secrete gastric juice, although there is nothing to be digested; or when it is taken very hot after a meat meal, and then it is not the tea which does harm, but the hot fluid, which kills the pepsin necessary for the digestion of meat. In some cases where dyspepsia already exists, tea-drinking does harm, as the large amount of hot fluid relaxes the already distended stomach and leaves room for flatulence to collect.

Nervousness sometimes follows teadrinking, but only in cases where it is drunk to force the brain to work beyond its natural powers, and without proper food being taken; as a result the nervous system becomes overstrained.

Coffee. The best coffee is made from "berries" that have been freshly roasted and ground. To get the strength it needs boiling, but this dissipates the aroma; the best compromise is to make an infusion, pour it off into a heated jug, then to boil the grounds and add this decoction to the infusion previously made. It should be made very strong, so as to bear diluting with plenty of hot milk without tasting weak; this makes coffee a useful beverage for those who cannot take solid food. It is a strong heart-stimulant, and invigorates without subsequent collapse.

Coffee is often adulterated. A simple test is to throw a little into a wine glass of water; if it is pure, it will float and will hardly tinge the water; if, however, chicory or dandelion are present they will sink and color the water red. Many people like the addition of a little chicory.

Cocoa. This is a milder and less stimulating beverage than either tea or coffee, and contains more food; unfortunately it is less refreshing. The seeds broken up are called cocoa nibs; after prolonged boiling and removal of the floating cocoa-butter, they yield a good beverage.

Prepared cocoas are often used; they contain less cocoa-butter, and are more quickly prepared than the nibs. In some (wrongly called "soluble") the cocoa is ground up with starch; with boiling water

the starch forms a mucilage in which the fine particles of cocoa remain suspended.

Chocolate is cocoa ground up with sugar and flavored with vanilla; it generally contains a little starch. Van Houten's cocoa is prepared from the nibs, some of the fat being removed; as it does not contain starch, it forms a thin drink.

All preparations which have drugs, such as kola, added, should be avoided.

Artificial mineral waters have as their basis water surcharged with carbonic acid gas. Soda water, potash water, and lithia water have those salts added, but not in the "lowering" amount often ascribed to them. Indeed, such mineral waters are practically no more lowering than an equal quantity of plain water.

Lemonade and ginger-ale contain in addition to the flavoring agents a considerable amount of sugar, and so are not such refreshing drinks; it is the sugar that causes the lasting froth. Ginger-ale is a pleasant adjunct to a convalescent's meals; if too hot, it may be diluted with an equal quantity of soda water.

Home-made lemonade, made by pouring boiling water on a cut-up lemon (the white rind being removed) and a little sugar, forms a refreshing acid drink.

Of the natural mineral waters, Apollinaris is the best as a beverage, and should always be used abroad if the water supply is doubtful. It is a very pure water, and every precaution is taken in washing and filling the bottles so that it may not be contaminated.

patient with contracted kidneys and hypertrophy of the left ventricle, and other ills perchance following in the wake of these, of what use is medicine, of what use are pills and powders, if we allow such a patient to stuff himself with an excess of nitrogenous food?

When we order our pills and potions and powders in such a case, let us think in carbon and hydrogen and oxygen and nitrogen, and see to it that we do not increase his blood-pressure by food whilst we are endeavoring to control it by drugs. In such a case, if I must abandon one course of treatment and keep only to the other, give me diet; "throw physic to the dogs."

Another practical point in dietetics isstudy the individual. It is very true that what will nourish one man will poison another, and further, what will be proper for a well man may kill a sick man. Some individuals can live on milk alone when they try; with others it is impossible. Many a man can eat mutton and grow fat on it, so he can eat eggs and thrive; to others, again, these are poison. Such are mere idiosyncrasies, and it is well to remember them. I believe the principles of diet and nutrition, the effects of alcohol and tobacco and such, should be taught to some extent in the schools; not fanatically, but reasonably. Some general knowledge on this score would add much to the general health of a people and be of assistance to physicians in treating the average man. There is a diet for the young, for the man of middle age and for the aged person. We commence with milk, with the complete food, the balanced ration. We go through all the luxuries of a lifetime, and as we approach toothless old age we come back again to childhood and to childhood's ration-milk, and in extreme old age the nearer we adhere to the simple milk diet the better and happier we are, and the longer and more satisfactorily we live. My observation and experience lead me to believe, as intelligent persons grow to middle age and beyond, they, as a rule, become careful as to diet.

There is, no doubt, much suffering from

improper diet, and bad cooking is responsible for many ills, and doubtless many deaths. A little observation of the inner life of the poor will cause one to realize in a high degree the utter discomfort and utter misery, even unto death, which come to those untutored and unskilled in providing, in choosing and in preparing properly for the table even the simplest of foods. Education, supervision, the evolution to a higher plane of living for these people is the only corrective for such pitiable ignorance and carelessness. These people need supervision, they need instruction. The principles of cooking practically taught in schools would help out in this work. Call it paternalism if you will, but as we grow wiser in government such matters must come up and be taken up before we reach the highest civilization.

The simplest chemical classification is Liebig's nitrogenous and non-nitrogenous. The nitrogenous group are tissue-builders or flesh-formers; the non-nitrogenous group furnish the body with the fuel and keep up the animal heat, and are the force-producers. The tissue-builders also produce some force and heat. There is some nitrogen in vegetables, though not a great deal. The outside coverings of the starch granules contain some nitrogen, for example. Nitrogenous foods also are not absolutely nitrogenous, as they contain some fat and glycogen. The uses of food are to serve the body with materials for growth and renewal, and with power, much as fuel does for the steam engine. The consumption of fuel furnishes the power. The starches and sugars furnish much of the power to man. The original force is in the heat of the sun; this is stored by the plants in the latent form of chemical compounds, as Professor Thompson says. The main force of power is oxydation, chiefly of carbon. Wherever it goes, or any waste product goes, it is not destroyed, it only changes its form; you cannot destroy matter. Take urea; it is matter merely of our food in a changed form, something like ashes from coal. The urea and other débris, if not gotten out of the body, blocks the

system and prevents the normal processes of oxydation, which must go on properly to give one good health.

Water is to be looked upon as a food, composing as it does seventeen per cent. of the weight of the body, and much of it passes through the body unchanged. Withhold it, and life is impossible. I am sure, as a remedy, it is not half appreciated. Many persons do not drink water enough, and suffer accordingly, whether sick or well. Others, again, may take too much, and it is the duty of the physician to study each case and set his patient right on so important a matter. Of course, much of the water we take goes in as part of our food, and this fifty to sixty per cent of water in our solid foods must be taken into account.

Thompson, quoting from Von Pettenkofer and Voit, shows that during the performance of hard labor the consumption of albumin remains practically the same as during rest, whereas three and one-half times as much fat is consumed, and the amount of carbohydrates is the same, hence for hard laborers give plenty of fat pork, butter, oil and such. A workingman will take from fifty to seventy-five ounces of solid food in twenty-four hours, and about the same amount of water by weight. The ration should contain one part of nitrogenous food to three and one-half parts of nonnitrogenous food. The average albuminous food gives about sixteen per cent of nitrogen. Cow's milk and wheat flour approach nearest to a balanced ration of all food as to their nitrogenous and non-nitrogenous proportions. In cow's milk the proportion is one to three, and in wheat flour one to four and one-half.

These are matters of great practical importance, and all physicians should be more or less familiar with them. The destruction of the carbohydrates in the body is very complete when eaten in excess, and they do not produce fat like fatty foods taken in excess. This is an important practical point. The carbohydrates are more or less fattening when eaten with albumin and fats, because they check the consumption of albu

min and fats and leave more of them to be converted into tissue fats. Eaten alone they are not so fattening; for example, the Chinaman, living mostly on rice, is not usually overfat. Another practical point: When you have children growing rapidly and using their force in the ceaseless activity of the young, see that they get sufficient of proteids in their daily ration. The food of certain articles of diet is most important to the physician, whether to make up a ration for the soldier, for the laborer, the professional man, or women or children, or, more than all, of the sick entrusted to his care. Of albuminous matters used as food, onethird of it is excreted as urea. This is important to remember when the kidneys are diseased and cannot get rid of this urea, although as before said, some are beginning to deny that urea unexcreted is the great offender it has heretofore been given credit for.

Probably most persons over thirty-five years of age consume too much nitrogenous food, especially those who inherit gout. These gouty, bilious people are usually the strong and healthy, and, as a rule, have ravenous appetites; they live to eat, rather than eat to live. They often incline to be good drinkers of wines, spirits and malt liquors, but, as a rule, much to their disadvantage, are light water-drinkers. If they drink more water the ill effects of a vicious metabolism, of vicious tissue change in nutrition and secretion, would be carried out of the system more generally in the various secretions and excretions. It is surprising to see how soon one who has been a free meat-eater can come down to almost a nonnitrogenous diet and enjoy life and feel lighter and better and more contented in every way, provided the excess of nitrogen he had been taking was doing him harm. One must know something of the chemical composition of foods to lay out such a diet, for it will not do to tell a patient to live on milk and eggs and fish and all manner of vegetables, and to avoid only red meats and the black meat of poultry, etc.

The average fish diet is surely not the

light diet we unthinkingly are apt to take it to be; nevertheless fish is a safer and lighter diet than red meats and such, even if we take the stronger fish like cod. Fish diet does not load the blood with as much waste as the heavy meats do, requiring the getting of more oxygen by exercise to eliminate them from the system. Thus fish diet does

167°. A coddled egg is never boiled, for then the heat must reach 212°. At fifteen cents per dozen, hens' eggs are cheap food. At thirty cents per dozen they are expensive food.

Physicians should be able to instruct the families they attend as to their food supply and the nutrients required by different fami

meats, nor is there any truth in the common belief that fish diet is the best brain-food from the excess of phosphorus it contains.

Eggs are most completely digested, and hence are very nutritious as to their weight, and make a well-balanced ration with carbohydrates alone. The yolk is rich in fats, containing olein, palmitin, yellow pigment and lecithin. It also contains grape-sugar in very small amount, phosphates, iron compounds and sulphur.

Notwithstanding the general belief to the contrary, experiment shows five minutes' actual boiling to be the proper time to boil

health. A family where most of the members are laboring men and women surely requires a different food supply from the family of men and women living a quiet life of ease and comfort. Practically no thought is taken of this either by families or physicians. I am sure, as society goes on to the evolution of a higher civilization, it will be the duty and the every-day work of the family physician to take charge of such matters in the families they attend, and thus lead to a more general rational living, and to better, happier and healthier lives for the individual.

LOOKING over the Progress of Medicine, so frequently alluded to in current medical literature, the one word which epitiomizes the changes of the past quarter of a century is Prophylaxis. The study of how to cure has merged into that of how to prevent disease. Science reiterates and emphasizes the new rallying cry, “An Ounce of Prevention is worth a Cartload of Cure!"

Cures are undobutedly more prevalent than in the days of our ancestors, but it is chiefly because preventives have multiplied a hundred fold.

Among the effective prophylactics none occupy so wide a range as the oxygen group. Suboxidation complicates and retards the treatment of all modern diseases. Whatever will give us air, or its vital element-oxygen-will modify disease and facilitate its treatment, by whatever name it may be called. We are learning to breathe a little better than we did, and we ventilate our dwellings a little better. The improvements in this respect are adding to the span of life and to the sum of human enjoyment. But there is still a prevalent degree of oxygen famine. The bicycle, golf, football, tennis, rowing, sea voyages and mountain climbing are all on the right track, but there are millions who are wholly deprived of these privileges. The searchlights in materia medica are all hunting for economic and safe methods of relieving the universal famine. The "Tonics" are valuable to just the extent that they either supply or induce an increased absorption of oxygen, or as they act as oxygen carriers. Patients do not

assimilate appreciable quantities of iron, but it is often an excellent tonic, because it is one of the best oxygen carriers. Most of the reputed tonics act thus vicarously, by either inducing, supplying or conveying an increment of oxygen. The reason why so

why so much "tonic" treatment disappoints the physician and his patient is because the needed increase in the vital element is not supplied.

We speak of this element as a physiologic agent. Indirectly it is probably the most universally invoked of all our adjuvants in the treatment of chronic ailments. Patients are sent in all directions in search of it, across the seas, up the heights, and to "salubrious" retreats, where a more uniform or congenial temperature invites to out-door living and outdoor sports, or where some more or less harmless spring waters generally get all the credit for any good results that follow.

How to make this element more freely accessible to the millions who cannot afford to sail the seas, climb the mountains or tarry at the watering places becomes an important and decidedly democratic desideratum and a problem for the physiologist of the future to study.

As a medicinal agent oxygen has had its ups and downs. Quack chemists have made it, quack medicine men have advertised it under various delusive names and quack doctors have used it for all sorts of purposes, legitimate and illegitimate. Some good men in the profession, who ought not to be so easily diverted, have almost entirely avoided it on account of this mixed history. They