although it contains about four per cent. of sugar, can often be taken without harm, and sometimes with positive benefit. The patient will therefore see how necessary it is to know exactly what articles of diet to avoid and what to take. The diet ordered by the doctor will be chiefly composed of meat, fish, and fowl. Most vegetables are injurious, but green vegetables, such as cabbage, spinach, and cauliflower, are not hurtful. Ordinary bread, and all highly farinaceous articles, must be avoided. Instead of ordinary bread, the patient should take diabetic bread, bran cakes, or almond rusks, or he may bread in very thin slices, well toasted. In the matter of drink, the patient must be equally attentive to the directions given him. If an alcoholic stimulant is taken, it must be in small quantities, and those forms must be selected which contain least sugar, as dry sherry, bitter ale, brandy, whisky, well diluted claret, and Burgundy. Tea and coffee must of course be taken without sugar. DIET FOR THE OBESE. take Many doctors will strongly oppose what is known as Bantingism. This well-known system consists chiefly in freeing the diet from all fat-forming materials, and making the consumption of lean meat practically unlimited. That this plan succeeds, in lessening the bulk of those who adopt it, there can be no doubt, but it is open to this objection. The taking of such large quantities of albuminous matter is dangerous in many cases, inasmuch as it throws more work upon the kidneys than they are able to accomplish without sustaining injury. It may, therefore, produce renal disease, or gout, if persevered in. In place of rigid Bantingism, a diet should be substituted from which fat is excluded, together with such fat-forming materials as potatoes, etc., whilst a large quantity of such vegetables as lettuces, cabbages, spinach, etc., are taken, and a moderate quantity of lean meat or white-fleshed fish. In all cases of obesity, the diet must be regulated according to the idiosyncrasy of the patient. Exercise is one of the most valuable means employed for reducing fat. It is quite as important that all the medical man says about hygienic arrangements should be taken particular notice of, as that the subject of diet should receive close attention. It is notorious that neglect of hygiene is one of the most common causes of disease, and therefore it must be necessary to pay great attention to this matter in the treatment of disease. AIR. As an example of the ills following from bad hygiene, may be quoted the effect which bad air has in the production of consumption. Tailors, and ther men working at trades which keep them in a close atmosphere, suffer from this disease terribly. Dwellers in towns more than those who live in the country. The labourers in country districts are comparatively free from consumption, whilst their wives, who, unlike them, are rarely in the fresh air, but live in the confined atmosphere of their small cottages, suffer far more from it. The presence of floating particles in the air has a great influence on the prevalence of this disease, apart from whether such air be close-that is, overcharged with carbonic acid gas. Consumption is induced in coalheavers and bakers to a great extent by the irritation caused in the lungs from the constant introduction of small atoms of irritating matter. From what has been said, then, it is evidently most important that a consumptive patient should have plenty of air in which there is a large quantity of oxygen, and which is at the same time free from irritant particles. Such a patient may make a good recovery if these matters are attended to, who otherwise would go from bad to worse, let his medical attendant be the most able in the world, and the drugs furnished him the best that could be procured. And if pure air is so powerful a means of treating such a formidable disease as consumption, it can well be believed that it is able to accomplish great things in less inveterate complaints. It is a most important factor in the treatment of almost all pulmonary complaints, of dyspepsia, nervous affections, and many other diseases. LOCALITY AND CLIMATE. Directions are often given by the doctor as to the locality and climate in which a patient should reside, and this is a subject worthy of serious consideration. The dampness or dryness of the subsoil, as is well known by everyone, has a great effect upon the health. One of the most noteworthy examples of this fact is seen in what followed upon the drainage of certain towns some years ago. It was found that where the sanitary improvements had the effect of producing increased dryness, there the death-rate from consumption diminished, and this diminution was sometimes quite astounding. It in certain instances amounted to as much as 40 per cent. On the other hand, it was observed that where the sanitary improvements did not produce dryness of the soil, there the death-rate remained unaltered. The mortality from diphtheria, scarlet fever, and other acute diseases, is said to be greatly influenced by the dampness of the soil, and statistical investigations appear very often to prove this. The prevalence of rheumatic fever is also influenced by the same condition. Not only does the character of the soil materially concern the patient's health, but the degree of elevation, the temperature, and many other things, have an important bearing on the same. Elevated districts have been found most beneficial as places of residence in certain cases of consumption. Soft, warm temperatures suit many cases of chronic bronchitis, whilst a cool and bracing climate will often be found of great advantage in nervous affections. Warm temperatures frequently produce excellent effects in kidney disease, especially if combined with sea air; on the other hand, dyspepsia is often much ameliorated by a residence in a bracing locality. EXERCISE. The doctor's directions on the subject of exercise will vary very much according to the age, sex, constitution, and health of the patient. Frequently, it is necessary that those who dislike exertion should take a regular and increasing amount of exercise daily. For instance, numbers of people of bilious or gouty constitution are so largely engaged in sedentary work that, without some inconvenience to themselves, they are often unable to take the needful amount of exercise. The reason why exercise is so necessary in these cases is, that by its means the chemical change called oxidation proceeds much more quickly in the body, and thus the waste matters in the blood are more or less burnt up and got rid of. The action of the diaphragm,* too, has probably a good effect by the pressure which it exerts upon the liver and bowels during exercise. A large amount of exercise (by no means necessarily violent) combined with a strict regimen and an occasional purgative, may free the bilious The muscular partition separating the chest from the abdomen. |