clear debility of constitution with a fatty heart.
Tonics were strongly recommended by the
consulting physician; but, on the other hand, it
was urged that the patient was so wedded to
purgatives that she would take them surreptitiously
if they were not prescribed. They
were prescribed, and the woman lived only a
fortnight.

Another woman of the same age and like
constitution, apoplexy being imminent, was treated
only with quiet and tonics, and has been for
years in perfect health. A short, stout, florid
man, whose father and grandfather had died of
apoplexy, was not held to be the stronger for
the aspect of his face, was strengthened with
rest, tonics, and good diet, and recovered. A
man of twenty stone, steadily sinking under
purgatives, recovered upon the reversal of his
treatment. Seamen, after exposure and privation,
come sometimes into the Liverpool Northern
Hospital with their speech lost, and one side
paralysed. Quinine, or a quiet stimulant, with
good living and wine, cure them.

A burly coachman, very temperate in habits,
had an apoplectic stroke. Two surgeons in
succession saw him; the first cupped him, and
the second bled him, after which he lost the use
of his right side and the power of speech. He lay
six weeks without amendment, was then treated
with steel and alcohol. In a week he began to
mend. In three months, he could walk and talk,
and use his arm.

Unquestionably there are cases in which
blood should be taken, but even in these it is
taken for the removal of an instant peril, and
that being once averted, maintenance of the vital
force strengthens the curative power that is
most to be relied on.

We look to the chest. Quiet as healthy
breathing is, it implies the exercise of as much
strength by muscles of the chest, as in twelve
hours would equal the exertions necessary to
carry a weight of one hundred pounds up a
tower sixty yards high. It needs some energy
of life to do this work, and they who blow at
various times into the spirometer, do in fact
find that they can move the index farther when
they are fresh, than when they are fatigued.
The coughing that is necessary for the clearance
of clogged air-passages demands a great deal of
exertion, and in proportion to the force of life
in the body will be the ease and efficacy of this
sort of work. "When children die of croup,
they die of the debility which has destroyed the
power of the muscles by which air was to be
breathed in. Croup, when the majority of
ailments used to be treated by reduction of the
patient's strength, was one of the terrible
diseases from which a recovery was hardly to be
hoped. Now, it has lost many of its terrors.

Disease of the heart has always been a
common consequence of an attack of acute rheumatic
fever. The existence of much fibrin in the blood,
now known to be a symptom of debility, was
formerly regarded as a sure sign of necessity for
bleeding, and reduction of the strength. In
acute rheumatism there is a solid crust formed
on the blood after removal from the body.
Certainly, therefore, it was said, bleed and give
mercury. But, under this practice, strength
was reduced, and the heart became the more
liable to suffer. It is now found that under mild
treatment and attention to the general health,
recovery is at the least as rapid, and the risk
of heart disease considerably lessened.

We look to the stomach, and what is more
obvious than the debility attendant upon
indigestion? We know that, after too long waiting
for dinner, or under excess of fatigue, exhaustion
takes the appetite away, but that a glass of
wine, reviving for a time the force of life, promptly
restores it. A merchant advanced in life,
breakfasted at eight, went from a country suburb to
his business in town, ate nothing there, walked
home at four o'clock to give himself an appetite
for his five o'clock dinner, and found, first, that
after any harassing business or addition of
fatigue, but afterwards habitually, his dinner
produced vomiting. He was compelled to rest,
dieted on milk and cream mixed with
well-pounded blanched sweet almonds—which Liebig
finds to be as nourishing as milk—and took
steel as a tonic. In two days he improved. In
a fortnight he took exercise in the open air, but
at first always tired himself and brought the
sickness back: the stomach being found to sustain
less fatigue than the rest of the body, and to
have its strength exhausted before weariness
was felt in the legs. That is, by-the-by, a point
worth the notice of all people whose stomachs
are delicate, the fact being not an isolated
peculiarity but common truth. Strict attention to
rule, and avoidance of fatigue beyond the powers
of the frame, restored, in 'the case of the
merchant, health, and a freer enjoyment for the
usual family dinner than had been experienced
for years. But, afterwards, when hearty breakfasts
and dinners could be eaten, and long walks
taken without hurt, the old habits of business
were obstinately resumed, and an exhaustion
produced that proved fatal.

As it is through the stomach mainly, that the
powers of life have to be supported, something
ought to be said here about appetite. A very
large number of patients are unduly starved
because they cannot eat what is presented to
them. If some of the thought bestowed upon
combinations and changes of drug were spent
upon diet; if the hours at which sick people can
eat, were in each case carefully watched for,
and experiments made of many ways of nourishment
until the right one had been found; some
lives would be saved every year. We are still
too much disposed to believe that a sick person
whose powers of life are low, cannot only swallow
with impunity drugs in such doses as would
peril the life and most surely put an end to the
health of a sound person, but can at the same
time live on an amount of food that would not
keep a skeleton. There may be some reason for
the opinion; but, that in innumerable cases
patients die of drugs given to them in heroic doses,
and waste into the grave for want of food
enough to sustain nature in her conflict, we are