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  THE STOMACH





         AND






ITS  DIFFICULTIES.
/ 
VITA  BREVIS, ARS  LONGA,




OCCASIO PK.SCEPS. EXPERIENTIA FALLAV,




JUDICIUM  DIFFICILE.




                      Hipj-ocr.  Aphor.  i.
(») 
THE      STOMACH
ITS   DIFFICULTIES.
BY
      SIR  JAMES   EYRE,  M.D.,
MEMBER OF THE ROTAL COLLEGE OF PHYSICIANS OF LONDON; LATE CONSULTING
      PHYSICIAN TO THE ST. GEORGES AND ST. JAMES'S DISPENSARY.
' In primis valeas bene ; nam varise res
 Ut noceant homini, credas, memor illius escae,
 Quae, simplex, oiim tibi sederit. at simul assis
 Miscueris elixa, simul conchylia turdis,
 Dulcia se in bilem vertent, stomachoque tumultum
 L.enla feret pituita."
              Horat. Sat. L. ii. 2, 71-75.
CO
Vfr-''*?-
SIXTII EDITION.
        PHILADELPHIA:
J. B.  LIPPINCOTT  k  CO.
    LONDON": J. CHURCHILL & SONS.
             186 9. 
£98s
 1869
Lippincott's Press, Philadelphia.
(iv) 
         m  Affectionate Hememkrance
                       OP
   JOHI   ABE EKE THY,
             THE PROFOUND PHILOSOPHER,
        THE  HIGHLY-GIFTED INSTRUCTOR,
     THE  BELOVED  OF HIS PUPILS  IN LIFE,
              THE REVERED IN DEATn,
   THE  FOLLOWING  CURSORY REMARKS
          ON  HIS FAVORITE SUBJECT,
       FOUNDED ON HIS ENLIGHTENED PRINCIPLES,
AND CONFIBMED  BY THE  RESULTS OF EXTENSIVE EXPERIENCE,

           %n Swtifuttij £nm'ibt&
     BY A MEMBER OE  HIS  CLASS OE
                     1812-13.
(▼) 
 
PEEFACE.
  It is long since I promised  to  give to the
public the result of my observations on the Di-
gestive Organs, the study  of which has  been
always, to me, replete with  deep interest; and
having.at length  nearly renounced all nocturnal
professional avocations, I am thereby  enabled,
with undisturbed study and calm reflection, to
watch the ever-varying phases presented by that
important organ, the stomach;—which, when it
duly furnishes  its pure functional secretions, is,
like fire, invaluable,—as a slave; but otherwise
it becomes  a dangerous, because too powerful,
despot!   It is either, like the "vernal airs" that
usher  in the "gentle spring," mildly,  but mu-
nificently,'refreshing and revivifying the earth;
or else it  resembles the  rude violence of ele-
mental strife, devastating by its impetuous fury
all that impedes its disastrous  course.  Be  it
                                   (vii) 
via
PREFACE.
then still my daily study to minister to "The
difficulties of the  stomach" — that  Pandora's
box—the fons et origo—the source of so many
of our corporeal and some of our mental sus-
ceptibilities!   Let me not, however, be under-
stood  as meaning to  herald these  practical
remarks  in deprecation of severe criticism,  by
unfelt  declaration of  humility and unfitness for
the task I have undertaken.   On the contrary, I
have come forward to offer  in all truthfulness
some of the results of a diligent observation and
inquiry during a long life, for the consideration
of the  profession to which I have the honor to
belong, totally free from any anxious misgivings
as to its reception; for I anticipate a second kind
and cordial welcome from my brethren,—found-
ing my expectation on  the full assurance that
they love truth  for its own  sake,  and will  be
pleased to see, in this performance, not a mere
exhibition of  the lucubrations of others,  dap-
perly arranged and paraded for display, but of
those which  have been, in fact, gathered and
carefully garnered for use—being the fruits of
my own  gleanings at  the bedside or in the con-
sulting-room— following therein, though  haud 
PREFACE.
ix
 passibus cequis, the  example of my first surgical
 instructor, Sir Benjamin Brodie; who, when  I
 expressed my opinion  that  his  lectures were
 greatly  prized by  my fellow-pupils  even forty
 years  ago, replied, "I have myself wondered that,
 with so little experience as I then had, my lec-
 tures should have  been popular with the students.
 I believe the explanation is, that although I had
 not much information to give, what I did give
 was drawn chiefly from  my own  written notes
 of cases, so that I communicated my own knowl-
 edge, and not that copied from books."  It may
 be  said that the style of my work is not suffi-
 ciently grave, and  that the introduction of a'
 lively anecdote is hardly defensible, when treat-
 ing  on the serious subject of  human disease,
 and also that the rules which are here laid down
 for the preservation  of health are so stringent
 that it will  be impossible to  carry them into
practice.  To  the first objection I would  reply
 that man's nature  must be  changed,  before
 he who is daily and hourly " thankful for being
 (physically) not  as some other men are," can
not only think, but  speak  and write from the
impulse  of his contented, nay, cheerful  mind. 
X
PREFACE.
And be it remembered that happily, in medi-
cine, the  age of wigs  and canes (gold-headed)
has long since  passed  away!  And well I wot,
if there be  not capacity,  beyond the ordinary
caliber, in the  physician,  he will soon  be dis-
tanced in this  stirring go-ahead era;  and al-
though tricks and  traps for the unwary were
ne^er  more rife and quackery  and shameless
pretension more successful than in the  present
generation, such can, we may hope, only prevail
for a season; while honesty, plain dealing, truth,
and consistency will stand forth triumphant to
the last.   To those  persons who  talk of impossi-
bilities,  I would only say  that the  sooner the
word is expunged from the medical vocabulary
the better for*  the  weal of mankind.   And I
hesitate not to affirm that all which I enjoin
may,  though not  without effort,  be attained,
more or less, by every one,—and is entirely and
unmistakably within the power  of many.  One
great fact, at least, I have  ascertained (which of
itself might constitute the reward  of a life of
labor),—namely, that stomach complaints  are,
for the most part, curable; that  permanent de-
liverance from misery may be promised,  and the 
PREFACE.
xi
engagement  punctiliously  fulfilled.    Medical
men, those of England  even, are a class of per-
sons slow to take advice from any but their paid
and privileged teachers.  This may, with most, be
owing to their timidity and conscientious care-
fulness;  but with some it may arise from jealous
conceit,  and  repugnance  to  be taught,  even
when taking  the  lesson from  mature age  and
undoubted experience.   That this disinclination
to stir—this tardy reluctance  to  make even a
timely move on their parts—arises from apathy,
I will not  do my brethren  the  injustice to im-
agine.  Happily, however,  there already exists
a daily increasing friendly phalanx, who do be-
lieve a professional associate, when  he declares
that he  has  traveled  and  labored,  sought and
found for them an inexhaustible mine,—and who
desires nothing in return but that he may retain
their confidence and affectionate regard; which,
next to  self-approbation, is  worth more to him
than all the mines of California.  Whether this
shall be  the last time  of the  author's  appear-
ance in print, will mainly depend on  the public's
reception of the present performance.  But if,
as on several previous  occasions, he should be 
xii
PREFACE.
 again so fortunate as to satisfy the expectations
 of his  medical brethren, and also obtain the
 approval of those candid critics whose former
 encouragement to him, as an author, was cher-
 ished as the breath  of his literary life, he will
 then  have naught left to desire!   To  all such
fautores existimationis  suaz  benigni he tenders his
 grateful thanks, and desires, for the present, to
 conclude with  addressing  them, most cordially,
 in the words of the Venusine Bard,
                  Vivite (sodales) valeteque !

  Lower Brook Street, January, 1852. 
PREFACE TO THE  SIXTH EDITION.
   Messrs. Churchill having requested  me to
edit the new edition of this work of my old
friend Sir James Eyre, I readily acceded  to the
wish, out of regard both to  the author and the
subject.  I have  always advocated the opinion
that the most important part of the science of
medicine is to prevent disease;  and,  believing
that to succeed in doing so is to induce the pub-
lic to learii how  best to manage their stomach,
I  have  endeavored still further  to fortify the
advice of my old friend on this important point.
Those who would enjoy good health may do so
by attending to the laws of digestion, and by
administering to  the stomach wisely in regard
to food and drink.  The best proof that the fol-
lowing  pages have  advanced  and diffused  a
more extended knowledge on this most import-
ant subject, is the fact that a sixth edition of the
work is required.
                      Lionel John  Beale.
                                 (xiii) 
 
       THE  STOMACH

AND ITS  DIFFICULTIES.
   It may be considered by superficial observers that
the subject of Dyspepsia, or Indigestion,—according to
Dr. Armstrong, a most fruitful source of Consumption,
—has been exhausted, and that little if anything more
remains to be said, so many books on  Stomach Com-
plaints, from which most persons suffer at one time or
other, having been written by able men.  The opinions
of those who may do me the honor to read these re-
marks  will be, I trust,  of an approving and conse-
quently encouraging character; and I  hope they will
agree with me, that it is the almost imperative duty
of every physician, whether of the rich or of the poor,
to keep a faithful record of his experience, from day to
day, and from year to  year, especially if it be con-
siderable ;—since it is impossible for  any one, with
however excellent a memory, to recollect, as  one of
our ancient  medical writers  has  observed, the par-
ticulars  of more than two or three years of his prac-
tice, a very few interesting cases  excepted. It would
be well if every member of the profession  would keep
                                    (15) 
16         INTRODUCTORY REMARKS.

& journal (as I have done during  many years) of any
practical points which may seem to be worthy of no-
tice, when  glancing  over the medical contributions of
the day, or while  engaged  in his more studious  read-
ings ; for he would find, at a time when the anxiety of
the medical friend to relieve is only exceeded by the
desire of the afflicted patient for relief, how intensely
gratifying will be the feeling, when administering the
cup of health, to reflect that he has taken it from his
own repository; which, inspired by a sense of duty,
he had been  induced to treasure up.   This has  been,
this will be, more or less, the lot of him who has thus
hoarded his experience, and husbanded his strength,
for the  hour of need !   He will feel, also, as  I  have
done, the craving desire to add,  if possible, something
to the constantly accumulating mass of medical facts,
sincerely wishing to benefit the great family of  man,
before he goeth " whither he shall not return," to the
dark valley, which  to  all, but certainly to a sexage-
narian, cannot be very far distant.
   The importance of the stomach in the animal economy
can  hardly be exaggerated; it was' called at one time
the seat of the soul, and by Haller was  figuratively
designated  " the conscience of the body," though  of all
the organs belonging  to human nature  the most  ill
used!  It shall be the first  object of my present  occu-
pation, to describe, however briefly (otherwise a link
in the chain  would  be wanting), the structure, situa-
tion, and functions of the stomach, although this part
of my duty will be to some almost a work of superero-
gation, these  things  being so well known, at least  to 
        DESCRIPTION OF THE STOMACH.      tf

all  medical men.  My  principal object  is  to direct
attention to not only a careful and truthful  arrange-
ment of what is old, but a communication of some-
thing that  will be found to  be new, in relation to the
treatment of the organ in question, both in health and
under  disease.  A "great  book" being  justly con-
sidered a "great evil," the main purpose  should be to
condense that which must be said to acceptable dimen-
sions, and to round off the angular points which pre-
sent themselves, while  examining  inquisitively the
vitally  important  subject of human  digestion.   The
stomach is placed  on the left side, or hypochondrium;
and, as anatomists are fond of comparison, is very like
in shape to the Caledonian bagpipe, having its larger
end to the  left, and its smaller to the right of the body.
It varies much in size  in different individuals; it is a
continuation of the oesophagus or gullet, that tube
which passes down in front of the spine, and behind
the windpipe, and ends at the duodenum,  or pit of the
stomach, as it is commonly called, the commencement
of the first or small  intestines, into which it  transfers
its contents.   The stomach has three coats, or cover-
ings, the  mucous or innermost,  which begins at the
mouth, lining the  whole of the alimentary tube be-
tween thirty and forty feet in extent, the highway of
the body; the second tunic is the muscular, which, by
the contraction of its fibers, is constantly moving the
various matters while  under the process of  digestion.
The third,  or outer one, is the  peritoneal  covering,
which envelops and  protects not only the  stomach,
but the other important parts which are tributary to,
                         2 
13        THE PROCESS OF DIGESTION.

or connected directly or indirectly with,  that  organ.
Its nerves are cerebral, ganglionic, and spinal.  It is
plentifully supplied with blood; and hence endued with
a high degree of vitality.
   Man is an omnivorous animal, as  is shown by his
teeth and the structure of his digestive apparatus.   It
is true that many instances have occurred  of indi-
viduals who have lived to old age without ever tasting
meat—the late  Sir Richard Phillips, Sheriff  of Lon-
don, Dr. Lamb,* and others.  John Hunter, it is re-
corded, fed an eagle entirely on vegetable, and a sheep
on animal food; and yet life and apparent health were
sustained.   Rabbits, if kept fasting a long time, will
eat  meat greedily.   The teeth,  however,  were  no
doubt intended by our Creator to  be our main guide
on this point.   Animals which are destined to be sup-
ported by aliment'of  a mixed character have teeth
adapted to the minute division of flesh ; and also such
as belong to  the vegetable-eating tribes.  It would
seem  best, therefore, to adopt the evident design of
our  structure, and  acquiesce  humbly in the course
pointed out by nature, and justified by common sense ;
inasmuch as the food, whether animal or vegetable, or
both,  requiring much commixture for  its due diges-
tion, there are salival manufactories, so to say, estab-
lished, one on each side of the face and  under the jaw,
which abundantly liquefy the mass as it passes down
the  oesophagus into  the stomach; that  organ being
  * The doctor died, prematurely, as I must believe, at eighty-
three. 
          THE PROCESS OF DIGESTION.        19

duly prepared for its reception, and forming the grand
alembic of health and hilarity, the mainstay of bodily
comfort, and the happy precursor to mental perception.
On the instant that the admixture arrives at its desti-
nation, a second fluid is  simultaneously secreted from
the mucous membrane,  which is called gastric  (the
word juice having been formerly employed), and which
is so well adapted to break up and prepare the  hetero-
geneous masses with which it has  to deal, that it rarely
fails to pass them on in an  improved condition, the
product for further treatment; but if unusual  matters
be presented,* muscular power—the special constable
—is called upon to eject or transfer the intruder into
that tube which ends finally in the cloaca—the omnium
gatherum of all clean and unclean bodily things 1 This
gastric fluid, abundant in quantity and pure in  quality,
when not secreted from a vitiated source, contains an
acid, the hydrochloric,—or that which was heretofore
known as the muriatic,—partly derived from the food,
and partly from  the blood, and  essential to the pro-
duction of that nascent  fluid which is eventually  to
nourish the system during the wear and tear  of our
work-a-day lives.
   After this commingling of food and gastric fluid, the
mass passes through the pyloric or lower end of the
stomach into  the duodenum,  the first portion of the
small intestines,  which is comparatively very short,
but both long  and broad enough to receive the all-im-
portant contribution of the liver toward a second pro-
cess of digestion, in  the shape of an alkaline fluid, the
* As a hat, for instance. 
20    ANATOMY OF  THE INTESTINAL  TUBE.

bile, which is destined to  neutralize  the acid proceeds
from the stomach.
  The pancreas, also  an  important glandular organ,
which occupies a position near to this laboratory, lying
across the spine, transmits by a tube to the duodenum
a copious  bland secretion, similar  in quality to the
saliva, as its contribution  to the all-important process
in question.*
  The two next  portions of  the  intestinal  tube, the
small intestines (called jejunum and  ileum), furnished,
as has been said, with an inner delicate secreting mem-
brane, and, like the stomach,  with one  of a muscular
texture, pass the prepared fluid on through their long
tabulated structure, and are supplied  by  another de-
scription of vessels  which  permeate the  canal;  and
these marvelously (but all is marvelous), by  their
selective property, absorb from the stream as it flows
its  most nutrient and valuable portion;  they then con-
vey it to a receptacle by the side  of the spine, and
finally this new purified  product  is distilled drop  by
drop  into  a vein which conducts  it to  the heart and
lungs, that it may, by the action of  the oxygen of the
atmosphere, be  perfected into blood, the grand vital
fluid of the body, from which all the various secretions
are formed.
  This description, condensed to  the utmost, is, how-
ever  tedious, unavoidable in  a work which treats on
Indigestion;   since the normal or legitimate  process
  * Dr. Baillie said that the pancreas was the least liable to
disease of any of the internal organs. 
      FOOD FITTED  FOR DIFFERENT AGES.    21

must be first detailed in order that the variations there-
from may be presented, regulated, and removed.  Brev-
ity, indeed, is demanded  by the professional reader,
who so well knows these functional qualifications; yet
even  that must be "in measure due," since  there are
others, non-medical persons, who laudably seek to un-
derstand some of the  wonders of the animal machine,
and to comprehend, though necessarily imperfectly, the
striking  succession of changes which  occur in their
bodies, where chance has no place, and where, as  in
all things, design is the Alpha and Omega of the beau-
tiful whole.
   To advert to my object in the following pages : it  is,
firstly, to point out how we may best prevent indi-
gestion ; secondly, to indicate some of the means which
will assuredly remove it, or at  least alleviate  its an-
noyances, such  evidence being herewith adduced  as
may satisfy those whose  confidence alone one would
most wish to possess; and lastly, it is my intention to
conclude the subject by  recording a few  facts and
opinions thereunto relating, the  result of the inquiries
of a  truth-seeking mind, elicited by a  memory natu-
rally good,  but infinitely improved as  drawn  out  in
practice  by constant use.
   A dissertation on  the qualities of food suitable for
each individual would occupy volumes, and I can only,
therefore, give a very subordinate  share of considera-
tion to this part of the subject.  The sources of nour-
ishment are infinite, and the organs of  assimilation,
though  usually  accommodating & merveille, are some-
times, as it were inherently, wayward and capricious. 
22
MASTICATION.
The first part of the digestive process—namely, masti-
cation—demands  attention  at  the very  threshold of
our  inquiry,  for on its  due performance,  or by an
operation analogous to it, the health of man or woman,
and  especially of children, depends;  and of the last-
mentioned a  few  words  must,  in limine,  be  said.
None but foolish, incapable nurses ever give solid ani-
mal food  to infants not having the child's number of
twenty teeth, after  which  period legitimate eating
really begins; and  the most watchful care is necessary,
on the part of parents and guardians, to see that these
said teeth are duly employed, or that the substitute—
namely, ample artificial comminution—be insisted upon.
How indeed can we expect habitual obedience from a
wayward, inexperienced,  ignorant  offshoot  of hu-
manity, acting  on  strong impulse,* while those, who
  * In this place let me solemnly caution parents and guar-
dians (having so often seen the direful effects of forcing the
minds of children by excessive early pressure) to abstain, and
not work  the brain of the sensitive infant prematurely, de-
feating thereby  the intention in view.  Shakspeare, Walter
Scott, Sheridan,  Goldsmith, and Dean Swift, are  said not to
have been clever  as boys,  and  they  lived to  a  good age;
whereas Tasso, Pascal, Kirke White,  and some others,  who
all ripened precociously, were urged onward, and died young
That the mother supplies the mental faculties, and the father
the corporeal, I am quite satisfied :  almost every clever man,
living or dead, has had an intellectual female parent.   Of
great men who had clever  mothers, I may name, for exem-
plification,  Lord  Bacon, Sheridan, Schiller,  Sir  William
Jones, Sir  Walter Scott,  Napoleon,  Curran, Dr.  Samuel
Parr, and the Kembles. 
THE FOOD OF CHILDHOOD.         23
are ripe in age,  endued with  sound sense and much
resolution, perpetually take those things which they
know to be unsuitable, if not unsafe, and who require
a keeper much more  than the mannikin alluded to?
And while on  this part of my subject, I must advise
that it  be made  a strict injunction to children to take
salt*  with their  food,  so  necessary for  digestion, as
helping  to  supply that wholesome acid, the  hydro-
chloric, without  which the process cannot  efficiently
be carried on and perfected.  Sugar in  abundance is
an  abomination  to  the  stomachs  of  young people.
Water  as a beverage, or  very light  beer, is,  in  all
cases, the fittest for persons under the age of fourteen
or fifteen, unless  other fluids  are medically ordered;
also one substantial meal of animal food in the twenty-
four hours is  amply  sufficient.   The  lithic,  another
acid,  but of a hurtful character, is secreted by the
digestive organs  when either naturally weak, or made
so by bad management (stuffing in particular), and is
a source of great trouble  to those under puberty, by
day and sometimes by night; and  also to adults, who
have  passed the middle period of life ;f and, without
  * Some silly, misguided persons rail insanely against the
use of salt, which has been recommended strongly by physi-
cians in every age.  There is a very striking case mentioned
by the late Dr. Hugh Ley in his work  on Laryngismus Stri-
dulus, page 205, where the life of a child was evidently saved
by leaving off sugar, and taking salt instead.
  f- A great change takes place between forty and fifty in the
constitutions both of men and women, requiring, at that period,
a little medical and other care. 
24        GLUTTONY AND ITS RESULTS.

great caution, continues to injure and render miserable
those whose constitutions  are disposed  to secrete in
abundance this acid.  Nor  is this the only  evil pro-
duced by the irritated and outraged organ, since even
the oxalic acid is sometimes eliminated;  and how de-
structive to  the  constitution  the absorption of this
must be, can easily be imagined.  The liver, as is well
known, is situated under the ribs, chiefly on the right
side of the  body:  its office is to  furnish an alkaline
fluid, the bile, which is in a  manner  solicited for com-
mixture in the duodenum by  the  pure, healthy, mild
acid of the stomach ; but when this becomes rank, and
strong,—as  it were overproof—and poisonous, then
the  liver is  overtasked, and  excited  to  produce an
overflow of bile, and this often not of good quality, and
then the evil begins; Pandora's box is opened; impure
blood is formed (from heterogeneous, hostile,  incon-
gruous elements); in children especially.   Hence diar-
rhoea, eruptions, hydrocephalus, and convulsions arise;
but even escaping these, scrofulous affections and cal-
culous disorders,  more slow, but more dangerous, be-
cause creeping insidiously, enter the system without
warning:  and though these evils may not occur to
adults by the mismanagement  of themselves, others of
a not less dire and refractory character arise—such as
miserable, spirit-breaking dyspepsia,  forbidding the
proper enjoyment of a single comfortable  meal—gout,
gravel, and premature  old age.   Our allotted time on
earth would be easily attainable by man, if he did not
follow the blind guidance of his own willful nature; but
indolence and self-indulgence are his  bane, who might 
GLUTTONY AND ITS RESULTS.        25
fully enjoy most of his Creator's  gifts, both mentally
and corporeally, under  defined and reasonable restric-
tions.   But no:  suction and  cramming  have now
changed places; drinking is out of fashion, and glut-
tony is in: man rushes on heedlessly to the goal, and
compensates himself with his plentiful platter, far more
perilous than the heart-cheering, laughter-provoking,
temperate cup, and  as surely commits self-destruction
as the poor coward who accomplishes it by the razor,
the river, or  the rope !  But if he will be persuaded,—
though by a  stranger, yet a, friend,—and it be not too
late,—he may obtain abundance of aid from one who
has been long, very long, gleaning in the field of ob-
servation, and who will drop into his ear much useful
counsel, and  teach  him  how to remove many of the
thorns  and  brambles which impede his present errant
and hazardous course.
   But eating in excess is the vice of the present day,
and so well managed, that even religious persons will
not see its sinfulness*—sinful,  as absorbing and wast-
ing  so much more  food  than the body requires, and
which so many absolutely need;  and unioise, regard-
ing it in the lowest point  of view, as lessening the en-
joyments of  appetite by inordinate  use.   Thus  these

  * Is drunkenness a sin and gluttony not?  Is it not a sin
to make but one meal  a day—namely, to eat all daylong?
Those who refrain entirely  from wine  and  spirits (in per-
verse opposition to ancient and modern, profane and scrip-
tural authority) generally eat twice as  much as other per-
sons, since water alone fails to satisfy the due demands of the
stomach. 
26
THE FIRST INQUIRIES.
sensualists dig their graves with their teeth, and surely
march thereto by the slow but certain steps of prema-
ture decay.   But, as our constitutions bear not bold
and sudden changes, the snaffle-rein must be added  to
the bridle of common sense thus recommended, and
thus the victory over superfluous feeding may be grad-
ually obtained.   Great caution, too, must be employed,
especially at the period of convalescence from severe ill-
ness, many having been killed by gastronomic errors,
not only as  to quality, but  quantity also, at  that criti-
cal juncture.
   These may seem hard words, but they are advisedly
employed ; and they are used especially to warn those
who are yet able to listen and obey, and not to those
who have all their lives been outraging that most long-
suffering of all our bodily organs, and who will find it
so much  more difficult to submit to medical authority
than that part of the community who have not as yet
recklessly indulged in habitual insubordination.
   Nothing  can  be more difficult than the judicious
practice of  the  medical art, because each  case when
presented to our  notice, as physicians, must be studied
in all its individual peculiarities; — so much does the
same complaint vary in its aspect in different persons
and  also in the  'same patient at various times;  and
hence the necessity for the first inquiries being minute,
studiously careful, particularly made and attended to.
 And invalids would do well to remember that they are
 in the  presence  of their medical  director  and friend,
 and  that there  must be no mental reservation; other-
 wise the doctor is defrauded  of his best reward,'and, 
   LABORS AND REWARDS  OF PHYSICIANS.    27

what  is  far  worse,  the patients  cheat themselves.
"His  best reward!"—what is that?  I  answer, it is
the pleasure  of feeling that,  as humble instruments
merely, our skill has been permitted to prevail; and to
see, in such  cases, the  parent  restored to the family,
the wife to the husband, the husband  to the wife, the
child to the parent,  the friend to the friend, and thus
to see the eye brighten  again, beam  anew, and overflow
with the  grateful tear  of happiness.  It is  then that
the heart of the faithful physician beats blithely at the
joyful consummation  mainly  resulting  from  the pa-
tience and skill  of  him, the  confessedly undoubted,
though secondary cause.*

   * Much twaddle has been prattled, and from time to time
offensively written, on "the religious  principles of medical
men." I, for one, indignantly deny that any imputation can
be justly made against the profession  in the present day on
that head.  We can only judge of a tree by its fruit.   I, who
have freely mixed during half a century with my brethren of
every  grade, from the lowest to  the highest, in France and
in Italy, in Scotland and in  Ireland, and, above all, in dear
old England, in town and country, hesitate not to  declare
that I know no such disinterested philanthropists as medical
men.  We do  not make comparisons, but  we  claim equal
companionship, as Samaritans (as a privilege only, not as a
ground for boasting), with the clergy  of each and every de-
nomination.  We are  lavish of our  time, our money, and our
pity; for  "having the poor always with  us," we must not,
and we do not, as a body, heap up riches for ourselves.  We
are their privileged  protectors—at least in sickness—and
never refuse to them our advice.  Witness the thousands and
tens of thousands who are yearly assisted gratuitously by the
medfcal practitioners of this great city, and also by the poor- 
28          ACTION OF THE STOMACH.
  Among the real duties of life, one of the most import-
ant is to acquire sufficient acquaintance with the action
of the stomach to comprehend, in some degree, how
much our health and happiness depend on  the health
of this important organ.  In the first place, it is vain
to attempt to get rid of any disorder or disease while
we continue  to indulge in unlimited  gratifications to
stomach desires ; we must when laboring under disease
place them under  strict regulations.   We  may  even
assert  that the majority of complaints in their early
stages may be cured by strict attention to diet and regi-
men, even  without medicine, at least with  very little.
In  the  prevention of disease much  may be done  by
learning even a little about the action  of the stomach
and other  organs of digestion, in that process which
commences the conversion of our food into materials
for supporting the structure of the  body,  the health
law and other medical officers in the  provinces, who work
without a thought of obtaining what would be called, in any
other  grade of life, just  remuneration!  If the conduct of
medical practitioners be not universally Christianlike, it has
always appeared  to me to partake so much of that character
that I have never yet been able  to see the difference.  The
transactions of life  are so different in reality, and when in-
quired into, from the aspect which they bear on a first and un-
inquiring view; as, for instance, it would seem surprising that
that  august and learned body, the College of Physicians,
should go to Paris for a President, and her Majesty's talented
first physician to Holland for a consultation in the  case of a
royal  valetudinarian;  but the  probability is that neither of
the bodies alluded to could have properly adopted a different
mode  of proceeding. 
DIET AND  REGIMEN.
29
and strength of our internal organs, as well as our ex-
ternal ones of locomotion, etc.  The process of diges-
tion  is to supply the  blood with  sound materials for
supporting the health and strength of the body gener-
ally, and a knowledge of the means of accomplishing
these important objects may be attained by all who are
wise enough to think such knowledge of the greatest
importance to their happiness.
   The possession  of good health can only be realized
by the adoption of such rules of diet and regimen as
insure  a due re-supply of healthy blood to replace that
which  is daily consumed in our avocations of life.   We
use up, every hour of our existence, certain amounts of
blood,  the larger  the quantity in  proportion  to the
amount of work we give  to our mental and corporeal
powers.  To renew the quantity of blood daily used
up, is the duty of  the stomach and the other organs of
digestion; these prepare  our food  and drink for con-
version into  blood, and the more healthy their action
the better is our blood and the more vigorous are our
bodily powers.  Gout, rheumatism, and various other
disorders are often produced  by the injudicious sup-
plies given  to the stomach,  both in quantity  and
quality.  Irregularities in our mode of living generate
lithic and other acids in the stomach ; these pass into
the circulation of  the blood, and  lay the  foundation of
many  disorders which may be brought into action by
cold, wet,  or other causes of  disease.  We  too  often
charge cold and wet with being the cause of attacks of
disease, but  these attacks would  not have occurred
unless the blood had been infected with particles of de- 
30
LAWS OF HEALTH.
praved matter resulting from overindulgence, or other
irregularity of the organs of digestion, first  and fore-
most, from our injudicious supplies to the stomach.
  No one would argue against  the opinion that good
health was the greatest  blessing of life, although we
must admit that there are some who consider that the
constant superintendence of the stomach and digestive
organs renders life miserable.   But in point of fact
this  vigilance  ceases to be necessary from the habits
we soon acquire of always taking proper  food and at
proper times,  so  that we cease to suffer those discom-
forts which  so frequently occurred to us before we
learnt the means of keeping the stomach, etc. in proper
working order.  All admit the value of good health;
and  wnen by some experience they find how much this
may be secured  by moderate attention  to certain rules
in relation to the quantity and quality of their food,
they cease to think  such attention insufficiently re-
warded by the acquisition of an amount of health such
as they had not been favored with for years.
   Perhaps we might lay it down as  a rule, that the
majority of men eat twice as much as is really required
for the support of health and strength; but  in  most
cases the error is to  be  referred to ignorance of the
laws of health, rather than the mere pleasure of  over-
indulgence.  It is a common mistake among all classes
that the more we eat the stronger we shall be, and
nothing  is more fully believed than that our vigor de-
pends on the quantity as well  as  the quality of our
food.  Training  for feats of strength  and  endurance
contradicts this  opinion;  those  who  undertake the 
INDIGESTION, ETC.
31
 management of men who are being prepared for any
 muscular exertion, walking, boxing, etc., are only al-
 lowed certain quantities of food and  drink, together
 with well-regulated exercise in the  open air.  A mod-
 erate, well-regulated  supply of food  and  drink will
 establish a better condition of health and strength than
 that full amount which many indulge in under the idea
 that it is essential to  their welfare.  So much is this
 the case that we all know persons who have lived to a
 great  age and who have  been  the  most moderate
 eaters.  No doubt as  life advances we really require
 less food.  I could enumerate several healthy people I
 have  known who, always  moderate, after  the age of
 seventy,  never required  daily more than fourteen or
 sixteen ounces of solid food, two-thirds of  which was
 bread.   To have had a stomach ea'sily  upset has been
 a blessing to many, who have thus found the necessity
 of  moderation; a long course of such  mode of living
 has been so obviously beneficial, in the production of
 so high a scale of sound health, that this very modera-
 tion has been one element of great longevity.
   When we talk of the evils resulting from indigestion
 and other stomach derangements, our conclusions are
 educed from  the fact that it is the stomach  and its co-
 operatives, the liver and other organs of digestion, by
 which  the blood is prepared, the nutritive products of
 digestion being carried into the circulation, to replace
those parts  of the  circulating fluid  which have  been
used up in the nutrition of our various  organs, the ex-
ercise we take, etc.  We obtain our strength and capa-
bility of muscular exercise from the nutritive matter 
32
ACTION OF  THE STOMACH.
absorbed into the  blood, after the stomach and other
organs of digestion have  prepared  those  elements  of
our strength and health.  So long as we can manage
to supply the best  materials for the reproduction  of
such nutritive elements as are required to maintain the
quantity and quality of our circulating fluid, so  long
we may preserve  our health, and the very supply of
the best  materials  for conversion into blood is the real
source of sound bodily vigor.
   There are two special provisions which  characterize
the  action of the  stomach and the other  organs  of
digestion : the one is to  supply heat-making principles,
and the other what may be called building  materials,
which maintain the  various organs in  their vigor.
Our daily existence wears  away a certain  portion of
our organic  structure,  and  this should be 'daily re-
newed by the organic particles obtained from the food
we eat, to replace  those which are used up  by muscu-
lar action and the  vital  powers of all our organs.  Our
daily exertions wear away some portions of our frame,
and our daily food is converted by digestion into living
materials for its renovation.  This fact alone is  suffi-
cient to impress every thinking mind of the absolute
necessity to guard against  any supplies  of  food  or
drink that can in any way be injurious  to the healthy
structure of our body.   If the stomach  does not do its
duty well, our frame will not be kept in its normal
condition; we shall not maintain that vigor which is
essential to the establishment of sound health, and all
our organs being more or less injured by improper food
and imperfect nourishment, we  lose our strength, and 
           ADVICE TO  THE PHYSICIAN.        33

some disease or other is established.  But  before there
has been time for disease to be seriously confirmed, it
is wise to consult our medical adviser, by giving a
clear detail, not only of our present symptoms of dis-
order, but of all  the causes, irregularity of diet, etc.,
which may have produced the complaint we are  suf-
fering from.
  And here  may I interpose a word  of  advice  to the
physician, who should withdraw his services when he
perceives  the slightest want of confidence on the part
of his patients; for there should be as entire a feeling
of trustfulness on  the one side as the desire to relieve
on  the other; and it is  certainly the more dignified
course for him, whose authority ought to be absolute,
to make the first move.
  Patients, particularly those who  suffer from stomach
complaints, must be  told  that though  gorging from
the cradle to the grave is the chief cause of dyspepsia,
yet neglect and inattention to  nature's requirements*
are also very frequent causes.  There are persons who
have much misery to contend with,  who nurse their
troubles, who will not see that this  life is a training-
school, and  who  icill scarcely forgive  even their
Maker for afflicting them; or who will not behold
the  beautiful, the  cheering  resplendent  blue  sky so
nearly touching the dark cloud of their distress ! these
often shun their meals, or for solids substitute ineffi-
cient liquid nourishment, and thus add bodily infirmity
  * Though,as the French say, 'Tappetit vicnten mangeant;"
the same as to thir.-st, eir..
                         3 
34      BAD  EFFECTS  OF LONG FASTING.

to mental disquietude.  But such persons will in vain
consult medical men until their grief shall have somewhat
subsided.*  But  there is another and a large class of
individuals, who  are free indeed from  mental  anxiety,
but who will not inquire, and who forbear to  use that
common sense with which they are gifted ; these will
take no  sustenance whatever, not even  a cup of milk
or of coffee, on first rising from  bed  in  the morning,
before taking a long walk.  Others, again, who  are sane
on all other points, will take an early breakfast, dine at
a very late  hour, eating nothing in the  interim.   To
such I would  say, and especially  if destined  to close
mental application, take a biscuit, a crust of bread, or
some other light article of diet, at least, or you will,
when age advances, assuredly suffer from the  stomach
having been kept empty so many hours every day, and
this perhaps during many years.   The liver invariably
undergoes  pain and general derangement of its func-
tions, from mental  affliction  and depression, which
sometimes originate, and  always aggravate, dyspeptic
disorders.   But  the  patient who  has  no real trouble
may be duly directed  as to daily habits, the selection
of food, as to quality and proper quantity; and, having
received earnest injunctions on the subject, will find a
reward  in  the cure of  his  indigestion, which will  be
more or  less  perfect, according to the  extent of his
obedience.
  * That  talented  physician, the late Dr. Baillie,  always
avoided prescribing for those who were in deep affliction,
full well knowing that his medicine at that time would be
entirely inefficacious. 
QUANTITY OF SLEEP  REQUIRED.       35
  As a general rule, it  may be laid down that every
man ought to have seven hours' sleep in the twenty-
four, but more especially those who have much bodily
labor or mental  occupation; a woman requires eight
hours, and a child  still  more.   I quite  agree with Dr.
Baillie  that so  long as  sufficient sleep be obtained
during the night, it matters not which of the five, six
or seven  hours are selected for the purpose; there is
no harm in talking about "beauty sleep" before twelve.
Good sleepers are good workers, but  light sleepers, as
they  are  called, may  always  be  permitted to  doze
during  half  an hour or so after their great meal, as
also those who have weak digestion; but more on this
subject anon.  That vexatious tendency to sleepiness
so tormenting to active-minded persons, which espe-
cially occurs in men, for the first time, between forty
and fifty, can only be obviated by temperance in eating
and drinking, refraining from malt liquor (except bitter
beer), using  much walking exercise, and not allowing
the excretions* to  remain long in the body.  An in-

  * The bowels and the bladder, as receiving the most hurtful
excretions of our bodies, ought not only to be emptied when
they crave relief, but a wise man waits not for this; and I
would implore all of either se"x to retnember through life that
they ought to anticipate, whenever they may be able, the call
to evacuate the intestinal  canal, and especially to get rid of
the  last-named poisonous product; for this, of all others, is
the  most dangerous to our health to retain, even when com-
posed of its legitimate qualities; and how much more ruinous
must its retention be when loaded with albumen, or with one
or other of the various acids which so often oppress and harass
its containing receptacle I   It will be well, at any rate, for us 
36       QUANTITY OF SLEEP REQUIRED.

valid should never be out of bed after  ten o'clock at
any period of the year; he should never go to rest with
cold feet; and  should rise as early as he comfortably
can,  from the middle of May till September  or Octo-
ber,  particularly in a large city, where the consumers
of oxygen are  shut up in their bedrooms for ten or
twelve  hours,  breathing, over  and  over  again,  the
same vitiated  and  pestilential  atmosphere 1   A  ven-
tilator here is absolutely necessary, or an inch of open
window, in the  summer months at least, for those who
will  not rise early, but who have abundance of courage
for all other things.  Daily walking exercise,  in cases
of dyspepsia, must be insisted on as a sine qua non.  I
have myself often removed a beloved friend, by gentle
violence, from  the indulgence of a bed,  with  the hap-
piest results.  Every one, whether afflicted with indi-
gestion or not,  should walk,  and that every day, in as
pure an air as he can find, till he begins to experience
a sense of fatigue.*  A long room  or  passage may be

to be able to satisfy ourselves, which we can do by the follow-
ing test of Dr. Bence Jones—namely, that the excretion under
consideration is natural, in order that, if not, medical assist-
ance should  be sought.  "The renal excretion, when  of a
healthy character,"  the doctor says, "never  gives  a precipi-
tate,  after having been boiled, that is not soluble in a drop
or two of nitric acid."  Those who  chiefly live on vegetable
diet make  much water; and those who will  eat inordinately
of meat should indulge largely in weak potations, to diminish,
as much as may be, the substantiality of their overnutritious
diet.
  * Liebig remarks,  "one great objection  to excessive exer-
cise is, that it causes us to take too much food." 
      QUANTITY OF EXERCISE  REQUIRED.     37

u?cd  as  a substitute,  however sorry,  in inclement
weather,  which will rarely for  a whole day together
prove obstructive to  a  health-seeking  individual of
common  energy of character.   Horse-exercise is next
in value ; and where both these can be obtained, medi-
cal services will  be at a discount.   Carriages  change
the air and the scene, and, so far, are  not to be  de-
spised, especially by  those  who   have the  inclina-
tion,  but not the power, to accomplish all that they
would;   but driving is not deserving of the  name of
exercise.
   The want of a covered well-ventilated place, but free
from draughts, for delicate invalids to resort  to in
idnter, is a serious evil in this otherwise greatly im-
proving  metropolis.
   As the number of times in  the  day that we should
eat is of great  importance, and the most fitting hours
for it is not much less, that subject shall come next in
order.  And first, in regard to the number of times.
This must depend,  as also  the quantity and quality of
the aliment, on the labor that is about to be performed ;
for all who study  health ought diligently to employ
both body and  mind, whether  they live by their own
labor or by that of their deceased friends.  The fol-
lowing rule I would write in letters of gold : According
to our mental and bodily employment, so shoidd we eat.
But  there is a large number of persons in the  world
who do  nothing, who never did do anything, and who
 never will exert their faculties, even for the promotion
 of health, unless frightened at the thought of death.
 Such are persons who will not believe  that they are 
 38       QUANTITY  OF FOOD REQUIRED.

 stewards* of their time and property and act upon that
 belief; accordingly, they become mere locusts and cum-
' berers of the earth.   Yet  these eat and  drink  to the
 full as much  as  those who know and feel hourly that
 by the steady use of  all their faculties they have  the
 mens sana in corpore sano, which offers the best guar-
 antee for a long  and healthy life.
   And here it occurs  to me to give a  serious caution
 to those of  either sex who are small  in  stature, con-
 stantly to remember not to take much food, or, in other
 words, so much as those of larger corporeal dimensions.
 These individuals, however,  whom  I  would thus re-
 strict at table, may be comforted by the full assurance
 that, if long  life be desired by them, they will have a
 much better prospect  of attaining it than a tall person
 would have.  The stomach may receive, but the body
 must entertain it. The same rule of  abstemiousness
 applies to those who have had the misfortune to  lose a
 limb.  These especially should  consider—but they do
 not—that there  is the same quantity of blood formed
 as heretofore, but not the  same space  for its circula-
 tion;  hence  such individuals  are  usually plethoric,
 gross, overnourished,—and thus in an  unsafe state, as
 always traveling on  the brink of a precipice! And if
 they should  have lost a lower limb, they will not only
 be less inclined, but  less fit,  for taking salutary exer-
 cise.   In inflammatory disorders  the judicious physi-

   * The late Rev. Eobert Montgomery once, while preaching
 a sermon in order  to raise a fund whereby to build a church,
 Btartled some of his congregation by saying to  them, in con-
 clusion, "Put the money on the plate ; it is not yours J" 
THE SKIN AND  THE STOMACH       39
cian orders the abstraction of blood according to the
bulky or the diminutive  stature of his (adult) patient.
The same  precaution is observed  by the  legitimate
practitioners of medicine on corresponding occasions,
in bearing in mind the ages of  sick children.   Neglect
of bleeding has killed many, but rash, violent, opposite
treatment  has destroyed more, at every stage of life,
either by a coup de  main,—as in attacks of  palsy, for
instance, or of epilepsy.*   Those  again who scarcely
ever perceptibly perspire are the most difficult to treat
when  they are ill:  such are  found, I  think, chiefly
among the gentler sex;"{"  and therefore, the great safety-
valve of the skin being  ail-but closed, they should eat
little.   Lastly, young persons, on  account of growth,
require much  food,  as well as much  sleep; and  the
question of amount need not be considered here, as ex-
haustion will  seek reparation, and  the young, having
the key to the hearts of  their parents, will always eat
and drink and sleep  as much as they require.

  * While my epileptic patients are under treatment by the
oxide of silver (the very best medicine we possess for epilepsy),
I desire each of them to wear, just below the tie of the cravat,
a card with these words written thereon, Don't bleed me; as a
protection for  them,  while insensible, against  any active-
minded Sangrado who might be  summoned at the time of
seizure, and otherwise  possibly commit irreparable mischief.
  | To such I have found warm bathing and the  flesh-brush
of great use, so grievously neglected in England ; and, if they
wear flannel, as every one in this  changeable climate should
(next to the skin, if they can  bear it), it must not, in their
case, be taken off at night,  even in the summer; the stomach
and the skin sympathizing  so much with each other. 
40
THE TIME FOR MEALS.
  The  time of day for eating  is of more importance
than is generally  supposed.   Of this  I entertain no
doubt at all, — that  the  earlier in the  day  the  great
meal of the whole can by possibility be taken, the bet-
ter.  The stomach, and all the other important organs
which  are concerned in  digestion, are most vigorous
after sleep, and therefore most able then to encounter
and master the repast par excellence of the day; but
the artificial  state of society  in which  we live  abso-
lutely mocks the sanative advice of the physician, and
even a man's own  endeavors to help himself; for how
is it possible for those who are anxiously engaged in
important pursuits to possess clear heads (medical per-
sons not excepted), whose minds and bodies are wear-
ing away by  incessant  overexertion always by day,
and  often, in addition,  by night ?  Yet  much, very
much,  may still be done by those who are disposed to
hearken  to reason; for, although the  breakfast cannot
and ought not to  change places with  dinner, a two-
o'clock luncheon, particularly in the case of ladies, may
be substituted; this it is always quite easy to do, and,
indeed, many of my fair friends are in the habit of
dining in reality at two,  making believe only at seven
or eight.  Thus those who will listen to the voice of ex-
perience, and will accept friendly counsel, will go as far
as they can in the right way; and in proportion to their
conformity will they  reap that practical benefit which,
having fairly  earned, they may reasonably  expect to
enjoy.   I advise, then, that the breakfast, as a  meal,
be not eaten  till the appetite for  the  day shall have
arrived;  and those who  do not feel hungry (though 
DIET.
41
most lively, active-minded persons do so on  rising)
should,  however, if able to walk,  first take a cup of
milk, coffee, or cocoa, and then promenade for an hour,
at this the best portion of the day.   Those who  have
the great privilege of being able to dine at two, or not
later than three, will, at six or seven in the evening,
seek that refreshing beverage " which cheers, but not
inebriates," after which  a very slight repast—suppers
being abolished—will  suffice (a  biscuit, or some al-
most nominal  placebo, to  amuse  the  stomach  till
"balmy sleep" shall come). And this is the code of the
health-seeking, sensible man;  for  he will  treat  his
stomach exactly as he would a pet  animal (not a two-
legged  one), which ever makes a grateful return  for
judicious  kindness.  The  periods for taking food are
of less importance than the quantity and quality of it.
Whenever we find our stomach out of condition, when
our want of appetite is a hint from nature that  Ave
have done something wrong, having eaten in excess,
or  partaken of  articles which  former experience has
told us disagree,  and are unsuited to our digestive
organs, we  should at once, by abstinence on the one
band, and medicine on the other, adopt such measures
as we know to be required.   Yery serious disease will
often be prevented by timely attention to early symp-
toms.
   Diet is  a  large subject, and demands the lion's share
of our task ; embracing the important question as to
what substances,  whether  solid  or fluid, we should
supply to that insatiable  applicant, the mouth, whid?
seems  never to  be tired of  saying, "Give;" but be it 
42          AFTER-DINNER EXCESSES.
 my province, and that of my fellows, to say, Withhold;
 for to give, as is ordinarily given, is to destroy;  but to
 furnish half  rations at times is  to  insure the perfect
 zest for  those  creature-comforts  which  are so  abun-
 dantly supplied in such vast variety, for our legitimate
 present use, as well as the prolongation of our exist-
 ence, in  which many  have undoubtedly much enjoy-
 ment after seventy, or even eighty, years of age.
   Although other and far different maladies arise from
 the prandial pranks of the present day, they are not so
 soon developed as  the effects  of  post-prandial de-
 baucheries of  not very  distant  times, now, thank
 Heaven, gone by, let us hope, forever!—times when
 free agency for a soberly-disposed man was almost out
 of the  question; when vinous potations were indulged
 in, in quick succession, from glasses without pedestals,
 often with locked  doors (that a certain fixed quantity
 might  be  consumed);  till,  at length, those two- and
 even three-bottle  men would, one by one, fall under
 the table,  to be swept away with the rest of the refuse,
 by the  domestics  of these  habitual sots.   The toasts
 and the conversation after dinner among these so-called
 gentlemen of that day are frightful  to reflect upon.
 Early escape from such pollution could only by deci-
 sion  and  firmness be  accomplished.  But  how often
 have I heard  with grief of  a  young man, endued with
 all that delightful  purity of mind which we often* see
in early life, being first introduced, as a manly privilege,
to the society of these drunken debauchees, and  then,
ere long, the trail of the serpent has passed over him!
And there still are too many young men who, as yet, 
GOUT AND GRAVEL.
43
having had no contact with vice, appear to be hardly
of this world—yet gradually and insensibly by evil
communication give up one  virtue after another, till
they become  at length lost in the common herd—left
only to look wistfully back on the state of paradisiacal
purity they once possessed,  but which, alas ! only at
rare and transient intervals can they ever experience
more!  But now, happily,  an  intoxicated man is  rarely
to be met with : a  drunken gentleman, never.
  In consequence  of the present cautious shyness as
to the bottle, gout and gravel—both of which arise
from the same cause—are comparatively of  rare oc-
currence among men ; while women—perhaps from not
drinking to  excess—are  almost  exempt  from  these
two disorders, and which  men really need not have.
Another compensation, too,  the gentle sex enjoy for
their numerous miseries,  mental  and bodily,  is the
being less  liable than men to consumption.  But,  if
men will be  sick,  the miserably painful maladies of
stone and  gravel seem to  absorb, like Aaron's rod, all
others, and enable their  possessors, who  have duly
graduated in brandy and port, to hobble out painfully
pre-eminent as "Grand Compounders" of  their year.
And here  let me  say, in  regard  to port  wine, that
where my patients have had the resolution to renounce
it  as a habit, and  drank good full-bodied  claret, with
Scotch or Irish whisky-and-water occasionally, their
old enemy has invariably left them.  Sherry  agrees
with the majority  of persons better than Madeira, and
assimilates better  with that seducing tempter—cham-
pagne; which,  never having been seen formerly, ex- 
4 4         WINES AND  MALT LIQUORS.

cepting at the tables of the rich and the great, is now
found  everywhere.   The  dietetic  physician cannot
say much in its commendation.   A single glass even
would  cause the cheek of the Emperor  Napoleon to
become red;*  but, then,-though  a  great  sufferer in
other respects, his stomach was  his weakest organ.
An "outside barbarian," a remnant of the olden time,
will  be seen occasionally to venture upon a jorum of
John Barleycorn,  or even  a glass  of port,  with his
cheese,—an article of diet  which, being only eatable
with the afore-named liquids, is rapidly  losing  caste.
Ale  and porter, with the middle and higher classes,
are now rarely introduced at table, their use with wine,
excepting  with  sherry,  being  incompatible.   Malt
liquor  is now prescribed  by physicians, but in certain
suitable cases only.   The lower grades of society pre-
scribe it for themselves empirically,  and  without con-
sideration.   Breakfast, in this country, consists of tea
and  coffee,  with eggs, meat, and sometimes fish: in
Scotland, of all these, and, in addition, an abundance
of marmalade  and other preserves.   In  France  and
Italy, the cup  of  coffeef (the best in the world, inas-
  * Whenever the cheeks become rouged after dinner, it is a
sure sign of feebleness of the digestive powers, and is a hint
for the employment of reparative means.
  f The way that I was taught to  make coffee for myself
during a twelvemonth's residence for purposes  of study (in
Paris) was as  follows:—-Use it fresh roasted, immediately
after being ground; allow half an ounce of the berry to each
person; and, instead of  water, pour over the mass of coffee a
boiling decoction of the  coffee of the preceding day. 
         THE STOMACH REQUIRES  REST.       45

much as, in the former country especially, the coffee is
not grudged,  as in England) is taken  immediately on
rising, and le  dejeuner d, la fourchette, in other words
the first dinner,  at  eleven  o'clock.   Monsieur, after
the large stock which at this time he lays in, can very
well wait till  five, when he eats as  much  as he can ;
and this usually concludes (as he generally retires  to
rest early, that he may rise in good time) his gastro-
nomic feats of the day; so that, in fact, he takes but
two meals  in the twenty-four hours, whereas  those
persons in England who are unwisely advis-ed to take
"little and often," make but  one,  for they carry out
the idea  faithfully,  and eat  all the  day long.   The
stomach does not know what to do with such people.
In ordinary statutable cases, that wonderful receptacle*
always disposes of the previous meal before it engages
with the next; but those who make feeding their hobby,
and who  are, therefore, fit for little else, ungratefully
give  their  best bodily benefactor no quarter at all;
which, as well  as the  too long abstinence which has
  * Who has not heard of the experimental philosopher, who
fed a rabbit first on oats, and, after a certain time, gave the
animal a meal of parsley, and, suffering a proper interval to
elapse, killed it?  The stomach had nearly digested the oats,
but had not attacked the parsley.  The same experimenter
fed another rabbit, reversing the order of these two articles
of food, and, destroying the animal, as in the preceding case,
found that the digestive organs had been employed with the
parsley (the first meal), but the oats were  as yet unacted
upon;  their turn had not  arrived!  Would that we  would
deal as justly by the stomach as that abused friend does by us I 
46                 CORPULENCE.
been already touched upon, will  be equally resented,
nay, avenged,  later in life.   Persons do not,  though
they should, well consider what, as a matter of fact, is
the character of their constitution and of their habits.
A man or^voman who is plethoric, and makes blood
fast, should not  eat  meat for breakfast;* an  egg,  or
two, would be the extent of my allowance  to them ;
or, perhaps, should there be mental or bodily employ-
ment in prospect, some dried fish.   Corpulent persons,
again,  who have already taken too much sustenance,
in whom the accumulation of years is hoarded up in the
shape of fat, may well perform quarantine,  and rest a
little from their toil.f   Great corpulence  should be
looked upon as disease,  and means should be taken
not only to reduce that which is in excess, but also  to
prevent its recurrence by moderation in  diet, and espe-
cially of such things as are  known to fatten.  At the
  * Persons who are full of blood, and are above the average
size, secrete much lithic acid.  Fat in them, too, is stored up,
and nourishes them when ill, and when food cannot be taken.
Haller  mentions  a man who weighed eight hundred and
twenty-five pounds.  Daniel Lambert and Bright could only
boast each of a load of seven or eight hundred.  It is a wise
plan, and adopted by many who are corpulent and_ make blood
fast, and who resort frequently to feasts, to dine on fish alone
when at home, with a very sparing allowance of butter on the
subsequent day to  the feast.  As an inducement to perform
this penance, let them be  assured that obesity, especially in
men, tends much to the abridgment of life.
  f They should also  make it a rule to take a warm  bath
twice or thrice every week, for them a needful  act ff purifi-
cation. 
CORPULENCE.                47
same time, when corpulence is excessive it  will  be
right to adopt means not only to prevent any increase,
but also to diminish the existing excess.   Sudden ab-
stinence  or great change  in diet should  be avoided,
but a gradual diminution of such articles as are known
to fatten must be attended to, an-d the  effect carefully
watched, so that the health may not suffer.
   It is a great mistake to suppose that  stout people do
not eat as  much  as  those who are thin; their puffing
and panting, one would think, might give them warn-
ing,  as also their profuse perspirations,  particularly by
night.  Let such avoid the sugar-basin and the butter-
boat as much as  they have hitherto  sought  them, and
eschew oily food and malt liquor, unless  it be of the
pale and bitter kind; but when individuals say — as
I  once heard  a  corpulent gentleman  declare — that
" he would drink ale if it cost him  his life," what can
medical authority avail with a madman of this kind ?
Although  patients who have a weak digestion do not
get rid of  aqueous  fluids well, I have  yet found  that
black tea for breakfast, as well as in the evening (never
hot,  but strong, and in moderate quantity), is the  best
beverage for all.  Toasted bread is the most whole-
some solid for either the first or last meal of the  day,
either with rye or without, as it may agree.   Bakers'
bread is objected  to, on account of its containing alum.*

  * Dr. Ager (who lectured with  Dr.  Hooper, my early
teacher, in Cork Street, in 1811) was accustomed to tell us a
story relating to a friend of his, a physician, who, suspecting
that his baker took  the liberty  of putting alum into his bread,
had some  powdered, cut a slice from a loaf, sprinkled the 
43
BATHING.
The recent researches of the Lancet have shown that
this is the fact; but how few can have bread baked at
home!   Hot cakes, rolls, muffins, new bread, etc. must
never be introduced into weak stomachs.  Bacon need
not be refused : it rarely disagrees, its constituent parts
are so different from those of other meats.  When sea-
bathing is desirable, after breakfast is the best time
for it;  but with those whose circulation is  feeble, the
water should be tepid at first, that the shock* may not
be too great.  I do not recommend the shower-bath to
persons who have weak nerves, for  the  same reason;
sponging is  better for them.  This also is the fittest
period of the day for eating fruit, which, when thor-
oughly  ripe, especially raspberries, strawberries, and
gooseberries (not  currants), suit  marvelously well
most stomachs, as do some other products of the gar-
den or  hothouse;  but this kind  of additional indul-
gence  must  be attained by the patient's own careful
experience.  No  luncheon  is required, excepting the
dinner  be late;  but  all meats  should  be avoided  at
luncheon, unless sanctioned by medical authority.
   And  now, sitting  down,  at length,  to  discuss the
main repast of the day, I would  address, and, if pos-
sible, influence, those  who wish to be directed, and
who, I really believe,  from the care which I have seen
them exercise, desire  not  to be guilty of prandial ex-

alum upon it, and then sent  for the offender and showed it
to him, who, taken by surprise, said,  "Why, good dear me,
sir, there is enough there for a whole batch!''
   * This is more applicable to men, for the  gentle certainly
bear cold much better than the rougher sex. 
QUANTITY OF FOOD.
49
cess.   Such will accept as a guide one who has well
considered the subject in all its bearings, and who has
not,  he trusts, burdened  his book with irrelevant or
gratuitous observations.
   Quantity of food is of much more serious importance
than quality ;  for although every man is not a fool or
a physician at forty, he will have generally found out,
at that period of his life, what articles of food may be
taken by him, and those which may not; for there are
few—who live in  towns, at least—who  can  eat of
everything  that is to be  found in  the culinary list.
These  will, therefore, take care, nay, be somewhat cau-
tious, as to quality, but will probably indemnify them-
selves  in the other respect; it  being perfectly true
what  Mr.  Abernethy was  accustomed to  say, tbar
when eating four times as much as we ought, a quar
ter supported us, and the remainder we had to keep at
our  own risk!  and this is now the less to be justified
because, in these halcyon days, in more respects than
one  there  is perfect liberty  conceded, both  in  eating
and drinking.   It may be remembered by some  of my
readers how  pressing  to take more was  commonly
practiced  formerly, not  only  on those that needed it,
but on those  who  needed it not—on myself,* for ex-
  * I once escaped at table the well-meant persecutions of the
kind-hearted wife of a medical friend, from whom, ever and
anon, came the inquiry of what I would take next.  This had
been so often repeated, that I had begun to look round, fear-
ing that my character, as a teacher by example, might suffer,
and replied that, "If she pleased, I would take breath."   It
                         4 
50       NUTRITION OF VARIOUS  MEATS.
ample.   Yet let it be an axiom never to be forgotten,
that the stomach  must have,  at least once a  day, a
certain  portion of  animal food, which, if not properly
digested, assistance must be sought to ascertain  the
cause and enable it so to do.   The  taking of soup or
broth (potage)  is by  no means of the same value as
meat; an ounce of the  latter is more valuable  than a
pint of  liquid nourishment.   Fluids, as we have said,
are absorbed almost as soon as taken, but solids require
the action of the muscular tunic, or  coat of the stom-
ach ; and every one knows that by use all muscular
fiber becomes stronger—witness the legs of pedestrians,
and the boy-blacksmith's arm.  If the inherent proper-
ties  of  our  nature be not kept up by healthful habit,
they languish, and, languishing, die.  Soups  are  not
forbidden, but  are not to supersede  the solid substan-
tial  nutriment.   Man's  character is much influenced
by the aliment which sustains him.*   Of fish, the white

was saucy and ungrateful, but it was good-naturedly received
and understood.
  * The effect of  different modes of life on the human frame
and human character is strikingly instanced in the cases of
the hunting  Indians of  the prairies, and those of the pisca-
tory tribes on the sea-coast: the former, continually on horse-
back scouring the plains,  gaining their food by hardy exer-
cise, and subsisting chiefly on flesh, are.'tall, sinewy,  well
formed, and  have a bold and fierce deportment. The latter,
lounging about the river-banks, or curved up in their canoes,
are generally low in stature, ill shaped, with  crooked legs,
thick ankles, and broad flat feet.  They are inferior also in
muscular power and activity, and  in game qualities.  ( Wash-
ington Irving.) Again, good teeth are seldom to be seen among
tribes west of the Eocky Mountains, who live chiefly on fish. 
CAUTIONS IN RESPECT TO MEAT.      51
kind is the best, and, if boiled, agrees with most inva-
lids ; those who can digest salmon and fried fish may
encounter all other dishes without fear.
   There was great wisdom in the law of our ancestors,
that on two days of the week we  should live upon  fish
alone without any meat; and it is a mistake  to sup-
pose, as many do, that there is but little nourishment
in fish.   Of course, it is not  so substantial as what we
call  animal food ; but, by giving the stomach less work
to do twice every week, we  keep  our digestive organs
in such good  condition that they are  better  able to
abstract all the nourishing qualities of the food we eat.
It must be clear to all who will give their thoughts to the
subject, that if we can sustain the action of the stom-
ach by occasionally giving  it less work to do, we can
with greater success derive from its action  a larger
amount of support to the body, by the better quality
of the nutriment it provides for the blood.
   Our next  question is concerning meat, which, as
the French say, is the point d'appui, not after but be-
 fore all.   Beef* takes the lead for first-rate digestion,
 beginning with  the fillet, or the  inside of the sirloin.
 Yenison,  game,  and mutton are far more acceptable to
 the invalid than chicken, etc.  Pork is not desirable,
 unless when h|3g fasting is anticipated.f

   * Roasted meat is more nutritious than boiled.
   f The veal in Paris and on the continent being the only
 kind of meat which in general is  superior to that of this
 country, I was induced to make an inquiry of  a London
 butcher (selecting a young one), " if the atrocity of bleeding
 poor calves to death, gradually, is still practiced in this metro- 
52      CAUTIONS IN RESPECT TO  MEAT.
  Yeal is  always at the bottom of the list;  but not
even  mutton, any more than any other food, can be
taken continuously, without the occasional intervention
of some other viand, of which I had  a striking proof
very  recently.  A young man  was  fed by  bis  em-
ployer on mutton five days in seven; he was ill in con-
sequence, and could get no relief till  a change was
made.  A  striking instance of idiosyncrasy occurred
at the Hotel Dieu, in Paris: a woman was  uniformly
made  ill when  under the age  of fourteen  by eating
crabs.  A  great change in her constitution took place
(prematurely) at thirty-two; and  again the inability to
eat this kind of shell-fish returned.   Another patient
(a young lady) was  always sick after eating animal
food.   Dr. Stark, of Edinburgh,  lost his life by subsist-
ing partially, if  not  entirely, on cheese.  Dr. Prout
records the case of a patient who could not take mut-
ton in  any way without  being ill, though introduced
into the stomach surreptitiously in pills.*  I know an

polis?"  He said, "Yes, by many butchers, but not by all."
(The custom is more prevalent in the country.)  On being
asked how the torture was inflicted (which  that admirable act
of Mr. Humanity  Martin has not reached), he  said,  "We
bleed 'em every day for about four days, take a little out of
them the first day, and more every day afterward,  when on
the last of all  they are made to faint, and^^i, some hours
after this, killed."  And we, who know of this plan of whiten-
ing veal, eat it so whitened, and call ourselves Christians!
  * This patient should have lived in Rome, where they have
no mutton at all during several  months in the year; and on
my inquiring  the  cause,  was  told that it was then out of
season. 
        CAUTIONS IN RESPECT  TO MEAT.      53

instance of a gentleman who cannot eat a single straw-
berry with impunity;  another whose head would  be
frightfully swollen whenever he was imprudent enough,
being well aware of his infirmity, to eat the smallest
portion of hare ;  a third who will certainly  have  an
attack of gout a few hours after eating fish.  I have a
patient who has during the last nine months been  re-
laxed in her bowels whenever she has taken a cup of
black tea; another when she drinks a  glass of cold
water, as  she does every morning fasting, is simi-
larly affected.  And, while on this subject, I may men-
tion a fact to show that green tea, though so agreeable,
may not be so harmless as  it is  supposed to be  by
some.  A medical man of my acquaintance can drink
it made strong, and in almost any quantity, unless in
a morning  after he has been out of bed all night pro-
fessionally ; and then, on taking it, his hands always
shake violently, as if he had  palsy.  These peculiari-
ties prove stumbling-blocks  (both in regard to food
and medicine) to  the course  of the physician.  Meat
being so  much more  easily digested than vegetables,
is another reason*why the stomach should be accus-
tomed to its moderate use, even in preference to other
diet.   In addition to the practical experience of us all,
that of Dr. Beaumont, the American surgeon, must
always occupy &  place  in a professed work on Indi-
gestion, who, in the case of his young patient Alexis,
who had been  wounded in the  side, and  an aperture,
or window, being left two and a half inches in diame-
ter, all the arcana  of  digestion were exposed to the
prying eyes of the  doctor even for years, so that the 
54    PROPER  FOOD FOR  WEAK STOMACHS.

order in which the food passed the pylorus (which we
know means janitor  or  door-keeper)  was  recorded,
and by the curious may be seen in print.  Suffice it to
say that rice, trout, venison, eggs, etc. took the  lead,
while pork, salted -meat, veal, etc. were always "stop-
ping the way."
  If valetudinarians would  confine themselves,  while
under medical care, to one kind  of meat on each day
(ringing the changes  occasionally), with wholesome
stale bread, taking brandy-and-water, or sherry-and-
water, as beverage therewith, how greatly would their
cure and  their ability to indulge in  other  things be
expedited!  but they must clamor for unwholesome pud-
dings and  vegetables, and even (to them)  poisonous
pastiy.* Of some of these two former, a selection can
always  be made ;  but one of the greatest annoyances
which medical  men meet with is the cuckoo-cry from
the friends (?),  not the patient, of " What may we give
him to  eat, doctor?"  not knowing, and therefore  not
considering, that, where hundreds have died  from star-
vation, millions have perished from stuffing.
  Rice, vermicelli, tapioca, sago, an^ prepared barleyf
puddings may be allowed  to dyspeptics.  Oysters are
very nutritious and easy of  digestion, but they should
be stewed.   The best vegetables are mealy potatoes
roasted, young peas, asparagus, sea-kale, spinach, broc-
coli, cauliflower, and onions, which  last are highly nu-

  * What a blessing a cook would be—always the most danger-
ous person in the house—who could not make pies and tarts 1
  f Excellent; and to be had at  all the seed-shops, with direc-
tions for its  use. 
DYSPEPSIA.
55
tritious.   When a salad can be digested,—which the
stomach ever delights in, on account of the acid,—the
cure may be said to have been effected.   Sufficient
bread is not eaten by the English at dinner: we may
take a lesson from our French neighbors in this respect,
as we may a warning against their habit of mixing so
much water with their vin ordinaire, thereby diluting
the gastric  fluid, and rendering it  less able to subdue
the mass of aliment  with which twice daily they over-
load their stomachs  and weaken  their power.  Fewer
bad effects, however, arise than might be expected, from
their being so much  an  out-of-door nation; for it is im-
possible to state too  often, or rate too highly, the value
of abundance of pure air in promoting digestion.
   For one case of dyspepsia occurring in  the country,
there are twenty in London,—a fact which only those
who have lived much  in both localities  can well ac-
count for.   Who ever hears of this  miserable malady
while traveling  in  their  holidays, — while  viewing
beautiful scenery, scaling mountains, and when every
muscle of the body  is performing the office for which
it was originally created?  An extract from a most in-
teresting book (the best) on California, which has just
been published  by the  Rev. 'Walter Colton, of Phila-
delphia, well exemplifies our subject.  He says, "The
Californians eat meat,  and that beef, generally three
times a day,—at breakfast, dinner, not at tea, and again
at  supper.  A pig is quite a rarity; and as  for chickens,
they arc reserved for the sick.   The constant* exercise

 * Gentle exercise assists digestion; if violent, it retards it. 
56    QUICK EATING  CAUSES INDIGESTION.

of the people of this country, on horseback, gives them
the digestion of the ostrich."  In speaking of the man-
agement of children, a caution has been already given,
that, especially till they have effective teeth, their food
should be comminuted for them.   But what shall we
say of our transatlantic American brother, who, eating
animal food three or four times daily, positively bolls
it,* and as notoriously is grievously afflicted with indi-
gestion?  It is the curse of that country, and the more
lamentable because self-imposed.  But patients are not
docile, generally, when able to leave the house, and
are  not watched.   Those, however, who have once ex-
perienced the horrors incident to indigestion—the pain
of the  stomach after a meal, the headache, the  lovv-
ness of spirits, and all the other miseries arising there-
from—will gladly live as  has  been indicated, and will
consent to follow some other rules which have yet to
be laid  down.  They may  then anticipate, from  the
consciousness of  having vanquished an enemy, an en-
durable, and even an enjoyable, state of existence.  But,
before proceeding further, I would  in this place implore
those of my medical friends who are teachable, and
will  hearken to the words of experience, not to  treat
lightly, as if unreal, the sufferings of  their hypochon-
driacal patients.  Their  miseries  are  distressing and
real  to them, and  are greatly alleviated by commisera-
tion and  sympathy combined with hygienic  and  other

  * On  my admonishing a  patient  on one occasion (who
winced under it) for his supposed  habit of eating too fast,
and telling him that bolting the food was a bar to digestion,
he said, " You speak ironically, doctor."' 
VALUE OF KINDNESS.           57
curative means; but to him who has once been afflicted
himself, this advice will be superflous, like those who,
being one degree removed from poverty, are ever seen
most promptly to  bestow relief,  because  they them-
selves practically know  where the pressure  is most
grievous.   The same rule, too, applies  to insane per-
sons, the  best  mode  of treating whom—next  to isola-
ting them from all their present associations—being to
affect, at least, to enter into  their megrims and preju-
dices, and thereby  obtain their confidence, which in-
sures half the victory over their malady.
  It  is easy to say  and to  feel that no sorrows are
really deserving of the name, excepting those which
arise from loss of  character, loss of health, or loss of
friends; but  there are in this Babylon those who wor-
ship no other God than Plutus, to whom filthy lucre is
everything, and all things else nothing;* whose hearts
are in their banker's check-book.  These—especially
if they shall  have neglected or abused  their  digestive
organs—will, on a wrong turn of the scale, become at
once  prostrate, though all the blessings of this world,
to a highly-regulated mind, are still attainable by them
in all perfection.   They  claim, too, our pity  and our
aid.   Our advice they must have,—not hygienic alone,
for to that they are by right entitled ; for the physician

  * One of these devotees to mammon once received a lesson
from a humble follower, who did not seem to payto him, the
possessor of the purse, sufficient homage, and said, "Do you
know, sir,  that I am worth a hundred thousand  pounds?"
" Yes," said the irritated but not broken-spirited respondent,
"I do; and I know that it is all you are worth." 
58    BEVERAGES TO BE TAKEN AT DINNER.

who acts on the golden rule of "doing to others as he
would they should do unto him," has other means and
appliances at hand of a more elevated  character, far
more potent than the pill or the potion.   The kind and
encouraging word is ever ready  from a commiserating
and feeling heart.  Occasionally we meet with persons
whose appetites, though good, are very soon satisfied.
In them, perhaps, the stomach may be itself small, our
several organs* varying so much naturally in different
individuals; some there are with whom Madeira agrees
better than  sherry, in which case it  must be allowed;
others, again, who have all their lives fared generously,
appear to be unable to leave off port.   It would be
better that such persons should be restricted—if they
be docile—rather than forbidden ; for it is a dangerous
thing rudely to break off the habits of perhaps half a
life.
   Water, or barley-water, acidulated  a little  with
lemon-juice  and flavored with  the peel, is the best bev-
erage at dinner.  Ice I never  allow at dessert  to vale-
tudinarians, for the stomach when weak is for the time
paralyzed, as it were, by the frozen liquid ;  reaction
does not take  place  readily with them, and digestion,
for which warmth is needed, is thus partially or wholly
impeded. A small tumbler of warm weak brandy-and
  * Dr. Beattie has told us that Lord Nelson had one of the
smallest hearts ever known ; and I myself knew an instance
of a distinguished lady, one of great notoriety, whose liver,
not unhealthy, weighed five pounds, the usual weight of that
organ, in a man, being between three and four. 
   BEVERAGES TO  BE  TAKEN AT DINNER.    59

water or old wbisky-and-water is allowable instead.*
Some can take a cup of coffee after their principal meal
with advantage  ; and it is the only time when I should
be inclined to permit  the use of it to one who is really
an invalid.   Let those who  love to indulge in length-
ened post-prandial potations remember the observation
of that experienced physician,  the late Dr. Babington,
namely, "that a pint  of wine daily was hard drinking."
After a late dinner, anything of a solid kind is rarely
required.   I  am acquainted with an excellent cheerful
old Scotch lady, who has abundance of common sense,
and is nearer eighty than seventy, who has never taken
anything, during many years, in the  place of tea and
supper, but a glass of cold water every evening, and is
in perfect health.   If ice must be taken, the latter part
of the  day is the best time for its enjoyment.   But,
 although the intestinal tube is  the grand cloaca for the
 trash which, either twice or twenty  times a day, we
 turn into our stomach, the  skin and  the kidneys con-
 stantly come to the rescue.  Hence the necessity of
 wearing  flannel next to the body  by all persons, and
 also of taking abundance of tea, or some other diluent,
 to keep the renal functions in  action.   Many of the di-
 rections  of  medical  authorities  are irksome  to  follow
 by a headstrong man,—as  disagreeable as the potions

   * But the  best promoter of digestion is a contented mind ;
 this is  the spirit that is  required to help on the great meal,
 exciting the joyous joke and all the hearty amiable feelings.
 Those who are wealthy should keep a jester for after-dinner
 use, as formerly: he would be well worth his keep, and hia
 salary too, if he were a clever fool 1 
60   THE DO-NOTHING SYSTEM OF MEDICINE.

which we inflict upon him.   And this may account for
that which, if not ingratitude, is so like it that the dif-
ference is not perceptible, which he so generally shows
after he has,'through medical agency, been restored to
health.  Hence the favor which the homoeopath obtains :
he who, not  having succeeded in his  career of legiti-
mate medicine, takes up the Liliputian system  as a pis-
aller.  He  gives no disgusting draughts; he never
bleeds in inflammatory ailments, without which death
must inevitably ensue; he kills no one; he only stands
by and suffers the disease  to do it, which Mr. Aber-
nethy was  accustomed to  vow  he never would.   I
myself have been repeatedly called in by a physician,
now no more,  of no  small  note in the small-dose de-
partment of  medicine, to  various patients, to  his own
family, and even  to  himself; but a consultation with
him was, on my part, never thought of.   I gave him
credit for seeking information when he could not see
his way to a knowledge of  the nature  of the  disease,
and thus to forget himself and his system in his desire
to do his duty to his patient.  My reply, on being
asked  by this gentleman  why / did  not become  a
homoeopathist, was, that  I  could  not afford to throw
away the experience of  forty  years and begin again
de novo.  But there are some who, it is said, will treat
their sick by either method.  Now, as both  systems
cannot be right, a designation for such a practitioner
one should not be long in finding in Johnson's or any
other dictionary.   Allopathic, or  legitimate, medicine
is become altogether far different to what it was a very
short time  ago.   Much less physic is now prescribed 
HOMCEOPA THY.
61
than  heretofore  by physicians, diet and  management
being more  considered than it  used to be;  and the
general practitioner is allowed to charge a moderate
sum for  his  visits, so that he is not driven to look for
compensation for his services by the justly offensive
method  of  huckstering  in  a  daily  cargo of drugs.*
That  able practitioner, Dr.  Armstrong,  said that he
could judge of a man's abilities by the simplicity of
his prescriptions;  for as  the science of  medicine  im-
proves,—and what magnificent strides has it not made
in the last half-century!—he who sees his way will not
multiplyf his curative means.   I once saw a formula
for a mixture, by a late distinguished physician, with
thirteen incongruous articles in it. J
   A  lady who was very  ill, on  being asked  why she
did not seek relief from homceopathy,§ said " that she
  * The rebellion against  this practice,  however,  laid the
foundation, as I believe, for the ridiculous quackery of homoe-
opathy.
  f I have often taken my honorarium when I have contented
myself with laying down rules for diet, etc., and not written
a prescription at all;  and the patient, a sensible person, has
been well pleased thereat.
  J Like a soldier going into action armed with every known
weapon, instead of the musket and bayonet, the old well-
accustomed settlers of strife!
  \ I look back with much satisfaction upon an instance where
(being medical  director, that is, physician, for there was no
other examiner, during eight years, at an insurance office) I
refused the life of a nobleman of high rank, because his medi-
cal  man was a homoeopathist,  and my brother directors con-
curred with me unanimously. 
62
VARIETY IN FOOD.
could not wait."  It is an overwhelming fact, that of
all the physicians of this great metropolis, men second
to none in the world for  their judgment or for their
honesty,—men quite independent of their profession in
their worldly circumstances,—not one medical man of
note has yet  thought fit to entertain and adopt homoe-
opathy. But to return from this long digression : pure
air, abundance of oxygen, by day and by night, is ab-
solutely necessary for good digestion; but those three
thieves—the candle, the lamp, and  the fire—rob us of
it during half the year; ventilators, however, one of the
blessings of the present age, Avill compensate much for
these thefts.   Yariety, too, in food must be sought in
all allowable measure, man, as we have  said, being an
omnivorous animal.  The more  various  the  descrip-
tion of aliment that  the  stomach can  be induced to
tolerate, the better; and as that organ,  when healthy,
enjoys vegetable acids, the citric and acetic, especially
the latter, the patient may train it by degrees, as con-
valescence  advances, to return  to the moderate use of
acescent  drinks.  Again,  though to live one day as
another is in the main most desirable, yet an occasional
outbreak, always keeping within statutable limits, is
recommended, as has been before said, by both ancient
and  modern  authority.  This  I consider  to  be  the
legitimate reading of the toujours perdrix story of the
licentious monarch of France and his spiritual director,
on a totally different subject.  The reason why women*
  * I knew a lady most intimately, who sunk a sum of money
on her life at  eighty, at an insurance office.   She enjoyed, 
       IMPORTANCE  OF REGULAR HABITS.     63

live so much  longer than men, as  Insurance Offices
show, by allowing the latter more interest on money
sunk, is on account of  their temperance, and their not
eating and drinking like the rougher sex, and also from
their greater freedom from  turbulent excitement, and
from their  in-door habits in inclement weather.   Suf-
ficient importance, as it seems to me, is not attached
to the living one day as another, especially as to dining
at the same hour, going to rest, etc.  We are all crea-
tures of habit, natural or acquired; and the power  of
living  long—by secondary causes—seems to be very
much within the grasp of mankind in general.  Of one
fact I am quite certain,—and am anxious to give it in
the shape of advice to elderly persons,—namely,  that
by living very temperately—nay, at times abstemiously
—and  by never, on any pretense,  frequenting feasts,
they will  prolong  their  lives, should they wish to do
so, for years.   The greatest man of our age, who en-
nobled his nobility by the dignified consistency of his
character, owed his good health, next to his belonging
to an exceedingly long-lived family, to his universally
known temperance in eating and drinking, and also by
bis early rising, thus  adding virtue to  virtue,—thus
crowning a long and glorious public career by setting
during nearly fourteen years, eighteen and a half per cent.;
and, on expressing her satisfaction at her good fortune, was
told that had she been of the other sex she would have had
twenty-two per cent.   In the last census it was recorded that
there were 111  men in England, Scotland, and Ireland who
had lived from  100 to 119 years, while of aged women there
were 208. 
64
EARLY RISING.
an example in private life to ill-judging boys and girls
(in mind) of sixty and  seventy, and upwards !  Who
can have perused the  preceding  paragraph without
seeing the exceeding desirableness  of early rising—
that secret of secrets—la creme de la ere me of our sub-
ject—in  thus  seizing larger snatches of  life (for what
is sleep but mimic death ?)—not to say that we insure
almost a certain prolongation  of  our  existence when
the sand of others shall  have run out!. But, in enjoin-
ing the cultivation of this inestimable  habit, it is right
and fitting to be just.  All are not alike in these wake-
ful  moods, any more  than in any other.  The power
to leave the nocturnal  retreat with ease, is partly a
gift; but the mind, be it but  masculine, and  the body
not absolutely sickly, can be in a great  degree disci-
plined  to the task, but the earlier in life  the better, so
that there may be fixed  upon the act the force of habit.
There  are, however, some with whom the  desire for
sleep seems to be almost a morbid affection, and who, if
awakened in the night suddenly, are totally bewildered,
have no presence of mind, and appear to  be intoxi-
cated;  and if this state arise not from overfeeding, such
persons must  be of those who  probably require eight
hours'  sleep  in the twenty-four,—a third of their exist-
ence!   Sleep must be sought, like food, in correspond-
ing degree to the amount of wear and tear;  and na-
ture, in this  respect, will assert her rights.  Six hours'
rest, as a general rule, to an idle  person, is  sufficient
—seven, to one who has fair employment.
  I am acquainted with a sexagenarian who rises uni-
formly at five  (in London) as long as it is twilight at 
DAILY TIPPLING.
65
that hour; after this, the whole of the remainder of the
year,  at six.   He takes an hour more only when on
the previous night, being  much in  society, he cannot
retire before twelve.  This  gentleman is very rarely
unoccupied, mentally or bodily ; lives in all respects as
here directed, and  is rude in health ; but this  to  one
who is contented to exist and not to live, who has the
outside frame,  but not the spirit,  of man—the husk
without  the kernel—would  be to die  daily.   Any
efforts may be made by the steady exercise of the will,
de die in diem.   The plodders who rise early  will
beat the flashy members of the community.  This  was
the opinion of Lord Eldon,* and has been, and is,  that
of many other  thinking men, living and dead.   But
though more disorders arise, as has been said, from
eating than from drinking,  still they do not destroy so
quickly as those which  arise from daily tippling up to
the verge  of intoxication, to a point which habitual in-
dulgence renders it most difficult to  avoid.  At length
the resolution (good at first) is sapped, and disorgani-
zation of  the delicate mucous membrane  of  the stom-
ach takes  place, and then decay of the liver, especially
if spirits shall have been the poison imbibed.  In this
  * Lord Eldon asked a medical friend of mine how many
sons he had. The reply was, " Two—one very .sharp and quick,
the other slow, but sure."   " What do you mean to make of
them?"   " I purpose making a lawyer of the sharp one, and
a doctor of the other."  "Do no  such thing," rejoined his
lordship; "make the  clever one the doctor, the  other the
lawyer.  I was never anything but a plodder."
                         5 
66
DELIRIUM TREMENS.
case, delirium tremens* or the drunkard's  madness,
presents itself; in which, as all medical men know, if
sleep be not procured, a certain and often most tragical
death is the result.7   In  such cases, though by the aid
of powerful medicine  a state of somnolency is induced,
an ultimate recovery very rarely occurs.  I have never
known  but  one confirmed  male drunkard  who, by
management  and gradual  steps, retired victoriously
with his face to the enemy.  I never knew an instance
of a woman's  leaving off really drunken  habits when
once thoroughly established.  What a warning, then,
should this be  to those who, in morals, and, above all,
  * I attended a lady of rank many years ago, who, though
possessed of the purest and most delicate feelings, had imper-
ceptibly become a slave to the  glass.  I found her  one day
raving mad, delirium tremens  (not common  with  women)
having presented itself.  Sleep, without assistance, was quite
out of the question ; and remembering my old teacher's axiom,
namely, not to let  the disease kill, and knowing the cause, I
gave her a large dose of hydrochloride of morphia every hour,
anxiously watching its effects, as none but medical men can
understand; ten hours had  elapsed before the state of uncon-
sciousness occurred.  I allowed  her to sleep ten hours, and
then had her awakened, gave her some nourishment,  and per-
mitted her to sleep again, when she at length arose of her
own accord, perfectly sane in mind, and so remained for sev-
eral months, very grateful, as those of her sex always are, for
the benefit that she had received while unconscious of her          '
precarious and distressing condition.
  f A very dear friend of mine committed suicide some twelve
years ago,  when afflicted by this dreadful, though generally
relievable, malady.  I have a patient who  has had five  o»
six attacks, and he is now well. 
DELIRIUM TREMENS.
67
in religious conduct,, are, no doubt, so superior to the
rougher sex, though it  must be allowed they are not
so much exposed to  temptation !  I knew a man who
was wearing  out his  mind and body by intense excite-
ment, who would take  a tumbler of brandy at once,
and, not seldom, send a second after it; but he died at
forty-eight, and there was no inquest held.  This poor
fellow once lived most correctly, guided by high prin-
ciple, but  at length gave way to the tempter.   If such
persons break down,  how can we wonder at the intem-
perate habits of those who, not internally feeling that
they are stewards of that time of which they will have
to  give an account, tipple  on from  day to day, and
finally yield up  their useless  lives victims to solitary
sensual abasement,—the hopeless finality  of driveling
drunken men?   Excess in  eating is rarely seen, for
any length of time, combined  with the reckless desire
for liquor; but  the  two vices will occasionally run in
couples for a season, till the desire for food is no longer
felt by the outraged  stomach, and then the " beginning
of  the end" is  soon set up,—the period of nausea, re-
pulsion, and disgust.   But it is marvelous how much
fluid  of a  vinous, or even spirituous, nature can not only
be taken, but is really needed,  in making inordinate
bodily exertion, as in climbing mountains, etc., or when
the exhausted  body is  enfeebled by low or adynamic
feVer,__where  in the cases of habitually sober men,
ay, and sober women too, the brandy which they con-
sume comes to be reckoned  by glasses  and the wine
by bottles, without  which—such is  then  the  craving
of the constitution for support—death would inevitably 
68
VALUE OF CHLOROFORM.
occur, but by the bold  administration of which  at  the
critical juncture, as all experienced practitioners know,
multitudes of invaluable lives have been saved.  If the
liver  be disordered or  diseased, no  kind  of food  can
pass  into the system  to become  his  life,  which  his
blood is,  without this  organ furnishing its large car-
bonaceous* complement of alkaline fluid ; so that I  am
inclined to attach more  importance  to the  liver than
even the stomach.   We have great power over its  ail-
ments, however,—mercury in some mild form having
specific influence, as much as opium and  chloroforinf
have  on the nervous system, as rhubarb is said to have
 )n  the  duodenum, aloes on the rectum, and  as much
as ergot of rye and oxide  of silver  certainly possess

  * Eighty per cent.
  ■j- It is impossible  to  mention chloroform without being
deeply impressed with its immense value  as one of the great-
est discoveries of this marvelous age; great in a point of view
which has not been  noticed, as I am aware, for  it not only
arrests pain, one of nature's most formidable evils, but it  also
ter.ds to equalize talent. A surgeon's judgment was often nul-
lified, when about to perform an important operation, by his
nervousness and overanxiety:  through which  many who
would have been, from their anatomical knowledge, first-rate
operators,  have broken down, owing to an excessive desire to
do their work well, but who were inordinately distressed by
the cries of the patient, happily now no longer heard.  Over-
anxiety to do  at  least as well as  other men, and no blue  sky
then to be seen, was the real reason why I myself abandoned
the practice of surgery in  1831, and, unwilling to rust out in
a comparatively constricted sphere  of  action, went to school
again, and obtained,  after three years'  additional study,  a
qualification fitted for any locality whatsoever. 
THE STOMACH AND  THE LIVER.
69
 over the uterus.   The  unmistakable  signs  of acute
 hepatitis, unremitting pain in the right hypochondriac
 region, often  extending to the shoulder, increased  by
 inspiration and by pressure, must be first met by gen-
 eral  and  local bleeding,  which, in such  cases, will
 speedily relieve.  But  in  the slow  or chronic form, a
 more cautious abstraction of blood is demanded accord-
 ing to the age  and strength  of the patient,  and then
 mercury, either as a purgative  or as an alterative, on
 alternate nights, or administered so  as  to affect  the
 mouth, must be our sheet-anchor.   But general obser-
 vations only can be made on this section of our subject.
 This, however, I believe: that from the great proportion
 of recoveries, under judicious treatment, in those who
 return invalided from  India, absolute disease of the
 liver is not so common a complaint as it was once sup-
 posed to be, and that, like its neighbor the stomach, its
 disorders are generally curable.  When really disor-
 ganized  (of which emaciation is one of the diagnostic
 signs, more than  in  gastric ailments), there is cause
 indeed for alarm.  I am  one  of those in whom early
 impressions are indelibly imprinted on the mind; and I
 cannot,  therefore,  forget  how  much  importance Mr.
 Abernethy was wont to attach  to  the color*  of the
 motions,  which  is  also my own  invariable guide;
 although my late esteemed friend, Dr. James Johnson,
 mentions one instance where they were healthv-look-

  *He was so comically diacritical, that  he even  had colored
slips of turmeric-looking paper on his study-table, to assist his
patients in their reports as to the appearance of their alvine
evacuations. 
>70      THE  STOMACH AND THE LIVER.
ing, and yet the liver was found  to be  totally worn
out by  disease.   Mr.  Tytler, also,' in the " Calcutta
Transactions," and other trustworthy writers, have
made  the same  remark as to the uncertainty of this
sign.   Their being almost scalding  hot  in their pas-
sage from the body is a sure indication of the acrimony
of the bile.
   How much, too, as is the case with  the stomach, is
the liver affected by  emotions of the  mind!  How
surely have some persons a  pain in the  right side on
the occurrence of mental distress!   Should  the  mo-
tions  be light in color,  we must discipline the organ in
question by the careful  administration of the gentle
gray  powder, or the equally mild blue  pill, in small
doses up to the chloride, or even the bichloride itself.
But no wise person will  venture to take mineral medi-
cines without their effects being regulated  by medical
care.    Nothing then, let it  be remembered,  damages
the liver so much as the daily imbibition of spirituous
potations* beyond a cautious extent.   The evil results
of this habit do not appear till some trouble comes, and
then  the mine explodes.  It is my opinion that disease
of the  heart is not more  prevalent  than  formerly,
though nothing  is so  likely to  induce it as  excess of
eating; and irregularity in this respect does induce in-
termission of the pulse, which occurs in stomach com-
plaints,  arising  not  from the real damage which the
heart has sustained, but is merely a functional disturb-
  * Stimulants in excess hinder digestion, as the blood is
thereby diverted to the head. 
A  GOOD  WIFE THE BEST NURSE.      fl
ance of that  organ from the influx of impure  blood.
This is very often an inroad of gout, and will be easily
removed by colchicum, etc.   When the bile is unable
to neutralize  the impure  acid of indigestion, the mass
passes on into the bowels,  causing griping, tormina,
flatulence, etc., in  the first  instance, and secondly, as
has been said, foul blood, etc.  Persons, however, need
not have the  gout if they will obey in all things their
medical adviser.  But then a gouty man must, while
suffering  his  torture, have  a kind and  tender  nurse;
and if he should have neglected at the proper time to
have  provided  himself with a wife,  a  companion in
health, and a sure  refuge in sickness, how grievously
does remorse  tear him when he finds himself  with  a
hireling substitute of the Gamp breed for a guardian
angel!  Pseudo-selfishness  prevents  men often from
marrying; they will have certain enjoyments (such at
least  to them),  and distrust Providence,—and so do
not wed, which  any man may do;  for he cannot fail to
know that the sexes  are born in nearly equal propor-
tions ; and, having prudently selected his bride, and ob-
tained her consent to enter into partnership, a small
stock of love  will  suffice to begin with ;  but this will
grow  into strong  mutual  affection,  as I  have often
seen,—those cases always excepted where a wife, mis-
taking her role in life,  and forgetting her marriage
vow, madly mars her happiness by striving to be mas-
ter;  or where tyrant man puts ugly thorns and briers
in the path of a gentle mate, of her who, though often
smitten by stern severity, yet at the one kind word flies
back, like the dove of the deluge, bearing the ever-ver- 
72       FUNCTIONS OF THE KIDNEYS.

dant olive-branch of hope, of faith, and of joy !  But to
proceed.   Pulmonic complaints being thoroughly un-
derstood  by the physician of the present day, changes
of action and aberration of structure are soon detected.
Heart diseases, we often hear, are greatly more preva-
lent than formerly; but those who  make this remark
overlook  one fact,—namely, the  rapid  increase of our
population.  Knowledge, too, is now so universal, and
the veil with which medical gravity has so long cov-
ered  itself is so often lifted up by prying hands, that it
behooves all the  followers of Galen and  Hippocrates
to obtain an insight into  the important discoveries of
modern times relating to the  heart and lungs,  and
which medical men are now expected to  understand ;
otherwise, as Mr. Abernethy observed, when imploring
his pupils  (young and old) to learn  thoroughly the
anatomy  of the eye, non-professional  persons study-
ing optics as part and parcel of a  liberal education,
should they find their doctor ignorant on a point upon
which  they could judge,  would give  him credit for
nothing else, though he might really have an intimate
knowledge of his profession in other  respects.  I agree
with  Dr.  James Johnson in  thinking that  far more
disease of the heart originates from the liver than from
the stomach.
   The kidneys perform a much more  important part
in the  animal economy than is generally imagined.
They are employed, from the cradle to the grave, in
removing poison from our bodies.   The researches of
Dr. Bright, the late Dr. Prout,  Dr.  Bence Jones, and
other eminent men, have now effectually cleared  our 
STONE  AND GRAVEL.
13
course, while  formerly  we were laboriously groping
for  aid in the dark,—studying, as well  as we could,
the various phases of renal disorder and disease.  The
lithic-acid deposit (gravel, in fact) which most com-
monly excites our  attention, appearing in excess,  as
has been already observed, before fourteen,  and after
forty,—the gormandizing periods of life, the intervening
portion is engrossed by other pursuits,—children ought
to be controlled  in  their eating, as should middle-aged
and old men, whose stomachs are the masters of them.
The stuffing and bolting common at those periods of
life are most  injurious.   If gravel be the only result,
abundance of sand  will  come away ;  and if not, it will
settle into a calculus, and this, when large, will neces-
sarily require  an operation of a cutting nature for  its
removal from  the bladder, the horrors of which I have
often witnessed  (both in  England and France), in the
cases even  of infants and up to octogenarians, before
the introduction of chloroform, that blessing  above all
price!  Diet and medicine will usually check the forma-
tion of gravel.  When, however, a calculus has formed,
there is  no remedy but  lithotrity, when it is of a mod-
erate size, or lithotomy if large.   Red sand is induced
by too generous  living ;  the  white,  by the reverse.
 Much pain is caused by it  in micturition, but great
relief is obtainable by the aid of the physician.  It is
not, however, from starving or stuffing merely that
 calculi come.  He who would take a large  and com-
 prehensive view of the subject cannot generalize in this
 manner.  No one  knows better than myself how re-
 markably free  the inhabitants  of  Herefordshire are 
74      CAUSES  OF STONE AND  GRAVEL.

from stone and gravel.  Many  have thought, while
searching for a cause for the comparative immunity of
that county from the scourge of Norfolk and Suffolk,
and some other parts of the country, that it was to be
attributed to the drinking of cider and perry; but it is
quite impossible that such  should  be the  case, as in
some years they have scarcely any,  or " a hit," as it is
there  called.   Malic acid  is  then scarce, and beer is
the ordinary beverage, as elsewhere ; and this has been
the case during several consecutive years.  My opinion
is, that  the  purity or peculiarity of the water is the
main  cause of the almost entire exemption of these
Silurians from  calculous complaints.  The  following
extract  from a letter written by Mr.  Waudby, the
house-surgeon of the Herefordshire Infirmary, to my-
self, dated August 30, 1851, bears strikingly on our
subject: "My predecessor, Mr. Tully,  does  not re-
member a case of stone during the long period of his
residence  in the  hospital.*  I  have only seen  two
during the many yearsf of my official career.  One of
the patients was not even  suspected to have had stone
during  life; the other, a child, had a lithic-acid cal-
culus, which was removed by Mr. Cam.  Stone cases,
therefore, are exceedingly rare in this county."  During
my own residence in Hereford as a surgeon, from 1813
to 1831, I never saw a case of stone, and heard of but
one, which was that of a physician, formerly MP. for
our county (father of the talented author of  The Diary
of an Invalid); but I have had patients who, having
* Thirty-seven years!
f Elected June 9, 1842. 
SYMPTOMS  OF INDIGESTION.         75
been afflicted with gravel previously to their residence
among us, in a short time  passed no more lithic-acid
or other calculi; so that,  although  indigestion is un-
doubtedly  the  main  cause of these  formations, and
their frightful consequences, that cause alone is  not
sufficient to originate the evil, any more than in other
complaints; and  the same may  be said  of remedies
tending to its relief.  Specifics are indeed rarely suc-
cessful ; but medical power is great; and he who igno-
rantly  despises  it, and doubts the wonders that it
works, may just  as  reasonably  dispute  the  life-pre-
serving qualities of meat and drink, as says the great
Sydenham, "Ars  medica, si revera ars fuerit,  et non
solum nomine tenus, maximum est donoruin omnium;
quas hanc vitam respiciunt tantoque omnibus, prseferen-
dum,  quanto ipsa  vita iis, quibus in  ilia gaudemus,
praecellit."  It  is  an art which is only to be acquired
by patient perseverance and indomitable  industry, by
not allowing one's own experience and opinions to be
disparaged, yet gladly receiving  instruction from any
quarter which may strengthen us in our endeavors to
mitigate the miseries of man.   And then how gratify-
ing to us is it to be able to  promise a cure, and, having
so promised, to perform it!  Those who  are martyrs
to indigestion do  not, as  may well be imagined, all
present the same  s\*mptoms.   Some suffer only after
eating  animal food, others  at every meal; some bring
up a tasteless fluid, several times a day have  pain in
the stomach, and a sensation of heat in that organ;*
  * Water-brash (pyrosis), or more descriptively, in Devon-
shire, "the water-pang." 
76        SYMPTOMS OF INDIGESTION.
occasionally the fluid is slightly acid—this is denomi-
nated heartburn, and is easily curable.   Another form
is where that which rises into the mouth is so intensely
acid as to  " set the teeth on edge" (so to say), in which
case the constant pain, especially as there is headache
in addition, renders life a burden ;  but a glass  of cold
water will often remove this distressing evil of intense
acidity, and  should  always, in  extreme suffering,  be
had recourse to.   A  confined state  of  the bowels is
found in almost every case of indigestion.  Some per-
sons experience eructation* with  scarcely any pain;
others, again, have pain, but without headache  ; while
a third  class struggle  with  all  the annoyances which
have been enumerated—with, in addition, great sensi-
tiveness on pressing  the  pit of the  stomach.  There
will, too, be more or less of lowness of spirits,  accord-
ing to the strength of mind possessed by the patient,
and the ability to endure—in which the softer sex so
much excel creation's lords! so much so, that  I have
frequently  said to  the latter,  when deserving such
commendation, "that  if  he had  been a  woman  he
could not have shown more fortitude 1"  The  fact  is,
man has active, and woman passive courage ;  and how
admirably, how heroically, she meets sickness  in her-
self and others, none can tell so well  as those who, like
myself,  in  early life especially,  have witnessed hun-
dreds of times the surpassing, the marvelous patience
of the not, in this respect, feebler sex !f  Lowness of

  * An individual who is really healthy neither eructates
nor expectorates.
  | Well may the male member of the Jewish religion thank 
            SYMPTOMS OF INDIGESTION.        71

spirits is sometimes morbid, and assumes the character
of hypochondriasis, as  we call  it,  in  which case the
patient is truly to be pitied;  and really, when we are
angry with persons for being waspish and irritable,
the sensitive stomach is probably the cause, and great
allowance should be made for them.  Not only day by
day, but night by night, their  enemy pursues them:
they  generally have horrible  dreams; and,  if they
should have undisturbed sleep, the morning brings no
blessing to them, so that their lives are really a hell
upon earth!  If they, however, have not indulged to
excess in wine or spirits, they will assuredly get relief
from  all their miseries ; but  should they have gone as
far as they could in  the  daily indulgence of  tippling,
without being absolutely  intoxicated, they must  do
much in obedience to their physician, and in habitual
self-denial,  or else they will fail  to  obtain aid from
medical skill.
   Neither  sex is  exempt from  this terrible affliction,
but men, from living more unrestrainedly, suffer most.
Our main point is to  study the peculiarity of each con-
stitution, every one  having  one or more weak points,
the successful search after which  having been accom-
plished, all afterward will become easy;  but this  di-
versity must  necessarily call for proportionably  differ-
ent modes of treatment.  For instance, indigestion may
God in his daily prayer, as ho does, that he is not a woman.
But what is the humble submissive theme of her, his spouse!
She resignedly bends the knee, and  says, " I  thank thee, O
Almighty Father, in that Thou hast made me as it seemed
best to Thy good pleasure." 
78    COMMUNICAOIENESS  OF  CONSUMPTION.

be caused by improper food,—that is to say, unfit for
that particular patient's habits; and, on that account,
even a little of it would be too much; or he  may  have
been in  the habit of  fasting  too  long,* or have eaten
too  frequently; or the air which  he breathes may be
unsuitable;  or a woman may suckle a child when she
ought not to do so,—a fruitful cause of  consumption !f

  * Who can  doubt that Lord  Byron  seriously injured his
health from his  great dread of corpulency?   His physician,
Dr. Polidori, has told us that he would  abstain from food for
days together, and then, to appease his hunger, would take a
wafer and a glass of brandy.
  f I have seen many young mothers  become consumptive
from sucking beyond the time suitable for their constitutions.
My rule always is, when I am satisfied that weaning is neces-
sary, and  the patient  inclined to be  rebellious, to  refuse to
prescribe, and thus starve them out.   While  on the subject of
phthisis, I may say that long experience has fully convinced
me of its being  communicable from one to  another: I have
seen husbands follow wives, and  wives  husbands, who  were,
apparently, quite well previously ; brothers,  brothers ; sisters,
sisters; particularly if they have slept in the same bed to-
gether ; so that under  pretense—not to alarm the invalid—of
too much heat being thus created, I make it a point of duty,
invariably, to separate the sound from the sick, knowing that
otherwise death  will unite them indissolubly.  Mr. Roskilly,
the eminent English surgeon of  Naples, whom I saw in con-
sultation in that city in September, 18-51, expressed his opin-
ion to be the same as my own  on this question, and added
that the Italians were so satisfied of it that they even burned
the bedclothes and garments of the dead.  In Rome they put
all the consumptive hospital patients into one ward, through
fear of contagion. The same opinion,  as to the communica-
bleness  of consumption, equally prevails in France.   One 
WEANING  OF  CHILDREN.           79
Again,  either sex  may be  overworked, mentally  or
bodily; or may have some great trouble, causing them
either to neglect  food altogether, or inducing indiges-
tion of that which they do take; or, lastly, the appetite
may be  too keen, and  restraint of it not  considered
necessary,  nence all the dangers arising from fullness
of blood  at a period when the stomach and its tribu-
tary organs have been damaged by  overuse; and  thus
disease, real disease, is established,  which cannot  with
safety be disregarded.   Assuming,  then, that there is
no organic disease—for I write only on curable  indi-
gestion—the  first point to  be insisted  on is  a daily
evacuation of the bowels; which can always be accom-

cannot think upon this scourge of our country without being
thankful for the discovery of the value  of cod-liver oil, than
which nothing in  my remembrance has been so  useful in
arresting, at least, and often for a long  period, too, the  most
fatal malady with  which  the inhabitants of Great  Britain
have to contend.  It is a remarkable fact, that in Russia and
the East Indies, having the two extremes of  temperature,
consumption is very uncommon;  and in the former country
extreme longevity is rather the rule than the exception.  The
reason why young women are so unwilling to wean  their
children  is,  from  a reasonable  fear of  having  a family too
fast. But too  long suckling is far more  injurious than the
not supporting  their  offspring in the usual manner, which
s'ome really cannot  do.  While alluding to pregnancy, I may
also state,  as my positive opinion, founded upon much expe-
rience, that it  is notat all an uncommon  occurrence for the
term of gestation in woman to extend beyond the customary
assigned period of nine months.   In quadrupeds it is unques-
tionably uncertain: there  is abundance of evidence to prove
this. 
80        LAXATIVES IN INDIGESTION
plished;  the means at our command, dietetic and me-
dicinal, being abundant;  and from this dictum no ap-
peal whatever can be allowed.   The  best form for
habitual  daily use is  a mild pill taken about  twelve
o'clock,  either pills composed of ext. col.  comp. and
extract of  hyoscyamus;  or  pilul. rhei comp., or pilul.
cambogiae; or, if these should not be active enough, a
dessertspoonful  of conf. senna? with or without gr. v.
pul. rad. jalapas.   Liquid laxatives for  purging are
not allowed in dyspepsia;*  these may sometimes  be
necessary, but only as exceptions to the rule.   I object
not to a lavement every morning; many of my patients
not having omitted to use assistance of this kind during
many consecutive  years,  with  great benefit; but then
it should be remembered that aperients are also occa-
sionally required, lavements  emptying  only the lower
portion of the intestinal canal.
  Napoleon, who was  a  martyr to another complaint,
when lavements would not relieve, always found laxa-
tive effects from  taking a composition of milk and yolk
of egg, sweetened  with sugar.   The whole passage  re-
lating to the  subject,  and to  so celebrated a man, is
worth the  perusal:—"Dans son etat naturel de sante,
la constipation lui  etait habituelle ; c'etait chez lui une
incommodite de  l'enfance qui ne  l'avait jamais quitte.
Quand elle devenait trop penible, il avait recours airx
bains et aux lavements;  parfois il  etait oblige d'y
joindre des boissons acloucissantes, la diete et  le bouil-
lon aux herbes.   Quelquefois  meme  tout ce regime ne
* Broussais said, "Fuge purgantia, tanquam pestem.'1 
           EMPTYING THE  INTESTINES.        81

suffisait  pas;  il  etait force de  recourir & son remede
herolque.  Cette preparation de lait, de jaune d'oeuf et
de sucre produisait sur lui l'effet d'un purgatif doux qui
le soulageait  constamment.   C* etait  le soul remede
dont il elit fait usage en sa ive."*
   The lower intestines being  only emptied by the lave-
ment,  this should be composed of soap and water only,
and that as warm as  can comfortably be borne,  the
quantity from a pint  and a half to a quart.   When it
is considered that, quite irrespective of the mass of food
which we introduce to the system, the  delicate mucous
membrane which lines the long intestinal canal is con-
stantly secreting a fluid to shield  it from harm; that
the liver and the pancreas contribute their share of the
accumulation ; and that  the  secretion of the first of
these is  always of an irritating (particularly if long re-
tained) and often of a rank  and offensive character;
this alone is sufficient  to  indicate  to  those who have
common sense, that this, the  legitimate debits of  the
constitution, ought, each  twenty-four hours  at least,
before  absorption of it to any  extent can take  place, to
be duly  and habitually expelled, or bad breath, offen-
sive perspirations, drowsiness, and still  worse  evils
will  arise.  My most healthy patients are those who
have habitually two motions daily.   Happy are those
who require not " peristaltic persuaders," as Dr. Kitch-
enerf  was accustomed to  call them;  and these  are
  * Examen des Doctrines medicales de M. Broussais, tome
iii. p. 30i.
  f No one can regret more than myself the comparatively
                         6 
82
EMPTYING  THE INTESTINES.
"usually persons  having light-colored hair, dark-haired
people being usually of a costive habit.*   If, however,
where little food is taken, the bowels will,  of necessity,
become oppressed, how much  more must injury to the
body arise, unless systematically and  frequently res-
cued by nature or by art, when three  or four meals a
ay are superadded!,  Early rising should be practicedd
by all dyspeptics; the bed should be  left in the sum-
early death of Dr. Kitchener. He was bound to me, indirectly
by the ties of consanguinity, and, though an eccentric, was a
truly amiable man : he was only forty-eight when cut off.
  * To show the necessity of a daily persevering emptying of
the intestinal canal, I may  mention a case, related  to me  by
my old friend, the late Dr.  Blount, of Hereford, brother-in-
law to Dr. Lamb, who, feeling  sure (though the bowels of a
patient of his were seemingly open enough) that there was
some lodgment causing irritation, at last expelled the lodger,
to wit, a piece of stringy ham, which  the man had eaten six
weeks before, and which had  got entangled in one of the
many folds of the alimentary canal.  Friction  of the abdo-
men, and  that long continued, in these  obstructions of the
bowels, should never be neglected: though  it is, I believe,
little practiced.   It is good for  medical gentlemen  (and this
I say expressly) carefully to consult in concert  over a  case;
for, as the late Dr. Merriman, one of the brightest ornaments
of the profession, once said to me, " I like to call  in our neigh-
bor Dr. Chambers;  he has too pure a  mind to damage a
medical brother by word or deed ; and always brings me help
in the shape of practical  knowledge."  In ordinary cases, a
physician's treatment  of his patient  takes its tone from his
own constitutional character,—feeble and undecided, or rash
and inconsiderate, or,  what  is far  better, the steady  middle
course. 
NECESSARY EXERCISE.
83
mer at six, and in the winter at break of day, by those
who desire a  healthy old age; an hour after which,
when some appetite shall have come (as it will always
do when once the good habit has been established), the
first  meal should be taken, and  that  substantial or
otherwise, according to the time allotted for dinner or
luncheon, and according also to the work, if any, to be
done.  If much mental or bodily labor  be in prospect,
the large meal of the day should not be taken till this
shall  have been accomplished; in which case a  third
of the principal  daily repast may be had in the shape
of a portion of meat at breakfast; and the stomach may
in consequence be spared later in the day, when unable
to do much, the nervous and circxdatingpowers having
been by that  time nearly exhausted.   Those pitiable
individuals who rise day by day, and year by  year,
without  occupation,  or  the  prospect of any,  will, if
wise, take the chief  of their nourishment at or before
three o'clock.  But let me implore those who are con-
demned,  as millions are, to a strictly sedentary life, not
only to seek,  but to  make, opportunities for walking:
this would be the best kind of exercise, even if it were
not the  cheapest.   They must remember,  however,
that if they can only walk immediately before dinner,
and have become heated much thereby, they must not
take this, the principal meal, till they shall have be-
come cool. Dancing, for all of  suitable age, would be
better  even than walking; but the great good which
this  is calculated to accomplish is nullified by these
saltatory movements being performed in contaminated 
84
VENTILA TION.
air  and at unreasonable hours;  but ventilation* is at
last asserting her rights in the cabin, the cottage, and
the palace, and the life-giving oxygen will, in this glo-
rious age, be employed as the Giver of all good things
destined that it  should be, namely, for the absolutely
needful daily and nightly revivification of man.   But
where shall we  find a poet who  could compose and
chant an ode of a sufficiently laudatory character for
an entire change of air,—that is, the moving from one
place to another for a time as prolonged as possible,
once  at  least annually ?   The  poet-laureate himself
could not satisfy me, and, of course, no one  else  could:
so,  in  plain humble prose,  I say, let all those  having
the power, who are obliged to live in large cities, take
a tour, by land or  by water, or  by both, annually, for
as long a time, if men of business, as they can justifia-
bly spare, to as g-reat distance from home as they have
courage  to undertake, and accompanied by those  whose
lives  are dearer to them than  their own.   Let them
escape from a locality where the work of a week else-
where is often done in a day, thereby defying the doc-
  * The public are greatly indebted to Mr. Toynbee, the emi-
nent aurist, for  his incessant exertions, philanthropically
exercised, especially for the benefit of the poor of this metro-
polis, in introducing among  them a habit of ventilating their
close and confined dwelling-rooms ; a fertile source of dys-
pepsia, consumption, adynamic fever, and other serious mala-
dies, as London physicians well know.  None but consumptive,
asthmatic persons, and those  who have weak lungs, should
have a fire in their bedrooms at night; but these should always
have this in cold weather, if possible. 
        INGRATITUDE TO MEDICAL MEN.      85

tor, and laying in a stock of health for the remainder
of the year.   Traveling alone  is of little use.   But,
alas ! there are those who cannot command even a sin-
gle week in twelve months ;  and of these the greater
proportion are medical men, that unappreciated class,
who daily run greater risks, a hundred  times told, than
he who once or so in his life  may seek  reputation at
the cannon's mouth.   Dr.  Bence  Jones well said, in
his admirable lecture,  October  1, 1849,  at St. George's
Hospital, on the opening day, we are angels while our
patients are  ill,  and something else when they become
well—we, who  are conscientious, and honest, and just,
and considerate, and Samaritan-like, through the whole
of our lives, and dying, rarely, very rarely, leave any-
thing deserving of the name of substance for our widows
or our children.*
   It  is a  rule,  too, with some, to talk  wildly and at
random  about  the inordinate gains of the curators  of
the sick:  this, too, is idle gossip.   In  London, the ap-
pearance  to be  kept up (not  required  of the other
  * It will be conceded that members of the medical profes-
sion succeed best in this great Babylon.  I have been, during
many years, a Director of the excellent Society for the Benefit
of the Widows and Orphans of the Medical Men of London
and its Vicinity, an institution which almost all the first phy-
sicians and surgeons in the metropolis support.  Now, will it
be believed that the widow of one in four of such leading men,
with her children (it is  found on the experience of years),
comes for help to the institution, not having £50 a year, the
minimum sum, which would disqualify her?  Many are en-
tirely destitute I 
86       INGRATITUDE TO MEDICAL MEN.
learned professions, to the members of which 1 have
not yet been  able to see in what  single  respect xce are
inferior)  swallows up  the  larger  income  obtained
through there being  more  people here  congregated
together.   In the country, medical men never, or very
rarely, receive anything worthy to be called remunera-
tion for the  slavery of body and harass of mind  that
they  undergo.   Having  myself lived long  in  each
locality, I can testify fully,  truly, and undeniably of
these things.  Below will be found an example of the
old adage, that " all is not gold that glitters."*
   Before  quitting  the subject of air without, and air

  * I called one morning on my neighbor and friend, the^ate
Dr. Chambers, then  the first  physician in London, some ten
years ago, and congratulated him  unfeignedly on  his being
in the act of making a very large fortune ; and on his inquiring
what I meant, I replied that  I had seen many patients go to
his house that morning.   He  said, " Listen.  You  may have
seen as many  as nine this morning: eight of them begged my
advice on some pretext or another ; the ninth gave me a fee,
which I presented to the gentleman who  has just preceded
you, who is an honest doctor in distress."  I know another
London physician,  who, during sixteen years, opened  his
doors every morning, the Sabbath included, to all who might
desire his advice ; he made a free hospital, as it were, of his
house; but at length, having prescribed for  many thousand
persons gratuitously, and seeing how much  his charity waa
abused, by persons  sneaking  in who, he knew, were able to
compensate him, he laughingly said that he had made up his
mind at last (metaphorically, of course) "to carry the  hat
round," when, as happens  after street-performances, all  but
 the really poor and distressed, the maimed  and the cripple—
 fled! 
    CAUTIONS REQUIRED  IN TAKING FOOD-  81

with,  exercise,  I desire to  offer one word of friendly
advice to those, and they  are  many, who can devote
but one day in seven to the enjoyment of both of these
combined, namely, to be especially moderate* in the
use of such privilege, or they will injure rather than
benefit  their health,  since  the constitution will not en-
dure  extremes, particularly in this respect.
   Having obeyed his  physician in all preliminary re-
spects, the patient takes  the first in order, but the sec-
ond most substantial meal  of the  day.   AYould that it
could be the first in reality !   Whether  milk, tea, cocoa,
or weak chocolate be the liquid preferred, it will never
be swallowed  by sane persons scalding  hot in tempera-
ture, reminding one  of the ridiculous custom once the
fashion,—for,  alas!  there  is  fashion in  physic,  as  in
other things,—to drink  after dinner a pint  or more  of
water, as hot as it could be borne, by way of strength-
ening the  stomach!  If meat  be necessary, Brother
 Jonathan's plan of bolting it, for  which  he suffers
 grievously in his attacks of dyspepsia, will  not  be
 adopted; but  mastication, or minute  comminution,f
  * I have had often, as patients, those who, having only one
day in seven for recreation, have been  made ill by greatly
overtaxing their strength on that day, and  doing far too
much  at  once;  not considering that, being all  creatures of
habit, the free  use of their  limbs in the open air, with them,
was the exception, and not the daily rule, and therefore to be
only temperately, because rarely, enjoyed.
  f I am  acquainted with a gentleman who lost  all his teeth
soon after fifty years of age, after which, not troubling him-
self to masticate with his  purchased grinders, he has in- 
88  CAUTIONS REQUIRED IN TAKING FOOD.

which will answer the same purpose.  Do but sepa-
rate well animal food, and the saliva and the gastric
fluid will  do the rest; and the peristaltic persuader
(should there  not have previously been a call to the
temple  of  Cloacina), within the next two or  three
hours, is then to be dispatched on its special mission.
If more exercise can  now be obtained, by which  walk-
ing is  always meant, so much the better.  If a late
dinner should make a luncheon necessary, meat is then
never required, be it remembered, at this, which should
be merely an apology for a meal, mental  and perhaps
bodily work having  afterward  to be done.  Whether
the dinner be taken at three, or at seven or eight, all
the inconsiderate portion of man and woman kind will
eat till they can eat no longer;  and some will unblush-
ingly say  that they have  done so, and in good society,
too. Let such, if ever dyspeptic, eschew champagne,
at  least,  and  indemnify themselves with sherry in-
stead ; bread will supply the place of a superabundance
of animal  food ;  a moderate quantity of water will su-
persede beer; and, if ice be at last presented, the un-
happy wight who labors under  weak digestion will do
well to pass it on to his or her neighbor.
   The food, when the stomach is  treated fairly, and
due rest is given to it between  each meal, begins, as I
believe, to be digested in some strong persons  imme-
diately ; but even allowing it a brief period for  prepa-
variably divided minutely  his meat, and during thirteen
"ears  has  neither  had indigestion  nor  any  other incon-
venience, being in rude health, and full of strength. 
       MEDICAL  TREATMENT OF INDIGESTION.  89

   ration, two hours, whenever possible, must be spent by
   every one after dinner in perfect repose.  Even the
   newspaper is not to be read, unless a short nap be de-
   sirable and  cannot  otherwise  be induced.   But this
   entire state  of  repose will not,  and by some cannot,
   always be conceded to the just claims of the stomach,
   while engaged in its greatest diurnal duty, by toiling,
   care-worn man! and this,  I believe, is one reason why
   female dyspeptics (owing to their comparative  ex-
   emption from the worry of business, or the considera-
   tion of exciting political and other questions) are more
   easily curable,  as they certainly are, than those of the
   rougher  sex.   I  have also  said  that, especially for
   those who cannot sleep at  night, a doze of half an hour
   is not only allowable, but even  necessary.  No de-
   scription of nutriment  whatever  ought to  enter the
   mouth after a late dinner, excepting, perhaps, black
   tea, with a small  portion  of stale bread or biscuit.
   But to invalids, to amuse the digestive organs till sleep
   should come, either gruel or sago, or arrow-root, or
   tapioca (with  or without the flavor  of brandy as a
   placebo), for the night, may be taken.   Of the medical
   treatment of dyspepsia this may be said, that without
   it the observance of every rule that has been laid down
    as to diet, etc. will be of  no avail; but by attention to
•   it, and that to no great  extent, indigestion, however
    severe and harassing, unless there be real disease, is
    generally curable—perhaps more certainly than almost
    any disorder that flesh is heir  to.  And next to  the
    gratification of seeing a valuable life restored, by what
    we believe to  have been  our  well-directed exertions, is 
90    GREATEST TRIAL OF PRACTITIONERS.

the pleasure of comforting a  timid valetudinarian by
the assurance of the probability of his or her recovery.
It is the physician's best fee—his truest honorarium ;
and, although  he does not, like the empiric, promise a
cure of all complaints  to everybody (for this is the line
of demarkation between  the legitimate sons of iEscu-
lapius and the  irregular guerrillas of medicine), he yet,
by his experience, can so exactly estimate his power
as generally to foretell that which may by the sick be
confidently relied  upon.  There is even a look in dis-
ease,  which is recognized by a  medical man of expe-
rience (often  very early, and when invisible  to the
non-professional eye),  and which  tells him unmistaka-
bly when there is no hope  of a cure for  his  patient.
This is indeed the greatest trial which humane practi-
tioners of medicine experience, to know that the smooth-
ing the way to the tomb is all the privilege which they
are likely to  possess.  In a  case  of this kind  two
things appear  to  me  to  be  incumbent upon  us: the
first, to tell* the whole truth to the most sensible (sup-
  * I am aware that the propriety of our interfering in any
but medical matters is questioned by some.  To such I say
that it is not for us to decide whether a death-bed repentance
will avail, or, to use the words of the late Rev. Rowland Hill,
" whether the Almighty will accept Satan's leavings;" but I
hold it to be the bounden duty of a physician, should he see
unmistakable symptoms of approaching dissolution, to tell
some one his opinion on  this point, that, not interfering fur-
ther, an opportunity be  afforded for introducing a minister
of religion;  and those who may consider  this  extra-profes-
sic nal and intrusive must look for  help elsewhere than from 
SPIRITUAL AID  TO  THE DYING.       91
posed) friend of the invalid; and next, I hold it to be
a rule no less sacred, not to torment and distress  and
harass our  patient by tentative subjections,, when we
are sure  that we  cannot cure him.  I  say,  tell  the
truth to a friend.   Why so ?   Because the  inability to
bear the knowledge of his hopeless state is  ail-but  uni-
versal, either with Christians or others, such and so
close is  the clinging  of  the  soul to her  earthly tene-
nfent.   And those of our profession who  have lived
long and  seen much, know that it is so, however much
one would  wish that the case  should be   otherwise.
I had a most distressing  instance in proof  of this  two
or  three  years  ago, which I will briefly mention.  A
tradesman, living  in the Edgeware road,  for whom I
had been prescribing occasionally, came  one morning,
and said, "Sir,  I am very ill, and believe that I am in
danger;  you know whether I am, or not; and I am
come to ask the favor of you to tell me if my disorder
is  likely  to kill me, for  I have a good wife and a bad
son, and I  wish to settle my affairs.  You  may tell me
the truth,  for  I  can bear  to hear it.".  Distressing
though  it' was (for I had never been asked the ques-.
me
     In consumption, for instance, one of the symptoms of
the malady being  the expectation of recovery  at a period
when the medical  adviser knows it to be impossible, then it
is  that  the relations of the patient at least must not be  dealt
unfairly by, but be told the real truth. In the cases of Catho-
lics at Rome (as I was informed from high  authority in that
city), after the attendance of a physician upon a patient has
been necessary three consecutive times, he is obliged to de-
mand spiritual aid.  Such is the decree. 
92
DETAILING SYMPTOMS.
tion so pointedly before), I replied,  that  my opinion
was decidedly that he would not recover. (He had
cancer of the stomach, not to be mistaken.)  " I thank
you, sir," he said.   "And now, once  more, how long
do  you think I  may  continue?"  This question  (as
harassing as the other), I answered, by saying, " Some
weeks,  or even  months."   I  found, however, that
though he said he could bear it, he could not;  the axe
had been  laid to the root of  the tree,  and he lived but
a very short time afterward.
  Sick persons  are generally not so  straightforward
and open when detailing their symptoms as they ought-
to be.  They should then consider themselves  as in the
witness-box with  a friendly  barrister, and wait to be
asked questions;  and, when the physician  appears to
have finished his  inquiry, the patient  may  add any in-
formation which may not have been elicited, and which
may be thought to be important.   But how preferable
is a taciturn to a loquacious invalid ! Nothing  annoyed
Mr. Abernethy so much as this, which led to his method,
in one particular case, of spiking the cannon :* he was
  * A very talkative lady, who had wearied the temper of
Mr Abernethy, which was at all times impatient of gabble,
was told by him, the first moment that he could get a chance
of speaking, to be good enough to put out her tongue. " Now,
pray, madam," said he, playfully,  '■'■keep it out."  The  hint
was taken. Ho rarely met with his match ; but on one occa-
sion he  fairly owned that he had.  He was sent for to an inn-
keeper who had had a quarrel with his wife, and who had
scored his face with her nails, so that the poor man was bleed-
ing and much disfigured.  Mr. Abernethy considered this an 
THE PHYSICIAN.
93
facetious and humorous, and loved a joke; but he had
too generous  a heart—as those who  knew him best
were well convinced—to make personally  offensive
speeches  to women, however  angry with them.   The
late Mr. Heaviside* on one occasion sadly forgot him-
self, and was  punished accordingly.   But who so en-
duringly  patient as  the  pitying  physician, when real
danger is present?  and  who  seeks the dark  cloud in
the sky so soon as he ?  If he has a sympathizing  heart,
his feelings are tried every day;  if he has not, he pos-
sesses not the  magnet which belongs  to his  glorious
vocation.   But let  him  carefully avoid that patient
whose chosen subject  is the abuse and vituperation of

opportunity not  to be lost for admonishing the offender, and
said, " Madam, are'you not ashamed of yourself to treat your
husband thus? the  husband,  who is the head of all—your
 head, madam, in fact."  "Well, doctor," fiercely retorted
 the virago, " and may I not scratch my own head?"   Upon
 this, her friendly adviser, after giving directions for the bene-
 fit of the patient, turned upon his heel, and confessed  himself
 beaten for once.
    * Mr. H. had a patient, a very stout lady, who was ever-
 lastingly sending  for him, and often unnecessarily.  One
 morning the  message came, "he was to go immediately."
 He regarded it not, finished the business in which he  was en-
 gaged, went to  visit some persons  who  were really  ill, and
 then obeyed the summons of the morning.  The lady was in
 a towering rage, and said  so much in the way of reproach,
 that the  doctor lost his temper, and insisted upon knowing,
 without more delay, what  was the matter; and upon  her say-
 in- thatshe had a bad pain in the small of her back, he asked
 her  where that might  be, and was thereupon immediately
 desired to leave the house, into which he never went  again 1 
94
THE PHYSICIAN.
him by whom he had been previously attended;  for it
is useless to say to one of his description that all med-
ical men do their best, and, if they fail to relieve, they
themselves suffer next  only in degree to him whom
they would  gladly, because it was their interest, have
succored.   But no, says the  vituperant:  "he could
have relieved me, but he would not."  But,  above all,
let the physician avoid, as he  would a pestilence, the
brother—and the race is not extinct—who has ever been
known to say to the once patient of  another, "It was
well for  you that you  came for relief when you did;
a few days more  under that man's  care would have
proved  your  destruction !"   Medical men, medical
friends, ye who are gentlemen, eat bread  and drink
water all your lives before you condescend to meet a
fellow like this in consultation, whatever be his station,
—having first satisfied yourselves that he  had thus
spoken of any legally qualified man,* whether physi-
cian or surgeon; for one who is fit for  your society
could not, knowingly, rise on the downfall of another;
since he would feel that to die happily he  must live
honestly, and  that  that, and that  alone, would bring
him peace at the last.
  Although the boa-constrictors of the human race do
  * My dear master, whom I can never be tired of quoting,
was accustomed to say that " if dirt, in any quantity, were
thrown upon an angel, some of it would stick;" like a vile lie
published on the eve of an election (known to be a falsehood
by the utterer), specified early enough to do incalculable mis-
chief, but purposely circulated too late to be contradicted. 
CORMORANTS.
95
not usually eat hats,* needles, or, as the veritable boa
did, a blanket,"}" for a change, there is quite enough of
voracity  chargeable to  intellectual,  intelligent  man,
whereby  his stomach is everlastingly in trouble.
   The pulse must  be watched in dyspepsia, so that it
  * My old friend Mr. Judd,  Surgeon-major of the Scotch
Fusilier Guards, was once sent for to relieve a man who was
said to have eaten a hat.  On his arrival, he found a young
man, a soldier, exceedingly ill, and in great  pain.  Mr. J.,
not believing the hat story, sent for  the landlord of the pub-
lic-house, where the fact was confirmed by the whole staff of
the establishment, that the patient had really eaten a hat (cut
into pieces and  fried in butter) for gold I   Under suitable
treatment this cormorant recovered;  but not immediately.
In  the Museum at the College of Surgeons is a large  bottle
full of needles,  weighing many ounces, nay, more than  a
pound, which  were swallowed by a woman, who could not
have been in her senses.  She lived  many months afterward,
however, and, instead of being emaciated, got  fat.  Needles
are, nevertheless, not recommended as an article of diet, for this
was a case of post hoc, and not propter hoc.
  ■j- Seean amusing account in Dickens's "Household Words,"
giving a History of the Boa-Constrictor in the Regent's Park,
which, instead of eating two young  rabbits, which  had been
put into the  cage for his supper (downright murder), had,
while poking  about in the dark, as is  supposed, got hold of
his blanket, the end of which in the  morning (proof positive)
was hanging out of his mouth 1 and the intended " supper"
alive and well.  It is believed, however, that this patient did
not die, but that his patients  did 1   It is impossible to men-
tion the name of Dickens without gratefully acknowledging
his noble and generous and constant appreciation of medical
men, the much-enduring, never-tiring, unrequited benefactors
of their afflicted  fellow-mortals. 
96        TREATMENT OF INDIGESTION.

be not too full and hard, or too rapid; when near to or
above a hundred  beats in the minute, all our care is
required.  It is the storm at sea, and there are breakers
ahead.  Tonics then,  as  we  all  know, are  out of the
question:  the commotion must first be allayed.  When
pain exists, as it usually does in severe dyspepsia, and
must be our main guide, eight or ten leeches, and these,
perhaps, repeated once or twice, at the scrobiculus
cordis, will almost always  give relief, whether the
cause be congestion or inflammation.  The leeches may
be followed, should the patient not be able to bear the
loss of much blood, by a sinapism the following  day,
that excellent comparatively modern remedy, which,
in the cases of children especially, so often supersedes
blisters.   When harassing annoying  acidity prevails,
the  tongue being covered with  a white coating, no
curative means are so efficacious as some mild mercu-
rial, pilul. hydrarg. for instance, in combination  with
pilul. rhei co., every alternate night, followed the next
morning by a Seidlitz powder, or a dose of ol. ricini, or
a (gentle) old-fashioned black draught;  this to be re-
peated three or four  times,  interdicting animal  food,
and giving liquor potassae, or bicarbonate of potash,
with lemon-juice, thrice  daily.   But what are we to
prescribe, says my reader, when mercury cannot  be
taken, which we know to be  the  case with some very
few persons, who are  quite aware of  this idiosyncrasy
themselves, often to their sorrow; for the medical man
(a stranger) who has been called in may possibly  have
forgotten  the golden rule which  every one who writes
for the sick should have  in his mind, and the patient 
      MEDICAL TREATMENT OF DYSPEPSIA.    91

has  thereby suffered,  namely, invariably to ask, " Is
there any drug which  has been found to be hurtful to
your constitution,  the  introduction  of  which  your
stomach has resented ?"   The answer will  sometimes
be,  mercury* in any  shape  or  degree, or opium, or
rhubarb, or aloes, etc.  I know of no medicine, when  it
is desired  to act  upon  the liver  and where mercury
cannot be tolerated, so efficacious as a combination  of
nitric and muriatic acid with taraxacum, in large doses;
but the following mixture  of M. Lugol is  also  good:
—Iodinii, gr. f; hydriod. potassse, gr. iss.;  decocti ta-
raxici,  Oss.  Fiat mist.  One-fourth part of this mixture

   * One of the most annoying cases that ever occurred to me
 was the following.  I was sent  for to a hotel, to an Ameri-
 can lady, the wife of a barrister, who was ill  from  having
 neglected her bowels.  While writing my prescription, I  as-
 certained that she could not take even one grain of calomel,
 and I therefore promised that no mercury should enter into
 the composition of my remedy.  The lady was  enceinte.  In
 the night  I was roused from my slumber to go to the assist-
 ance of this patient, who bad been afflicted with violent tor-
 mina,  sickness, etc.  An anodyne gave relief; and on calling
 upon the chemist to order something more, he said,  "Sir,
 while  I made  up  the  medicine, yesterday, the gentleman
 waited; and  when I took down the blue pill, he started!"
 And so did I! and requested to see my prescription (in order
 to  take it away), which contained 9'ij. of ext.  coloc. co. and
 9j. ext. hvo=cyami only, written sufficiently well. ...  It was
 just a  stupid mistake.  It behooved me, however, to clear my-
 self with the husband ;  but the chemist never forgave me for
 not screening him at my own cost; though I made the lawyer
 hold his tongue (no easy matter) ; for this careless compounder
 of medicine had seven children.
                            9 
98    MEDICAL TREATMENT  OF DYSPEPSIA.

may be taken at first daily in divided doses, increasing
it to three-fourths;  at the same time eight or ten grs.
of pilul.  rhei comp. in pilulas xij., two on  alternate
nights, to be assisted off the next day or not, as may
be required.  I  do not venture, where opium cannot be
borne,— a most unfortunate  peculiarity, for it  is the
second-best medicine, next  to mercury, if not the best
of all that we  have,— to prescribe morphia, but  find
hyoscyamus or conium tolerable substitutes.   Rhubarb
and aloes will not be badly represented  by jalap, senna,
or castor oil.
  Till acidity be removed, "tonics and sedatives  will
not furnish their large share in  the cure of indigestion.
The following mixture is an excellent one:—Potassae
bicarb.,  3iss»  potassae nitratis,  9ij.;  infusi diosmae,
§xv.; tinct. hyoscyami, 3iij-  Eiat mist.  Quarum ca-
piat cyath. vinarium  ter quotidie.  Some cannot take
potash who will be benefited by soda  or magnesia, or
sesquicarbonate of ammonia.  When  the tongue  (the
sure index of the condition of the stomach—for even
when dumb it speaketh) is white, flabby, and the im-
pressions of the teeth remain on it, saline food, porter,
and wine, and iron, are indicated ; and of the prepara-
tions of  this metal I prefer the tinct.  ferri sesquichlo-
ridi, especially  when one of the gentle  sex is my pa-
tient (from ttlxv. to xxx. thrice daily, in a wineglass
of weak cinnamon-water) ; or the following mixture :—.
Acidi sulph. dil. 3j-', infusi chirayitae  vel  gentianae
comp., o^ij-; tinct.  aurant. 3ss. M.  Sumat coch. tria
ampla ter quotidie; or, if the stomach  be irritable, and
has undergone  much wear and  tear, and constant sick- 
              THE  OXIDE OF SILVER.            99

oess prevails, hydrocyanic acid may be  tried three or
four times a day ;*  from three to five  minims, in mint
or other distilled water, for a dose ; but  till I had had
more experience with a better medicine than  any of
these, in certain suitable cases,—for each, differing so
much as we do in constitution, must be  treated on its
own merits,—I was accustomed  to  add to every dose
of the above acid  from one-sixth  to  one-eighth  of a
grain of hydrochloride of morphia.   The preparation
which I have  alluded to  is the  oxide of silver,f the
best and safest, because  the most sure,  medicine  that
we have in most, I do not say in all, cases of dyspepsia.
Having  not only introduced but prescribed it more fre-
quently  than any other living physician, once daily,
  * In a case of incessant vomiting, the stomach refusing any-
thing, Dr. Alison entirely nourished a patient by lavements
of broth, yolk of eggs, port wine, etc., during forty days, who
then recovered.  I had myself a successful case so treated,
where, during sixteen days, nothing  could be retained in the
shape of nourishment per vias naturales.
  f The mode of its preparation, which contains one atom of
our second-best metal, with one of our most noble gas (oxy-
gen), will  be found not in the London, but in the "Dublin
Pharmacopoeia."  This oxide is incompatible with calomel—
or conserve of any kind.  I have  invariably prescribed it, as
I have said in  my " Practical Remarks,"* in a fluid form,
with a diluted mixture of acacia ; if in powder, in combina-
tion with pulv. acacise, and a small quantity of pulv. glycyr-
rhizse; or if in pills, cum mica panis.
 * Practical Remarks on some Exhausting Diseases, more especially belonging
to Women.  Second edition.  Churchill. 
100
THE OXIDE OF SILVER.
generally much oftener, in various ailments during the
last twenty years (since July, 1841), and watched  its
effects with entire fidelity, aided by very many enthu-
siastic friends, any objection to its use, therefore, from
any quarter whatever, passes  by me as wind and va-
por, against the deep conviction of positive indubitable
experience.   Time will  settle  the question; and I de-
sire  no other arbitrator.*   Every observing medical
man must have valuable  information to communicate,
which, neglecting to record, is lost to his brethren for-
ever ; for myself, not writing for pelf, though loving
employment, it is my intention, so long as I may live,
to treasure up, and  chronicle from  time to time, any
practical points that I may have the  good fortune to
discern.
  The oxide of silver is a tonic and a sedative of the
first class, in dyspepsia  and diarrhoea, especially with
children; it is, moreover, the best astringent that I
know in  every kind of slow or chronic hemorrhage, as
I have reported; and I shall do  this again and again,
so long as I may live; for I have never said or written
a word to my medical brethren, respecting the pre-emi-
nent qualities of  this admirable medicine, that I could

  * If I am asked, which I have been many, many times,—and
a very fair question it  is,—What are the bad effects, if any,
arising from the  employment of this medicine?  I reply,
really none, if prescribedproperly, and for a reasonable length
of time.   I never had but one case among thousands where I
had any doubt of its agreeing;  I never saw the  skin af-
fected ; but if it should be, I desire  here to say, once for all,
that the gauchcrie of the doctor alone will have been the cause,
now that the medicine is so well understood. 
MR. ABERNETHY.              1Q1
not entirely justify;  and whether they take it up gen-
erally or not, is of no consequence to me individually,
so long as I feel  that I have presented to them,  with
the purest intentions, a faithful report of my very large
experience; but,  as  the Times  of October 23,  1851,
says (in  one of its grand sledge-hammer leading arti-
cles, which so often extort our admiration, whether we
agree with the sentiments or not), " Truth, in its sim-
plicity, is too powerful a medicine for the great bulk of
mankind, the  mere creature  of a thousand prejudices
and habits."   My dear friend and adviser, the late Dr.
James Johnson,  before he became satisfied of the su-
periority of the oxide,  was accustomed  to  give, as he
told me, from  half a grain upward of the nitrate of sil-
ver even (a very  much stronger preparation), with the
happiest effects, twice a day, for three months together.
He it was to whom I  submitted  my " Practical Re-
marks," and who urged me  to publish them, saying
that he could testify to their truth.  I  do not prescribe
more than two months at one time. * When dyspepsia
is very obstinate,  as it  occasionally is, I suspect dis-
ease of the kidneys.   Mr. Abernethy  was accustomed
to say to  us (after relating a case which did not end
as he wished), " The patient died,  gentlemen, but he
ought to have  recovered  under the  treatment.''''  This
my excellent master was dotingly beloved  by his pu-
pils; but  by some, who knew him not,  he was  con-
sidered unfeeling; he was irritable, and (like another
great surgeon,* now living—another,  to whose words
* Sir B. C. Brodie. 
 102       ACTIONS OF THE STO31 ACH.

 of wisdom I had the privilege in early youth to listen)
 would not allow his patients (men or women) to waste
 his time unnecessarily; but he had a generous affection-
 ate heart; he who has given a hundred pounds at once
 to the distressed young widow of a medical man, with
 a family of infants, as he has done, to my knowledge,
 —he who, after a long gratuitous attendance on a very
 poor lady, who pined in vain for sea-air to perfect her
 recovery,  had abundant means placed at her disposal
 by  this her generous and pitying surgeon,—by him
 who might have now and then been brusque, but the
 rough outside had a brilliant diamond, a Kohinoor of
 sympathy for real suffering, set within.
  While it is most important to obtain  knowledge of
 all  the means  by  which  we can remedy  disordered
 states of the stomach, liver, and other of the organs of
 digestion,  perhaps it is even more  important to give to
 the public some knowledge of the means by which
 such disorders  may be altogether prevented by strict
 attention  to diet, the best periods for meals, and  the
 quantities of the various kinds of food which we ought
 to take.   Strict attention to these points verifies what
 has been before asserted, that by such vigilance  as to
 the quality and quantity of food  we may  altogether
 prevent most of the evils of indigestion.  By obtaining
 some knowledge of the actions of  our stomach, and of
the  food which best agrees with it, many diseases may
be averted altogether.  Personal experience is of much
importance on this point; for although  general  rules
can be laid down for the management of the stomach,
yet experience tells us that no two of these organs  are 
                OVERINDULGENCE.            103

exactly similar, and that the same system of diet is
not applicable  to  all.   Personal  experience must be
called  in to aid in the  treatment  of all diseases, but
most essentially so in the  case of the  stomach.   We
must learn the kinds of food which best agree with
each individual patient, because  the most important
conclusion on the treatment of indigestion and  other
morbid affections may be obtained by the individual
examination of every patient.   The most unobservant
person must know what articles  disagree with him,
and every information of this kind will  go far to assist
in the selection of remedies for disease.  Mere  absti-
nence  from certain things  Avill often remedy derange-
ments  of health when too  much  or too rich food has
been continued, even  after the organ so supplied has
repeatedly afforded warnings of approaching disorder.
Nature herself often gives notice of overindulgence, by
destroying appetite.  Children take the warning and
refuse  food altogether:  but it is so common a notion
that we  cannot get on without regular  meals, that
many  adults aggravate stomach  and  liver derange-
ments  by persisting in  taking food of some sort, but
which  affords no nourishment at all, because it cannot
be digested,  and thus  acts as any  other extraneous
substance, by increasing the already deranged powers
of the  organ.  We may rest  assured that  mischief
rarely  happens in disease from want of food, although
much mischief is often caused by the ignorant in press-
ing it  against the warnings of nature  in depriving us
of any desire for it.   In the incipient  stage of many
diseases, abstinence  at  first, and  then a very  strict 
104  PRINCIPLES  OF HEALTH AND DISEASE.

attention to judicious nourishment, will alone  cure
them.
  However, we should be careful not to overlook any
real  approach  of  disease; for we  may  thus neglect
symptoms of important  derangements easily removed
in their early stages, but often very  obstinate if al-
lowed to increase  by our disregard of them, and many
valuable lives are  annually sacrificed by the non-obser-
vance of early symptoms of disease.  Many medical
men think that some knowledge of disease ought to be
acquired by everybody.  Had I not been in the profes-
sion, I think I should not have been satisfied without
obtaining  some knowledge of disease and  the best
means of treating it in accordance with former experi-
ence. Probably the  time will come when some general
principles of health  and disease will form one of the
subjects of an advanced state of  education.  Much
good would be done if in early adult age  we acquired
such acquaintance with common diseases and their an-
tecedents as to be able to suppress them in  their pri-
mary stages, by abstinence, etc., or, by the knowledge
we have acquired  of their nature, to call in the aid of a
medical friend at the very beginning of any serious dis-
order.  There can  be no doubt that some physiological
teaching would be beneficial in several points of view.
By physiology we mean a knowledge of the  structure
and mode of action of our various organs.  Most people
know a little on the subject; they have general ideas
of the use of the  skeleton, that the various bones are
moved by muscular power, etc. So great is the import-
ance of some knowledge of the means of retaining our 
         KNOWLEDGE  OF PHYSIOLOGY.      105

health and vigor, and it is a growing  opinion that in
the higher schools the general principles of physiology
should be taught, on the  ground that  such knowledge
would sometimes enable us to prevent disease. Healthy
blood is essential to our welfare: blood is the product
of the ordinary actions of the organs of digestion and
respiration:  we cannot, therefore,  be  in  good health
unless these organs do their work well.  Some knowl-
edge of  physiology will  better enable us  to guard
against  derangements  in our digestive organs.  The
teaching of  physiology in our highest  schools and col-
leges has been strongly advocated, and such knowledge
would be of greater value  to happiness than much of
that which is learned in  such  institutions.   To teach
every one how best to take care of his health would be
the primary result of  such knowledge, and it would
open the mind to a new variety of facts most essential
to  our happiness.   The good to the community that
would result from making physiology, and some knowl-
edge of the  animal frame, a part of general education,
is much greater than would appear from a cursory and
superficial view of the subject.  Perhaps  there is  no
department of knowledge which opens and enlarges the
mind so much as acquaintance with the structure and
functions of animal and vegetable life.   What can give
us knowledge of a deeper and more important kind than
animal life?  And, with  all the  drawbacks and objec-
tions to the occupation of a medical practitioner, the
very elevated kind of knowledge, and the grand views
which the subject  presents to the  mind, are sufficient
compensation for the very  disagreeable appendants of 
106  DR. BRIDGES ON MEDICAL PHYSIOLOGY.

his profession.  Who, in the pursuits of life, have such an
opportunity of appreciating the grandeur of the power
which  has created the mental and moral  faculties of
man,  and  his capability  of enlarging those powers
through life?  There  is no greater mistake than the
inference, drawn  by superficial  observers, that the
study of physiological knowledge renders men skeptics,
and that such inquiries have the  effect of destroying
the religion which has been acquired in early life by
example  and  tuition.   Among the  effects  of  such
knowledge of the creation as is acquired by researches
into the structure and living power of vegetable and
animal life, there is a vulgar conclusion of an irreligious
effect  on the character of the student, than which no-
thing  can be more false.  If there is  any  one kind of
study more influential than another in  elevating our
conceptions of the great Author and Giver of life and
mind, it is  that of the structure and functions of the
human frame, and specially of the mental and  moral
powers with which the human soul has been endowed.
  In corroboration of the opinion  that some medical
knowledge is desirable in education, I have copied the
following from the pages of the "British Medical Jour-
nal" of November 7, 1868, from an excellent paper on
the subject read at Oxford by J. H. Bridges, M.D.
  "That physiological truth should be in  one way or
other  incorporated into our educational system is a
conviction which is rapidly becoming general.  It has
even penetrated into the venerable seat of  learning in
which  we are now assembled.   Yet,  if it were pro-
posed to teach physiology in our national schools, the * 
THE LAWS OF  LIFE.
107
proposition would be met with disregard or ridicule;
and, without discussing whether the ridicule would be
rational, I content myself with remarking that this pro-
posal is not what I am now advocating.  I am recom-
mending merely that a list of certain very elementary
sanitary truths should be inculcated by all certified gov-
ernment teachers on children above ten  years of age,
with the same universality and strictness that we teach
the alphabet or multiplication-table, and  that the gov-
ernment system  of inspection should provide for this
being efficiently done."
   If the laws of life formed a part of education, if such
knowledge could be more generally acquired, its influ-
ence would  have the effect  of increasing health and
diminishing disease; our children would be managed,
as regards health, very much better than they now are,
and a diminution of disease would be the result, more
especiallv that class of diseases  known as hereditary.
Health alone, as one of the most important  objects of
life, ouo-ht to be a sufficient inducement to all thought-
ful persons ; but it would be easy to show that knowl-
 edge of the structure and working of the various organs
 of the animal  body would be useful in almost all pur-
 suits and occupations of life.   The structure of our
 various organs has been suggestive of instruments of
 a somewhat similar adaptation in many departments
 of life.   There are contrivances in the animal frame
 which give hints to architects, engineers, etc.  To the
 artist some knowledge of the structure of many of our
 organs would enable hitn  to  give the most correct
 drawing  of  the human form, and prevent some of the 
108        ACTIONS OF THE STOMACH.

caricatures and blunders we  too often witness.  It is
not a little remarkable that we should  be taught gram-
mar, mathematics, languages, history, etc., but what
is to all the  most important knowledge—that of our-
selves—is left to  the chance of being picked up, as it
too often  is, by very bitter experience.  Some knowl-
edge of physiology would enable us to prevent  many
of the evils which beset us in our passage through the
world.   Some of the disorders and diseases into which
we fall  in our ignorance might have  been altogether
prevented by a little knowledge  of  the  structure and
functions  of our own body,—in other words, a knowl-
edge of physiology.
  That very large class of diseases  known as indiges-
tion, which are referrible to the stomach and its various
derangements, and what are called bilious disorders,
referrible  to  the  liver, together with  torpidity of  the
bowels, are all more or less caused by  ignorance of the
actions  of the stomach and organs  of digestion.   No
doubt most of these complaints are within our control;
and, if we made ourselves acquainted with the process
of digestion, the supply of new nutrient particles to the
blood,  and the vital  importance that these supplies
should be regular and healthful, we  might defy all  the
various disorders  known as  indigestion,  and  other
stomach complaints.  We can control such disorders,
and the tendency to them, by learning how the stomach
acts  upon our food, and  it converts it into materials
calculated to restore to  the  blood  other particles to
supersede those which, in our  ordinary occupations in
life, are daily used up by the actions of our various 
DAILY SUPPLY OF FOOD.         109
organs,  in  thinking, speaking, walking, or other pro-
cesses connected with our daily life.  The marvels per-
formed by our minds and bodies, by our various organs,
liver, stomach, heart, etc., and the amount of nutrient
matter  required to re supply the  daily waste caused
by the actions of these various organs:  when we con-
sider these points,  and the enormous variety of the
actions of our frame, it is only surprising that our
organs of nutrition can go  on for so many years  to re-
store new parts for those worn  away by our  daily
business in life.   It is, of  course, impossible to  calcu-
late  how long the existing condition of our organs and
our blood would continue to act without fresh supplies;
but  the daily demands made by our stomach for fresh
materials to re-supply the heart and blood-vessels with
new particles of blood to replace those constantly used
up,  enable us to form some conception  of the large
amount of new materials  daily required  in the  circu-
lation  of the blood.  If the stomach and digestive
organs  do not perform their functions of separating
from our food those particles which are calculated to
afford elements  that  can be converted into blood, we
lose our power of  action;  debility and various  other
consequences follow, and, unless we can restore the
process of digestion, we may fall into various  condi-
tions of bad health, and perhaps  the establishment of
diseases fatal to our existence.   Thus, many of the
most important of  diseases may commence with indi-
gestion.
   It will  not be superfluous to  conclude with  a few
more remarks  on  our  daily supplies  of food, the due 
110         TIME OF  TAKING  MEALS.
quantity and quality  of  what we administer  to  our
stomach, for the performance of the most important of
our animal powers, the circulation of the blood ; and,
even at the risk of a little repetition, I shall make a few
more remarks on this subject.   The number of our
meals, and the daily periods of taking them, are worthy
of attention ; perhaps the most generally adopted  sys-
tem is three meals per diem. Breakfast, luncheon,  and
dinner  are better  than breakfast, dinner, tea, and sup-
per.  Some do well on two good meals a day, break-
fast and dinner.  Those  who can wait for their food
an hour or two after leaving their bed in the morning,
and can make a  hearty  meal with  meat or fish, may
do well with a second toward  evening.  When  we
make a substantial meal about nine or ten o'clock a.m.,
we may go through  the  day with a biscuit  or other
slight refreshment, and dinner in the evening at seven
or eight o'clock.  It is a good proof of sound digestive
organs when  we can make a hearty breakfast; and it
is always desirable that animal food should form part
of it when only one other substantial meal is taken.
The quantity of animal food to  be  taken daily must
vary much  in  different  persons.   We  have  known
many very  healthy persons whose consumption of
cooked  animal food  has  not exceeded  eight or  ten
ounces ; three to four  for breakfast, and  five to six for
dinner.
   Tea  or coffee for breakfast is preferable to the conti-
nental fashion of wine; even the small quantity of alco-
hol in light wines is objectionable so  early in the day.
After breakfast, five, six, or even eight hours may be 
          EXERCISE  IN THE OPEN AIR.      Ill

 spent in the open air with great advantage; for we can-
 not enjoy good health if we spend much of this part of
 our lives in sedentary pursuits.  Occupations or pur-
 suits which oblige us to be out in the air much daily,
 are most to be desired, and we may observe, even in
 large cities, that those  whose business obliges them to
 be  very much  out  of doors enjoy infinitely  better
 health  than those who are  in shops or offices the
 whole  day.  Inhabitants of country places will not
 have perfect health if they shut themselves up in their
 houses the greater part of the day;  mere residence in
 a healthy country place is not sufficient for good  health
 without considerable exercise in the  open air.  The
 daily amount of exercise can only be arranged by per-
 sonal experience; but no day  should pass away with-
 out some, and, when this has become a habit, nothing
 can be  more irksome than to be kept within-doors a
 whole  day.   Weather itself is seldom so  bad as to
 oblige us altogether to abstain from a walk, and it is
 wise not to be dismayed even by some amount of cold
 or wet.   There is no truer  maxim in relation to good
 digestion, and consequently  to general  health, than
 that we cannot spend  too  much time in  the open air.
 To  obtain sound and good digestion, which can only
 result from a good condition of the stomach and digest-
 ive  organs,  we must not keep the  house during the
 day.  As examples of this fact, look at the coachmen
 and others equally obliged as it were to live in the
 open air, even of London and other large places, and
compare their  healthy and ruddy complexions with the 
112           ABUSE  OF TOBACCO.

pale and cadaverous appearance  of those who spend
the whole day in shops or offices.
  One other important  subject yet remains to be con-
sidered,—namely, the great abuse of tobacco in these
modern times.  I am decidedly of opinion that cigar-
smoking, in an age where it seems to be practiced, by
many,  all day, and by some even  during a part of the
night, is a fertile source of ruin to the  stomach. The
taking of snuff, I believe, may safely be  indulged  in,
as a general rule, after dinner; but there are many
who habituate themselves to its use from the first hour
of the day,  while others, it is said, busily occupy them-
selves  with the powder of the fragrant  weed even
when in bed,  at a time  when all rational persons are
seeking that  repose which all  our organs  require.
Snuffing, however, is by no means so  injurious to the
digestive functions as the excessive practice of smok-
ing,* that remarkable vice of the present day!
  And now, at length, the bow must be made,  though
very much  is yet striving for  utterance;  but hoping,
Deo volente, for more of such leave-takings, I shall soon
begin to again hoard information for the youthful and the
teachable, especially for  those of my own noble profes-
sion.   Some may think  that there is a chasm  in the
course  of  my description,  inasmuch as  I have not
touched at  all upon some delicate subjects which influ-
ence both sexes far more than those we have made so
  * While on the subject, I may mention, however, that a
cigar or pipe smoked immediately after rising in the morning
will insure, with many, a visit to the temple of Cloacina. 
         THE AUTHOR'S  LEAVE-TAKING.       113

prominent; but these I considered to be matters for
personal friendly  inquiry,  and not  for  the prying,
prurient eye  of the idle and the depraved, to whose
taste it is, in the present age, too much the custom to
pander.   For myself, I trust I may say, with Sir Wal-
ter  Scott, that I have never knowingly written a line
that I could not look  upon with comfort and satisfac-
tion in old age,—seeing that my medal of self-selected
decoration, though only of silver, has around it  the
ever-present glorious halo of unalloyed and imperish-
able Truth.
TBE END. 
 
 
 
 
 
 
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