FADS OF AN OLD PHYSICIAN
 
 By the same Author 
 
 PLEA FOR A SIMPLER LIFE 
 Seventh Edition. Crown 8vo. Price 2s. 6d. 
 
 PLEA FOR A SIMPLER FAITH 
 Crown 8vo. Price 2s. 6d. 
 
 (London : Kegan Paul & Co.)
 
 FADS 
 
 OF 
 
 AN OLD PHYSICIAN 
 
 A SEQUEL TO 
 'PLEA FOR A SIMPLER LIFE' 
 
 BY 
 
 GEORGE S. KEITH, M.D., LL.D., F.R.C.P.E. 
 
 A II rights resented
 
 PublhJied iznd April 1897. 
 Reprinted May 1897.
 
 PREFACE 
 
 I HAVE frequently been asked by readers ot 
 my ' Plea for a Sim-bier Life ' for more details 
 regarding matters treated in the volume. 
 Some of these details were given in an 
 appendix written at the time and intended 
 to be issued with the text, but it was omitted 
 for what were thought to be sufficient rea- 
 sons. This appendix forms the basis of the 
 present volume ; and I have taken the 
 opportunity to give to the public and the 
 profession my views on some other matters 
 of general interest to both, bearing more or 
 less directly on the prevention and treatment 
 of disease in a simpler way than is generally 
 followed in this country.
 
 vi FADS OF AN OLD PHYSICIAN 
 
 In the preface to the ' Plea' I ventured to 
 speak somewhat defiantly of the criticisms 
 which I expected would follow its publica- 
 tion. This I have found to have been an 
 unnecessary precaution, as the volume 
 though in many respects opposed to the 
 ruling ideas of the day both as to principles 
 and practice has met with no hostile criti- 
 cism whatever, although its reception by the 
 public has been such as is seldom given to 
 an unknown writer. On the contrary, it has 
 been favourably reviewed by most of the 
 leading papers and by several of the medical 
 journals ; and some of the older heads of the 
 profession, both physicians and teachers, in 
 this country and in America, have written to 
 signify their approval of my attempt to 
 simplify the teaching and the practice of 
 medicine. As yet, however, I can see no 
 signs of improvement. During the last 
 twelve months I have come across instances
 
 PREFACE vii 
 
 of such gross maltreatment as I never before 
 met with or even heard of. At the same 
 time I am constantly told that there has 
 been a vast improvement, and that there is 
 no such physicking, feeding, and stimulating 
 as there was some twenty or thirty years 
 ago. I sincerely hope that it is so, but I 
 can see no proof of it whatever, and I wish 
 much that some of the younger members of 
 the profession would point out to the public 
 what are the principles by which they are 
 guided in treating their patients. Not many 
 months ago a mother came to tell me how 
 her son, who was said to be suffering from 
 an enlarged stomach, was being treated by 
 the family doctor under the direction of a 
 leading consulting physician. Into this 
 enlarged stomach there daily passed a pound 
 and a half of pounded beef, a pound of fish, 
 two large meals of revelenta quantity not 
 known exactly, but a packet which cost us.
 
 viii FADS OF AN OLD PHYSICIAN 
 
 lasted about a fortnight one large meal of 
 Benger's Food made with strong meat stock, 
 six to eight tumblers of milk, with part of 
 which the revelenta was prepared, coffee, 
 and during the night biscuits. To get this 
 into a stomach an enlarged one was pos- 
 sible ; to digest it from day to day was a 
 different matter ; but science now came in, 
 in the form of the stomach-pump, which was 
 used every night to get rid of the fermenting 
 mass and to wash out the unhappy organ. 
 This had gone on for the last five months ; 
 the youth was still able to go about, and 
 even to do a little business. Was this a 
 new form of homeopathy, only going from 
 the extreme of infinitesimals to an extreme 
 of quantities, a big stomach to be relieved 
 by extreme repletion? My theory is that 
 the quantity of food was so enormous that 
 it had not time to get very acrid and intoler- 
 able before it was removed ; and this would
 
 PREFACE ix 
 
 also explain how that during the night, when 
 pain came on in the emptied stomach (no 
 doubt from acid poured into it from the 
 blood), biscuits were given to dilute the acid 
 secretion and render it less intolerable. The 
 youth did not seem much the worse for this 
 strange cure. I should like much to hear 
 what was expected from the treatment ; and 
 if it was only an experiment I doubt if it will 
 be often repeated with the same immunity. 
 Once I was threatened with the law for leav- 
 ing an old gentleman to get well in his warm 
 bed without food or physic, and he did not 
 disappoint me. I would not have taken the 
 hint so calmly had I been acting contrary to 
 nature and to common sense, as in the case 
 I have mentioned. I could not have credited 
 the story had I not got it at first hand. The 
 knowledge that such cases for this is not 
 the only one are possible in the present 
 day, will explain if it does not excuse
 
 x FADS OF AN OLD PHYSICIAN 
 
 some plain speaking in the following 
 pages. 
 
 Most of my peculiar ideas have been 
 looked on and spoken of as ' Fads ' by my 
 medical friends. I do not object to the 
 word, as I have noticed that the faddist not 
 infrequently gains the day in the long run. 
 It is therefore in a hopeful spirit that I have 
 adopted the word in the title of this volume. 
 
 G. S. K. 
 
 CURRIE, MIDLOTHIAN, 
 January 1897.
 
 CONTENTS 
 
 PAGE 
 
 PREFACE ....... v 
 
 1. ON SO-CALLED 'STARVING' . . . . i 
 
 2. THREE DIFFERENT METHODS FOR PRESERVING AND 
 
 REGAINING HEALTH 10 
 
 3. ON STIMULANTS . . . . .35 
 
 4. ON SELF- MASSAGE . . . . .47 
 
 5. ON HOT WATER ..... 65 
 
 6. ON LIQUORICE ...... 77 
 
 7. ON CANCER ...... 82 
 
 8. RELIEF OF PAIN AND SLEEPLESSNESS . . 97 
 
 9. ON RHEUMATIC FEVER .... 109 
 
 10. HOW ONE SHOULD LIVE IN A HOT CLIMATE . Il6 
 
 11. ON MATTERS WHICH RETARD DIGESTION AND PRE- 
 
 VENT WASTE ...... 124
 
 xii FADS OF AN OLD PHYSICIAN 
 
 PAGE 
 
 12. ON NATURAL CRAVINGS AND DISLIKES . . 130 
 
 13. THE RESPONSIBILITIES OF HEALTH . . .141 
 
 14. THE EFFECTS OF HIGH LIVING ON THE MORALS OF 
 
 THE YOUNG ...... 154 
 
 15. MY TEACHERS ... 160
 
 SO-CALLED ' STARVING ' 
 
 I HAVE frequently in my ' Plea for a Simpler 
 Life ' spoken of starving, and of being rather 
 pleased with the name often applied to me 
 of a 'starving doctor.' I never, of course, 
 allowed that my treatment was a starving 
 one in the ordinary sense of the word, and 
 frequently was able to prove that it was 
 exactly the contrary. I had to work with 
 the stomach as I found it, and that was often 
 in a weaker condition and less fit for work 
 than any other organ of the body ; very often 
 because it had been specially overtaxed in 
 a vain attempt to 'keep up the system.' I 
 have sometimes said to ignorant intruders 
 who were urging me to give food to their 
 
 'V,
 
 2 FADS OF AN OLD PHYSICIAN 
 
 weak friends, that I would gladly do so if, 
 in the first place, they would kindly provide 
 them with fresh stomachs. Here the infalli- 
 bility of inexperience and of ignorance comes 
 in very strongly, and with much evil to the 
 patient, as well as worry to the prudent 
 doctor. A case or two will bring out the 
 force of these remarks better than any 
 argument. 
 
 A lady came to Edinburgh from Ceylon, 
 suffering from that very serious disorder, 
 tropical diarrhoea. She saw several medical 
 men, but with no benefit, and she went to 
 die quietly in the country, in the house of 
 a friend formerly a colonel in one of the 
 Ceylon regiments. This gentleman and his 
 wife had got benefit from my treatment some 
 years previously, and, on finding that I had 
 not seen his friend, he insisted that she 
 should return to Edinburgh and try if I 
 could do something for her. I found her 
 reduced to an extreme degree. She was 
 taking a large quantity of food and stimulant,
 
 SO-CALLED 'STARVING' 3 
 
 which all passed through her in the usual 
 form it assumes in such cases, but clearly with 
 no benefit to the patient, as she was gradually 
 losing what little strength and flesh she re- 
 tained. I was shown a great bundle of pre- 
 scriptions I only once saw a larger which 
 had been given for her relief. Everything 
 that drugs or food could do had been tried 
 already by some of the best of our doctors, 
 and had failed. This I pointed out to the 
 friends, and it helped me very much in aban- 
 doning all attempts of relief on these lines. 
 I felt very hopeless of being able to do better 
 than the others. Shortly before I had read 
 of a Russian cure for extreme cases, called 
 the 'skim-milk cure/ and as it exactly 
 carried out my views I was glad to try it. I 
 advised that all drugs and stimulants should be 
 at once stopped, and that the only food given 
 should be an ordinary wine-glassful of skim 
 milk three times in the twenty-four hours. 
 This was the Russian cure. To this, as she 
 was so excessively low, I added a minute
 
 4 FADS OF AN OLD PHYSICIAN 
 
 quantity of extract of malt, also thrice a 
 day in the intervals of the milk. This, with 
 hot water, was literally all she got. In a 
 week the diarrhoea quite left her, and she had 
 even got a little stronger. I then left her 
 in charge of my brother, long my colleague, 
 and when I returned after a six weeks' 
 holiday I found her, I may say, quite well. 
 
 Some years later I was called to look after 
 a lady for a medical friend who had to leave 
 town for a time. She was dying from old 
 heart-disease, with general dropsy of the 
 body. She suffered terribly in breathing, 
 and could only sit in her chair, lying down 
 bringing on suffocation. Sir Robert Christi- 
 son had seen her, and the case was looked 
 on as hopeless. I was told that milk 
 treatment had already been tried, and had 
 failed. On inquiry I found that it had been 
 given in considerable quantity. She was 
 now taking what concentrated food she could, 
 and a fair amount of wine. With great diffi- 
 culty I got the lady to try the milk again,
 
 SO-CALLED 'STARVING' 5 
 
 but in the same quantities as in the former 
 case ; she was very unwilling to give up the 
 wine, as she felt some momentary relief from 
 it. At last, as her only hope, she agreed to 
 give it up and try my plan. Except three 
 small glasses of skim milk a day, and hot 
 water, she had literally no other sustenance. 
 But she soon rallied, was able to lie down 
 comfortably, and by and by to take some 
 food. She made a rapid -recovery, and she 
 died several years afterwards from blocking of 
 the arteries of the lower extremities, probably 
 from a clot which had formed in the heart. 
 
 Knowing as I did, from long experience, 
 that I could starve my patients to a good 
 purpose even in such extreme cases as the 
 above, the name so freely bestowed on me 
 gave me very little trouble and did me no 
 harm. Sir J. Simpson used to say that abuse 
 did one as much good as praise, sometimes 
 more. 
 
 Milk is perhaps the best of all foods, but 
 it too may be abused. Returning once from
 
 6 FADS OF AN OLD PHYSICIAN 
 
 a professional visit to the West, I met in the 
 railway carriage an oldish baronet on his way 
 to Edinburgh to see his doctor. I was told 
 he was sure to tell me of his case, as he knew 
 I would be in the train. He soon told me 
 all about himself. He was suffering from his 
 stomach, and had tried many cures ; he was 
 now living solely on milk, of which, he 
 said, to my horror, he was taking fourteen 
 tumblers a day by his doctor's orders. He 
 was almost skin and bone. At Stirling he 
 went out, and on returning was very angry, 
 as he could only get one tumbler of milk 
 instead of three, his ordinary dose. Very 
 soon he began groaning loudly from pain, 
 and as there were ladies in the carriage it 
 was very unpleasant to all of us. In about 
 half an hour the groaning stopped, much to 
 his astonishment, as he said the pain usually 
 went on till towards his next meal. I mildly 
 suggested that perhaps one tumbler did less 
 mischief than three. I had already given 
 him my mind about the treatment, as he had
 
 SO-CALLED 'STARVING* 7 
 
 asked it. I do not know if the milk was 
 continued ; probably it was given up as a 
 proved failure. But this I know, that, had I 
 then begun to take fourteen tumblers of it 
 daily, I would not have lived as he did 
 for three months longer. My own stomach 
 was then in a very irritable condition. I 
 rarely took plain milk, as it at once brought 
 on pain as it did with this gentleman, and no 
 doubt from the same cause, the immediate 
 formation of hard curd, which irritated and 
 brought on spasm. 
 
 The case just related is one of the many 
 I have met with of real starving from taking 
 in too large quantity what, under other 
 circumstances, might be the very best food. 
 The gentleman mentioned was, I was told, 
 supposed to be suffering from cancer of the 
 stomach. If such was the case, there was 
 still less need to torment the diseased organ 
 in the manner which I witnessed in a minor 
 degree. It has been an absolute rule with 
 me from a very early period, when milk
 
 8 FADS OF AN OLD PHYSICIAN 
 
 disagrees with a child, to stop every drop 
 of it till the last trace had left the stomach, 
 along with the well-known ferments which 
 cause its conversion into hard curd, or what 
 in Scotland we call green cheese in its first 
 stage. This will often at once put an end 
 to diarrhoea in children who may hitherto 
 have lived on milk only. Water will suffice 
 for a few days, if the stomach is out of 
 order as well as the bowels. If something 
 more is wanted, very thin soup from young 
 meat or chicken may be given, or thin oat- 
 meal gruel well boiled. After three days 
 the milk may usually be resumed with 
 safety. Many adults cannot take pure milk, 
 who take it freely in bread or puddings. 
 When so taken, it cannot form a curd even 
 if it meets with acid in the stomach. This 
 acidity is a very common cause of trouble. 
 If the youth or grown-up person who suffers 
 from it, instead of taking drugs for immediate 
 relief, would exercise in a greater or less 
 degree, as may be necessary, a wholesome
 
 SO-CALLED 'STARVING' 9 
 
 abstinence or call it starvation he would 
 soon find that he had no cause to accuse a 
 weak stomach for his share of the misery 
 which so many of the well-fed suffer in this 
 country, and all the world over. This is 
 the key-note of what I have to teach in this 
 as in my former volume, and it indicates a 
 strange bias in human nature that it should 
 be necessary to harp on it so often and so 
 loudly. I am by no means the only one in 
 the profession and out of it who, but often 
 in vain and with little thanks, endeavours to 
 benefit his fellows in a way that runs contrary 
 to custom and fashion, and which has only 
 experience of its value and common sense 
 to recommend it.
 
 II 
 
 THREE DIFFERENT METHODS FOR PRESERVING 
 AND REGAINING HEALTH 
 
 WITHIN the last two years two volumes 
 besides my own have been published which 
 recommend the treatment of disease by a 
 different method from that usually taught. 
 The one is by Dr. Haig of London, 1 the 
 other by Dr. Dewey of Meadville, Penn- 
 sylvania. 2 Both differ on many points from 
 the method laid down in ' Plea for a 
 Simpler Life,' but all three have much in 
 common in their endeavour to arrive at 
 the same end. Dr. Haig, whose method is 
 
 1 Uric Acid in Causation of Disease. J. and A. 
 Churchill. 
 
 2 The True Science of Living. Henry Bill Publishing 
 Company.
 
 METHODS FOR PRESERVING HEALTH 11 
 
 based on strictly scientific investigations 
 carried on for several years, and suggested 
 to him very much by his own personal 
 experience, finds in uric acid, present in the 
 blood or deposited in different structures 
 of the body, the cause of most of our 
 common and troublesome ailments. For 
 the prevention and cure of these ailments, 
 he recommends mainly abstinence from all 
 foods which contain uric acid, or its elements. 
 Under the first category are to be found 
 all animal foods except milk, and under the 
 second, tea, coffee, cocoa, etc., which contain 
 xanthin, a chemical substance which he says 
 is always changed in the system into uric 
 acid, and which thus possesses the same 
 disturbing properties. His own food, which 
 he gives in full detail, consists of milk, cheese, 
 and butter, with a liberal variety of bread 
 stuffs and other cereals, and of vegetables 
 and fruits. By adhering to this diet he has 
 raised himself from a very low and suffering 
 condition ; he is now in the enjoyment of
 
 12 FADS OF AN OLD PHYSICIAN 
 
 good health, and he has seen equally good 
 results in those who have followed his example. 
 
 To start his patients on their new mode 
 of life, Dr. Haig gives some drugs to wash 
 out the excess of uric acid in the blood, or 
 deposited in the various textures and organs 
 of the body. These are salicylate of soda, 
 and others, but with a proper diet none of 
 these should be afterwards required. 
 
 Dr. Dewey's method is a very different 
 one. He .had found very early in his 
 practice that he cured his patients at least as 
 well with small doses of medicines as others 
 did with big ones. Twenty years ago he 
 met with a case of typhoid fever in a young, 
 full, married woman, whose general health 
 had not been good, and whose stomach now 
 rejected all drugs, food, and drink. This 
 went on for three weeks ; on the twenty-fifth 
 day the aversion to beef-tea ceased, and for 
 ten days longer, when his services were dis- 
 pensed with, he left the feeding to the 
 patient. A perfect cure was effected without
 
 METHODS FOR PRESERVING HEALTH 13 
 
 food and without remedies, with no unusual 
 wasting of the body ; while the mental and 
 physical strength increased with the decline 
 of symptoms, and before any food could be 
 taken. Dr. Dewey had already seen, as has 
 every physician, numerous cases where for a 
 time little food had been taken with no loss 
 of vital power ; but this one led him to look 
 more into nature's methods, and to the dis- 
 covery of the value of the store of nutriment 
 which is found in every human body until 
 reduced to what he calls its skeleton form. 
 
 Thus far Dr. Dewey 's progress was 
 owing to observation of others, and it 
 affected only his treatment of the sick ; but 
 eight years later he was led by his personal 
 experience to apply his method also to the 
 more or less healthy. ' I was/ he said, 
 ' the victim of slow digestion never attended 
 with pain, but always with discomfort, which 
 disappeared under the excitement of business. 
 I never was without appetite in fact, it was 
 always too strong to be manageable. I was
 
 14 FADS OF AN OLD PHYSICIAN 
 
 never disabled by it an hour in my life, but 
 there was always an abiding sense of dis- 
 comfort when not under excitement.' ' I 
 habitually ate a hearty breakfast every 
 morning, with or without previous exercise ; 
 no meal ever fully satisfied hunger. I could 
 take a lunch between meals with relish, only 
 that I dared not ; and all through the days, 
 the months, and the years I was more or 
 less starved because of habitually overtaxed 
 machinery.' At last one morning he got 
 up without an appetite, having partaken of a 
 heavy meal the preceding evening. He 
 now recalled what a friend had told him 
 some years before. He had been on a tour 
 in England, and had noticed that a common 
 breakfast there was a cup of coffee and a 
 roll. Dr. Dewey bethought him to try this 
 instead of his usual heavy meal, but as he had 
 no appetite he omitted the roll. The result 
 was that instead of feeling faint, as he had 
 feared, he had, he says, a ' forenoon of such 
 lofty mental cheer, and such energy of soul and
 
 METHODS FOR PRESERVING HEALTH 15 
 
 body, such a sense of physical ease, as I had not 
 known since I was a young man in my later 
 teens.' He continued the coffee breakfast, and 
 in the course of a few weeks, he says, ' there 
 was such a quickening of my life in every 
 line that friends began to notice it. It was 
 very cheering to be met in the streets with 
 the remark that I was looking better ; and 
 all the more as I had reached a time when 
 mental and physical wreckage seemed not 
 so very far off.' 
 
 Dr. Dewey's grand means of cure now is 
 abstinence for the time from all food, and 
 this he carries out to a degree which must 
 astonish most physicians of the present day, 
 as well as their patients. During times of 
 sickness, when there is no desire for food, he 
 gives none till the desire comes, and then 
 only if the state of the tongue and general 
 condition show that the power of digestion 
 has returned. This may be in a few days, 
 or in severe cases, as of rheumatic fever, it 
 may not be for forty days or even longer.
 
 16 FADS OF AN OLD PHYSICIAN 
 
 He points out very forcibly that we have all 
 a store of material laid up in the body which 
 supplies what is required for keeping the 
 necessary functions of the system going, 
 while no food can be usefully taken into the 
 stomach. I had mentioned this provision in 
 my ' Plea? and had stated that so long as 
 it lasts it is sufficient to preserve life. I also 
 suggested that it might be found that the 
 waste of the body was less when this 
 internal supply was alone trusted to, than 
 when it was supplemented by food from 
 without which the organs of nutrition were 
 not in a condition to utilise. This, to my 
 mind, Dr. Dewey has proved to be the fact, 
 and no one can read his cases without being 
 convinced that it is so. He gives a most 
 interesting table from Dr. Yeo, showing 
 what textures of the body waste most rapidly 
 in disease. Fat is at one end of the scale, 
 and at the other the brain, which does not 
 waste till all the other textures and organs 
 are depleted to the utmost.
 
 METHODS FOR PRESERVING HEALTH 17 
 
 In cases of slighter disease, where the 
 patient is able to be about, or to carry on 
 his business, but with discomfort, the same 
 abstinence from all food is recommended. 
 It is usually found that work can be done 
 more easily, and that strength actually in- 
 creases, although the starving may have to 
 be kept up for several days. But the great 
 coup in Dr. Dewey's practice is, that to im- 
 prove or to preserve health he advises all to 
 give up breakfast, and to fast till the mid- 
 day meal. In this he has had a very large 
 number of followers, very much to their 
 advantage. It may be that the omission of 
 breakfast is more needed and has greater 
 effect in America than it would have on this 
 side of the Atlantic. In America the meal 
 is usually a very full one, made up in a large 
 measure of a variety of hot cakes, also flesh 
 food and tea or coffee. The other two 
 meals of the day are full, ' square ' meals 
 likewise. I have seen much overfeeding in 
 this country, but never to such a degree, and
 
 1 8 FADS OF AN OLD PHYSICIAN 
 
 so generally, as I have seen in America and 
 in American steamers. In one of the latter 
 the cooking was the worst I ever met with, 
 but the hard meat was swallowed all the 
 same, and the consequences must have been 
 grievous. 
 
 Dr. Dewey gives much prominence to 
 the relief got in following his plan of no 
 breakfast by the women of the household, 
 who are thus saved a large portion of their 
 work. This is of much wider importance in 
 America than in this country, as even in 
 better-class households, from want of ser- 
 vants, much work necessarily falls on the 
 women of the family. 
 
 In Dr. Dewey's first volume (p. 172) he 
 states with approval that by adopting his 
 system more food will be taken and properly, 
 digested than when too much is taken from 
 day to day, with occasional breaks-down and 
 inability to take food. He seems to use 
 abstinence from time to time as others do 
 aperient medicines, and visits to spas, in
 
 METHODS FOR PRESERVING HEALTH 19 
 
 order to clear out the digestive organs, and 
 thus enable them to do more and, for a time 
 at least, better work. I ventured to express 
 my fear that in this way though an in- 
 finitely more rational way than is usually 
 followed life may be no longer than it has 
 hitherto been. The return to a fuller diet 
 than is necessary, though stopped from time 
 to time by the rule that no food is to be 
 taken when it is clearly not properly utilised, 
 is fitted to render the blood more abundant 
 and richer than the secreting organs can 
 properly manage, and may lead to acute 
 attacks of illness from chill or other accidental 
 cause, or to deposit, in some perhaps weaker 
 or overworked organ, a part of its overload 
 of plastic material, and thus bring on per- 
 manent changes most difficult, or impossible, 
 to get rid of. 
 
 In a later work, however, by Dr. Dewey, 
 A New Era for Women, published in 1896, 
 he states (p. 75), that by following his 
 method of no breakfast a much more moder-
 
 20 FADS OF AN OLD PHYSICIAN 
 
 ate mid-day meal is required, and the even- 
 ing meal becomes very light indeed, the one 
 square meal of the day having been much 
 more thoroughly digested. 
 
 Another slight criticism which I will ven- 
 ture to make on Dr. Dewey's method is, 
 that he notices with approval the feeling of 
 keen hunger as necessary for the enjoyment 
 of a plentiful, or of any meal. I have long 
 maintained that keen hunger, in most cases, 
 if not in all, implies a more or less morbid 
 condition of the stomach. This indicates 
 that it is not empty, as it ought to be after a 
 meal is fully digested, but contains some 
 acid or acrid matters, which may be part of 
 the food previously taken turned sour, or, if 
 the food has entirely left it, an acid secretion 
 from the blood. In either case there may be 
 a feeling of keen hunger, but this is only a 
 crave by the nerves of the stomach for relief, 
 which the sufferer knows from experience 
 is to be got by diluting the acrid mass with 
 a fresh supply of inert food. That this is
 
 METHODS FOR PRESERVING HEALTH 21 
 
 the true reading of such cases I have often 
 proved. Relief for the time may be got by 
 using plain water for dilution, or by eating a 
 bit of liquorice, or by taking an alkali. Some 
 of the most satisfactory cases I have had to 
 deal with were of ladies whose health had 
 gradually deteriorated, and their strength 
 got to so low an ebb that they required, or 
 were supposed to require, food or wine every 
 two hours. Such a case is difficult to 
 manage, as the immediate relief from tak- 
 ing food is so great. I have sometimes 
 succeeded by pointing out that the ease and 
 renewed strength which at once ensue cannot 
 possibly arise from the food, as there is no 
 time for its digestion. If the case is not too 
 chronic, the result of rational treatment is 
 very satisfactory. One of the best instances 
 of this I have met with was that of a young 
 lady of good Scottish family, who had 
 married two years previously in Yorkshire. 
 I had known her a perfectly healthy and 
 handsome girl, plainly and healthily brought
 
 22 FADS OF AN OLD PHYSICIAN 
 
 up. In her new home the mode of living 
 was a full one. She had two children, the 
 first of whom she tried to nurse. This was 
 supposed to demand still fuller living and a 
 larger amount of stimulant. She had to 
 give up nursing, and was gradually getting 
 into bad health. She did not attempt to 
 nurse her second child, and now she fairly 
 broke down ; her mother, who brought her 
 to Edinburgh, told me she could not under- 
 stand her at all. I found her pretty much a 
 wreck, mentally and bodily. By the doctor's 
 orders and her own desire, she was taking 
 food or wine every two hours, and a good 
 deal even during the night. All her stimu- 
 lants and medicines were stopped at once, 
 and more than half her food, which was 
 given at proper intervals. In one fortnight 
 she was able to walk along Princes Street as 
 well as ever she was. But in this case I 
 had the mother's help, and could at once do 
 what I knew to be best. 
 
 Dr. Dewey, in his two volumes, gives
 
 .METHODS FOR PRESERVING HEALTH 23 
 
 many instances of cures effected quite as 
 rapidly, by his mode of complete abstinence 
 from food for an indefinite period. He 
 makes no use of stimulants, and his one 
 drug is opium given by injection, which in 
 painful cases he uses to give relief, while 
 nature unassisted is curing the disease. 
 
 The method I have been led to follow in 
 the treatment and prevention of disease, as 
 given in the ' Plea for a Simpler Life,' agrees 
 in its essential features with the two methods 
 we have been considering. With Dr. Haig 
 I give up, under all states of ill-health, the 
 use of strong animal foods, especially beef; 
 and I also give up these in all who, though 
 in their usual health, are of a decidedly 
 nervous temperament, or of the rheumatic 
 or gouty diathesis. To all, even the 
 healthiest, I advise their use to a very 
 moderate extent, from their tendency to 
 bring on acute rheumatism and gout, and, 
 if taken even by the healthiest too freely 
 and too long, causing, through deposits in
 
 24 FADS OF AN OLD PHYSICIAN 
 
 the internal organs, diseases which only in- 
 dicate their presence after cure has become 
 impossible. For the young I recommend 
 little or no strong animal food till they reach 
 the term of puberty in this following the 
 rule laid down by the writer of the Epistle 
 to the Hebrews, that ' strong meat be- 
 longeth to them of full age.' There are 
 few rules that have no exceptions, and 
 although beef may seem my bte noire, I 
 have used it even with children, and with 
 great benefit. In some protracted cases of 
 diarrhoea in children a year or two old, given 
 raw, or slightly warmed, and pounded very 
 fine, it often acts splendidly. The child 
 usually takes it at once and greedily, and 
 will live on it for some weeks, when the 
 desire ceases ; but the child is now cured, 
 and can take other food. Raw beef has 
 much in common with the albumen of white 
 of egg, and in the circumstances mentioned 
 I would just as soon think of giving hard- 
 boiled egg as cooked beef. Beef slightly
 
 METHODS FOR PRESERVING HEALTH 25 
 
 cooked, and in moderate quantity, is some- 
 times very grateful to a convalescent from 
 acute disease, and for a time may be 
 indulged in with safety and even benefit. 
 
 I do not altogether follow Dr. Haig in 
 proscribing tea and coffee and all substances 
 containing xanthin. This I allude to more 
 fully elsewhere. One consequence is that I 
 consume daily a much smaller quantity of 
 food than does Dr. Haig. He gives a de- 
 tailed account of his daily food, and it 
 amounts to much more than three times 
 what I find to be necessary for myself, and 
 which keeps me in the best of health. 
 
 As I have been asked by readers of the 
 ' Plea ' to give my own diet, I take this oppor- 
 tunity of doing so. This will save me a 
 good deal of writing. I have always to 
 explain that what I do myself I do not urge 
 on all. Here they will have three different 
 ways of living, which may help them to fix 
 for themselves what is best under their own 
 perhaps widely-differing circumstances.
 
 26 FADS OF AN OLD PHYSICIAN 
 
 For breakfast I have a large cup of tea, 
 with milk or cream ; brown bread from two 
 to three ounces, and usually one and a half 
 ounce of fish, or half that quantity, and that 
 very rarely, of bacon. Sometimes for a few 
 days I take a cup of coffee with half milk, 
 but no fish nor bacon. Lunch is a cup of 
 cocoa or chocolate, if the weather be cold ; 
 if it is warm, a small tumbler of milk, about 
 six ounces, with the same quantity of bread 
 as at breakfast. At both meals I use butter, 
 not a quarter of an ounce, and quite as much 
 jelly or marmalade. This is my usual lunch, 
 but occasionally instead of cocoa I have a 
 baked apple or some prunes with milk, or 
 strawberries and cream so long as I can get 
 them, or, very rarely, vegetable soup. When 
 I have no milk I take usually a morsel (not 
 half an ounce) of cheese. 
 
 At 4 P.M. a small cup of tea, and some- 
 times biscuit or cake. For dinner at 7, 
 which is my chief meal, I have soup, from 
 peas, lentils, potatoes, celery, carrot, etc.,
 
 METHODS FOR PRESERVING HEALTH 27 
 
 the first two made with no meat stock, and 
 the others with little, from lamb or a bone ; 
 or fish soup, the only pure animal soup I 
 indulge in. Fish, mostly white deep-sea 
 fish direct from Montrose. Of this I take 
 no more than three ounces, with a potato 
 and always another vegetable fresh from the 
 garden. If there is no fish, I may take once 
 or twice a week an ounce or two, certainly 
 not more, of lamb, game, rabbit, or tripe ; 
 but often I have neither fish nor flesh. The 
 dinner ends with stewed fruit with cream, or 
 pudding or fruit tart of these I take a fair 
 helping. During the winter season, instead 
 of fruit or pudding, I often have celery with 
 cheese, oatcake and butter. 
 
 On this diet I enjoy the best of health, 
 and for my age (78) am up to a fair 
 amount of exercise, walking three to six 
 miles daily in good and sometimes in bad 
 weather, and usually part of this is up a 
 steep road with a rise of 250 feet. The 
 only confession I have to make is, that
 
 28 FADS OF AN OLD PHYSICIAN 
 
 when at home I do not rise till I have had 
 breakfast and read the newspaper. This is 
 a habit I have recommended to many ap- 
 proaching my own age, and those who have 
 tried it admit that they are stronger for the 
 rest of the day. I enjoy breakfast just as 
 much as my other meals, though I never feel 
 what can be called hunger, and have not done 
 so for many years. I could omit a meal at any 
 time without discomfort. This I have long 
 looked on as the best proof of perfect digestion. 
 During very warm weather I take rather less 
 bread and butter, and I do not try to make 
 this up by taking more of anything else. 
 
 In Dr. Haig's book he gives full details 
 of his daily food, and it amounts to above 
 100 ounces, 42 being milk, with jam, sugar, 
 potatoes, and fruit in addition. Mine cer- 
 tainly does not rise to one-quarter of this ; 
 it comes much nearer to that given by 
 Cornaro, 1 the well-known Venetian who lived 
 
 1 Hoiu to Regain Health and Live a Hundred Years, by 
 One ivho did it. Simpkin, Marshall, and Company, London.
 
 METHODS FOR PRESERVING HEALTH 29 
 
 his hundred years, and whose food amounted 
 to 12 ounces a day, with 14 ounces of light 
 wine. With me tea takes the place of his 
 wine, and were I living in a hot climate I 
 should be much inclined to follow his example, 
 and thus escape taking any xanthin, which 
 Dr. Haig so strongly condemns. I tried 
 lately for about six weeks to take milk at 
 breakfast and lunch instead of tea and cocoa. 
 The only difference I noticed was that, al- 
 though there is much more nourishment in a 
 cup of milk than in the same quantity of tea, 
 I felt that I began sooner to think of lunch 
 and almost to feel a desire for it, and I missed 
 the feeling of satisfaction which a good cup 
 of tea certainly gives. In the afternoon I 
 took sometimes a cup of Paraguayan yerba, 
 which I had got to like in South America, 
 and which sets one up even more distinctly 
 than tea ; so I fear that this too contains 
 xanthin. Without tea or cocoa I would, no 
 doubt, find myself taking more food, but I 
 am not sure that this would be more bene-
 
 30 FADS OF A N OLD PHYSICIAN 
 
 ficial, and I am sure that to me at least it 
 would not be so enjoyable. I doubt if any 
 one enjoys his food more than I do. I 
 endeavour always to eat slowly, but I am 
 sometimes told that in this respect precept 
 and practice do not quite accord. 
 
 I have only given an outline of the two 
 other methods, and my readers will do well 
 to study both volumes for themselves. On 
 the diet indicated, I find that if I have to live 
 differently in travelling or visiting, I can 
 make considerable errors for a time with but 
 little harm. The last great error of this sort 
 was several years ago, when I spent six 
 weeks with hospitable friends in South 
 America. There I partook of at least three 
 times the amount of flesh food that I do at 
 home. I kept in excellent health, but to- 
 wards the end of my visit I felt that I had 
 gone far enough astray. Fortunately, prob- 
 ably from the heat of the weather causing a 
 determination to the surface, I suffered from 
 a great increase of eczema, which had stuck
 
 METHODS FOR PRESERVING HEALTH 31 
 
 to me for many years and has not yet quite 
 left me. This with lighter living for a month 
 near Rio, and some wholesome sea-sickness, 
 restored me to my ordinary condition, and 
 the effect of the trip was on the whole salu- 
 tary. Last spring I made a three weeks' 
 visit to the Riviera, going and returning by 
 sea. My previous experience made me 
 more careful ; I could manage my food 
 better as to quantity, but the quality was too 
 rich, and the consequence was that in six 
 weeks, with no sea-sickness, I lost four or 
 five pounds in weight. This I began to 
 make up at once on my simpler home fare, 
 but it was only after several months that 
 I recovered my normal weight. 
 
 Dr. Haig's personal experience seems to 
 indicate that, if substances containing uric 
 acid, or xanthin, are practically eliminated 
 from food, a much larger amount can be 
 taken than if even a very moderate quantity 
 of flesh, etc., is substituted. I am not 
 astonished, however (p. 540), that if he at-
 
 32 FADS OF AN OLD PHYSICIAN 
 
 tempts to increase his fish and egg, he ' at 
 once begins to suffer for it in the way of 
 headache, dyspepsia, catarrh, asthma, or some 
 other trouble connected with uricacidaemia.' 
 I have had my full share of these troubles; 
 now they are but a memory of the past, and 
 it will, I believe, be my own fault if they do 
 not remain so in the future. 
 
 A friend of my own age, who for thirty 
 years has followed very much my mode of 
 life, lately came across a disciple of Cornaro, 
 a man several years older than himself, but 
 enjoying even better health and spirits. He 
 determined to adopt the very restricted diet 
 which seemed to suit an older man so admir- 
 ably. I quite encouraged him to do so. 
 After two or three months his wife got 
 alarmed that he was even thinner than 
 formerly, he being always on the spare side, 
 and he returned to his old diet. The ex- 
 periment, however, did him no harm at the 
 time, and he has certainly enjoyed better 
 health than he did before. Should he ever
 
 METHODS FOR PRESERVING HEALTH 33 
 
 care to repeat the experiment, it will be with 
 full acquiescence on my part. 
 
 I have gone more into detail in matters of 
 food than I wished ; but I am so often asked 
 to do so, and to give something more than a 
 few general rules, that I see there is need for 
 something more precise. Strict rules, how- 
 ever, can only be given with safety by one 
 who can examine and judge each case by 
 itself, and this is the duty of the medical 
 adviser. Hence my earnest wish to do 
 something to change the teaching and prac- 
 tice of medicine in this country. It is to the 
 medical man we must look for any real and 
 general advance in medical science. But he 
 must learn to think for himself, and not go 
 on the easy idea that all he has been taught 
 in the schools is true, and that if the patient 
 does not improve as he ought, the fault is 
 with the patient, not with the treatment. A 
 trusted doctor is the most prized of all one's 
 friends, and the exigencies of society are 
 such that it is not easy to guide oneself by 
 
 3
 
 34 FADS OF AN OLD PHYSICIAN 
 
 the most perfect rules, even if these were to 
 be had. Under present circumstances it 
 takes as long a time, and as many failures, 
 to enable one safely to be his own doctor, 
 as to be his own lawyer. What a simpler 
 system may effect in both instances can 
 only be dimly seen as yet, but it is worth 
 working for. If a few of us, on very 
 different lines, have found each from his 
 own experience that we can get health 
 ourselves, and give it to our patients, by 
 methods very much the reverse of those 
 which we have been taught, and have for a 
 time followed, it may be hoped that others 
 will follow our example, or, what is better 
 still, may discover other methods more suc- 
 cessful and more generally applicable.
 
 Ill 
 
 ON STIMULANTS 
 
 SOME of my teetotal friends and I have 
 many have urged me to adopt their cause, 
 and to promote it. I have always assured 
 them that I firmly believe I can do, and 
 have done, more for the cause of temperance, 
 if I leave myself free to act as I think best 
 in each case as it arises. As to the evils 
 which attend the use of alcoholic stimulants 
 being enormously in excess of any benefits 
 that may arise from them, both in health and 
 disease, I can have no doubt whatever ; and 
 could I see any possible means of stopping 
 their use entirely, I would most gladly assist 
 in their adoption. There are a few cases, 
 however, in which I have found a temporary
 
 36 FADS OF AN OLD PHYSICIAN 
 
 use of some form of alcoholic stimulant of 
 very decided advantage. From these I give 
 two or three. 
 
 When at on a professional visit, I 
 
 was asked to see, a few miles off, the elder 
 sister of the lady I was visiting. I was told 
 she had been on her back for twenty years, 
 and was only able to have her bed made 
 every second night. She had suffered so 
 much pain that for many years she had taken 
 a large dose of opium every night. This 
 quieted her till next night, when, from a re- 
 newal of pain, she always wearied for her 
 dose. She took almost no food, but seemed 
 to live mainly on the opium. No attempt at 
 any change had been made for years. Her 
 illness had commenced very much as that 
 of her younger sister, who, it was feared, was 
 falling into the same helpless condition. I 
 had seen several such cases before, and had 
 declined others my medical friends had wished 
 me to take over, both they and I knowing the 
 difficulty of treating them with any success ;
 
 ON STIMULANTS 37 
 
 but I had noticed that sooner or later they 
 came right of themselves, if at all simply 
 managed, or rather if mostly let alone. 1 It 
 occurred to me that in this case, as the 
 patient was getting up in years, the cause of 
 her ill health might have passed off; and 
 that the pain or supposed pain, want of ap- 
 petite, etc., might now be owing to the con- 
 tinued regular use of the opium. I advised 
 that the opiate should be stopped at once, and 
 for a time in its stead half a tumbler of London ' 
 stout should be given at bedtime, and that a 
 little more food be given as she could take it. 
 The result was better than I or her friends ex- 
 pected ; and just six weeks later she was able 
 to come up to Edinburgh in very fair health. 
 I doubt if this could have been done 
 certainly not so easily without the stout. 
 
 1 These I believe are the best, if not the only, cases in 
 which the ' Weir-Mitchell ' treatment gives such splendid 
 results. I have known about half-a-dozen cases, and could 
 wish I had also known this method of treating them. But 
 I doubt if I would have continued the feeding so fully or so 
 long after the desire for food and its healthy digestion were 
 restored.
 
 38 FADS OF AN OLD PHYSICIAN 
 
 I have met with a few cases of great 
 depression and irritative fever after a 
 bad confinement where a temporary use 
 of stout, or of a still pleasanter and more 
 potent liquor, Prestonpans old twelve - 
 guinea ale, has been of great and undoubted 
 service. 
 
 My brother, the late Dr. Thomas Keith, 
 was recovering slowly from a severe attack 
 of scarlet fever. He was a most temperate 
 man, and rarely took any liquor whatever. But 
 quite unexpectedly to himself he took a great 
 desire for sherry, a wine that he had never 
 cared for. He got it, and was astonished to 
 find it so good. Every drop of it he spoke 
 of as nectar ; he looked forward to enjoying 
 sherry all the rest of his life, and could not 
 understand how he had not discovered its 
 value sooner. He certainly did well upon it, 
 and made a more rapid recovery than he 
 otherwise might have done. But, after 
 taking two bottles in the course of a fort- 
 night, he was equally astonished to find that
 
 ON STIMULANTS 39 
 
 the pleasure from it was gone, and he never 
 cared for sherry since. This case and others 
 have led me to what I believe is the proper 
 use of wine and other stimulants. If one 
 who is not, and has never been, in the habit 
 of taking wine or alcohol feels a natural 
 desire or crave for it, I usually let him have 
 it, but I always tell him to stop at once when 
 he finds he no longer cares for it. It is 
 rarely wanted for above a few days, or at the 
 utmost for a week or two, when it may be 
 stopped without the slightest difficulty. Un- 
 fortunately this rule is not followed by most 
 medical men. Their patients, on the con- 
 trary, have pointed out to them the benefit 
 they have clearly got from the stimulant, and 
 they are told to continue it. If they do so 
 for another week or ten days after the desire 
 has gone off, the original enjoyment does 
 not return, but in its stead the stimulant has 
 already created a want asking to be supplied, 
 a bad habit is formed, and the result may be 
 most unfortunate.
 
 40 FADS OF AN OLD PHYSICIAN 
 
 I have met with unfortunates, especially 
 ladies, who have strongly blamed the doctor 
 or the nurse for launching them on a course 
 of intemperance from which they could find 
 no escape. In the too rare case where an 
 acquired habit of intemperance has been 
 given up, I know of no circumstances in 
 which I would order any alcoholic stimulant ; 
 and some of the cases given in my ' Plea ' 
 will show that even in extreme states of 
 debility we can get on very well without it. 
 For those who have once fallen victims to 
 intemperate habits there is no safety but in 
 absolute abstention. 
 
 From purely medical treatment I have 
 known very little benefit in cases of con- 
 firmed intemperance. Some of the numerous 
 vaunted cures may be of use, but I have no 
 experience of them. But in one case the 
 effect of a powerful and now old-fashioned 
 remedy was very gratifying. A young 
 married lady after her first confinement gave 
 way to intemperate habits. She blamed the
 
 ON STIMULANTS 41 
 
 nurse, but of this I was by no means certain. 
 She got worse and worse, though her 
 husband used all possible measures short of 
 absolute seclusion for her reformation. At 
 length she got so violent that, fearing it 
 might be necessary to lay her up, I asked 
 the husband if her friends, who lived in Eng- 
 land, knew anything of her condition. He 
 told me they did not. I advised him to take 
 her to them, and leave her with them for a 
 time. She remained for several months, and 
 when she came back she was perfectly cured. 
 The doctor of her family tried a remedy, with 
 which I was told he had succeeded before. 
 He put her to bed, gave her mercury to the 
 extent of causing severe salivation, and this 
 he kept up for six weeks. At the end of 
 this treatment her system seemed to have 
 undergone a great change, and for several 
 years, when the family left Edinburgh, she 
 remained perfectly well. 
 
 I have long been convinced that there is 
 a causal connection between a free use of
 
 42 FADS OF AN OLD PHYSICIAN 
 
 flesh foods and an inclination for stimulants, 
 especially in the young. Roast beef is 
 perhaps the most sapid food that exists. 
 Desire gratified leads to a demand for some- 
 thing higher in the same line. This cannot 
 be had from food, but it may from drink. 
 This seems a very vague mode of argument, 
 but I have known cases for which I could 
 give no other or more rational explanation. 
 Many years ago my old friend Dr. Farquhar, 
 physician to the Governor-General of India, 
 asked me to take him to Morningside 
 Asylum, and introduce him to the physician, 
 Dr. Skae. There was, he told me, a proposal 
 to set aside part of the fort buildings of Agra 
 as an asylum for intemperate British soldiers, 
 with a view to their reformation, by keeping 
 them for a time from the use of all strong 
 drink. Dr. Farquhar wished first of all to 
 ascertain what might be expected from such 
 a course. Dr. Skae at once threw cold water 
 on the scheme. He said that in his ex- 
 perience forced abstinence was of no use, and
 
 ON STIMULANTS 43 
 
 a patient, after being with him for twelve 
 months, was very likely to go wrong on the 
 first day of his freedom. My friend was 
 much disappointed, and I do not know if the 
 experiment has ever been tried. But Dr. 
 Skae's patients were kept on full flesh diet. 
 Some time after this, a young friend of mine 
 who went so far wrong from drink that he 
 could not be kept at home, was sent to an 
 establishment in America which had a name 
 for reforming youths in his condition. The 
 manager, an enthusiast, had given evidence 
 in London when an inquiry was made by the 
 Government as to whether more power might 
 be given to medical men to lay up for a time 
 those who, through indulgence in drink, had 
 become a nuisance to the community. This 
 gentleman stated that in his establishment 
 cures were made of 30 per cent of those 
 who remained long enough and submitted to 
 his rules. This, Dr. Skae said, was simply 
 untrue ; it was so different from his own 
 experience. No explanation was given as to
 
 44 FADS OF AN OLD PHYSICIAN 
 
 the methods of treatment. Shortly after this 
 my young friend entered this same establish- 
 ment. He was accompanied by a faithful 
 servant of his family, an old cook. The 
 cook remained for a time, and he by and by 
 wrote the mother of the youth, giving an 
 account of the establishment in his own way, 
 rather a graphic one. Part of the letter the 
 lady copied for me, and it was to the follow- 
 ing effect. He was pleased with everything 
 except the cooking, and he asked the negro 
 cook why he always spoiled the good meat. 
 The answer was, ' Meat not good for the 
 thirst ; if meat not good, must eat what is 
 better for them. 'Cos why ? must eat some- 
 thing, you know.' Besides the beef and 
 mutton which were always spoiled, there was 
 abundance of lighter food well cooked, and at 
 all meals there was a large supply of apples 
 in all forms. This explained to me the 
 success of the doctor, though but for the 
 accident of the cook being there I would not 
 have heard how it was brought about. My
 
 ON STIMULANTS 45 
 
 young friend, who had got to live very much 
 on roast beef, would not have gone near the 
 place had he known he should get none of 
 his favourite victuals ; and he would no doubt 
 take the badly-cooked meat till he discovered 
 that there was something better. As a large 
 board was charged, and meat is cheap in 
 America, it was no doubt found more profit- 
 able to spoil the meat every day than to 
 frighten away new-comers by a premature 
 disclosure. I read the letter to Dr. Skae, 
 and he was obliged to own that there might 
 be something in it. 
 
 Some years later I happened to come 
 across the report of another establishment in 
 America for the same purpose. In this 
 report the doctor states that during twenty- 
 five years he has cured 98 per cent of those 
 who submitted to the rules. The main treat- 
 ment was abstention from all flesh food 
 whatever. He says that there is something 
 in this that, if it is indulged in, renders the 
 cure of intemperance impossible. If ab-
 
 46 FADS OF AN OLD PHYSICIAN 
 
 stained from, the crave for drink by and by 
 passes away and does not return. Another 
 rule he mentions which recommends itself 
 specially to me ; it is, that if any one falls 
 sick while under his care, he must get well 
 the best way he can without any medicine 
 whatever. In the numerous cases of intem- 
 perance I have had to treat, I have acted as 
 far as possible on the principles stated, and 
 have had at least a fair share of success, but 
 under present circumstances it is very difficult 
 to carry out thoroughly any such plan ; and 
 this has shown me very strongly the necessity 
 for preventive treatment as the real method 
 of getting rid of a horrid evil. Here also 
 ' strong meat ' is only for those ' of full age,' 
 and under some circumstances not even for 
 them.
 
 IV 
 
 ON SELF-MASSAGE 
 
 WHAT is now called massage has come much 
 into use in recent years for numerous ail- 
 ments. Under the old name of rubbing I 
 have long been familiar with its great and 
 varied usefulness. One of my oldest recol- 
 lections is of a boy who was going about on 
 crutches. The doctors could do nothing for 
 him, but an ' old wife ' undertook to cure 
 him, and did so merely by rubbing. He 
 soon discarded the crutches, and is now one 
 of the oldest of the Scottish clergy. There 
 have been rubbers in Edinburgh almost as 
 long as I have been there, and I have known 
 good work done by them. Massage has now 
 been taken up by the profession ; like other
 
 48 FADS OF AN OLD PHYSICIAN 
 
 good things it may be abused, and it has 
 been. I have long known its use in rheu- 
 matism, both for relief of pain and still more 
 for preventing or relieving stiffness of joints 
 and muscles. I have frequently known its 
 good effects to be lost, from its being done at 
 first too strongly and for too long a time. 1 1 
 exhausts, and is discontinued. This arises 
 very much from the usual mode of remunera- 
 tion of the masseur being at so much an 
 hour; and canny Scotch people like to get 
 the good of their money. Many also find 
 that though it gives relief for a time it requires 
 repetition, and this and the cost disheartens 
 them. Quite one-half of my friends who have 
 tried it have given it up for these reasons. 
 Some rub on no plan, even of those who have 
 been trained, and when they cause pain at 
 any point they avoid it, whereas in proper 
 cases the pained or tender parts are exactly 
 those which should be acted on though 
 gently at first, and at short intervals till the 
 pain is removed
 
 ON SELF-MA SSA GE 49 
 
 Having been rheumatic from my youth, 
 and of a strong inherited gouty diathesis, I 
 have had abundant experience of both rheu- 
 matism and gout in the chronic form ; and 
 after all, one's own body is the best corpus 
 vile to experiment on. I have thus become 
 aware of the advantages of rubbing oneself, 
 which I have had occasion to do for a large 
 portion of my life, but more in recent years ; 
 and I have no doubt whatever that but for 
 this useful habit, I would long ere now have 
 been as distorted, stiff, and helpless as were 
 some of my forbears. I have had to do it 
 many times a day if I have remained long in 
 one position ; or have over-exerted some 
 muscle, which frequently brings on pain ; but 
 this is easily removed if the rubbing is had 
 recourse to at once. Chiefly, however, the 
 rubbing is done at night, and before getting 
 up, when ten minutes' work lets me rise 
 supple and fresh, instead of stiff and languid. 
 There is a knack in it, and many cannot do 
 
 it with any satisfaction to others ; but with a 
 
 4
 
 50 FADS OF AN OLD PHYSICIAN 
 
 little perseverance I believe that most can do 
 it for themselves, and with this advantage 
 that each one knows best for himself what are 
 the aching parts, and he can take his own 
 time. 
 
 It is amazing how many pains may be 
 relieved in this way other than in the muscles 
 and tendons, as in the head, the intercostal 
 spaces, and the surfaces of the joints, especi- 
 ally the knee-joint. The pains over bones 
 seem to arise from congestion of the peri- 
 osteum. On touching the part tenderness 
 is felt at once, which comes to pain after a 
 slight rubbing, but by continuing this, then 
 stopping for a few minutes, and again re- 
 peating the process, the pain and tenderness 
 pass off, and in some cases do not return. I 
 have known a pain in the knee on attempting 
 to move it, of months' standing and so bad 
 as to stop walking almost entirely, removed 
 permanently by one rubbing, followed by an 
 occasional rub by the patient himself. I 
 have also known very long-standing pain,
 
 ON SELF-MASS A GE 5 1 
 
 seemingly of a rheumatic character, removed 
 at once by passing through the part a large 
 volume of galvanism, such as is used by Drs. 
 Apostoli and Keith in cases of fibroid uterine 
 tumours. Here probably there is a molecu- 
 lar massage of the muscle or part affected, 
 and I have had personal experience that it is 
 very effective. 
 
 But my chief reason for mentioning mas- 
 sage here is, that I may take this oppor- 
 tunity of giving somewhat in detail a use of 
 it which so far as I know is new ; at least, in 
 four years I have come across no one who 
 had heard of it. 
 
 During the whole period of my profes- 
 sional life, being of a very nervous tempera- 
 ment, and having peculiar views as to the 
 mode of treating my patients, mostly antago- 
 nistic to those held by others, I often had 
 times of great anxiety. Sometimes, besides 
 pure mental trouble, I was conscious of a 
 dull physical sensation in the region of the 
 heart, rarely amounting to pain, but in a few
 
 52 FADS OF AN OLD PHYSICIAN 
 
 instances, when very much exhausted as well 
 as anxious, with acute pain. On one occa- 
 sion this got so severe as to feel intolerable, 
 and had I not gone home and at once taken 
 a full dose of chloroform I felt that I should 
 have died. After giving up practice I had 
 little or none of this feeling for many years ; 
 but some four years ago I got as a trustee 
 into a very troublesome lawsuit which 
 worried me very much. The old well- 
 known feeling returned, though never to the 
 extent of causing pain. Naturally, somehow, 
 I often found myself rubbing the upper part 
 of the chest, especially over the heart, and 
 there must have been some relief in this, as 
 I often had recourse to it. One night, for 
 it was then I was most frequently affected 
 in this way, I found a distinct tenderness in 
 the space between the first and second ribs 
 of the left side, apparently in the intercostal 
 muscle ; and, as I had done in different 
 parts of the body before whenever I felt 
 such tenderness, I began to rub it. After
 
 ON SELF-MASSAGE 53 
 
 getting rather sore for a short time, the 
 tenderness went off, and to my astonishment 
 and delight the peculiar feeling of oppression 
 went with it. At the same time I felt in- 
 clined to take several full breaths. I have 
 often had the same experience since, and 
 have invariably got relief in the same way. 
 The relief is very great ; it somehow enables 
 one to take a more satisfactory view of what 
 is causing the trouble, and, what is even of 
 more consequence, it makes it possible to 
 forget it, and to go quietly to sleep, which 
 before was impossible. After a sleep there 
 may be a return of the feeling, but a very 
 little rubbing now at once removes it. 
 
 Before making this discovery I had been 
 very sure that the worst attacks I had long 
 ago were of the nature of angina, the essence 
 of which seems to be intense anxiety accom- 
 panied or not with pain. Of the few old 
 friends who when sick would still see no 
 one but myself, there were two who had 
 occasional attacks of that most serious
 
 54 FADS OF AN OLD PHYSICIAN 
 
 trouble, and I took the first opportunity of 
 trying if they could be relieved in the same 
 way, and the result in both cases gratified 
 me very much. One was a retired medical 
 friend who had already, on two or three 
 occasions, alarmed his friends by falling 
 down by the roadside when on a walking 
 tour. He also had some attacks very like 
 angina, coming on in bed, and always the 
 precursor of a bilious attack which, after a 
 few days' sickness and vomiting, left him all 
 right again. One morning I was sent for, 
 and I found him at 6 A.M. suffering from 
 severe angina which had lasted for some 
 hours. There was little or no pain, but 
 intense anxiety and oppression in breathing. 
 On being pressed pretty firmly with the point 
 of the finger between the first and second 
 ribs on the left side, he at once complained of 
 pain. I commenced rubbing, at first very 
 gently, and then somewhat more strongly. 
 At once he felt relieved, and took full deep 
 breaths which were before impossible, and in
 
 ON SELF-MASSAGE 55 
 
 a very few minutes the fit was over and did 
 not return. He had his bilious attack, how- 
 ever. Several months after I was sent for 
 again. I arrived at his house at midnight, 
 and found that he had got so much worse 
 that my friend Dr. Wyllie had been called 
 in. He had given a dose of nitro-glycerine, 
 which had relieved him considerably, so I 
 went to bed after a talk with Dr. Wyllie on 
 my new method. In half an hour I was 
 sent for ; the symptoms had returned. I 
 found the old tenderness, and relieved it and 
 the other symptoms just as formerly, and I 
 had no further call during the night. The 
 bilious turn, however, came on, and was a 
 bad one. After this he was most careful in 
 his mode of life and in avoiding climbing 
 any height, and he got to enjoy really good 
 health for several months, with no heart 
 trouble whatever ; but one day he was 
 walking up a steepish street to attend a 
 meeting, and had perhaps hurried a little. 
 He fell down on the street, was at once
 
 56 FADS OF AN OLD PHYSICIAN 
 
 carried into a shop, and then into a cab, 
 but before it reached the infirmary, which 
 was close by, he was dead. On the former 
 occasions of his falling down he was allowed 
 to remain till he was better. So far as I 
 know his heart was a sound one for his age, 
 which was much about my own. 
 
 My other patient is a lady, about the same 
 age, who has suffered from heart disease for 
 at least forty years. I was about that time 
 cautioned by her uncle, a medical man, not to 
 give her chloroform at her first confinement, 
 she had so bad a heart. It looked as if there 
 must be some aneurismal swelling in the 
 immediate vicinity of the heart, the throbbing 
 was so great to the sight as well as to the 
 touch. She never would permit a proper 
 examination to me or to any one, so I do not 
 know what may be the real condition of the 
 organ. But all along she has been one of the 
 most careful livers I ever knew, mostly a 
 vegetarian, and a very small eater of any- 
 thing. For many years she could not go up-
 
 ON SELF-MA SSA GE 57 
 
 hill, and for the last three or four years she 
 has had attacks of real angina. One day, 
 nearly three years ago, I found her ill. She 
 at once complained of the tenderness between 
 the first and second ribs as in the former case, 
 and was as speedily relieved. I had pre- 
 viously given her nitro-glycerine and amyl, 
 but they had little effect. A year later she 
 told me she had no relief from them, but 
 always from the rubbing, which she did for 
 herself. Two summers ago I found her at 
 the seaside some distance from her house 
 and looking better than I had seen her for 
 years. 
 
 About four years ago I had a meeting in 
 London with a friend who was equally con- 
 cerned in a troublesome lawsuit with myself. 
 Our business was a particularly anxious one. 
 Something in his look made me think that 
 my friend was suffering in the way I have 
 described. I asked him to let me give his 
 chest a rub, to which he agreed. There was 
 no tenderness, or it was very slight, and he
 
 58 FADS OF AN OLD PHYSICIAN 
 
 thought only from the friction. At the 
 moment he did not speak of any change, but 
 within two minutes he got up, stretched him- 
 self quite erect, took a full breath or two, and 
 said that somehow he felt ever so much better. 
 About a year afterwards he was found dead 
 in bed, and the cause was ascertained to be 
 a fatty heart. 
 
 We have here three instances of relief 
 from a most simple procedure, and in each the 
 condition of the heart was very different from 
 that of the others. It would seem that the 
 structural condition of the heart has little to 
 do with this peculiar form of physical oppres- 
 sion. The most common cause, so far as I 
 can judge, is a purely nervous one, brought 
 on by a strong mental impression, and giving 
 rise to some local congestion. It must act 
 through some of the nerves which supply the 
 heart, and probably through the pneumo- 
 gastric, which also goes to the stomach. 
 This is rendered more probable by the fact 
 that in some cases of worry the oppression is
 
 ON SELF-MASSAGE 59 
 
 felt over the stomach just below the end of 
 the sternum. When this is so, tenderness 
 is felt in that locality, affecting apparently the 
 superficial muscles, and the relief by rubbing 
 is very much the same as is got by rubbing 
 between the first and second ribs. This I 
 have often observed in myself and others. 
 In a very few instances I have found that the 
 tenderness was greatest between the second 
 and third ribs, and sometimes it extended 
 slightly to the opposite side. 
 
 In other cases of nervous shock or of 
 great anxiety and distress we have undoubted 
 local congestions, which are relieved by secre- 
 tion of different fluids. Thus a sudden terror 
 is often followed by a cold sweat ; great 
 doubt as to anything much feared, or even 
 hoped for, may bring on a copious flow from 
 the kidneys, or more rarely from the bowels. 
 Students going up for examination are well 
 acquainted with this. Deep sorrow relieves 
 itself by a flood of tears and it is always 
 well when this relief comes. In all these.
 
 60 FADS OF AN OLD PHYSICIAN 
 
 cases there must be some congestion, that is, 
 an additional flow of blood to the part from 
 which the secretion comes. As there is no 
 secreting organ in the region of the heart 
 except serous surfaces which do not seem to 
 be affected in this sudden way the mechan- 
 ism of relief from oppression in that quarter 
 must be different. In some states of sorrow 
 relief is got by a succession of sobs that is, 
 of strong spasmodic breathing after periods 
 of very imperfect respiration ; these tend to 
 quicken the circulation through the heart and 
 lungs, and relieve congestion in this way. 
 If the imperfect respiration is long continued, 
 and if this leads to congestion and tenderness 
 of the intercostal muscle, the gene to the 
 respiration will be still more increased till it 
 may bring on a fit of real angina. In this 
 condition, or in the slighter forms of the same, 
 smart friction to the affected intercostal 
 muscle may at once remove its congested 
 state and tenderness, and thus allow, or per- 
 haps excite, a freer respiration, and this in
 
 ON SELF-MASSAGE 61 
 
 its turn may quicken the circulation through 
 the heart and lungs and remove the feeling 
 of oppression and anxiety. Whatever be the 
 modus operandi the salutary effect is un- 
 doubted, and the relief is immediate and 
 great. 
 
 The connection of the heart with the 
 stomach, most probably through the pneumo- 
 gastric nerve, has been long familiar to me, 
 and here the value of simple living comes 
 in very strongly. Every one knows that a 
 full stomach, whether from food or from 
 flatulence, often brings on derangement of 
 the heart's action, it may be to a very serious 
 or even fatal degree. But the quality of the 
 food is of equal importance with the quantity. 
 Savoury food, such as roasted beef above 
 all, attracts blood to the stomach at once, as 
 well as to the tongue and gullet. This I 
 have frequently known to affect the heart 
 in a very remarkable degree. A good many 
 years ago I was asked to look after a well- 
 known Edinburgh literary man. He was
 
 62 FADS OF AN OLD PHYSICIAN 
 
 a very powerful man alike in mind and body, 
 and had enjoyed excellent health. He was 
 past middle life. He was blessed with an 
 excellent stomach, and had taken full ad- 
 vantage of it ; but for some years he had felt 
 something wrong in the region of the heart. 
 By the time I saw him this had come to 
 very frequent attacks of angina, from which 
 his only relief was by inhaling amyl ; but he 
 was now getting quite unfit for his literary 
 work, he had to give up all his outdoor pur- 
 suits, and latterly he could scarcely walk across 
 the floor without a threatening of an attack. 
 He had not been dieted in any way, but 
 naturally his appetite was not what it had 
 been. I stopped all stimulants at once, and 
 still more emphatically all beef and mutton, 
 and recommended great moderation in simpler 
 food. He very soon began to improve, was 
 able to resume his literary work, and even 
 in a moderate degree shooting and fishing, 
 of which he had been very fond. His attacks 
 of angina became very few, and I daresay
 
 ON SELF-MASSAGE 63 
 
 they never came on without a cause. On 
 three occasions only during a period of four 
 years he partook of beef at dinner, and on 
 all three he had one of his worst attacks. 
 I was beginning to hope that the angina was 
 of an entirely functional character, and that 
 with great care his life might be a prolonged 
 one. He was preparing to go to his place 
 in the country, and had on the previous day 
 done more than his usual amount of literary 
 work, which he accomplished with ease ; but 
 in the morning he was seized with a severe 
 attack of his ailment. This continued, and 
 was followed by pneumonia and inflamma- 
 tion of the heart, and after a hard struggle 
 he died. On examination the heart was in 
 one part found to be riddled with small 
 deposits of pus, and one of the coronary 
 arteries was found so contracted that a 
 minute bristle could not be passed into it. 
 The other organs, except the liver, which 
 was somewhat enlarged, were splendidly 
 healthy ; the brain was about the largest we
 
 64 FADS OF AN OLD PHYSICIAN 
 
 had ever seen ; and had our much-honoured 
 friend lived a simpler life all his days he 
 might well have attained to his hundred 
 years. As it was, considering the condition 
 of the coronary artery, which is the most 
 fatal cause of angina, the comparatively good 
 health he enjoyed for four years was remark- 
 able, and it was no doubt due entirely to his 
 changed mode of life.
 
 V 
 
 HOT WATER 
 
 THE drinking of hot water as a remedy has 
 come much into vogue in recent years. I 
 take this opportunity of telling how it has 
 come into general use. It was recommended 
 to me for headache by Dr. Merei of Pesth, 
 afterwards of Manchester. I was then living 
 too fully, and I could not take it ; it brought 
 on fulness about the head. When later, 
 after having given up the use of butcher's 
 meat, I took to it again and found its great 
 value, Dr. Merei was dead, and I never 
 knew what were his ideas about it ; he died 
 in 1857. It often enabled me to go on 
 working longer, and it sometimes kept off 
 a chill or a threatened headache. This it 
 
 5
 
 66 FADS OF AN OLD PHYSICIAN 
 
 did, no doubt, partly by diluting acrid matters 
 in the stomach, and partly by its stimulating 
 effects enabling the organs to get rid of 
 these, and to send the blood to the surface. 
 This was the introduction of hot water as a 
 remedy into Scotland. Gradually it came 
 to be used by my patients, and by a few 
 medical men ; and by and by it spread into 
 England also. A few years ago the Edin- 
 burgh Medical Journal spoke of me as the 
 'Apostle of Hot Water.' The writer 
 thought he had got me into a difficulty 
 about the 'Salisbury Treatment,' of which 
 we have heard so much lately, where hot 
 water, combined with beef in huge quantity, 
 is said to work wonders. He well knew my 
 antipathy to the latter, and he did not see 
 how I could explain the good results. Some 
 ten years ago there was a great run on hot 
 water in London. I have not heard so much 
 of it there lately, and I suspect that like most 
 good things it also was abused, and may 
 have fallen somewhat into discredit. During
 
 HOT WATER 67 
 
 all the time I have used it I have only come 
 on two individuals who had discovered its 
 value for themselves. 
 
 Hot water may be used properly as a 
 diluent, as a stimulant, or as a food ; and 
 all these actions may be usefully combined 
 in the same case. 
 
 As a diluent its action is so manifest that 
 little need be said. Cold or tepid water has 
 much the same effect. Its only perfectly 
 safe competitor that I know is liquorice, of 
 which I speak elsewhere. 
 
 Hot water acts as a stimulant by supply- 
 ing ready - made heat or force, when the 
 organs are not able to form the same by 
 the ordinary digestion of carbonaceous food. 
 Hot water thus aids, or rather supplements, 
 the chemical actions of the system. Alcohol, 
 on the contrary, checks these actions, and its 
 effect therefore is to lower the activity ol the 
 system that is, to reduce the strength for 
 the time ; or at the best it may give, through 
 some obscure nervous action, a short-lived
 
 68 FADS OF AN OLD PHYSICIAN 
 
 fillip ; but this is speedily followed by re- 
 action and by an increase of weakness. I 
 have given in the ' Plea ' cases to show that 
 this stimulating action of hot water is suffi- 
 cient to bring the body out of the very 
 lowest condition as to strength, and that in 
 cases where alcohol had entirely failed to do 
 so. I could give numerous instances of the 
 same kind. 
 
 A medical friend who was liable to very 
 severe headaches, which prostrated him for 
 days, was spending some time in London. 
 On the evening before he left he entertained 
 some friends to dinner, and, being very 
 hospitable, he showed them a good example, 
 and took a hearty meal. Next morning he 
 awoke early, and was much annoyed to find 
 one of his headaches coming on, as it was 
 most inconvenient for him to delay his return. 
 He bethought him of the hot water, which he 
 had often heard of from me but had been in- 
 clined to laugh at. He rang his bell and asked 
 ' Boots ' to bring him a large jug of very
 
 HOT WATER 69 
 
 hot water. This he drank right off and lay 
 down. He fell asleep, and in a few hours 
 awoke quite free from headache and ready 
 for his journey. I read a similar story told 
 in an amusing manner in an American 
 periodical, where the effect of a huge drink 
 of hot water was equally successful. 
 
 Before America was opened up from west 
 to east, as it is now by railways, two English 
 gentlemen took the journey across a great 
 portion of the continent on foot ; their only 
 provision was hard biscuits and a spirit-lamp 
 to boil water. The hot water they used at 
 first to soak the biscuits in, but they soon 
 began to drink it, and were astonished and 
 pleased to find that it acted as a powerful 
 stimulant and producer of strength. Till 
 they thus accidentally made the discovery 
 they had no knowledge of the strengthening 
 virtues of hot water, and they acknowledged 
 the benefits they derived from it in their long 
 and perilous wandering. Hot water acts as 
 a food under precisely the same circumstances.
 
 70 FADS OF AN OLD PHYSICIAN 
 
 Carbonaceous food, if only enough and no 
 more be taken for daily need, goes to burn in 
 the system, and to form bile. 1 If more is 
 taken, and if the digestive organs are healthy, 
 the surplus is stored up as fat, to be used 
 subsequently as circumstances may require. 
 If no carbonaceous food can be usefully taken, 
 the heat in the water takes its place, and may 
 alone supply the wants of the system, or may 
 supplement the fat laid past, which also now 
 comes into use ; and it is in this way that hot 
 water acts as a true food. It would take a 
 considerable amount of carbon fuel, say in 
 bread and butter, to produce the quantity of 
 heat in hot water. 
 
 Hot water is abused if advantage is taken 
 of its stimulating action to force more food 
 through the organs than is wanted. It gives 
 great relief for the time in this way, and it 
 
 1 I am not speaking here quite scientifically, but suffi- 
 ciently so for the purpose. A larger or smaller quantity of 
 carbon in the food passes undigested. Hence in many 
 climates the dung of animals, such as the camel, is often 
 the principal article of fuel.
 
 HOT WATER 71 
 
 may be gone on with for a long period. But 
 the ultimate effect on the overtaxed organs 
 can be nothing but hurtful. It is in this way, 
 I fear, that most use it. Under some cir- 
 cumstances this may be allowable and even 
 salutary for a time, when an error has been 
 already made, and if care be taken that the 
 error is not repeated. Drinking hot water 
 may also, in a small degree, take the place of 
 exercise, by increasing the action of the heart 
 and lungs, and thus of the nervous system. 
 
 The first time I knew of hot water being 
 taken as a remedy was in dining in 1834 in 
 London with the widow of Admiral Lord 
 Keith. She took no wine, but half an hour 
 after dinner she sipped a large wine-glass of 
 quite hot water, and she ascribed much of 
 her good health to this practice. She said 
 she had used it regularly for thirty years by 
 the advice of her doctor, whose name I 
 forget. She was Dr. Johnson's favourite 
 pupil, his 'Queenie,' daughter of Mrs. 
 Thrale.
 
 72 FADS OF AN OLD PHYSICIAN 
 
 Since this volume went to press, I noticed 
 in the British Medical Journal, 6th March 
 1897, a short article on 'John Hunter as a 
 Physician,' from which I extract the follow- 
 ing (the article refers to Dr. Newton 
 Pitt's oration before the Hunterian Society 
 in 1895): 'Dr. Hunter was the subject of 
 vertigo, and suffered from noises in his ears 
 and insomnia. Nothing gave him relief till 
 he took a tumblerful of hot water every night 
 just before going to bed. This gave him a 
 good night's rest. So impressed was he 
 with the value of this simple therapeutic 
 measure that he frequently prescribed it for 
 patients with irritable stomachs, and with the 
 greatest success. I have often found a 
 glass of hot water useful for insomnia, but 
 in two cases it had to be given up as it 
 brought on irritability of the bladder an- 
 other cause of insomnia, particularly in elderly 
 people. A glassof milk, which also sometimes 
 relieves insomnia, may cause the same irrita- 
 tion, and with children frequently does so.
 
 HOT WATER 73 
 
 The ' Salisbury ' treatment of most 
 chronic complaints by hot water and beef 
 has had a considerable run in recent years, 
 and the immediate effect of this strange 
 combination has in many cases been highly 
 satisfactory. Here the relief to the stomach, 
 liver, and other organs of digestion is enor- 
 mous, inasmuch as ready-made caloric takes 
 the place of the more crude fuel from which 
 heat is usually manufactured. If carbon- 
 aceous food had been used in too great 
 quantity and it is in a great measure in 
 many cases the cause of illness the relief 
 of symptoms may be very great. But 
 what about the ultimate effect on the great 
 eliminating organs of nitrogenous foods, the 
 kidneys, when such a large addition to their 
 work is thrown upon them by the enormous 
 quantity of flesh taken, which must be dis- 
 posed of somehow ? For a time, no doubt, 
 the stimulus of the hot water will enable the 
 kidneys to do more work with ease and 
 comfort to the patient, and with no signs
 
 74 FADS OF AN OLD PHYSICIAN 
 
 of mischief, such as soon show themselves 
 when the excess is in carbonaceous food. 
 I believe that an equally satisfactory cure 
 could be got in the same cases, by stopping 
 for a time most or all carbonaceous food, 
 which may be replaced by hot water ; 
 giving a moderate amount of nitrogenous 
 food, but not necessarily beef; and resuming 
 a more natural and rational mode of living 
 as soon as the overloaded organs have 
 recovered their functions. I think I have 
 seen quite as brilliant and almost as rapid 
 results from this mode of treatment, and 
 common sense might tell us that they will 
 be much more permanent. I am by no 
 means sure that the plan of Dr. Dewey, 
 of abstinence from all food for the necessary 
 time, may not be a still better method. It 
 has the virtue of simplicity, and he has 
 shown it to be safe. 
 
 I had a couple of years ago the pleasure 
 of lunching with Mrs. - , the apostle of 
 the Salisbury treatment in this country. She
 
 HOT WATER 75 
 
 lunched on a large quantity of beef pure and 
 simple, more, certainly, than I ever before 
 saw taken at one meal by man or woman. 
 My lunch was a modest supply of straw- 
 berries and cream, a very common mid-day 
 meal when I can get it. After lunch we had 
 a long talk, when I pointed out to her that I 
 had taken practically no beef for forty years, 
 and now enjoy better health than when I 
 gave it up ; while after some five or six 
 years of a very full beef diet, she did not 
 seem to me to be in better health than 
 before. She had during these years some 
 very serious illnesses which, I believe, had 
 enabled her to continue her system. In her 
 last book she has modified her treatment, 
 and she only recommends one pound of beef 
 to be taken daily, instead of as much as 
 could be taken, or could be got by her 
 poorer patients. She also recommends some 
 carbonaceous food, as biscuit. I cannot help 
 thinking that had she taken my advice when 
 a mutual friend asked me to see her pro-
 
 76 FADS OF AN OLD PHYSICIAN 
 
 fessionally years ago in London, when she 
 was a great sufferer from rheumatic and 
 other ailments, and had she then reduced 
 her diet generally till she could digest it 
 properly, the good effect might not have 
 been so brilliant as it was when she adopted 
 the hot water and beef treatment, but it 
 might have been more permanent. But my 
 mind is always open to conviction, and I 
 have been watching with much interest this 
 curious episode in the history of medicine.
 
 VI 
 
 LIQUORICE 
 
 LIQUORICE as a remedy has hitherto been 
 very little known, if at all. But it has some 
 most useful properties. For relieving the 
 symptoms caused by acrid matters in the 
 stomach, I know nothing to equal it, and 
 I have used it for this purpose for at least 
 forty years. It does not, like alkalies, con- 
 vert acids into more or less inert salts, but 
 it seems to remove their irritating -effects 
 in some other way, and the result in relieving 
 the irritation of the nerves of the stomach 
 is much the same. Many object to the use 
 of alkalies, especially of soda if used fre- 
 quently and in large quantities, as it often 
 is, as injuring the coats of the stomach, and
 
 78 FADS OF AN OLD PHYSICIAN 
 
 thus doing permanent mischief. No doubt 
 this action may be from the use of the soda 
 prolonging the period during which relief 
 from the acid can be readily got, and the 
 mucous surface may be injured by the con- 
 stant recurrence of the acidity rather than 
 from the soda. But this evil does not attend 
 the use of liquorice. It in some way of its 
 own for it is neither from mere dilution 
 nor from neutralising the acid removes the 
 irritable quality of the acid or acrid mass, 
 and adds nothing deleterious to the contents 
 of the stomach. It certainly relieves, often 
 in a very remarkable way, the innumerable 
 pains and discomforts, mental and bodily, 
 which arise from irritation of the gastric 
 nerves, as local pain of stomach or bowels, 
 headache, sleeplessness, lowness of spirits, 
 or irritability and general misery. 
 
 I have known relief from liquorice in a 
 very large number of cases both of dyspepsia 
 and sleeplessness. I may mention two of 
 these.
 
 LIQUORICE 79 
 
 A lady from Forfarshire consulted me for 
 severe dyspepsia. She got rid of all her dis- 
 comforts except pains in the small intestine, 
 which came on about three hours after taking 
 food. This proved very difficult to remove, 
 till it occurred to me to recommend liquorice 
 in large quantity before food. This at once 
 relieved the pain, and permanently. Either 
 it soothed an irritable bit of the bowel, or it 
 prevented some change in its contents, which 
 may have come on in the course of digestion 
 at a distance from the stomach. 
 
 I met one day in the street a friend who 
 afterwards developed general paralysis. He 
 was a strong healthy man who lived well, 
 and did a large amount of head-work. He 
 slept badly, and had found that for a time 
 a good tumbler of whisky and water enabled 
 him to sleep better. This, however, had lost 
 its effect. He was induced to take a less 
 full diet for a time, and he got to sleep at 
 least as well without the whisky. But on 
 the day I met him he told me he was again
 
 8o FADS OF AN OLD PHYSICIAN 
 
 sleeping badly, and I advised him to take a 
 piece of liquorice on going to bed. The 
 next time I saw him he said the liquorice 
 had been a great success, and he was using 
 it, and was sleeping much better. 
 
 Liquorice may, of course, be abused if 
 taken to enable one to consume with less 
 immediate discomfort too much or improper 
 food, but of itself it seems to have no evil 
 qualities whatever. It has antiseptic proper- 
 ties, and is used to preserve such articles as 
 fluid extracts of coffee, but the taste it gives 
 to these is not agreeable. To most it is 
 pleasant to take, and I have sometimes given 
 it in considerable quantity. In quality it 
 varies greatly. Solazzi brand is perhaps 
 the best, but good Pontefract cakes are a 
 very handy form, and there are some excel- 
 lent concentrated forms in small pellets, 
 which are to be had from a good druggist. 
 
 Many years ago when visiting a lady in 
 East Lothian, I mentioned to the doctor 
 that his patient might be benefited by
 
 LIQUORICE 8 1 
 
 liquorice. He then told me he also had 
 found it very useful, but in a way I had 
 not known. Many of the farm servants, who 
 were perpetually smoking strong tobacco, 
 found by and by that their stomachs were 
 so much affected that they could not look at 
 breakfast till they had a smoke ; this was 
 always relieved by taking a bit of liquorice 
 on getting up. He said he had got great 
 credit from their wives for this prescription, 
 so I concluded that the men's temper had also 
 suffered. This is the only occasion on which 
 I found a doctor who knew the value of 
 liquorice, but I have heard of its being used, 
 and much prized, by old people a generation 
 or two back.
 
 VII 
 
 ON CANCER 
 
 SEVERAL years ago I read in the British 
 Medical Journal a debate on Cancer in one 
 of the London Medical Societies. Two or 
 three of the surgeons who took part in the 
 debate spoke of starvation as the only 
 remedy for the disease. This interested 
 me much, as I had not noticed similar views 
 in any medical literature with which I was 
 acquainted. I had long known, however, 
 that high living, that is, the use of wine and 
 other stimulants, and of strong animal food, 
 aggravated in an extraordinary manner all 
 the symptoms arising from this terrible 
 . disease ; while abstinence from these, and 
 the use of a light and sparing diet, if it
 
 ON CANCER 83 
 
 could not cure, certainly relieved in a high 
 degree the pain and irritability of the patient ; 
 rendered the course of the local disease 
 slower and prolonged life, while it made it 
 much more tolerable till the very end. I 
 know of no class of cases where the benefit 
 that follows a change of living is so marked, 
 and I am not sure that I know of any in 
 which the change is so difficult to make, 
 whether the sufferer be rich or poor. In 
 the one case the relatives, from the kindest 
 of motives, take every care that the doomed 
 one shall want nothing that money can supply, 
 and in the other, kind friends and neighbours 
 have a similar care for the poorer sufferer ; 
 while most surgeons, thinking of the exhaust- 
 ing nature of the malady, recommend all 
 sorts' of what are usually considered the 
 richest and most setting - up meats and 
 drinks ; and trust to opiates and other drugs 
 to relieve the pain and suffering. My own 
 experience has led me to adopt a very 
 different treatment to that which is certainly
 
 84 FADS OF AN OLD PHYSICIAN 
 
 still followed as a rule, both as to feeding 
 and giving soothing medicines, and I have 
 found that if a proper diet is given, there is 
 little call for relief by opiates, and sometimes 
 none at all. 
 
 Some twenty years ago I read, I think in 
 the same medical journal, a short notice of 
 a woman who had for some years suffered 
 from cancer in the breast. At last her con- 
 dition got so low and her digestion so bad 
 that she could only take for sustenance a 
 very small quantity of milk. On this alone 
 she lived for two years, and at the end of 
 that period the cancerous growth had quite 
 disappeared. Unfortunately in neither case 
 have I kept a note of the date of the journal. 
 
 I give a few cases, which I have met with 
 in my own practice, where I have found the 
 good effects of light living, both in easing 
 the patient and in prolonging life. 
 
 I first saw Mrs. M - at Leith in 1852, 
 owing to the death of her doctor, a kind old 
 friend whom she deeply lamented. I had
 
 ON CANCER 85 
 
 known him well, and we were good friends, 
 though differing very much in the mode of 
 treating our patients. Mrs. M - was then 
 about 40, of a very nervous, irritable tem- 
 perament ; she was constantly suffering from 
 some mucous irritation to a degree I have 
 rarely met with, and she had also a moder- 
 ately-sized uterine fibroid. She had been 
 kept up with the best of everything though 
 from the state of her stomach she could take 
 but little but with no good result, and she 
 remained wretchedly thin and rarely able to 
 be out of doors. A change of diet and 
 an almost complete cessation from drugs 
 rendered her life on the whole a much more 
 tolerable one, and of this she was so well 
 convinced, that afterwards when on more 
 than one occasion I begged her to get a 
 local doctor, as she lived out of my usual 
 beat and I had difficulty in giving her 
 proper care when ill, I could only get free 
 for a few months, when again I had to renew 
 my attendance at her urgent request. On
 
 86 FADS OF AN OLD PHYSICIAN 
 
 the whole her health gradually improved ; 
 she was able to go to the country and to 
 visit her friends, and she could take more 
 food and had got a little stouter although 
 living very sparingly. Thirty years after I 
 first saw her, she told me that one of her 
 breasts was beginning to trouble her as it 
 had done long ago. I was startled to find a 
 well-marked knot of scirrhus, and told her 
 my opinion of it. She then said that she had 
 been told the same forty years ago, and she 
 was sure of the date as it was before 1 843 
 which was an epoch in her life, as the year 
 of the Disruption of the Church of Scotland, 
 she being a keen Free Church woman. Dr. 
 Kellie of Leith, a well-known physician 
 there for a long period, was then her doctor ; 
 and her breast had been seen at that time 
 by two other surgeons, and all agreed as to 
 the nature of the case, and said that the 
 tumour should be removed. I rarely saw 
 her after this, having now given up practice. 
 The breast, I was told, gave her considerable
 
 ON CANCER 87 
 
 trouble, but she died from a general break-up 
 when upwards of eighty years of age. 
 
 I was asked by an Edinburgh client to 
 see his sister who was then an inmate of an 
 asylum for the insane in York. She was 
 suffering from malignant disease which had 
 been operated on some months previously, 
 and my opinion was wanted as to whether a 
 further operation would be possible. Another 
 point on which the brother wished to consult 
 me was as to whether it would be prudent 
 for him to receive his sister into his house in 
 Edinburgh. Before coming to the asylum 
 she lived with another brother, and the care 
 and anxiety which her suffering, and still 
 more her irritability, occasioned, had quite 
 upset two of his daughters, and had rendered 
 her removal to where she could be more 
 easily controlled a matter of necessity. She 
 had improved somewhat, and the doctors 
 found that the case was not one fitted for an 
 asylum. My friend had only one daughter 
 at home, a very delicate girl, and though
 
 88 FADS OF AN OLD PHYSICIAN 
 
 most anxious to do the best for his sister, he 
 feared much for the health of his daughter 
 if she was subjected to the same anxiety and 
 worry which had upset her cousins. It was 
 an easy matter for me to find that no further 
 operative treatment of the disease was pos- 
 sible. The other point was more difficult to 
 decide. I ascertained, however, that though 
 of a nervous temperament, the lady had not, 
 till disease came upon her, been irritable and 
 troublesome ; also that to help her to support 
 the weakening discharge from her ailments, 
 which was very abundant, she had been kept 
 on a very stimulating diet, both as to food 
 and wine. In the asylum this had not been 
 carried out in the same degree, and she was 
 already calmer and more easily managed 
 than before. Taking these circumstances 
 into consideration, I recommended that she 
 should be taken to Edinburgh ; and that 
 with the help of a still less stimulating diet, 
 I hoped that no harm would result to her 
 delicate niece. She was accordingly re-
 
 ON CANCER 89 
 
 moved to her brother's house, where she 
 spent the last two years of her life. She 
 took no exciting food, and no stimulant 
 whatever, and she required no medicine of 
 any sort. There was a large vinery on the 
 place, and, while they lasted, her chief sus- 
 tenance was from grapes, which she enjoyed 
 more than anything. The irritability left 
 her at once and completely, and I seldom 
 had a more contented patient, or one whom 
 it was so much a pleasure to visit. On one 
 occasion her brother on his birthday brought 
 her a glass of champagne. She unwillingly 
 tasted it, but at once rejected it, and said it 
 put her mouth on fire, although formerly she 
 could and did partake of it very freely and 
 with relish. In this case no one could doubt 
 that the extremely light and sparing diet 
 prolonged life, and, what is more important, 
 made it much more tolerable both for the 
 patient and her friends. 
 
 Lady - - at an advanced age suffered 
 from a large, open cancerous tumour of the
 
 90 FADS OF AN OLD PHYSICIAN 
 
 breast. It had existed for years, but I did 
 not know of it till it was far advanced, and 
 no operation could be thought of. The 
 suffering was considerable, but was relieved 
 from time to time by rather alarming bleeding. 
 She was able to be out of doors, and to look 
 after her household. She lived carefully, but 
 till lately not very sparingly. In the autumn 
 she went to live with a brother near Lin- 
 lithgow, and my friend the late Dr. - 
 attended her. After she had been there for 
 some months, I was asked to see her. She 
 had lost very much and certainly seemed to 
 be near her end. She had, I found, been 
 treated in a very different way as to food and 
 medicine, but fortunately her stomach had 
 got so weak that she could take little of any- 
 thing. The great desire was to get home to 
 Edinburgh, but this her friends and doctor 
 considered quite impossible, and as a com- 
 promise I was asked to visit her. After 
 full consideration, and seeing that there was 
 still some life in the old lady, I told the
 
 ON CANCER 91 
 
 friends that I did not think she would die on 
 the road, and that it might be best to let her 
 have her own way. This was very un- 
 willingly agreed to, and she was driven to 
 Edinburgh a few days later. She now gladly 
 returned to her old mode of living, and to the 
 a'stonishment of all but myself, she soon got 
 back to much the same condition as she was 
 in before she went to the country. For two 
 years she was able to be from time to time 
 at church and market, and she died at last 
 from exhaustion and with comparatively little 
 suffering. 
 
 I have to acknowledge that it was but 
 rarely that I could carry out in its fulness what 
 I considered to be the right treatment in such 
 cases, the difficulties, as always, being due to 
 the friends much more than to the patient. 
 Few of my colleagues have even attempted 
 to follow my example. I was pleased, how- 
 ever, lately to hear from a patient of a friend 
 now deceased, and who had twice been 
 operated upon, both of her breasts having
 
 92 FADS OF AN OLD PHYSICIAN 
 
 been removed by him, that on the last 
 occasion she had by his orders lived for three 
 months on three meals daily of oatmeal 
 gruel, and on nothing else. On the first 
 occasion she had told no one of her ailment, 
 and had lived as usual so that there might be 
 no suspicion of anything being wrong with 
 her. It was necessary to operate at once, if 
 at all, and she suffered terribly almost, she 
 said, going wrong in her mind. On the 
 second occasion she had no suffering what- 
 ever, and made a rapid recovery. The first 
 tumour removed was most markedly malig- 
 nant ; the second was not so, and was judged 
 to be of a simple character, although its 
 history and diagnosis were such as to call for 
 its removal. 
 
 On discussing this matter several years ago 
 with my friend the late Mr. I , F.R.C.S.E., 
 and telling him that I believed that high 
 living was certainly one cause of the scirrhus 
 form of malignant disease, and that I had never 
 met with it except in well-fed women, with
 
 ON CANCER 93 
 
 one doubtful exception, he said that he was 
 the distributor of a fund for poor women 
 suffering from advanced cancer, and he did 
 not think that what I said could apply to 
 them. I asked him to inquire into each case 
 as it presented itself. After six months 
 he told me I was quite right, and that as a 
 general rule he found that his poor clients 
 had been well fed, and so far as they were 
 able to indulge, were well fed still. He 
 took some trouble to get them to alter their 
 ways and live more simply and sparingly, and 
 to some of the stronger ones he gave by my 
 advice small doses of iodide of potassium. A 
 year later he told me that I had brought him 
 into a difficulty. Formerly he had been able 
 to take on most of the fit cases which had 
 applied, and could usually admit the same 
 number from year to year, their average life 
 being one year after admission to the fund. 
 Now he said they were living longer, and 
 several applicants were waiting whom he 
 could not admit. An experiment such as this
 
 94 FADS OF AN OLD PHYSICIAN 
 
 requires much time and pains to carry out, 
 more than a busy man can afford, and probably 
 it was gradually dropped, as, so far as I 
 recollect, my friend never again mentioned 
 the subject. 
 
 Some twenty years ago I was called to the 
 west of Scotland to see a young married 
 gentleman with malignant disease in the 
 groin. He had much pain and suffering, 
 and had already been operated upon ; but the 
 disease had returned. For his relief he was 
 taking opium freely, and he was being as well 
 fed as was possible ; but he was losing ground 
 fast, was quite confined to his bed, and from 
 being of a particularly happy and gentle dis- 
 position he had become irritable and morose, 
 much to the distress of his friends. I could 
 recommend nothing for the local symptoms, 
 but I advised that he should be put on a 
 much more simple and restricted diet, and I 
 hoped that by this means they would be able 
 .to reduce or stop the opiates, which were 
 blamed as the main cause of the sad change
 
 ON CANCER 95 
 
 in his mental condition. This was done, and 
 the result was even better than I had hoped. 
 He improved so much in every respect that 
 his medical adviser was soon able to get away 
 for his holiday, which he had put off owing to 
 the constant attendance on his patient, who 
 was an important one. While he was away 
 I was requested to make a second visit, as 
 after some weeks of comparative quiescence 
 the local disease was getting more trouble- 
 some. I found the gentleman in a very 
 different condition mentally and bodily, 
 although his case was quite hopeless ; and 
 all his friends were loud in their appreciation 
 of the change of treatment. The end came 
 soon, but there was no occasion to resume the 
 opium. 
 
 The few cases I have mentioned will, I 
 hope, induce some surgeons to try the method 
 I have indicated on their patients suffering 
 from ordinary cancer. They may have 
 difficulty in so doing, as I have already stated, 
 but if it is tried and carried out, especially
 
 96 FADS OF AN OLD PHYSIC /AN 
 
 with those of a nervous temperament, they 
 will at once notice a change for the better. 
 Such at least has been my invariable ex- 
 perience. 
 
 I am pleased to see that Dr. Haig states 
 that cancer has been noticed to be rare among 
 vegetarians, and that he has long thought 
 that it is at least possible that it may often 
 have the way paved for it by the chronic and 
 recurrent local irritation produced by urates 
 in the tissues. 1 
 
 I was told many years ago by a medical 
 friend who was long in India that some forms 
 of malignant disease were common among 
 tribes who lived mostly or entirely on vege- 
 table food ; and I was told by another that 
 they were also common where the only animal 
 food used was fish. These statements have 
 made me all the more careful to inquire as to 
 the mode of life of my own patients before 
 they came into my hands. 
 
 1 On Uric Arid, p. 320.
 
 VIII 
 
 RELIEF OF PAIN AND SLEEPLESSNESS 
 
 SOME medical men seem to think it a duty 
 to relieve pain whatever may be its cause ; 
 and if one form of sedative is evidently in- 
 efficient or attended with bad results, they 
 try another and another. As the number of 
 these is now legion, there is abundant room 
 for experimenting on this line, and the result 
 is no doubt often satisfactory. It is, however, 
 often the reverse, and experience of this 
 taught me early to do without sedatives 
 when there were other methods of relief. 
 Of these a little patience was often the 
 best ; I have frequently been told by invalids 
 that they would much rather submit to pain 
 than to the unpleasant effects of opiates 
 
 7
 
 98 FADS OF AN OLD PHYSICIAN 
 
 given to relieve it. There are in a number 
 of cases other means of relief, as hot fomenta- 
 tions, mustard poultices, opiate or belladonna 
 plasters, and above all massage, and of this 
 the best and most powerful form I know is 
 dry-cupping. I got a lesson in this at an 
 early period from a country gentleman who 
 suffered from spasms of the stomach. He 
 had got made for himself a small cupping- 
 glass to which was attached an air-pump. 
 The glass was placed on the back, and the 
 air exhausted to a moderate degree, so that 
 the glass could be drawn along the back 
 and all over it. A red wheal is left behind, 
 and soon the whole surface is as if a strong 
 mustard poultice had been applied. The 
 relief to the spasm was immediate. The 
 instrument could be used by any one with a 
 strong hand, and the butler was well up to 
 its use. I have often had recourse to this 
 mode of dry-cupping with great effect. It 
 can be done with an ordinary cupping-glass, 
 if the air is only partly burnt out so as to
 
 RELIEF OF PAIN AND SLEEPLESSNESS 99 
 
 permit of the necessary traction. I never 
 knew the pain of lumbago to resist this 
 method or even the ordinary dry-cupping by 
 fixed glasses left on for a few minutes. I 
 have had relief from the pain of lumbago in 
 this way scores of times, and my servant 
 could use the glasses in both ways with 
 great facility. I mention under 'Self-Massage' 
 the numerous pains which can be relieved by 
 rubbing. 
 
 I remember when the now common mode 
 of using opiates by injection was introduced 
 by my friend the late Dr. Alexander Wood. 
 No practitioner now is without his injecting- 
 syringe and needle. The relief from pain 
 is delightful and is almost immediate. But 
 severe and prolonged sickness often follows, 
 and some suffer the pain rather than have 
 recourse to the injection a second time. 
 With others the agreeable sensations are 
 enjoyed quite as much as the relief from 
 pain, and if the process is often repeated a 
 bad habit is easily formed, which may be
 
 ioo FADS OF AN OLD PHYSICIAN 
 
 as difficult to cure as is that from taking 
 opium in the ordinary way. I have seen 
 terrible evil from this, and to surgeons as 
 well as their patients. I soon became so 
 afraid of the evils arising from opium given 
 or taken in this way, that I am not sure if 
 I have used it in a dozen cases since its 
 introduction. While by no means con- 
 demning its use in every case, I cannot 
 use too strong terms in giving a caution 
 to the younger members of the profession. 
 
 Anaesthetics, which are perhaps the 
 greatest blessings of the age when properly 
 used, may also be abused when given as 
 antidotes to pain not caused by a surgical 
 operation. Here also a bad habit may be 
 formed, from the ease with which anaes- 
 thetics, particularly chloroform, can be ob- 
 tained and used. I must plead guilty to 
 having employed this new remedy on myself 
 in an extreme and foolish manner. But at 
 the time there was some excuse for me. 
 Being the colleague of Professor Simpson
 
 RELIEF OF PAIN AND SLEEPLESSNESS 101 
 
 when chloroform was introduced, I was often 
 asked to try the drug as manufactured by 
 different chemists, and also to try instru- 
 ments which were at first considered neces- 
 sary in using it. Besides taking it to relieve 
 headache and sleeplessness, I took it for a 
 considerable time twice or thrice a day, to 
 see if any evil results would follow. This I 
 was soon not allowed to do at Professor 
 Simpson's house, as on coming out of the 
 chloroform I had such a craving for more, 
 that I sometimes broke through all rules 
 of propriety in attempts to get possession 
 of it. This strong desire I have seen in 
 others, and it helps me to sympathise with 
 persons given to drink. The desire which 
 follows chloroform is much more transitory 
 than that which follows alcohol, but for the 
 time it is very commanding. I did not keep 
 an exact count of the number of times I 
 was under chloroform, but I calculated that 
 within six months after it was introduced 
 I had taken it some three hundred times.
 
 102 FADS OF AN OLD PHYSICIAN 
 
 It was certainly injuring me, upsetting my 
 stomach and liver especially, though I am 
 not aware that it caused any permanent 
 harm. Perhaps I could not have continued 
 to take it much longer, as I was coming to 
 have an intense dislike to it, so that the 
 sight of the bottle or even the thought of it 
 brought on a feeling of disgust, and almost 
 of sickness. This went off as soon as a 
 few breaths of it were taken. I have known 
 the same effect produced in others who had 
 become addicted to the practice of inhaling 
 chloroform. 
 
 For inducing sleep opium in its numerous 
 forms has always been much in use. Of 
 the new remedies I have no experience, and 
 no knowledge except from reading. I am 
 constantly receiving papers and pamphlets 
 from the manufacturers or sellers of these, 
 with wonderful reports from medical men 
 and others of the value of some new chemi- 
 cal of which I had not previously heard. 
 They often insist on the superiority of the
 
 RELIEF OF PAIN AND SLEEPLESSNESS 103 
 
 new drug over any previously used, of which 
 they proclaim the faults in no measured 
 words. It is to be hoped that some 
 grains of real value may result although 
 much chaff may have to be blown away ; 
 but it would be well if more time and 
 care were taken in honest inquiry into 
 the effects, immediate and final, of each 
 novelty, and if the consideration of its 
 commercial possibilities were deferred till 
 its true value has been fully established. 
 
 In my own practice the use of drugs 
 for procuring sleep gradually got less and 
 less, as has their use for relieving pain. In 
 this matter my own case has given me most 
 help. I have slept badly for at least three- 
 fourths of my life, partly from a nervous 
 temperament, partly from a bad stomach, and 
 these aggravated for many years by frequent 
 calls during the night to visit the sick. On 
 one occasion, from a bad chill, I was seized 
 with severe pain over the left shoulder-blade, 
 ending in an abscess, which destroyed part
 
 104 FADS OF AN OLD PHYSICIAN 
 
 of the periosteum and of the bone under it. 
 I was then in poor health, and vainly trying 
 by too much food and physic to keep up my 
 strength. I suffered so much before the 
 abscess was opened that for three full weeks 
 I had no sleep whatever, and very little for 
 as much longer, when I went to the west 
 coast for a yachting cruise. My sleep 
 gradually came back, but at this time it was 
 at best restless and unrefreshing sleep, and I 
 was sometimes tempted to try chloroform or 
 an opiate, but that I did very rarely ; opium 
 alone made me more restless. I had been 
 recommended some years before by a country 
 gentleman to use for toothache a full dose of 
 laudanum with a tablespoonful of castor oil. 
 This I was told was an excellent cure, and I 
 found it so in my own case and many others. 
 Years before this I had once taken half a 
 drop of croton oil for toothache and found 
 immediate relief. I was then a student and 
 I had seen croton oil recommended for 
 toothache and neuralgia. The two oils have
 
 RELIEF OF PAIN AND SLEEPLESSNESS 105 
 
 much in common. The addition of castor 
 oil to opium certainly increases its soothing 
 effects, and prevents unpleasant consequences. 
 This was one of the few remedies that I 
 adhered to long after giving up almost all 
 others. When suffering from gastric attacks 
 with severe headache, although the dose had 
 no effect the first day or two, thirty drops of 
 nepenthe with a tablespoonful of castor oil 
 often removed the headache and restlessness, 
 and sometimes induced a long sleep, from 
 which I woke up comparatively well. Since 
 getting into better health, although I usually 
 sleep badly I can rest quietly, and I have 
 found that this makes up, in all essential 
 points, for a shorter period of sound sleep. 
 For this comfortable if not perfect mode of 
 spending the night the great necessity is 
 perfect digestion, so that when one goes to 
 bed there is no sour indigested mass in the 
 stomach, and when the stomach is empty 
 there is no flow of acid secretion into it from 
 the blood To reach this happy condition of
 
 io6 FADS OF AN OLD PHYSICIAN 
 
 digestion once it has gone wrong is a slow 
 process at best, but the simplest and most 
 rapid method of bringing it about is by more 
 or less complete abstinence from food, and 
 this may be safely done to a very much 
 greater degree than is supposed safe by those 
 who have never tried the experiment. Tem- 
 porary relief may sometimes be got by nature's 
 own method, complete rejection of the acid 
 mass by vomiting, or it may be neutralised 
 by alkalies, or by a free use of liquorice. All 
 of these frequently allay the general irritation 
 and induce sleep, but unless the hint is taken 
 and a more rational use of food be followed, 
 these and other worse attempts at cure only 
 allow the wrong system to be carried on 
 longer, and the disorder to get more fixed 
 and chronic. 
 
 One useful lesson I have learned from my 
 own case and from others is, that a large 
 amount of sound sleep is not essential for any 
 one, that what is taken is very much a matter 
 of habit, and that if sleep be wanting for a
 
 RELIEF OF PAIN AND SLEEPLESSNESS 107 
 
 time, it is as a rule safer to await its natural 
 return than to have recourse to drugs which, 
 though they may give some immediate relief, 
 may in the end be the cause of still greater 
 evils. I know that this view can be contro- 
 verted, but I only seek to uphold it when it 
 is combined with a rational plan of giving 
 food and stimulants. When the stomach is 
 very irritable, quiet sleep may frequently be 
 obtained by the use of a large mustard poul- 
 tice. It should be kept on only so long as it is 
 quite easily borne. Sometimes the effect is 
 so prompt, and the sleep induced so sound, 
 that the pain may not be felt until the skin 
 has become so inflamed as to be troublesome 
 for many days. 
 
 Thinking, especially if the subject is an 
 unpleasant one, is the bane of sleep. I have 
 often been able to counteract this, and some- 
 times to induce sleep by fixing the eyes and 
 noticing the curious changing forms of light 
 and sometimes of colour which usually appear 
 when the attention is turned on them ; or the
 
 io8 FADS OF AN OLD PHYSICIAN 
 
 eyes may simply be kept fixed, in an upward 
 direction in the darkness, or, if there be light, 
 on some object in the room. The slight 
 effort required for this is enough to stop the 
 current of thought. If continued for some 
 minutes it becomes somewhat irksome and 
 tiring, and unconsciously one sometimes falls 
 asleep. 
 
 These little experiments at least help to 
 pass the time, and to break the continuity of 
 a long night. A not infrequent cause of 
 sleeplessness is liability to cramp in the legs, 
 especially in persons of advanced years. This 
 is sometimes relieved by raising slightly the 
 lower part of the bed, so that the lower 
 extremities are higher than the rest of the 
 body. This simple change will prevent 
 congestion of the muscles, which may be the 
 exciting cause of the spasm.
 
 IX 
 
 RHEUMATIC FEVER 
 
 RHEUMATIC fever or acute rheumatism has 
 always had an attraction for me. It was the 
 first disease which I had specially considered, 
 as it was the subject of my thesis required 
 for passing as M.D. I got up all its litera- 
 ture on which I could lay my hands, as I 
 then knew nothing of it practically. It was 
 the treatment that chiefly interested me. 
 There was not much room for coming to any 
 definite idea about this. The only conclu- 
 sion I arrived at was that cases treated with 
 quinine were shorter than those treated in 
 any other way, but that this treatment led to 
 more deaths. 
 
 This disease is, I believe, a much more
 
 no FADS OF AN OLD PHYSICIAN 
 
 common one now than it was fifty years ago, 
 especially among the young, and it leads to a 
 large proportion of the cases of organic heart 
 disease, which also tends to be much more 
 common than formerly. It is to be met with 
 occasionally amongst children of only a few 
 years old, but more frequently among boys 
 at school and youths at college. It is not 
 even yet a very common disease, and a 
 school may have had no case of it for years. 
 I have never in all my experience met with 
 it in young or old except when the diet had 
 been full, and had consisted largely of beef 
 and mutton, and the changed feeding of the 
 young in this respect is to my mind the 
 main, if not the only, cause of the compara- 
 tive frequency of acute rheumatism at the 
 present day. I have been on the outlook for 
 at least forty years for a case of the disease 
 in a child or youth who had not been fed on 
 red meat, and I have not once either met 
 with or heard of a clear case of the kind. 
 Once, indeed, some twenty years ago, I
 
 RHE UMA TIC FE VER 1 1 1 
 
 thought I had come on a slight though well- 
 marked case, and was looking on it as the 
 exception which proves the rule. The child 
 was four or five years old. The mother, 
 before her marriage when she came under 
 my care, had got into bad health from the 
 prevalent too good feeding, and I doubted if 
 she could have had a child at all but for a 
 complete change in her mode of living, which 
 - after some time restored her to a fair state of 
 health. I had told her what I thought the 
 right way to feed her boy, and never dreamt 
 that she would try any other. He was quite 
 healthy, but being light -haired and rather 
 pallid, and of the pure nervous temperament, 
 he had not the robust florid look of children 
 of the sanguine or muscular temperament. 
 I found him one day very feverish, with dry 
 furred tongue, and complaining of pain in 
 front of one ankle, which was somewhat red. 
 I told the mother that the symptoms pointed 
 to acute rheumatism, but that I did not think 
 it possible it could be so in a child that had
 
 112 FADS OF AN OLD PHYSICIAN 
 
 been brought up as hers was. Next day the 
 other ankle was affected in the same way, 
 and by and by both knees. There could 
 now be no doubt whatever that the case was 
 one of acute rheumatism. It was a mild case, 
 however, and in ten days the symptoms were 
 passing off. The mother now told me she 
 had a confession to make that a friend had 
 been telling her that it was foolish to try to 
 bring up her pallid boy in the way I recom- 
 mended, and had induced her to give him a 
 bit of meat every day. This was begun six 
 months ago ; after two months he looked no 
 better, so for the last four months she had 
 given him more meat, and still with no 
 change in his appearance. She was glad 
 now to return to the old diet. The only 
 evil that resulted was that the heart was 
 decidedly affected and gave trouble for 
 years, but when last I heard of the young 
 man he was in good health. It was well 
 for him that the disease came on so soon, 
 as, had it been delayed and the flesh feeding
 
 RHE UMA TIC FE VER \ 1 3 
 
 continued, the result might have been very 
 different. 
 
 When in the Argentine Republic some 
 ten years ago I was told by the principal 
 English doctors in Buenos Ayres and 
 Rosario, the two chief towns, that rheumatic 
 fever is there an exceedingly common disease 
 among the young, and that it leads to most 
 of the heart disease, which also is very 
 common. The amount of meat, especially of 
 beef, consumed there by old and young is 
 enormous, when compared with what is eaten 
 here. The main evils I myself saw from this 
 were anaemia in children, and neuralgia both 
 in old and young. I believe that high living 
 may do less harm in so fine a climate, and 
 there seemed to be fewer sufferers from 
 dyspepsia and other functional ailments. 
 
 I have attended several third attacks of 
 acute rheumatism, but I never had a recur- 
 rence of it in my own practice, as I always 
 proscribed beef and mutton for those whom I 
 saw once with the disease. During the ill-
 
 114 FADS OF AN OLD PHYSICIAN 
 
 ness I gave little or no food, and a favourite 
 remedy was small doses of iodide of potassium. 
 Two severe cases which occurred about the 
 same time I treated with hot water only. 
 One was a third attack. Sir Robert 
 Christison saw them both, and was pleased 
 with the treatment, and he recommended 
 nothing else. In neither case was the heart 
 affected. 
 
 Dr. Dewey has had much more experi- 
 ence of rheumatic fever than I have had. 
 He believes that it is due to disordered 
 digestion, arising from eating for an unknown 
 period beyond the power to digest and assi- 
 milate. As his clients, old and young, con- 
 sume much more butcher's meat than did 
 mine, his experience quite coincides with my 
 own. But his treatment is much more 
 thorough, though quite in the same lines. 
 He gives nothing but water whatever be the 
 length of the illness, and in one case there 
 was no call for food for forty-six days. He 
 then gives whatever the patient asks for, but
 
 RHE UMA TIC FE VER \ 1 5 
 
 not till the tongue is clear and the appetite 
 evidently a natural one. 
 
 The late Dr. James Begbie, who was 
 considered our first authority on gout and 
 rheumatism, told a lady patient of mine, 
 whom I had seen through her third attack of 
 rheumatic fever, that for the rest of her life 
 she ought not to touch beef, mutton, beer, 
 wine, or brandy. I had asked him to see 
 the lady when her friends were insisting 
 that, now she was getting well, she should 
 return to her ordinary mode of life. I had 
 found it useless for me to point out to them 
 that this was precisely what had already 
 subjected her to three attacks of a most 
 dangerous malady.
 
 X 
 
 HOW ONE SHOULD LIVE IN A HOT CLIMATE 
 
 IN a warm climate less food is required than 
 in a cold one, as in the latter a large portion 
 of our food goes to keep up the temperature 
 of the body. This is a self-evident pro- 
 position, but it is often forgotten, and 
 especially by sufferers from dyspepsia who 
 go to a warm climate for their health. The 
 immediate relief is often very marked. Dys- 
 pepsia is usually attended with, and often 
 caused by, an irritable state of the stomach. 
 This implies some degree of congestion that 
 is, of too much blood going to the organ, and 
 the necessary complement is that too little 
 goes to the skin. In a warm state of the 
 atmosphere there is much more tendency of
 
 ii; 
 
 blood to the surface, and this alone is enough 
 in many cases to cure dyspepsia. If a 
 rational system is now followed, and no more 
 food taken than before, or only enough to 
 restore an impoverished condition of the 
 system, the cure may be permanent. But if, 
 as often happens, more food be still taken 
 than is required, the health may be good for 
 a time, but by and by the same symptoms 
 may recur as before, and now the same means 
 of cure are not available, and the last state is 
 worse than the first. Many also who go to 
 a warm climate and whose health is good, if 
 they continue to take the same food as in a 
 colder country, by and by suffer in one of 
 the many ways that repletion leads to, unless 
 they are wise enough to reduce their diet, 
 especially the carbonaceous or fuel part of it. 
 But many do not think of this, and as they 
 become languid and oppressed, as they suppose 
 from the heat, they often have recourse to 
 some stimulant to relieve them. There 
 would be no great harm from this, provided
 
 nS FADS OF AN OLD PHYSICIAN 
 
 they at the same time reduced the quantity 
 of food. It follows that, if food be properly 
 managed, life should be longer in a hot than 
 in a cold climate, as there is less tear and 
 wear of the organs, less work being required 
 of them. A very large number of both sexes 
 who have returned from India have come 
 under my observation, and as a general rule- 
 so far as I can recall, a universal rule those 
 who have kept their health at least as well as 
 they had it in this country, and have returned 
 sound and strong, had been moderate livers, 
 and still more moderate drinkers. 
 
 On the other hand, a large portion of 
 those who broke down had soon found it 
 necessary to take to stimulants to help them, 
 and their career was often very short. One 
 curious observation forced itself on me long 
 ago, that abstainers from all alcoholic stimu- 
 lants sooner or later were liable to break 
 clown and to have to return home, when a 
 temporary use of some form of stimulant 
 might have tided them over. It would have
 
 LIVING IN A HOT CLIMA TE 119 
 
 acted by diminishing the waste of the body, 
 and thus acting as a food, when the weakened 
 stomach would not do its duty. Cases of 
 this nature are, however, rare compared to 
 those where the combination of too much 
 food with an undue amount of stimulant have 
 sent the young and strong homewards pre- 
 maturely, and often with the foundations of 
 permanent disease. 
 
 Upwards of forty years ago I had the 
 opportunity of sending a young medical friend 
 to Madras as assistant to a civil doctor there. 
 He suffered much from dyspepsia, and was 
 somewhat afraid of the climate. I assured 
 him that the warmth would suit him, and 
 that if he did not take undue advantage of 
 his improved health the relief would be per- 
 manent. For five and twenty years he was 
 perhaps the busiest doctor in Madras, as 
 besides his practice he lectured in the medical 
 school and was coroner. When he returned, 
 he told me that I had been right in advising 
 him as I did. His dyspepsia very soon left
 
 120 FADS OF AN OLD PHYSICIAN 
 
 him, but he did not take the care that I had 
 recommended, and for a time his stomach 
 again failed him. He now took to living as 
 he should have done from the beginning, and 
 got into excellent health, which he brought 
 home with him. I saw him for the last time 
 five years ago, when he was well and doing a 
 fair amount of work in his native city. He 
 died three years later. 
 
 I have met with many cases of maltreat- 
 ment of friends which have roused me to try 
 to improve the methods of the leaders in the 
 profession, but none of them vexed me more 
 than the following. During the mutiny in 
 India in 1857, the wife of one of the most 
 active officials in putting down the rebellion 
 was a patient of mine in Edinburgh. Her 
 husband, one of the hardest workers in India, 
 was a most moderate liver, his only stimulant 
 being one glass of beer a day. He retired 
 soon after the mutiny was ended, and he 
 returned home in the enjoyment of excellent 
 health, and looking, for his age, none the
 
 LI VI NG IN A HOT CUM A TE 121 
 
 worse for his long and laborious residence in 
 a hot climate. Several years later I saw him 
 in Edinburgh on his way to recruit in the 
 Highlands. He had had some alarming 
 attacks of haemoptysis, and his London 
 physician feared his lungs were in danger 
 from phthisis. He had got weak for a time, 
 and he was of course being well fed. When 
 I saw him he had had no bleeding from the 
 lungs for some weeks, and the signs of mis- 
 chief in the lungs were by no means decisive; 
 there was nothing, in fact, but what might 
 have been caused by the local haemorrhage, 
 although of course this of itself was a sus- 
 picious symptom. I put him on a much- 
 restricted diet, and with little or no wine. 
 On his return in a few months, he was in 
 very much better health and stronger. There 
 had been no return of the haemorrhage, and 
 after a careful examination of the chest I 
 came to the conclusion that he was all right, 
 and only required care, especially in diet, 
 to enable him to continue so. By and by I
 
 122 FADS OF AN OLD PHYSICIAN 
 
 was grieved to hear that he was ill again. 
 The London physician to whom he reported 
 himself on his return at once put him on his 
 old full diet and stimulants, and very soon 
 the haemorrhage returned, and in a few 
 months he died. Shortly after, I had a letter 
 
 from my old friend Dr. F , formerly doctor 
 
 to Lord Lawrence, and through whom I had 
 first known the lady and her husband, in 
 which he wrote that he was pleased to know 
 that I was not the medical man who had put 
 his old friend on a wrong diet. 
 
 I will finish these few notes with an extract 
 from a letter from a medical man living in a 
 hotel in the south of France to a friend close 
 by. It gives very neatly the view that most 
 English residents in a warm climate take of 
 the situation so far as heat and free living 
 are concerned : 
 
 ' This seems the coldest day we have had 
 this winter, and I see the low hills white with 
 snow, but the change seems to suit most 
 people in this house. Continuous sunshine
 
 LIVING IN A HOT CLIMATE 123 
 
 and warmth do not fit in with the English 
 habit of over-eating. We prefer the weather 
 to change a little rather than be bothered to 
 alter our ways. In short, we get out of 
 the difficulty by saying that too much sun 
 shine and brightness are unwholesome.'
 
 XI 
 
 ON MATTERS WHICH RETARD DIGESTION 
 AND PREVENT WASTE 
 
 THERE are several substances in common use 
 as medicines or foods which check the chem- 
 ical actions concerned in nutrition, and thus 
 lessen the waste of the tissues, and also the 
 secretions which carry off effete products 
 from the system. These are alcohol and 
 opium in all their forms, tea and cognate 
 substances, and osmazome of flesh which 
 gives their stimulating quality to beef-tea, 
 Liebig's Extract, and other preparations of 
 beef. Any of these may be given for a long 
 period, and may favour long life, provided 
 that the quantity of food taken is in an in- 
 verse ratio. It is a well-known fact that an
 
 RETARDED DIGESTION 125 
 
 old woman can live with comfort on a free 
 supply of tea, with very little else. The 
 same is the case, as I have pointed out else- 
 where, with an old Highlander who lives 
 mostly on whisky ; and also with the Indian 
 or Chinaman, who, if he takes a moderate 
 amount of opium, can do much work on very 
 meagre fare. It needs no argument to show 
 that if one or more of these inhibiting sub- 
 stances be taken with an ordinary quantity 
 of food and they are often taken under the 
 false idea that they assist an enfeebled di- 
 gestion the result must be hurtful. It is 
 only the younger and the very healthy who 
 can for any lengthy period indulge in such 
 an unscientific mode of life, and it is those, 
 if they have no one organ weaker than the 
 rest to give them a timely warning, who die 
 earliest. Many years ago I had it from the 
 manager of our foremost life insurance office, 
 that his company lost more on the healthiest 
 lives to which no objection whatever could 
 be made, than on those which, though ac-
 
 126 FADS OF AN OLD PHYSfCIAN 
 
 cepted at the ordinary rate as sufficiently 
 good, were not altogether of a first-class 
 character. I had asked him the question, 
 and got the answer I expected. The num- 
 ber of the healthy who throw away their 
 lives in this way is, I am convinced, much 
 greater than is generally believed ; and in- 
 stead of living longest as they certainly 
 ought, they must help very materially to 
 lower the average of human life. The cause 
 of error with most of them is simply want of 
 knowledge, which, to those who do not look 
 beyond their own case, comes too late. I 
 have given a warning to many when I had 
 the opportunity to do so, and not a few have 
 gladly taken it, and have got the sure re- 
 ward. On the many, however, the advice is 
 thrown away, and they have chosen what 
 they consider the pleasanter path. Here, 
 too, they are wrong, as, if they but knew it, 
 the pleasure is all on the other side. With 
 a good stomach, one which would do its duty 
 for a long lifetime, if its very goodness did
 
 RETARDED DIGESTION 127 
 
 not lead so easily to its abuse, the habit of 
 taking too much food is easily acquired. 
 This soon leads to a more abundant supply 
 of blood being sent to all the abdominal 
 organs, as they are all engaged in the pro- 
 cess of digestion. The vessels of the stom- 
 ach become enlarged, and also its capacity 
 to receive food, and satisfaction with a meal 
 is not arrived at till the expectant organ is 
 fully supplied. If alcohol, or osmazome, or 
 tea, or all of them together be also taken, as 
 is usually the case, a crisis is sooner arrived 
 at. There may be a period of enjoyment in 
 the consumption of a long and varied meal, 
 but even with the healthiest this cannot last, 
 unless assisted by aperients and other means 
 which are resorted to by almost all who live 
 fully. Were it not for these aids, nature 
 would soon assert itself, and apply the fit 
 punishment for its broken laws by an un- 
 pleasant but salutary cessation of all desire 
 for food, which, if allowed, would soon re- 
 store in some measure the health of the
 
 128 FADS OF AN OLD PHYSICIAN 
 
 damaged organs. This should suggest to a 
 rational sufferer that the manifest cause of 
 his discomfort should not be repeated, and 
 if this simple rule were attended to, what an 
 amount of suffering and of lives shortened 
 would be saved to humanity ! But we live 
 in an age of science, false as well as true. 
 Nature, if its first hints are not taken, resorts 
 to severer and sharper ones ; the doctor is 
 called in, and, according to the rules of treat- 
 ment of the day, drugs are given to relieve 
 troublesome symptoms ; and if food is de- 
 clined for a few days, it must be taken 
 whether the patient desires it or not, and, 
 along with food, one or more of the inhibit- 
 ing substances we have been speaking of. 
 What might have been only a salutary sick- 
 ness of a few days, resulting in a return to 
 health, may be converted into a long illness, 
 leaving the system seriously impaired. If 
 now a more rational mode of living were 
 adopted, a fair amount of health might be 
 recovered and maintained ; but the anxiety
 
 RETARDED DIGESTION 129 
 
 of the patient, and of his friends and doctor, 
 is to get up the strength as fast as possible, 
 and satisfaction is felt if the weight lost is 
 rapidly regained. The real benefit from the 
 illness is thus lost ; the evil round recurs, 
 and the strong man becomes a confirmed 
 invalid, or, what is perhaps better, comes to 
 an early and premature grave.
 
 XII 
 
 ON NATURAL CRAVINGS AND DISLIKES 
 
 A NATURAL and sometimes an extreme crav- 
 ing by the sick for some special food or 
 means of relief is not uncommon, and it is 
 usually looked on as absurd, and is disre- 
 garded. A remarkable instance of this is 
 given at p. 37. A somewhat similar ex- 
 perience happened to myself when a youth, 
 and suffering from a severe attack of scarlet 
 fever. The fever was strong, and my tem- 
 perature was no doubt very high, but we 
 had not begun to test it by the thermometer. 
 The weather was intensely cold, and I would 
 not allow the window of my very small bed- 
 room to be closed night or day. For several 
 days I kept thinking of the delights of sea-
 
 ON NA TURAL CRA VINGS AND DISLIKES 131 
 
 bathing and swimming, which I used to 
 enjoy like other lads. I was looking for- 
 ward with much satisfaction to next season's 
 sea-bathing. This was in February. The 
 fever was relieved at last by a copious 
 bleeding from the nose, which for a time 
 was rather alarming. I now lost all desire 
 for a swim, as my brother did for sherry. A 
 cold bath as a remedy for my hot condition 
 was not then thought of, although about 
 the beginning of the century Dr. Currie of 
 Liverpool had begun to recommend it for 
 scarlet fever. He had few followers till a 
 more recent date, when the local use of cold 
 water or ice was gradually adopted by many 
 as the best means of reducing the tempera- 
 ture of the body when excessive. 
 
 A well-known doctor of divinity in Aber- 
 deenshire was visiting an old woman sup- 
 posed to be at the point of death. He was 
 left alone with her, but he could not get her 
 to attend to his services, as she had taken 
 such a craving for green cheese that she
 
 132 FADS OF AN OLD PHYSICIAN 
 
 could think and speak of nothing else. He 
 returned to the friends and told them the 
 circumstances. ' We know,' they said, 
 ' the craze of the poor body ; she has done 
 nothing but cry for green cheese all day.' 
 ' Why do you not give it her ? ' said the 
 clergyman. ' Because it is the worst thing 
 for her,' was the reply. ' But she is dying, 
 is she not?' 'Oh yes, she is dying.' 
 ' Then the green cheese can do her no 
 harm, and it will let me speak to her 
 quietly.' This was unanswerable; the green 
 cheese was given and eaten greedily, and 
 the old woman recovered. The reverend 
 doctor was in the habit of saying that after 
 this he would never refuse a sick person 
 anything. This story I had from my father, 
 the son of a neighbouring clergyman. 
 
 If I am not much mistaken, a wider and 
 more important subject is the converse of 
 this craving for some specific means of 
 relief; I mean the dislikes of the sick, 
 especially to food, but also to noise, motion,
 
 ON NATURAL CRA VINGS AND DISLIKES 133 
 
 light, or close air. In all these matters the 
 invalid is, when it is possible, allowed to 
 have his own way, except in the case of the 
 most important of them all, his dislike for 
 food. Here he is very much at the mercy 
 of his doctor and his friends, and unless he 
 has a very strong will he must obey. He 
 may indeed be a willing victim so far as he 
 can resist his natural antipathy ; and sup- 
 posed duty may induce him to take what 
 he would much rather avoid. I have the 
 strongest conviction, and that after more 
 than fifty years' experience, that the forced 
 giving of food when it is not wanted is the 
 cause of more misery, more aggravations of 
 disease, and greater shortening of life, than 
 all other causes put together. This doctrine 
 I have held absolutely for very many years, 
 almost indeed from the beginning of my 
 medical career. I long ago said that I 
 knew of no circumstances in which it was 
 proper to force food on an unwilling patient 
 except in the case of a lunatic who refused
 
 134 FADS OF AN OLD PHYSICIAN 
 
 to take anything. Even this solitary excep- 
 tion I gave up, on coming upon the follow- 
 ing case in a medical journal. Unfortunately 
 I took no note of it, but it was some twenty 
 years ago, or more. A man had been in 
 an asylum for the greater part of his life. 
 From time to time he refused food, and it 
 was put into his stomach by a tube. At 
 last his health quite failed, so much so that 
 it was considered useless to force food any 
 longer upon him, and he was left to die in 
 peace. He did not die, and, more than that, 
 he recovered his sanity, and was able soon 
 to leave the asylum. This case recalls to 
 me one given by Dr. Dewey (p. 314). A 
 boy of five had lost his appetite a year pre- 
 viously. All means were used for his relief 
 by regular and homoeopathic doctors, but he 
 got worse, and his food was regularly ejected 
 shortly after it was taken. All hope of re- 
 covery was lost, and as a last resort his 
 father was carrying him to a consultation of 
 several doctors. On the way a friend met
 
 ON NATURAL CRA VINGS AND DISLIKES 135 
 
 him who had been cured, after a much 
 longer illness, by Dr. Dewey, and he urged 
 the father, weak as the boy was, to give him 
 nothing till a desire for solid food returned. 
 The father had faith in his friend, took his 
 boy home, and gave him no food for four 
 days. A beef-steak was now asked for and 
 digested, and soon the boy was in the best 
 of health, in which Dr. Dewey saw him five 
 months later. ' This boy,' he remarked, 
 ' had suffered a living death, week after 
 week, month after month, and yet always 
 within four days of a beef-steak appetite ' 
 a very natural remark, but what a reflection 
 on our science of medicine ! Had the poor 
 boy been let alone at first till the dislike for 
 food was changed into a natural desire for 
 it, what an amount of suffering to him and 
 anxiety to his parents would have been 
 prevented. 
 
 I have noticed very often that after an 
 acute illness when little or no food has been 
 taken for a considerable period, a time comes
 
 136 FADS OF AN OLD PHYSICIAN 
 
 when the natural desire for food is strong, 
 and, if indulged in according to the patient's 
 feelings, leads to too much being taken for 
 the still weak stomach to digest, and to con- 
 valescence and return to health being more 
 or less retarded. I have also noticed that 
 if this too keen appetite is not given way to, 
 but a wholesome restraint is exercised, in a 
 very few days the appetite becomes more 
 natural, and in the end a more complete cure 
 is effected. If one has, previous to the ill- 
 ness, been a too free liver which has very 
 probably been the cause of the illness this 
 is now the time when he can with least 
 trouble adopt a less full and simpler way 
 of living for the future. The short abstin- 
 ence enforced by the illness has done what 
 it would have taken a long period of volun- 
 tary moderation to effect. 
 
 Since these pages were written I have 
 read in the British Medical Journal, 13th 
 February 1897, a short paper on 'Artificial 
 Feeding of the Insane.' As it is by a
 
 ON NA TURAL CRA VINGS AND DISLIKES 137 
 
 medical officer in a private asylum in England, 
 I may take it as giving the ordinary treatment 
 in such an establishment. There are several 
 statements in the paper which I should like 
 to notice. 
 
 Refusal of food is said to be more com- 
 mon in an asylum for private patients than 
 among paupers. May not the reason of this 
 be that the wealthier had more need for 
 temporary abstinence than the poorer, and 
 that nature points this out to them ? 
 
 Of the last 200 patients admitted to the 
 private asylum, 27 required forcible feeding, 
 and these were ' performed upon ' by the 
 doctor nearly three thousand times. This 
 is quite a hundred times on the average for 
 each patient, and as ' in some cases a few 
 feedings effected a cure of the habit of 
 refusal,' these must have been very few, or 
 the average performances must have been 
 still more numerous. 
 
 'The 27 did not include many patients 
 whom the attendants were able to feed with
 
 138 FADS OF AN OLD PHYSICIAN 
 
 a spoon, but only those who successfully 
 resisted this method.' 
 
 ' Complete refusal of food for twenty-four 
 hours in a strong well-nourished patient, or 
 the missing of two meals by a feeble one, 
 may be taken as a general rule to indicate 
 the operation ; freshly-admitted cases with 
 a history of starvation, who are feeble with 
 weak pulse, should be fed at once.' 
 
 I say nothing of how the forcible feeding 
 was carried out. It is not pleasant reading, 
 and had better be left buried in the pages of 
 the Medical Journal. 
 
 The food is given thrice a day, and is 
 made up of three pints of milk, six eggs, a 
 pint and a half of beef- tea, two ounces of 
 whisky, two ounces of port wine, and an 
 ounce of maltine. This, to a strong well- 
 nourished patient who has refused food for 
 twenty-four hours, is a pretty full allowance, 
 but his stomach may dispose of it better than 
 would that of a ' feeble one with weak pulse,' 
 who apparently gets the same quantities.
 
 ON NATURAL CRAVINGS AND DISLIKES 139 
 
 The effect of this forced feeding is said to 
 have been very good, and ' no doubt the lives 
 of many were saved by its adoption.' What 
 the result would have been had the patients 
 been left to themselves, we have no means of 
 knowing, but none of them, I imagine, had 
 approached Dr. Dewey's skeleton form, and 
 'the strong well - nourished ' amongst them 
 must have had at least a month's supply of 
 food laid up ready for absorption, and requir- 
 ing no nervous energy to digest it. Believing 
 as I do that rest is nature's great cure for a 
 damaged organ, I cannot help thinking that 
 this rest to the brain might be a large element 
 in the cure of the insane, and certainly the 
 experiment of giving it would be a very safe 
 one. An accidental experiment of this nature 
 is actually given in the paper, with an excel- 
 lent result. ' In one lady, a case of stupor, 
 gastritis was set up "by irritation from the 
 tube," and, curiously enough, the pyrexia was 
 coincident with the commencement of her 
 recovery.' Although this is not mentioned,
 
 140 FADS OF AN OLD PHYSICIAN 
 
 the gastritis necessarily rendered the feeding 
 impossible, and we may well suppose that 
 stopping the feeding would have been equally 
 salutary, without the gastritis. 
 
 The lasting moral effect of this barbarous 
 treatment is said to be good ; so is the moral 
 effect of a Maxim gun on a crowd of savages, 
 and it may be lasting on the survivors. 
 
 If water is refused as well as food, the 
 experiment can be carried on safely for a 
 much shorter period. Fluid could, if abso- 
 lutely necessary, be given by the bowel, with 
 but little trouble ; but if water is left in the 
 way of the patient, and no inducement what- 
 ever is given to take it, there can be little 
 risk of death from thirst, the craving is too 
 strong ; but force naturally excites resistance.
 
 XIII 
 
 THE RESPONSIBILITIES OF HEALTH 
 
 HEALTH is to man his supreme blessing. With- 
 out it life is a more or less constant misery. 
 The force of the instinctive dread of death 
 may be measured or judged of by the rarity 
 with which the miserable bring it on them- 
 selves, when suffering becomes intolerable ; 
 and when the desire for ease and rest, which 
 is so easily within their reach, so fills their 
 thoughts as to exclude every other feeling. 
 The health of the individual, like his religion, 
 depends originally, not on himself, but on the 
 circumstances of his birth and his surround- 
 ings, on the health of his progenitors, on the 
 care taken of him before he can do anything to 
 guide himself, and on making the best he can
 
 142 FADS OF AN OLD PHYSICIAN 
 
 of the bodily condition in which he finds 
 himself. Up to the age of puberty a man 
 has little responsibility for his own wellbeing. 
 His actions are so dependent on the will of 
 his parents and teachers that little room is 
 left for self-guidance, and his habits are 
 often formed before his own observation and 
 experience have taught him what is essenti- 
 ally right and true. He may be already on 
 a path which will lead him downwards, and 
 his life may be a lost one before he has begun 
 to realise its value. There are others, however, 
 and it is to be hoped the great majority, who, 
 when come to years of discretion, have a 
 more or less healthy body entrusted to them, 
 which they may use aright or which they 
 may abuse. The authority to which they 
 have been subjected must still in a great 
 measure influence their actions from the 
 habits formed during its rule ; but they can 
 now use their reason in judging of the value 
 to be attached to the teachings of this 
 authority, and they can strike out a new path
 
 THE RESPONSIBILITIES OF HEALTH 143 
 
 for themselves. It is right that it should be 
 so, otherwise there would be no progress in 
 humanity, as here what applies to each indi- 
 vidual applies to all. One generation thus 
 becomes responsible in a great degree for the 
 wellbeing of the next, and the result may be 
 progress or deterioration according as the 
 general influences of the day are conducive 
 to the furtherance of what is good and true, 
 or of what is evil and false. 
 
 If we are right in the foregoing general 
 remarks, it needs no argument to show how 
 great is the responsibility of every one of us 
 for our free actings, as it is by these only that 
 we can affect one way or other the tendency, 
 good or bad, of human progress. We not 
 only, each one of us, receive for ourselves the 
 reward or punishment of an honoured or a 
 broken law, but we pass on to another 
 generation, as our parents passed on to us, 
 the blessings or the curses which are the 
 certain consequences of our good or evil 
 actions. How needful, therefore, it is for us
 
 144 FADS OF AN OLD PHYSICIAN 
 
 to search out, so far as our powers and our 
 opportunities allow us, what are the laws by 
 acting in harmony with which we may live 
 and prosper, and by resisting or opposing 
 which we doom ourselves and others to 
 degradation and premature extinction. Here 
 we will deal only with the physical side of 
 the question, and this may prove to be the 
 most important, as without a sound and well- 
 regulated body there is little or no hope of a 
 healthy and well-ordered mind. 
 
 As has been noted elsewhere, 1 the laws by 
 which we are governed are often made clear 
 to us by the results which follow their being 
 broken. We may learn in this way by the 
 experience of others, but the lesson is much 
 more effectual when we ourselves are the 
 sufferers. But even so, the lessons may be 
 many and sharp before we come to their true 
 reading, especially if they are contrary to 
 what we consider our very natural desires 
 and feelings. Our appetites seem to be given 
 
 1 Plea for a Simpler Faith, p. 124.
 
 THE RESPONSIBILITIES OF HEALTH 145 
 
 us that they may be gratified, and we have 
 to learn that their full enjoyment can be ours 
 only when they are used temperately, and 
 with occasional intermissions when their pru- 
 dent use may have gone on to abuse. 
 
 To many it will be a novel idea, and some- 
 what of a paradox, that health may be too 
 good, and a cause of evil to its possessor. 
 Like all other good things, it may be abused, 
 and its very goodness may lead to its being 
 so. A strong machine is the only one which 
 will stand a large amount of overwork and 
 ill-treatment, and for a time show no signs of 
 failure ; but its period of usefulness is unduly 
 shortened, and sooner or later it comes to a 
 premature end. It may be that this is right 
 and proper, as it may suit the owner better 
 to have from it a larger quantity of work done 
 speedily, than to have the same work spread 
 over a longer period ; and when the over- 
 worked machine is worn out another can be 
 put in its place. It is not so with the human 
 body, a healthy condition of which is neces- 
 
 10
 
 146 
 
 sary for the performance of its proper func- 
 tions. If from an excess of work demanded 
 of them the organs become weakened and 
 worn out, there is no possible means of re- 
 placing them. Nature may demand a cessa- 
 tion from work before exhaustion is complete, 
 and life may still be prolonged for a time, but 
 it will be a life not worth living, all useful- 
 ness and happiness having gone out of it, 
 and nothing being left but suffering aggra- 
 vated by deep and unavailing regrets. There 
 are, no doubt, circumstances under which a 
 man may knowingly shorten his life by over- 
 working his body, with honour to himself and 
 benefit to others, but such a sacrifice can 
 seldom be demanded, and at best it implies 
 the breaking of nature's laws. The very 
 much more common case is that from ignor- 
 
 o 
 
 ance, or from wilful indulgence, the system is 
 so overloaded by more food being taken than 
 is required for the proper acting of its func- 
 tions, that undue means must be taken to 
 get rid of the excess. This may be done by
 
 THE RESPONSIBILITIES OF HEALTH 147 
 
 over-stimulation of the organs of digestion 
 by drugs ; or by excessive and useless 
 muscular work, as an engine can be got to 
 use up more steam than is required for its 
 proper work, by increasing its speed ; thus 
 wearing out the machine, and it may be lead- 
 ing to the work being done in a less satis- 
 factory manner. To some it may seem 
 absurd to dwell on these so manifest truths. 
 But it is still more absurd for any one to for- 
 get them, and this forgetfulness or inattention 
 undoubtedly has led to the existence of more 
 misery and more throwing away of health 
 and of life among the strongest and healthiest 
 of the well-fed, than has war, pestilence, and 
 famine among the same races of mankind. 
 It is the strong and healthy individual only 
 who can make grievous errors, and continue 
 them for an indefinite time, with no sign of 
 failure, and with no hint or warning of com- 
 ing evil ; and he may go on in comfort till all 
 his organs have become irretrievably dam- 
 aged. The weaker in constitution, especially
 
 148 FADS OF AN OLD PHYSICIAN 
 
 if one organ or set of organs is even more 
 feeble than the others, cannot go so far 
 wrong. He is pulled up in time ; and though 
 he may not be able to enjoy life and its good 
 things so freely as his apparently more for- 
 tunate brothers, yet with care he may be 
 quite capable of doing all the work required 
 of him with ease and comfort, and for a much 
 longer period. I have known very many 
 strong, healthy men and women who natu- 
 rally would be expected to live to a long age, 
 but most of them, from presuming on their 
 strong constitution, and living too freely, 
 have died while still in their prime ; or of the 
 few who have reached a moderate old age, it 
 has been with health much broken down ; 
 and the very few who have attained to their 
 threescore-and-ten and upwards have had 
 their years renewed by one or more severe 
 illnesses from which recovery for a time 
 seemed to be hopeless. It is reasonable to 
 think, that if the strong and healthy who lived 
 too fully had done as their weaker brethren
 
 THE RESPONSIBILITIES OF HEALTH 149 
 
 were obliged to do, their lives would, compara- 
 tively, have been much longer and happier, 
 and they would have transmitted to another 
 generation in a still higher degree their own 
 inherent good qualities ; and if their descend- 
 ants should happily learn to follow in the 
 right path, there might well be reached in a 
 few generations the term of a hundred years 
 and upwards, which some physiologists 
 have fixed as the natural period of human 
 life. The pity of it is that most medical men 
 overlook the evils which come upon the 
 healthy from free living, and that in this 
 they are encouraged by the prevailing 
 doctrines of the day as taught in the medical 
 schools, and that they misread the clear warn- 
 ings which nature gives. Some there are, no 
 doubt, who do recommend moderation when 
 excess is carried so far as to be manifestly 
 dangerous, but even they, when nature rebels 
 against a wasteful abuse, instead of prescrib- 
 ing abstinence till she indicates the restora- 
 tion of the exhausted organs, resort to
 
 150 FADS OF AN OLD PHYSICIAN 
 
 drugs to do what in most instances is 
 being better done without them, and, if the 
 desire for food does not return in a very 
 few days, they force it in some form on the 
 reluctant sufferer. This they do on the false 
 idea that it will support his strength, and 
 enable him to throw off the disease, whatever 
 this may mean ; or that it will at least retard 
 the waste of the body. I have known for 
 many years that there is no truth whatever 
 in these ideas, and that on the contrary 
 nothing causes more discomfort and weak- 
 ness than taking food which cannot be di- 
 gested, and which only adds to the matters 
 which the system is busied in getting rid of. 
 In my anxiety to get well quickly, I tried 
 this method on myself times without number, 
 and I now know that I only aggravated and 
 prolonged my sufferings. Dr. Dewey of 
 America, whom I have already quoted, has 
 proved, in a very large number of cases, the 
 benefit which follows complete abstinence 
 from food, both in acute and in chronic
 
 THE RESPONSIBILITIES OF HEALTH 151 
 
 ailments of all sorts, and this he does much 
 more thoroughly than has been my custom. 
 For upwards of fifty years I acted on the 
 idea that white of egg much diluted, or 
 lime-water and milk, or both combined, 
 helped to carry down the bile and other 
 secretions ; and they certainly were often 
 grateful to the patient, when taken from 
 time to time in small quantity, and they 
 seemed to relieve better than anything else 
 the irritable stomach. 1 If plain water was 
 preferred, it was given instead, and had I 
 the occasion now to use either, I would 
 
 1 I first saw white of egg in water used for diarrhoea by 
 Chomel, in the Hotel Dieu, Paris, in 1841. It was given 
 ad libitum, and with no other food or medicine. The effect 
 was excellent on a large number of cases, an epidemic of 
 diarrhcea having prevailed at the time. The patients were 
 kept strictly in bed. For diarrhoea I have rarely used 
 any other means, unless it was accompanied with pain, and 
 then opium, or opium with castor oil, is very efficacious. I 
 have known white of egg most useful in catarrhal jaundice, 
 probably from relieving irritation of the duodenum, and 
 temporary obstruction of the gall-duct. I read long ago in 
 a medical annual that before mercury came so much into 
 ' general use white of egg was used for the same pur- 
 poses.
 
 152 FADS OF AN OLD PHYSICIAN 
 
 follow Dr. Dewey's example and give water 
 alone. In my own case I have done this 
 frequently, but I cannot recall an instance 
 in which it was necessary for more than 
 three days. When very busy at home I 
 had to go to London to give evidence in a 
 law court. I lived for three days and nights 
 in a hotel in Jermyn Street. The hurry 
 to get away and the journey brought 
 on a slight attack of my old headache 
 and sickness, and as the case was de- 
 layed till the third day, I was glad to re- 
 main in bed. One day I asked for a cup of 
 tea, but could not drink it, and I took liter- 
 ally nothing but water. As soon as the trial 
 was over, I told the landlady that I was to 
 return to Edinburgh by the night train. She 
 expostulated with me for dreaming of taking 
 the journey without food, when I told her I 
 would take nothing till morning, if then, but 
 that I was nearly well, and would be able to 
 do my next day's work. She then told me- 
 that she was treated very differently by her
 
 THE RESPONSIBILITIES OF HE A LTH 153 
 
 doctor. She was a stout, dark woman, and 
 one would not have taken her for an invalid, 
 but she suffered from terrible headaches. 
 She was ordered to live very freely, and to 
 take a full supply of wine. Her last pre- 
 scription, a very recent one, was to take on 
 going to bed a large glass of whisky, with 
 water. Next day she told the doctor that 
 she could not take this as it made her tipsy. 
 The doctor's answer was, ' Take the whisky 
 after you go to your room, and no one will 
 see you tipsy ' ! I gave her very different 
 advice, but I do not know if it was acted 
 on or not ; most probably it was not, but, 
 should this meet her eye by any chance, I 
 would be glad to know. Our meeting was 
 twenty -seven years ago, and unless she 
 changed her mode of living, the chances that 
 she still survives are very small.
 
 XIV 
 
 IN the ' Plea for a Simpler Life' I scarcely 
 touched on the subject of the moral evils that 
 arise from bringing up the young on a too full 
 and exciting meat diet. This is a matter which 
 it is difficult to treat in a popular manner, 
 and some may blame me for touching on 
 it at all. I have done much for many 
 years privately, whenever I had the oppor- 
 tunity, to impress on fathers and mothers 
 the danger to their sons and daughters from 
 exciting prematurely their natural desires and 
 passions ; but custom and fashion have so 
 powerful a hold, especially in the higher 
 circles of society, that I have frequently had
 
 HIGH LIVING AND MORALS OF THE YOUNG 155 
 
 to feel that my efforts were in vain. The 
 foundation of mischief is often laid at home, 
 but the evil system reaches its highest de- 
 velopment in many, if not all, of our first- 
 class public schools and colleges, where the 
 youth is away from home influences, and 
 comes into contact with others older than 
 himself, whose evil communications soon put 
 him on a level with themselves. The exist- 
 ence of bad habits in such schools is well 
 known to the masters, and they take 
 what measures they can for their preven- 
 tion. Even when they know the truth, 
 the strength of custom and habit so impera- 
 tively demands a full diet for the growing 
 youth that they are obliged to fall in with 
 the fashion of the day. But few of them are 
 aware of the main cause of the evil, and the 
 last thing most dream of as a remedy is a 
 simpler diet. They think to give vent to the 
 spirit of their boys, and to make them strong, 
 hardy, and self-reliant, by encouraging them 
 to the utmost to active exertion in the
 
 156 FADS OF AN OLD PHYSICIAN 
 
 gymnasium, and in outdoor games, and by 
 free use of cold-water bathing. They think 
 they prove the value of these exercises when 
 they point out that some of the best athletes 
 are also the best scholars. But this only 
 proves that vigour of mind and body often 
 go together, which was well known before so 
 much credit was given to what many consider 
 a premature use or abuse of physical energy. 
 It may be well to err rather on the side of 
 exerting one's muscles somewhat too much 
 than too little, but there is a medium in all 
 things ; and, if an abnormal amount of 
 exercise is required in order to redress a too 
 full diet, the final result may be an unneces- 
 sary waste of energy and of bodily strength ; 
 just as too much premature mental study and 
 strain weakens the mental power, often for 
 a time, and sometimes permanently. It is 
 well known that a large amount of mental 
 as well as bodily work may be done on a 
 moderate diet made up wholly of vegetable 
 food and milk, and that this may be kept up
 
 HIGH LIVING AND MORALS OF THE YOUNG 157 
 
 for an indefinite period, with no risk to the 
 system ; while it is also known that a pro- 
 fessional, or any one else, if he lives too long 
 on a training diet, made up very much of 
 flesh, often comes to an untimely end, unless 
 he be pulled up in time by an acute disease. 
 In New Testament times and countries 
 morals were at a very low ebb, even in the 
 Christian communities, and good rules are 
 given for attaining a higher moral standard 
 than was professed by the surrounding 
 heathen world. Some of these rules have a 
 physical as well as a moral side. The former 
 may be found, in a very precise and emphatic 
 form, in the last verse of the fifth chapter of 
 the Epistle to the Hebrews. ' Strong meat 
 belongeth to them that are of full age, even 
 those who by reason of use have their senses 
 ['organs of sense/ as literally translated by 
 Dean Alford] exercised to discern both good 
 and evil.' In the first lines of the passage 
 we have given in a complete form the rule 
 which in a very modified form I have en-
 
 158 FADS OF AN OLD PHYSICIAN 
 
 deavoured to inculcate for wellnigh half a 
 century. In the remainder of the verse we 
 have the reason given why the rule is neces- 
 sary. It is, that only those who arrive at full 
 age can make a right use of the organs 
 indicated, which are absolutely needful for 
 the preservation of the species. If they are 
 excited prematurely they can only be made a 
 bad use of, and this precocity comes as a 
 consequence of giving strong meat before the 
 arrival of full age. Punishment necessarily 
 follows every broken law, even though it is 
 broken in ignorance. It is a sad thought 
 that so many of our best youths, especially in 
 the higher classes, are subjected to a bring- 
 ing-up which makes it very difficult for them 
 to live a natural and pure life. Youths of a 
 coarser fibre, especially those of the muscular 
 or sanguine temperament, may stand a great 
 deal of wear and tear with but little per- 
 manent injury. Such may 'sow their wild 
 oats ' freely enough, and become after it all 
 respectable members of society. But those
 
 HIGH LIVING AND MORALS OF THE YOUNG 159 
 
 of a more sensitive and delicate type, and of 
 the nervous temperament, suffer most, and, 
 unless they have an unusually strong con- 
 stitution, often permanently. A headmaster, 
 as I have told in the ' Plea ' (p. 106), was con- 
 vinced that high feeding was the cause of 
 much evil, but under the circumstances in 
 which he was placed he could do nothing to 
 prevent it. Some twenty years later, the 
 same master said to a friend of mine, who 
 had asked him what became of all the fine 
 lads under his charge, ' One-half of them go 
 to the devil.' And the same system goes 
 on still. The subject is an unpleasant but a 
 very important one. I would not have 
 touched it had I no remedy to offer. A 
 youth on simple diet may go wrong ; on a 
 full diet and with a good stomach he can 
 scarcely fail to do so.
 
 XV 
 
 MY TEACHERS 
 
 THE history of three ladies, who fell to my 
 care very early in my professional life, gave 
 me timely hints of the benefit which may 
 result from a very restricted diet both 
 temporary and permanent. They owed 
 nothing to me for the adoption of a method 
 that proved so salutary, and the only credit 
 I can take is that I watched the process with 
 an open mind, and had the good sense to 
 make use of it for others when I had seen its 
 value. I must confess, however, to an error 
 I made in the case of another lady, whom I 
 could not induce to take the food I considered 
 necessary for the work she had to do in the 
 way of teaching. At last I told her I would
 
 MY TEACHERS 161 
 
 not continue my attendance, as it could be of 
 no use so long as she would not take suffi- 
 cient nourishment. I left her, and I heard 
 long after that she was still taking her own 
 way, and was getting on very well without 
 me. This also was a lesson. 
 
 A lady, Mrs. S , about middle life, 
 
 was in 1845 P ut under my care by Professor 
 Simpson. He told me that she could not 
 live long, as she was in an advanced stage of 
 albuminuria or Bright's Disease not so well 
 known then as now. She was very thin and 
 very irritable, but had still some strength, 
 especially of will. For some time Simpson 
 and her husband had been making every effort 
 to induce her to take more food and any 
 stimulant she could fancy ; of the latter she 
 would take none, and of food in any form 
 extremely little. A reason pressed on her 
 was that she must take something to make 
 up for the constant loss of albumen. At first 
 I did my best to induce her to eat, but to no 
 purpose, and I dare not mention the amount
 
 162 FADS OF AN OLD PHYSICIAN 
 
 and kind of food she took ; it would not be 
 believed. Time went on, she continued to 
 do the duties of her household ; she spent the 
 summer always in the country, and though 
 incapable of any but the most moderate 
 exercise she in a measure enjoyed life. 
 After some years I found that the albuminuria 
 had completely ceased. She was now taking 
 a little more food, but still her diet would be 
 considered a starvation one. After twenty 
 years and she had her troubles in the mean- 
 time, from the death of her husband and 
 other circumstances she began to enjoy 
 better health, and latterly she liked a glass of 
 wine. But by and by, when arguing with a 
 fishwife at her own door one cold day, she 
 got a bad chill. Acute albuminuria now 
 came on. She got over the first attack, but 
 another in a few weeks killed her. The 
 kidneys were both found to be reduced to a 
 mere shell, and this, I believe, must have 
 been very much their state from the time I 
 first saw her. Had she fed then as we all
 
 MY TEACHERS 163 
 
 wished, no doubt her life would have been a 
 very short one. 
 
 Mrs. F , a pretty, young, healthy woman, 
 
 one of a large family of daughters, all robust 
 and good-looking, suffered very much on a 
 long and rough voyage across the North Sea. 
 She was very sick and did not get her clothes 
 off during the voyage. She had a bad fever, 
 which ended in an unsightly eruption on her 
 face which would not leave her. Everything 
 was tried by others, and then by myself in 
 1847. The chief means I used was careful 
 dieting, but with little benefit. I had not 
 seen her for about six months, when, to my 
 astonishment, I found her with a face free of 
 eruption and fair as before. She told me 
 
 that Captain had advised her to give up 
 
 all flesh meat. He had been troubled with 
 a similar rash, and had found this a perfect 
 cure. Very soon, on the same plan, Mrs. 
 
 F had the same experience. She was now 
 
 married, and by and by had a well-developed, 
 healthy child. I was by no means sure that
 
 1 64 FADS OF AN OLD PHYSICIAN 
 
 she would make a good nurse on her present 
 fare, and advised that she should take a 
 moderate amount of boiled fowl. She tried 
 it a few times, but she thought the eruption 
 was threatening to return. She dropped it, 
 and has gone on her old way for fifty years. 
 She has had a large and very handsome 
 family of sons and daughters. When I first 
 knew her she had bad heart disease, which 
 came on also after her voyage. It has 
 given her much trouble in recent years ; but, 
 as I have found in others, her simple living 
 seems to have checked its development. 
 Her diet has been extremely simple, and in 
 quantity very restricted almost as much so, 
 
 in recent years, as that of Mrs. S . 
 
 Mrs. L , a young married lady, came 
 
 under my care in 1849. She was healthy and 
 had already a young family. She was in a good 
 position, and enjoyed life and its usual com- 
 forts, but occasionally she made a bad break- 
 down. It was in one of them I first saw her 
 along with Professor Simpson. She went to
 
 MY TEACHERS 165 
 
 bed and took almost no food ; for weeks it 
 was only a little oatmeal which she kept by 
 her, and occasionally she wet her finger and 
 put to her mouth what adhered to it. I think 
 this first attack was the longest she had, and 
 it prepared me for others, of which she had 
 altogether a good number, sometimes at inter- 
 vals of years. She had other illnesses, but 
 there was nothing remarkable about them. 
 The difference from the two other cases I 
 have mentioned was that she lived well during 
 the intervals, while the others lived always 
 most sparingly. Later in life she had a smart 
 attack of the prevailing influenza. She 
 followed my plan of treatment, or rather I 
 should say I encouraged her to follow her 
 own. As she was getting better, she told me 
 one day with some amusement that her sister- 
 in-law, a younger and much stronger woman, 
 was also laid up with influenza, and was 
 taking a rather gloomy view of her case. 
 She was, of course, being treated on the 
 ' keeping-up ' plan. One day, in presence
 
 1 66 FADS OF AN OLD PHYSICIAN 
 
 of her doctor, one of her friends tried to cheer 
 
 her up by alluding to herself (Mrs. L ), 
 
 and pointing out that she was much older and 
 frailer, and had a worse attack. 'Yes,' she 
 replied, ' but she has a sensible doctor.' The 
 younger and stronger lady died in a few 
 days, much to the distress of my patient, who 
 lived for years after this and died at a good 
 old age. 
 
 But for the fact of my having met with 
 these three cases so early in my professional 
 life, I doubt if I would ever have come to 
 carry out so thoroughly the natural mode of 
 treatment I have so long followed, or that I 
 would have ventured to recommend it to the 
 public and to the profession. And had I not 
 been so convinced of the great mischief, 
 especially of late years, to sufferers from 
 influenza from the opposite treatment, I 
 would still less have dared to mention the 
 rather grim anecdote I have just related. 
 Had the treatment in the two cases mentioned 
 been reversed, I cannot but think that the
 
 TEACHERS 167 
 
 result in both would have been reversed 
 likewise. But as I have said elsewhere, the 
 physician has but one chance. 
 
 The three histories given above were, 
 more than any others, of great value in 
 showing to me nature's methods of dealing 
 with disease. But ever since they put me 
 on the right road, my education has been 
 carried on by the occurrence of innumerable 
 instances in which I have been enabled 
 to give help in well-nigh hopeless condi- 
 tions, where the opposite plan of ' keeping 
 up the system ' had been long followed, 
 with no result but more or less rapid 
 deterioration. The two following cases I 
 am tempted to give as fair specimens of the 
 safety with which the necessary change of 
 treatment can be made when strength is at 
 the lowest, and as indicating what an amount 
 of suffering might have been spared had the 
 change been made at an earlier period. In 
 August 1874 a youth of eighteen was brought 
 to Edinburgh. His health had broken down
 
 1 68 FADS OF AN OLD PHYSICIAN 
 
 eight months before when studying for college. 
 He had spent some months at a hydropathic 
 institution in England, and had subsequently 
 been under the treatment of two of the most 
 eminent physicians in London. His health 
 had gradually got worse, and he was now 
 reduced to an extreme state of emaciation 
 and feebleness. Any food he tried to take 
 brought on pain and chilliness to a degree 
 I had never met with before, and I never 
 undertook a more hopeless case. On the 
 lines of treatment followed hitherto there 
 was manifestly no hope whatever ; but my 
 methods were known to some near relatives, 
 and I was able to treat him as I wished. 
 Very small quantities of farinaceous food 
 with a little milk gave less discomfort than 
 anything he had tried, and to this he 
 was restricted for many weeks ; but the 
 cure, which commenced at once, was a very 
 tedious one. The great peculiarity in the 
 case, was chilliness coming on when he took 
 anything like a meal. He could swallow
 
 MY TEACHERS 169 
 
 nothing without hot bottles to his stomach 
 and back, or when somewhat stronger he 
 sat with his back to a hot fire ; and when 
 he was able to take a drive, he needed hot 
 bottles and the warmest clothing even in 
 fine weather. Another difficulty was to keep 
 the bowels open. In infancy, from a fall 
 owing to the carelessness of a nurse, he got 
 hemiplegia of the right side. This no doubt 
 rendered the bowel difficulty greater, and, 
 after some attempts were made at intervals 
 to relieve it by medicine and other means 
 which did more harm than good, it was 
 absolutely left to nature ; and for twenty 
 years no artificial means whatever have been 
 required. His strength slowly improved and 
 ability to take more food, which had still to 
 be of the simplest kind. After nearly five 
 years I advised that he should go to a warm 
 climate, and he went accompanied by an excel- 
 lent nurse to Pau, Portugal, and Madeira. 
 He returned after a year and a half very 
 much improved, and he was soon able to
 
 i yo FADS OF AN OLD PHYSICIAN 
 
 occupy himself with literary work, in which, 
 both in prose and poetry, he has proved him- 
 self a successful worker. He is of too high- 
 strung a temperament even yet to indulge 
 in wine or strong meat, but this notwith- 
 standing, he can enjoy London society in a 
 moderate degree with safety and pleasure. 
 
 Twenty years ago I was asked to visit a 
 lady at Tunbridge Wells. I had seen her 
 occasionally before when she was a patient 
 of Professor Simpson. She was then very 
 delicate, and suffered from neuralgia. Her 
 health got gradually worse, and she had to 
 spend the winter in the south. She had 
 just come from Cannes. I found her in 
 about the lowest condition I ever saw any 
 one. The best of everything had been tried 
 to keep up her strength, but to no purpose. 
 She told me that at Cannes she remembered 
 I had said, twenty years before, that if she 
 would give up wine which she was taking 
 freely by order, she would get rid of her 
 neuralgia ; and in despair, and against the
 
 MY TEACHERS 171 
 
 advice of her doctor and all her friends, she 
 gave up all stimulants. The result was as 
 she hoped rather than expected, and she 
 resolved to see me as soon as possible. As 
 I have stated, she was in a wretched con- 
 dition, and she did not seem to have a sound 
 organ in her body. The food which she 
 still tried to take was doing her no good, 
 and she was about as thin as possible. I 
 confess I had not much hope of being of 
 use, but as the only chance of getting her 
 stomach into a better condition, I stopped 
 all rich food and put her on the lightest of 
 diet, and very little of that. Very gradually 
 she began to improve, but for years she lived 
 on the most meagre diet. She came up to 
 London, and for many winters she kept her 
 room, and mostly her bed. But she gradu- 
 ally got stronger ; her heart and lungs, from 
 which she suffered most after her stomach 
 improved, got into a healthier condition. 
 For some years she has gone to the south 
 during the winter, but her headquarters
 
 172 FADS OF AN OLD PHYSICIAN 
 
 are in Scotland. Though still requiring 
 to live very carefully, she is now in 
 better health than I have known her at 
 any time. Of late years she has escaped 
 the dreadful rounds of neuralgia she "was 
 used to. These in a milder form were 
 long troublesome, and during them I re- 
 commended a moderate use of wine, and 
 she found it helpful. 
 
 These and other cases which I have given 
 in this volume and in the 'Plea,' give full 
 information as to my ordinary, and I may 
 say invariable methods of treating disease 
 when I was allowed to have a free hand. 
 They differ absolutely from the depleting 
 measures which ruled the profession during 
 my student days, and early professional life ; 
 and they differ just as widely from the medical 
 doctrines and methods now generally taught 
 and practised. I can claim no special skill 
 in treating disease apart from the methods 
 used, nor any immunity from errors in diag- 
 nosis to which all are liable. If I have been
 
 MY TEACHERS 173 
 
 right in adopting a middle course for half a 
 century, during which my clients have given 
 me credit as a successful physician, there 
 must be some huge errors on the part of 
 those who follow methods which in many 
 cases are the very opposite. 
 
 THE END 
 
 Printtdby R. & R. CLARK, LIMITED Edinburgh.
 
 PLEA FOR A SIMPLER LIFE 
 
 BY 
 
 GEORGE S. KEITH, M.D., LL.D., F.R.C.P.E. 
 
 PRESS OPINIONS 
 
 " Whatever discussion may arise over this book between the author and his 
 fellow medical men, the fact will not be altered that there is much in it that 
 ought to be carefully considered by most of us." The Scotsman. 
 
 "There is much sound advice given in this little volume which will be of great 
 service to both the healthy and the unhealthy." Dundee Advertiser. 
 
 " His opinions may be read with advantage." The Times. 
 " Pithy and pungent little treatise." The Globe. 
 
 " There is no doubt whatever that the book is full of wise counsel." Edinburgh 
 Medical Journal. 
 
 "There is much truth, and earnestly expressed, in the pages of this small 
 volume, and we sincerely hope that it may receive the attention which it 
 assuredly deserves, from the medical practitioners of the present generation 
 and that the publication may bear fruit towards the reformation of some few, at 
 least, of the many flagrant abuses of medical teaching and practice." Dublin 
 Journal of Medical Science. 
 
 " Dr. George Keith's closely-reasoned and temperately-worded ' Plea for a 
 Simpler Life' cannot be dismissed as superfluous. Much of his advice is as 
 shrewd as it is sound." The Speaker. 
 
 " There are few works containing more sound common sense and good practical 
 wisdom put into small compass as in the little book bearing the above title. 
 It is worth its weight in gold to the man who would rather go in for prevention 
 than cure." The Liberal. 
 
 " It is the old exhortation, plain living and high thinking. But it is more, it 
 shows the way to reach it. It is indeed a most earnest yet scientific exposition 
 of the evil we do to our bodies and souls and spirits by mixed dishes and medi- 
 cines. If we would follow Dr. Keith's advice and take his prescriptions, we 
 should have less dyspepsia and less atheism amongst us, less need for doctors of 
 medicines and less need for doctors of divinity." Expository Times. 
 
 " This very interesting little book." The Guardian. 
 
 " As interesting as it is disinterested, and as valuable as it is cheap." Great 
 TJioughts. 
 
 " The treatise is a powerful argument against the abuse of food and stimulants, 
 both in health and sickness." St. James's Budget. 
 
 " The book is well worth reading." The Lancet. 
 
 " This essay is a most profitable and even weighty contribution to medicine, 
 full of observation and original thought." The Academy. 
 
 " This is a charming little book. There is much sound common sense and a 
 great deal of solid truth in what he says, and his little book deserves to be widely 
 read." Manchester Guardian. 
 
 " Most of us, I suppose, want to live as long as we can, and to make our lives 
 as comfortable as possible. Various counsellors in all ages have given advice 
 with a view to the attainment of these desirable ideals ; but I am not sure that 
 any one of them hits the nail on the head with a finer precision than is achieved 
 by Dr. George S. Keith, whose ' Plea for a Simpler Life ' is of sturdy common 
 sense all compact." The Ne-w Age. 
 
 LONDON : A. & C. BLACK, SOHO SQUARE.
 
 DATE DUE
 
 WB 930 
 K 28f 
 
 1897 
 Keith: Fads of an old physician 
 
 WB 930 
 K 28f 
 
 1897 
 Keith: Fads of an old physician 
 
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