Popular Science Monthly/Volume 24/December 1883/The Remedies of Nature VIII
By FELIX L. OSWALD, M. D.
ABOUT a century before the birth of the Emperor Augustus, the most popular physician in Rome was the Grecian philosopher Asclepiades. His system seems to have resembled that of our "movement-cure" doctors. Instead of being stuffed with drugs, his patients were invited to his palæstra, a sort of out-door gymnasium or hygienic garden, where they were doctored with gymnastics, wholesome comestibles, and, as some writers assert, with flattery—probably courteous attention to the jeremiads of crapulent senators. At all events, his method proved eminently successful, though we need not doubt that all respectable druggists retailed canards about his establishment. He had devised a special course of gymnastics for every disorder of the human organism, and repeatedly declared that he would utterly renounce the claim to the title of a physician if he should ever be sick for a single day. Medicines he rejected on the ground that they accomplish by violent means what the palæstra-method would effect in an easier way.
Still, in certain cases, a short, sharp remedy might be preferable to an easy-going one, but unfortunately there is a more serious objection to the use of drugs, viz., the danger of complicating instead of curing the disease. For—1. The diagnosis may fail to establish the true cause of the disorder. No watch-maker would undertake to explain the irregularities of a timepiece by merely listening to a description of the symptoms, and before he can trace the effect to its cause he must minutely inspect the interior mechanism. But a physician is not only generally obliged to content himself with the evidence of the external symptoms, but he has to deal with an apparatus so infinitely more complex than the most intricate chronometer, that, even under normal circumstances, the process of its plainest functions has never been fully explained.
2. We risk to mistake the suppression of the symptoms for the suppression of the disease. We would try in vain to subdue a conflagration by demolishing the fire-bells, but on exactly the same principle the mediæval drug-mongers attempted to restore the health of their patients by attacking the outward symptoms of the disorder. Habitual overeating produced a sick-headache: they applied a blister to the head. Impure blood covered the neck with ulcers: they applied a salve to the neck. The alcohol-vice resulted in a rheumatic affection of the knee-joint: they covered the knee-pan with leeches. They suppressed the alarm-signals of the disease, but, before the patient could really recover, his constitution had to overcome both the malady and the medicine.
3. We risk to confound an appeal for rest with an appeal for active interference, and thus to turn a transient and necessary suspension of an organic function into an actual disease. Numerous enteric disorders, or bowel-complaints, are thus artificially developed. The marvelous self-regulating principle of the human organism now and then limits the activity of special organic functions, in order to defray an unusual expenditure of vital energy. The after-dinner lassitude can thus be explained: the process of digestion engrosses the energies of the system. Mental labor retards digestion; a strenuous muscular effort often suspends it entirely for hours together. Fevers, wounds, etc., have an astringent tendency: the potential resources of the organism are engaged in a process of reconstruction. Perspiration is Nature's effort to counteract the influence of an excessive degree of heat, and, when the effect of sun-heat is aggravated by calorific food and superfluous clothing, the work of reducing the temperature of the blood almost monopolizes the energies of the system, while at the same time the diminished demand for animal caloric lessens the influence of a chief stimulus of organic activity. Warm weather, therefore, indisposes to active exercise, and produces a (temporary) tendency to costiveness. That tendency is neither abnormal nor morbid, and to counteract it by dint of drastic drugs means to create, instead of curing, a disease. If a foot-messenger stops at the wayside to tie his shoe-strings, the time thus employed is not wasted. The sudden application of a horsewhip would force him to take as suddenly to his heels, but during his flight he might lose his way, and perhaps his shoes.
With a few exceptions, which we shall presently notice, chronic constipation results from the abuse of aperient medicines. A spell of dry, warm weather, sedentary work in an overheated room, a change from summer to winter diet—perhaps a mere temporary abstinence from a wonted dish of aperient food—has diminished the stools of an otherwise healthy child. The simultaneous want of appetite yields to a short fast, but the stringency of the bowels continues, and on the third day the parents administer a laxative. That for the next twenty-four hours the patient feels considerably worse than before does not shake their faith in the value of the drug; the main purpose has been attained—the "bowels move." Properly speaking, that movement is an abnormal convulsion, a reaction against the obtrusion of a drastic poison, which has "cured" the stringency of the bowels as a showerbath of vitriol would cure the drowsiness of a tired man. An imaginary evil has yielded to a real evil, and, what is worse, becomes itself soon real enough to confirm the opinion of the drug-worshipers that the patient must be "put under a course of corrective tonics." For very soon the unnatural irritation is followed by an abnormal lassitude, a digestive torpor, attended with symptoms of distress that plainly distinguish it from the original remissness of the bowels. In the eyes of the drug-dupes, however, it is nothing but a relapse of the former complaint, and must be combated with more effective remedies. "Treacle and brimstone, thrice a day," was the verdict of the mediæval Æsculap. "The timely use of our incomparable invigorant will regulate the action of the bowels and impart a generous and speedy impulse to the organic functions of the whole body," says the inventor of the new patent "liver-regulator"—a new combination of "valuable herbs" with the usual basis of alcohol. "A wineglassful every morning." The herbs prove their value by enabling the vender to accommodate his customers on Sunday morning, when common dram-shops are closed, and with an equal disregard of times and seasons the alcoholic principle opens the bowels. The incomparable stimulant admits no such excuses as fatigue or warm weather; the charm works; the regular attacks of a life-endangering poison have to be as regularly repelled. Other symptoms, such as troubled dreams, fretfulness, heart-burn and irregular pulse, seem, indeed, to indicate the approach of a new disease, but that will be met by other drugs, and in the mean while the liver-cure is continued. After the lapse of a few months the patient gets possibly a chance to escape his doom; out-door exercise, the excitement of a pleasant journey, a new residence, a change of diet, encourage the hope that the bowels may be left to their own resources, and the "tonic" is provisionally discontinued. An exceptionally strong constitution may really be able to overcome the after-effects of the drug-disease (for from beginning to end it has been nothing but that), but in a great plurality of cases the event proves that the stimulant has fastened upon the system: constipation, in an aggravated form, returns, and can now be relieved only by the wonted means—"a fact," as the orthodox drug-doctor would not fail to observe, "which should convince idealists that now and then Nature can really not dispense with a little assistance."
That assistance has made the fortune of numerous nostrum-mongers and helped our made-dishes to wreck the health of many millions. For, without the interference of a positive poison, dietetic abuses have to be carried to a monstrous excess before they will result in chronic constipation. A slight stringency of the bowels is often simply a transient lassitude of the system, and may be safely left to the remedial resources of Nature. After the third day, however, the disorder demands a change of regimen. A chief objection to our system of cookery is the hygienic tendency of the essence-mania, the concentration of nutritive elements. Ours is an age of extracts. We have moral extracts in the form of Bible-House pamphlets; language-extracts in the form of compendious grammars; exercise-extracts under the name of gymnastic curriculums; air-extracts in the shape of oxygen-bladders, and a vast deal of such food-concentrations as Liebig's soup, fruit-jellies, condensed milk, flavoring extracts, and branless flour. But, somehow or other, the old plan seems, after all, the best. In the homes of our forefathers morals were taught by example, and with very respectable results. Six years of grammar-drill in a dead language do not further a student as much as six months of conversation in a living tongue—the concrete beats the abstract. Boat-racing, wood-chopping, and mountain-climbing, are healthier, as well as more pleasant, than gymnastic crank-work; the diverting incidents of out-door sports which the movement-cure doctor tries to eliminate are the very things that give interest and life to exercise. And, for some reasons (not easy to define without the help of such analogies), concentrated nourishment does not agree with the nature of the human organism. The lungs find it easier to derive their oxygen from woodland air than from a ready-made extract, and the stomach, on the whole, prefers to get its nourishment in the form for which its organism was originally adapted. Want of bulk makes our food so indigestible. In fruits and berries—probably the staple diet of our instinct-taught ancestors—the percentage of nutritive elements is rather small, but the residue should not be called worthless, since it serves to make the whole more digestible. A large, ripe watermelon contains about three ounces of saccharine elements, which in that combination have a mildly aperient effect, while in the form of glucose-candy they would produce constipation, heartburn, and flatulence. The coarsest bran-bread is the most digestible, and to the palate of an unprejudiced child also far more attractive than the smooth but chalky and insipid starch preparations called baker's bread. Graham-bread and milk, whortleberries, rice-pudding, and stewed prunes, once or twice a week, generally keep the bowels in tolerable order, provided that the general mode of life does not prevent the influence of the natural peptic stimulants. But even in a case of obstinate costiveness few people would resort to drugs after trying the effects of a legumen-diet. Beans do not agree with some persons (though the Pythagorean interdict has no hygienic significance), but one of the three legumens—beans, peas, and lentils—is pretty sure to suit every constitution, and as bowel-regulators their value can hardly be overrated. Taken like medicine at regular intervals of eight hours, and in doses of about a pint and a half, the third or fourth meal of pea-soup (boiled in soft water and flavored with butter and a pinch of chopped onions) will prove as effective as a moderate medicinal aperient; but, while the effect even of a mild cathartic is followed by an astringent reaction, the relief obtained by an aperient regimen is permanent, unless that effect is persistently counteracted by the original cause of the disorder. Fruit, fresh or stewed, ripe grapes, or tamarind-jelly, and frequent draughts of pure cold water, will insure the efficacy of the remedy.
Besides an astringent diet, the chief predisposing causes of constipation are: warm weather, overheated rooms, want of exercise, sedentary occupations, tight garments, the after-effects of drastic drugs, of malarial fevers, and sometimes of self abuse. Parturition is frequently followed by a protracted period of close stools. In the most obstinate cases of constipation clysters are preferable to cathartics, for the reason that the former reach the special seat of the disease, viz., the lower part of the rectum, while the latter begin their work by convulsing the stomach, and, by irritating its sensitive membrane, disqualify it for the proper performance of its function. But injections, even of the simplest kind, should be used only as the last resort, after all the following remedies have proved ineffective:
Mastication.—Thoroughly masticate and insalivate each morsel of solid food. Eat slowly; do not soak your bread, etc., to facilitate deglutition, but let the saliva perform that business. The stomach of bilious dyspeptics often rejects a stirabout of bread and milk, but accepts the ingredients in a separate form.
Passive Exercise.—Kneading the abdomen, or riding on horseback or in a jolting cart, often affords relief by dislodging the obdurated obstructions of the lower intestines.
Cold sponge-baths excite a peristaltic movement of the colon, and often induce a direct evacuation.
Air-baths have an analogous effect, and in summer the bed should be removed to the airiest room in the house. After the stools have become more regular, exhausting fatigues (in warm weather especially) should be carefully avoided. The advent of winter greatly lessens the danger of a relapse. Frost is a peptic stimulant, and after October the cold ablutions can be gradually discontinued. Fresh air, an occasional sleigh-ride, or an excursion on a rumbling freight-train, will do the rest; and the cure is complete if, during the next warm season, the digestive organs perform their proper functions without the aid of artificial stimulants. The remedies for bilious constipation have been mentioned in the chapter on "Dyspepsia," but I will here repeat the chief rule for the cure of chronic indigestion: "Never eat till you have leisure to digest." Avoid after-dinner work; break through every rule of conventional customs, and postpone the principal meal to the end of the day, rather than let the marasmus of the digestive organs reach a degree that calls for a change of climate and occupation, as the only alternative of a total collapse. Open your bedroom-windows, take a liberal dose of fresh spring-water with the last meal, and an air-bath before going to bed, and the result will convince you that night is not an unpropitious time for digestion.
Unlike constipation, diarrhœa, even in its transient phases, is always a morbid symptom, and a proof that either the quality or the excessive quantity of the ingested food calls for abnormal means of evacuation. For the incipient stages of the disorder the great specific is fasting. Denutrition, or the temporary deprivation of food, exercises an astringent influence, as part of its general conservative effect. The organism, stinted in the supply of its vital resources, soon begins to curtail its current expenditure. The movements of the respiratory process decrease; the temperature of the body sinks, the secretion of bile and uric acid is diminished, and before long the retrenchments of the assimilative process react on the functions of the intestinal organs; the colon contracts, and the smaller intestines retain all but the most irritating ingesta.
When that remedy fails, the presumption is that either some virulent substance resists the eliminative efforts of Nature, or else that, in spite of the diminished sources of supply, the accumulated alimentary material still exceeds the needs of the organism. In the latter case, unless a continuation of the fast should seem preferable, the waste can be stopped by active exercise. After a hard day's work a man can assimilate a quantum of food that would afflict an idler with grievous crapulence. The Kamtchatka savage has earned the right to digest the flesh of the brute which he has slain in a rough-and-tumble combat. The stomach of the negro does not reject the fruit which he has plucked from the top branches of a tall forest-tree. Loose bowels become retentive if Epicurus has chopped his own wood and fetched his own cooking-water. But the best of all astringent exercises is a pedestrian excursion. A liberal supply of green fruit has a laxative tendency. A campaign in an orchard country costs the invaders a good deal of laudanum; in midsummer some forty per cent of the rank and file are generally on the sick-list with diarrhœa. But the first forced march stops such symptoms. Laxatives and pedestrianism are what lecturers on materia medica call "incompatibles." By a combination of foot-journeys and abstinence even a malignant case of chronic diarrhœa can soon be brought under control, though the debility of the patient should limit his first excursions to the precincts of his bedroom. Care should, however, be taken not to abuse the partially restored vigor of the digestive organs, especially during the period of deficient appetite that often follows a colliquative condition of the bowels. Progressive doses of out-door exercise will gradually overcome that apathy, and, when the stomach volunteers to announce the need of nourishment, it can be relied upon to find ways and means to utilize it.
But the problem of a complete cure becomes more complicated if the bowels have been tortured with astringent drugs. Diarrhœa itself is an asthenic condition, indicating a deficiency of vital strength, yet nearly every health-exhausting poison of the vegetable and mineral kingdom has been employed to paralyze the activity and, as it were, silence the protest of the rebellious organs. Bismuth, arsenic, calomel, opium, mercury, nux vomica, zinc salts, acetate of lead, and nitrate of silver, are among the gentle "aids to Nature" that have been employed to control the revolt of the mutinous bowels. An attempt to control a fit of vomiting by choking the neck of the patient would be an analogous mistake. The prescription operates as long as the vitality of the bowels is absolutely paralyzed by the virulence of the drug, but the first return of functional energy will be used to eject the poison. That new protest is silenced by the same argument; for a while the exhaustion of the whole system is mistaken for a sign of submission, till a fresh revolt calls for a repetition of the coercive measures. In the mean time the organism suffers under a compound system of starvation; the humors are surcharged with virulent matter, the whole digestive apparatus withdraws its aid from the needs of the vital economy, and the flame of life feeds on the store of tissue; the patient wastes more rapidly than an un-poisoned person would on an air-and-water diet. In garrets, where the last piece of furniture had been sold to defray the costs of a direful nostrum, I have more than once seen victims of astringent poisons in a state of misery which human beings can reach by no other road: worn out, corpse-colored, emaciated wretches, with that look of listless despair which the eyes of a dying beast sometimes assume on the brink of Nirvana. The first condition of recovery is the peremptory abolition of the poison-outrage. For the first three days prescribe nothing but sweetened rice-water, and only tablespoonful doses of that; give the stomach a sorely-needed chance of rest. On the fourth and fifth day add a few drops of milk, and toward the end of the week inspissate the broth to the consistency of gruel. There are persons with whom milk disagrees in all its forms; for such prepare a surrogate of whipped eggs with sugar and warm water—a tablespoonful every half-hour. Do not hope that the stomach of a far-gone drug-martyr will at once tolerate even such feather-weight burdens; it will not repel them with the spasmodic violence that characterized its reactions against a virulent nostrum, but it will often protest its disability to retain the whole quantum. A small but increasing percentage will be assimilated, and, if the corresponding enlargement of the rations is not overdone, the patient, at the end of the third or fourth week, may be rewarded by the return of something like positive appetite, i. e., a craving for more solid food. Try a slice of rice-pudding and fruit-jelly, or a homœopathic dose of blanc-mange. Try a soft-boiled egg or a baked apple. Eschew cordials. Avoid food-extracts, even strong beef-tea, which for a person in such circumstances is a stimulant rather than a nourishment. In the mean time watch the weather, and on the first clear day screen the lower windows, open the upper sashes, and treat the patient to a sunbath. Sunlight, applied for half an hour to the bare skin, is a better tonic than cold water, which invigorates a healthy man, but exhausts an asthenic invalid. In the form of tepid sponge-baths, however, water should be applied as soon as the patient can bear the fatigue of keeping on his legs for a couple of minutes. The first decided gain in strength employ in the preparatory exercises of pedestrianism. Carpet the room, clear a track for a circular walk, provide supports at proper intervals, a small table in one corner, a chair or a curtain-strap in the other. Interest the patient in his progressive achievements, keep a record-book, procure a boxful of chips and tally off each round. Three miles a day mark the time when the sanitarium can be transferred to the out-door world. In a vineyard country devote the vintage season to a three weeks' grape-cure. The cure consists in dining on bucketfuls of ripe grapes and transparent slices of wheat bread. Grape-breakfasts, grape-luncheons, and grape-suppers, ad libitum, but no bread, nor anything else that could interfere with the system-renovating effect of the sweet abstersive, that has been tried with signal success in the treatment of bilious dyspepsia, gout, and cutaneous diseases. Extreme caution in the use of animal food, acids, and fermented beverages, for the first six months at least, is as necessary as after an attack of dysentery, which should be similarly treated, except that a more rapid recovery of strength will permit a speedier return to out-door and active exercise.
Colic can generally be traced to the presence of fermenting fluids, and'is the penalty of excessive indulgence in such beverages as mush, new beer, fresh cider, together with sour milk and watery vegetables, but may in rarer cases indicate the agency of more dangerous substances, drastic mineral acids, putrefactive and zymotic poisons, noxious gases, etc. Rest and warm bandages are the best remedies. The antidotes of corrosive poisons will be named in a separate chapter. The pains of gastric spasms, as a consequence of dietetic sins, may be alleviated by manipulation and friction with a moist piece of flannel; in extreme cases, indicating the presence of virulent acids, by means of a stomach-pump. Generally a semi-horizontal position, reclining on the left side, with the upper part of the body slightly raised, together with local friction, will considerably ease the distressed organ, though intermittent griping pangs may continue till the alchemy of the physiological workshop has neutralized the irritating substance. From a kindred affection colic can be distinguished by a simple test: if pressure against the upper part of the groin increases the pain, the complaint is an inflammation of the peritonæum, but otherwise due to the presence of acid fluids or expansive gases. Painter's colic may be recognized by the discoloration of the gums and lips, and can be cured only by the removal of the cause. A napkin, sprinkled with aromatic vinegar, and tied loosely across the nostrils, will, however, lessen the effect of the noxious effluvia; and the Italians recommend the internal use of olive-oil (cotton-seed oil would probably serve the same purpose) and wine. For a few days after a severe attack of colic, pure water should be the only drink.
Flatulence tends to obviate the proximate cause of intestinal cramps. As a concomitant of dyspepsia, it indicates the accumulation of undigested food and the necessity of greater abstemiousness. Burnt magnesia absorbs gastric acids, but at the same time impairs the functional vigor of the stomach too often to be, on the whole, a lesser evil. It is, however, one of the very few chemical remedies which act, temporarily at least, by a direct removal of the proximate cause. Its permanent removal can be effected only by a change of regimen.
In the treatment of hæmorrhoids, too, we have to distinguish between palliatives and radical remedies. If the statistics of the complaint could be tabulated, I believe it would be found that its centers of distribution coincide with a prevalence of sedentary occupations, combined with the use of narcotic drinks, especially coffee. Monkeys have posterior callosities, and their habits prove that an occasional sitting posture is normal to the primates of the animal kingdom. But, in a state of nature at least, our arboreal relatives are too restless to avail themselves of their sitting facilities oftener than five or six times a day—for about a minute at a time. In menageries they become sedate enough for ten-minutes sessions. But a German chancery-clerk has to sit fifteen hours a day, awaiting promotion and the supper-hour, for he is often required to eat his dinner in situ. If his dinner-basket is sent from a cheap boarding-house, it is sure to contain a selection of highly astringent comestibles—tough beef, leathery potato-chips, allspice, ginger-cakes, and pickles. The accompanying flask contains coffee. If the man of sessions stoops, he damages his lungs; if he leans against the edge of the table, he may endanger his stomach; but, as sure as he sits, he compresses the region of the vena portæ. Obstructions of that vein are favored by two circumstances: it has to pass a double system of capillaries, and, before it can reach the liver, it has to pump its heavy blood upward. Sooner or later the incessant pressure results in varicose enlargements, actual obstruction occurs, the vein-bags become engorged and at last inflamed, and their rupture discharges the blood, which mingles with the secretions of the rectum, and causes that incessant pricking and burning that make haemorrhoids (emerods, piles) as troublesome as a combination of itch and gout. An astringent diet aggravates the evil by inspissating the blood and retarding the process of circulation. The stricken Philistines obtained relief by sacrificing golden fac-similes of the afflicted parts, and cauterizations temporarily free the obstructed passages; but the days of miracles are past, and, as long as the cause continues to operate, it would not avail the patient to sacrifice his entire stock of emerods. Inunctions of warm tallow will palliate the itch. Common mutton-tallow serves that purpose as well as any patent ointment, for itch and its cognate complaints are not amenable to the influence of the faith-cure. The radical remedies are gymnastic's and an aperient diet. The gymnastic specifics are the exercises that promote deep and full respiration, and at the same time react on the abdominal cavity, as spear-throwing, swinging by the arms, and dumb-bell practice. The diet should be digestible, and as fluid as possible; while exercise stimulates the circulation, the diluents will attenuate the blood, and thus obviate the proximate cause of the disorder. If the patient has to stick to his office, he should procure a combination-desk (which any carpenter can construct without infringement of patents), and stand and sit by turns.
The ancients kept slaves who had to work all day, sitting before a primitive grist-mill, and it is possible that hæmorrhoids are really a very antique complaint. But during the age of gymnastics and unfrequent meals it is not probable that people suffered much from maw-worms. Parasites are marvelous colonizers. Wherever the ground is prepared for their reception, the seed is sure to make its appearance. There are about sixty different kinds of mildew, a special variety for nearly every special kind of fruit or vegetable; and, if a decaying berry of the rarest sort is exposed to the open air, it will soon be covered with its specific kind of mold. A piece of putrid flesh will attract blow-flies, even where flies of that sort have never been seen before. The germs of numberless parasites fill the air, and each species, after its kind, will promptly fasten upon every sort of decaying or stagnant organic matter, even in the interior of the body. But in the living organism of the human system such stagnations are wholly abnormal. In the economy of the digestive organs peptic disintegration should precede putrefactive decay; the chyle should never stagnate, the stream of the organic functions should move with an uninterrupted current. There are rivers that become so low in summer that pools of water can be found only in the deeper cavities of the river-bed, and such pools are sure to swarm with "wrigglers," or incipient gnats. But, as soon as the current of the rising river drains those pools, the wrigglers speedily vanish.
The maw-worm plague is caused and should be cured on the same principle. Most people eat too often. Before the stomach can dispose of the first meal, it receives a second consignment, and soon after a third, of comestibles elaborately contrived to retard digestion; afternoon work monopolizes the energies of the system; the melange in the small intestines becomes unmanageable, stagnates, and at last ferments. Babies are gorged with milk till the contents of the little vessel literally spill at the muzzle; they are swaddled and bandaged, kept in horizontal confinement, and anxiously prevented from every motion that might ease the labor of the sorely overtaxed bowels. Fresh air, the next best peptic stimulant, is likewise carefully excluded. Nature fights the enemy for a week or two, but at last succumbs to odds: fermentation sets in; parasites fasten upon their well-prepared pabulum, and soon the tortures of the mummified little martyr are aggravated by the wriggling of hundreds of ascarides. Nervous children can thus be worried into epileptic fits, and even delirium and brain-fever. Locally the worm-plague produces constipation, hæmorrhages (often resembling the symptoms of true hæmorrhoids), and burning stools.
If the evil has reached proportions that defy dietetic specifics, the removal of the cause (as in prurigo, scabies, and syphilis) requires the application of artificial remedies. Injections of warm water with an infusion of quassia, or carbolic acid, will expel pin-worm; oil of chenopodium (worm-seed) in minute doses, administered with a tea-spoonful of castor-oil, is an effective prescription for the expulsion of the "round-worm."
Among the remedies against tæicæ, or tape-worms, the following vegetable specifics are not less effective and much safer than the calomel preparations which were formerly prescribed for that purpose: Pomegranate-bark (Granati fructus cortex); male fern (Filix mascula); but especially pounded pumpkin-seed. Three ounces of the fresh seed, mixed with a pint of water and pounded into an emulsion, taken after a twenty-four hours' fast, rarely fail to evict the tenant within three hours.
But the germs of the parasites remain behind, and the same predisposing conditions may at any time effect their redevelopment. Dietetic remedies must complete the cure. Children should be restricted to three meals a day. Let them earn their recovery by exercise—running, tumbling, dangling at the end of a grapple-swing. Adults should limit themselves to a lunch and a good dinner, drink a liberal quantum of fresh, cold spring-water, but no fermented beverage, and strictly abstain from indigestible food, especially cheese, sour rye-bread, sauerkraut, archaic sausages, pickles, and hard-boiled eggs. Light bread, cream, and grapes (or baked apples), should constitute the staple of the diet. A two-weeks grape-cure can do harm. An occasional fast-day will insure the elimination of undigested food-deposits. Pin-worms that have escaped the day of wrath may now and then betray their presence, but they have ceased to multiply, and, after the current of the organic circulation has once been fairly re-established, intestinal parasites will disappear like the wrigglers of a drained river-pool.