d.i.c.kinson (ibid., chap. VI.): "There are few disorders which are more under the influence of medicine than is the catarrhal inflammation of the kidneys." And the very next sentence is one worth pondering on by those who are accustomed to take medicine whenever they come to grief through ignorance or neglect of the laws of life: "Under some plans of treatment,"

says this celebrated authority, in continuing, "plans which formerly were almost universally adopted, and _still have their advocates_, the disorder is one of heavy mortality. Under other circ.u.mstances the danger is so small, that if once the complaint be recognized, a recovery may be reckoned upon in a large _proportion_ of cases. Without treatment of any kind there is reason to suppose that a large _majority_ of the subjects of it would recover." (The italics are my own.) From this it will be observed that it depends on one's luck whether he shall fall into the hands of a pract.i.tioner who belongs to a cla.s.s still adhering to the plan ensuring a "heavy mortality," or of one whose modified form of treatment is less fatal; and upon his good sense, whether he shall come under the influence of either, or adopt the methods indicated herein, viz., the abandonment of disease-producing, and the adoption of _ease_-producing, habits, which would be an immense gain over the "no treatment" plan which, according to a rational interpretation of Dr. d.i.c.kinson's language, is the safest of the three referred to by him. From the three-hundred-page treatise before me, which is fresh from the mint (1881), and is a most valuable book for those who wish to study the pathology of the disease (Bright's), but which is little calculated to aid any one healthward, except he be already pretty well informed in hygienic matters, I cull, in addition to the paragraphs already quoted, the following little nugget of pure gold: "We must avoid the use of any drugs which, under the name of stimulating diuretics, might exasperate the existing congestion; and we must enforce such diet as to reduce to a minimum that nitrogenous excess which finds its way out chiefly by the kidneys, and provides in many shapes effective means of irritation. Physiological repose is to be sought, not by debarring the gland of the harmless and necessary solvent, but by cutting off the materials of urea and uric acid." How naturally, then, do we look for the continuing sentiments: "'Spare diet and spring water clear' may often be found sufficient though simple remedies. _Of all diuretics water is the best._"[45] But how can we reconcile, with such counsel, the treatment that he himself commonly adopts?

[Footnote 45: Ibid., p. 86. The italics are my own, and I am amazed to find that this best diuretic is rarely the one used, and never fairly tested by this authority, who seems almost to exhaust the _materia medica_ in the treatment of even infants of tender age.]

In one case noted by him, and in which, as he says, "the attack was slight," and "the boy became convalescent," but later, although under the doctor's own eye at the hospital, with "no evidence of his having taken cold," he became worse, went on to a fatal termination, "the urine becoming loaded with alb.u.men and abounding with fibrinous casts--convulsive attacks--death!" It seems to me easy enough, however, to reconcile the unfavorable turn and the fatal termination with the treatment he adopted, viz., digitalis instead of "the best diuretic"

(water); "fluid diet," consisting chiefly of beef-tea--a non-nutritive fluid whose solid const.i.tuents are mainly urea, kreatine, kreatinine, isoline, and decomposed haematine, exactly the animal const.i.tuents of the urine, except that there is but a trace of urea.[46]

[Footnote 46: London _Lancet_.]

As the little fellow grew worse, "a little brandy was given to counteract the depressing effect of the digitalis." "On the 27th, the pulse had fallen to 52, and was not quite regular; the brandy was therefore increased to two ounces daily," with digitalis every six hours; later, a "diuretic draught composed of scoparium, acetate of potash, and nitric ether; on the 29th, this diuretic mixture was changed by the addition of nitre and squills; on the 30th, as was antic.i.p.ated, he was seized with eliptiform convulsions, a succession of which came on, accompanied with foaming and biting of the tongue, and caused his death in two hours and a half."[47] The next case reported was that of a child eighteen months old, treated at the hospital by the same physician, and described: "Dropsy--persistent diarrha--peritonitis--death." "The child," says the celebrated pract.i.tioner and author, "was frequently fed with pounded meat and milk; a little brandy was given, and opiates and astringents were prescribed to check the diarrha." As he went on to his fate, he was made to swallow the following remedies: "opium, dilute sulphuric acid, tincture of the sesquioxide of iron, acetate of lead. The quant.i.ty of brandy was increased to three ounces daily. The child became paler and had a sunken look," etc. "The child sunk a week after admission." I make mention of these cases for the reason that up to this day the same horrible treatment is being practiced. Although these, and many even worse cases contained in this new work, transpired some years ago and were recorded in the first edition, still they remain in the new edition unaccompanied by any note of warning; and young or old medical students pore over and imitate the examples here set before them.

[Footnote 47: The case of Thomas Vallance, 9 years old. Oh, wise physician: the fatal symptoms came along "as antic.i.p.ated!"]

I quote another paragraph from the treatise of Dr. d.i.c.kinson, which, if it has, as would seem evident, thrown little light about the doctor's own pathway, as regards the appropriate treatment of the disorder, will prove instructive to some of my readers, and bear favorably upon my theory of disease. In the early pages (p. 29) of the treatise, Dr. d.i.c.kinson says: "It may be generally stated that this inflammatory disease arises from unnatural stimulation of the kidneys. The blood is charged with [food]

material excessive in quant.i.ty or unnatural in quality, which these glands take upon themselves to remove. Their own proper elements of secretion are poured upon them in sudden and excessive amount, or matter is thrown upon them which is foreign to their usual habit. As a consequence of overwork, or of work to which they are not adapted, they take on a turbulent and abnormal activity. They become congested, the tubes get choked up with epithelial growth, and the disease is established."

Many of the symptoms in the following list are more or less frequently, some of them invariably, present in the case of supposably healthy infants, and are commonly considered as entirely normal. Fairly considered, however, they are the effects of excess in diet. To the greatest possible extent the superfluous water contained in their gross diet pa.s.ses off by the kidneys, causing immediately a diseased condition of those organs from overwork; the cellular tissue becomes loaded and distended with the fatty matters, and also with much water, unrecognized as dropsy until it reaches immense proportions; what really amounts to purging is so universal as to be regarded as the normal state of an infant's bowels, and this is, sooner or later, often very early, succeeded by the reaction termed constipation. The back-aching that results from all this is none the less terrible because the little sufferers can not talk and tell where the pain is; peevishness, general _malaise_, and crying, tell of suffering, not of (their) perversity. Among the

SYMPTOMS OF KIDNEY DISEASE

are the following: frequent and copious micturition (wetting the bed or getting up at night); later the excretion of urine is scant, pa.s.sed frequently, or, may be, suppressed altogether. Fat; later--emaciation.

Heat and dull pain in the loins[48] (small of the back), increased by pressure; slight or considerable "puffing" about the eyes, noticeable only at times, or it may be constant and unrecognized as a symptom of disease; it may be diminished at times, as the secretion of urine becomes modified, or the condition of the system happens, temporarily, to improve. And it increases often when the secretion of urine diminishes, or is pa.s.sed less freely. The countenance is more or less pallid, and may have a brownish tinge. Croupy breathing accompanies dema of the larynx. "With children, inflammation of one or other of the organs of respiration is the most fatal tendency of the disease. Not only are they liable to pleurisy, pneumonia, and bronchitis, but, also, to membranous croup." Constant tendency to irritability of manner, easily angered, unreasonableness, petulance; with infants--constant fretting, crying, nothing will interest or amuse them.

[Footnote 48: Of all portions of the body, this should be lightly covered, never sweltered with wraps, bindings, or weight of garments.]

Diphtheria is, I believe, only a phase of alb.u.minuria. Says Dr. Grasmuck, treating of diphtheria, and other physicians have observed the fact: "Another peculiarity of the scourge is its fondness for children of a certain condition--the fat, sleek, soft, tender, 'well-fed' children so generally admired--such children can offer but slight resistance to this disease; being, in fact, chronically diseased, they are predisposed to 'attacks' of all kinds; and, living to adult age, furnish the greater proportion of cases of tuberculous disease. On the other hand," he continues, "I do not know of a single instance where the disease proved fatal to--rarely attacking--a child of the _genus_ 'Street Arab'--children who spend most of their time out of doors, are thinly clad, sleep in cold rooms, have a spare diet, and who have no one to pamper them unwisely."

Dr. d.i.c.kinson treats of alb.u.minuria under three heads, viz., tubular nephritis, granular degeneration, and lardaceous disease. He designates, also, such other diseases as are likely to result in consequence of this disorder; and finds some of these peculiar to, or more apt to afflict, sufferers from one or the other forms. He says: "It is seen (from the table presented) that nephritis is a disease of infancy and youth, causing most deaths in the first decade coincidentally with the prevalence of scarlatina; many in the third when the toils and exposures of active life are perhaps the most prolific of evil. Granular degeneration belongs to middle and advancing life, and is most fatal between fifty and sixty. The one flourishes upon the febrile accidents [!] of childhood and the susceptibilities of youth; the other develops when _the habits of life begin to tell_ and the effects of old age begin to appear. The lardaceous disorder has little to do with either extreme of the mortal course; it is chiefly a.s.sociated with the _vices of early maturity_, and with tubercle and struma, disorders more incident to the young than the old, and in their suppurative form to youth rather than childhood." Among the diseases resulting, or likely to result, from one or other forms of the disease, Dr. d.i.c.kinson names the following: dropsy, pneumonia, pleurisy, peritonitis, bronchitis [before mentioned]; pericarditis, endocarditis, hypertrophy of the heart, with cardio-vascular thickening, [heart "diseases"]; hemorrhagic accidents [bursting of blood-vessels--apoplexy]

depending as they do upon structural changes of the vessels; diarrha.

SOME OTHER SYMPTOMS.

Nasal catarrh; the radical suppression of this discharge is likely to be followed by serious if not fatal kidney disease.[49] (To remove the former by removing its cause, thus rendering the discharge unnecessary, is quite another thing). Hence the danger of using so-called catarrh remedies, or of adopting any specific local treatment: they are either inert or injurious.

[Footnote 49: As ill.u.s.trating this point I will mention the case of M. K., of Troy, N. Y.,--a case of successful (?) self-treatment for catarrh. This patient had for a dozen or more years suffered with nasal catarrh, and had tried most of the advertised "specifics" without avail; in fact, the disorder steadily increased. At last, the twice daily snuffing of slightly soapy water, for some weeks, "cured" him, as he said; but simultaneously with the suppression of the catarrhal discharge there resulted (without, however, any thought of connecting the two events, in the mind of the patient) an excessive flow of urine, extreme thirst, etc., etc.; in short, true diabetes. In this case great relief was experienced from an exclusive diet of skim-milk for five months, the patient swallowing nothing else for that length of time, except two tablespoonfuls, daily, of wheat-bran thoroughly chewed, "for the bowels." At the end of the five months the patient weighed 210 lbs. This he realized as excessive, and my attention being directed to the case at this point, the patient at my suggestion adopted the bread and fruit diet--discontinuing the skim-milk and bran--and gradually reducing his weight by moderate diet and increased exercise, went on to a complete recovery.]

Erysipelatous inflammation of the dropsical limbs; "vomiting may happen at any stage, even the earliest; it is often incontrollable." Head symptoms, which occur in the more prolonged forms of the complaint, are usually of a convulsive kind, whereas, in acute cases, coma is apt to set in without any such prelude. Epileptic seizures may be preceded by pain in the head, drowsiness, or peculiarity of manner, or may occur without any premonitory sign.

Says Dr. d.i.c.kinson: "The gouty habit, from whatever circ.u.mstance it arise, is one of the more obvious and immediate conditions to which granular disease of the kidneys can be traced." ... "The disease is a frequent result of gout; this is by far the most important fact in its etiology. It is one of the results of the gouty diathesis (see Rheumatism), and may precede or follow the external manifestations.... It is scarcely necessary to insist ... that the gouty condition comes first." The fact is that there is a process of degeneration going on throughout the entire structure of the man, even to the last tissue, and the symptoms are all indicative of this; and this is more or less strictly true of all disorders. The naming and cla.s.sifying of "diseases" is calculated to mystify and mislead: sickness is the proper term for describing them all; self-abuse, in the broadest sense of the word, is the cause of them; and obedience to law, the only means of prevention or cure.

I hold that the gouty, the rheumatic, the strumous, the "colds," and all other diatheses, are practically unimportant distinctions. The technical difference is, of course, well understood and admitted. In any event, it is certain that the course of living best suited to prevent one, is also best adapted to prevent or remove all. For all practical purposes, however, they may be cla.s.sed together; and whoever desires, either for themselves or their children, exemption from, or the alleviation of, suffering, have only to adopt a pure mode of living in order to escape, or emerge from, the _disease diathesis_.

NOTE.--The limits of this work forbid an extended consideration of the influence of this or that occupation in promoting this disease; nor is it, in my estimation, essential. The trades must go on, regardless of their influence upon health. There must, for example, be painters, plumbers, compositors, tin-workers, etc., even though the absorption of lead does tend to produce the gouty condition and, so, a predisposition to renal disease.

A sufficient degree of care in other directions would enable this cla.s.s to outlive the more favored ones who neglect the laws of life.

See note 2 in Appendix, p. 276.

CHAPTER VI.

INSOMNIA--INSANITY.

Sleeplessness is often referred to as a cause of insanity, but it would be much nearer the truth to say that insanity causes sleeplessness. Dr. Rush says: "A dream is a transient paroxysm of delirium, and delirium a perpetual dream." Not every dreamer becomes insane, in the common understanding of the term, nor every person who is distressed by wakefulness; nor do all those persons who dream dreams of a strange, droll, startling, heart-rending, exhausting character, become inmates of lunatic asylums, although all such are fit subjects for a rigid hygiene; and not a few out of this large number of bad dreamers--who are likewise afflicted with insomnia--but could with advantage place themselves under the charge of an expert in diseases of the brain, or even in an asylum, if either the former, or the physicians in charge of the latter, were in all regards thoroughly equipped for their work--a rare circ.u.mstance indeed.

Normal sleep is dreamless; in default of this total oblivion, sleep is only partial--it is not perfect nervous repose. No person who suffers severely from indigestion but is also troubled with much dreaming, and, more or less, with wakefulness; and no person who has these last-named symptoms but can safely set them down; at least in great measure, to digestive disorder; and as, almost invariably, removable by improved habits.

Some very wise men have stated as their belief, that no man living is really of sound mind, any more than of sound body, in the strictest application of the term; all have their crazy aspects--their "weak spots,"

as we say; and the anxious, brooding man, who fears the loss of his reason, may take courage from the thought that his symptoms are only a little worse than his neighbor's, and only demand of him to diminish his dyspepsia if he would become normally insane! To attack insomnia as a disease instead of a symptom, is sure to result in discomfiture in the great majority of cases, and is in every instance unsound in principle.

Once established, this condition of wakefulness tends to perpetuate itself; but this would be otherwise with an absolutely natural regimen. A man is wakeful at night because under his present physical condition he ought to be--just as in diarrha, the looseness is doing its work of cure.

So with all symptoms. _Pain_ has its office, and this is coming to be better understood; is already well known to thoughtful, well-informed people; and the _wakefulness_ of which so many complain, and which, in some cases, is of the most distressing, painful character, is as truly normal, considering the present physical state of the sufferer's brain, as is pain following a cut. As an aid in the removal of this symptom, next to a radical reform in one's living habits, which is the only possible cure for the disease, the above reasoning is one of the most effectual.

When a man is wounded severely his anxiety is not increased by the pain; it causes no additional alarm, because he knows that it is entirely natural; let him know that sleeplessness is an a.n.a.logue of pain, and he will, or may, bear it philosophically, and thus tend to its removal. He has a poverty-stricken mind, indeed, who can not, under such circ.u.mstances, pa.s.s an hour, or several of them, in comparative comfort, knowing that sleep will come in good time. But, thinking all the while that it is sleep only that he needs, his sleeplessness distresses him, causes him to be more and more alarmed, and, consequently, has the effect to postpone the oblivion so devoutly prayed for, but so little earned. To _deserve_ sleep is to _have_ it. Let the insomniac read the concluding article of this volume, and by the light of it review the hints on diet, air, exercise, etc., in the body of the article on consumption, so as to know what he has to do to become a _good man_, physiologically; and go to bed at about the same hour every night, if possible, or at any rate when he does lie down to sleep it should be after a quiet hour or half-hour devoted to peaceful and thought-steadying occupations, never exciting mental exercise, whether amusing or instructive; and when he draws the blankets about him, let it be with a sublime indifference as to whether he shall or shall not go to sleep promptly. "As to the subduing of the senses, the attempt to shut out external impressions by deafening the ears, closing the eyes, and lowering the sensibilities generally, is in itself a frequently recognizable and always possible cause of persistent wakefulness. The effort to compose the mind (after lying down) and subdue the activity of the senses is made by the higher mental faculty, a part or function of the organism which, of all others, needs to be itself restful in order that the physico-mental being may sleep. It is, therefore, obvious that an _endeavor_ to go to sleep is a mistake."[50]

[Footnote 50: J. Mortimore Granville, M.D., in _Good Words_.]

Rather let me, when staring out into the darkness,--for to attempt to shut out the sense of sight by closing the eyes is always to render the inner-mental sense increasingly acute: "the field of sight is soon crowded with grotesque and rapidly changing images--a phantasmagoria, the worrying effect of which is only a too familiar experience of the sleep waiter,"

and all the mental senses are in like manner stimulated, and their acuteness intensified, by the endeavor to lower the sensibility of the sense organs; and, worst of all, to narcotize them with drugs or sleeping-draughts is irrational and its effects injurious, and if long continued, fatal;--rather, I repeat, having ears to hear, let me hear, and eyes to see, see; and a brain, let me think. Let the brain, the ears, and the eyes "forget their cunning," only when the eyelids droop in sleep because I am sleepy. Meantime, not self-abasingly, but calmly and dispa.s.sionately, would I philosophize thus: Well, I am in for it again! I would like to sleep promptly, soundly, and long; why do I not? I suspect that I am not running this physico-mental machine even in a fairly physiological manner; I cause it to run at an abnormal rate during the day, and keep up intense mental excitement through stimulation of one sort or another, prolonging excessive mental activity too far on toward the night; and because of this, and the lack of a fair degree of muscular exercise, I only half breathe; of my fifteen or sixteen inspirations per minute, not one distends the air cells of my lungs to half their capacity.

[Thus it transpires that the organism suffers in two ways, viz.: (1) the circulation is not sufficiently oxygenated for its general purposes; and (2) the waste matters are not "_pumped out_" of the substance of the brain,[51] as effectually as need be]. My coffee was strong and nice this morning; it stimulated me very satisfactorily throughout the day; and, what I had not bargained for, I am still feeling the spur (see article on Coffee). That new brand of cigars is exquisitely flavored; but, upon the whole, a perfect night's sleep would be far more exquisite; at least, just now I am in the mood to think so. I sneered at that food-reformer who told me he was never a good sleeper until his present simple, natural habits made him so; but now, just at this moment, it seems as if it would be a good trade to exchange some of my favorite dishes for coa.r.s.e food and balmy sleep! Oh, if I only could get "balmy" that way every night! I "got the best" of ---- yesterday morning on those ---- stocks, and spent an hour, bent over my desk, figuring to see how I could get hold of some more at that price, before its holders had time to ascertain its real value. I will tell the widow ---- in the morning, what it is worth, instead of trying to buy hers under-price as I contemplated doing. And so I would con over and look through myself and my habits, feeling sure that my eyelids would droop, and sleep would come before I should have completed the work of reform; and I am sure that every sufferer will find that a real reform--a permanent reform--will unfailingly lead on to _health_, and so to sweet and satisfactory sleep.

[Footnote 51: "As stimulation of the brain causes dilatation of its vessels, and increases the flow of blood through them, mental action of itself not only attracts more blood to the brain, but provides to some extent for the removal of waste products. Hence sleeplessness is normal for a clogged brain. The movements induced by the cardiac pulsations are not so extensive as those caused by the respiratory movements or by muscular exertion, and therefore, when the brain is overworked and the respiratory and muscular movements are restricted, the cerebral nutrition will be diminished by the imperfect removal of waste from its substance.

But if, in addition to this, the cerebral cells and fibers are actually poisoned by the circulation within the vessels which supply them, of noxious substances due to imperfect digestion or a.s.similation, matters will become very much worse."--T. L. BRUNTON, M.D., F.R.S. (ibid.)]

"Let no sleepless person be discouraged. Maintain hope under all circ.u.mstances. Remember that there are many worse cases of suffering than your own in the world, although to you it seems impossible. Keep up your general health by all sanitary means possible; walk much in the open air, if you can walk; ride, if you can not walk. Above all measures, keep the functions of the skin in prime condition; cleanliness is antagonistic to sleeplessness. Dry friction over the body by the use of the hand, or better by the use of the French hair mitten, twice a day, we have found of great service. The air-bath should not be neglected. A few minutes after the employment of friction over the body, walk about without clothing in a cool room, and if possible let the sun strike upon the body. Do not remain uncovered too long, so as to become chilled. Keep the digestion good; eat only such forms of food as suit the digestive organs. Surround yourself with cheerful company if possible, read such books as do not tax or weary the mind, and life will cease to be a burden, even if you do not sleep as others do. Avoid above all things constant dosing; throw into the ditch, or into the sea, all nostrums that may fall into your hand."

Comparatively few, even of the so-called hopelessly insane, but might in the early stages of their disease be completely restored; and at any period, so long as there is great vital force, or what would commonly pa.s.s for robust physical health, no case need be set down as hopeless. But while the present system of treatment prevails (it is not worthy the appellation of "system,") the present small proportion of "cures" will continue to be the rule. The inmates are confined more or less closely, often in imperfectly ventilated apartments, deprived of the exercise in the open air they so much need, to the lack of which in their own homes is, in part, attributable their present condition; they are fed generously, even to plethora; and this, through the fault of the ignorance of their attending physicians, although, if these were wise enough to know when and how their patients needed "dieting," the friends of these sufferers would never submit to anything bordering upon a strictly abstemious diet in their treatment. In visiting lunatic asylums in this and other countries, I have been struck with the appearance of groups of patients--the similarity of their _physique_, as compared with the men and women seen on our streets every day--fat or lean, seldom medium--all exhibiting clearly the physical characteristics of disease, as emaciation, obesity, lack of, or ravenous, appet.i.te, usually the latter. Meal-time comes every five or six hours, and if the appet.i.te is good, all are permitted to eat very much in excess of their needs; they are urged to eat when they desire to fast; and food is forced into their stomachs if they are inclined to abstain for any length of time. It is not uncommon to find patients who upon entering an asylum begin to fatten, though already in an abnormal condition in this regard, their symptoms becoming more and more discouraging as their weight increases, although neither physician nor friends connect the two facts in any way. The latter feel thankful that "poor dear J---- gets enough to eat!" In this connection I introduce an incident of recent occurrence, not as indicating that a compulsory fast for an extended period should be resorted to generally, nor my own belief that it is a specific for all mind-troubles, by any means, but as a fact of great significance which all interested in this question may well pause a moment to contemplate.

[Dispatch from Philadelphia to the New York _Herald_].

TANNER'S RECORD BEATEN.

AN INSANE ASYLUM PATIENT ABSTAINS FROM FOOD FOR FORTY-ONE DAYS.

One of the most extraordinary cases of an insane man attempting to restore his reason by voluntary starvation was discovered recently at the ---- County Insane Asylum. The case presents an interesting study for medical men generally. ----, aged forty years, a well-known resident of ----, who has been confined in the inst.i.tution for the last two years, has abstained absolutely from all food except water, for the s.p.a.ce of forty-one days.

From the forty-second day of his fast until the fifty-first day he drank one pint of milk daily, and from then began eating strawberries and milk.

This diet was maintained for three weeks, and was then succeeded by oatmeal gruel and milk. The case is a matter of careful record at the inst.i.tution and under circ.u.mstances that prevented deception. Therefore, there is not the slightest doubt as to the extraordinary performance having been genuine. Mr. ----, when he first came to the asylum, was very violent at times, but, like many insane persons, he was a ravenous eater.

His insanity is supposed to be hereditary. Occasionally he has had lucid intervals, and during these brief periods he frequently expressed the belief that there existed some method by which the insane might have their affliction alleviated if not entirely done away with. To Mrs. ----, the matron of the asylum, he took a great fancy, and, while averse to having anything to do with any other of the officials, he confided in her thoroughly and often expressed the wish that his mind might be restored to him and that he could be released. "For forty-one days," said Mrs. ----, "nothing pa.s.sed his lips but water, and tepid water at that. Of this fact I am thoroughly positive, knowing as I do the continuous efforts made every day to induce him to eat. When he began the fast he had been living on the same diet as the rest of the patients. He came to me and said, seemingly in a perfectly rational manner, that he was anxious to be cured, and that he thought abstinence from food for a time might benefit him. Mr.

---- said he did not intend to carry his experiment to extremes, but that the moment he felt it would be proper for him to break the fast he would do so. On the second day ---- again refused to eat, and did not go out of his room. On the third day he drank a small cupful of water. At the end of the seventh day he had drank about six pints of water, and the natural functions of the body had then ceased. All of the attendants were instructed to use every possible means to induce the man to partake of nourishment, and a man was with him constantly through the day."

"Could he not have obtained food at night?" was asked.

"It would have been impossible," replied Mrs. ----. "All the rooms are locked, and none of the patients have access to other parts of the building after sundown. We would have been only too glad had he taken food. About the 20th day he began to get thin and haggard-looking about the face, and seemed to be feeble. He said that his head felt better, and that he did not intend to eat anything as long as he felt so well. On the 35th day he became so weak that he had to go to bed, and remained there until he broke the fast. I had told him that whenever he wanted to eat to send me word, no matter what hour of the night or day it happened to be, and I would see that he was provided with anything he might fancy. On the afternoon of the 41st day since Mr. ---- had ceased eating," continued Mrs. ----, "he sent up word by an attendant that he should like to have a cup of coffee.[52] I hastened to comply with the request at once, and had a cup of very strong Java prepared. Mr. ---- drank it, and followed it up an hour later with a cup of nice, rich milk. He stuck to the milk for a week, I think, and then added strawberries. This low diet was kept up, oh, for a long time, probably a month, then he gradually began eating oatmeal mush and gruel, which has been maintained up to to-day."

[Footnote 52: One of the worst moves be could have made; but it is significant that this was his last attempt to return to his coffee habit.