, II as to all U- ri- -/ ,>t .)/,/,,'/,
Gricsingcr, W.. M.D.,
. 1. 1 ,,r M,
. > M, in 1 ,
I \l. l'\TIInI.i H.V \M> TIIF.IJAIM'J'TICS Ti i!.-lat,-d from the flennan hv
II'.'I ' "'-. M.I), i tin M, ., Sup, lint,-:, deM ,,f tlie Sns-
,. II:.;. aid- H nd .i \MI> 111 '1 ill. 1:1 uI!H, .M. I)., Kdin-
W.-od's Pocket Manuals.
,.- ,. ,.,. , . \ , nvci.tMit li"'. pock'-t manual: ili-
1 iei ai-ci li-nt- ai ranged in alphahi.-tii.-Hl
; e pr-'-crij lions of \\ ell l;ni,un
T . :iv. n under < a'ch ln-ad."- ('>>. /> > r'-
io. k i,v,.. ti,, i . , \,, v , ,! ,- l-v]_
n%. nicM little hook for ha-ty
if '!" '.''.' '/ . Novcn.!,, r,
// '-, :/
I,.-: '-:
ITBLIf'ATIONS OF WILLIAM Wool) \ roMl'ANY. 'J 1
M t<'/-(><'(>>/.
Brocklesby, John, A.M.,
IW.'-v-or .if MiuIieiiMiies .in 1 Nutur.U 1'hi'.. '-<.]. hy in Trinity f,,i:,-t;,', Hiirtf'.rl.
TIII: A.MATKcii .MI< KOSCOIM^T . ,.r, Views ,>f tin- Mi. ,-, -,,,,,,, Wmid. A n,i:,, (
Look of .Mi.To.M'opic .Manipulation and M i.-r< .-. opic ( il.ji-ci.-.. liiii:
two hundred and forty. M-vt'ii li-iir. - on \\o..d and >t"iie. (in-- \niuH.B fSt
Ml pa^e.s, muslin. 1'ruv, sl.i">.
"A little liook full (if eurioii- and interest- examination. . . . 'I'll re are ;.'..,-
iiiK fact- re^anlin:; thf microscopic worhl." - hiimlr.-'! :u ,.i ti!t\ illustrations l. -aut:r. , . ..
n,,,- y..,.,,,/ /,,//,-.s : . cent,-,!." //',/,. ;,.v /;.,.',,,-.
" I'uMi-hed 111 Very beautiful shape-."- "The In. ok is tim-lv uott.-u up. ami u. 111.
f:'/; !,/ .(/,;//. found ii-i.-ful t.i all t.-acli.-rs \\lin .1. -ir. t , , \
" It ti-.a;s iif th.' mitTi>-ri>i>i'. lui\v to use it. t. -mi thi'ir kin>\\ irdu'f into tins ni..-i int. j. st-
and how to jirujiaro iiiiiTuacu]>iu u'ljccts lor ing iluiualu." An/i.^im ' 'it-j J> i".r, fii.
Frey, Heinrich,
rrofi'.-Mir of Me-iichu' in the T'lc.vt ivity i.f Zurich.
Till! MICROSCOPE AND MICROSCOPICAL Tl'.cil Nnl.i x; V. A T.-xt-l k :..
I'h\-ieians ainl Stnd-'iits. Translated and Ivlil-d dy ( ! Ki i. li. Cl III i;. M.I)
iSni^it'ii New York M\e and Liar Itilinnarv . ( Ipht ha! in i. and Aural Sui'-o"!: t'
tin- >t. Catherine and Williaiasliuru' Jltispitals. i-tc , e'e. Illustrated l.\ 'hie.
hundred and ei- li! V-IML lit I-IIL raviiiu's on wood. On.- \oluine. v \.., 1'iiiup.i..:
I'j-ico, muslin, si'). nil: or color. -d leather, Si. nn.
.
"A .'onipli't.' r\po-inoi! cif tin 1 suliirct, " Thus..' \\ ho arc familiar -wit h ! j 'ri-\ '.- a.L.ii
thn:'(i-.ii:iilv iinlisi'i'ii-aliii 1 to til. 1 jirai'tii-al ralili- manual will I', i-l urat.'l'ul to l>r. (..!!.:
iiii'.'1-o-i'i.i'i-.t." -''/,:, ././.< .)/. ,i:..i! .!,>! ,-,!<. I'ov l;:s vi-ry r.^ulalil" ; ran-1 .t :. .n. whirl! .;ii-
" Tin 1 v.-ork is iiri'.-c'itr.l vcrv Tiioiirs'ly. yi-t i.li-sour A iin-riraii an.i l''.ii^ii-.li -tii.:.u;- wl:n
\v.- tit ill it in >t UM!V vi TV ai-riirat in all its <!,.. an- iinai_'i|Ualiiti'i| with t l.r ( irnnan to:.. : '.
taiU ol' ])riici-.-,s. 1 1 it roin jiii-ti- as r. Lfanis varii 1 - ].art icipat in tin 1 in -inn -I i. -n- of tin- ivi'o A n. .1
t\ of toj.ii's trrati'il. Tli- 1 C'lii'lcnsi-il stylr of /unrh |.i-oi'c---or. Tur-" 1 <lh i-rt ions f ! i . \ . -
the author, th. 1 fairness ,,f his natiiri-, to^i-t'ln-r t lira t ion possess an espi i-ial value to I lie A :, >!
witii ins im 1. rstamli'i^ ot' hi-tolu^v. permit iean observer, 1,11 aeeount of the \'.':".'
an :inhiasseil lii^.'ussion of nearl v all i|iifstii-)iis manner in which ai e iieseril n-. 1 ! lie mat.: ; '.'I
of nncr. s.-opie anaio;n\', ami man 1 ,' of oli-ciir.- im pro veil nn-t hmls of il- mon-t at n,.; : . . . i
pat 'loln^v. Tli' 1 rules for test i tli; aii'l s -leet ous struci ures in their luallhy or ills. .1 til
in_ r an uist rum.'iit are c.-pecialiy valualili- to con, lit ions. To-uni up all. we t iiink tliat ' :i.-
iine alpo'.lt In piirciiase. "- -- A". -' Y"i'!,' Jintritnl. l.amU.'me \olunn 1 i^ one whiell t he \v. '1 k 1 u.;
at' .W i/ii'iin . miei-0-.copist cannoi ail.ini to ilo \\ it hunt ' -
Wo conceive t:-is wi.rk. df all others, ],ar- /'.',: ',,!, ',,',.< .I/. ./;../' /.',/,-,<.
tieulariy htt.-.l Kv i:^ comjileteiiess anil ar- "\\'e aihi-e all COIMIII neiii^ the ~',';i\ i'
raii^em.-nt, to -erve the stn.leiit. wlirtliei 1 I).- !M!cro~cop\ to |nirfli:i-.e l-'re\ on : : ." M i
-inn. T or one far :ut van.-eil. The hest ami .scop,-. "-- - A'/^/r,,/. . .I/, ,/;<!<,',/ ,s ., .
nio^l recent methods are here i,'i\ en in iletail. ml/.
The add!' i ins of the i .lit .r ma ke t his part of " 1 1 is a pleasure, indeed, to cali tie a' ' n
the Wol'k eiimplete to tile present time. Ivacil tioll of tie protessioll t" thi- > i -r\ - ,' ' ii.l
tUsiii .and on: in i- t feat e. I u it li a c. nnpl.-te- work. \\'it h I his excelleni \\orktii. " .i:n,e!
nes^ iimlt.eil niily liv the present progress of and the e\p. rt po-se-s ,-illthat cai ' id
microscopic art. The translator and editor for the pro-ecu! i. .11 "t' their -' udi.--
<le-crves til,- ^'ratit mle of t he In. . 1 ieal profi'S- t i^at n ms. " /,',! 'nt, /(./',',(.//.."
i-ion for pia.-iii^ In-fore an Ku^Ii-li leading ,lnrii-il.
pulilic Dr. r'rev'.s work, lend. -red still more
Carpenter, Wm. B,, C.B., M.D., LL.D.
Till: MICIIOSCOIM-; AND I'l'S IJI'.VKI, \Tln\s. Sixth IMitio:
:>:? I'lT.LK'ATIONS OF WILLIAM WOOD \- COMPANY.
/'oot/x, ./ '(>/>"// .v, Snr</i)'t/.
Pavy, F. W., M.D., F.S.
A TKFATISi; ()\ Foo|) AND DIFTKTK'S S.-coml Fdition. Sold unly by Mib-
.-criptl .11. See i,:,_re .V>.
Blyth, A. W., M.R.C.S.
Tin: \NAI.YSIS OF FOODS AND TIIK DKTKCTFON or POISOXS. with n-
hlstratiol^ On. Volume, 1'Jlllo, -Id.! panes, Hills'.!]]. Price, Sl.(H).
This w..ik consist* I'f t\\u parts. One are obtained by processes of distillation, being
,j,. . ,,(, ,i tn th' AIM] - sis of the principal :irti- eonsidei d Ins;; and in the second place.
,.;!, - ,,f |)i, t in ,i ;i iiy use ; tin' otncr to tin- those extracted by alcoholic or ethereal .-ol-
I), ;, i-i :.'ii ai; 1 M~t iiuat :on of I'oisons, uryanii 1 vtiits. Ti.c //.../v/""" /'.</'M</.V, tinally, an-
;. : inoru'itiiii'. liiiii' tii'-i j'l'i'tinn tin 1 iiutlior tak> n in tin 1 i>i''!r in whicli they may IHC.M
IK;- i ii'i' avurril t" u'ivf a clrar ami concise nimvnirnl iy lie bought." I'.ji i-ii-t j'r<nn /';_/'-
H nl ti.i various l-'noils and licverairi's, r/o.
witn t... In-.-t and niot rrrcnt .Methods fur "\Vili In- n>c.'i 1/y cv-ry analyst." /'//
t:, 11,'tTMon nf MI\ Adulterations. A few /.. ///--,/.
il!.. : inu.ort.tnl 1-ual ca>'-s are detailed. " A work full (-f great intcn-si . . . t!;e
n the Mitiject renders mi'tlio.i of treatnn nt excellent.'' H' x/iiiin -
d t.i e\ -i t\ articleisa|'peli led ft, r !,',>'>'
:: \\ liiu^raphy i-f tiio \\oiksand papeis con- " Stands uni'ivallcd for eonijilt'ti.-ncss of in
s ! r ..i. formation \ really practical hand-
le tin. Second Portion, the arrangement of Imok. ''>'.//.'/./;// l{,>-i-<l.
T:., ii /.i,,', /'.-.'>', ,.s i- simplv tliat which sutr- " Tlie \vholc work is full of useful practical
: ralh into nict imdical inve^ti- infm malioti. " (7n inictil ^'ni'S.
tin n.oie volati.i' 1'oisons, those that
Hamilton, Frank Hastings, A.M., M.D., LL.D.,
Till-: IMMNt Il'l.l'.s AND PIlAiTlrK oF S! U(,Fl;V llhistrati-.l with four linn-
di'.-d and sixtv seven i.nji-a\-iiiL r - on \vdud (>:i.- vn| iiiin-, I'oval Svo, II.") -4 jia^es.
I'rii'e, in niiislin, !<;.<'ti, or in leatln-r, S^.tm.
"Has evidently bee'] prepare 1 with t.l.e "This is n e of t] e Lest text-books upon
Lot i on the pa; t of thi lut'lol snr^er\ whicli we !.a\e ever see-i. and \\ e rec-
: and as a te\t ' kt'iTt'-i- < 'lid it highly to the profes.sioii." <7ii"i;/'>
M ,.;' tin iil:di"-t ere lit njio-i its .I/"- '/-' n ' I'', j : n '. >, r .
v.-' I k ... : i itt.-d wrier. As a d-xl " 1'rot'essor Ham.lto-'s latest work is one
1 . k ' the -'ndi'iit. o'- on. ol' reference for that will add t.. his already hiL'h reputation.
the l.u-\ pr ictitiotier. it undoul.te il\ is one of . . . It i, fill of \alnalile practical sr[,'-
th-- !- a;.d .,-...s/ iiioilirn that has yet ap- u'e-,tions and . i n e.-t:o:s. "---.I /// < rii-mi Jniininl
I ... " <l l;,,;,r,l. ,,f n,, \l,, !,,,' S,'\, ,,.;s.
"A val'ia'.le addition to our li.-t of t -\; ". \niericat] i'i plan, scientifn- in method.
. wo. k of reference, a ere lit wri:ten in cie .r. coneis.', classical Fni,'lish.
, ' A"ii, )'. I';.;, : Hau ilton'- Snr-er ,' is a nol.le le^'a -
cy t., the inedical stmlent. an honor to t he
"I' will IM- found ent and coinino; [.rofessioii. and an ornament to our native
.luine." /."./,,,( IA-. /,,,/' Tint'. > unil toligPL-.' /Jilrvit Jt'fitir uj' Jftlticillf.
Kcctlcy. C. B., F.R.C.S.,
alpha'oetii:al. ai-d tiietext is written in as ele
' :' M to tin ; _-ai:t and inli i.i.ri i.ie IJi^lish as can lie ex-
!'"/:.- 'I'hi pi '.ii!']ei]:itiiiiis and abridgments. "-
u !i:it the >y-tcm /,'; ',>', I/. ,//' ,,.' Jrn-tl.
.1. . . . ild ever he, imri !\
1TULICATIONS OF WILLIAM \\()()D A COMPANY
Holmes' System of Surgery.
A SYSTKM OF SKKdEUY, THKORKTK'AL AND PRACTICAL. 1\ Tl:i.ATl>KS
(>F \ AKlol s ACTHOKS. Kdit.-d l.y 'I 1 . U<>i.\n>, M D.Sur..- i-ei I.e.
mi Suruer\ , M. C.eor^o's Hospital, and Sur ;.-. >u i iH hief !" tie- M- ; : -. .|... i;..,'i
I'.. lire. Third Ldith'ti. 1 h..r..n _-li 1 y r, -vi^-d. Thr--o vuliiin--. upu
paje.s \\lth numerous WoodrtltS, lit ho _'raphs. and rh n>ni"- 1 it !. >. Tal -hs. Pi . .
i;i nuir-liii, $v!1.0u ; in leather, .*'.' l.uo ; in half m, .1 . . L -,-, ., .s-j ;.IMI.
k i- fully up tu tin- tiin.-s. iiinl f-nii> :i ' " \\"liat"\ i-r may In- thr I'di- f i:i tii.- ii.:;-:
in. .-t cuiiiplru"; \vork en t;ir tlifory and {irar- : t -nrc nl 1 initi-.-jisi>.' i>. uh.,1.- ..i in |;ii;. >\. :
tier of suruC'-ry. "'t'/<triiji<i/!i<' <iii~< tt> . i.m^rrs.sivi; -.m ^'roti i.as Irani, ! tin- \ai.i. o' t :.
" Ti:r w.'i'k as a \vi.o!,-. rlaiin'.llL.' a> i il.i. s rar.liiial principles ul' rl. anlitu -.-.. I",-:,! iii-i:.
to i < -pn-M'Mt t in- I'.n^hsli M 1 lin ul ut' > ur., ''I".', is [rtliui. aiul ti rr lira '. i ax' 1 '. In ' ;'' \ i.iuti.r !
ci.:i:plrt' in r\rry ri-spi-ct . aii'l really stands t'urr \is tnt-sr |M'iiirii.!.-, art- dnlv r..n-1-i- i .-. i
viii.i.iit :i ri\al. As it Man<U. it 1'rpri scuts ami the (lili'rn-nt ]...in!s in iiUputi- a: , . : \
the .irminal anil latent llohiir.-' Sy.stt-ni (.!' Sill'- j.i(liriiii;-!\ p:.-in. I. '1'ln- .-atii.- ina;. l.e-a:i
^ -l'v, and (.MPinailis the most rrivut views ut' i-rj.-iriiii:^ "t In r .->iil.'.-ct- i.l (-41. al i;up r'a'.C'j
tiie many ilit-tiiiiiui.-he I authors who tirst con- | in ti;. ir I'.-ann.; iui .Niiri^icul operation. "-
tribute. 1' to ;u pa-r.s." 7'/<t Jfttiu-n! Ji<cor<L , Jldii'-nl 2t:<>rd.
Clarke, W. Fairlie, M.A. and M.B., Oxon., T.E.C.S.,
\ MANTAL OK STHCKRY. A n.-\v -.liti..n, th.-r.-u-lily n-vis-1. M i;l, impor'ant
:i'l'!iti.nis l.v an Atnerieaii sur-eoii Neari\' two huii'li 1 .-.! ill u>tra; i. :.- '''.:
;iiM j'a_.'S. Sol.loiilv I.'.' >ul)Srrijitiou. See pa_e."ir.
Wyetli, John A., M.D., Univ. of Louisville,
KSSAYS IN St'ROICAT. ANATOMY AND STiKJLRY One volume, ^v... "JtiO
}>u_es. illustrated, inii.-din. Price, ^'.'.nil.
A JIANDP.oOK OF A1LDICAL AND SI'IK.ICAL RI'.l-TiULM Tl. On- voluiu.-,
I^iao, ''?'.! pau'es. muslin. Price, Sl.^.")-. tucks, Sl.."u.
Bauer, Louis, M.D., M.R.C.S., Eng.,
I
LKCTTItKS ON OIITHOI'.KDIC sriiOKUY. I>. liver. -1 at the I'.r.x.klyn M.-iii-a!
and Siii'L-i.-al Institute. Iievi~ed and aiii'iuenied. One vnhnne. ^v<i, :;:!i', j,a_-. -,
illustrated, tnu-liii. Price', ^:J.'J.").
' U'e arc .--pe'iall v pleaded \\ith the rh.ip o'ir kiiowli -l_'e admits of." /'''//',- .!//.
ti-rs on di-ei.-cs of the spine and joints which ./;/-/>/'/,','''."'./''/,;,,/'.
o ',-up\ a la '_:(' port ion of t lie \,,,, ,k. Dr. I Saner " As a treatise on det'ormit ies \\ , have \ e: v
h is had cver\ opp'.rt unit \' ot :i<-.]naint inu r him- few work ~ to compare wi' h it . -o t ::OM. :>!: :.:;d
sc.i \vit Ii all the source- of infomiation on t.he exhaustive Iris t he aut h..r n: .! i ' - c, ,i.~;^e; a -
.":!. ieet. and his work uill he found as nearly tioll."- ->'. /."tin .M-><".'' /.'-..
c.iv.ph le a- the present ad\anced co-iditioii of
Carnochan, John Murray, M.D.,
A TIM' \TISI; OF TIII: I:TK>I,O<;Y, I-ATIIOLOCV. \M> TKK\'|'MKNT or
CONCKMT \l. DISLOCATIONS <>!* THK Ili:\D or I'll.Ml '!;. ir.u-.tiMt.-d
l.y lithographed plat, s One viilunie, S v ,i. 'J:'."i \ ,_-.-, nit^'i'i. 1'ri.- . f'.'.itii
:M ITDl/iCATIONS OF \\1LLIAM WOOD COMPANY.
/'<f< /'>/.
Poulet. Alfred, M.D.,
--i-.ii M.u r. Ii:*|H-i-t..r "f ih<- Scho.il f..r Military M.-.li.-inc- nt Vul .VOn
ATUKATISF, (>N FoKKKiN I'.dl >l KS I N ST R( i ] ' AI. I>UA< T1< 'F. Illustrated l,y
ori-in.ii \viii'd-i-n_raviiii:s. Translated from the Fivn< h. Volumes 1. and II.
. v oid oiilv 1'V su'o.-crii'tion. Si i 1 J'a.,r 50.
Taylor, Charles Fayette, M.D.,
OX Till: .\IF.( HAMt AI, TRKATMKXT OF DISKASH OF TIIK IIII'-JOIXT.
(>n<- vohiine. >vo, C>'1 p:i-- f es, illustrated, muslin. Price., ,sl.vJ."i.
Peugnet, Eugene, M.D.,
Tin: NATfiiK OF <;rxsnoT worxns OF TIIK AP.DOMKX, AND TIIEIII
n.'FAT.MFNT: I'.as.d on a Ileview of the Case of the late James Fisk. Jr.. in
Pilchcr, Lewis S., A.M., M.D.,
. X. V.
Till: TI!i:.\T.Mi:\T OF \VOrXnS. V,, in- a Treatise on the Principles upon which
the Treatment of \Vomids should lie Founded, and on the llest .Methods of cur-
i . in_' them iut" Practic.'. imdmliim a ( 'oiisideration of tin- Aludilicatiuiiri M'hii-li
>pi-cial hi'iirie.s mav demand. IHiistrati-d l>v wouil-c'iiijraviiiirs.
Saltcr, S. James A., M.B., F.H.S.,
iiilu-r ill ]>. iitnl Sr.ixvry MI the Collet;.' ; ln-ni:ii S-.ir-
DKNTAL PATlloI.ociY AM) SUIOKUY. One volume, Svo, :U) ( J page.-, illns-
' i. I'riee. s !..>().
: :< i'"liii"iti-'l H-* a surfji-nn. anl luntr ' -on known as oiif of tho most scientific
wa-II - > UM '.' Kiinr'sColl'-^eliosjiital. ilt-nti^ts nt' the <l:i y. M r. Suiter had the irrcat
i tin 1 tn~t IIAV vi-ars a> 1\ ant.'iLTcs of such a coinjilcte niodii'al I'lliii'a-
i ;~ l!i it h' has u'i\rn lo t:on as is implied \<\ tin- possession of a dr-
,,.! tp-atisi-, not. only ^rrc of tin 1 I 'ni vt-rsit y of I> mdun, iipi.n which
on i'.i : th I'i.t ;: ; -. i on di -n - he turned his attention <.o dental subjects, and
i ii -MI _'i i . . . . . 1 n o inr his ii .11. \M' would h',' has continued his la' tors ii jion tlio ln'oad t>a-
ar.d prai 1 - >is thus laid down, "\vitli the satisfactory rc-
liinl |iatl;oloiry. Milts that he has con! riluiti-d not a little to
1'i'i! in a Inith the scii nee and practice of dentistry, the
1 ! a-id i ! i .: : I i. i.'.ul l.\- latter in its widest sense. . . . \Vc close
.llwiio:iri nit. i .,ut Mr. ,->;iiti r's work well satis!ii-d that it is an
1 !'.. The a ii'Conl of u r 1 ]in\sii>lo; ; ieal and |irai'-
tic.il work, and we congratulate lioth the siir-
! nt '. i 'l-i ;ind dental I'l-olV-sii-n- mi jios-e-sin^ such
:i Milualjlc \\ork of leferelici;." Ao/a/'J/t /./<-
'I . ' ' !!. Vol'I! ' , ' !' ' .'.
Goddard, Paul B., M.D., M.R.N.S., M.R.P.S.,
Till; \XATnMY, IMIY-Inl.oCY. AM) I'\TH< >!.< )( ; Y Ol' Til K 11 1 ' M A X TKKTII.
Wi'h tin .M' t Iinjii ,-. d M"t]p"i- "f Treatnu'iit. iticlndiim Ojierations, and tlie
M- f ! : ' Makin.- and S..tti h . \rtiiieialT.-.-tli. With thirty plates Aided in
"i ' : " ' v JiKi'ii i;. I'AKKi.i;, ])..-nti.--t. Onu vuhane, 4to,^'JT patrt-',
n. . l'i ;. .-. .<:;. , ',
PIBLK ATIoNS OF WILLIAM WOOD \ COMPANY. -J."i
S>l I'ljl ft/, />/>'/ <l*i X <if II ill/I'll.
Owen, Professor Richard,
Till: I'IMNVIPAI. I-'OKMS OF THK SKF.I.KToN \\D Till: TFKTil ^ a I.,- -
I'm- a S\ ~t--lii i't - N.-itural Hi-tnrv and < 'olnparat i v- \!,.ttiuv. t n. v./.uin--, I'.']:.. .
oi'l {.;i_'i .-. iiluMnitcd, cloth Price. ?."..
Tho International Encyclopaedia of Surgery,
A Sv-t. inatic Tr.-atir-e nil the Theory and Practice nl' Sur.-i-rv. ]'.: autie :
variou.- nation.-. Kdit.-d \>\ ,l<>lt\ A-niii U-l. .1 I; . M I >. . I 'i . .ft-.--, -i- .,!' ( ..:. .
Snrjerv in tin- rniy-T.-ity of 1 Vnn-y ' v:iiiia. In -is: vi'liitne- n-ya k -\n. I
'rati- I \vitli chroiao-litho_.'raphs and u noil-.-i]_'r;iviiiL:- Price p.-r ,! ,:i.-.
InUMill, Sti.lMI; Lather, S7.0U; half UiiTuCCo, S^.IKI. >nl,l ihly I _v -i.i..
tion. St-c [.a_./ 01.
Munde, Paul F., M.D.,
I'rof. .r .,f (;VU.M-,.I.,_'V nt i 1
A 'n:.\'r-i;(")OK' oi" .Mi.\>it srncifAi. (;v\i-;cni.o(;v. r; n .- ..:ii:i,.-. ^ ,-...
ii.-ar!v (Jill) paif'--, il'iustrate'l with ov.-r thr--.- lur.i'lr.-'l n_T,r.-;n_-. i -un-i i:. .
tra inii-iin. I 'ri.-f, So.UD.
~ u 'hi'. Mnid'-'s Manual, \viiii-h ajipf-fii'i-il a- unc cf ti.i- vi.lniiif- nf t!.i-.- r.iTnl s. ri> - 1.1
\\' !' Library nf St.'indanl Mniioal Autlmrs. uii-t \\itii -uca a ( .niial i'. .-,;,( i. .;.. an i i \;. ;.
M\ . .- >!. t !!at tin- 1 1 i Wishers urr;mi{i''l \vitn l h'- ui-t in_ui-h' 1 a;ii hur !' ir t ;.< ;!" i ';.!;. .n .1 a
ill i u'tir \V'.rk whirh wouM In- lins.^1 upnn tiir pivviir;- nn.:. iitnl inci)r|.nratc ;:i it- lir--T f. a" -
iii-f- in a |iii'!"ii t'i .-iicJi ntiirr matter as woiil I \n- tn-i-i---a ry i;i c. .!i-f. ri. nr,- nf ih.- ;L'l\a:n-i--
T'.,r-ir .if t:;<- -''i -nr,' ati'l the r<"['i ircMicrt - nf :t Im.ik - .italic for ti'aciiin , r ]'i;:]i -.>.
'1'iir \v.>rk h-Ti 1 anii'iuiu'O'l i< Tliu rc-nlr. aii'l t !; ]>ul-!i-l:ci-s c.ini'il.-nt l\ i \j>i ,-r f, r it ar ni.
\ i !:]>!>'! iMp[i:il:i!-!;y in its tii-1'1. 'J'i surii a-; arc i;nt laiuiiiar u ith tin- p: i". io'is u < >i ,;:::
\ -'ili-ii.'rs w.iiiM .-ay, in explanation of the snipi.- a:nl ciiara^ti-r of thi-. ti.at it i-. in:, n.ii-.i to
IP-C of t:i'i>r inii. or torimit-a'.it < ; aii'l inanip:ilat o 1 :- cninnionly cniployi ! int:,. d i i .:).. -is
ii-i'l tr.-atim-nt of dist.-i-i-- of \vo:ni-n. A- th.- .-i-op-i-f a work w iii'-i: co\ cvs 1 1 < u i .. ', \ a-t
lit-M of _'ynn'o!o_;ii-al M-i.-neo doi-- not prr:ii:t t !:i- drtailnl ili.-ciis-i .11 ni :n:i!'.;, pra.'t.ru! i ..iiit-i
\viii --;i t:i.- -tud-nt an I praotitioiir:- should know, and is o!.li.:--d ro1-ar;i witii n.aiiv :iiui..y-
aii' 1 < in tin- i MM I'M- of his prart ii'i-. tins work, wlii c it i> imt >upposi-d to -up; !\ t ::r k; "'.'.'. !^
trail, i- i at tin- !> 1-id op.-ratiiiLT -taMo. wdl attempt to la\ lief ore tl.e 1 1 ade a e!< .: a:: i .>.:-
ci (.> i[ a ion of detail- and nrtnipulatioi:-. tie iu r no ranee of, or \vai;t, of ,-\|.i ri- nee in -A ... :i
v. :1: oft n ].-ail to rrors l.ot.i of omission and eoiiinii-- ion. The j.rofu-.- i!!;:.-t i'at ion nf i:.-': ;-
in- -lit- an 1 o[ i. -rat ion, and the i -a reful details in d.--enpt ion. \\ ill render t lie u ork v, j t '. illv
v .man].- to tlio-i- ^'i\-in^ c-pr-i-i-il attention to the treat :nrnt of di-ea ; nf women, and iinl.--
fi--!i-.ilile to tnv ue-neral practitioner, \vho ran inti:i- form o.ni\ avail him.- 1 ! f nf t i. '-;- :..'.-
l-l.-' i xperi.-neo.
Duncan, J. Mathews, A.M., M D., etc.,
i;:--r ..!; M : \:\ :l'e-v a:i I ] ,- ,-,.- , ,f \V ,. ; , .. ;..! C ;.;. n :n S::r.'. :.-' H;.'! M- '; . a! --''. -;: '",:!
A PRACTICAL TIIKATISK <>\ PKRIMKTIMTIS AND I'AUA M r.TKITIS. (>-..-
\nlnine, I'.'ni". '_' 1'. i pa ,- -. in ii-lin . Price, s 1 .' oi i.
" T: o!,,:i_'h a'lilit \ . power of LT- ttiiiLj to t!ie ' I iinu-an's form. pu 1 -lical '-"is. ' _ )/" ,,-' , t '
liottntn nf Id, >uli ;,-.(-. ae'it" eritiei-iii. an i /V/,,, ,s ////./ ',,; ,",.
>-.Lref-il oli-crvati.n iniik tn-- pru~. nt, as Dr.
Partridge, Edward L., M.D.,
Tin: (I:STI:TI:IC.\I, KKMKMIUIANCKI:. \ i,- .; :;-j;n.. m: :ill ,,.. p.-,,!
trated with ininiatiii-c u i-. n -ravin .---. \V. .- :'- 1'. , k- t .Ma'ina'..-
Sl.UU.
riT.UCATlONS OK WILLIAM WOOD & COMPANY.
J >ix, i (si N nt 1 1 tin i' n.
Sims, J. Marion, A.B., M.D.,
-\.-\\ >iu:il '- II --,'
n.iNicAi. NOTTS ON rTKiMNK srucr.KY. With sj i :i i n.-iVivmv t.> th.>
Ma!i:ui 111 ' ' ' tin- Si, ri Condition. <>nr volum.-, Svo, -lul i:i'4i's, i! lustiati-i.
|..-ij..-i >; . !.'. : '. ni. I'l'i . . si. 00.
"II is nri 'in'i-]it inn. ]" rs.'vcrir.^' t'vi-ry j'ructitiiiiiiT, yinui^; and old. Wliili its
' . , . ni ilui-tiun, ainl tiMi-hii!'.:- ap- sn simpli liiat tin- men-.--! tyi.)
' -.- il.-\ i-l, ]>- can fully ciiin]irclu-iiil ttitiii, tii'-yari 1 n-pk-ti 1
iia.- In it ;i stiunliMiiLr- with viilualiU- I'-ssnns to tin- jiliysioiaii ( liju-
:, . \\'t- folll l-xpi ]'ir]].-r. \V.- l:a\i- ]ru-i-ii I i . i- \> i ' : k W it ll
\i <i,-- lunch .-:il isf'aciioit, ati-:i,_ r li-nin it n-l'ivMt.-d
: > ' .' .,-'<:'. ratin-r tlian s.'tt.rd." l'n<\tii J/' <H a I. u id Sr-
Th . U:n.. f\i< i U- in tli,' hands of <ji>;ilJ<>".i-
Skonc, Alexander. J. C., M.D.,
DISKASKS ir 'nii; r.i. ADDI-III AND rur/niiiA IN \VOMI;\. Ono voium-,
Ss-n, 117-1 |i:i '-. illu~trat''d. inu>Iin. Pnrr. s:!.(n).
" In uddiiinii tn t:n -! ;\i:. . pi ;,rl ;>-:i! inattrr " I >r. Skriir has ri'inlri'i'd tin' profi->.-ioii a
i:t wl:ii-ii Cii-'Wiirk ai'mnni.-. \\v i.avi-tln- .id- n-al M-rvicr. wliihrtlu- jiu'a.uri- illfo] nuitioii nn
, '.'._', 'i i,. -tr;it imiK adiiiiral.lv i xefiitt d, 1,'iis sulijri-t ln-n t"l"t f \\itliia tin- narii of
n ihr L-liajitcr el! urinary aiialy- Imsy j'rartitiiiiicrs \\ ni i-niiiniaiid for this Imck
/ <'/,<,,,/. im/i'la,-.- it .-liould tdl in every lil.niry. ">'(!.
'T .' rk nl tin; ili-tiniiiiishi-l jjyJii-c-ol..- l.i.'i'o. .\f,,li. n' nml Snr;ii. ,il ji>nr,,,i! .'
- in ini'dii i] l.t, ratur,-. It " Tlu-si.- li-i-tun;s an; t.-.\;u-t.i\ u hal tin- atithur
n-d tin dtilv Bvst.i'tuatic 1 trt-ati-i 1 claims for tin-in a i-oiivniirut., (-lain, iiiirnni
i-'-i in tli.- 1 ; ] : a_u-r, and plicated ;-tat, im-nt of tin- iiriiK-i|)al iiisi-ascs of
i.. haili-d \\ith the innalu uicthia and 1'ludili.r." J'-tr'-nl
; -' --imi thri n^ in nit tin.- ci mil try." l.mti'it.
' M..I:
Bedford. Gunning S . A.M., M.D.,
\Vi coii^ratulati' the author upon
' '" i ! !ii- l.i_rh rornpiinirnr paid t" Id- lalmf-- in 1 hi-
' : It" hi- -'i.: ii'-w fi. Id ,,f uterine path, i]o;, f .v, wlierr >o
. . '. \ ainl\ f'.r f' p'itai ion. " --- .!/, r-
- i.-,,., M.,J. T.,,U*:
G.irrii^ucs. Henry Jacques, A.M., M.D.,
- I
PUBLICATIONS OF WILLIAM WOOD \ COMPANY.
2Jia<-axfx <)f \\ oin< il.
Verrier, E., M.D.
PRACTICAL .MANUAL OF OP.STFTKICS. Fourth edition. .-nlai _---d a:,-! r.-vi-, i
with four Oli.stetru; Tables of ProtV.--or Pujot. Fir-t American edition. w::h j.
vi.-ion and annotations by Ki>\\ ,\i;i> 1.. 1 '.\ i;Ti:i i >< .K. -M 1).. I'r..:. ---! ..: il-.-t.-ti i. -
in tin- New York I'ust-t .raduate .Medical Sclio.il. One volume. "v. -1'jn !;..:-
illu-trat'-d l>v one hundr.-d :in. I livi \v.i k/ .l-,.ii_'r;ivin_;-
Suld l.iv subscription only. See pau'e ">.*.
Braun, Dr. Carl R.,
I'riifrs.-or of MiiUvift-ry. Virnna.
THI: rii.KMK; CONVULSIONS or I>RI;<;NA\( v. i-AHTrurnoN, AND
C11ILDUKI). 'I'r.-ui-httc.l IV, .m tl.c (.crin;ui, with in-ti-.-i. l>v .1. .M A I Til i: w> Di N
(AN, F.It.C.r.H.. Lecturer on MMwilVrv, .-tc. On,- volume. I'.'in.'. !^'J p;i_-.-
iiuislin. J'rii'c, ^l.Ul).
' It contains, in u condensed form, tho iiii>st perusal." >Y. l.nu',
f.i:ii]ilete ;ind n-liaUe liistorv ill this afi'i-i.-t inn Jnnrn-i'.
yet {.iil.lisln-d." A"- (' Yurk" Journal vj .Will- "A most v;ilii:i))lc essay, an.l c.ne t'::r
wili not In- riisilv rivalled t'.>r it^ conipk ! i:- >-
'\Ve iidvist- all win) feel intercMte.l ill the aud erudition." lJ,i>,! lt , .I/- ./:.> /',; ,x.
subi.'ft t(i juvcure it, as it will fully repay the .
Byford, William H., A.M., M.D.,
A TIIKATISK ON TIIK 'I'HKOllV AND PI! A( 'TI( i: oF OI5STKTIIICS. Ulii-
trat.e.l with one hmnlre.1 and lii'ty wooil-u-iitrraviiiL's, On.- Volume, Svn, -iii'.i
]'a_'es. mii-lin. I'rice. s.",. 7-1.
" i'r'iiVssor JSyfcird ha^ ln-i-n lnn^ a:id favnr- art in the mu>t availnKie i'nrm It i- i-MinpK-t.-.
a:il\ kii'iwn tn the prnt'e.-sii)iial pul.lic liy his tlioir.rh imt l'ir;:e ; it is full and pen. et. an i
l'.u:::ei'<i'is coinmunications to the medical .-till is ci.iniir.'S^,. 1 int'. comparai : \ . ;\ Miidi
jiri-s-.. iiis previously pnlilishcd i laliorate tnioks. .-pace It c,.nt;iin- \vlrit i- knou n. and coin
u::d hy lii> widely extcndi- i ]>rivate and con- mends itself to tin- prnt'i SM<>M. and e-p'C ; :ii:\
s'dtative practice. . . . Professor Jiyford's tn medical students. l.\ iti pt-dn. wc!i-c,.n
h.n.l-: i- I'ully ii]i to the times, and a succi-ssfal -ideivd. coniplet.' teachings. Iv. rythin,' t ir;t
t.'\pM-ition d( the .-uliject." < 'liii-iiij,, .][i<lif:il can lie said in t'av.ir d' ;.nv wnrk on this .-;:!.
./.. .'/-,,;/. jectcail be K.lld.il It " Jj'njf'.l!u M"iu'll ./-/..'-
1!;. l.u-d's Olistftric-iatlords tliestudein and '/fit.
jiract.rioncr the si'ieiicij and ractice ot' tiie
Klob, Julius M., M.D.,
PATHOLOGICAL ANATOMY of^ Till-; FKMALi; SEXTAL OIIC.VNS. Trans-
lated from tie- ( ;,.| -man liv .d i.i;i'ii K \ \l M I . Kl : i;, .M.D. I'l: \ .-i.-ian to the ( i. -i -in. in
ll.ispital and I )i- p.-.-. -ar y. N,-u Voi k : and P.KN.MMIN I'' D\\\-<>N, M.D., A-
.-i-tant to the ( 'hair ,,f Oh.vtet rics in the Co! l.--e of 1 'h v-ician- and Surgeons. N'.-w
^ oik. (>ne \-oliime, s vo, ,".)'. i jia.'es. mii-iin. Price, s:!..")(i.
Chapman, Edwin Nesbit, M.D.,
I.:it. !Y..f.--.,r '.f Di,-i. -]-. Ij;,. .,-,.- ..f \V..;n. :i n:i.l C::iMi.-i.
PI PLICATIONS OF WILLIAM \VOOO \- COMPANY.
/>/..vf/,srx of Women.
Emmet, Thomas Addis, M.D.,
VESICO-YACINAL FISTU.A Flto.M I'AKTC H ITloN AND OTHER CAUSES;
ui:h Case-; of llei'to vaginal Fistula. Illustrated with svood-engriivings. One
volume, SVM, -.'.Mi i.aje>. muslin. I'rire, ji'J.75.
\ ireful and i>am>takim,' record of many '' No work of its si/o has BO much enriched
i a-i ' I \iMcn \a_''l ia! ti>ti:l.i. arising I'mniall tile literatni'e nf gyiU'Cology as this one."
n|.e|-ations in ce^^arv in Muliriil /,', , -r<l.
v lie..,,'] .\f,<!i,,il "As to tin- j,/,i/xi</n> of the hook, if we
have any fault lo lind, it, is with the elegance
Brown, W. Symington, M.D.,
M. :: . fihi liyiKi ' . ii-t\ ni li.-t.iii: Fi'llow of tho Massarhnsptts Modion.1 Society, otc.
A i LINICAL I! \NDP,(ioK ON Till". DISEASI-'.S OF WOMEN. Illustrated with
tc volume, Svo, 'J-l? jia.'e.-.. mu-lin. Price, S'J.5l).
1' wnt.-s -.vith irreat simjilii'it v i a master nf his subject, and chooses, off-hand,
-t \ le in ue ii re^eiu ill in:: thai ( i f a the shortest route to the' understanding of his
Tilt. Edward John, M.D.
\ I! \.\DllouK OF FTEHINE TH EI1APEUTICS AND DISEASES OF WOMEN.
Tait, Lawson, M.D.
Fritsch. Hcinrich, M.D.,
>iul . li-ni.-: :it the University ..f I!:, li .
Tlir. DiSE\S|-:s OF \V<.MEN. \ Manual for I'hysiriaiis and Students. Trans-
I iimiii: Fi i:vr. I! u-trate,| with one hundred and fifty tine wood -
. Sni 1 (inly l>y suhM-rijitinii. Sec |I:IL.'I- ,";{.
Savage. Henry, M.D.,
- .' : <.f Kncl.TM.!, i.JH' i,f the Ccill--nltillK Moilieill ( HTleCT.- fif t!,(j Sa-
II..::'
THE <i ii'ir.nv. sn;i;icAL PATIIOEOCY. AND SFRCICAL ANATOMY OF
Till; FE.MM.i; I'EI.VIC OIKiANS, in a Series of I'lates taken from Nature,
i'h ( "iiniv. 1 M i. -. .N.ites and Cases. Tliird fMitiou, revise, I and u'reatly cx-
t' lid' d. >,.; 1 ihsei'ij.tioll. See ],;iue 5(1.
Hart. D. Berry, M.D.,
' r;. . MI-. ' '',' , f -, if, ;,.,., iMintmreh. fto., etc.; nn-1
Barbour, A. H.. M.D..
; ' : ! . . "..
M\M \l. iiF liYNKCOLnc.Y. \ , : [ I !u>lrate,l with ei.-l.t j.hiti.'P, two of
ii<-ty-two line \vood-en_'raviiiL's.
PUULICATIOXS OF NYILLIAM WOO]) A CO.MI'ANV
West, Charles, M.D.
HOW To NTRSF, SK'K < 'II I LDKKN : Inten.l.-,! .-p.-eial! y a- a H.-lj. t >; i,. N ur-
at tii>- lln-pital !''! Sick ( hil'lr.-li ; Lut c. -nlai II i li _T 'lire,-; ;, .;;- !h i- iu,i-, )... |..iji, 1
of service l.i all \\lm have the char.'- of the yn'.uu'. Uin- volume. i'-tno, m:,-
lin. I'rice. ~>i:v.
Smith, Eustace, M.D.,
A PR ArTirAh TRKATISK <>\ DISKVSI; ix CHILDRKX. on.- *vi> voium-, ->-;
j.H.'os. Price, in cloth, so. 00: in leather, si:. MO.
N'n Hi' -ilical v. Til r has writ tell -o well upon hance its |ir;ictic;il \vnrtll. The sc.lijcets e, >i,
the \va-tin-.; il'.-ea- - "t eiiiiiireii a.- Dr. M:iU.i. -hieiei ;ir.- :-- Simple A'n>p;,y fin::: It:-i,!: :
These alVecti-n'.s are c\cee<liii'.rly common, an. I e.t.-nt Nnur. -i:inent ( 'li: < <i: ie Dia: Tinea, ( 'h : :.
often I'.-itMe tiie hot efforts ot' tin' piiy.-iciaii. ie Vomiting I tick' -I - -- In he rite 1 S\ phili-
' hi p paring a t mirth e'i:t:..n nt' I hi- wnrk Wnr-.-i- -' ':.<' >i: ie l'u,m<-ua: \ 1'i.' !-. i-is ( 'a- ^
f,,! t:.'' pi'' .-s, tlie text, has IIC.-M f-\ i~ecl ;iii.i !" ni' l.\ mpiiat :r < i iaii' l> Da: "I < ii.i'h-n
jnan v ait'-r:it ;uiis tin i mliiitimis have liceii in- in i I'-ait h IUH I I >i-< a-e. Smne ri \ ie\v. rs h.\\ ,
tiixlii'-'-il. lv>e|-y care, liciwever, has I)IT:I criticis.il tie: i-:.a|it.T HM .ii. t a- lu-in/ ' ' t .>
t L!."". T.' niaiiit:ii:i i he practical ehara-'ti-r m cl.-itinnite " '-it \v.- cun-ii!.-:- it i. t eia!e.ra'e
tu. '..,ik. -.tiiat it ma\ continue to lie a sal'e lmt c^mplet. ."'';,;,-,,,/,, J/: ,/,,/ /',/..-.. I ;.;.,
^ ,'d.- t" : i.e management of -onie ]' tlv- c'.m- l vv ">.
Ii!"!:i-:, '.;it imt ti.e lea-t tatal. mnhiilifs of ''The author i- a cl.-ar. conei-e \\ritcr. an 1
ca:i\ life. l-;\erv jiliv.-iciaii shoni'i have a. l.-ave- no ilmilit a!>":;t t!a iiiia !. !: !'<.- i<>
(MM-, of riii- \v,.rk in hi- hl>rar\ ." "/'//' '',,,, ;,,. c..nvey. ( )ne of t he Timi't \ ai-;al ie cnat't--! - i;;
: \l~., i;,.,' .\' '-.s, June, 1 ^:>. i:ie h.'ok is tnat 'ipon inhi-rit...i -\tiiiii;-. '\'..~
" I) a'.inj \vith a c, .mpr<-h' nsi ve L r ro:ip ot (ii-i-:isi> i- so jin". ah-nt, an-i e-jieciallN ini-i:ii->.
di.-.-a.-'-s clniM''t"ri/--il l>y \\a-tiie_'. it hee, ,jn,'-- tiiat a fu.i ii:seiiw.-loii i.f t;ii,^ .-ul^ec! i> at a.!
ru: inva'.nal)!e aiil t > ili'e_'ti"-is in tn. >e ot't'-r. ti.ue-, vahiai'le.
ohsc'.ae leases. h is especial i v valual >le 1" the " I )r. Sm.i ii has spnk'-n in siich la::^ i;a. T a^
practi 1 1> .ner in iaru' 1 - citie.-, or p.-r'naps \ve mu'ht To leave no mi>tak- a hunt the .iia_'n. -i- ..i ::
more tra!\ .-ay tn the practitioner wh 'revr ; < iti.-e;i.-o, an i t::i- ; .- a ] r.int \viiieii cani.ifl : .
ii.;i-.' In- !oc:iiivl. \vho lia- t" ileal \v'tn inf:it. i overe.-' i-nat eil, a- '!. liitiiciilty nf n.--... n ; a
c m-ti; :itinn- \vhii-h have lu-i-n \vrec'i:e i !.y cit y 'i;auii"-i- of the i,i- a-- is often vei\ ;'i- .:.
In- '[':. '. Ic is full of ;,-,il|..iiii: l ry int'or;n:i . . . Th'-re i- nn Let tcr Imok of t h-- 1. ir,, i'l
tin:,, an i. 'i'-a':in_ f as it iln---, with ill- -a-e- 1 hi; IviL.'lis!i lan-.rna'je. a:i-i \v e a-l\ i--- oi;; '
ciri: ,e''. -: i/., l l-iru",'lv In' ii;al-nn; fit ion. c -n t,, proee.re it at -,nc--. a~it i< te.il'. ;i',;-, .-: ,
tjiit: - '.'-.' ; no-it cavi f 'ii I v claliopi*'-' i a'i'i sc.c 1 ;.e time- ;iM<l ;l nm-t va ina ' >'.< coi. t ; : I ' : : ii : ' o
c. fnliv t,--e| -\st,-ms nf f,'. .iinvr." /''- a lil-rary." '/'/,, .I/:,/;.,' //,-,-,;. I,, ,-;.-v::i--.
'/'. ' >,.>..!'., Detroit, Mich'., ,]!-.-. Kv . July, is-.'..
I *-.">. "The L';r-'at impiin:i:;i-e , .f t!i" sii. l 'iivl
'I'i.i- is a -t ;lM , !;,,>! work. ... It i- treat-. I. the s.niml unljmei-! .-\i i 1 ..t.-.i r. t '
tiie . k t . w:;ieh the ;mthor o\v---. i;: a !ar-_'- iiire.-t inn.-, a- to tn-itmi nt. a'.i'i tin c! ;u : ,:i j
l:.. : - :-t . i:i- _'i eat repeta' I'-u in p'-iiat r-je m. ,) : --\i. . if writ mi: . re!i. ier it . in our npiti'i M. ;i.,
ri .ui-1 if :. i.a'l \viifen no other, wm i m"-r inti-re-tire; an-i n--. p.l i,,, ,L nt " e '^ . :
i:' !1 -\:l:e: -.'.T t, ,-,;.,;,,,, I 1;,- f', III,'. . . , t l '1 1 h -i s ,.\ , l- t lee 1 1 T e ; i ,1 ; - !l , , i . ' / ', I.,
:,: . nf \:. _; ]-.'. at \-,- to t , ; ,t ..,'' \ ar. . v -, pt i- ,nai!v rieii ::. \ ale- ! --\ ; .
-nrv o! th" alTect inns nam, i i- ill a\\ n lY"' a '.'.el, a:>j mr- i
: ' ..- r .1! ijiii -t ion oi i'i ill- 1 r'icl ive :r : t e\ pi rier. ,--." - / ; , A .' -.','.
t'.- ;;'ic- i- ii. pt eve]- in the f, n-e_'l , ,,] n, j. /,.,-.'!,. \ i._ i; -r. i --."i.
:,-. : oi e - ii in all i' - I- arir,_-- aft- r the " . . . t nl! uf fact - ( ! t : :. _ T . i t : . I .'
n i who has ma.-rer.-il t hN uitficnh e-t ,|,.\ , i .p:-,, n t of ;hi- (...;
t l . i'.t'intile me.hi'iv.e." /."" : ;,!i (.Vf-r.--- . h. t::- '.:-,-._ . ' a : - :
'
Ellis, Edward, M.D.
:;o ri INDICATIONS or \\ILLIAM \voon & COMPANY.
/>/.s> r/.sv x df (Jhil'li'tn, <>f tfi< : Ky< * A
Hcnoch, Dr. Edward,
l.T.i TriM'.S ON 1HSKASKS OF riHUHlKX. A Handbook for Physicians and
Mud. nt- Tiaii-dat.-d I'ri'iti tii.- (M'Miian. Sold onlv bv subscription. See
1,1,,- M.
Routh, C. H. F., M.D.
!\F\\T FF.FIHM:. \M> ITS INFLFKNCK ox LIFK-. r.r, Tin- Causes ami PI-
veiiti.'li i !' InfaiM M. '' ility. Third Kdition. This mii<|iie work forms a volume
ct' ',' s ii pajes iii \\'i'''>i's I.:! T.'ti'v. S.'M uiilv l>v siili-crijitinn. Sec pairo 57.
Dwight, Thomas, A.M., M.D.,
iiynn,] !Ii-i..1,,,.'y in II.'irv:ir,l Tniv.-rsity : FdlfW nf tlio Anu-ri-i.n
A.-:i 'i-Miy "I ' .--. S;iiV"li at the ('nriii'y ll<ir>|iital.
1 i;n/i;\ Si;i TIitNS <!' A C1II1,I). I''it'ti-t'n full-pairc- lithotrrajiliic jilatcs, draw-
l.y II. 1'. .M'lNcv. M.l>. Our volume, royal J^vo, l>(5 pages,
Price, S:;.IKI.
'I' i- !., ok pns-i'-i - tin- LTi'':it merit iinwa- t, r ans are no lunu'er tliosf of an infant, and not
liny-* . t' nri^in . es are jien draw- yet tlio<.- of an adult. The sections frum
,:._,;; in > c; j..vi of the liody of a ^irl said to which these drawings are mado begin at the
i!n . .. : 1. . 1 at beautifully and neck, and continue, about and inch apart,
'' po
Mauthner, Ludwig,
. ; . , .; , \ (I..- Piiiver-ity ef Vic-inin.
Till; SYMrATIIKTIC DTSRASKS OF THE KYI'. Tran.-lated from flu- Herman
Iv \VM:KI-;N \\'i-:i:vrr:i:, M.D., Sur-e<m Fniti-d States Army, and JAMKS A.
Si'\i I HIM., M !., M'-nii,. r ,,!' tin- American Ophthalinoloeii-al Soeietv ;
Oj.!,'l ' .,: Sur m to the Maine (Jeneral lli^pital. Oil... volume, 1'Jmo, '2^0
j,a . i I'rice, f.'.iHi.
: Mpiit h;ilmia, so that the\- may at once rceoi;-
i I : . ' ' . ni/.- it- presence, and treat it from tin- outvt
appr.'pi iatcly and etli-ct nally. All houtrh ca-i s
M 1 . i ) ' .' :... ire. must of tin-; nature are comjiaratively rare, then
rtani-e U sutlici'-ntly ureat to account I. .-
:;:'r\. In the appearance of this excellent work in an
.iici n:i\ \ : l.a ;i . k-:n and l^iuiish version."
Noycs, Henry D., M.D.,
Foolc. John, M.D.,
PUBLICATIONS OF WILLIAM Wool) ,v COMPANY. -". 1
I>ix,-ttx, .y of tin' A'//' .
Stellwag (von Canon 1 , Dr. Carl,
I'r .f. --.-a- -,f > >|.hth.i!m.'] ;. in th,> Iini..-1-.al il. ;. :\l Uiiiv.-r-i:y f Vi,-:.:iii.
TRFVnsi; OX TMH IHSF.VSFS or THF FYF. I \< 'I.r I >I M ; THF. \\AToMY
ol-' I'll i: ( >ll<IA\ Trail.-! at.-. I t'r.>m tin- I'inirtli ti.-riirni i ;:<>n. an i .- ii-. ! I.-.-
I). 11. ST. .Inll.N Il(t(\. .M.D., < lilliral I'r.,f,-.-.-.-l' i.:' tin l>i-.- - ..!' tii.' K\.- aii-l
Kar in th.- I' niv. r.-ity uf tin- t 'ity of Nc\v Ynrk : Snr_.-. .;i :. r i,. Manhattan K\,-
ami Far Ho.-pita! : t'll \KII.~ S. UII.L. .\i I >., fi.nm-r'.y A.--:-:ant >,;!_' .;, t.> th-
.Manh ittail Ky>- :ui 1 Far Hnspital ; Clini.'al .V-;-talit in tin- N . \v Y..rk Fy.- ah i
F:<r I nlirmarv, ftc 1 . : an I < ')! \ i;[ l> I',. 1 1 \. K 1.1 > . M. I >..<'! in i.-.:! I'r..'' r , !' !',-
I>:.-.-a.-vs of the Ky,. an.l K:ir in tin- \Vi. man's M.-liral P.. 11. ...... ..f tin- \ '. Y-;k
I ntinnarv ; Sur_'.'..n l<> th-- N.'\v Y"rh ]'.' an.l Far 1 n:ii mar^ . O;,. v..'.i;iii",
Sin [..-rial ^s'.i, !U."i j. a _".->. ill n.-Trat.-.! I.-,- v,' n<l-i-n_'r;i\ hrj~ an.l rur.'i:: !/.!,.._:.:;.!..-.
I'rir.'. muslin, if"), nil; Irath.-r. si'.iiii.
" ! -!.(.' 1 1. 1 In- in tii.' !i:iii.ls ni' e \-.-r\- in.-.iii-al 1- . n JI:I.-M ! snri'<--s!'ul!v : aii'i th.' tr:ii^iar..rs
iiiai;. an i n<. (.!!' C;IM >-it'.-!\ pr.u-M-r c.piiti.ai ar.- i'nil\ ju.-.; n.< -1 in .-ai.in,' r 'a ;.-x! :.... ^
in .l.ijv wiiu iii'.s nut ii-^anl thi 1 si:l iji-t-t i'n :u u i.i.'ii i^ i.-_;ar.i. .1 jis m.. 1 . t' t !.-!..- i :.;;;
a ~t iii'lp'.i' t at ii-a.-t. a- l)i^' ; i a- St.'lhva.,' nci'ii- ' ' nnan '.'iii^:ia_'-'.' It ! ;i!s l"..i!v ana ii>-.-;;-
j.i. s. " \' " }'"/': M- ii''<;i/ .luiii-ii-i*. riii-!y \\it:: .%.!.- i.r;ui''n . !' !;. s-ul.ji-.-t i.i
11 Tiii- i-* i-lH 1 nf t inis.- ri.iiU'I.'tt 1 . i-xhaiist iv. 1 . Wi.ii'll ii n-lat.-s." AU/II/.;// l.-ni,--t.
nia_'ii:!i<- -i .t THUII- <j,: aphs \vhirii w.- inav l....k "'I'::.- r:q>i-l a.l\anci-, t.v t:..' ;;:at.-.l la':..-^
t'n:- in >. :.i:i .mt.-i'i.- i.f <!'nn:i:iy. All tlia; .'f < Ira. !'.-. i I. ht:i;.i" t/. 1 t. .n.i.'i^. S:i.-!l\v:i j. rurl
iMi.i.-i'n >.! MO' lia-i 1. nt '.<> Kic 1 .iia 1 ^;.. .-i.-. all ..':: r-, !.'.. s-cicn.'i 1 l:a- nri i- in th'- 1 i-' -::<-
Tin* rh.' in .<t c.iri-f il n!^.-rva f ii.n i'as i-mi- :- . n y-:u'>, v.-rv i:;il urn i! v !.>! i:- tn ! k >
triii'it-ii to t!i.- tr.'.-itni.-nt, a:;.l all ti:at ill.' 1 1. rtnaiiy !'. T ti.i- (ir-r anpi'Liranr- -.; ay.-' rn-
n;.>-t p-ri'-nt r. -:. r.-h ins fMrm-h.M t" tii-- alii- t j-.-at :-. '.vliich siii.nl.i I'liitn-iiy t.'.. 1 j.r. s-
p-:tii.'.. '/v . >t' 'li-i-a-M s <it' t!:r rvf. jil'i- t;:if lii'l'i-.l cut 'a tvanr. <1 staL'-' "t uptit i,a!nii.- rn-'-li.'!:;.. 1
._:- :!i'-r" in tiii- c.ini|.:-.-!i.-n-i\i.' vnl.ini.-." - an-l surt,', ry. Pr.'f. ST. liwv h;is furm-:..- i ::
!',''</>'/ hni M,II;,-,I!,I>,:! V, /,,/;,,;/ /,'.,,,,;'-/. \\irii -m-h a ti'.-ati.-.-. I; ;< a lil.rarv :;i i'--lt'.
u:-:, 'i -lit!]',- in I.,i-.",ir:.t (,f this I k. a- /> 'r-. >/,'..:, ,,,' .!/.,/;. .,, ,,-,,//",.,,-, .,.;,.
tin ii. us! L-uinpl.-ti- an.l trs-twurt '..; c. .!,.;.-!! " I' is i:.i|.-i-.| i irn-at u. rk. aii'i will taki- it.n
iii:ua ut' ..piit liainii. I".' 1 .' i nat has li.-.-n uil'rt-.l j !a.-i- a^ a 'tan.lar.l autiiu: it v in rv.'rv ni'-'liral
t" An !-:r! can i.livsi.'ians sini'i- t!i.- :i pi -carat u-.-, 1 i I. rar ,."- -/'!(!: M- -/c -c' .1 -r</' >, /';/ '' /'.;-
!:!'[.'. v--a.-~ a-_'", i.f *lu, - jr-at. 1.11" iiu\v, in ;</'.
i!i,-ni> i-.-s;,.-i-t.s. uli-iil. -t,- \v..i'k- ..T' .Mack-tr/a- " \Vi- lirtvi- no hr.-itatinn in sayit:;,' tha? ' :.H
aivl L .w!---ni-.-." - .V. I.o'i'is .I/ ./;./.',/-,-/>''./'. \v..rk. a> :i -.vhulc is fa: t :. ! -t whirl, '.a- \
npp. ai-,- 1 n lv,.:!i-i : an.l M< a ' ,. ( ,k of r- f. r-
" O; " wiirk. as a whul.-. it is sr;irr.-Iy i-in-.- fi.r t !: <-uiis!i:t-it imi of ar.r!.m-:ty t!i u.wC-
!:.- --.!. 1..at wi- shr, M ]4 sji.-ak. A tiiir-l 1 r ^ pert ainii:.' : . t.li-- oy. , i- t'r. .i.ai ..y -.\ i' ;... -':'.
'.n 1 1 . ; . ! .. .. > k "I sncii iiKiui.ii in i.- IIP -an- in i' - - ip. r'.nr . -\ :i it :: h:.s- r > ..,': a! : n an v .:\:.-
( J.-j'nri'-v \. .'.- niM'-h v.'ha' i' w.nil.1 in. 'an in _'irij,'." . I //,./>.)// .I<iti ni'li "1 '.'c !/-,'
Fn !a:;.i. '.'lit tii.- ur.l.al (if critici-m h;i.l >'-' ".--.
Roosa, D. B. St. John, M.D.. and Ely, Edward T., M.D.
1 n. :-t ..[..>- .n c\r P-iii' !v n-i-fi.l uui k : . " A- a r>-n<'i--- t r. :IT i.-i- nil 1 ' c
!-,! , : 'i'l -:-:-. ..'" -.iv'ir!-. as it liurs. .--.. an i i-.:f. t!..- ' .M.-i-i, .:-,!: 1 .
-..:.-. -ii -.!'.;-.!.' ';:. ( -.,n;,i 1,,- .;,-;!-,:!. 1 1 1 1, hi:.- lK :t.
I - -a i ,', !.. . !;. ! I .'!_' I! c unt '. II: in J i.!li '.' |.t . .Illl-r. " - il ,;'-. /
v - . . ' . M t . inn nip; :iiit i o;n; - ' ' \\ . :.,-.vi- /at <'. '. .-i-.-n - ,
:-....-. .n i ,.'_;, its' ,|-. :. i.-t.-i,,^ .,. ...-;, !..:-- /-.:.
.i-.- til - : Ml n -i. VI, i i nf .'1,-ar /'
Knnpp, H., M.D.,
1'IT.LICATIONS OF WILLIAM WOOD COMPANY.
I >',. </,svx of' (hi J'.t/c ((//</ hid'.
De Wecker, L., M.D ,
IM i l.\|; Til FK VFF.FTirs. Translated and Edited 1>y LITTON FORUF.S., 3T. A.,
M D. F K. <;.S.. I. a!.- Clinical Assistant Royal London Ophthalmic Hospital.
t Mi. volume, s vo. o.YJ pajes. illustrated, muslin. Price, -1.00.
\\ T \i, Week< r has writieH a, \<!> in- nude ml iti-il srenius lit' the niitlmr, his ^reat
, , , ,vm' vobnm-. :ui i Dr. Llttn Forbes has op.-ra.tive skill, his vast experience, anil the
,[.,., ,.,,. | s- rvii-e in i< n-nnm_ it into excel- many advuneiM in the treatment of eye allee-
; u; | ;,, |j,;, \t \v hati-ver ]>:v^'i- it i^ n|n-ne'l timis which have tiiuli)utiteilly liad thoir source
( ,. ., t |. ] u j;; t !, ! Miiiir-thin^ t. intm-.-t liim in the iiri^inality aini inveiitivt- power of |)r.
- n.' t i.:ii_' !. '\ i. o: -.-.inn IM \v aj'pliiMt ion nf I)i> Wci-kiT. ( 'dining 1'ioni sneli a pen, eaie-
, M ku.m'.. .1.;. Int t! y and airrecalile fully revi>e<l ami cnmlriise'l, tlie.-.c lectures
,;,.-!;... ;. uiiL'lv of tliiis.- will lie read with avidity l>v all workers in this
,,; '('>-, u--. an." /"' / .' ' branch rrf siir^,' TV, and heiieeit is not a inattiT
\\ , ,;,, i,, t , \:i_'_:.rai, >(!; importance of for surprise t hal already they have ItiH'il trans-
i :i,ii it marks an era lated into Italian and Spanish., and are about
.'. ^ri, m-e. The rapid ad- to be issued in ( IiTinany." -- l)u>>li ' n Journal
' ,-] ecially on the / .Mr;il / in;*.
i : .- |e-.\ ye:ir-.. renders " 1 1 ere we have tl:e fruits of an except ionally
, ,. i.;' th.s transla'ioii of Dr. larire evperienee. and the matured judgment of
]',;'- . rtuiie; ami this i-. one one wdio has contribtitt-d largely to the recent
, , ; r i'.i:s of t his work, that advances -,\\:\< le in t hi < branch of medicine." -
. te:--.M"-s and pi r-p ; cuity Cl-tstjnii' M< <Hi-nl Journal .
: r i' i i-v n'' comprehension to \\\<- " \Ve do not know t hat we ever read a work
:' ; -: -;al v. 01 ki r. dealing a^ jiroiit. It i> a splendid r-xnitu' of modern o pi i-
i' ; - ..''t . ,|iie.vtio:i< of practical t halmolot;ieai science. It- sheds still greater
. : ,-i aji'ati-il t!ie miiids of (iph- lustre on the name of it s illust rions author,
- r_t o::- for -o:ue time past : and this while it retli'cts the Create.-, t. ci'cdii on the able
i wh.-n w.- r.-membu'- the irav.siator." I>ul,liiL Jfnli'-ul Journal.
Buck, Albert H, M.D.,
i)i.M,\n>is \M TI:K\TMI:\T OF DISKASKS OF THI-: KAII. s,,id only
[) See aje .")('(.
Allen, Peter. M.D.,
dition whicli eventually i--nders them jnsn--
e p! i ' '!e "(' aim 1 1 1 [ at ion . even b\ the ni"~t in-
1 ' ' : l i nt iv directc 1 1 efforts. It is a work, tin n,
' ' :d'i ir:.i '1\ a. i apt i i| to tin r- i |nin-meiit s of :\i 11-
; pi act i 'e. and on- wiiich w- e>pi-i-i:illy
ommi i To t ill- st lldel't in otoli>;_'y and to
ti.e b i-;, pra.'titioiier." Tl W<<li,;tl /,V. -../-,/.
" \ ' a 1 ' ' < t -i i r'i in all it - various 1 1 irin^. and
I ' n.| li'-nt ions wit h t he t nroat, is t r. ated
i ' i'. i, ei at one, iiitffe-t 111^ ami satis-
' (.,!., |t ;s Ijll it e Up to ! i), im pl'ovi llU'llt *
' ' 'i oft:. i \<i-i-^nid-A$." < iii'-iitinif.i Lnn<;t.
Hclmholtz, H,.
''' I ' H \\I-M i iF T11F iSS|i [.!> ( IF Till: F \T! AXD M F.U1H? A\A TVM-
' ' 'i ! Ai;tl oi-\- F. niii.-i.ni, bv Ai.in.K"!
' V"KM \ Mr >M I H, i N'eU Volk. Oln Vol ii Ine. oetu vo,' (j!) ji:i-c?.
PUBLICATIONS ( >!' WILLIAM Wool) A CO.Ml'ANY
Roosa, D. B. St. John, M.D.,
A PRACTICAL TRl'ATISK oN Till: IHSKASKS < >F Til 11 KAIl. I\<U !>I\<;
Till: ANATOMY OF Till: olJiiAN. Sixth K,liti..n On,- YO!U;,I.-. - ',]>
pa_'os. Illustrate. I l.y lln w l-.-ii_'r:xviius and .-hi-.. tin. li'ln ._ raph-. I'r : .-,
muslin. $.">. .">() ; leather, Si>..Vi.
li any .in.' hasthe ri^ht <o speak !i';ti:iri- treatment of ear-t 1-1 iiil.le, involve-, a r -, .::.
ta'ivei\ ii|Kiii otoloeacal matter-, it. is |)r. mate knowledge ot ^'eiieral medicine ; second,
lloo-a. t". .r it i> In- \vl:... in.. re than any on.- ti::it ti.e im-aMi: e nt success i.-, det'-rmin. d I..
*!--. !ia- made known t.i tiic American men th" thoroughness which the practitioner IIMU.'S
c tl in nt'r-.si..ii tii.' tji-li'-ral priuiripk-s of tr.'at- t> i th.- cxaininat imi "I his case-. In-fur.' ai'i-!-.
lii'-nt ..I' aural ill^.-asi'-~ ; anil it is sal.- !> >av 111^' his Minj>!.- a: maim-nt ai'l i;i:i.
tiial n.i h.mk upcii any -i'i-c:al snl.j.-rt lias "It is ."i:-ffiili\ incnli'at-'ii that not l.ii. J is
li.-cii ni.ir.' wi.lflv .list nliu tfil thfoiii^hnut t .: to !)' dun.- \\itii.mt a kiujwli'ili;'' i.f what i- r.'-
i'..iintry than has his a'lniiralil" tr.'ati-i'. Ii ipiin-il. ami tiiat pnictici: ' in t!if ilai k ' t. nt'i-
this wi.rk In- I'ar.-t'iilly stmli.-.l, it will In- seen t ve pnietiee] i> 1.--S jn st iliahle in t:i)s l.rane:i
tiiat t w.i main i.(.-:is nin thron^li th'- wii..!.- uf i.f ini-i lieine than in any other." /'/ .!/ /" .;'
what has l.-.-n \\ritteii; tiist. that a .-kiiful ' !!< <!>'/.
Bosworth Franke Huntington, M.D.,
A .MAM'AL OF DISK \S1-.S o|' Till', TIIP.oAT AXI> XOSI-:. Oin- vulunie, netav.>,
-II s pa.'eS. Illll.-trate.l \vi;li Wnuil-ellirnivillL'.-. -Mtlslin. I'l'ie.'. So ','.").
" TIL- authur has ddiii- his work well, anil in "A work on this s:il.' ( r(-t, inteii'li-d in, .re
eh- i! and i-xpi'i-ssiv :;i::^:ia^e L,'i\es t i...- ri suit e.-perially for the i;i-neral piaefit ion. r Tl'.an t he
of i, is liy no ni.'ans small experience. . .. 'I';..- spi-c'ali-t. is wh.ar is waiite.i. and !>:. !!.--
woi k. like most emanating from the otin-r ,-ide wor'.i has li. ( .'n fortiinat.- in tin- manner i:;
<if tiie Atiatiti,'. i- w.-ll '.:nt r !-n MI.. p'Uier. typ' 1 . wiiic:; he has approached the snleec' II:-
and \\onilciits li.'in.; ixeeli.'iit." J-Miti'mi'if/i handling of it. moreover, has 1,,-,-n },,,i\\ a'.ie
.!/. ./.-.</ ./.,/////,//. and j'ldicions a starenient whicii an exam; na-
T.'ie Look is an excellent <i>"ciip.oti of I,. - ik tii i- 1 of tii,- hook is >;:th''-i' nt to substantial.-."
making, and I )r. Ho-worth has honored him- .I//-A/V"" \T '/',, .,i \, ,i^.
s If and tii" pro!'essj,in l.v writing ii." /'/' "Tin-!-.- ,-ir-- a thousand ex. .'!.-"-' hin's ;:
. I ,...,-;.,/., /',.,.' ,/.,,!,., ji,j s v ..li:m.-. \\hi.-h is an emi!i.-!t!\ praenca
" Tin- a 1 it :.!>: ^ r i \ . - Us a 1 k a.- in-t met iv.- inaimal, e. inalh ered ira Lie t-i ant hor and pn'i
a^ it i- int. -i-e-tnu. not aione to the specialist, li-lier, well iih si ; at- d. ait..u r . tin r a work t..
li'.t TO tin e.-nera! practitioner as w> il." >'. I. recommended to li..th stndei.t and p!a.-ti
/....,-. <-li,>;-"-' /.' "/-/. tioner." -II.- 'a ,/,, /.,; t,
Van Troeltsche, A.
DISHASKS OF TIIK i:\il IN I'll I l.DUF.N. I'rice. sl.T.O.
Saltcr, Henry Hyde, M.D.,
I'. ". .-.v .f '':- li..-, ;M i '.. ' L.'.' ..f I" v- ; :-,'-: I ' ; ,\-i. ;;.', t,. I '!, ,.-;.; . '.-. - i I . .-; , ; : a ' . n ! : 1 I.. .- - '
I 'i i'.eii.;. - :,ii.l l'i-a."j.'.- ..T M.-'i! :,. . :c i-..- Cli.r::!_- ( 'n ! |. .- i.i. M.- : ..,: >.-'..., .
ON \STIIM\: ITS I' \Tllol. ill, V AND TK KAT.M F.\T S..M,.;
Se, ,,,_,- r,4.
See, Germain,
V,- :. r ..f the Pa. ;:!, ..f M. i , a.-- : M. :-,'.. -r of rh-- \e:i -.;. f V. i : , '., : ;";
1 1:. :. r- . I 'iiris.
IMSKXSKS ni' -I'M!-: i.i'Ni;s. ( ! \ si'i-:< IFI<\ \< >N-Triu:i:cri.( " s \ \TJ i;i:.
\eu!e I'.nmeliin-, hif..,-tio'i- l'!,e, m ,,, M i a . ( ;,'iti-ren... S\-|.!ii : >. Can.-.-!', and Hv-
ila'i.U ,.f tlie l.uilu-s. Trali-lati'd l.\ I'.. I'. Hll.'l-. M . 1 > . \! . in h.-r . ' h .M ..-'a-
chu-etts V.-lieal Sociery. \'ice- 1 'r/.-id. n: (.f :!,. F x \-:' ; : Ii-;:l." M.-.i : .-:il
So.-i,'t\ ; One ..f the rhvsifians to :!:- \:iiia .I.eiie- !I..-p::.ii. N'.-u !.in ;, p..r: ,
.Ma-~ WithaiiAppendix li\ tin- Tra:is!at..r on t':..- (I. i-iiiall Theorv ot' |):-.-a.-e,
and on the Tul.ercle Kaei !', u- S,.:d Ls - ; I -crip: i. .11 ..:i'. . . >.-- pa_.- "il.
^ - ' I >ne of the n.o^t \ a lua 1.1.- \\'..rk~ on t h- sulrect <.f '', cent t ime-. tui!', up to late.
I'l IJLICAT10NS OF \\II.1.1AM AYOOI) A COMPANY.
/','.x, ,/x, .s- i, T' tin .\ii*<i j < 'i/riftfM, Lti nj n. i'. if* .
Scmelcdcr. Dr. Fricdrich,
n.i-; , J.i-Mn-. ' . .:.- f Mevicn : Member nf i he Royal Miilir.nl Society ..f
, l'a-ithe., n in I'iirU: I', nm-riy Member of the Meilical Knci'ilty
, I : -...-::. : ',.,: lln' llnineh ll-<-i.U:i! ill i I <-,m]n-nii< ,rf.
i;iIINi> t'I'Y \M> I.AKYMiOSt dl'V; Til HI K VA 1. 1' K IN i'RAl Tl( 'AL MKDI-
( ]N|; rra!i-':itcd Cennaii 1'v Ki>w\i;n T. ( \>\\ I.I.I., M I). AVith
hie jo.-ites. (iii'' viilmiif. uctavii, l!lj pa^es,
. . ' nl lids i',l tilr I't-lVs-i..li;il JMllillr tn \vliulu it i-dlnt-s,"
::i,-tu-:il - .\rir }'.,//, M,,li,;il JultriKll.
\.li\. . .1': I'.'.' i" '.! \r 1 ' . till' M rilii't
Mackenzie, Morell, M.D., London.
iu<r. \->is UK i HI: riiAitYNX. I.MJYNX. \NI> 'I'I;ACIII:\. niustr:it-ii i>y 112
Sulil ulllv liv Mll'-iTil'tii'M. SIM. |.;i-i- .")(!.
Robinson, Boverley, A.M., M.D. (Paris),
;i -In- TJi'lIcviii. H.i'pitnl Mi..ri-nt Ciillr^c, Xi-\v York: I Ir. - -.-i.in i,, S; .
James, Prosscr, M.D.
YNi,ii<f(tpY \ND I'.IIINOSCOI'Y IN DIA<:\OSIS AND THKA'r.MHXT OF
'>'-r\-l.- OF Till: THIHiAT AND N'OSK, [..unl, editimi. enhu-L-.-d, uin-
- . i '.rated M i| ! - i. lid-ei. . : -. and !i\ liaiid-cnl -
.Licobi. A.. M.D..
Ross. James. M.D.,
iri'i-e clinical digest. It i-. an en -
nd i.f r. fcri nces in the
M- nl' [-'ranee, I '. , n,;an\ Knuland. and
T ,M i k may I"- c',n.-id. ml a
! ij, nii,-t a lit i ent je literal me nf t Ids
)-. .;- ][.,;;.-.,! .!,.,">.
It : v l,i dli i d t i.at 1 in- xt iident <'f nei-
I ,w|,ere el-e tilld all t llC
: - 'it, / l her in a fiii-ni -<i convenient
. . \1 ,,,,' \, ,r.i.
PU3L1CAT10.NS OF WILLIAM Wool) A COMPANY.
I)ii$t(tx>$ <>f tin* A > /'/'6>//.s' .S'//x// a,.
Rosenthal, M., M.D.,
A CLINICAL TUKATISK ON 'I' UK DISKASF.S <>r TIIK NKRVoI's >Y>TK.M.
\Vitli a Preface liv I'K< )K1 :-- t|; I'll \K< (iT. 'I'l alislated from the Author's Revised
an. I Lnlaived K-litiiiii l.y L. I'lT/.li, .M.l>. \i-itin_ I'liv.-i.-iaii for N.-IV..I;-.
1)1.-. -ases, Randall's Island Hospital: l'liv>ic-iaii t.. tli.- < ia-> 1 -r N. r\ 'oil- I '!-
eases, I!- !!' -viit- Hospital < >iit-d.M.r | ),-|,ai t HP lit, and I'al li>.l,,_ i-t t- the Lunatic
A.s\ium, iJlackwell's Island. Illustrated. <>MO \ "1 nine. s \ , .YV> j..i_ .-. mii-l in.
['rice, $.")..")(!.
" Km- a treatise on diseases of the tiervoiM " T!.i- ^reat ad\;inces thai have !..,M made
s\ stern, tin-ii- is no work ttelter arranged m 1 in the d.a_;nosis, pat Iniln^s, a nil triatnunt of
Iiioi,- scient ilicall V executed. The author U nervous disi-ases ot' late \ ears, have l.i'en ii..t..|
iilent itiecl \\ith thi: nio:e a'lv.-n ri-.l ilisi-i>\ ei ie, in this tn-ati.-e. ami we rlieer! ully i-on.ineinl
aii.l re-earrlies in this ino>t ilitlicult tieMoi' tin- Imok to tl.i- ]irnt'i-ssinii. ">'., K///I ;//' /..M'.-.
liieilie.il srienre. aii'l we ina\ salely as.-ei t that "The \\ork i- one wiiirii iieui'o'o^i-t , will
110 other linuk will LI\I' inofc Kciietit or int'or- scan with interest. "-- .!/" '/'- "I >in'l >'///./.'.,/
ih.iTinn on ner\ cms . ii-ea-es. " . 1 ffitiit'i M' '/i- /,' /"</.'/.
,;,' .,,/ X./ ,-,//-.// J<t,-,,,ll. ' Thiswoikof Il4e! thal's hasl.eeii a>tai:,l
" Ainoni; tin- merits of this hook worthy of ard on tin- diseases of tl.e nervon^ system in
>j.e,'ial ment ion a if its imit'ormity of plan and ( i> r:i;an\ and A u-tria i'oi' a mm:! c-r of \ ea: -.
systematic 1 divisions and siilnii\ i^ioiis ; t!;e having i:one through -e\ eral edit i- .n-. It i;as
\\ell c'!m-f!i anioimt of -pan' and attention I.e. 11 tl'aiialated into Kre.'.eii. and reei-ived t : .-
\\hieii a:' ili-viiti'cl to each di-ea-e. l!ie rarej'n.l comnif ndat ions ot' Fivni'h Neiiro-pat iioln^i-ts,
]in-eiit it ion of t ne -.iiliject, of syinptomaiol. i^'y. esptjcially I'r. it'e--.or ('harcoi, who is tie aii-
ilia^iioi~. and prognosis, .-i;id riie iriiiii-roiis thor of a pjvfacv to th>' American tran-!ation.
c'oin'isc reports ol' original )iatholou'icjaland his- The work is, as it purports to tie. a ehuieal
tolcu'ii-al !.li~ervatioiis." - /',', :!,,,!, :/,.',;,, .\[,<l',- one, l.eiiu i-1'erially full in th- prac-t :.-al .!.
i'ii' Ti'inX, part:nentsol symptomatology aiid tn-at ;i.c-nt.
"The 1 k lias many in--rits. and jiiueh to The pat hoio-ric-al du-.'i'ip: ! .ns are al-o made'
foinmciid it to the' attfition o! the' piof. -do n. prominent, and are nnu-iially clear. T;.<- oat i
ThN i-- c.spi'cially tri-f in regard to the- ela>-i fnrni-heil l,y clii:n'al uliservatiolis and p.itl.o
tii -at i on, t hedf. script ion of many diM-asos. and, logical anatonu a !'c- e \plaii.ed as far as [ c --:
011 the whole, in regard to t ivat mcnt . " .I/'- Me l>y physiology, Imt I )r. Itosent h , 1 divotfs
<-hii;.-inj' M. .I',,-;, a-. very little space to thf 01 ie s r, -nrdi: - ph\>io-
"It is systematically arranged, and is writ- logical nn-rhanism, ditl'eriiiL r in ti;is respect
ten in a st\le that is plain, clear, an I forci from mo-t rer.-ni \\iiiirs on m-rvons di-
l,ie; is devoid of hypothetical speculations, . a-es. "-'/',.',,;., \f- ^'il ' '<> .V</ ;'/.'<
and -tarilin' and remarkaMe cures." -'I'/,- //.//.
If, /,-; 1 1, !' .1, ,,-. il.
Beard, George M., A.M., M.D.,
" The 1 took is wi in en in the author's usual or.: aide changes in t !., varion- de pai 'm* ::ts of
Iu>-: 1 -!> !e. and exhil.its t ho results ,,f original lie ni-r\oiis s\ stem. \\'e can n ..- 1 ur_etitK
r -e . : c.i in a m.<st i ni , i e-t in.; d, part men t of recommend to ail ph\ sicians, an-i to n, : \ ,c;s
me ii.'ine Tt:e medica! world owes to Mr. specialists, in part icnlar, the W.M k ! er. Icioilv
I'.-arl its \varni'--t a Iniirat ioti for lia- r.-d:\ icviev.ed as t:,e result of aliundi:: 1 prac-lical
:;o , 1 wi ,i k u hii'h he iia - done :u this special experience, and o| sharp i-rit ica! .1 .- er\ at i"!i. "
jW.f'-'ii-at ion. made in tile ne'itral -pace I,,. . 1 " /r ,,;, II", ,- I/ ,','../ >*J >
fAeen eleai pli\siolo u ical and pathological "The I k is f>dl of ... i ; i, ,1 r . -.'- nvh and
' M 11. ,11 i .". is. more t nan anv ol iier \\ i iter |. .m~. c-t iolojv, and 1 i e . ' :>: : t . a: e a!i,p -. ;!
of the da \ . coi:t i ihute 1 to e-t 1 1, 1 ! -I, t 'a- t'act his) rated l,\ cases \vhich ! M \ . ci ci .- u la ii -r ! h
tiiat /rave appe ir.nice ol 1 loc-i! di-ea-i- may author's ,,\\n ol,-ervat i. ,n." ' > -i-i I/- /'
c'Xlst wit ii out, I'l I act . ha \ in.; a lo -a ! organic n nil >i/ /,/,',./' -In ' r > , ,- '.
haliit.ition, or reiiuires a name diss, vered from "The p:.-f:a \\m k treat- of the di-ea-, d
tiie ueii.-ril nervous s\stem." . I',', /,'-' :in'/ c-oiidit ion wliicii has. m the list , ie.-adi's, 1 e
A'-" come s,, d's-em.inat d. not onl\ in Atne-ic.i.
"The' merit inc'ont. -tatily l.elon-s (.. Mr. tint aUowitli n-. in lo-rm.u,
Heard, of havin.; pro\ ed, on a scient i !'c 1 ,as]s, litionc'i' c iic-oiinters it on In- ro'tii U. -e' e ii
the existfiic" of iic urast hc'ilia, and lia\in-,ie- times daiK " /'/',>,/, ''/ /'/'-//. .-t ", '.,;-
lined the difference !>ct ween this form of n. r unni I r >n ~ ',/',.)'.
v.cisi.ess and t hat which is the expression of
"i; ri jiLicATioNs <>r \\ILLIAM WOOD A COMPANY.
/>/st </*< X at' t]i< .\ 'XT'*. Aj>Oj>l< : ,rij.
Gowers. W. R., M.D.,
-.-.% f. >-. 11 ,-i .M. 1 !,;.
LPii.F.psY AND OTHER CHRONIC CONVULSIVE DISEASES. Their cause>.
>\ Hip! 1;.- atnl Tfi iitllli lit. >o:d l'\" subscription Olllv. Si-e pULTe ,"")!.
DIACNosiS OF Till: D1>EA>ES oF THE J'.RAl.N AND SPINAL CORD. Sold
Bramwcll, B.,
DISEASES ol-- TIIK SIMNAL CORD. Trie... s:>.l)0.
Putzcl, L., M.D..
A TREATISE o\ COMMON FOR. MS OF Fl'.Xt TIONAL NERVOUS DISEASES.
Si M milv l>v sul'MTiption. See p:ue ."">(>.
Lidcll, John A., A.M., M.D.
\ THKATISI-; ON APOPLEXY CEREP.RAL HKMoR RIIAC F. CEREBRAL TM-
I'.ol.ISM, CEREP.RAL COCT, CFRKP.RAL R II FC M ATIS.M . AN I) KPIDFM K '
ri:i:i-:r.i;o-siMN.\L MI-:NINCFI'IS. on., volume, svo, :;!).") \^^, mu>iin.
IT;.-. St. I'd.
\\", 1 1; nk I i.c niiiili-st hnii' nt" the ill. tin 1 1'. " To ;ill I'rieinU ot' ours \vlio are en^u^c 1 in
:iv .\:i.-- .1 n ti,e |iret';u'e to tins exiellent t he st ltd \' or T n at ineiit of ei-rcl irnl diseases, we
iiii,. t!:at i' uill [ri'Ve ! : t eiv.-t in_' iiml eonliiillv coniiiieiii I t his work as t lie ino.-t i-oin-
,'t;:o-r- -,\li,) p.. -id n. will ) t'ully n-a! jilete aipl Mit ist'iu'tory of ;iny that we have
:. . :. . . . We heartily recommend the work -ecu. The mechanical execution ol' th.'Work
,il | i,- ].. ;. r T,, i ' r prof. -M..U as oi:e of very is excellent." /A ^/-.-iV /,'> i-ii-ir.
/" ' ',,',', .If,,/;,;,! Til,,,*. '
Erichsen, John Eric, F.R.S.,
- ,. >-. n-ir-, ),, th-' i, i: : l-ln.iTitu- l'!-Mfr-~..r nf Clinical Suivrry in I'Tiivcrsity ('ullc^..,
.: : r th. II n till : V.\ I'lv-i.li-nl nf tiic K< iviil ( '. .;:'CLTI- . if Surirfoii- of KIIK-
i. M i, :,',.'' il .!_: :.: >... ct;., . tc,
i,\ ciiNrrio.\ OF Tin: SIMM:. NFRVOTS SHOCK. AND OTHER on-
-ii Ri: l\.M'R!i;s OK 'I'liK NFRX'OTS SYS'I'F.M IN THKIlt CLINICAL
AND MF.DIi o !.!-;I;AL ASPECTS. One volume, 1','ino, :M I paws, mu.-lin.
T . : :; his j.r.'facc ex- r.'lilwtiy coi 1 i.-ii ills, they wfe not peculiar to
plan ' '... a- having lieeii t hem. lint nii^'ht lie the I'OliseqnelH'e of any of
r in juri. ..I the the more onlinar\ accnleiit s of ci\ il lite. As
' . . ' . r- the Work is llo\\ presellteli, it illclliih^ ei'Jit
I 1 : . . . ' el, . . ],, i v ,-,| in c.-ili- a.l.litimial lectures anil has IK <-n expandeil in
II . ; . |. Mica- -cup, I., einlirace a wider raiiLTc of Milijects.
ill' i i : . ' : . ' . ' , :i la r u 'e. ol iscui'e. and ini].oi taut elass ol in juries
-in- ol ;, ui'rvoiis s\>ti;iu, thl.s work is highly
Richct, Chas., A.M., M.D., Ph.D.,
ITBLK'ATIONS OF WILLIAM W<><>1> A COMPANY
Benedikt, Moriz,
AN ATo.MK'AI, S'lTDIKS ri'oN UliAINS OF rltl.MINAI.S \ ( >\ TK I 111 Th V
TO AN niKoi'oi.ocY. .Mi:i>h INK. .11 HISI-KI IH:N< i:. AND i^vriim.-
0(IY. Tra:iat.-l fi'.nn the Cci-maii l>v K 1'. l-'mvi I:K. .M.D., N.-\\ Ymk . !>.-
pai'tnu-iit I'i 1 Traii-latHm. N.-\\ Y<>rk .Mcilieu-< 'liirnr..'i'-al S,,,i, ty. I !. ,,-;i .,- !
v.ith \v ..... l-i-iu'ravin_'.-. On,- \ ,,, [.Hi--. Svn, !*"> pa.'--, luii-lin. I'riec, s! "in
]t i- s'rietly M'ieutilie p!;i!;mt':iri>pv. an.'i l.iek <{ tin- f-,-ntm,- -nt "f\s:i.i;_. t'-,.,':Ji ,. j-'n
r. :,,-:.. - in tli-- M'upe <i: trie linma:ii/in _. a i!i-ir pcreept.nn nf i'. . . .:>! r ;! ! . -...,
( 'iinn'r'-hi-M'iniu' as it dni-s t hr ; i--\ c' 1 .. \\:: \ i.f privi-iiial ps\ t'!inl,r_'i |l a] c::ai :iri .-: i-, ],-, -\
i:ir i-xi-rnn-i-. it la\ s hc.l.i n;i iart> inn^t |- r- r!a~- ! wliii-li 1..-1..H-.-. f.^r- tiiaii I.IH- .'.,,1 i>f
tilH-nt In t l.i' \\ It'al't' cif Mu-ii-ty, ili'llviil'Kuiv <"!;. |i-inlif I r: iniinal-.
aii'i i-ull.-i-f i\ i-lv 111 1'ai-l. it Aprils up :i very ' II ?h"-.v^ <! lirii'iii'ir-i in til-- 1-1-! I-!HM! ,":
liin.iil aii'l ciitiri-ly lii'u'l.-i-ti'il MIMT.'I- nf int'nut.- ^-t it'H inii f rMinin.N. \i/ : ii. !:rii-::t L_
.-! i i\. aii-1 >hiiilM ;i\v.ik'-l! liru j'.-- t -aiT!i ilit'i c if. ''.<>; .1111-1,1 . au-l a rnll-r-pir'it -.1 <-. i-! I.-
Iin-:it ii p:ii-iiuiiu'iia. ^-.r-~, wnl'\i :ir- f'.tr laiir-lil a; .'li-!'i- -t -. T!.,---
' Ih l'i.- i- likt i- nl' iijiiiiinii t'ri.-.t an ilia', i!- ilr!'i-.-ts ar.- <-\iirl:t t lirniu'iini.l !:; f.t :i-
i:\ tn i, '.-.train t :K-:QM-!\ .-- I'i mn t ; n- n-pct it i-in extent "!' I'M- l>rain. Ti,'- \v,.ik i-- .: i::-at,
nf a i-', iir.i-. iintwith-laiiiliiii; t !)< full appiv -ia- value." 1 1 -' i'n JT -<V' -/.' /,'/."/'' /',
ti'iii 11' th" ^ ipiTir jiuwer ul' th-; law. airia
Charcot, J. M.,
!:-.'. -. r ;:i I'..- ri.-.-.'.ty ..f Me.li.-in.' nf Tar.-: Cir- f. f t : ..- S:i'!..':-:--!-- It-.-. 1 '; '" : V'-::- ! : " ' i-
,--. ; : -- -:- \!'- ..-I- i..-. .if i!i-- i .:i.ii-.i: > ..... -y ' !.-' i -n : Pn-- .!.-;.: -.:" 1 !:.- S. ,.-:. A- .:. ,-.--: ;' -
. : \ :.-.- I'M--: i- 1,1 ,.f in.- S.n- >>< ! !;: i.-'^-i", :..,< !'..
i.ij TI i:i:> o\ i.ocAi.i/ATiuN IN I>ISKASI:S or Tin; nuAi.N. i>- ' : .-.i at
! !.. I-': i. MI.;.' .1.- M. i Ice in.-. 1'uri-. I ">">. I'Mitcil liv Ki 1 1 i:\l\llli.. 'I'i :i!,.-! a' --I
l.y Kiiu \i:ii I'. IMIWI.I.K. .M.D.. \i-\vYm-k. L m~: i-at.-.l v.iih :'..rt\ -:! v.- :iiu-
\v ..... 1 .-]u'ra\'iii_s. On.- viiiuiii'-. ^YI>. ]:!:! pa_>-~. inn.- i;i. I'riee. sl.."in.
\Ve i.eavflv .-,!!, HI, etui t'le 1 ..... k 1.1 Jill -f- I! Vlnil' ' I til - I - T 'Ml! I- , Xa-'l't" ie il, rcll-
(i... '---',:- r\e -I :-' ifi ie:--. I r t'".'.-.- i'-'-t ;; e- t :..- o ii :n:i -I" 1 ' : _-i !ia! !:. ; i: ^. :i'n i a - a <-!ear
7!:.-il i .-I 1 i~ f iM-iii.-ic I in t '..r i lire -t 'ii pnint e i an i I.M- \.-.-i.; .1 > ,! -i \ !e .'!.:.. '. I
<i;t ' iv IP Tin.'i! ii'iii* iitn\ a II- 1 eN i i t iM'i'Mt a ! i 'i:\ - '.-/ ./ /-..''..'/',. I/. /.' (/-' >,,...-,.
iul'iL".' Ii ",t a- >'it.pl' in i-!i t a i". 1 1 1 t n ; ~, I !;. iv " A :. -. h':i : l"r< ' i 1 1n- t e i ' r ' i; -- i: .M < 'l.rir
1- .-.-Me i elitii "il ;i!l'l pati.il!i'_'!i',al M--I- ireh." eot i- I!! i>!iee tl'-a-irel li\ lie pliill -I'll.
"l--n.M i'- i \f. '!!" sty 1 .-', rui-i \\ it'; ; li':-- * : i M n!' ee'.e'ifa! In.-iili^itim:. Imth a!n ea'.lin
t:a'..),- -.1 _ ..... 1 fia he may i" il t ; .at u-i.is e, ,i ia Imrai ii n \vlt '.: .M . I', tie- an. I ' t ,<" ~. hat,
t:.. 'e--n:i^ \'.:.ii'!i ill.-, t--aen. |)r. l-'n\v]..|''s he i- ; '.i a po.-ilinll tu ,-Jie.ik . . ..
i:,,'. -:... ,.n i- en- IT- .1 !-;. C;iai,' t hiin-.-li' a, .)/./ > /,'.-../'./.
Kamilton, Allan McLane, M.D.,
S?c'uiii, Edward M.D.
I'UJUCATIONS OK \\lU.i\M WOOD A COMPANY.
Burtholow. R., A.M., M.D.
Harrison, Reginald, F.R.C.S.,
i.iicTi'iir.s <i\ TIII: si KCH AI. i>isoi;m:i;s or TIIK IKINAKY OKCANS.
1 i, , , ; : Liver] ! linval I ntirniary. One vnluuio. Svo. oil!) paues,
;;_,- tl . ; : and \unxl-riiuruv iiiiTs, muslin. I'rice. S-l. ','.").
'!'):> ,.\:;\ : M:. I I c. i : -. !.'- leetures orders of tin- Madder are c|iiite fully treated
!.--. i, i '1'lie w..rk ut iu tht- latti r liulf ut' the houk, and Lr. lii<;c-
;:rit-il ' ' .;. \arioMsini-tlnidsuf low's uperal inn, lii liolapaxy, i'avoralily coni-
:-.!_!'.! e.i.'ii . \i-' pi imi in 1 >r. inented mi. Injuries and Mir^ery of tln-kid-
ii- - !-.i-rli."l i.!'. i mine, injuries iievs ari- eon^iileieii in Cliajiters '-'"> and '.'(i.
li.ra, i'i i in. .! ' >; il;e. etc. The dis- 'J'iic \\cik uoiifludcs with a lull index."
Coulson. W. J.. F.R.C.S.
ON riir. DISKASKS ((! Tin-; r.i.Ai)i)i;i; AND TIJOSTATK CLAND. sixth
: (Mil- vnlmiie. Svn. li'.il! juiL-'i's, liaiidsniiiel \- i 1 1 u.-t rat < 1. Sold
: ' . : . > > | >a .).).
Ncubauer, C., M.D.,
' , ':xl l.aln;Hui .ami |i ic-ciu in tin- Clu-inieul l.:iti..r,it"rv In
Vogcl, J.. M.D.,
Of M:, ,-.
v i,i IDK r i'i ' Tin; i,r M.ITATIVI; AND <?\' \\TITATIVK ANALYSIS or TJIK
1 i:i\i: I . : i for !'i ; ,-j !IS . Ch.-nii>ts. and IMiarniacists. ^'ith a
I ',. !'' - 'I 1 l>r I! l'i;i -l-.MI s. Tralishiti-d tr^in the seventh enlar'_''d
l',diti"n l,\ r.i.r.i: 1 1 ii . i : (i. ('1111:1:. >].!>.. l'!i\>ieian to
1 M.-o-.-i- Its d Hi !I< -pital. I'atlioliij.rist at the r.o-toii
' \.--i-t:iiit in 1'athoio. y in ili,. .Aledieal Srlioul of Harvard
I.', l.i>\\ \i;n S. \\,iui.. .M.I).. I'l-nlV-iMir of Cheniistry in
Harvai-'l I niver~:tv. In , in,- siip,-rli Svn vnluni.-, "i."i I
!i 1 \\ it h eiuravi M-S and lour line elirniini-liilinura|di ic
! .' . !' . si; <,M : ., ..- i,. ; . s;.ini.
n ; 'tual Irs-ly the innsf emnplete and comprehensive
t '.: i ! ' '. i rk ol it.- Kind in anv l.inun.-ije. The nil, m-
!]' ' i o t ,i ,. i, ei.pie ill iiM rat ions an- unsurpassed in p. n'.-i 1 -
I :: 'han leal e.xeeut ion t li>- Ixiol, i~ a
.: .I"- 1 ' , ' : r .peeJTii, n of ait. \\V s.-ldmn w e a.
.1,11-. "---/',/,;//. M. ,/,,;,/ ,,,/>/,-
I .-...:...- .
' .
Bclficld, W. T., M.D.,
Milton, J. L., M.D.. M.R.C.S.
PUBLICATIONS OF WILLIAM \V()()I> ,\ COMPANY. .">'.'
l)isrttt<(x oft/it I\ hint //x <fn<I ( riniini (//'/<///*.
Gouloy, John W. S. M.D.,
1MSKASKS 01" Till! IUINARY oRCANS; ! \< 'I. I" I )I N( ; STK H "IT III! < >T Tl 1 1!
ritr.THKA, AI'!T.< TK>N> OF Tin: IM;<>STATI:. AM> STOM: IN TIII;
r.l.ADIH'.K With lu:; \\ uod-e!i_ r;iv iii_s. One vo!iau,. s vu. .'l''^ pa_-e-, uii:.-;i:i.
1'ii,-,. *:;.::>.
" \\ ar<' u'lad to \Vficoiii' 1 tin- alile COM-- op, rat ion - on tin' <_'et;lt< i-tiri!i:i r\ o'.an-. and
trilnition to American siir-jical literature. It having l-.-n profoundly impi.-s-.ij win. i.is
i- 11,,: so xhaustiv a- ti.e treatise- of Sir eoii-uiniiiate skill iiinl a"i:n\ a- a pra,-ti>ai
Il'-nrv Tlmmp-on on Strietui 1 and on l,ithot- surgeon, we hailed v.ilh ea'_ r ' Tiles- tin- proini-e
( , iiy. nor doe- it iip'tend io Ke. ln;t it i- ;i vt-ry o! a M.OIII _ r i\i|iii t'roii: hi> j"-n on :i i-las- ol 'h--
cli-.trl 1 . -written aii'l [T.n-t b'.il L;" ] ii'i,. ainl \viii i a-u~ t whicli ;n- ha<i _;i\ en i-]n-ci;i! at (,:;! i. in
1 1 lo ni'l u-rl ul to lar_'f cl,i>-, o] ri-ailer-. . . . No | .1 a>-; itioiu-r who nmli rt ak' - ! :.r
I:s in >-:ia:ii .1 .xectiti"!! is \i-rv cr'^iitalil'-. tr'-atnn-nr of the urinary o:'_'ai.- ran alVor. I to
an i it contain- ivmarka! M \ iVw typo^raplncal lie witii nt it. It will, we are conliol- nt. L;:\C
error-." /'// "'<i>i< 'ii/iiii .!/.//(,<// /'/,,, ,.s. h;ni a nii;ii p'^itioti an;on_ r tin- ri-cnu'iii/eci .. i-
" Ha\in^ on liii], rent occa-ion- iluiinu" t.'ie t^.oriti - in !;: >|iec:ait\ with wnicn i:i- inni,-
list six ye.ii> enjoy i th |iri\ile_ r " of wit- has li'-en for soni.- years iiuiiuraljiy a.-sociat.'cl."
llessi.:L' tile piTl'orilKlIlCe liV 1'r.lfessor (eilll,-\ ' tli'-UiJ'i .)/'-/-:<.(.' Ati.
ul .-nine of the ino.-L ditlicuit and important
Fowler, E. P., M.D.
Millard, H. B., A.M., M.D.
|i i~ ran that we tin.l a Imok so evi.i.-nt 1 y i.- <\< ei i,-iil \ oil" of t':ie ti.-sr lu^ks ni"int!ie
tin- r --Tit of caietnl. original stii'ly, so fresh sullied e\er |i!iiiii^ne,i. aiiu no one can n ,M it
from t !! l> -,|-i'le. \\-e may -ay. as tin- one I"-- wit noiit, aitvantaue. "--'/'//, .!// >' !!
I'M]-. ];. t ,i.. ;:._'. for rea.-on- \vlii, -h lie "We l.a\c -i'-iiveii L. r :ea' |i;--a-nre fri in the
sta' -. a :i' I v.' i leli a r" MII 11 iM, t in- genera] term perusal ot t .11- work, a i l-.i-ur> , n l.anci ! i <\
15ritriit'- I >i- -a-i-,' I ne antlior mclinlcs in liis t lie rea.ialii,' typi- and e\eei., n' ,|\a l:t \ ot the
stnd'.'iiie s.i'.!" 1 ,- form- of ir-|'!inti-. \\li.ci: jiai.i-r up m wiiicli it i- prime i. U .:;. i : t i!v
s!ne. t!i- d,r. - of l>i. liri^ht i:ave K, en i eco^ reeommeiid it to the public. " ''- ' /',<
ni/.-ii .1- -i tuple, ac'i! a 'id cnronic, mter-titiai. i, ',-,,, ,-.
CI-M ipMii.-. a'n.l -n;.:,::ia' i ,.." I'l, .!/..-'.,,' From st,in to st.-ni the 1 kp:e-eiits:i
ii s. ',--/- i '/,' /,.,,'./. I'nil.i'li'lpiiia. I'a. practical and an o: i-inai c:.aiae;.| : it i-
" 'I'iii- va 1 na I.,,' WMI k i f i int i in- n -arl\ all t nn\ i 1 r, -innu t-i t :i p: act .1 IM;..
till', i- kiiown I'M r.-latiin t.i t.iis m,,-t fatal >/</' I" /, .!/"' ' I.'"
,il--i- Tni- \vo; k 1- f.l!i\ iiill-t I'ated l,\ " 'Throe.^ ::ollt t i.c Imok lie .11-1 : i'k -
v: ni '-:it-. wni'ii ii'" a'niM-t, eiitireK original alile lucidity wi,icii add- . ri- i '.'. n t:e |'!e,s
\'. i' . i ' !; a :t h >r an I ai e '. e: y aceMi at e Ti.i-v. mean i i f"' ' iiTi \ rd i rom a pi : n- , . ot :;
a Ion . ji\. r :.,- read r a v.-vy fair i ! a of this '',-,,,,-/,/ '/'/' ''
di-. ,.-... /.'"'l'.!'',, ['.I,,,*;, ;,<'*' .I,,. I >--,,;.,,' " Dr. .M; laid r.
/ -' / ' /-. t ion of t i.i- ills, a-e i-. a y.'-rj t :
'I':., p :--:-al of t!:i, li,,,k v/il! Piak- the eal manner. I; i- a weriv w aich amply
\ o : .: !';.- '! i 'i I am i , iar w:t !i tin lit "1'at lire repa\ t e: ;; i : e, a' . t :..
a d ' ..era- i- .' les of IM- di-ea-e of \\mcii it ','/,.;,/' !.' .
t '-e.i' - v. !' !i-. ;' ii'-ce--i!-it in.: a laiiori'i'is r--- ' ' T: e .1 . ii ,; i: , w it '-! a- ' , . , '
s arc , tlno'iuh the n nneroiis Milnme- tiiat mil'. ' na.- t ,, e,, ir.u-- . f :.i- ] r.\'.-.' K-.t
llll Ve liei-U Wl'itte.l on tile slllij. Ct." .!/"'(/;. ai-o a- i !! V. :.o p - --e. I ..
" T:.e in! \ i:e r: - t !.e a-i tin : i-!ai:i:- for ti:i- p: -i' .: t 'em i- - ,: - \ :
\\ ork Is t iiat i" ji\ ' s I'M. i-' -suit of n.-ai'l v w,'il d, - r-. ".. - >t IM. t i ie 1 ,".:,,: , :< \ o! t :.
f \vi-nt y--.-ix year- of ;;o-pua! and | n vat" prac - t'a-t IMHIJ; n.ak'-rs ot ;;...- c.v.t 11:- i,; "- ' 'u ,,,.//
tice, and oi -eM-ral veat's' -fm\ in !.'; ]-.ii,,ra /./// :.
t n-\. 11 i, . ntitled to claim muca ,,-. . 1;
40 ITJJLICATInNS OF AYILUAM AV(H)I) A COMPANY.
/V.VM/.sv .9 (if (In /\.f<ltll-i/f<, ' /('.
Dickinson, W. Howship, M.D., Cantab.,
Charcot, J. M., M.D.,
i.r.rTriiKs ON BKK.irrs DISEASE <>E THE KIDNEYS, DELIVERED AT THE
xlKMiL nl' .MliDirlNE (i I-' 1'AltIS. Collected an. I ]>ul)lishe,l l>v Di;s.
I '..it I:M.\II. i i ;nnl SK\TKK, editors of the /'/"</'<'. Mi'<Hi;il, ami translated,
the p-niii-sion of the author. l>v HKM;Y !'.. .M i I.I.A I:D, .M.D.. A.M. Illtis-
. : " v two colored plates an<l with wood-, 'n^raviiiu's. One volume, ^-vo,
1 1 'ii |,;i_ ...-, uiu-liii. I 'rice. S 1 .Till.
"'I' t:;;i:;k- "i th.' ] i .;. --Inn ;:re i\u<- t.i "Whatever mav hi- tlioiiLl'hi "f I'l'nffSxir
. ,'.-:it'r. I >r .Miii.-ii.i. for the \va\ in C'hareot's vu-ws of tile xariiin.s toini> nl' n-nal
,- ]..:;,.! MI. ,i h,-, iiurtiidi of the alteration, i.diie can frl'iise to him the merit
. > ' : ;ii.i-hei-.- li .] t in- i'leai t \ pe of a | in it on ml t Ii inker aiui a most .-agarious
.. lit |ii'eai ain-e nl' the Ijo^k. 1 1 .-::. u: i. 1 ohs.Tver, I he | .|i il.ix iph ]e eiiaraet ei' of his
. \ .. lie v, ho (ie-ii e, t o lie ii, tonne. 1 views lieinu' at o] ice a I'ecori 1 ( if t lie kllowlecij^C
,v of !! ]-:.!'> 'I;-. ;!-.." .]f,,;;,;i! of t lie da\ a ml . >!' t he geiiiiLs ol' their autiior. M
r,, ,,,!', I,,, ,;t.
I'll ..-.,,.!, ,,- :l ; i. u - f he pat h.i'O ' 'I'll. hroeiillle is vai'aahle enough to lie wt'll
'""' f ".i '- : I-.-;,-" a- .-at i I. wort h i he s: n< 1\ . if e\ ery Imsv jn aet ition.-r who
i\va;, - ni. nf the olenri h:i- a lieu ea - . .f al hum in n I la, t o ma na^i , and
\ i.i't.vi to el.inile.l the -tn>i\ of it \vill, of eotii'se fim 1 a place u pon t he lihrary
ih.ct' /',.,//..!/--/',-;//,,/ helv. s of e\e,\ one. "-.I, ,,/. ',< ,1,, ,/ ,' l ,>f
':, .]f, .a,-.,: ,s, ;', ,-,*.
Stewart. L. Grainger, M.D., F.R.S.E.,
Ii ''" forms \\ ith \\ hidi the name of Bright
ii- in e]malilv ami hoiiorahh assoi'iated. . .
" 'I'm -i.li'ject ; !iroii--h,.i'it i- haii.lleii I '\ a
n I r mji 1. To t he ^ nei al praet it,'oner,
anii p. i :-i!l\ to i ho-e Intel e^teii in oi -' a-es
- oi ; . l-ihiiieys, t he win 1; i- in\ alualile."
'
Pifl'ard. Henry G.. A.M.. M.D..
IHBL1CATIONS OF WILLIAM. WOOD A COMPANY.
Vidal, A. (De Cassis',
A TKFATISF ON \ FNFRKA I. DISFASF.S. With ,-oi i-,-,l p'.at.-- TMII-'.V.-,!
\\ itli annotation-, liv <i i:ui;i.i; ( '. Hi. \. KM AN. .M !>., I ']<>:'.--,,[ ..; >iu_, \-\ in :),
.M> -liral ( 'dlli'iri- c'!' < "hi" : SlllXf.'ll !" ill.- '< .111111. Tcial lln-|.it.il . 1
i;..\al M.-.lir.-il ami < liirurji.'a! Sori.-tv i.f LOIM..M. OIL- vulum.-, v v.,. I'.i'.t ].;,_,
luii-'iin. I'ri'-.-, st..")ii.
Taylor, R. W., M.D.,
-VI'IIIMTK 1 LKSIOXS OK THK OSSKol'S SYSTK.M IN INFANTS AM) Vnl N<;
( I11LD11KN. One vi.luni.-, S\-.., IT!" |o ...->. muslin. I'ri.-.-. ^-J.:.n.
Keyes, E. L., A.M., M.D.,
Diday. Paul.
o.N SYPHILIS IN INFANTS. Tran.-iat.-.I l.v Di: C. WIIITI.KV. With Not > ami
A.l.liti.ni- liv !'. i;. STfKtils, .M.I). \\'ith a .-..!. .i-.-.l plat.-. ..i-i i.iilv |.v -nl,-
Busey, Samuel C., M.D.,
Cazenave and Schedel,
M \NI\\L OF l)FSI-;\SI-;s OF Til!'. SKIN: I'r.-tii ti,-- Kr.-:i.-h ..;' M .M. ( ' \:/i:\ \ \ i
a:i.| S. ill ni.l . wiih i,..t.-- iiii.l a.i.liti..!i-. trauma!. -i l.yT. II. I5i i;i.i.--. \1.|). >
i.ii-i A 1 1 1- !!.-;. 'i Ivtitii.ii, . -n.ai ji-'i a i i.l i-.iiT.-.-'.-.i 1 1 ..in ill.- ;a~: l-'r.-n.-h .- i'.ri.>n. \v : :h
^.i.liti.iiia! n..;.-.- L\ II. I). Ill I.Kl 1.1. M. I).. Phx-irian ..!' I!.-- \.-u Y-i'k ll.-). : r-tl ;
F, l!,.-.\ ..' it..- <,,.;,.._,. ,,f l'l.v.-i,-iaii< an-1 S.II-..M.H-. N.--.V Y.-ik : I ..,';;.! -:i I >i--
Livcing. Robert. A.M., and M.D.. Cantab., F.R.C.P.. Loud.,
Wilson, Erasmus. F.R.S.
Till'. STI'DF-NTS I'.ooK oF (TTANF.OFS MFDH'INF \\l> I>M:\SF.SOK
Till: SKIN, on- volnn,.-. Svo. !!."> i.ar. -. in'i-'.i:!. Pi : -. s:i :,n.
l-J 1'IBUCATIONS OF \\1LLIAM WOOD \ COMPANY.
'/' /*' /'<'/*/
Fox. Tilbury. M.D., London,
M\ 1 \ !>I>I". \>l>. their !>-: i| ti"ii. Pathology. Diagnosis, and Ttvatllicllt Sec-
,,,,,( American from I ' I !i i" !: r.dition, re-written and enlarged. \\'ith a
I 'u:. i-:. ,.-..- I'han '' ns-urial Index, and sixty-seven additional illiis-
( I:,. \.'luiii'-. v ''. '<''- pa_e~, muslin. Price. S.YOO.
T ...;- ; i .i i . , i uli- iNnos Am. I'll! i. '. \\ill ini\v find its sucees-
. un' :_-. and. sor launched forth a< an imposing octavo, lux
: i. nun- urious luitli a~ to paper and type. This is. in
. ', in,'! our opinion, a ui'eat improvement. \Ve must,
confrss to a virt nous honor of pocket manuals
\ ,\\ ' ' d in the as recall i ii^ d;u s when medieal .students were
-, -." /'/,, /ht',/;// less sensible and industrious than, happily,
i, I/ tl,e\- now are. .Not only is this volume much
\\ i, :i,!ii. i:'i it to tin stn- enlarged, luit is also recast m parts and re-
: prai-tii-al u'uide written. One of the most important new fi-:i'-
oi i:. -'.. iii. in u hirli nres is t he addition ol many new illustrations,
' t investigations of which there ai'e now nearly one liun<lreii in
;.,-, \ of the-e allec the volume. The author has taken f,'reat pains
. i pr.-i'-t it ioiier it will I'Tove to include i he latest i ( searches in dermatology
i\ Iniok <if reference." in this edit ion ; and we ran, therefore, unhesi-
tatii;L;!v r< ciinimend the hook t<> our readers.
1; : : ci-.-. and practical. The \\'it::out i|iie-tiou. ii is now the most complete
: ric::er in \ alualile eon- and jiract ical wi irk on cutaneous medicine in
.'; i u the subject of the Ivi^'lish lanuuau'e. The oi'dinary student
,' ,',,,/ /.,,,//x ///, will find in it all that he can desire.' and will
'..' only lie led I iy its tone to wholesome methods
\\i v, dd advi-" all practit inner- of med - and hiuher flights of resoarfh ; while t lie ]>rat-
( ins practical \vork and study it." tit ioner will fall hack upon it s resources wit h
I/ .,' ll-,;i',l satisfaction and with fresh resolves." Notice
T n familiar ii ' volume of the ne\\ edition in the l.>t<l<n< Ln<'<t, l-'eli-
i. ::. t ie furm oi' a pocket manual ruarv s . l^T-J.
:.n :;,. : !; lions w. !' small, t iiick
The Pharmacopoeia of the United States.
: !'... ' II. -vision. P.y authority uf tin- National Convention for Revising
ti.. i 1 i-;a !.':! at \\'a-hint,'t"ii, A.D. l^sn. ( )ne volunii', Svo, about
i_ . l.olllid 111 inlislill. I'l'ii'e, S-l.dll; leather, S."j.(l() ; leather
i vi i. S''.. nil. I] id. printed oil uiie side. !v.").(l().
(' i;.i-i: pro\ :n. -lit- \\hieli ap- adulterants." - .!/,,/,',,(/ f '<,//;, */ /,,/-, (Irand
; -...-. 1 '.:. o: i ; , i - ; h- -i:li-; : Itapids.
' ' ' uli iiiea-r.iem e!M- of " Thi National 1 'hnnnacopn-in is t he stand-
', N> w Vo:k ard authority as tome<lical preparations. 'I'he
pl'e-i-nt r. \ ised i d It ion represent s the lies! i f-
I'i.armaeopii-ia foi Is oi tin- liest represi-n tat i ve men in t he
' ('ommittee pharmaceutical profession of our conntrv "--
. : i-osm-.t t:;. ir t is!; in no '/.,,., ;.,,','', ]f,,li,;i! \, ,,-x.
' i">is "The committee eertainlv liave lived unto
' ' ' :.- i ' i : : vti '< t heir privileges. T!;e\" have revi.-i d it . < 'i im-
: '::.! '[ r pa ri-il wit h l^T' 1 , it is almost ii revolution. Hot
A. a -Iniple r \ision." -77- .\fl,.;,l .!-/,',,,,
Ann Ar!, or.
I' r! , -"p ' : prop-r, "'I'!;.- co,n!i.itt">; devoted a little more than
. . :.]':. v !' - t wo \ ears to t he wi >rk of revision, ami the ie-
1 of i pi 11 lalnir is now In lore us. ()u i-x-
''." ' niiiiu iiiu t lie woi k we are at once st ruck wit h
' : ' ' '. i: | mr! a nl ditlen nces t hat exist 1>.-t u i en
:.'.'. . ' it and it- predecessors.". .lf lf /i><i! /,',-.,>'/,
- .', r \ -.'i i. ] ss;;
"If. on i In i'li\Mcian - s tal.le. this work
I ro ; i;ii ] -, i J un if I 1 1 ipielit ly eon-ult''d as
' i i' I 1 1 pi eserii iin;,' t han an v of her btmk ill
' ' f"r i f repi'i -'lit -the 1 1 ~nlt s of the
' ,i : ' '. ' . ' i''''-.a: r-h. s. The commi'tee
' \ ii! \MI; k in hand deserve ureat eiedit,
::.'li . 1 lie \: ork i;|i to t he pi is. 'lit needs
}'.: . r;, ' dical library should contain a
' . ' r\ pi. a t maci-t should o\\ n one.''
: ' ';.' /,.
PUBLICATIONS OF WILLIAM AVOOI) A COMPANY.
Edes, Robert T., A.B., M.D. (Harvard*,
THKUAl'KCTH' HANDBOOK ol" Till: I'MTKD STA'IT.S I'll A I,' .M A< < >l 'T.I A.
I!. 'in- a condensed statement of t'n>- I'h \ -ioloj ;,-al and Toxic Action. M.-di<;na!
Vain--, .Method- of Adtnini-tratio!!. an. I Do-.-.s ..(' th.- Dm.:- aii.l I'r.-parat !..i,- in
th" l.at.-.-t lid it ion of tli.- t 'nit>-.i Stater- I'hanna.-opo-ia i A pot h' -oar;.--' aii.i Met! ;
S\>t.'ini. with sum.- remark- on I iiollioinal 1 'reparations. Oin- volum--, >vo,
;iun pa-es. muslin. 1'rin-. !>o..~>n.
* - 'I'll.- " H \ MH-.OI IK ' ir TIM: I'sn i:i> Si vrr.s 1'n \I;M M <ir<n \ " is intcn.it-. I t < lie a i ..;:,
mentarv. t' I'm n it medical rat he r than from a jiii.inna.-.'ijt i-- iitmit t>t' vit-w. nj.tiii t h.- iat.-st .-.ii
tiuii i). that wiirk, which i> ju.>t cDinp.i-tfd. ana w;ii.-ii nmtuiur, jnany inor.- chaiiu'i:.- tliaii h.i\>-
l.vt-:i mail.- in any .if tin- ].n/\mi:s 1 1-\ i^iotiv
As th.- I'iiariiiacnpci-iii now stands, it iv]>n-M-nts a \ ei \ . -\t.-n-;i \r phannaceiit i.- ain:a".-n
t u'i-nn. t-iiiiirai-in.; all t:n- inijioi'tant illtruiliii'tions to tht-rai'i-'itics ol tin- la.->t t>:ii ur i'.-:h,i|.>
t w.-nt v y. :ti--.
It i-, i vi l.-nt that a foni[ilt-ti> trcatisi.' tin tlicraj't-uti.-s is not to l.t- looki- i f..r in a work of
l\i i- -[<. i-vi-n il' t !n- aiiti;or IV! t himself i-onlidi-nt to \\ riir om-. lint it has lici-a h > aim to -: : ..w,
as Miccinct !\ a^ is consistent with ck'arm'ss, what c i.-ii di-n^ can do in tin- tn- itim-nt . f d;.>-
ca-.-, what it null/ .lo if not caivf'dly n^t-d. and ho'.v far tin 1 varion* jii't-j.arat ion- air tittt-d to
tlisj.l 'iv it-, i-f'in-iiia! powers. \Vhik- tht-.nies cieeti-d ii|>on .-!>!. di-r foundations hav.- l..-en ^t-n-
erail v ne.:le.-t^d, tin.- ]ili\ stolon-leal act ion .it dnms has In-eii f ,tatt- I. in accordance wit h n-.vnt
in\ e-;t luat i.ui>. MI far as it hears upon tiieir practical u.-cs and upon t::e s\i!ipt.im.- and tieat
in.-nt i'f p. ii-oiiin_,' which mav In- occasioni- 1 liy tln-m. Thi- knowlt- l_ r e. -.. far as .litainalile.
while it can iicvt-;- supplant t i'.e linai te<t of car. f'll and unprej ndieed clinical oliscrvat ion. !>
of tin- iitnio-t innii it nice as a iiasis for the rational KM- of dm.,'", and, especiallv so. as a step-
pi :u r -stone for tin.- ad\anct- of therapeutic -ci.-nce.
Much a:ti"iti..n has Keen paid to tin- very important snli'rct of dosau'.-. and while ti'i-
en It.'aviir has IIC..MI to err. if at all, on the side . >f >afrt \ , t lit- neci-ssitv of pnnlncini,' in soint-
cases iihviiins effects, jf it is tlesircd tt) ^ r et therapeutic re-nil -,. has not lieen nverlooked.
It i- hope 1 that this lunik will lie found !>\ the ph\sician a t rust wort hv u'ldoe in ntili/iriu'
the agencies wid'-li the 1'harinacop.ria places in hi> hand.-, arid liy the pharmacist a luief and
inte'digilile ntateinent of what may In.- expccte I from tlic siilistance he dispenses.
Thomson, Anthony Todd, M.D., F.L.S.,
A mNsi'Krrrs oi"nn: IMIAII.MACOI'M'.I \s <n-- THK [.ox DON, iiniNr.i'K'.ii.
AM* Di'iu. IN c( >i.i.i:<;i-;s oi - IMIVSICIANS AND sruci'ioxs AND or
nil-: r.NiTKD STATI-;S IMI.\I:.MA< <i'<i:i A . r,r.i.\<; A IM; \CTICAL COM-
ri:\ DII M or \i ATI'.IMA .MI;DM \ AND IMIAILMACV. i:d ; ,i. i i , n \i;n -
A I.! i . M.D.. I'm)' r of C.'ii.-ra! I'at !,,.!. u; and Mat.-ria M.'dica'in C.-n.-ial
M- ii.'al ( '.i ! l-'-'i-. On,- v..l n 1 11.-. l^iun. '.\'1'1 pa_. -. niu.-iiii. I'ri.-.-. s 1 .(in.
Footc, John, F.R.C.S. 'London).
nn: i'i;\< TiTioNKir
( '. .ii'.ii niiu t\\o ! h. n
the in o-i cm i in 'ill I Irii i-ii and I'oi'.-i n ni.-d ;.-,ii ant i,. .::' i- 1 -. "' . . . t.- \\ r i, .1 :
ti..' - l.y P.l \.l\\ll\ \\ . M< ( III Mn. M D, I':-.. I--.-- . .Ma: : M.-d:.-a a
I 'iii i m. a. -v : :i th.' ( nl !.'._! n.' I'hariuaev, N'.-'.\~ \ . 'i k. .',.-. In oif 1 'Jia. \ . ..ni
Ii'.i i ]M_.'-. m ii-' i n I'ri.-e, S'J i ii i.
Johnson, Laurence, A.M.. M.D.,
A MKDH'AI, roIl.MrUAUV. Sold ..n!\ l.\
44 I'l T.L1CAT10.NS Ol' \\ILL1A.M \\OOJ) A; COMPANY.
Oldberg, Oscar, Ph.D.,
Wall, Otto A.. M.D., Ph.G.,
A m.MPAMoN T<> TIM; r\ri'i;i) STATKS PHARMACOPOEIA, pen^-a com-
i!,. -itrirv nil ': . !...' -' Kdi!i"ii '.' the Phannaenpu'ia. and containing tin- l.'escrip-
l'i , >i ..! ;;.-. 1 'M -s. and hoses of all (M'icial and niin.eroiis 1 notlicial 1'nm's
i Pr< ; .:.:- in eiim-nt u--.- in th^ I'nited States. toL'et her with Practical
Ilii.--.. \\nrl\m_' I'i'i inn', a-, t-tc. . doiiriinl a> a r^a ly i-ct'Ti !!< In ink for Pliai ma-
p] - us, and Students, \\i:h nvri 1 :!()( oi-iirinril Illustrations. Piici\ in
s in! ith.-r, Sii.OO : in liall inorn .-u, S(i. ."().
'I'i.i- " I 'i iMi 1 \MO\ 'in IHI: 1'si IIP S'r\'ir- ]'i! A KM w< ii'<i:i v " jiivcs sucrinrtlv the
,iji,ij\ins iM-ludin^' all roinnii'ii nrlnral l'Jiuli>h. togothcr with the < icrnian, Picnch,
rind >\M' ii--!i iiaincsi, uri^in. lial'it'it. dc.-i'riptiuli, varii-t irs. Milist itut ions, adnltcra-
ii lU-l'i 't--. marks nl' 'iiiality. ]!'] rrtic-. uses aud dusi-s nt' all the drills and rhein-
; .iN "' w:.:e|i .t tre.it ^, ai '. ndel each dl'llj-T nl 1 chfinieal will I n- de^i-riln 1 1 its several Jirejiara-
. r :;.a'\i:i.; I i e>e.
A'.! ' ;..:.' di it<' i|t;autil '-. solids liv w. i^iit . ami iiijuids generally liy
.. i> .1.-, ilie "tli'-ial l'niji;las in ]'ai t - li\ ueii^ht j l:a\ i:i.^ lieen t ran si a ted aceui at eh a coord ing
'I': i nk t ,ii- -ir\r- a- a ke\ and c :inrii:;-n to t he Phaniiarojiu ia. It t;ive only such
i:,l". ! .' .it n a- pham ' i- 1 - an i plr -ii 1 M - n.o-t rrei|i:ei!tiy ha\e cu'easioii to put to pi at tiral
i-i id\ \ oca t ion-, aud i.i'iu-e let inical de-n ijit ions nf jihtnts, except of the ] 'arts
: |o i -.si s. a i en ,ut - ' I t i.e I >h\ -i" logical ;irt lon~ oi 7nei li.'im >, etc . are
r-'iati ii ia\i ! r.iii>idereil latlier with retercnc.' to aetaal eoll-
ol t i.e : i ade ; i,d t he practice ol' t i.e pro! . -s>ii m - cancel lied than I rum
- ,
h , .< nd a reliab'o and I'oinplcti' pharmaceutical ami
:, a practical and relialile LTUiile ill tile i' ientitieat iull
\\ ' '.'' ,.'!- are aci'dinpanied liy illllstratiolis whic'h. as
| eci r'.ei: to t!.i fa simile I'eprodiicti >\ the detail^ of the
. it 11 . r-1 shown 1>\ the figure-; are not re| cate I in
' ' . i . .'.... el c.
iiMMinn over t \vel\e hi]iid re 1 p-i.ues, illitstrntod liy more
. ' . - 'irawn from nat.,ie, printed on line calendered
Rice. Chas., Ph.D.,
r'h tr.'irv M<_, r n-- which ieme lies
: -. which i e.|iiive rant ion. and
in ' i - The iii i-e^ are ;-i\ en ill
1 a ni I a ! il.le tor eonvel t -
' : . :: et i,- - '. -tern i- api ended."
. - : ' /.:,,./,:
h h:i I.een prepared with
1 i- admit,. I. ly adaptfd
'- tor ',. hii-h it i- designed."
<> J.j., ,.,!.
PUBLICATIONS OF WILLIAM Wool) \ CoMl'ANV -L>
Hii'irt* <>f I>rn<i*; ( '/" in ixt rii. rictnr'*.
Lewin, L., Dr.,
THi: INCIDF.NTAL KFFKCTS OF Dl!F(;s, A I'll A KM A< ol.oi ; K \ I, \ND CLIN-
ICAL HANDBOOK. Translated by W. T. A \.\.\ \ M >i i;. M D. On.. ..lum.-,
Svo, 'Jo'.l pa.;.'-, muslin. Price, X'.'.dd.
"That in.ih i duals vary in t heir MIS rep t ibil - 1 elmmim,' to t iiis eate^orv abound in tin- n e i
ity to drills, and that idiosyncrasies of the ieal periodical.-! aim in the unuiitten .\ie:i
mosi une\p<-.-te 1 character icveal themselves enee of doetoi s, but Dr. Leu in i- th.- l.r-t To
in practice. a;e observations of \er\ ancient make a b. ok by colic. -tin.; and c!. ; --i \-i ; _'
date. So startling are tl:e-e accidental ellects the-e data. a:-d addinu' to them his ou n . h-,-r
that sometimes tleir cause is apt to escape \atimis sharpened- b\ speeia! studs. He -I
detection. \',anations m the phenomena of M-r\cs ciedit I or br.-akim; new LTiound i: the
disc.i-e an- not mo; e common than variations tir-t phi. e. and in t i.e sec >nd tor an not at :i _-.
:n fie in-! ion of drills, depending hir^elv, like wit :i admirable judgment . t his somewhat neu
the di-ea-e. phenomena, on the acquired or in lectcd br '.nch of kin.u Ied e. " /.<< ,.-.< , .", .I/- ./
iiented peculiarities of the patient. Facts (>(/ .V- <''.-,
Witthaus, R. A., A.M., M.D.,
A TKXT-r.noK oF MKDlt'AL ( 'I I KM ISTI1 V. I'riee, iniislin, >;:',. :ii).
\Ve do not hrsit.-ite to r-eoiiinieiid this " The author IKIS, \vo tliink. sueeec-ded fairly
work to till- jTot'essioii ;i~ a emnpiete text --1 look in pi-e~eii! ini; wl.at everv iiraet itioiier .-i.i.iild
on the di>e;i.-e> of uhich it treats." Mniii'iil know of tin- si-i.'iie.- of eiieiuist ry. " -/'/,/'././/-
'/.-.'.-(//-. j,/,;,i .]f,,/;,;ir ,/ >//,,/;,,,/ /,-, ,,',,,/<,.
KSSKNTIALS OF CH H.M1STU V, Or-unk- ;uul Inor-ani.- . Wood V I'oeket .Manual- .
I'lier, Si. (Id.
Draper, John C., M.D., LL.D.,
A PRACTICAL LAP.OKAToKY CoIliSI] IN Ml'.DICAL Cl 1 1'.M IsTU V. One
\-oluine, oldonir Ivlmo, 71 pa^i'S interleaved, mu.-iiii. I'riee, Si. (id.
"Th.- book contain-, in a concise and srien- turn' is liini'e-1, and who desires practical re
title form, all upon the above topics tliat is of suits with tin- least expenditure oi tiim-and
pra.-t n-iil value to t he pn\ -iciau. We cordially labor and wit hunt the aid ol" an in-t ructoi ."
recommend it to ph\-ieians and student-."- - C/ ( .V,f//,i .]/../;,.<' '//,/, /.v.
.lAWiA/'/./o' V.,1',,',, )/,,/;,-,,/ M,,nll,l;t. "Tins little uork comprises what a your-
" In priiitin.; ill I k every other pai, r e has doctoi- oii^nt to know about chemistry for his
been left blank in order that the student may patients' uood." - /,'^l'n '" M- ./.,//,/ \,, ,-,/./,,/,,-.
be enabled e. .n \-eii ienti\ to record, in n s prop, r " 1 1 i- bnund so as to op. -n from the top. so
place, th" results of the experime Is he makes, as to easilv lie open on the table, and. a- it
and of additional fact s obtained from oral in lies open, the Io\\er paje ha- been left blank
st ruction." \! ! 'inf'i M'll'-'i' /,'ti/ixti r. for an \ notes and addit ions which thestu.i.-n:
" I iii I.-, d. l.-\\ books combine so much I'-cful desip s io n iak. as lie pr,.c,-e.l- -A ;t h his u,.rk. "
inf. n m iti. .11 in such a compaet.corrcct.com- - /,,',,,,,!,,,< \[, ,/;,..'./,,/.,,,,'
|ir--he:isivi'. and applicable manner." .I///'/'- "The -indent is indeed to he coiiL'iat ulat.-d
"Tiiis excellent manual is one of the best prepared b\ a teacher of Dr. Diaper's i xpi n-
e.\r I'll for tne student or praei it ioner whose e'l.-e." /'/,. .!/-./.'./'. |./. , Detroit.
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no attempt had ever been made by medical publisher- |o pro-
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:,-/,.> ,n\'it of such chara. 't.-r. :iu<l i-oii.-.-.ni.-iitlv tin- f..i;..-.v in. -,-li. m- l.a-
p!''-]i.i: - '1 \\ith much cart 1 , and is !<> ]"'! I'ully Hil>mit!'-<l !ur th. ii :ipj>i <>v;i. :.:. 1 -:,p|..irt.
Tin- I ii inks M-li-i- 1> -i 1 fur jiuliliriitiiiu in this >! i.-> will In- i-lianu-tfi-i /.! l-v '!:
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: l!,i- :it'i-.- <>{ !m..k~ Ii. i.-in ;tiiii(iiiin-i-.l will rl.-ai'iy >ln>\\ tin- inti-M d' th'- jmi -li- ;. -r~.
;t'.!'l thi 1 \viili- raiiL.'"- of >nl>Ii-cts inchi'ii-'l.
" In tin- iiiaiiin'acturi- of thrsi' Imnks thi-r-- i- iinthi:i_' ""initt.-d "--.-nti:ii tn Vr-' '-..i~.-i
wni'k : tlu'v ai'i- as \vi-ll nui 1 !' 1 in i-vi-r\ ]>ar: ii-'iiar a- th>- hi.-li jiiii-i^i i-ilitinii^.
" A liroaii-t'aci-d I.oiii: I'rimcf tv|n- i.- n-i-.l, ra-t i jM-rial! v fur tlu->>- V"'.;nn---. :n:-l
v. itli thi> 'yjii-. and si/i- of jia^'i 1 adn|it"-d. tin-si- vnluni' - wiii ruiitain a- ni'i.-h in rt.-r
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I'l'i-ani laid, inanul'actnrrd i-\]iivssly fnr tin- piii-pn-i-.
FINE COLORED PLATES AND SUPERIOR LITHOGRAPHS
\viil In- inti'ndiii'i-d. and \viiiiil-i-iii:raviiij.- will I..- t'ri'i-Iy i;.-cd as i-.-ipiii'.-d. 'I'h- r^v.-rs
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(Vi-rv M-HM- thi-v \vill '" hniir>tiv lirid.- Imnks.''
'I'hi' al'iu-i- .'Xpri'sscs tip- purpos' 1 nf tin- iiiil'li.-li- j r.- a- aniiniiin-i-d in liii-ir
ti;.- at ti.' 1 iipi'iiiirj o!' thi- rnti-rpriM'.
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ll:ir( ;in<l IC:i rliou r* l>i--:i -<-. <>T \\ < m i n . "
< :i !-|-n I-r"x TI MTOXC-OIM- :inl i I - II < ^ < 1 : i I i <> 11 -. "
l*:ii-l" II > a i'iu-.*" %>!!!! il* " i in . i-i < ;i n \ |> |>< 11 (I i \ .
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lloil<-n". * II 11111:111 O-l -olo;i > ."'
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i I )> tai!"-d iiil'ni'liia: inn i" ardin . '1 '.'"' ;IM- - p 1 ;'
fnlllld l[pn!l th" t'i.l!i)\vill. pa_'-s. tn will'-
invit.'d iip.in th" part nf tin- //j'"''
IBRARY OF STANDARD MEDICAL AIT
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'i . df tin- n':t~nTi< \vhy uinliral In mks arc so expensive, as compari'il with liooks
. . -.- their rdinparat ivrly limitril sale."
i j ihi "i!v\\a\ in whic-li On 1 ciitfr]>ri-i' <-;\\\ pav its nri^iiuiturs i-- in an
; . :. . : .-i-ripuc 'ii \'-^\ . ;ti.i i \\ < cai'm >l I v a>k Sir a '..-c-iicral snpi '''! ale 'inr mir line. "
r li.nk fir thi' -ii]i|icirt of tin- prufi --inn in ;'iis rnicrpvist'. "
Ili-llii 111- pi'' ifi-s-iiiill -hnlllll l-Tl.li ] -
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M \... ;ni - will IK- ilbist rat'-il. Nnlhiirj' yl nil'crcil \vili at all cdin-
p:t! liit! I inn. "
\ ' . i-j.t . wi- lidjic ii . liirii-iitly n-niunt-rat iv to
'I'l ' ii !;: .- ari- -'i fi-a-i nialili- that a library
. ' -r ':, nf all. "
.\ ; i licvi' ;h;il cvci'v innlical man in ihc pi'iifosinn shonld rntrr iiis
ill, nhori I'riss \<tfiiT* s/intr lh< ir<lcnni<- ifii'fii fo IIic
nt i/s t nri'jtf ion .
1 ' firi'i ilii' arti^lic wnrk. i-sprrially. it is
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k- I'.'lll In nr t 111' IHOIH'V, Til'- '.''-t-llp
:' . prirctl filitiuus now Ix.-iiiy sold.' 1
IBRARY OF STANDARD MEDICAL AIT
1005.
Seventh Serie*. Price, * . . Volume* not sold
HUMAN OSTEOLOGY. r,,nipriin^ n I>e-cription of the I5..n.-, -
nf 1 he Mll-ele-. till- I ienerill JUKI .MliT..-c..p|e Mnicll.rr "I ll'Hic ill.'l ll- '.'.
KIRKES' HANDBOOK OF PHYSIOLOGY. I'.;. \V. M' >;; |; \NT Ii A K Kit, IM;
work, t,f it^ kin.), ;in.| in this i.r\v r.liti..n." |:;-r .-..nip . ! ! .> IT-. I'.Ak.-r iih.l II n: .-. .- pi . ,i;..j. .,- :;
<vpt:l>!<' ;i li.mk mi [he r. ill >|'-ct ii- ci.uM lie pr--M'Hii-(| ;.i i:.. pr.i. ;:!;:,:- . .1 \:i.. : : . i.
THE SAME. V. .lain.. II. \Viili m-arly x.'.">il iiltistmtionv.
ON THE WASTING DISEASES OF INFANTS AND CHILDREN. !'.. l.r > r \( T -M i i H.
M.H.. I.. .:.!.. /'.;..'/ "ft!,- i;."/:i! <'"ll- '/f "f /'.',,/, , t /./.,- .- /"..,.,..., ,'.,'/,, I/ :. ",,/'. A, ..,./('. /,.
//.(..> /'',-..,,.(.(-/ '- .",.. A'./v' r.<ni-i, i i, ;:<[,: .,,//.../,.,'.(/ ./,i,/ r.. ,-/. <.'./.'/. ..... /..//..>
//,..,,,.,,,///,, (7,,..^, l /'/. .,/,( /'<//'/-. I'., nnh Ivliiii.n.
!:* ..i Mi-li-'in,.. i'- Uy ilu-:ii-.-,,iii].!i-,lu-.l iiulhi.rt.l I 'i-i-a-i- it, i 'i..: .r.'i.." ..,.;.:.;. t -.1..^-: .
A TREATISE ON CHOLERA. l-Mlfd :ui.| pt-.-p:uv,| l.y I'liMi'Mt '
'
Catalogue of the Titles of the Works published in
IVonirs LIBRARY OF STANDARD llnrAL AITHIIRS.
Sixth >cn-. l'ri<-<-. .!*. <>o. Volumes not told separately.
LEGAL MEDICINE. r,\ CHAKI.F.S ME\ MOTT TIHV. M.I)., V.C.K.. Mister of Snrrjtry, Proffer
' r-Kunntra ,// <>f /'"rr/w .V.-./i -ine and /'italic ll,"Mh at the l.n,,,l<i Jloai>itnl, MeUicdl (\<Jli:<r of
,'f i ' ',.- A.V:i ;.''!, T.t'.'' !> ii-''" Mt'l'fitl O'H-er t>f Health <i"d I'tl'iUn Analys: fo>- ttt,- L'Uy uf Landon,
.;:. C '.>'.'.-: I,"L'itimncy 1111 t Paternitjr Prcfrnain'v, . \bnrlion R-ipi-. Imlcoi-nt K\-
, ; < hi iiny. Ur-n.ility I.ivi- Birth, Infanticidi Asphyxia, Dn..vniiiK II:ingin;_ r , Klr^uij-'uhiti.in
l'ATHOLO'3-Y AND TREATMENT OF GONO3RHCE \. I!y .1. T.. MIT.TOX, M.D., JI.R.C.S..
, 7 - ,, t < [i . ixni f the Skin. St. ,Jnhn'n llonpitnl <\,r M in /...'(/.>f,s. ftr.
' " ["hi- w ik i" fri .-,!', from the author's hamls, ami treats in a very )>r:iet:eal way of this (:onini"n
A PRACTICAL MANUAL OF OBSTETRICS, fiv K. VKIIR1 H!i. M.I). Tninslateil from tlie French.
.. I. P \ UTiM in: !'.. M.I). I'rofusolv iUustratiHl u-ith tine wonil fiiuravin^s.
:: .- ! IIYSICIAN'S VADE MEC'JM : .V Manual -if the I'rim-ipVs ;ui.l Pr.u-tir,. of Phys-ii- : vith
.fi! !!!-.: I'.itho'o.'v. Th -raueutie-ivml IIy(.'i"n<\ 'JVnllll-Mitii.il. Kevi<i-il by WILLIAM
"V. M. .. Cantali, I'. U.S.. .1 )HN H\KI.!:V. M.H.. l.oml., L L.S. Vuhiuu: ] I. Jllus-
. :. : a 1 , int,'^'.
DISEASE: s r THE -ESOPHAG'JS. NOSE AND NASO-PHARYNX. u\- M' 'i;i;i:i.r, MACKKN/.I i\
" i., :. . -: /'/, . (./ .-/,. II 'iiitu: f.n- tit, lii*e>ixcx nf tlv 1'lu'nt Hud Tin-fit, l.-.lnrt-.r
'.' i ' '\- :' " : : ',,1, n ff,t.iiiittl M-ti'-.t <>:'/>. >'.;>. louslrated In \vo, nU'n-ravin.i:-.
J "-"^" .' . k. n iim-ly. " Di-ea-e-i i)f i !u- l'liav\ nx. Larynx ami Ti-.-u-hea,"
'i : ii- I. -. n.! 1 ', a:i 1 elieued thf warim--t coiiiiii-niiation from tin- im:.lii:al jiri'-s
A TEXT-BOOK ^F GENERAL PATHOLOGICAL ANATOMY AND PATHOGENESIS. T.y
i ..' l>'ith;.'i ill Annl;m'j i" < t'iiir,rity -/ '/':<' n</, . TrHii^laii-I
h >N\I.I) MACAMSTl-IK. A.M.. M.U.. ./!'/</< 7.V/'i< '''(//ri/'
/i..- /' i/- / (./ >/ .( <!.,_ '!/'> a/ M. -/H/IH'I < : <>llru>, Crinibriitge.
-. "i..!.- I VI II. I'njfu-i-lv illii>trati-.l.
IBRARY OF STAMIAUD .\lnr.\L IITIII.IRJS
I'i IHIi Serif*. lriff, *I*.OO. \ oliiini . noi oll iar:tl 4 I) .
MANUAL OF GYNECOLOGY. liy D. Itr.N.I. IIAKT. M,l>.. l-Ml.r. I', i;.. l.,.:urcr .. Wliii/,ry
'i 1 />I.V.|A-I "f \\',nn- it, N.7,,,,,; ../ M,,l:. i ,,'. K.li>,r,,tr-Jf,, <t'\, <['.; ;n..l A II. !:Ai;i:' i!']:. M.A.. I: -.-.,
M.l:.. -\-.int'i'it tn th> />r<>/-'xi<>r / M<-t"-'/'i->/. t'nir, r*ity f K'ltnhtu-jfi. V.>him.' !. i: u-'rut-l -.nt!i
MANUAL OF GYNECOLOGY. r,>. 1>. r.KN.I. HAItT. MI'., K.l:.( M'.K., /..'<./. r .-, M i-,
i ,,l /</, M.;V ../ ll'.'/. i, .-> ,'<j.,; ,/ .I/- (.-,, /:,!, ,','ir /><. : . el--.: ;n. 1 \. !I. i! \ !;!> > ' ' i:. M. \ . !;.
<,-.. \\.\\.. Aasittunt to t>,- I'l-ofi-wr <>.f Uft'nf. n/. I nr'f.,t>/ of t:>U:i>ntt -<jh. Volume II. I '..:-: i'.,i
\\.l : i ;i ht!i.>.-niT.)ii.' [ : n.- .iii.I -JH'.I tin,' -.\ ..... 1 . n-r.r. in^.
THE DISEASES OF WOMEN. .V M:nn:.i; i'..r 1':.;. -'.:;.:. un-l Stmli-nt-i. I'.y 1 1 1'.i N ILh.'H n:lI.-'H
M.I)., /;/'.'"/ r/ '/i,'/!- -.'.'/'/ -I "' H^l.tri-'-i-ie ."..' C'<i>:r-i>i/ </ //-J.V. Tr;vn-::i:\l !.y ISIli'iUK
ITIIST. I ::.;- nit. M wli'i ;.Vi lin.- \v ..... i .-nirniviiiL'-.
THE MICROSCOPE AND ITS REVELATIONS !:, >.VM. i:. i ' \ IUT.NTr.lt. C.H.. M.I)., 1. 1..!'.
THE MICROSCOPE AND ITS REVELATIONS. l;_v \','M. K. CAiilT.NTKK. C.I'... M.D.LI..D.
s''j-- ; - l-:,l,H"ii. V iliiJiif 1 1. H'.ii-!tr:ii'-.l with .''; p'.:it.- nn.i ,">ir.' lin.- w..o ! i-iu'r:iv:i. t ->.
HANDBOOK OF ELECTROTHERAPEUTICS. I'.y nil. \VII.IIKI.M r.Itl'.. /V.//C
.,/</ ../' /..-<;. :/!/. r.!i:<tr:i:.-il 1>\ -'.'.I w. ...1 , !:_-ru\ hiu'-
A TEXTBOOK OF GENERAL PATHOLOGICAL ANATOMY AND PATHO.iENESIS. r.y
;i.,.l !-,l!r, -,| f..r Kn^i-h -in :ci.]> i.y DOS \ I. Mf.U.ISTKIt, A.M., M.I:.. M- ,,,','r >-J~ t!,. A'.^.!.'
THE TREATMENT OF WOUNDS. IVin- a T.v ;1 ;>,- ,,u ilu- ].rinci|.!.'s ::p,.n which :!.. Tn;itn., i.t -
\V..;;n.l- -!..,;.! 1 !.. f. iiu.l.-,!. ;in i ..:, ::,. l,,-.-t in.-h- N -f c..r:;. n._- I!:,-MI int.. pv.icti.'c. inc'.u V:..- . ,-..n
-iilcnit:..!! iT 1)1.' ino.l!:'c;itii.ii> which special injuries mny ilcm:uul I'.y LH\VI.- S. 1'lIX'll KK, A M.
M.I)., of I'.rooiviyn. N. V. i;!i;str;r.i-.l liy woc.l ci.^rn\ n.-s.
A MANUAL OF PRACTICAL HYGIENE. I'.y KI >.M r N I > A. !'\UKKS, M.li., K.U.S.. /'.- /'/-
,-.-,' (/ I/. '"-/ //."/-/'' ' I" "it .\r-ll!l M:,i:>:ll .- -...I..-. M. Hi'-, .'f '! ',: , / '.' '
f-/,/c /' -' : /' '.'" >>f i!" .<'-/',- ,,f it,,- /">,,,,>/ ../ /..//- /.!.<; A'/.i. /-'-'< //.' / ,_- i ;, ,. : M, !
;,: i.; I >>,, *,>,' ''.'//.;/.. /...//.f"H. Mli-.i-l i.y I'. S. I'lIANTiilri 1 ii i ' 1 1 A I ' \I . 'N T. V. I'. i'.i.S
i.f >;r--it i:,-:-<ii>: /'//;< w/ 1 '/ M:^I u-;/ II- i,e > ,i i'.,- \rnxt M- i u
V..1H-:..- I.
MANUAL OF PRACTICAL HYGIENE. Vv'ITH AN APPEr.'Di:-:.
i. VIA'. '...'.(,/-.- 1 ,,;/:.; H-,..,-. hl'i^n:. . !., el:-.,:-., i; l.o.-i-ivhic ;,;,
; <'*" \ : i, :. ..!! -ii \i;.> i-;. MII i'.ii:'.,:i ..f H, i ,;. - w.-
i;> : ' i ! S.- :.-..'- :i-.a: thi~ !! ,..,i ..f ;ui!...:'it imi wi I ,!',. !.. :; :.f ..-.:
:in i Tn...Vn.-i:- ..!' li;f..iili;i' -y|.!i.l:-- IM-II.T thiin .1 c..,:;.| t..-i-... :..:. .Mini :
A TUEATISE ON VETERINARY MEDICINE, .
dor-.', i ' ..;..'.! fp.iu ;.!. .l.inl :\:,.| -i... :-MI .nil!. . :' HyT. " KIKl
l':'..i-'r:ip:ii. - p'titc-, .-. in:;iii:.n_' II;;I..I.T. .;i- IIL'I i: c- in.. i :i:< :i! I" ti:.. 1 'A . 1
IBRARY OF STAND ARD MEDICAL AUTHORS.
I <MII-I|I Series. I'rirr. ! voo. Volume* noi *ol<l separately.
ILLUSTRATIONS OF DISSECTIONS. In a serie- of original colored plfttrs representing the dissec-
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ML. r 'Pi. fr-::: dire. 1 101.- by l'i,.f. ]:!:;-. Volume 1. Containing V'.l full piiK<J chromu-lithogrnphio
.1 , H.,,,,1
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*>" U !..,. ::: : re f . >i.d
l'rlv:r i i.v.ii:-." i !i '. i - full
r. IT .l-.i.Mij.' . \p. IIMM- li.i-.k- .i' - 1. A ,. pri.-.'. Lm Ihe-e t\v.i v..iiiiiie- ..f Illlis ini.l K..n! far exeee.l e\eii
l ; .-\:. 1- > .-:::. p'. , Wnii.li rf::l. :ii,.l eiinii.it fail !"<)/././ :irkin>\vi.-.iunii'nt .f the valur of tills i-crii- of S
i ill,];- ,t; .n. i- ..i::.l II.IM- I ..... . i:np..-il.le to ae.-..ni|.li-!i Mich results, >:i\e in a lil.r:iry Mich a> this, J
i,, whi.-'i r.; t! e v .:.::..- ha\ea l.iri;.- an.l i//M/hule.
LECTURES ON DISEASES OF CHILDREN. A Hnml-honk for Vhycipinns nn.l Stu.leiits. liv Dr. i
!:;.,i \u:> li: Nm-H. //,. / ,.f t/,, CUnn- untl /'(.///</(;,/,,; l>i*rnsi.t f (7//,',/r,)/ /// II,,- 'l;,, i/iil
i i.'. t/,--.i . I ui'l l'r. f ' -"! n, 11,. Is, r. iii t'/tir-r*iti/. 'I'ruii^luu-.i fnun tile (iernuin. W~ A new
MATERIA MEDICA AND THERAPEUTICS. In-r^.Tiiic Piil.stnnees. T,y CHAIJI.I:.- li. !'. %
PHlI.l.Il'S. M.li.. I' K -.:' . Lfrtitrfr on M'H rut Mt,lfn. \Vrxtininxtfr llox/ntnl, l.aiutoi,. Adaiiteii
t . :!.r ri.;t..l Mat.- rii.i!" a.-i.pii'i:i. hy l.AWHKNCK JUHNSuN. Jl I). Vulutne 1. *J
MATERIA MEDICA AND THERAPEUTICS. [nprtiiinie Sul..-!aiiees. I'.y CHAItl.KS I), r. -
1'Ml! : ]<. \! I". V.li >'.*.K.. J.rrturrr on Mot- riu M<-li' a, U't xtimiixti-r JfmtjHft'il, J.uHiion. Adapted
;.- ;. -i Mate- riiarmiie.,|,,ei!i. I'.v I. A \\ K I .M ' K .It '1 ! N Si i N . M . I >. Volnin.- I 1 . 4,
J^"" -.he pi;l)lieatit.n .if the learned aniln.r'- treatise on the Ma'erhi Mediea and Therapentiei- ..f CJ
i.i!.;.. ..: .i.iai. MI t ;e lir-; serie-. tlien- has been a i-mnil.lied iii.in-.ry for thi.- promised con- H
V, :.:.- h.ipp\ !.. be a!>!e ie.\v 1. 1 pre.-eiit it fre-li from the haiuU of Dr. 1'hiliips, and jmli- ^
.','. !'- I. ibrar\. b\ special urrun^emeiit \\itli linn. g
PRA T;CAL MEDICAL ANATOMY. A ^uide t.> the physieian iii the Study of the Relations of (lie S?
V;-e.-ra t ..':. ot h^r in He.. ith and Disease, and in I lie l)iL'iio-is ..f the- Medieal and Suix'ienl Condiiion.- -2
i-: ! Striu-tnn- of the H.-iul and Trunk. By AMI'.lii iSK I.. RANXKV, A.M.. M.D., .li/- "Cg,
l'i-,.(. ,:> :,f .1 >,: .,)/ ,n,, l lut, I.ertunr tm Omitn-'ui-iii'iri/ Hint Minur *u,-<ji-ti/ in tin M,diil * a.
'.'... ;, . '. ,'., ..,,,-/ . f I',, fiti, <,f \t-ir r-vt; l<i'r .itiru'ini i" "" \ortticrn tmtl St-rth- $ Z
; /.'. . r, n'f till \tW )'"//'. I. <!,(. mil i'f .Urdu -int': Mi.iiitx-r of tin- .M,,li. t, *
,.-..-. '( ' ty <>J' Xi'r Yiii-l,- ; Atilhiirtif "'lli? .\},i.!i.4 Ai,tit<imii<if the ServoitH Xi/Klrni." w
.I /' n /' -> fjiLtil iHwjimxix." "'/'/" A'>,xti,l,:fl i'f .\nnt"ii,i/,'' ilc., tti: Jllustrated ti
,..,de, p . --
e\v ti.-id in Anatoinv ..f an i-xi-feilinvlj ] raetieal ehararter. Xg
MENTAL PATHOLOGY AND THERAPEUTICS. 1',-. \\ . (i K I KslNi; KK. M.D., t>rr>fe**t>r </ -^
i.' in, t <:f M' it' -ii Kiieine in if,'- Cnirtixitii '' lii-rlin : llmiiirurn M< ml*, r ,,f tl,, a *,
M- l, . -,,'j /. l.v, -:-i-r ..-, : Membrf AH*'"-I<- Hn-nn-i- r <: In s,,,-iitf Mi-i'irti-'f'/it/X'titiiiiiiiii? ,i<- 3 ;
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DISEASES OF THE KECTUM AND ANUS. |[\ CIIAIM.IS [I. KK1.SKY. M.ll.. .S'wj'i/eow In St. T
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ON ASTHMA: ITS PATHOLOGY AND TREATMENT. !!y III'.MIV lIVDi: SAT.TOU. M.I), *,
1. 1; ',. /, . .; i ... .-./'-' "/ fliy-i'inns; l'hij*u-i,tn ' ''I,,!,-,,,-! C',-,,.,.v H.-<}'it<ii. <in,l I., r-
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RHEUMATISM. .i'JfJT. AND SOME OF THE ALLIED DISEASES. I'.y Mu|;iMS I."N<; c
.- . i. :...:.
J'- !-.: t. - l . m an .\M!i-ri.-..n -land point, the works heretofore in i
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LEUAL MEDI.:iNE.
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LEGAL MEDICIN; P-.-Ci .... M ,, K.C.S.. Mnxn-rof
al.or of pr.-i ar >a- -t eh a work :*
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Catalogue of the Till>s of \Vorks published in
11'iniirs LIIIIIAHV OF STAMUIIH .\li'inr.\L .liTimiis.
Third Serif.. I*ri<-', xl VOO. \li!ii-> not <|<| - p;n ;ii I \ .
ON ALBUMINURIA BY \V. 11. DH'KIN- i\, M |i. i;: tl ,tnit.-.l \v:th plum an. I .-..: r.-l .: h. v:iM' ; -.c
MATERIA MEDICA AND THERAPEUTICS OF THE SKIN. i:-. lii:.Ni:V
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A TREATISE ON THE CONTINUED FEVERS. !!. ,I\Mi: - r \VII.S IN. M IP , .1"
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Catalogue of the Titles of the Works published in
IViinirs LIBRARY HF STAMIAIID HEPIUL IITIIORS.
o
Second Series*. I'riee, tfls.OO. Volume* not sold separately.
X
VENEREAL DISEASES. I'.y P.. I. K I'.YKS. A.M.. M I)., A^tunet TrnffMnr of Surgery, and frofexKnr ~
m.ii'.i'j: n /.v -r'f '/A--/-.. -a. ti,. in-ill <jin!rijK : {',in.\iiiti>nj .sr;/t nt to tlit Vitality Hospital ; il
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.. , ,;.,. ri I., e t.. the i.. phv-ieinn in acti\e pni'-tice, and i- well il.n-i rated. T
A HANDBOOK OF PHYSICAL DIAGNOSIS: Compri-inn the Throat. Thorax, and Alidomi n. ];> g
(.'I.i ri'MAX. /' -' .' ' 'Ht in Mfilii-iiif, r>iitei-nita t>f lirrltu. Translated from the Thiiil 41
i,,'... . M.P.X. NAl'll i:. M.I'., l-'rl. /'</.'. I'hijsifiint^ unit .s-0"'" A , ''< './"". American *
1. . . . , : ., roi!> ilhi.-tratioi.s. I
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ATRE./::-r x FOREIGN BODIES IN SURGICAL PRACTICE. n> AI.PUKU PCI i.r/r. M.P.. z
, I.' . / . - *.',... f", Mi-ttiii tlnln int ni \'nl-i />- 1,1-11, -: . I hi-iratid
[e i-n i.c,. TrimMaled Iroin thcYrcnch. Volume I. %
work upm; mi rmiri'ly lii-w -nlijei-i i- of tinn-iial inti rnst and value. It *"*
no lie !ii;thr, wh.i has revi-ed an-i . orri I'ted it, u ith audit ions, e-p. --ial y '-
ll-lrated liv II .11,;. line , : .. : t . : i
A TREATISE ON FOREIGN BODIES IN SURGICAL PRACTICE, P,\ Al.PIIKI) l'( iPl.l'.T. .M 1).. ec
t/ ,; IHXI-I ' i - ' :l" <"' IK "i ! r .(/,'"/ Mi lin-iiif <h \~at-iii I, nut. llln.-tmtid _
- in--. Volnn , II. 2
A TREATISE ON COMMON FORMS OF FUNCTIONAL NERVOUS DISEASES. Uy P. X^
rhi/xii-inn fur .\< iron* liixritxfi, liiiini i/'.s l!,iii,l lltmjiititl ; I lii/xicimi In .
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; ISEASES OF THE PHARYNX. LARYNX AND TRACHEA. liv M' lUKEI.). M Ai K KNX.1 11, * jj
M. i : . ;. i ..--.; y 1 :-J tine \v. : eni;rn\ :: _-. ~
,--':-... li.elx-tl'i ' : i -t ei'inplet, d. ar.d wiil l,e w- icoini ,1 l,y the prof. -- J
THE SURGERY SURGICAL PATHOLOGY AND SURGICAL ANATOMY OF THE FE- - i,
M..-LE PELVIU ORGANS n. a era ; ; '.a' . omn . n'ai i, -. n. ;, -. :,i i ~ ^
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Catalogue of the Titles of Works published in
IVoiiirs LiBii.iiiY OF SmiuiiD .\kinr.\L .\IT
rirt Si-ru-o. I'rirc, *I*.<>O. Volume* not .<>ll M-|mri:U'l) .
DISEASES OF THE INTESTINES AND PERITONEUM. (...tiii.n-iisK Arti<-U- .m i:nt. nili/ia
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MATERIA MEDICA AND THERAPEUTICS V,..TI :I ,'> K !.._ i- '-. l!y C!lAl:l.I> I'. 1'
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SKND i )K IU.USTRATK1) ANNOUNCEMENT
INDEX.
ALLEN. P. Lorturrs on Aurnl Catarrh ......
ANATOMICAL REMEMBRANCER .......
ASHBY. H. M.'munimla nf I'tiy.siiiltiK.v.. .....
ASHHURST, J. Tin- lnt.-rii:iti(.n:il Knoyr;,,
BARTHOLOW. R. Sp. : nniil.>rrhn-a. . .
HARWELL. R. A TtviUiM- on J)is.-ivs<-> ol the
BAITER. L l.rctun-xoii i inhopaMic Sundry.
BEARL). J. M. Ni'i'voi-.s KxhauMioii. N. :.:;.-
COMSTOCK and COMINGS. I'r
CORSON. j'.'W. "',,. A.., T. ,..,:. .-M f
COULSON, W. J. is::i.l :. .
CURTIS. E. M.-ui-.i.i.
T. .-'...: _
UELAFIELU. F.
.11. .MA, Vi.l. I .il.. I ! 1
DELAFIELD' and PRUDDEN. I':i
BENNETT. J, H. (' .incul I..-.-M
I', in. ip..- mi. I I'nirti.-c of M.
BIJELOW. J. ' N..f;r. in [Ms.- :1 -r
iniKil M. '.l
B!NZ, C. Tni
BLYl'H. A. W. ('.. Au:iiv-i- ..f F I an,l i
It.-',
BOCK. C E. A: n- I lli::.,:in Anal
ELLIS ;.nd FORD.
ELLIS. E. I'.-.-
EMMET, T. A. \
EHB. W. I ..:!-. I
EKICHSEN. J. E.
FLINT. A. r -:;
HOOFER
FHYSICIAN's. /A HE ME
f,4 ITBLICATIONS or UILLIAM \Yoon \- COMPANY.
Jn<l( -I'.
HUN H A I'nid,' i" American Medical sui RICHET. C. |'hy-i"lon
;,.,;.-:, H, !-..] ..... . .. I''' Cerebral' Cnnvniutin,,* ....... ' ...... :;
INGALS. E. F. !>:. ,-i...-;- ai,.l Tivattn. n! nf RINGER, S. Hand-bonk nf Therapeutics ...... I'!
|r. ,a-,- ..f i!u (';.,-. I in- .iit. :in.l ROBINSON. B. lln Na-al Catarrh uml Allied
\a ai C.-iMt .-.. ..... I'.' I), -,,,-,.- ........................ IJl
JACOBI. A. A Tiviiti-'i'ii iMphthcr! i ...... :;i ROCKWELL. A. D. [.crturcs ,.u KU-ctrifit.v ^Dy-
JAMES. P. l.arYiiL'o-n'i'y mill litiiM-enpy .. . 'M nainie and Franklinic) ......... '....'.. f,
JOHNSON. L. \ Medi. al r,.r:. .:...ir. ......... |:; ROOSA, D. B. ST. J. < > ihe Diseasi'suf the Ear 33
\ M. .;.. -a! P.. .till:-. ........... '' - Ve-t-I'ncket Medical I..\ie..n .......... !
JOHNSON and MARTIN. The Inthience of Ophthalmic and Otic Memoranda. .. HI
Tinpicai < lituaii- nn K-.r.'p. aii t'.m<t i ROSENTHAL. M. nnihe I >i-ea.-es of the Ner-
....... .pi von- S\ -ten, ..................... .'!.">
KEETLEY. C. B. ' . -' Stif-.-r ...... -'.' ROSS, J. A Treati-e on the I lisraM'S of the Ner-
KELSEV. C. B. P. -,.i-.- of . i;.-.-min and vmi- sy-teni ....................... :>,!
\, ; ,^ .................. !-' ROUTH, C. H. F. Infant 1-Yi-ilinn audits In-
KEYES. E. L. \VntT.-al I>S.-a.^ ......... -tl tlr.,-n.-.- . n I.:fo ................... :;0
KIRBY F. O. \ Tivuti-.-i'ii Vi-ii'v!i:ary Mrilirini' -Hi SALTER. H. H. < in Astlnna : It- I'athol.iu'y
KIRKE'S HANDBOOK OF PHYSIOLOGY. ].S mid Tivalini'til .................. ' ".}'.}
KLOB. J. M I'.i;!,..:. tin- 1'.- SALTER. J. A. Di-nial I'utholojry uml Sur^-ry. 'i-1
...". ........... <>: SATTERTHWAITE. T. E. A JIaiiiuil uf )[fs-
K N A p p. H. . : .......... :;i !.,;..._> ............................. r.i
LAMBERT. T. S. I'riu : Sy-:.-!:.ati.- Ilnntan SAVAGE. H. Th.- Snr-ical Patliolnuv ........ 8S
i" .--...-.. \ ; ..,:..v .' .,i .ill-.-;, tic . . . IN SEE, G. !> : -,.-!-, - nf tin- I. uni:s ............... .;:]
LE\VIN. L ' '1 In' I: I. 'iiia Ktl : "i Drills -15 SEGUIN, E. |.lini-\ ami its 'rrratiiiriii l.v iln.
LID.-LL. J. A. Ap..pl.'\y ........ ' ..... ::'i I'liy.-iulM-ic'al .Mctlioil ........ ...'.....'i7
LIVEING. R. HII p l'r.-ari!i.'in nf skin Disi-usi-s. -I! - - MnliiMl TiiiTiiitiiiH-to- uml Iliiiuan T.'in-
....... -I! pi-i-iitiiri- ....... ". .............. 7
LONGSTRETH. M. l:h.-imiai -in. C.ut. and SEMELEDER, F. IMiinnscnpy and I.arynirn-
'
LOOMIS. A L. I ..-:..,.:,!,.,.- . . ..II SIMS. J. M. ( In Uterine Sur<j.T.v .......... -^i
f - ; :. II. .-pirat'.ry ()ivan>, SKENE. A. J. C. I >i.-..a.-e.- nf i he Illaddrr and
li i-r, and !\i i y ............... 1I I' P.; lira in Wonit-n ................ SC.
- \ T. " ...... II SMITH. E. (in Di-. a-c in ChildnMi ........... '.''.I
I...- n n l-i -.*<'' I'lrj:,.,-:- ..... n; STEEL. J. H. i iiitlim-s of Kiinim- Anntoiin .. -ID
LYMAN. H. M. Art;] ;ii Ai.a-tli.-.-ia and STELLWAG. C. On tin- K\e, in.-liaiin-' t ti-
...... I \iialniiis ..f the i M-u'an . ... 31
MACKENZIE. M. I >-,-,,-,- ,,; i h. -I'liavMix, STERNBERG. G. M. and MAGNIN. A. I!a.'-
i. . . !.>., a . . . :j.| i, i-j;i ....... ...}0
MILTON. J. L. i- nd Tn-at nil-ill ..f STERNBERG. G. M. Malaria and Malarial
'..I...M ...... :;-~ hi-ca-i - ...................... Hi
M::.LAHU, H. B. i' ~.-.a-,. ..f iu,. STEWART. T. G. im p,r;-iir- uisca-o ..f n,.'
....... ............. :;'.i Kidney* ............................ i' 1
MuK.'AN. f : E. i; :-, T: . ., .-..,,., i T!,, M, STRICKER. S. A Manual nf Hi-tnlniry ....... 2n
.' ........ f, STURGIS. F. R. Mi'di.-nl Tnpi,^ ........ n;
MTTNDE. P F. ' , HM, ,.,,, i,, L ry . -jr, TAIT, L. Disesi-e- of Wom-n . . . .
M';Ki.'HISON. C. M,,]' , irralip-n'ifnt- - ( Hi Di-.'a-i- (.f the O\anc- ............. -J-
> TAYLOR. C. F. MerhiniMlTiviitmcnt of ])is.
< ------ f ill.- Ifip-J.iinl ............ -'I
THUDICHUM, J. L W. A Manual of Clif-m-
. ;:>. E ,.. e . P; TIDY. c. M. i.. L
!IDJE. E. L. ' nf < M,M, trie* :, TILT. E. J. \ Ma
i!,.., in .. ... .'-
J-.' TROUSSEAU. A. Treatise on Therapeutic- . II
PEABOhY. ; I. : i, Xiem^.-nS VERRIER. E. Practical Manual nf < Ih-tetri.- . -J7
1" VIDAL. A. in, Vcncrial Hi- a-- 11
THAR:.: : r IHE UNITED VISITING LIST . ... in
I-J VON TROELTSCHE. A. l)i-ea f the Kar
li WAGNER. E. A Manual nf Cenera Pathnln K > 1
WEISSE. T. D. The Detnnn-ir.itnv 1
II WENDT. E. C. ATreali-enn \-iatic Cholera. i:>
iURFS FI H PHYSICIANS' OFFICES WEST. C. II. , m Nurse r-iek Children '.'It
',:. WILSON. E. The Sn
1 M. dieiiie nn.i |ii-i' iv- .at]
J I ln.irj_Mi,ii. and i Iriranie I.")
I d;eal Stn.lenl.-' Mannal ..f < hem.-tiy -i:.
. UEX RERUM ."'
yii WYETH. J. A. \ llnndl !. nf Me.'deal and
in Sur rieal \nai..inv and Surtri r\ . --' : ;
1 ZILMSSEN. H. VON. Cyelo|p!i..li.i of th.'
f Medicine 1"
!''. ZIEGLER. E. \ ri'\tli.i.,k ..f PalhnlnKJcal An-
il and Pa,tli"--.'en.--i.-. . . . !
OF CALIFORNIA \T LOS ANGELES