but approve the use of animal foods in very many circumstances in disease.

The conclusions arrived at are as follows:

First, because of the inheritance of civilization for centuries past, of constitutions based on anatomical and physiological conditions dependent largely if not chiefly on animal foods, a hasty, complete, radical change to vegetarianism is not always attendant with the best results in the healthy adult. But a gradual change may be effected with safety, and usually with great benefit. It is generally safe and useful for such an individual to reduce the meat diet to a minimum.

Secondly, it is very easy, and greatly beneficial to health, to bring up the young on a vegetable diet, inclusive of milk, which, during at least the first year or two of life, is practically indispensable.

Thirdly, in certain diseases (as will be seen farther on in this article), a vegetable diet is very beneficial, and often necessary for recovery.

Fourthly, a flesh diet is, on the other hand, often useful and necessary in other classes of maladies.

The studies and observations upon which the writer bases these conclusions are as follows:

BACTERIOLOGICAL STUDIES.

To determine the toxic products generated in the system by the action of microbes and various fermentations in the alimentary canal, investigations were carried on which sustain the views expressed by others more learned; viz., that animal substances produce the maximum amount of toxines, such as neurine, muscarine, choline, peptotoxine, and toxic albumen; and that vegetable substances limit the production of these poisons to a mini

mum.

Without going into details, I may say that the aerobic and anaerobic germs that enter the alimentary canal, produce a much greater quantity, and possibly a greater variety, of toxic products when developing at the expense of animal cultures than they do on or in vegetable media. There are possibly some exceptions to this rule, as there seem to be among pathogenic microbes. The bacillus of anthrax, for instance, produces, it seems, as deadly a poison on potato media as in meat broth. From a bacteriological standpoint, however, it is safe to

say, as the results of investigations indicate, that with a flesh diet which causes the production in the alimentary canal of more and greater poisons than do vegetables, the nervous system, the kidneys, etc., must suffer more than they would under a vegetable régime. We shall see by practical observations that this is actually a fact.

OBSERVATIONS ON A VEGETARIAN DIET IN HEALTH.

It is necessary to touch upon this point to realize the effects of diet in disease. I need not give observations of the influence of animal foods, except to draw comparisons with the effects of vegetari

anism in cases where meats had been the staple article of the régime before.

Case A.- Male; 31 years; in healthy condition before beginning a vegetable diet; weighed 148 lbs.; refrained from flesh suddenly and entirely from a moral standpoint; used a glass of milk or cream once or twice a day; habits and exercise unchanged. unchanged. After eight weeks his weight had dropped to 139 lbs.; the stomach suffered from bloating after each meal; strength was decreasing; and his sleep was dreamy, and failed to give satisfactory rest. He continued the same diet for three months longer, using grains, milk, cream, fruits, and various vegetables; weight decreased to 136 lbs.; dyspepsia became marked and painful; face sallow; and general condition miserable. Then he began to use an animal diet again, gradually, and all these unfavorable symptoms slowly disappeared, the strength was regained, weight increased to 152 lbs., the complexion cleared remarkably, and the symptoms of dyspepsia disappeared, until they are no more.

Case B.-Woman; aged 30; married; perfectly healthy in every respect; weight, 157 lbs; complexion bright and rosy; digestion good. gestion good. She began a vegetable diet as above, with exactly the same results, and in addition, chronic constipation was produced, which lasted four months, and was difficult to cure, even after the return to animal foods. In this case, the complexion, which was remarkably clear under an animal diet, became remarkably dark and brown by the exclusive use of vegetables, milk, and cream for a period of three months.

vegetarianism by choice, using besides it some eggs, milk, cream, and butter daily; had about the same experience in three months' to one year's trial, more or less continuous. On the other hand, five cases of healthy adults, students observed closely,-who adopted this régime on practically the same lines and as abruptly, did not experience any malaise; one indeed increased slightly in weight; viz., two pounds in a period of three months. The other four lost weight. Nearly all the cases above recorded, had bad breath.

Three more cases were observed, who made a gradual change from the animal food régime to vegetarianism, and experienced little or no bad effects; and after the change had been completely effected, all of them seemed healthy, and expressed themselves as completely satisfied. One appeared better than ever before, slept better, increased eleven pounds in four months, and could do more mental work. This man, it is well to say, had been a glutton before on animal foods and wine.

VEGETABLE AND ANIMAL FOODS IN CERTAIN DISEASES.

Case A.- Man; aged 32 years; suffering from prostatitis and inactive kidneys. Had been on rational treatment for three months; before that, had used a meat diet, i. e., meat two or three times a day; weight, 162 lbs.; bowels constipated; tongue coated; liver periodically torpid.

The new treatment under my care consisted of a vegetable diet (grains, fruits, nuts) including milk once or twice a day, and for the first week, meat (beefsteak) once a day. At the end of this week, meat was banished for six weeks. During this period, under the same medical treatment as before; viz., large doses of hot water, local electricity, aided by massage and occasional hot baths, the patient became practically well. The kidneys were active, free, and the urine normal, and the prostate glands seemed at last cured.

From close observations I am convinced that the vegetable diet was of the greatest benefit in this case. The malady could not, perhaps, have been so easily cured. without it. The patient lost in weight, but gained in health. And now, two months after the last day of treatment, the health is still good. The patient re

mains practically under a vegetable régime, eating but little meat.

Case B.- Man; aged 48 yrs. ; suffered from albuminuria for two months; normal weight, 172 lbs. ; weight at beginning treatment (after two months of perceptible illness), 145 lbs.

Treatment consisted of a physical tonic in the bathroom, lactate of strontium internally; vegetable diet, composed chiefly of the greatest amount of vegetable albumen, and including the free use of milk, and one glass of hot water before each meal. The result was anything but encouraging. The digestion became greatly troubled and complicated; weight decreased daily; albumen appeared more and more in the urine. Tube casts were exceedingly rare at the beginning of the disease and during treatment. Naturally, such a disease was not expected to yield readily to any treatment, but I expected some benefit from the strontium, which had given such good results in France, whence my supply was imported.

I then changed the diet completely to fare of animal substances, mainly scraped beefsteak, game, fish, milk, cold and hot, with vegetables rarely. The balance of the treatment remained as before. The patient under this régime held his own, but the kidneys were too inactive to eliminate the waste products of such a heavy diet. Consequently, I ordered two to three full tumblers of very hot water an hour or so before each meal. By this method the kidneys were kept flushed, and their work was freer. The urine still continued to show a large amount of albumen, but the weight decreased no longer. After six weeks of this treatment, the weight began to increase, while albumen in the urine decreased; eight weeks, and only a trace of albumen remained in the urine. It is now ten weeks since the patient was put on the new treatment, and the weight has increased from 140 to 161 lbs., appetite is better, albumen very rare. Though I scarcely hope for a radical cure of this disease, I expect to prolong this patient's life; perhaps a cure will be effected; who knows?

Case C. Man; aged 52 yrs.; suffered from dyspepsia contracted on a ham diet and by rapid eating; had severe gastralgia and vomiting for two weeks, and five weeks of dysentery prior to his coming under my charge. His normal weight.

was 164 lbs.; weight first day of treatment, 126 lbs. He had been kept for five weeks on grains, fruits, and boiled milk, and had continually decreased in weight to this low point. The sanguinolent mucous catarrh of the bowels progressed, notwithstanding the continual attempts on the part of the physicians to stop it.

The treatment under my care consisted of the following:

Cool baths; salt rubs; massage; hot water drinking before each meal; almost exclusive meat diet, consisting for three weeks of nothing but scraped beefsteak and zwieback milk toast. After this, grains and torrefied bread were allowed sparingly. Hot milk and cream used occasionally from the beginning.

were

Medicinally, the only substances used, were at first, fractional doses of arsenite of copper for three days, followed by the administration of albuminate of iron (Flexner's) and celerina, equal parts, for three weeks. After this no medicine was given. The patient gained one pound a day regularly from the third. day until he reached 147 pounds, and then continued to gain more slowly. He is still under my care, and improves rapidly.

Case D.-Woman; aged 28; married; has two children; suffering from subinvolution and tear in the external os; very nervous; dyspeptic; constipated; subject to severe intestinal colic from accumulation of gas; subject to headaches; kidneys inactive.

Treatment consisted of electrical applications, etc.; hot water internally; vegetable diet with milk, cream, and eggs. In nine weeks the kidney affection disappeared; elimination was better, certain forms of headache were almost completely eradicated; but the digestive troubles increased. I changed the diet so as to include animal food (scraped beefsteak), with very little vegetable food, but plenty of hot water. The kidneys remained sufficiently active, and the digestive difficulties were greatly improved. Neither diet seemed to have any influence on the uterine trouble or its treatment. The weight was not perceptibly changed by either of the dietetic régimes.

Case E. Incipient tuberculosis. The treatment: Continued inhalation of eucalyptol and creosote in closed room. Patient averse to meats, but relished vege

tables, fruits, milk, and cream. Took emulsion of cod-liver oil. Weight decreased perceptibly from day to day. Four weeks after beginning treatment, cough seemed less severe, but weakness increased. Changed diet as much as possible without forcing patient too much. into a régime of animal foods. Gave plenty of liquid peptonoids. Wyeth's beef juice, scraped beefsteak, cod-liver oil, and the least amount of fruits except pineapple, which was urged because of its beneficial properties in digestion.

Under this régime, everything else being equal, the weight increased, the cough diminished, and the bacilli became much less numerous. The patient improved remarkably, and after a few weeks was able to move to a more congenial climate, having gained 13 lbs. in the last 40 days of treatment.

From these few observations, the observations and investigations of others, the experiments and laboratory studies I have made, and also from numerous other casual observations of patients in sanitariums and elsewhere, I am convinced that in health, the change from animal food to a vegetable diet is useful, and perhaps a necessary reform, in order to secure the best health physically, morally, and mentally; but in the adult the change must be made gradually and cautiously, under the physician's guidance, as at a sanitarium, for instance. In disease, a vegetable diet is useful in certain affections, and one of animal foods in others, but one must discriminate.

THE TREATMENT OF HEPATIC COLIC.

BY J. H. KELLOGG, M. D.

THE method of treating hepatic colic by hypodermic injections of morphia or the employment of opium in other forms, is objectionable for the reason that opium arrests the muscular action of the duct, the continuance of, which is necessary to the expulsion of calculi. Chloroform, if carefully administered, is a better remedy, as it will relieve the pain without arresting the action of the muscular fibers of the duct. Pain can often be relieved, however, without the use of any drug, by the application of heat. Large fomentations applied over the region of the liver

and stomach, or passing around the body, often give the greatest relief. The fomentation should be large and thick; an ordinary woolen sheet folded so as to be about eighteen inches wide, answers admirably the purpose; and two rubber bags filled with water, one placed behind, the other in front, are a very convenient means of applying heat in cases of this

sort.

Laxatives should not be used at the beginning of an attack, but a large hot enema greatly facilitates the determination of the paroxysm. The hot bath is also considered of great service in these

cases.

Most important of all is the prevention of an attack. There are certain prodromal symptoms which are commonly overlooked, but the recognition of which. may lead to the employment of important preventive measures. These are described by Dr. Colladine, of Geneva, himself a sufferer from this disease, as follows: "A peculiar drowsiness, general torpor, even after a good night's rest, irregular arterial pulsations, especially at the temples, false sensation of hunger and emptiness of the epigastrium, or very pronounced nausea, constriction of pharynx, eructations and intestinal flatulence, excessive flow of urine, sense of constriction under the ribs, distention of stomach, tenderness in the region of the gall the region of the gall bladder. All of these symptoms above enumerated, indicate an irritated condition of the solar plexus. Hot fomentations, application of dry heat by means of rubber bags, hot enemas, and copious hot water drinking, if employed during the prodromal period, will often ward off the attack entirely, or greatly shorten the paroxysm."

It is well known that in a large number of cases in which the symptoms of hepatic colic are very pronounced, no calculi can be found. It is probable that in these cases the difficulty is wholly the result of an excited state of the solar plexus, and that no calculi are present. There is intense congestion of the liver, however, and this condition, if frequently repeated or prolonged by continued excitement of the plexus, may ultimately result in the formation of calculi. Consequently the condition is one which should receive careful attention. Preventive measures are of the greatest

consequence in these cases, both when calculi are present, and when they cannot be found. They consist of the following precautions:

1. The most careful regulation of diet, avoiding the use of condiments, flesh foods, alcoholic liquors, and tobacco. Tea and coffee must also be avoided. The patient must carefully abstain from everything that will excite the solar plexus. The diet should be nourishing, but not in excess; it should be plain and unirritating in character.

2. The patient must take abundant outdoor exercise, thereby promoting increased respiratory activity and consequent aid to the portal circulation. The exercise should be sufficient to induce vigorous perspiration; such exercise as bicycle riding, horseback riding, especially Swedish gymnastics, and Swedish medical gymnastics, are of particular value in these cases. Massage, which the patient may himself administer after being properly instructed by a competent physician, is also of great value. Massage is of course of greater value when administered by a skillful màssauer or

massauese.

3. Some simple hydropathic measures are of very great value. Warm eliminative baths two or three times a week are of value in ridding the system of excretory elements, thus relieving the liver of some of its work. An electric light bath and a wet sheet pack are of special value. The wet sheet pack is administered by simply enveloping the patient in a sheet wrung out of cold water and covering him closely with several warm blankets, so as to promote reaction and perspiration. Habitually wearing a tight, moist abdominal bandage is another excellent measure. A towel should be wrung out of cold water, dry enough so that it will not drip, placed about the body, and covered with several thicknesses of flannel. If inclined to chill, the flannel wrapper may be covered with oiled silk or muslin. Daily fomentations over the region of the liver, two or three hours after meals, are also of great value. pious hot-water drinking should be practiced daily one or two hours before eating; a large hot enema should be taken at least two or three times a week, in order to wash out the bowels thoroughly, and also stimulate the portal circulation.

Co

TRANSLATIONS AND ABSTRACTS

[THE articles in this department are prepared expressly for this journal.]

GLYCOGENIC FUNCTION OF THE LIVER.

BY DUJARDIN-BEAUMETZ. Member of the Academy of Medicine, Physician to the Cochin Hospital, Paris.

Translated by J. H. Kellogg, M. D.

(Continued.)

WE have studied, in the preceding lesson, the physiological basis of the glycogenic function of the liver. We have learned what are the conditions which the body must supply to maintain, at a nearly constant percentage, the sugar of the blood; and having examined the different theories which have been proposed in explanation of the passage of sugar into the urine, either permanently or temporarily, this lesson will be devoted to the study of the therapeutic conclusions which may be drawn from the premises already presented. The treatment of diabetes is a question of great importance, owing to the frequency of this affection.

According to the facts which I have presented in the preceding lesson, it is apparent that, for the cure of diabetes, it is necessary to reach directly the glycogenic functions of the liver, and to diminish them. Are we able to do this?— Yes, to a certain degree; but, unfortunately, the methods by which this result is obtained are more dangerous than the disease itself. This statement is based upon the belief that in destroying the hepatic cell, the glycogenic functions of the liver are likewise destroyed. I have demonstrated to you that the antiseptic function of the liver goes side by side with its glycogenic function; and that, in order that these functions should be performed physiologically, we must have a sound hepatic cell. The hepatic cells are destroyed by various processes, and particularly by sclerotic processes.

Unfortunately, in man such processes are quite too frequently produced under the influence of alcoholic drinks, in which we see a true physiological experiment, and which, by destruction of the functions of the liver, may cause the disappearance of diabetes. However, I see no advantage in substituting for an affection

so tractable as diabetes, a disease so incurable as cirrhosis. Hence this method of procedure must be abandoned as a therapeutic resource.

Another method consists of depriving the diabetic man of nourishment; and the experiments of Claude Bernard have demonstrated that the glycogenic function disappears after prolonged abstinence. But when a man is deprived of nourishment, he draws his nutrition from his. own tissues; and in diabetics, this draft upon the tissues is so great that emaciation occurs with extreme rapidity. This method also is one that cannot be employed, since it is more dangerous than the disease.

Being thus unable to act directly upon the glycogenic function of the liver, we are forced to take an indirect method, and address ourselves to the origin of the glycogenic function. Although the knowledge of the glycolitic power of the blood has given rise to some very interesting conclusions from a pathogenetic and physiological point of view, we are not able to draw therefrom any therapeutic indications, since we are ignorant of any means of increasing the power of the blood to destroy sugar.

There remain to be examined two other causes which affect the production of diabetes.

As you will recall, from the statements made in the last lesson, the glycogenic function of the liver is controlled by two great functions, the intestinal function and the nervous function. It is from the digestive tube and from the food, that the liver obtains the sugar which it stores. under the form of glycogen. On the other hand, the nervous system controls. this same glycogenic function. If to these two sources we add a special nutritive state or predisposition, originating in heredity or diathesis, in consequence of which we see a more or less persistent diabetes occurring in persons who have reached a certain age, you will have three sources which may be reached by therapeutics in combating diabetes, and we shall have three classes of remedies to study: 1. Dietetic; 2. those which affect the nervous system; 3. constitutional.

The hygienic treatment comprises two parts 1. Dietetics; and 2. general hygiene. At the present time, all are agreed that alimentary hygiene is the capital