WBJ HI34 18% c * The patient showed improvement as time elapsed; the enemata were well absorbed, as was the nourishment taken by the stomach. The enemata were continued after the first thirty-six hours only three times in the twenty-four hours for a week, after which they were discontinued. The physician in charge of the case at first objected to this plan of nourishment, but seeing the marked and rapid improvement in the case, said he believed with the writer, that it gave the best and quickest results he had seen. Bovinine was continued by the mouth, § ii three times a day for about four months, at the end of which time it was no flattery to say she looked better, felt stronger and weighed more than ever before. CASE No. 2. Mrs. W. L-, aged 28, II-para, family history good. Her prev- ious labors had been prolonged, but otherwise normal in every way. The present labor was complicated by an accidental haemorrhage, necessitating rapid delivery. The large quantity of blood lost pro- duced the usual symptoms in exsanguination, syncope, cold surface, feeble pulse, etc. The usual treatment, such as surrounding the patient with hot bottles, elevating the foot of the bed, administering hypodermic injections of ergotol, strychnia and brandy, was done. A high enema of Bovinine 3 ii, warm water 3 i, table salt qs., was given and repeated every three hours for three doses, after which it was given only four and later three times in the twenty-four hours for ten days. Small quantities of Bovinine and milk were given by the mouth every half hour, and as more could be taken, were increased to two ounces in a glass of milk every three or four hours and later on given three times a day. This treatment was con- tinued four months, at the end of which time the patient considered herself well. CASE 3. Mrs. Annie T., age 29, Vl-para, family history good. She had always been in good health with the exception of having the diseases of childhood, up to the time of her marriage. She gave birth to six children in nine years and nearly always became preg- nant while she was nursing, thus really never giving the uterus a chance to undergo complete involution from one delivery to another pregnancy. The patient was of good physical development, had a roomy pelvis and her labors had been not at all difficult. 64 At the last labor, which occurred on Oct. 17, '93- uPon vaginal •examination there appeared to be no abnormality, but a short while subsequent to the commencement of the real labor pains and dilata- lion of the cervix uteri there was a profuse haemorrhage which was found to be due to an undiscovered placenta previa marginahs. Delivery was hastened as much as possible, but not until exhaustion was quite marked. The pulse became very weak and the advisability of transfusion considered, but conveniences were not at hand to do it, and as there was a disagreement between the consultants it was abandoned. The heart was stimulated by Strychnine and whiskey. Bovinine 3 ii, warm water 3 i, table salt q. s. was given by high enema and repeated in four hours. In the meantime Bovinine and pepton- ized milk was given by the mouth, alternating with brandy and digitalis. The reaction in this case was slower than in either of the former two reported, but as soon as it had taken place sufficiently to favor absorption the improvement became more marked, so that at the present time she is feeling quite strong, but has not regained her former flesh and strength. SOME CASES OF OTHER PHYSICIANS. Lewiston, Me., April 12th, 1887. Gentlemen;—Permit me to speak in the highest praise of your Bovinine. I have tested it in several cases, notably in one severe case of Placenta Previa, which occurred two years ago in one of the most dangerous of all the presentations in child-birth, my experience with which I will relate. I had just returned from the Philadelphia Lying-in Hospital, where I had been for the Winter for study in the department of Obstetrics, and the lady had been awaiting my re- turn for some weeks before her confinement two years ago. She had had several severe haemorrhages, which had weakened her very much, and she was in a critical condition to undergo parturition. On my arrival I was called to her bedside, and on examination I found her very weak and exhausted. There was no time to lose and I stimulated with Bovinine and brandy. I immediately ruptured the membrane, and turned and delivered the child as soon as the os uteri could be dilated sufficiently. From the great loss of blood both before and after delivery, the case looked doubtful. She could retain nothing but Bovinine, with a little brandy and milk, for weeks. I am confident that Bovinine saved her life, and to your splendid fluid food both this mother and child are indebted for their existence, as the child was violently ill a year after from cholera infantum, and was brought through by 65 Bovinine alone, the great nutritious qualities of which are a boon to humanity. I have used it in many cases and find it always to be relied upon. You are at liberty to use this letter in the interests of suffering humanity. W. S. HOWE, M. D., 135 Ash Street. Toronto, Ontario, Nov. ist, 1887. Gentlemen:—I have used Bovinine with great satisfaction in several cases where a highly concentrated nutrient was indicated,, and especially in partial collapse from haemoptysis. I have found that it caused systemic reaction with almost the rapidity of trans- fusion. In all cases of severe haemorrhage from any cause, or in low and depleted conditions of the body resulting from typhoid fever or septicaemia, and more especially in diphtheria, gastritis, gastric ulcer or malignant disease of whatsoever nature, its place cannot be supplied by any other preparation. R. HEARN, M. D. C. M. St. John, N. B., March 3rd, 1887. Gentlemen:—I have used large quantities of Bovinine in my practice during a year past, and have found it especially useful in restoring the strength after excessive uterine haemorrhages and in irritable conditions of the stomach, as well as in all cases of exhaus- tion or debility from whatever cause. GEORGE A. HETHERINGTON, M. D.. BOVININE IN RECTAL INCRETION. Joseph M. Matthews, M. D., Professor of Principles and Practice of Surgery, and Clinical Lecturer on Diseases of the Rectum at the Kentucky School of Medicine, said: " I cannot understand why anyone would advise Colojtomy in cases of ulceration, per se, of the rectum. With strict antiseptic precautions the rectum can be kept perfectly clean, and by the aid of the different meat extracts and fluid foods in the market the bowel can be absolutely rested any length of time. "The milk diet, as recommended by Mr. Alhngham, can be used or what is better than all in my experience, the preparation called Bovinine, which contains 26.58 of soluble albuminoids, and is the vital principle of beef obtained by a new process. It is a raw fluid food extract, and admirably suited to those cases which require during treatment, entire abstinence from the solids. I have kept patients for weeks on this preparation alone, during which time local applications were made to the bowel until all ulceration had healed." 66 Bovinine as a Food Stuff in Typhoid and gastro-lntestinal diseases. By Dr. MAC GRAFF. Bovinine is a concentrated, easily assimilable, nitrogenous food stuff, especially adapted to the treatment of those diseases accom- panied by marked wasting of the tissues; particularly diseases of the alimentary tract and long-continued fevers. In typhoid fever, a disease in which the waste of the nitro- genous elements of the body is excessive and where the function of assimilation is markedly impaired, Bovinine is an ideal food and is of especial value, being concentrated, and very readily absorbed for the most part from the mucous membrane of the stomach. Not only is the excessive emaciation absent, but during the whole course of the disease the heart action remains much stronger, and owing to the prevention of the excessive waste and degeneration of the tissues, there is not the usual need for cardiac stimulants. It is best given in quantities of from two to four teaspoonfuls in each glass of milk. In acute gastritis where the irritability of the mucous membrane of the stomach is marked and all other food is rejected Bovinine in small quantities will be retained, and being easily absorbed, allows the inflamed mucous membrane to regain its normal tone. In the treatment of chronic gastro-intestinal diseases, from its concentration and readiness of assimilation it is most valuable. In bad cases of gastric dyspepsia where the emaciation and weakness are the most marked symptoms, the administration of Bovinine gives results that are most satisfactory. In the worst cases it may be necessary to give Bovinine exclusively for a few days, or combined with milk; with milk it is given in quantities of from one to three teaspoonsful three or four times a day. 67 In other cases the simple regulation of the diet, chiefly milk and Bovinine, and proper mode of life, are all that are necessary to effect a cure. In these cases the effect may be noticed from the start and is continuous and steady. In anaemia, especially the cases with emaciation and marked gastric symptoms and defective assimilation, the use of Bovinine produces the most satisfactory results. The Bovinine is given, a teaspoonful before meals in three times the quantity of milk or water. In carcinoma of the stomach where all other foods are vomited, Bovinine is retained and actually prolongs life, preventing the rapid emaciation and starvation and the pain and discomfort caused by ingestion of less concentrated food. In acute and chronic inflammation of the intestinal tract accom- panied by emaciation and diarrhoea Bovinine is again a valuable agent—many obstinate cases of chronic enteritis and colitis being cured by a diet exclusively of milk and Bovinine. In treating the gastro-intestinal diseases of children Bovinine proves itself to be very useful—many cases of cholera infantum which reject every food, will retain Bovinine given in small quanti- ties at frequent intervals—many of these cases if the nutrition can be kept up recover, that would otherwise die. SPECIMEN CASES IN TYPHOID FEVER, ETC. Indianapolis., Ind. Dec. 30th, 1887. Gentlemen:—I have had the pleasure of using your fluid food, Bovinine. I have used it in several cases of typhoid fever and have observed that it sustains the patient's strength better than broths, beef-teas, etc., and is better borne by the stomach, being less bulky.' It hastens convalescence and enables them to better resist the disease. The improvement from its use is noticeable to the patient himself and relations. Its effects are so gratifying that the patient asks to be supplied with it. I have used it in pneumonia, where its effects are equally well marked. I have also used it in a case of pyonephrotic abscess, the patient subsequently undergoing an external urethrotomy complicated by a perineal abscess, a fistulous tract connecting abscess with urethra. The patient, debili- 68 tated by the pyonephrotic suppuration,^ was not well prepared for the subsequent operation and disease. The tissues wasted and his vitality diminished. He became so weak that his relations became alarmed. It seemed impossible to secure union. Bovinine was administered at this time and union dated from the commencement of its use. The patient soon was strong enough to sit up. _ He is improving rapidly under its use. Care should be exercised in beginning its use, commencing with a small dose. It gives me pleasure to say that I cannot speak too highly of its use. G. W. COMBS, M. D., 22 E. Ohio St. Pittsburgh, Pa., Dec. 10th, 1887. Gentlemen:—I recently made ^se of your fluid food Bovi- nine, in the case of my own wife, who was suffering from debility brought on by lung trouble. She was utterly unable to take any food at all, as her stomach was in so weak a condition that it would reject everything. The Bovinine, though, was retained, and she lived for upwards of two weeks on Bovinine solely. The fluid was administered at first, a teaspoonful every three hours,' and gradually increased to a tablespoonful four times a day. The patient gathered strength under this treatment very rapidly, and now, after three weeks' time, is able to take solid food and is rapidly regaining her normal health. I have also used Bovinine in a variety of cases of typhoid fever with most excellent results, and am now using and recommending it in every case where there is nourishment necessary. It certainly is the highest and best form of concentrated nourishment of its kind that ever was brought to my notice, and I take great pleasure to call the attention of my professional brethren thereto. Respectfully yours, JOS. B. ENOS, M. D. Cincinnati, Ohio, Dec. 27th, 1887. Gentlemen:—I take pleasure in saying that in a practice of twenty-two years I have never used a beef food that has given me the satisfaction that your Bovinine has. Samples of it were given me by Health Officer Dr. Byron Stanton. I commenced the use of it on several patients under my care, who were typical cases of typhoid fever, and after the second or third day I noticed great improvement in the pulse. Their stomachs retained it without the least appear- ance of nausea. It is entirely free from unpleasant taste or smell. I am certainly well pleased with it, and as a new and vitalized blood-maker, am sure it is all you claim for it. H. H. WATSON, M. D., 399 John St., Assistant Health Officer. 69 Chicago, 111., Nov. 3rd, 1887. Gentlemen:—I have been prescribing Bovinine in hospital and private practice for the past two or three years in cases of mal- nutrition or wasting produced by typhoid fever, tuberculosis and allied conditions, and find it of marked benefit in sustaining the strength of the patient. I usually combine it with milk. D. A. K. STEELE, M. D., 1801 State St. [President of the Chicago Medical Society and Professor in the College of Ph3*sicians and Surgeons.] Winona, Minn., Feb. 4th, 1888. Gentlemen:—I have used Bovinine with great satisfaction in cases of mal-assimilation, chorea, and typhoid fever. In the latter disease it is a nutrient of wonderful value. In one case, a young lady whose temperature reached 1050 for two days, with other very unfavorable symptoms, it did glorious work and it was continued during subsequent convalesence. Very truly, L. G. WILBERTON, M. D. Indianapolis, Ind., Dec. 30th, 1887. Gentlemen:—I have given your preparation, Bovinine, a thorough trial with convalescents from typhoid fevers and gastric troubles with a great deal of satisfaction. I have also used it in enteric diseases of children with wonderful results. I have truly found the preparation quite as valuable it was represented to me. F. O. CHAMBERS, M. D. Detroit, Mich., Jan. 10th, 1888. Gentlemen:—I have used your Bovinine in several cases of typhoid fever with the most satisfactory results. Have used it in two cases of persistent vomiting in pregnancy, also with excellent results. F. D. WHEELER, M. D., 452 Antoine St. Indianapolis, Ind., Dec. 8th. 1887. Gentlemen:—I have used your Bovinine in a case of typhoid fever with great effect. The patient's assimilative powers were restored at once, she being almost moribund. W. F. BARNES, M. D. [Expert in Dis. of Mind and Nervous Diseases.] 70 [From the Medical Times and Kegisti/r, Dec 24, 1892.1 The Diet in Typhoid Fever. BY WILLIAM F. WAUGH, M. D. According to Hoffman,1 the salivary glands in typhoid fever exhibit almost constant alterations. In the first week they are denser and firmer, of a brownish yellow color and tense in feel. The septa are like cartilage, and creak on section. The acini are filled with closely crowded, very large, multi-nuclear, granular cells. Later on, numerous fatty granules appear in these cells ; they become turbid, lose their sharp outlines, and a part breaks down. The glands then become redder and softer, and the tension diminishes. It seems that we have here a parenchymatous degeneration, re- sembling analogous processes in other organs except that an in- crease of the cells precedes the degeneration. These changes, in which all the salivary glands participate, ex- plain the scantiness of the saliva. The pancreas also exhibits per- fectly analogous changes. The secretion of bile is often markedly diminished. The hepatic cells become granular, the nuclei disappear, and fat globules are vis- ible. In bad cases the cells break down into granular, amorphous detritus. In 174 typhoid livers Hoffman found only thirty-eight presenting little or no change ; while all the others showed marked degeneration and destruction of the cells, or marked new growth. The secretion of bile is often quite scanty, as may be inferred. In the intestines the affection of Peyer's patches and of the soli- tary glands is acknowledged to be the characteristic primary lesion of the disease. It is necessary also to remark that all the glands are not affected by the morbid process. In a large number of cases the solitary follicles entirely escape; in many others those of the ileum are alone attacked, and when those of the large bowel suffer it is often only in the coecum or in the ascending colon. The same thing is observed of Peyer's patches, the highest of them are very seldom, if ever affected.2 No special lesion of the stomach is described by Lieber- 1 Ziemssen's Cyclopedia, vol. I, p. 113, 2 Fagge's Practice, vol. I, p. 200. 7i meister, Strumpell or Fagge. Wilson says that this organ is in many cases healthy, but occasionally it is the seat of hyperemia, softening and superficial erosions of the mucous membrane ^The secretion of the gastric juice is, however, partially or wholly sus- pended, as is the case with the otner digestive secretions. The condition of the digestive system during an attack of ty- phoid fever, as shown in this brief sketch, warrants our first propo- sition: That during the course of this fever the power of digesting tood is impaired, always seriously, and sometimes almost entirely- lost, from the suspension of secretion. My second proposition is, that food that will not be digested in the stomach or bowels of a typhoid fever patient, is not only useless but harmful; as in the absence of digestion, decomposition is certain to occur, with the production of substances that are certain to be injurious to the patient. I must refer to this cause the tympanites that occasion so much trouble in improperly fed cases. I am as- sured by the results of numerous observations that this symptom does not become prominent, or even noticeable, when the diet is properly guarded. The conclusion is, that in typhoid fever the stomach and bowels should not be looked upon as digestive organs, but simply as recep- ticles for food that has been previously digested. That absorption may take place cannot be denied. The whole gastro-intestinal mucous membrane is adapted for absorption. Saline solutions, grape sugar and peptones, are absorbed from the stomach. The most active area for absorption is the upper half of the small intestine—the section least affected in typhoid fever. While this absorption is diminished by the presence of catarrh, it is not entirely lost. But as the catarrh, as well as the graver affection of the intestinal glands, become more marked as we proceed down- wards from the stomach, the indication becomes very clear: that in typhoid fever we should employ such food-principles as are absorbed from the stomach and the upper bowel. Our list, then, of available foods, comprises water, salts, peptones, maltose and dextrose; while casein, egg-albumen, dextrin and gelatine are not absorbed with the same readiness. As fatt}' substances are principally absorbed by the lacteals, but little of these can find entrance to the system. We now come to consider the application of these principles in practice. In France, the obstacles to digestion and absorption appear to be exaggerated. Assuming that only salts and water can be absorbed, and that the patient practically lives upon his tissues, Dujardin-Beaumetz returns to the Hippocratic diet, of water-soup. 3 The Continued Fevers, p. 20.^. 72 Liebermeister insists on the importance of giving abundance of water. He objects to the proteids, and falls back upon the carbo- hydrates, barley-water, oat-meal, gruel, and weak meat-broth Milk may be given, if boiled and diluted. Later in the attack, the yolk of an egg may be added. Very feeble patients may have beef- tea with claret, or perhaps Leube's pancreatized beef enemas. Stumpell recommends milk, with coffee, brandy, or cocoa added; Nestle's milk food; broth thickened with rice or sago; zwieback; with an egg or raw beef for very feeble cases. Beef tea is strongly recommended. Meat peptones may be sometimes useful. None of the writers quoted appear to have a clear conception of the pathological conditions present, or of the physiology of digestion. Soups depend on gelatine; milk on casein; the yolk of eggs on albu- men and fat; the carbo-hydrates mentioned on unconverted starch; beef tea on innutritious extractives. None of these are suited to the conditions present. Liebermeister is right in insisting upon the liberal use of water. The digestion is thereby improved, and the emaciation largely prevented. If patients do not ask for it, water should be given systematically, in stated quantities. Milk should be administered only when predigested. Recently I have employed the Fairchild peptonizing powder, and with good results; better than when employed for children's diet. Kumyss is better still, when some stimulant is required. The raw white of egg, treated with pepsin, and dissolved in ice water, is always acceptable. As this is wholly digested in and absorbed from the stomach, it is especially applicable. Junket, milk digested with rennet, comes under the same category. To these I will add one of the manufactured foods,— Bovinine. I do not wish to be understood as condemning other foods of this description, but simply to state that my experience has been largely confined to this one. I began its use years ago, and the results have been so satisfactory that I have not found it advisable to experiment with others. ) Notwithstanding the patient's condition, he will often note the nature and taste of the food offered ; and for this reason, as well as others, it is best to vary the articles given. It is my custom to alternate the use of Carnrick's food, peptonized white of egg, and junket, giving a cupful of either every two hours, in alternation, and with each one a small quantity of Bovinine : from ten drops to a tablespoonful, generally a teaspoonful. This may be given in the other food, or in a little porter sangaree. Another most useful article is coffee, made with milk instead of water. With this a dose of pepsine must be given, say a teaspoonful of Procter's wine. The Carnrick's food consists of milk already digested, and of 73 soluble carbo-hydrates, so that all its elements can be absorbed speedily from the stomach. The Bovinine consists of beef's blood, egg-albumen, whiskey and glycerine. » The action of this food is peculiar and somewhat complicated. As a food, nothing is so readily absorbed as egg-albumen and blood, as nothing comes so near the composition of the human blood. The glycerine assists in keeping the bowels soluble; the whiskey is a useful stimulant, and the boric acid assists the antiseptic remedies with which most practitioners now treat typhoid fever. But there is something more than this in Bovinine. Some years ago I mentioned this and cal ed attention to the fact th*t in blood we have a substance that has been not only digested and assimilated, but vitalized. It is a living fluid, whose existence is identical with that of the individ- ual in whose arteries it flows. I speak simply as a clinical observer; but I feel sure that when the science of biologic therapeu- tics has progressed a little farther, we will be furnished the reasons for my present claim, that there is in blood as a food, a value not wholly explicable by its chemical composition. Stern has shown that human blood-serum is destructive totheKlebs-Eberth bacillus, and that the serum of persons convalescing from typhoid fever has an attenuating effect upon the toxicity of typhoid bacillus cultures. The effect of the serum of animals insusceptible to typhoid fever seems to be the next step for investigation. <•> The net results of the application of the diet herein recom- mended are these: i. Avoidance of the gastro-intestinal irritation due to undigested food. 2. The sustaining of the patient's strength, by really feeding him (as distinguished from the mere placing food in his stomach), and the consequent avoidance of collapse, and all the long train of ills that come from mal-nutrition. 3. The avoidance of the excessive emaciation so often seen after protracted attacks of typhoid fever. 4. Shortening of the convalescent period. 5. I put forward, tentatively, my impression that the secondary degenerative lesions of muscles, nerves, and other tissues, are not wholly due to continued hign temperature, but, in part at least, to innutrition; and that these lesions are not nearly so marked when the patient has been fed upon the system herein advocated. TWO ILLUSTRATIVE CASES WITH PECULIAR SYMPTOMS.. In the latter part of August, a young man employed at Cramp's ship-yard applied to me for relief from a severe pain in the head, following a heavy blow on the Lfc temple. The pain was most severe at the site of injury, and close examination detected a slighi depression of the frontal bone at that spot. The pain did not sub 1 74 side, although he was confined to his room and kept on low diet, with cold to the head and arterial sedatives. In a few days fever manifested itself, worse at night, with a slight tendencyto delirium, together with tympanites, some diarrhoea, tenderness in the abdo- men, anorexia, and a typical typhoid ^tongue: "small, pointed, red at the tip and edges," with a tendency to dryness, and brownish along the middle. The typical typhoid spots appeared a few days later, and the urine responded to Ehrlich's test. The onset of the specific fever had been masked by the symptoms resulting from the very severe injury received on his temple. This accounts for his not being placed on the sulpho-carbolate of zinc at the beginning of the attack. About the fifth day of the attack he was placed on this treatment—his temperature at that time being nearly 1050 in the afternoon. He was given one of Upjohn's 2^2 grain, keratin coated pills every two hours, until the stools became natural; after this he took the pills every four hours until the temperature returned to normal. The usual results followed the administration of the zinc salts; the temperature fell to 1030, and never afterwards exceeded that height, ranging from 1010 to 102.50, as a rule. The abdomi- nal symptoms subsided, and were not marked during the rest of his illness. The headache became less after the first week, but did not entirely leave him until convalescence was fully established. Suc- cessive crops of rose spots appeared. The patient was under treatment for thirty-two days; so that the duration of the case was not materially shortened, although its severity was much ameliorated. During the first three weeks he took scarcely any nourishment excepting Bovinine, of which he was given a teaspoonful every two hours, night and day. There was not nearly as great a degree of emaciation as is usual after attacks of typhoid fever, lasting nearly five weeks. On November 17th, six weeks after he was discharged from treatment, he reported, looking and feeling very well. As supplementary to the foregoing article, we add the following remarks by the same authority from the Medical Times and Regi- ster, Jan. 6, 1894. I have several times called attention in this journal to one of the most important problems presented to the practitioner—the feeding in typhoid fever. In Europe the practice has reverted generally to the Hippocratic diet of water-soup. In America milk is all but universally used. Milk, according to Dujardin-Beaumetz, can only act as salt and water, as neither the fat nor the casein can be absorbed. 75 The disease affecting the glandular apparatus of the intestines, absorption tnrough this channel is impossible, and the patient can only be nourished by means of absorption through the veins. That this is insufficient is shown by the cases occasionally seen of occlusion of the thoracic duct, in which the patient becomes greatly emaciated. In fact, this condition is exactly paralleled in typhoid fever, where the glands drained by the thoracic duct are rendered incapable of absorbing food. The only exceptions to this rule lie in the facts that all of Peyer's glands may not be wholly disabled at the same time, as the glandular affection is somewhat progressive from above downwards, and some of the glands may not be affected at all. It becomes, then, a question whether we can supply food at all during a typhoid attack; whether any substance can be directly absorbed into the veins without passing through the intestinal glands and yet be assimilated. There are two substances in which this may be possible. Egg albumen is directly absorbed into the tissues of the growing chick, without digestion or assimilation. The food is the life; the digested, assimilated and vitalized final product of the whole chain of pro- cesses by which food becomes transformed into an integral part of a living organism. If any substances are available in these cases it must be these. Even milk must be digested before it goes to nourish the child. Several years ago I presented this subject, and spoke of the excellent results I had obtained from the use of these foods in typhoid fever. The white of egg can be mixed with iced water and given very readily. . For blood we must rely on Bovinine, as fresh blood cannot possibly be obtained at the times it is required. Bovinine, consisting of beeves' blood and egg albumen, pre- served with glycerine and whiskey, with a little boric acid, answers the need most admirably. It has been my reliance in feeding to typhoid cases for many years, and its success has demonstrated the correctness of the above propositions. Fourteen drops to a teaspoonful may be given every two hours, &y Patients fed on Bovinine get up with much less emaciation than those fed on soups or undigested milk. Ouite recently a very remarkable series of cases have been reported in which chronic ulcers, even of many years' duration, 76 have been cured by the local application of Bovinine. Several hundreds of such cases have been so treated with great success. These go so far to confirm my views ; for if Bovinine can be absorbed from the surface of an ulcer, or from the subcutaneous tissue about it, and so improve the local nutrition as to bring about healing, how much more likely that such a substance can be absorbed from the stomach, and keep up the general nutrition. I would like to know the experience of others in this matter. Too often the good results one gets, or thinks he gets, are not con- firmed by the common experience of the profession, and thus error finds credence. It is not what one person, specially skilled in the use of a remedy, can do with it, but what the average doctor who has no special experience with, or liking for the remedy, can accomplish with it; that is the true test of its utility, and this I wish to obtain. 834 Opera House Block, Chicago, 111. SOME CASES OF EXTREME EXHAUSTION. South Easton, Pa., Nov. 15th, 1887. Gentlemen:—I have recently used your Bovinine in two typical cases which I will now relate. The first was a case of pros- tration during severe diphtheritis, where it sustained and restored strength in such measure as to astonish the friends as well as myself. The child, after being deemed dead by the friends and neighbors for nearly half an hour (so the}' told me), rallied, and when I called in the morning was sitting up. In five days she ran about the house. The second bottle I gave to a case seven miles out from the office, on account of great debility, four weeks after a confinement, owing to the patient getting around too soon. I could find no disease, except debility, and waited patiently for a summons to go seven miles against a north wind. None came, and when I met the husband three weeks later he assured me the bottle of Bovinine did wonders for his wife. I fully believe that Bovinine caused the cure in both these cases. Respectfully, A. H. R. GUILEY. M. D., 413 Centre St. Cincinnati, Ohio, Jan., 1888. Gentlemen:—In the case of a girl 14 years of age, from whom a large intraligamentous cyst, with extensive adhesions to the liver and stomach, was removed: vomiting commenced on the third day 77 while the patient was taking milk and lime water alternately with whiskey and hot water. The stomach was rested for 12 hours, after which Bovinine, one dram in half an ounce of water, was substituted for the milk and lime water. The vomiting ceased and did not recur. The digestion of Bovinine is not attended by the formation of gas, as is observed to result from the digestion of milk. This is a consideration of importance in conditions where tympanitis is a troublesome symptom. CHAS. L. BONIFIELD, M. D. Brooklyn, N. Y., Feb. 14th, 1888. Gentlemen:—Some three months since, while I was slowly recovering from a severe attack of diphtheria, my attention was called to your fluid food, Bovinine. I had no faith in such pre- parations, but was determined to find out in my own case if the high praise given to it was well founded. I took a large tablespoonful four times a day diluted and flavored to suit for nearly three weeks, by which time my anaemic condition had almost entirely dis- appeared, and at the same time a careful microscopic examination of my own blood both at the beginning and at the conclusion of my use of Bovinine showed an increase of nearly 35 per cent, of red blood corpuscles in this comparatively short time. Bovinine dis- closes large quantities of blood corpuscles floating in its albumin- ous fluid by the use of a first-class microscope with one-quarter inch objective and a B eye piece. HENRY TUTHILL HALLECK, M. D. 61 Fleet Street. St. John, N. B., Mar. 31st, 1887. Gentlemen:—I take great pleasure in testifying to the bene- ficial results consequent upon the extended use of your Bovinine. Having used it in a variety of cases, I have no hesitancy in recom- mending it as an excellent nutrient, and I feel confident that its use will largely increase among practitioners who are sufficiently un- prejudiced to recognize its superior merits. I have proved its efficacy in the following cases: uterine haemorrhages, exhausting diarrhoeas, nervous prostration, excessive irritability of the digestive organs, haemorrhages of the lungs, ob- stetrical cases, convalescence from fevers and the wasting diseases of infancy, such as anaemia, marasmus, cholera infantum, inanition and infantile atrophy. It is especially beneficial in diseases of women where there are exhaustive demands on the system. W. S. MORRISON, M. D. 7« Diseases of Children BY JAMES C. OAKSHETTE, M. D., C M. Post-Graduate Medical School and Hospital, Chicago Coincident with the beginning of the new life commences the struggle for existence. Battle is immediately waged by innumerable foes, and is maintained until the close of that life. Among the many ills peculiar to infant life may be mentioned, first of all, the inherent, nerve-tiring diathesis, or tendency to certain forms of degeneration, constantly sapping the fountain .springs of healthful life, and handicapping it from the very commencement. A weakness due to certain forms of disease, as for instance, Syphilitic, Scrofulous or Tuberculous conditions, so commonly met in daily life ; how far-reaching and all-encompassing are these diatheses, the veriest tyro in clinical work will fully appreciate. Resultant from the diathetic tendency (in many cases) we find the child falling an easy prey to various forms of acute troubles, among which are Cholera-In fan turn, Stomatitis, Chicken-pox, Measles, Scarlet Fever and Whooping-cough, or the more deep-seated, and therefore more formidable chronic complaints, of which, prom- inently before us, are Marasmus, Rachitis, Inanition, Chorea, Glandu- lar affections and Blood diseases: all of these are, alas, but too often aided and abetted in their work of destruction by the gross ignorance of even the simplest safeguards on the part of those who, in the natural order of things, .should stand for the guardians and protectors of the infant life committed to their care. Over against this formidable array, most frequently single- handed, stands the physician, of whom, in the light of clinical ex- perience, it is quite within the truth to assert (despite the many fail- ures) that he is more than conqueror ; and if anything can be offered that will assist him in his warfare, add to his armamentarium or en- hance his power, thereby giving him the more easy, sure and un- qualified supremacy, our purpose will be served. Leaving for abler men to discourse on the more complex substances and potent reme- dies, we shall confine our attention to the question of fortifying the citadel against attack, by means of ample nutrition. 79 Nature has furnished us with a typical, ideal food for the sus- tenance of its young, and has supplied the mother with a pabulum suitable for the preservation of her offspring, in the form of milk. The study in milk, then, should be, and must be, our standard in dietetics especially prepared for the nourishment of young children, and the nearer we arrive at its chemical and physical properties, the more adaptable will be our food for the nourishment of infant life. Prof. Tarnier describes milk as a substance composed of two parts,—a liquid portion derived from the serum of the blood by transudation, and a solid part suspended in the liquid, consisting essentially of fat globules. The liquid part of milk is mainly water, containing various substances, such as sugar of milk, nitrogenized matter, inorganic salts, gas, etc., in solution. The proportion and composition of milk varies very greatly among the several orders of the Mammalia, no two ever producing milk of the same chemical composition ; it also differs widely in this respect among different individuals of the same species, this being brought about by the conditions under which they live. But while the proportions apparently differ in the various species, yet the com- position is always constant between well defined lines, and by taking the average composition of a large number of samples, we can arrive at definite conclusions. The essential constituents of milk are Casein-Albumen, Fat Globules and Sugar of Milk, and amount to about thirteen per cent, of its weight. The Casein-Albumen is by far the most important factor of all, but these three substances with a small proportion of inorganic salts and water, are absolutely neces- sary for the sustenance of healthful life. The elaborate experiments of Voit, Ranke and Munk have proven, beyond a doubt, that the Albumenoids, or Proteids, are absolutely essential to the welfare of all flesh-eating animals, and that while they are able to exist for an uncertain period upon farina- ceous substances, yet sooner or later the inevitable result will come, and death from semi-chronic starvation must, of necessity, ensue, owinc to a lack of sufficient albumenoid matter for the maintenance and regeneration of the protoplasm and secreting cells. From the foregoing statement it will be evident that food pre- pared from farinaceous substances can never be really applicable for proper nutrition of infant life, inasmuch as it does not conform to the standard, viz., the composition of milk; for when starchy matters are acted upon by " diastase" they are converted into Maltose and Dextrine, not into Albumenoids and Nitrogenous substances such as the standard calls for ; and while it cannot be denied that children do live and thrive on these artificial foods, yet our attention must be 8o directed to other channels before we can produce a suitable pabulum, perfectly adapted to the nourishment of the infant life, and until we can produce some such food more nearly approaching the composi- tion of this lacteal fluid, we must admit the too evident fact that our food is faulty in construction, and hence productive of disease. In your daily practice you will be brought face to face with this condition of affairs. Cases will be presented demanding definite, decisive and speedy action, leaving no room for an experiment, no time for delay. We must act. The child has been sick for days, perhaps for weeks. Its strength is exhausted, its vital resources drained, its little hold on life is lessening with most alarming rapidity. Its parents have called you to save it. Tears are falling ; the home is threatened ; their hearts are breaking; they read your face with steadfast, search- ing gaze. May they hope? Doctor, what will you do? Let the experience not of the one, but of the many, guide and counsel. Dr. Caldwell Smith (in the Hospital Gazette) says: "Nitrogen, which is one of the main constituents of Albumenous or Nitrogenous foods, is present in the brain, the nerves, the blood, and some must therefore be supplied to make up for the waste which goes on con- stantly in the system." * * * " If too little of this form of nourish- ment is supplied, loss of weight, bloodlessness, want of energy and life result.'' The very conditions of your patient, Doctor. Because of its wealth of Nitrogenous elements, eminent col- leagues all over the world, in all climates, in all conditions, have given in such cases, '' Bovinine.'' It meets the indications, saves the patient, and establishes your reputation. In my own experience, this article "Bovinine," stands pre- eminent above all other foods for these cases, and not these only, but all where the largest amount of nutrition in the smallest bulk, the least irritating and at the same time the pleasantest form, is the desideratum. Bearing in mind the above statements, and in the face of the ex- perience of many, it is at once a pleasure and a duty to direct atten- tion to this well tried and thoroughly nutritive agent, representing more nearly the ideal nutritive force than any other within our reach to-day. Among its commendable features may be mentioned its rapid absorption and ready assimilation, approximating the trans- fusion of blood into the system, rendering a happy response to its ad- ministration almost immediate, at once gratifying to the physician and parents ; it is thus restoratively healthful and sustaining to the patient, even though he be bordering upon the confines of an- other world. 8i PHYSICIANS' CASES IN CHOLERA INFANTUM, MARASMUS, ETC. Indianapolis, Dec. 16th, 1887. Gentlemen:—During last summer, while attending a case of cholera infantum in a child of six months, I used your Bovinine with most satisfactory results. After exhausting all other methods of nourishment to no purpose (they being either rejected or passing undigested, and my patient being at point of death from starvation), I happened to think of a bottle of Bovinine left with me a short time before. Without much hope of benefit I commenced the use of it in small doses diluted with the mother's milk. To my surprise it was retained and perfectly digested. At once a great change was ap- parent in the little sufferer. I continued the Bovinine in larger doses and with the most gratifying results. The vomiting ceased, the stools were more natural, showing no undigested food in the passages—in short, I attribute to your Bovinine more than all other treatment the cure in this very critical case. S. H. MOORE, M. D., 152 Virginia Ave. Philadelphia, Pa., Oct. 2nd, 1887. Gentlemen:—About July last, during the excessive hot weather, I was called to see a child three months old, that was rapidly wasting away from that dreadful disease, Marasmus. My attention had previously been called to Bovinine, and I at once ordered the same to be given in doses of five drops with a table- spoonful of water every hour. Improvement was almost instantane- ous, and the dose was gradually increased to fifteen drops, and this treatment kept up for four days until a wet-nurse was obtained. In about a week's time I had the pleasure of seeing my little patient bright and sprightly, who but a week previous had been given up by another physician to die. Very respectfully yours, W. W. JAMES, M. D. Wilmington, Del., Oct. 12th, 1887. GENTLEMEN:—I cannot too sincerely express my thanks for your Raw Food Extract, Bovinine, to which my attention was most opportunely and fortunately called. My babe was sick all Summer of cholera infantum, which had emaciated and so wasted it as to pro- duce marasmus, and it was, when first taking the food, in an almost helpless and hopeless condition." It is now thriving and growing, 82 being amply nourished, and a living triumph for proper food intelli- gently administered. I wish you the success which your prepara- tion so richly deserves. Most respectfully yours, J. R. C. GORRELL, M. D. Pittsburgh, Pa., Oct. 7th, 1887. Gentlemen:—My attention was first called to Bovinine in the latter part of August of this year. From that time I have given it in quite a number of cases of cholera infantum and the so-called summer complaint of children, and have been gratified beyond my expectations with the results. I can recall several cases where impending death from inanition was averted beyond all question by the Bovinine. No other food that I am acquainted with (and I think I have tried nearly all) has given me the uniform good results that this one has. W. J. MARTIN, M. D. Richmond, Va., Nov. 15th, 1887. Gentlemen.—I have recently used your Bovinine with the most gratifying results. A child who had suffered for many days with the most distressing irritability of stomach, and to whom a number of tried remedies had afforded no relief, after the first dose of Bovinine quietly slept, and waking with no return of nausea, made rapid recovery. Thus, I am prepared to say that, in addition to its superior food qualities, so easily assimilated, Bovinine possesses the great merit of being acceptable to the palate, and is tolerated by the most irritable stomach. Truly yours, SAML. D. DEWEY, M. D. Allegheny, Pa., Jan. 12th, 1888. Gentlemen:—I have used your Bovinine and found it to be everything that is claimed for it, finding it especially useful in fevers or other diseases where a fluid diet is necessary. It seems to have stimulative as well as nutritive powers, and is very readily assimi- lated. In very exhaustive diseases of all kinds it has wonderful restorative power and deserves the highest indorsement the medical profession can give it. Respectfully vours, G. A. MUELLER, M. D. Wilmington, Del., Sept. 26th, 1887. Gentlemen:—We have found Bovinine more than satisfactory in a number of cases. In cases of mal-nutrition, prostration and exhaustion, it is the remedy par excellence. It is without doubt the most efficient of all raw food extracts. L. & L. A. KITTINGER, M. D., 724 King St. 83 Feeding in Some Forms of Malnutrition. BY WILLIAM F. WAUGH, A. M. M. D., PROFESSOR OF CLINICAL MEDICINE, CHICAGO POST-GRADUATE COLLEGE- To all such remedies as iron, manganese, the phosphites, oils, etc., the reconstructives, in fact, the objection has been urged : that these substances exist in the common, every-day food, and that, in quantities beyond the needs of the system, as a part of what is taken may be found in the faeces. If this be so, why give more, when the body cannot utilize what is already taken ? But this is only a bit of a priori reasoning, of which clinical observation has long since demonstrated the futility. For we may give a grain dose of iron and find the stools blackened by it, showing that the larger portion is not absorbed ; nevertheless, if we give ten or thirty grains, we will find vastly more of it is absorbed, and the chlorosis is much more rapidly cured than by the small dose. The same is true as to the administration of manganese and cod-liver oil. In the latter case, the presence of fatty acids renders this the most digestible of fats, so that it cannot be replaced by cream, butter or any ordinary fat. Another principle enters into consideration when we take up the phosphites. It is questioned if any of the ordinary phosphorus combinations can be assimilated at all by the human body, and claims have been put forward for the hypophosphites as being peculiarly fitted for appropriation, by reason of the instability of their chemical composition and the readiness with which they are attacked by oxygen. A similar plea has been put forward for the lacto-phosphates, as they are so freely soluble in water that the 84 chances of absorption are very great. But others express a prefer- ence for powdered bone dust, claiming that we have in it the phosphorus-lime combination as it exists in the human body, and that even in its finished state, digested, assimilated and vitalized. In all this statement we see the lines of reasoning finally con- verging at the point of use j the ultimate, crucial test. The world is no longer satisfied that a person is fed when food has been put into his stomach ; it is necessary to follow that food to its ultimate destination and see if it be digested, absorbed, assimi- lated and finally become a constituent part of the human organism, or if it be arrested at any of these milestones and wander off into the byways of pathology. In affections whose pathological processes are carried on notably in the alimentary canal, these considerations are of special import- ance. Mothers must be taught that their infants will die of choleraic adynamia, no matter how well filled the stomach may be with wholesome food, and the evacuations penned in by opiates. Great as is the necessity for food to sustain the strength during these exhausting attacks, it would be better to leave the child with- out food than feed it as many do, on raw milk not always beyond suspicion, bread and sugared beverages. When the intestinal mucosa are in a state of acute catarrhal inflammation, the ordinary processes of digestion are interrupted, and food ordinarily bland becomes intensely irritating to the in- flamed viscera, especially if the food undergo decomposition. Hence the indication is for food that in the smallest bulk contains the largest amount of nutriment, in a condition that allows of its speedy absorption. For if the food is likely to be soon ejected, it must be predigested, that some of it may be absorbed before vomit- ing occurs. Nothing answers so well as the raw white of egg ; for this is already prepared for absorption into the tissues of the embryo, without passing through any digestive or glandular systems what- ever ; mixed with ice-water, it is as unirritating as any food can be and if it only remains a few minutes in the stomach a part will in that time be absorbed. 85 In typhoid fever we see also the digestive processes inhibited, but the stomach usually allows food to be retained. I "am always sorry to see an otherwise sensible article on the management of this disease close with the recommendation of "milk and light farinaceous food." The casein cannot be digested, nor the fat emulsified, nor the sugar converted, as there is no secretion of the peptic ferments, nor could the fat be absorbed, as the disease of Peyer's glands blocks up the lacteals as effectually as if the thoracic duct were occluded. If the glandular affections be general, milk can only act as salt and water ; and the remaining constituents, incapable of digestion and absorption, remain in the alimentary canal to decompose, and thus increase the patient's danger and distress. The proper foods in typhoid fever are those that can be absorbed directly into the stomach-veins without requiring diges- tion, as below this viscus little or no digestion is performed. Tne nearer we come to blood itself, the more likely we are to nourish our patient. The raw white of egg is of use as far as it goes, but in an attack lasting as long as a typhoid some more gen- eral diet is required Nothing would answer so well as pure blood if we could get it. We have it, however, in Bovinine, in a form that amply fulfills every indication—bullocks' blood and raw white of eo-g( preserved in glycerine and whiskey, with a little boric acid to prevent decomposition after the bottle has been opened. Here is all we want, without any objectionable ingredient. Even Davis could scarcely object to the amount of whiskey present in a tea- spoonful (about 12 drops), while most physicians would be more likely to reinforce this dose. In all my cases of typhoid fever treated during the last few years, I have relied on Bovinine as the principal food, giving up to a tablespoonful every two hours. There has been vety little emaciation in these cases, far less than in those treated without Bovinine. In the first week, and after con- valescence has begun, I give junket, or the best predigested foods in the market, and no other nutriment is given or required. 86 The advantages of this diet are : the task of alimentation is re- duced to a minimum ; the smallest possible quantity of food is to be swallowed ; the food is pure nutriment with no waste ; the food is such as to require absolutely nothing of the patient except ab- sorption ; the nutritive value of the diet is so high that the patient is not compelled to live on his own tissues, and emaciation with debility during a prolonged convalescence is avoided. Not the least of the advantages of Bovinine is its ability to keep well, without decomposition, in any sort of weather with any sort of care from nurse, parent or friend, without special education or intelligence. For a system may be almost ideally perfect, and yet of no practical value because its carrying out requires a degree of perfection in the nurse, never to be secured outside of the pro- fessional ranks. I am aware that very good results are obtained with the milk diet, but my remarks are intended for those who are never satisfied wiih a good result if they can obtain a better. In the use of Bovinine in cholera infantum, marasmus and other diseases of children in which malnutrition plays a leading part, I am always reminded of the soldier who hung a horseshoe about his neck on going to battle. When a bullet flattened itself against the horseshoe he remarked, " But little armor is necessary if it be in the right place." Very often the vital power and the force of disease are so nearly balanced that there is but a narrow margin between life and death. But the effect of five-drop doses of Bovi- nine every half hour will overcome an adverse balance larger than any one would believe possible who has not watched its effects. Give a little aid to the bodily powers, invigorate the leucocytes with a steady supply of reinforcing albumen and haemoglobin, and the winning rally becomes possible. With richer blood the diges- tive glands elaborate more of their products, better digestion of food becomes possible, and thus the effect is confirmed. There is a nicety about such feeding that commends itself to one who believes in accuracy in medication, in precision wherever possible, rather than in the slovenly practice of "general prin- ciples" and nothing more. 87 SOME FURTHER AUTHORITIES. Dr. Burwell's careful investigations and experiments with the various foods for infants give great weight to his conclusions. The moral to be derived from his article is that Bovinine is always valu- able, having within itself life-giving properties which may be lack- ing in any other food. Therefore, to insure full and perfect nutrition and avoid the deadly Summer diseases of infants, use Bovinine in connection with any food you may be feeding to your child. In "The Medical Bulletin," Philadelphia, the Doctor says :— '' I have found the most satisfactory food for children to be cow's milk sweetened with sugar of milk, diluted from one-third to one-half, to suit the age and condition of the child. I generally add a peptonizing tablet and a few drops of Bovinine. " The addition of Bovinine makes the mixture more nutritious, for Bovmine is more readily digested than any other food substance and supplies the cow's milk with a pabulum at once highly nu- tritive and easily digested.'' He also gives the following report regarding the use of Bovi- nine in the Washington Foundling Asylum :— 1' During my attendance at the Washington Foundling Asylum I had occasion to use a mixture of cow's milk and Bovinine in a large number of cases and met with uniform success. In several instances of extreme emaciation, and where the child was unable to assimilate the slightest quantity of cow's milk, I gave the Bovinine alone by putting a few drops on the tongue. It was surprising how readily the little sufferers responded to this treatment; they at once brightened up and soon were able to digest the usual cow's milk and Bovinine mixture. Several marked cases of marasmus were treated with Bovinine, milk and brandy, with an inunction of cocoa butter and alcohol. In two cases at least, where the burial clothes were kept in readiness by the head nurse, the children, to my surprise, rapidly gained strength under this treatment, and a year later one of them (little Annie Bennett) was adopted from this institution a plump and healthy child." Dr. Herman C. Marcus, in the " Times and Register," another medical journal in Philadelphia, says in the treatment of invalids:— " Whatever food be given, the quantity should not be large ; say a sxuall teacupfull given every two, three or four hours. A large bowl of broth will sometimes bring on a violent headache. If the amount cf nutriment in a cupfull be insufficient, it is best to increase the nutritive value without increasing the bulk. This may readily be done by adding Bovinine, from a few drops to a teaspoonfull to each cup of food.'' He mentions several cases to illustrate its value in this respect. We print one for example :— '' A child eight months old had ceased to nurse and all efforts at feeding occasioned such pain that the struggle still further ex- hausted the child Bovinine was ordered in ten-drop doses every half hour, and as the baby took it readily the dose was increased to half a teaspoonful. This was the only food taken for two days, the child refusing to take the blandest food known, the white of egg. It is doubtful if the child would have borne up under its afflictions had it not been for Bovinine. These cases were mentioned as types of a large class in which the addition of Bovinine to the other means employed was the one thing needful to tide the patient over the critical, period.'' The '' Times and Register'' also says Bovinine should not be con- founded with other preparations, some of which are totally unfit for use in a sick room. The article concludes by remarking : —' 'It is suf- ficient to say that no other liquid food preparation has been tendered the medical profession of equal nutritive value with Bovinine, whose composition and method of preparation are made public, so that physicians in employing it may know exactly what they are giving. Until some other preparation approaches the fulfillment of these conditions, Bovinine cannot be said to have any rivals.'' Dr. Edward P. Voilum, U. S. Army Medical Director, reports a large number of cases of gastric irritation, dyspepsia, nausea and distressing sensations of fullness and weight in the stomach after eating. All of these cases were promptly relieved by Bovinine taken soon after eating. He sa}rs :—"I was greatly surprised at the anodyne effect of Bovinine on the stomach when I first noticed it, but the explanation of the action would seem to be that the Bovi- nine contains the elements that the stomach in its moments of dis- tress needs." Dr. J. Wesley Bovee, of Washington, reports a number of instances in which Bovinine was given with marked benefit at the Washington Asylum Hospital in cases of wasting diseases, and of aged people who seemed to pick up and get vigor from its use. Dr. J. R. Wellington, of the Children's Hospital at Washing- ton, permits our reference to that institution as having used Bovi- nine with excellent results. He mentions one interesting instance oi 1' Gastrotomy '' where the child was fed with Bovinine for days through a tube inserted through a hole in the stomach. QO Chlorosis. BY DR. HERMAN D. MARCUS, Late Resident Physician at the Philadelphia Hospital. Chlorosis is a disease of the blood resulting from a diminution of red blood corpuscles and haemoglobin. Examination shows a decrease of nearly half the red corpuscles, which takes place slowly, while the haemaglobin becomes rapidly decreased to about 25 or 30 per cent, of the normal amount. Chlorosis is generally a disease peculiar to the female sex, at the age of puberty, and may be predisposed by congenital and functional disorders of the circulatory and sexual apparatus, which at times furnish accompanying symptoms of chlorosis. Organic diseases only rarely cause this condition. One of the most prominent symptoms noticeable is anaemia. The skin becomes of a peculiar pallid, greenish color. The decreased oxygenation of the blood causes more or less depression of all the organs, and the patient becomes easily tired under slight exertion, complains very much of malaise and lassitude, is continually drowsy. The mental activity decreases owing to the mal-nutrition of the brain. The patient sleeps considerably and a certain amount of mental torpor is noticeable. Very often excruciating headache is complained of. This in itself may be the symptom which brings the patient to the physician and may manifest itself in migraine or as a dull pain felt in any part or over the entire head. Other symptoms such as muscae volitantes or tinnitus aurium may be also observed. The appetite of the patient is very much decreased and it is at times necessary to use extraordinary means to prevent inanition. The bowels are generally constipated. The circulatory system shows a number of symptoms such as the loud blowing sound noticeable in the veins of the neck, the so-called bruit de diable. The excitability of the vaso-motor system is also peculiar to chlorosis, causing blushing under very slight provocation. It would be well to remark here that chlorosis is not of necessity accompanied 9i by pallor. The other organs such as the liver, kidney and spleen. show _ nothing abnormal. The urine shows very little difference from its normal status. Menstruation may be abnormal, and if so, it is due to the changes in the blood vessels. Chlorosis, as mentioned above, affects mostly the female. Men ma}' appear chlorotic, but when such is the case we are generally able to discover a tuberculosis of the apices crurum, medulla oblongata, abdominal organs, or some nervous affection due to overwork. Constipation, which is so commonly a symptom, is frequently the underlying cause of chlorosis. This may be explained by the decomposition of the faeces causing an absorption of ptomaines into the circulation. This theory receives strong support by the fact that a number of cases may be cured by thorough purgation, without the use of such therapeutic agents as arsenic, iron, etc. This explanation may be rather far-fetched, but recognizing the possibility of such a theory we can in the absence of other expla- nations do nothing better than accept its probability. The prognosis of this disease is in the majority of cases favorable. But it must be remembered that quite a number of com- plications may arise during its course. Nervous symptoms may manifest themselves, such as migraine, neuralgia or pains in various parts of the body, causing a lessening of the power of resistance of the nervous system. This may result in time in neurasthenia or at least hysteria ; such a result is of course very unfortunate, as long-continued and persevering treatment will then be necessary to save our patient a lifelong suffering. Regarding the therap)^ of chlorosis we must in the first place pay strict attention to the action of the bowels;—this becomes important whether the constipation is the cause or only an accompa- nying symptom. Regularity of the action of the bowels is all important and any purgative may be employed, such as rhubarb, aloin, podophyllin or any mineral water having laxative properties. A very good prescription is: -- Extr. Stilling fl 1 Tr. Belladonna I Tr. Nucis Vom. f Tr. Physostig. aa, 3 ii. J M. Sig. Twenty drops in water before meals. Above prescription is highly recommended by Prof. Bartholow of this city for habitual constipation. 92 Next to the condition of the bowels, the appetite demands attention. Nearly all chlorotic patients suffer from anorexia, and this condition must be remedied. Iron is here our best appetizer. This agent has however found a great many opponents to its use, they claiming that the small amount of iron which is necessary to augment the amount of iron in the red corpuscles is taken daily with the nourishment. The amount of iron present in meat, eggs, etc., is sufficient to give chlorotics enough iron. It is therefore unnecessary to intro- duce iron into the system as a medicine. Still the fact remains that with the use of iron, the symptoms of chlorosis disappear quicker than without it. We notice under the influence of such treatment a reaction of all the functions. Very soon haemoglobin is increased as well as the red corpuscles. Hydrochloric acid which was dimin- ished in quantity is again present in its normal amount and causes thereby an improved digestion, and with the return of the appetite, absence of the prevalent dyspepsia; the other functions which were very much disturbed during the progress of the disease, become normal and the patient soon regains her health. The number of iron preparations are so large that it may become a question which form to employ. We find in the phar- macopia such preparations as Citrate, Carbonate and Sulphate and Iodide of Iron (syrup) etc. The Iodide of Iron is not as efficient owing to the small amount of iron present. The preparation to be employed depends largely upon our patient. Very many are unable to take it in the form of pills or powders, and in such cases we must prescribe tinctures. Another objection is its action on the teeth and mouth, which is very objectionable to the female patient. Pills or powders will be found a very convenient form of prescribing it, but where the liquid preparations are preferred, it would be well to caution our patient to use a glass tube. The dose should be rarely more than 6-8 grains daily, owing to the length of time during which it must be administered. This dose of course means the equivalent of iron in its powder form. It should be administered after meals and continued for a considerable length of time. After 10 to 15 weeks it may again be discontinued to be again taken up if the disease is still present. Another very important therapeutic agent in the treatment of this disease is arsenic. This drug may be very advantageously combined with iron. Fowler's solution (liq. potass, arsen.) is the preparation commonly used. The proper nutrition of the patient is one of the most important points in the treatment of chlorosis. Easily digestible food, such as 93 rare meat or soft boiled eggs should be given. It may be necessary to appear most rigid as regards the directing of nourishment, so great becomes the aversion of our patient to food. The appetite becomes at times capricious, in which cases it is well to humor the patient, providing of course that no indigestible articles are craved. It is a very common occurrence in chlorotics to eat sand, chalk and such like, a procedure which of course must not be tolerated. Pickles when asked for may be permitted as they excite the secretion of the gastric fluids. No substitute for the common nitrogenous articles has been found of so great a benefit as Bovinine. This preparation is a highly nutritious food containing the important elements of defib- rinated ox blood, and desiccated egg albumen. It is therefore a powerful factor in sustaining and nourishing the system after it has suffered from debility and disease, and in restoring to the blood its lost haemoglobin by continually increasing its supply of red blood corpuscles. Whereas meat or eggs may not be well borne by the chlorotic patient, Bovinine when properly given will be assimilated. It is best administered in ascending doses, 20 drops to a dessertspoon- ful every 3 to 4 hours. It may be combined with milk, wine or whiskey if preferred, but if repugnance is shown to it, a tablespoon- ful in a pint of warm milk may be given as enema 5 to 6 times daily. Diabetes. While it is true that the most learned JEtiologists differ as to the causes of this very distressing disease, it is conceded that the element of nutrition is the all important factor in its treatment. Bovinine possesses in a very marked degree all the elements needed in the reparative process of an organism suffering from this disease, being especially rich in the nitrogenous elements that go to replace the waste of the nervous system; it is at the same time the most easy of assimilation and is absolutely devoid of all the elements of starch or sugar. It has been used with signal success in scores of well- marked cases, and with uniformly good results. Tablespoonful doses in milk or Alkaline-Carbonized water 4 to 6 times in 24 hours will prove the above to be correct. 94 Tuberculosis. Is Nutrition the Sine Qua Xon in Tuberculosis ? Without fear of contradiction, it may be asserted that tissue building (the establishment of healthy cell life) is the foundation treatment of every case of tuberculosis, not only in its incipiency, but in the advanced stages as well. This proposition is not antagonistic to the germ theory; rather has the knowledge of the existence and important role of the bacillus led us to a better understanding of the necessity of proper nutrition. Nutrition is the '' sine qua non'' in all cases of tuberculosis. In some instances its necessity is more evident than in others; in acute cases other needs may be more urgent, but the rule holds good, that the victims of tuberculosis must be nourished. In "thin living and thick dying'' we find tuberculosis rampant. Feeding is not always nutrition. The best diet may not be assimilated—may do harm rather than good. The practice of stuff- ing, so honestly advocated by some authors not long since, has been rapidly abandoned. Years ago every case of phthisis got a bottle of cod liver oil; now it is given only in selected cases. Nutrients are chosen which can be appropriated, and food is given in such a manner and of such kinds as will favor complete assimilation. There must be a demand for nutrition before assimilation can be satisfactorily performed. There must be the ability to appropriate food that is taken, else the defective cell in a remote part of the system will profit little thereby. Just here, I believe, is the impor- tant point in the treatment of tuberculosis. The best of food and the most reliable nutrients are taken, and still the waste in many cases goes on. There is either a want of assimilation, or a lack of proper food. There is need for '' Respiratory food '' as well as for that in the alimentary tract. Oxygen must be taken into the system and the cells empowered to use it in the nutritive changes which we aim to accomplish by proper feeding.—Dr. Wm. Porter, in the St. Louis Clinique. 95 The gratifying success attained by the use of Bovinine in cases of incipient phthisis, proves the truth of Dr. Porter's statements regarding nutrition, which are copied above. Bovinine conveys into the system a wealth of oxygen through the medium of the red blood corpuscles existing in such abundance in this raw food, and which are destroyed by heat in cooking in all other beef pre- parations. The subjoined remarks are taken from a very exhaustive treatise on " Diet and Hygiene in the Treatment of Consumption," by Dr. Edwin F. Rush of Chicago, a well known authority in such matters. '' The diet of consumptives should consist of animal food of all kinds, fats, oils, milk and cream, butter, eggs, bread, farinaceous preparations, and scientifically prepared raw food extracts. They should be encouraged to eat, and to this end the bill of fare should be as varied as possible, and served in a tempting manner. It is better to eat moderately five or six times daily. The surroundings should be cheerful, the tray and napkin clean, and each article of food daintily served, and small in quantity. A sick person will often eat if a small amount of food is nicely served, where the sight of a large amount would cause disgust. Beef juices, or raw meat extracts, are very valuable adjuncts in all, and absolutely necessary in most cases of phthisis on account of their immense nutrient force in a concentrated form, the small quantity required, its tolerance by the stomach, and rapid and complete assimilation, whereby the strength and vital powers are quickly nourished and maintained. Periods will occur in every case of phthisis when gastric irritation will preclude the use of ordinary food; then our reliance must be placed in these raw con- centrated foods. Many '' meat extracts " and " raw food extracts'' are uoon the market, a large proportion of them containing no food or nutritive properties, for instance, the highly-prized "beef tea," popularly supposed to have great food virtues, but actually contain- ing none whatever, being merely a temporary stimulant, upon which a patient would soon starve.* Some of the raw foods are repulsive in taste and odor, or in some manner objectionable. I have used, m iiiv practice every known raw food extract, but for two years past I have exclusively prescribed a raw meat extract, prepared in this city and known as Bovinine. This article of food is very rich m all the'elements entering into the formation of blood and tissue, is easily borne by the most delicate stomach, of excellent taste and 96 odor, and is rapidly and completely assimilated. I am personally familiar with the mode of preparation of this food, and know that the blood used is from the best of the finest cattle supplied by the great Chicago stock yards. I do not wish to appear invidious, but I prefer Bovinine above all other raw food extracts for its great nutrient qualities, acceptability, and its large percentage of album- inoids (20.56 per cent). I usually administer this food three or four times daily, in doses varying from ten drops to one teaspoonful, diluted with four or eight times the quantity of water, or milk and cream mixed. In conditions of great exhaustion and debility requiring stimulants, the raw food may be added to milk punch or egg-nog. In extreme cases, or in violent stomach irritation, our main reliance must be placed in raw fluid foods, administered by the mouth, a few drops at a time, and in cases where the stomach will tolerate nothing at all, we must then administer the fluid food by the rectum, a teaspoonful of the food to four teaspoonsfuls of sterilized water, injected slowly, thus giving the stomach absolute rest until it recovers its tone. "Bovinine contains lactic acid, a normal constituent of the muscular tissues. This acid in the presence of pepsine or pancrea- tine, rapidly digests nitrogenous matter, which accounts for the speedy absorption and assimilation of Bovinine in cases of impaired digestive functions.'' Newark, N. J., Dec. 21st, 1885. Gentlemen:—Having used your preparation, Bovinine, I can say my experience has been so satisfactory I desire to recommend it to the medical profession. In my hands, it has yielded unparallelled results in cases of typhoid pneumonia, acute phthisis and gastric catarrh. The patients all express great satisfaction and confidence in this most valuable nutrient. Respectfully, E. W. EDWARDS, M. D.. 11 Washington St. Reading, Pa., Sept. 25th, 1887. Gentlemen:—I have used your preparation, known as Bovin- ine, m a marked case of phthisis pulmonalis with exceedingly satisfactory results. Yours truly, S. L. DREIBELBIS, M. D. 97 Chronic Alcoholism, In the treatment of Chronic Alcoholism, Bovinine has been put to the severest tests, and has not been found wanting. Begin with 10 to 30 drops in a little carbonized water every 30 to 60 minutes; continue these small doses until the stomach has become settled; then it may be given in milk in from teaspoonful to two table- spoonsful doses, six to ten times in 24 hours. The continuous use of Bo vinine and good milk has cured and will cure the Alcohol habit. The Morphine habit can be cured in the same way, for it is a principle well established in the treatment of both ^chronic alcoholism and the morphine habit that in the ratio that the functions of nutrition can be brought up to a normal standard, in* that same ratio will the de- sire for either alcohol or morphine subside. Boston, Jan. 7th, 1888. Dear Sirs:—It gives me great pleasure to give you informa- tion in regard to a case of delirium tremens treated with Bovinine. The circumstances were these: I was called to Mr. C, and found him furiously insane from " Mania a Potu." After the mania sub- sided, all the acute gastric symptoms were manifested with a total inability to retain food—all but your preparation Bovinine, which I began to use by adding two teaspoonfuls to a goblet of water, of which a teaspoonful was given every ten minutes the first day, gradually increasing the strength day by day, with the most happy results of fully maintaining the patient's strength and preventing the exhaustion which so often sets in, causing a fatal termination of the disease. I am convinced that if physicians would but give a portion of the care and study to your valuable food remedy they do to ordinary medication, they would realize the great value of Bovinine in general practice. Very respectfully, H. F. BRACKETT, M. D., 61 Indiana Place. y8 Report on the Use of Bovinine AT THE GENERAL HOSPITAL OF MEAUX, SEINE-ET-MARNE, FRANCE, By DR. DUFRAIGNE, Surgeon-in-Chief. [translation.] '' Having read the eulogistic testimonials of American and English physicians concerning Bovinine, and this preparation appear- ing so familiar to the foreign medical profession, we thought it advisa- ble to give it a fair trial, and that, in spite of our general distrust of all the medical specialties coming to our notice from the other side of the ocean." '' Our first trial having been found successful, we felt no hesita- tion in giving a wider field to our experiments and we must say that these experiments fully confirmed the happy results of our first trial, and now we may safely declare that the medical value of Bovinine, and above all its nourishing value in certain particular cases, cannot be doubtful, for it is an ascertained fact that the Bovinine preparation surpasses in its qualities all the similar so-called nourishing prepara- tions known to us. Now let us relate a few cases which will de- monstrate the efficiency of Bovinine beyond all doubt.'' ' 'A patient aged 40 entered our hospital in May, to be treated for a diffuse phlegmon of the hand and left forearm. Continued anti- septic irrigation seemed at first sufficient to check the inflammation, but soon the articulation of the elbow and the lower part of the arm became invaded, and two large incisions were made on the lower surface of the forearm allowing that part to be drained, and revealed an extensive destruction of muscular tissues." The patient was becoming weaker and weaker, and a large slough over the sacrum with abundant discharge gave further evi- dence of the considerable loss of vitality. We had then before us a case of septicaemia, and amputation was decided on above the elbow, under very critical circumstances in consequence of the generally debili- tated state of the patient, who had not been able to take any food for 99 several days. We had then a good opportunity for testing Bovinine, and to see for ourselves if that preparation could justify its reputation. The patient took Bovinine with ease, and a few days after (having taken nothing but Bovinine) gradually recovered his strength; deliri- um and fever disappeared, the mental state was better ; the system being less debilitated absorbed more nourishment, and a general im- provement followed. The terrible effects of septicaemia were con- quered. To-day the patient is able to walk ; he is convalescent.'' This splendid result was obtained by the easy assimilation of such a vital extract as is contained in Bovinine.'' "A young patient aged 15, suffering with osteo-myelitis, half of the lower end of the diaphysis of the tibia being involved, we were obliged to remove a large sequestrum of the anterior surface of the bone and to curette the posterior face ; in short to make a deep excavation of that region. The patient being much debilitated before and especially after this severe trial, Bovinine was administered, 15 grammes per day, and for eight days the patient took it well." "What is remarkable, regeneration of the bones rapidly became apparent, and when the patient could take the ordinary regimen of food we reduced by half the dose of Bovinine. The result is satis- factory." "Another patient of a delicate constitution, whose left thigh had been amputated, was fed on Bovinine alone for several weeks. By the help of that preparation, the system, which had been so debili- tated before the operation, in consequence of a tumor of the knee, which had resisted treatment for ten months, has regained its vigor. The patient will soon be able to leave the hospital in excellent con- dition. '' "Therefore we may condense and say, judging from these cases taken at random, and also from many others which have given the same good results, (and without according to that preparation any therapeutic value), that Bovinine remains a powerful re-building factor for debilitated patients after a long illness; for patients after surgical operations; for patients digesting their food with difficulty; in an accidental or traumatic case, or after a constitutional illness; as the results obtained in our medical service and other wards of our hospitals have thoroughly demonstrated. These results are the consequence of the vital principles contained in Bovinine, principles- carefully studied and analyzed by the pharmacists of our establish- ment with reference to their qualitative and quantitative value, promi- nent amono- which are fibrin, casein, haemoglobin, peptone^ and the albumen oAhe egg/' (Signed), Dufraigne.' IOO NUTRITION IS THE PHYSICAL BASIS OF LIFE." '' The effects of diet are profound and far-reaching, and cannot be over-estimated. The present indications are that a change in the relations of food and medicine is slowly taking place. The tendency among our best physicians largely to substitute food instead of medi- cine in the treatment of disease is not to be looked upon as a mere fashion. The dietic movement has a wider and deeper meaning." Sir William Roberts, Address before the British Medical Society. "CHRONIC STARVATION." "For the last six or seven years I have tested, by carefully inquiring into the past history of patients mostly suffering from some uterine or ovarian disease, or some affliction incidental to child- bed, and these conclusions have stood the test of this long-extended inquiry. I have to state the important conclusion that a continu- ous insufficiency of food, or what may be called " a chronic starva- tion," more or less intense in different cases, was found to have existed almost universally. Consequently, I have naturally been led to consider chronic starvation as a most important factor in disease." "It is generally admitted, by authorities on the subject of diet, that nitrogen is the most essential of all foods, and that a certain amount should be taken daily. It appears that the diminution in quantity of food most frequently affects the nitrogen. Meat is the article of diet which as a rule, is the source of the greater part of the needed amount of nitrogen, for, in England, at all events, meat is the popular article of food, and, in cases of chronic starvation, we mostly find the quantity of meat taken is exceedingly small.'' Dr. W. M. GRAILY HEWITT, Address before the British Medical Association. Bovinine contains precisely the elements indicated by Dr. Hewitt as being highly essential to the proper* nourishment of the body, and those in a form most easy of administration and agreeable to the taste. The Bovinine Company, London, August 22nd, 1802. Gentlemen:—I have the highest possible opinion of Bovinine as an easily assimilable highly nutritious food. Again he writes:— October 31st, 1890. I may remark that I have every week additional reasons to speak well of Bovinine. It is one of the few articles which, I believe, will never go out of fashion. ------M pj IOI at>, tt -r> . . 3 Roundhay Terrace, Leeds, 1 he Bovmme Company, Oct. 15th, 1890. gentlemen:—I duly received the sample bottles of Bovinine you were good enough to send, and after taking half one bottle myself I usecl the rest on poor patients, whose condition called for nutrients exnibited in concentrated form. I am more than satisfied with the preparation—it is one on which the Profession may rely without fear of disappointment. I found its immediate effect to be increased blood-pressure, showing that it is a true nutrient-stimulant needing no digestion, but being at once absorbed. Its invigorating effect in a case of severe choleraic diarrhoea was magical—the symptoms of collapse yielding in a minute or two. F. ARNOLD LEES, M. R. C. S. Eng. L. R. C. P. Lond. The Bovinine Company. -----, Ireland, Oct. 27th, 1890. Dear Sirs:—I have much pleasure in bearing testimony to the beneficial effects of Bovinine. I used a large bottle in a case of extreme debility, and can safely say it saved my patient's life, when I could not use special stimulants in any other form. Faithfully yours, -----L. R. C. S. I. &c. DISTINGUISHED DOCTORS AND PATIENTS. General U. S. Grant was sustained for months previous to his decease almost wholly by the use of Bovinine, as the following letters will testify. '' During the last four months of his life, the principal food of my father, Gen. Grant, was Bovinine and milk, and it was the use of this incomparable nutrient alone that enabled him to finish the second volume of his personal memoirs." F. D. GRANT, [Late U. S. Minister to Vienna.] The Bovinine Company, Gentlemen:—It is a long time since I became acquainted with your excellent fluid food, Bovinine. I have embodied my experi- ence with it in the case of General Grant, in my narrative of "The Last Days of General Grant.'' My attention was first called to the preparation by the Hon. Salem H. Wales, of New York, who sent me a quantity which I critically examined before using, and compared with other foods of a similar character which had been most liberally supplied me. The Bovinine was finally adopted. I commenced its use some time in April, 1885, and my record reads as follows: 102 "The liquid nourishment recently used was a preparation of the raw expressed juice of beef, rich in albuminoid properties, known as Bovinine, which with milk and eggs furnished a rich, palatable and readily digested diet. This constituted the General's principal article of food during the remainder of his life, he taking it well and with satisfaction up to the 21st of July, when his ability to swallow failed him." J. H. DOUGLAS, M. D. [Physician to General Grant, General McClellan, General Rawlins, and others.] My Dear Mr. Stuart, 523 Thirteenth Street, Baltimore, Md. Washington, D. C. I take pleasure in introducing to your favorable notice Bovinine, a nutrient of great value, as I can cheerfully testify from a practical test during my own recent convalescence. I am sure you will be pleased with this preparation, which presents so many points of improvement over any other meat prepara- tion with which I am acquainted. I am, yours very truly, D. W. BLISS. Dr. Bliss was the surgeon in charge of the late President Garfield's case. Philadelphia, Pa. The Bovinine Company, March ist, 1887. Gentlemen:—It gives me pleasure to give my testimony to the very great value of Bovinine as a dietetic preparation. I have used it for more than a year in a very aggravated case of nervous dyspepsia, and have found it to answer very much better than any of the many preparations or extracts of meat before used. I find that it keeps perfectly, even in the warmest weather; is very easily prepared for administration, and it has proved acceptable and beneficial in every case in which I have known it to be given. Very respectfully and truly yours, R. MURRAY, M. D., Surgeon General (retired) U. S. Army. 3316 Arch Street, Philadelphia, Pa. January, 19th, 1887. Col. J. H. Baxter, Chief Medical Purveyor, U. S. A., Washing- ton, D. C My Dear Doctor:—I have been asked to say in a letter to yourself what I know about Bovinine. Well, in brief, I will say that my eldest son had capillary bronchitis, and became greatly reduced and exhausted. I put him upon Bovinine, and in the course of two months he regained all his flesh and strength, and has io3 now grown quite robust. I also prescribed it for a niece, who was fragile and delicate in the extreme, in fact neurasthenic, and the result has been that she has now become a strong, healthy woman. Hoping, my dear doctor, that you will pardon this small draft on your valuable time, I am, as ever, your friend, D. L. MAGRUDER, Surgeon U. S. Army. Ann Arbor, Aug. 18th, 1886. Gentlemen:—This is to state that I have used Bovinine in a number of cases needing a food at once nutritious and easily assimi- lated, with very gratifying results. V. C. VAUGHAN, M. D. [Professor in the University of Michigan, and discoverer of Tyrotoxicon, &c] Louisville, Ky., Oct. 20th, 1887, Gentlemen—I have prescribed Bovinine for several months with satisfactory results. It is the best fluid food in use. W. H. WATHEN, M. D. [Dean of Kentucky School of Medicine; Ex-President of State Medical Society, and Consulting Gynecologist to the Louisville City Hospital.] 1' Where swift support is called for, for rapid vitalization, there is no better than that form of defibrinated blood advertised as Bovinine. It is fairly palatable, easily assimilated, feels good in the stomach and will keep an indefinite time, the latter quality being absent from all other similar preparations with which I have experimented. If every one had not used Bovinine already and made up his mind as to its value I should be glad to advise its trial, but it is not needed-suggestion is sufficient." DR. W F. HUTCHINSON && in the N. E. Medical Monthly. 104 MEAT EXTRACTS PREPARED BY HEAT, BEEF TEAS, ETC., HAVE LITTLE OR NO FOOD VALUE, AS WILL BE SEEN FROM THE FOLLOWING OPINIONS. Many "meat extracts," " essences," etc., are upon the market, a large portion of them containing no food or nutritive properties; for instance, the highly-prized '' Beef Tea,'' popularly supposed to have great food virtues, but actually containing none whatever, being merely a temporary stimulant, or flavor, upon which a patient would soon starve. In the British Medical Journal, Dr. MiLNER Fothergill sajTs that " a patient dying of exhaustion is generally dying of starvation. We will give him Beef Tea, calf's foot jell}-, alcohol, seltzer and milk; that is, a small quantity of sugar and milk, and some fat. But the jelly is the poorest sort of food, and the Beef Tea a mere stimulant. The popular belief that Beef Tea contains ' the very strength of the meat' is a terrible error; it has no food value whatever." Professor Robert Bartholow, of the Jefferson Medical College, Philadelphia, an undoubted authority in such matters, says: "Nothing has been more conclusively shown than that Beef Tea is not a food. It is nothing more than a stimulant. All extracts of the nature of Beef Tea carry but a portion of the proper- ties of the meats that they are made of, and in most cases are of no avail as they cannot be retained by the enfeebled stomach. Extract from a report on several descriptions of meat prepara- tions, by Dr. A, Stutzer, of Bonn, Director of the Imperial Agri- cultural and Chemical Laboratory of Rhenish Prussia: " The beef extract made from Liebig's receipt is not an article of food proper, as containing no more than 7 per cent, of nitrogenous matter; nor did the illustrious professor introduce it as an article of food destined to nourish the human body. Liebig's idea was not to produce a nutritive article, only a relish.''' Dr. Stutzer further exposes the often exposed superstition regarding the nourishing powers of Beef Tea. He shows con- clusively that one would have to take a half-gallon of Beef Tea before he would get as much nourishment as is contained in a quarter of a pound of steak. He also calculates that a patient would be obliged to consume eighty pints of that deceptive liquid, Beef Tea, prepared from eighty pounds of steak, to obtain the flesh- forrhing and blood-producing constituents in one bottle of Bovinine. Bovinine containing as it does 20 per cent, of coagulable albumin, is not to be classed with preparations of the above character. io5 [rr<..;;i "Food and Sanitation."— London.! Meat Extract Revelations. u- ou-.?enjS atlaly§es and experiments made in 1801 by Mr. R. H. Chittenden, Professor of Physiological Chemistry at Yale Uni- versity, tne results of which were communicated to the Philadelphia County Medical Association, on May 13th of the same year, Mr. cnittenden gave the following as the percentage composition of Lie- big s Extract of Beef, Valentine's Meat Juice, and Bovinine. The figures were:— Liebig's Valentine's Extract of Beef. Meat Juice. Bovinine. 2 ozs. 2 ozs. 2 ozs. Cobt1/2! Cost 3/-. Cost 11 d. J fter (at 110 C.)...............................20.0(.( ^.^ 81.0Q Solid matter .« ...............................T!).,)4 89.69 ls.(n Inorganic constituents........................34.04 n .30 i-02 Phosphoric acid Pi OS.......................... 913 4.()() 0.03 *at (ether extractives1 ......... 091 OTH 14') Total nitrogen......................'.'.'.'.'.'.'.'.'. 9'52 2(is 243 Soluble albumen coagulable by heat........... 006 0-55 i:>-«.in Total proteid matter available as nutriment___ 0-06 0-55 13-!is Nutritive value as compared with fresh, lean beef (lean beef = 100)........................ 0-30 2-s() 72-40 These analyses were, as regards Liebig's and Valentine's Meat Juice, practically confirmed by results published by Mr. Jesse B. Battershall, Ph.D., F.C.S., chemist, United States Laboratory, New York. Mr. Battershall in Fqod Adulteration, page 256, gives the following analyses:— Liebig's Valentine's Extract. Meat Juice. Water......................................................1827 5067 Organic Substance.........................................5K-40 2941 Ash........................................................23-25 11-52 Soluble Albumen........................................... 005 — Alcoholic Extract .........................................4411 — Phosphoric Acid........................................... 783 3-7(5 Potassa....................................................1018 5-11 Readers of Food and Sanitation do not need to be told that we accept nothing on hearsay or upon testimonials. We believe that for the public safety every food, every drug, and, above all, every patent preparation ought to be subject to analysis, as we are now subjecting every patent food offered to the medical profession and the public. The results, be they favorable or the reverse, ought to be honestly stated, the more so as few medical men have the appli- io6 ances, the time and the training necessary to make individual in- vestigations. We shall, therefore, in investigating Mr. Chittenden's and Mr. Battershall's analyses, deal with them in a plain, matter-of- fact manner, and entirely upon their merits, however unexpected may be the results and astonishing the conclusions. Divesting thus our minds of cant, we have first to note that Mr. Chittenden gives the soluble albumen as o*o6, whilst Mr. Battershall finds 0*05 per cent, in Liebig's Extract. In Valentine's Meat Juice Mr. Chitten- den finds C55, i. t?d., and Bovinine is worth 43s. To avoid the possibility of error, we have had duplicate ana- lyses made of Bovinine. The second analysis gave the following results:— io7 BOVININE. "Water and Alcohol....................................................80*70 Fat (Ether Extract)..................................................... 1-21 Gelatine and Albumen................................................12.92 Peptone.................................................................0'62 Creatine and Meat Extractives.......................................... 0-21 Salt.................................................................... 0-78 Other Mineral Matters.................................................. 0.08 Non-Nitrogenous Extractives............................................ 3"48 100-00 It will be noticed that there is a slight difference in the figures, but this is to be expected in any food preparation, which must vary to some extent. The lesson to be learnt from these analyses, and from the others already published in this series of articles, is, that the system of manufacture of patent food preparations needs revolu- tionising, and that no medical man can afford to neglect the study of the real value of the meat extracts, etc., he prescribes. At one time the Liebig and Valentine preparations were undoubtedly the best that were placed at the service of the physician. Instead of advan- cing with the progress of science, the makers have been content to rest where they were when the science of foods was in its infancy. Tradition has invested them with a halo of testimony no doubt hon- est enough in its time, and with respect to some of the most largely prescribed patent foods, that tradition has been handed from teacher to teacher, from father to son, and from school to school, without anyone being iconoclastic enough to examine into its bona fides. It is dangerous for the medical man, above all men, to take any- thing on trust. Dr. W. M. Grailly Hewitt, in an address to the British Medical Association, emphasised that danger in weighty words, saying:— "For the last six or seven years I have tested by carefully inquiring into the past history of patients mostly suffering from some uterine or ovarian disease, or some af- fliction incidental to child-bed, and these conclusions have stood the test of this long- extended inquiry. I have to state the important conclusion that a continuous insuffl- ciencv of food, or what may be called a chronic starvation,' more or less intense in different cases, was found to have existed universally. Consequently, I have natur- ally been led to consider chronic starvation as a most important factor in disease." Experiments have proved that an animal fed upon Liebig's ex- tract of beef alone, will succumb more readily than a like animal entirely deprived of food. The claims advanced, therefore, in favor of preparations of Liebig's Extract of Beef, Meat Juices, and Beef Essences that they represent 30 or 40 times their weight of lean beef is absurd, inasmuch as such preparations are practically devoid of nutritive value, and the waste creatine and extractives (at times half the bulk of the preparation), although of some value as stimu- io8 lants, have the disadvantage that their use in many diseases is posi- tively dangerous. It is time, therefore, that such preparations were relegated to the kitchen for use as flavoring agents — with which no one would quarrel — and that their makers ceased to represent them to the public as foods. What, for example, are we to tbinkol the following announcement accompanying Brand's Essence of Beet "BRAND & CO.'S ESSENCE OF BEEF. "This essence conists of the juice of the finest beef, extracted by a gentle heat. without the addition of water or any substance whatever, by a process first discovered by ourselves in conjunction with a celebrated physician. „,*„,,•„,•= "In cases of extreme exhaustion or urgent danger, a teaspoonful may be adminis- tered as often as the patient can take it, in less urgent cases it may be taken as re- quired with a small piece of bread and a little wine." —in the light of the following analysis : Brand's Essence of Beef Cost Is. 2d. Water...............................................................91-23 Fat (Ether Extract)' ".'.'.'!!!.'.'... .-.-.•.............• • • -......■ •............ 0;18 Gelatine and Albuminoids.............................• • •----'......... ^ ™ Peptones................................................................ ~ , Creatines and Meat Extractives almost non-nutritious.................. o Salt. 0.45 Other Mineral Matters.................................................• °'39 Non-nitrogenous Extractives.........................................IN one. 100.00 or of the assertions re Liebig's Extract — that it " makes the most nourishing of beef tea ? " Again, if we take the nutrient values of the three preparations, as compared with fresh lean beef — Reckoning lean beef as equaling......................................---• 10000 Liebig's equals only............................—......•................... 030 Valentine's equals only..........................-....................... 2'80 whilst Bovinine equals................................................... ' •J"40 109 FORMULA OF BOVININE. Defibrinated Bullock's Blood......................65.00 Desiccated Egg Albumen..........................19.00 Old Bourbon Whiskey............................10.00 Chemically-pure Glycerine........................ 5.00 ______________ 100.00 ANALYSIS OF BOVININE. Washington, D. C, Sept. 30, 1887. The Bovinine Co., Dear Sirs:—A microscopic examination of Bovinine reveals the presence of large quantities of red and white blood corpuscles; also minute fat globules and crystals of leucine and tyrosine. No fibrin or bacteria present. The blood corpuscles are practically un- changed, the red cells being simply decolorized, due to their suspension in a watery medium. Culture tubes of nutrient jelly, agar-agar, and peptone broth, inoculated with bovinine and kept in an incubator for a week, failed to develop any bacteria. One or two drops of bovinine placed in a test-tube with 10 c.c. of water, heated, and a drop or two of nitric acid added, reveals the presence of large quantities of albumen. W. M. Gray, M. D., Microscopist to Army Med. Museum. J. J. Smith, M.A.F.R.S., Bristol Med. Chir. Journal, Bristol, Eng., Sept. 1, 1887:— '' Bovinine is a dark colored fluid containing little sediment, the amount of coloring matter, estimated by the globinometer, being .20. Its spectrum gives a well marked band at C, with a fainter band at D, resembling that given by an alkaline solution of haematin. The fluid is neutral in reaction, and contains 18.2 per cent of coagulable albumen. The nitrogenous extractives soluble in alcohol, and including the inorganic salts (phosphates, sulphates and chlorides of potassium, sodium and calcium), amount to 6 per cent. The nitro- genous extractives insoluble in excess of alcohol amount to 0.45 per cent." ' 'A fluid containing one-fifth of the coloring matter of blood, with 18 per cent, of extractives and salines, ought to be excellent material from which to manufacture new blood. We are inclined to think that this fluid is likely to become better known and more extensively employed than at present; its dietetic value is undoubtedlv great." no OTHER MEDICAL TESTIMONIALS. (Enough of these might be given to fill another book like this.) Lexington, Ky., Nov. 2nd, 1887. Gentlemen:—I take pleasure in mentioning that I have given a satisfactory trial of the special properties of Bovinine during my visit to Washington, in attendance upon the International Medical Congress, the patient being an infirm maiden lady of 91 years. Other tonics and foods having entirely failed I presented this, and the result was indeed magical. Subsequent letters from them con- tinue the reports of very satisfactory results, and the friends said thereof, "Give Bovinine everywhere. Give it by the quart; it is the very best thing in the world." L. B. TODD, M. D. Dr. J. P. McGEE, of Memphis, Tenn., in reporting to the Tri- State Medical Association of Tenn., Miss, and Ark., a number of cases of Laparotomy performed by him, while discussing the importance of supporting the system and maintaining the strength of the patient, said: '' The importance of an easily digested concentrated fluid form of food is too evident to need more than simple mention, and in this connection I desire to state that while I am not here to advertise anybody's goods, I have found Bovinine incomparably superior in these cases to any food I have ever used, in that you obtain the largest percentage of nutrition with the smallest residuum." Memphis, Tenn., Nov. 7th, 1887. Cincinnati, Ohio, Dec. 1887. Gentlemen:—Allow me to thank you for calling my attention to Bovinine. It has proved of inestimable value to me in cases of dyspepsia. During its use the pain, tenderness, in fact all the attendant symptoms, have subsided. I believe we have in it a nutrient that is non-irritating, still abundant, and one that will be quickly assimilated, thereby gaining the time so much needed for rest in such cases. It should not be forgotten in wasting diseases and following surgical operations, in which a nutrient possessing the above qualities is of the first importance. D. W. HARTSHORN, M. D., 124 W. 7th St. Washington, D. C, Oct. 25th, 1887. Gentlemen:—I have been engaged in the regular practice of medicine for more than 30 years, and in all that time have found nothing that I regard as equal to the Bovinine in all cases indicating its use. I most heartily recommend it to the notice of the profession. J. STINSON HARRISON, M. D. Ill Washington, D. C, Oct. 20th, 1887. Gentlemen:—I take great pleasure in adding my testimonial to the remarkable value of Bovinine as a nutriment. I have used it extensively in my practice, and can record many cases where it proved invaluable as an adjuvant in impaired digestion, anaemia with mal-assimilation, phthisis, adynamic fevers, and indeed where there is any loss of tissue I find that I can depend upon Bovinine without fear of disappointment. M. ESTER HART, M. D. Attending Phys. and Phar. Homeo. Free Dispensary, Wash., D. C. Port Huron, Mich., Feb. 6th, 1888. Gentlemen:—I have given your fluid food Bovinine an ex- haustive trial, in which its merits were fully tested, and I find it everything you claimed for it. In a practice of forty-seven years I have found nothing to equal it in its power to restore a patient after being very low by wasting diseases. May you prosper in the production of such an excellent nutrient. I shall never be without it. WM. CAMPBELL, M. D., 317 Park St. Toronto, Ont., March 31st, 1887. Gentlemen:—I take great pleasure in eulogizing your Bovi- nine. I regard it as the very best food for invalids, or those de- bilitated from any cause, I have ever used; and not only for those sick or convalescing, but for exhausted professional or business men. Bovinine will, better than any nutrient I know of, build up and restore the overtaxed mind and body. E. T. ADAMS, M. D., 450 Yonge St. Allegheny, Pa., Jan., 1888. Gentlemen:—I have used your fluid food, Bovinine, and am convinced that it is the best and only reliable food of the kind in the market. I am myself subject to dyspepsia, etc., and have used Bovinine in my own case with excellent results. A. P. H. SHAFER, M. D. Late Dist. Phys. of the City Poor Board. N. B,—This is the first indorsement I have given to any prepa- ration, but your food is so superior to any I have used that I thought :t but justifiable in this case. A. P. H. S. f'/*'w£. ,''■$3; NLM 0013flSt.fi 2 ^'/£ ;^>>^w NLM001385682