its effects. Englishmen like to use white bread, which, independently of containing less nutritive matter than brown bread, as I have fully shown elsewhere, contains alum. This adulteration is known to make inferior flour, and of a bad color, white, and in appearance equal to flour of superior quality; and, secondly, it enables flour to retain a larger quantity of water, by which means the loaf is made to weigh heavier.-(Hassall.) The bread is also less liable to crumble as it gets stale. Accum, quoted by Hassall, states the smallest quantity of alum that can be employed to produce this white appearance is 4 ounces to a sack of 240 lbs. Dr. P. Markham states 8 ounces to be the usual quantity employed, and Mitchell found in the 4 lb. loaves he examined the amount of alum varied from 34 to 116 grains in each. 114 grains would amount to 20 ounces to the sack.-(Hassall.) In 28 samples of bread in London examined by Dr. Hassall, in all was alum found, in smaller or larger quantities. The injurious effects of alum cannot be too strongly urged. Alum forms with phosphoric acid, as Liebig has shown, an insoluble salt, thus preventing the phosphoric acid from being appropriated to the economy. The blood thus becomes incapable of performing its duty, and hence the child deteriorates, and in the end will die. And herein is the explanation of that frightful amount of disease in pap-fed babies. The phosphoric acid, so essential to them, is lost altogether. The brain and nervous system, the bones are arrested in their development; and hence also the explanation of the great comparative success in bringing up children by hand in the country on home-baked bread, which contains no alum, and which, although of darker color, provides phosphoric acid in an assimilable state to the child. But there is another way in which pap proves injurious. It is, perhaps, more often than is recognized, the cause of death. It has long been known that bread and milk, if given to canaries in any quantity, swells in their stomachs, and thus, pressing against the heart, impedes its action, and is often a cause of death. The same result sometimes occurs in the infant. In a paper published in the 'Association Journal' for February, I have enumerated several fatal cases in which the coroner's verdict assigned over-feeding with pap as the cause of death.

Another fraud extensively practised in London is the large admixture of riceflour in bread. This, I believe, is not generally known; its great whiteness, its great power of absorbing water, are properties peculiarly well known to bakers, and not only ordinary bakers, but many of our hypocritical workhousepoor feeders. I have been informed by a wholesale corn and flour merchant, that there is a species of rice-flour which is expressly kept for the purpose of adulterating bread, and which is largely employed by our London bakers. In this way the nutritive power of the bread is considerably diminished, although the calorifiant power is increased, the proportion of the former to the latter being, instead of 1 to 7, as it ought to be in wheat flour, increased to 1 in 10 or 11, producing precisely the same results in the human frame as those which follow the employment of a diet too exclusively saccharine, viz., scrofula, atrophy, and all its dependences.

Among the vegetable substances, that which comes closest to milk in its composition is, without doubt, lentil powder, or, as it is called for the purpose of obtaining a better sale, Revalenta Arabica, containing both phosphoric acid in abundance and chloride of potassium; it also includes casein, the same principle which is found in milk in its constituent parts. Moreover, its nutritive matter is to its calorifiant matter in the proportion of 1 to 22, milk being in that of 1 to 2. No wonder, therefore, that under its influence many children affected with atrophy and marked debility have completely recovered. I have given it with the very greatest advantage in such cases, and, so far as I may judge from my own experience, I should conclude that practice fully carries out what theory, from a knowledge of its composition, would have led us to anticipate. Lentils have also a slightly laxative effect, and, therefore, in many instances, where the child is of a constipated habit, they are to be recommended. Peas and beans in this respect resemble lentils; the former, however, is objectionable, on the ground that it produces much flatulency. The latter is not generally obtainable; still the bakers take advantage of this fact in regard to the beans, and usually, where wheat by partial germination has

lost some of its nitrogenous aliment, or where the flour used is poor in quality,
they add a proportionate quantity of white bean flour, to restore it to its proper
nutritive value.

The only advantage which another popular ingredient seems to have (I allude
to what is called baked flour) is that it contains a smaller quantity of water,
which has been expelled during the heating process, and in this respect it
comes to resemble more closely, because more concentrated, an animal com-
pound. Moreover, from its greater capacity to absorb moisture, it is somewhat
more astringent, and less likely to produce diarrhoea, which, indeed, it often
checks; but the absence of chloride of potassium and fatty matters in it, both
so essential in growth and all development, is, I think, a great objection to it.
Indian corn flour, which contains much oily matter, is preferable to it for this
last reason. Hence, if given, they should, to supply fat and chloride of potas-
sium, be mixed with milk.

The conclusions to which the present paper leads me are-

1. The analogy of comparative anatomy of warm-blooded animals, and the
special anatomy of a child's alimentary canal, indicate that its food should be
animal.

2. The child should not be weaned, if it can be avoided, before the eighth
month. At this period it may be allowable to give vegetable food, but animal
is better.

3. The vegetable aliment selected should contain chloride of potassium and
phosphoric acid among its mineral ingredients, and a due proportion of plastic
as compared with calorifiant matters, excess of starch being very difficult of
digestion.

4. If pap be given, it should be made with milk, so as to include fat and
chloride of potassium in the compound, and not given in large quantities;
above all, it should not be made with white town-made bread, which contains
alum, and is nothing better than a slow poison.

ART. 4.-Regulation Diet of the Paris Hospitals. By Dr. GEORGE SUCKLEY, late
Assistant-Surgeon in the U. S. Army.

(New York Journ. of Med., July, 1858.)

The following is the diet system of the Parisian hospitals: The aliments are
divided into bouillons, potages, soupes (au pain), aliments solides (solid ali-
ments), and boissons (or nutritious drinks)-namely, wine and milk.

The diet of a healthy man in his natural state is assumed at about 1350
grammes of solid food (about 42 ounces). This, at first, when the general diet
of the hospital patients became systematized, was called one portion; patients
confined to less being ordered one quarter, one half, &c. of a portion.

It was found, however, that the sick were very much dissatisfied at eating
parts of a portion. In consequence, the full portion was divided into four parts,
each called portions; and it was then found that the patients who grumbled
most lustily at being restricted to three quarters of the old portion, were per-
fectly content with three portions of the new standard; although in reality the
allowances were in equal weight.

There have been, however, several alterations in details, and the single por-
tion, as now used, although approximately in direct proportion to the old full
portion, is still slightly varied. This is also the case with the others.

To give a correct notion of the shifting value of the different portions as now
used, it is necessary to go into the following details. But I will premise by
saying, that a patient confined to what is strictly called low diet is only allowed
broth without bread, farina, or vegetables. The fixed daily amount of this ar-
ticle is a quarter of a litre given twice, making in all a half litre per diem.*

A patient allowed a little higher diet has two broths and two soups a day.
The soups contain a little bread or farina, rice, &c. One soup contains a small
trifle more than a quarter of a litre.

When one portion is prescribed it contains: Soup twice a day, a quarter litre

The litre is equal to gall. 0.22.

each time; bread, a quarter kilogramme (about half a pound); meat, six de-
cagrammes (about two ounces); wine, three portions, each containing about
two and a half ounces. This wine is light, red wine, coming from the middle
of France. Milk, three-fifths of a litre daily, boiled. Note.-The wine and
milk may be exchanged for each other, at the patient's option.

Meat varies in quantity somewhat according to the number of portions, but
not exactly. When one portion is ordered the patient is supposed to be weak,
and therefore meat of a better quality is ordered, such as roast beef or fowl.
The same quality is allowed when two portions of diet are ordered, but two
portions of diet do not contain double the quantity of meat that one does;
although a little more than this latter, being seven and a half decagrammes
(about two and a half ounces). Three portions of meat represent twelve de-
cagrammes (about four ounces). Four portions, eighteen decagrammes (about
six ounces); but the meat of the third and fourth portion allowance is boiled
beef. The usual amount of vegetables for one portion of diet is fifteen deca-
grammes (say five ounces); but of the coarser kinds, as potatoes and cabbage,
double weight is given.

With all the portions there is a little boiled fruit or comfiture allowed.

Fish is given twice a week in lieu of meat, and a little more by weight allowed
than of meat. The regular proportion is kept up with everything but meat
and milk. The milk of the hospitals is contracted for by the general adminis-
tration, and is supplied every day fresh and pure.

It is the duty of the chief apothecary of each hospital to analyze this milk
daily, and also to examine it with the polarimeter (sugar deviating the rays of
polarized light).

Four portions of diet complete contain: Soup morning and evening; meat
six ounces a day; bread, a pound; wine, from twelve to fifteen ounces.

No milk (except by replacement); vegetables, twenty ounces; and more
when potatoes, &c., are given.

Extras.-Chop, beefsteak, Bordeaux wine, eggs, chicken, &c., are allowed
only upon a special written prescription of the attending physician. Eggs, how-
ever, are sometimes given in replacement of meat; say one egg to replace two
ounces of meat. The rule of the hospitals is to give meat itself at least four
times a week.

Four portions are not often allowed in the hospitals of the city; as a patient
eating them is supposed to be convalescent, and able to go to the hospital for
convalescents at Vincennes.

A surgeon occasionally allows a patient five portions, but this is done very
rarely.

"The foregoing diet," says Dr. Suckley, "seems to be excellent and liberal
for the usual run of medical patients, but it seems far too little to support
those who are being rapidly weakened by excessive and long-continued sup-
puration.

66

'We misguided Anglo-Saxons think that patients in this condition crave
and often require a much more considerable portion of food than men in a
healthy state. This is to compensate for the drain of the suppuration. The
stomach comes to the rescue of the poor suffering system. Should we not, they
ask, put into this stomach what it demands? The building-up treatment of the
English, or of our surgeons at home, casts far into the shade even the apparent
prodigious allowance of five portions, by the French surgeons."

ART. 5.-Observations on excess of Diet as a cause of Disease, and on its connection
with a hitherto unrecognized hypertrophic condition of the Lungs. By Dr. REN-
NIE, R. A., Surgeon to the Convict Establishment in Western Australia.

(Proc. of Med.- Chir. Soc., June 8, 1858.)

In this paper the author states that he was first led to an investigation of this
subject on entering upon his duties as surgeon to the Convict Establishment at
Freemantle, in June, 1853, by noticing a remarkable prevalence of cutaneous
eruptions and other affections which were entirely confined to the convicts, the
explanation of which he discovered in their excessive diet, which consisted,

amongst other articles, of 27 ounces of bread, 16 ounces of fresh meat, daily,
some of the men being allowed even more, and each prisoner having also a
daily allowance of ounce of tobacco. It was noticed, that the reconvicted
prisoners, who had less diet and no tobacco, suffered far less than the general
body of the prisoners. It appears that defective means of restraint was, in a
great measure, the cause of this great allowance of food being continued by
the convict authorities, on the ground that it facilitated their control by moral
force. In December of the same year, ophthalmia and dysentery began to ap-
pear, and these, too, only among the prisoners, for the most part taking the
place of the cutaneous diseases, and leading to the inference that they were
mere local varieties of a general constitutional disorder, and, in most in-
stances, were cases of pure metastasis of the cutaneous eruptions. The troops
and population generally were entirely free from these complaints, so that
there could be no reasonable doubt that they originated in the diet being in
excess of the systemic demand; and it must be borne in mind that from
October to May the temperature in Western Australia is almost tropical.
Under these circumstances, he (Dr. Rennie) made strong remonstrances on the
subject; but the convict authorities being unable to comprehend the scientific
principles involved in the adaptation of diet to climate, and taking as a prece-
dent the very large diet given in the English prisons, as well as being strongly
prepossessed against any reduction of the scale on disciplinary grounds,
received his suggestions unfavorably. The result was, that during the year
1854, with a daily average of 706 prisoners, 2921 cases of sickness occurred,
of which 1058 were treated in the hospital. Another urgent appeal was then
made by Dr. Rennie, in which all the scientific bearings of the subject were
fully discussed; and though the conviet authorities still continued to oppose
his views, Governor Fitzgerald ordered a medical board for the consideration
of the question. This board, of which the principal medical officer was presi-
dent, completely bore out the correctness of Dr. Rennie's objections to the diet,
and recommended a gross weekly reduction of 136 ounces. The reduction
scale came into force on the 1st of June, 1855, and the results proved increas-
ingly satisfactory, as there was abundant evidence by statistical tables to show.
Dr. Rennie having arrived at the conclusion that the immediate cause of dis-
ease amongst the convicts in this colony was an excess of food operating on
men with impaired constitutions, and consequently with impaired powers of
digestion, devoted himself to an inquiry into the physical cause, which he felt
satisfied was developed previous to their arrival in that colony, and succeeded
in identifying it with a hypertrophied condition of the pulmonary parenchyma,
and a remarkable adherent state of the abdominal and thoracic viscera, gene-
rally unaccompanied by tubercular deposition, or any indications whatever of
previous inflammatory action, and leading him to believe it to be a pure form
of hyper-nutrition. The proofs and evidences which led to this conclusion
were entered into at great length, as also the appearances, which, with few
exceptions, were found in upwards of eighty post-mortem examinations. The
portions of lung found most hypertrophied were the upper part of the right
lung, and the lower portions behind. The lung-tissue in these parts resembled
the appearance described by Laennec as carnification, and at first the condition
was viewed as one of chronic pneumonia, but this was disproved by the fact
that it was present in nearly every case, and also that, almost without exception,
the men so affected never had been, and were not at the time, affected with any
symptom of chest-disease. Dr. Rennie, therefore, attributed these abnormal
symptoms and appearances to the prolonged operation of a diet too bulky and
nutritious for the peculiar circumstances (hot cells and sedentary occupations)
under which the convicts are placed during the earlier portions of their
imprisonment in England. As the question has naturally presented itself as
to whether these extraordinary appearances were developed before or after the
prisoners landed in western Australia, and with the view of ascertaining the
condition of the respiratory organs, Dr. Rennie availed himself of the oppor-
tunity of examining upwards of fifty men immediately on their coming to shore,
and in almost every case found a marked difference between the capacity of
the two lungs for containing air, the functions of the right one being almost

invariably most defective. In most cases there was, in addition, a general absence of healthy respiration, and, curiously, the more so in those men who had previously been totally free from chest-diseases. All this, Dr. Rennie thinks, strikes at the root of the whole dietetic system pursued during the earlier period of their confinement in England; the state of these convicts with respect to sickness contrasting strongly with that of the inmates of the military prison, who have a simple, wholesome, and yet ample diet, and plenty of exercise in the open air; whereas the convicts, during the first twelve months of their imprisonment, are shut up like hot-house plants in a warm cell, employed at a sedentary occupation, and placed on a diet double that allowed to the military prisoners.

ART. 6.-On the Death-rate of London. By the REGISTRAR-GENERAL.

(Weekly Return of Registrar-General, June 27, 1858.)

The following extract requires no comment of any kind.

"Man was made to live a definite time and to experience an average rate of mortality. But the natural lifetime has not been revealed to us, and the circumstances of no city are such as to give us an opportunity of determining the average mortality of a people living under the most favorable circumstances. We cannot, like the ancient writers, refer to a model republic: we cannot point to a single town in England on the slopes of some of her hills, looking southward over fertile fields or distant seas; bathed in a pure atmosphere; supplied with a river of water of life, clear as crystal;' with no impurities resting in its houses or streets for a single day; occupied by a people fed on fruits, grain, meat from healthy places, and leading an active, good, intellectual life. No such city has ever been projected, and is certainly not shadowed out by the watering-places of our own, and still less of other countries.

"Hence, the only standard to which we can resort is derived from the least unhealthy districts of England. The mean lifetime of the people in those districts is forty-nine years; and the mean annual rate of mortality would be 20 in 1000, were it not that the increasing population gives them an undue proportion of young and middle-aged people, by which the proportional number of deaths is reduced to 17 in 1000.

"To apply the standard to London. The population consists now of about 2,721,000 persons; they are of all ages; but upon comparing them with the comparatively healthy districts the proportion of young children under five years of age is the same; before the age of 15 is attained the London children are greatly reduced in number by untimely deaths; at 15 to 25 immigrants restore the lost numbers, and from the same source the men and women of the ages from 25 to 45 grow into a great excess; at the ages of 45 to 55 the proportions are the same; after the age of 55 the excessive mortality in London speedily reduces the numbers: the old people, who naturally experience everywhere a high rate of mortality, are not in due proportion in the population of London. By applying the ascertained rates of mortality in the sixty-three comparatively healthy districts, it is found that the annual deaths-if the chances of life were the same in London-would be 41,668 on the above population, or at the rate of 15.32 in 1000 annually.

"The weekly deaths in London on the above population in such a state of health as is actually experienced in those districts would be 799 on an average. "The actual rate of mortality in London during the last ten years exceeded 24 (it was exactly 24.46) in 1000, which implies 1275 weekly deaths, or 476 above the healthy average.

"In the last week 1092 persons died in London, or 293 persons in excess of the healthy average. That 293 persons died unnatural deaths during the week is the finding of this great inquest.

"What were the causes of these unnatural deaths? The people of London live as well as the people of the sixty-three districts; and they now suffer nothing from cold. Many drink spirits to excess. Too many sleep in the same rooms; and, as in our barracks, this destroys large numbers. Crowding in