rasthenic, with the general appearance of a girl approaching puberty, rather than of one having four years previously passed it.

Miss H., aet. 16, of healthy parentage and, to my personal knowledge, in good health up to two years ago, when she menstruated normally, and has since followed the prescribed course in the high school. One year ago

a misguided friend gave her a piano, and a music master was employed to further stimulate the waning energies. After a few months harrassing, she requested medical advice, as her mother feared diabetes. She was indeed passing an increased amount of limpid urine loaded with phospates. She slept poorly, and an innocent anychia had been sufficient to put her to bed. She had become unable to wash dishes without dropping them, and a few minutes' piano practice would unnerve her for the day.

Miss D., aet. 18, of exceptionally robust Welsh parents, consulted me two months ago, because of backache. Examination disclosed the drooping shoulder and spinal deviation of an occupation curvature. Long hours at the desk, with long walks to and from school, with the arm of the low shoulder full of books, followed by an hour's piano practice after school and night study comprised the daily duties of this slight girl. She has practically ceased to menstruate. If accomplished at all it is with much pain and little flow. The chest Is distorted, and she is an invalid, a physical maldevelopment and a neurasthenic.

Miss B., aet. 19, good heredity; had been a student in the State University for two years. For five years she had been an incessant student, intent on graduation honors. Medical advice was requested for the relief of a cough and progressive weakness. Cord symptoms suggested posterior spinal sclerosis, and the was examined for symptoms of this trouble. In a few days she had learned the typical symptoms of this disease, and some of the less common ones as well, and believed she suffered all of them. The gait, however, became typical of hysteria; menstrual disturbances were regular symptoms, the periods being delayed from two to three months. She later became sleepless, suspicious and utterly helpless when under observation. A course of studied neglect was necessary to restore to her a degree of mental control.

The case of Miss S., aet. 19, good heredity, is similar to the first case described, except that stimulation of the emotions resulted in vertigo or syncope instead of gastric pain, but the same hysterical spinal symptoms were present.

Miss A., aet. 20, of good heredity, immediately upon being released from the usual process of "finishing," detailed a similar history of nervous disturbances and menstrual irregularities as did the preceding cases, and sought relief from convulsive seizures which followed slight excitement, and had been growing more frequent,

In none of these patients was there definable organic disease, they were all of good heredity, had been subjected to the same duties in different homes and schools, and presented the same general symptoms. Pain when menstruating, of passing at some time (with one exception) increased quantities of limpid urine; of being nervous, of having no endurance, inability to read or study continuously; of pains and irritable hearts. These are not

selected cases, nor yet taken from the practice of a specialist in nervous diseases, but simply a feature of general practice.

In an increasing number of our young girls, the sexual development seems to cease soon after the advent of puberty, and instead of mammary glands for the nourishment of offspring, and a broad pelvis for the support of its contents; the sternum is most prominent and the ilii vertical, as in the male. Instead of an inclination to domestic avocations and the cultivation of those traits of character once thought to render them attractive, there is a growing disposition to affect the clothing of the opposite sex and select masculine pursuits.

The ultra "new woman" has not been of spontaneous generation, but she is, apparently, the result of blighted instincts evolved in place of the distinctly feminine emotion, which in childhood attaches the girl as closely to the rag doll as to the painted mechanical wonder, and in womanhood insures the most tender care for the helplessly deformed.

There is some reason to apprehend that the remote cause of our poorly developed neurasthenic girls, is the misguided efforts of parents and educators to make young ladies of children, and mentally matured women of girls, with the inevitable result that many of them will at forty years be parodies on their placid grandmothers of eighty; and there is accumulating evidence. for the belief, that the immediate cause of their breaking down is excessive mental stimulation. In addition to the school pressure allotted to the average girl of sixteen, many of these brain-fagged girls of unbalanced nervous. systems, go at once after school hours, to the piano teacher. Music is called upon to further stimulate the already depressed nervous centers, and their exhaustion is accomplished. The nervously tired stomach craves no supper, and laboriously digests what is forced into it; often embarrassed by the lunches and the excitement of an evening party, a musicale, church festival or a scorching wheel party, each a potent device for wrecking the nervous systems of tired, excitable girls, by excessively stimulating them when exhausted, and occupying time demanded by nature for sleep.

The glow of expectation, and the blanching of anxiety and mental depression, seen in the face, are coincident in time with a vaso-motor disturbances of other surfaces and organs, and indicate a corresponding congestion or depletion of some adjacent or distant organ. The stimulation of any organ means its physiologic congestion; if continuous it becomes pathologic. The constant blanching of an organ like the ovary, results in its starvation, and from either extreme arises the nerve mimicry of uterine disease, for which young girls have been subjected to moral rapes that diseases might be relieved, which existed only in fancy.

What may be expected of the woman, if these organs which determine sex are starved, or morbidly congested, or blighted in the girl. It would naturally follow that the monthly molimen would be atypical, and that the maternal instincts and a perfect female physical, would not be possible for those in whom the origin of these traits was abnormal.

The physiologic defects in the sexual organs result in their abnormal function and mental influence, and the desires, perceptions and intellect are as likely to be masculine as feminine, or possibly held in abeyance. The

sympathetic relation between the mental and sexual organs of the girl is such that she can be neither capable mentally, nor attractive physically, if this dependence is disturbed.

It seems probable that an exciting cause of the female sexual perverts; not the extreme cases, but those barren of sexual and maternal instincts, aspiring to anything rather than to motherhood, seeking marriage for its temporal protection only; is faulty processes of education, and that the popular training of our young girls is inconsistent with the sole purpose of their creation. That girls may become women, in all the term implies, they should be physically, morally and mentally trained, not alone mentally strained. Character and health are the two requisites for motherhood; other traits are accessories, but the popular systems of mental stimulation now in vogue precludes the possibility of either.

Apparently the growing girl cannot mature at once, the dual functions. of womanhood and that degree of intellect demanded from the girls of our finishing schools; either the menstrual phenomena will become abnormal, or the mind will be less acute, or through nervous relations, both will suffer. It is a matter of common knowledge among us, that a profound mental impression will stop menstruation already begun, and a fear of pregnancy may delay it. It has been demonstrated, too, that mental processes produces rhythmic contractions of the bladder, nor is the pregnant womb or bowels exempt from mental influences. There is a clearly defined "mental" dyspepsia, and we now know, what was once a belief only, that death may occur from a "broken heart," not literally of its ruptured muscle, but by the emotions acting so powerfully through the pneumogastric nerves, that death ensues. Long continued mental application under pressure, necessarily increases the circulation within the brain, with the immediate effect that it is overfed, the more remote effects being the overwrought brain, impaired digestion, poorly nourished spinal system and anemic ovaries, typical of the girl for whom the one thought is entertained; the idea that she must be "intellectual,"

No one can doubt that nervousness in school girls is increasing out of all proportion to the increase of population, and it is unfortunately true, that it is a much cultivated vice, but the requirements of any system of stimulation that graduates girls at seventeen, and demands of them that degree of knowledge our higher schools do, will graduate neurasthenics and scholars from imitation and memory.

Well Balanced.-We have received from the MEDICAL FORTNIGHTLY, of St. Louis, an elegant booklet, containing twenty-five half-tone portraits, representing Dr. Frank Parsons Norbury, managing editor, Drs. Work and Hopkins, associates; Charles Wood Fassett, secretary; together with the twenty-one department editors. We congratulate the FORTNIGHTLY for its enterprise, and this enterprise, we are happy to say, seems evenly balanced with literary merit.-N. Y. State Med. Reporter.

The Practical Nourishment of Infantile Invalids.

ONE

BY W. THORNTON PARKER, M. D.,

GROVELAND, MASS,

NE of the most perplexing problems which confronts the physician in the care of the sick, is that of providing suitable nutriment to sustain the patient in his battle for life. More especially is this true in the management of infants and children. Even in those cases where it would seem as if everything which money can obtain were at the disposal of the physician, he is still perplexed to know what is best to employ. We have at the present time a large number of excellent nutriments, some of them possess very decided sustaining properties; but these are not always available, neither are they convenient to prepare, or agreeable to the sensitive taste of little invalids. It has been very truthfully stated, that the very efforts made by physicians to supply suitable nutriment, are proof positive, if proof were needed, that diet is of the first importance in nursing the sick. And yet what physician of experience is not constantly coming in contact with medical attendants who seem to be ignorant or careless in this particular.

So many seem to regard therapeutics as of primary importance, and in their earnest attention to medicinal agents, neglect the more urgent call for rational sustaining treatment. A very large proportion of little patients perish through starvation, or because the nutriment provided for them is not suitable.

At present, I am inclined to give the preference in the treatment of infants, where more or less fever is present to the new nutriment called Somatose. What is equally desirable in a nutrient, is that it shall contain the largest quantity of available food capable of being utilized successfully to repair the inroads of disease caused by the consumption of the tissues of the body, which always takes place in fever.

Somatose is an albuminous food substance, which increases the nourishing properties of cow's milk. "Somatose contains the nutrient elements of meat in a soluble and digestive form, so that they are readily and rapidly taken up into the system of the infant, as well as the lime salts which are absolutely necessary for the growth of the bones; and it has the further advantage, that its addition to milk helps to prevent the curdling of caseine in large firm masses." Somatose should be given in small doses, frequently repeated.

This preparation has won my confidence, in that it possesses decided sustaining properties, and that it does not disturb the stomach, and that it does decidedly recuperate tne patient. It is to be recommended, because it is tasteless and odorless, does not excite repugnance, and its use can be continued for many days. I have used it in cases of diphtheria, scarlet fever, typhoid fever, pneumonia, and in disorders of the intestinal tract, where the question of nutriment was especially perplexing.

My own experience justifies me in agreeing with Dr. Bosse, that in Somatose we have practically solved the problem of infant nourishment.

COMPRISING THE REGULAR CONTRIBUTIONS OF THE FORTNIGHTLY DEPARTMENT STAFF.

OPHTHALMOLOGY

BY J. ELLIS. JENNINGS, M. D.,

SAINT LOUIS