BOUGHT WITH THE INCOME 
 FRo/l THE 
 
 SAGE ENDO^A^MENT FUND 
 
 'A THE GIFT OF 
 
 Henrs W. Sage 
 
 1891 
 
 .AIHHH^% 
 
 1.4^ 
 
Cornell University Library 
 arV18858 
 
 On sanitary and other matters. 
 
 3 1924 031 268 000 
 olin.anx 
 
Cornell University 
 Library 
 
 The original of tliis bool< is in 
 tine Cornell University Library. 
 
 There are no known copyright restrictions in 
 the United States on the use of the text. 
 
 http://www.archive.org/details/cu31924031268000 
 
ON SANITARY AND OTHER 
 MATTERS 
 
BY THE SAME AUTHOR. 
 In Crown. Svo, cloth, price zs. 6d. each. 
 
 Plea for a Simpler Life. 
 twelfth thousand 
 
 Fads of an Old Physician, 
 sixth thousand 
 
 In One Volume, Crown Svo, cloth, p-ice js. 6d. 
 
 Plea for a Simpler Life, and Fads 
 of an Old Physician. 
 
 Containing Portrait Frontispiece of the Author 
 and a Special Preface. 
 
 A. & C. BLACK, SOHO SQUARE, LONDON. 
 
 AGENTS IN AMERICA 
 
 THE MACMILLAN COMPANY 
 
 66 Fifth Avenue, New York 
 
ON SANITARY 
 
 AND 
 
 OTHER MATTERS 
 
 BY 
 
 GEORGE S. KEITH, M.D., LL.D., F.R.C.P.E. 
 
 LONDON 
 
 ADAM AND CHARLES BLACK 
 
 1900 
 
PREFACE 
 
 The papers given in this volume are of a 
 somewhat mixed character. Some of them 
 may seem better fitted for the pages of a 
 Review, or of a daily or weekly paper. 
 Several of them I tried to put before the 
 public in this way, but with one exception 
 they were declined, owing mainly, no doubt, 
 to their controversial or rather their uncon- 
 ventional character. They all point out 
 prevailing errors on sanitary or economic 
 matters, or on both, which seriously affect 
 the well-being of the community, and which, 
 but for the strangely resistant force of con- 
 ventionalism, could easily be set aside, and 
 with much advantage to all, 
 
vi ON SANITARY AND OTHER MATTERS 
 
 The last three papers go mainly to con- 
 firm, very much from more recent observa- 
 tion, what the author has already brought 
 forward as to the evils resulting from the 
 long-standing system of over-stimulation, 
 over-feeding, and drugging, both in health 
 
 and disease. 
 
 G. S. K. 
 
 CuRRiE, Midlothian, 
 September 1900. 
 
CONTENTS 
 
 1. On Waste of Water in Water-Closets and 
 
 Baths .... 
 
 2. On the Modern System of Treating and 
 
 Nursing Infectious Diseases . 
 
 3. How to Profit by Life at Sea 
 
 4. On Rice-Meal 
 
 5. The Story of an Eye 
 
 6. On the Rapid and Progressive Deterio- 
 
 ration OF THE Young . 
 
 7. On Athletics, etc. . 
 INDEX .... 
 
 24 
 34 
 49 
 59 
 
 8S 
 106 
 
 127 
 
ON SANITARY & OTHER MATTERS 
 I 
 
 ON WASTE OF WATER IN WATER- 
 CLOSETS AND BATHS 
 
 The supply of water to our towns and vil- 
 lages is becoming every year a more difficult 
 problem ; and if the drought which we are 
 experiencing over many parts of the country 
 should continue till the winter frosts set in, 
 which is certainly possible, the results to 
 health and to numerous industries where a 
 large supply of water is necessary may be 
 disastrous. (Written autumn 1898.) 
 
 The waste of water is known to be enor- 
 mous, but no remedy has as yet been found 
 short of stopping or restricting the supply. 
 
2 ON SANITARY AND OTHER MATTERS 
 
 The former can only be done as a last resort, 
 and not until the water reserves are well- 
 nigh exhausted ; and with partial restriction 
 the comparative waste seems to go on as 
 before. 
 
 I have long held and given expression to 
 the opinion that a large portion of the water 
 used in accordance with our present habits 
 may be saved, not only with no loss to the 
 health or convenience of the community, but 
 with much advantage to both. 
 
 Some years ago I asked the late engineer 
 of the Edinburgh Water Trust what pro- 
 portion of the water consumed in Edinburgh 
 was, in his opinion, used for flushing the water- 
 closets. His reply was, twenty per cent. 
 Now this twenty per cent of water may be 
 saved by using a small quantity of dry earth 
 in an earth closet. The use of this is con- 
 stantly met with in the country, as yet 
 mostly in the smaller houses, where the 
 husband looks after such matters. In the 
 larger houses this is not considered by the 
 
ON WASTE OF WATER 3 
 
 ladies to be a fit duty for the female servants, 
 who are more fastidious now than they were 
 fifty years ago. Where a gardener or other 
 man-servant is kept there is no difficulty. 
 In a town, large or small, there should be 
 no difficulty whatever, as the Corporation can 
 do all that is necessary, by a moderate 
 addition to the ordinary staff of scavengers. 
 The quantity of earth requisite is very much 
 less than is usually supposed. The official who 
 allowed that twenty per cent of the water used 
 in a town went to the water-closets gravely 
 said to me, that it would be impossible, in 
 a large town like Edinburgh, to bring in so 
 great a quantity of earth as would be wanted, 
 and to carry the increased product away. I 
 asked him how much earth he supposed 
 would be necessary for a medium -sized 
 family, say of six or seven. He considered 
 a little, and then to my astonishment said 
 he supposed about a ton a month. This is 
 of course absurd, but it shows how little an 
 expert on all things connected with water 
 
4 ON SANITARY AND OTHER MATTERS 
 
 supply may know about a matter certainly 
 cognate to his business. He was, however, 
 equally astonished when I told him that not 
 from calculation, but from actual careful trial 
 over a sufficient period, I had found that half 
 a ton sufficed for a year. Half a pound a 
 day per head is enough, and with this no 
 more smell is felt than in an ordinary water- 
 closet. In both there is some odour at the 
 time the closet is used, but not more in the 
 one case than in the other, and what there is 
 is quite innocuous. I find that the usual 
 weekly allowance of bread to a servant is 
 four pounds, thus exceeding the amount of 
 earth required for one person in the same 
 time. On a large scale I would be inclined 
 to arrange for double the above quantity ; but 
 no one can say that an average of one ton a 
 year of clean earth could not, with the greatest 
 ease, be brought to each house of our largest 
 towns. What is carried away is, of course, 
 a larger quantity, but call it two tons, and 
 there can be no possible difficulty here either. 
 
ON WASTE OF WATER. 5 
 
 The latter should have no smell whatever ; 
 certainly it may be considered pure compared 
 with the filth with which Edinburgh, the 
 town I know best, is polluting the air in the 
 neighbouring country, and to which even 
 the Government cannot legally put a stop, 
 when it is deposited too near one of their 
 soldiers' barracks. 
 
 The arrangements necessary for convert- 
 ing a water-closet into an earth-closet are of 
 the simplest description. The pipe is cut 
 and sealed under the old pan, which is re- 
 moved, and a pail with a handle put in its 
 place. The latter is the only article which 
 costs anything, as to be more easily kept 
 clean it should be enamelled, but any pail 
 will do. A plain deal box to contain enough 
 earth for a week may be made for the pur- 
 pose, but there is in all houses an abundance 
 of boxes, which are usually got rid of by 
 burning. This and a small wooden spade 
 or trowel completes the plant, and is abso- 
 lutely all that is required. A self-acting 
 
6 ON SANITARY AND OTHER MATTERS 
 
 apparatus to spread the earth has been used, 
 and highly recommended, but I may say I 
 have seldom found it to act well for any 
 length of time, and it is at best a needless 
 superfluity ; as in everything else the simpler 
 the means used, if sufficient, the better. In 
 the country, to take my own case, the pail is 
 lifted out every fourth day or so, and emptied 
 in the garden on the soil nearest where it is 
 to be used as manure. It sometimes makes 
 a small heap if it is not wanted at once, but 
 there is no smell or unpleasantness from it 
 whatever, and no one would notice it unless 
 he knew and looked for it. In Algiers, where 
 I followed the same plan for nearly a year 
 and a half, during one summer and two 
 winters, the whole mass was left quite near 
 the house, exposed to sun and rain, and I 
 often said that one might at any time have 
 smoothed the surface, put a tablecloth over 
 it, and eaten his dinner without being aware 
 of any odour whatever. This is not, I 
 acknowledge, a nice statement to make, but 
 
ON WASTE OF WATER 7 
 
 it certainly disposes of any possible objection 
 that could be made on the score of health, or 
 even of amenity. In India the dry earth 
 system has long been in use ; in the jails 
 it has been universally adopted. Colonel 
 Cadell, late Governor of the Andaman 
 Islands, where are the great penal settle- 
 ments of the Indian Government, tells me it 
 is used there with perfect success, and with 
 great advantage in the raising of vegetable 
 foods. On one occasion he was showing 
 Admiral Fremantle over his command, and 
 on Viper Island he took him into a large 
 long erection, and asked him for what pur- 
 pose he would suppose it was used. The 
 Admiral looked round, and seeing nothing 
 but that on both sides all along the apart- 
 ment the space near the wall was divided 
 into narrow sections by wooden partitions 
 three feet high, he said that perhaps some 
 of the convicts got their food there. He 
 was amused to hear that the apartment had 
 been used that morning by five hundred 
 
8 ON SANITARY AND OTHER MATTERS 
 
 convicts as an earth-closet. Here the pro- 
 duct, solid and fluid separately, was sent 
 from time to time by boat to another island, 
 where it was used as manure. In the Islands 
 the rainy season lasts for more than half the 
 year, and then the earth must be dried by 
 heat. But in this country it is not necessary 
 that the earth used should be dried by any 
 artificial means. If too dry, indeed, it has 
 seemed to me not to be so good a deodorant. 
 If on a dry day, when there has been no rain 
 for some days, the earth is removed to a 
 shed, or to any place where the rain does not 
 reach it, this is quite sufficient. I believe 
 it is the humus in the soil more than the 
 mineral matters which is the useful ingredient, 
 and as it is mostly carbon, the reason of this 
 is obvious. Dry ashes have been found to 
 do very well instead of earth, and also the 
 refuse of shale, the huge mounds of which 
 disfigure the landscape near every oil-work in 
 the country ; it only requires to be ground 
 down to a powder. 
 
ON WASTE OF WATER 9 
 
 After the removal of all the solid excreta, 
 and of a portion of the fluid, perhaps one- 
 fourth, there remains still to be got rid of the 
 other three-fourths of the latter, as well as 
 all the soapy water from the bedrooms and 
 laundry, and the dirty water from the scullery. 
 In the country these also may be utilised to 
 advantage, and at very little expense. Al- 
 ready on my premises a large portion of 
 them went to the garden, and now, to suit 
 the demands of the Water of Leith Purifica- 
 tion Commissioners, the whole is sent there. 
 Use is made of a tank or cesspool into which 
 formerly all matters from the water-closets 
 went, any overflow going into the neighbour- 
 ing stream, and the solider portions being 
 cleaned out once a year. By a slight change 
 in the drains, everything except a portion of 
 the surface water now goes into this cesspool, 
 and by means of a pump reaches the garden 
 where it is utilised as a liquid manure. Any 
 occasional overflow goes into a loosely-con- 
 structed drain, whence it gets into the open 
 
lo ON SANITARY AND OTHER MATTERS 
 
 subsoil and disappears, but we hope that not 
 much of it will escape in that useless fashion. 
 In towns it would not be easy to dispose 
 usefully of these subsidiary matters, but if all 
 the solid part of the w.c. sewage with a 
 considerable part of the liquid is at once 
 rendered innocuous, and can be removed at 
 leisure, it may be found in many cases that 
 all the rest of the house sewage, with the 
 water from the roof, baths, etc., may be left to 
 pass freely, with no obstruction from traps, 
 into the outside drains. This ideal drainage 
 could at least be used in country houses 
 where there is a free outlet to the sea or 
 stream, and in small towns, where no chemical 
 or other matters might lead to bad smells. 
 In towns, of course, there must be other 
 arrangements for utilising the solid matters, 
 though in districts where villas predominate 
 with a half or even a quarter-acre stance, 
 the same mode may be adopted as in the 
 country, and with much advantage. This, 
 however, will probably not be done, and the 
 
ON WASTE OF WATER ii 
 
 municipal authorities must arrange a general 
 system for the whole community. I have 
 not the knowledge sufificient for giving the 
 details of such an arrangement, but any 
 official who has to do with the removal of 
 other town refuse could have no difficulty in 
 doing so. The cost of the change from one 
 method would be, as I have already shown, 
 next to nothing. 
 
 From the economic side the water system 
 compares very badly with the earth closet. 
 Besides the huge loss in water, the value of 
 the fertilising material lost to the soil is 
 perhaps even greater. In his presidential 
 address to the last meeting of the British 
 Association at Bristol, Sir William Crookes 
 puts the loss at sixteen millions sterling. In 
 a paper on ' Dry Earth ' in Farm and Home 
 for February 29, 1896, I put it at a still 
 higher figure, viz. twenty millions. This 
 was based on a statement made to me by a 
 medical friend long resident in China, where 
 the land is absolutely dependent for its fer- 
 
12 ON SANITARY AND OTHER MATTERS 
 
 tility on house sewage. I asked him if 
 Europeans resident there used the same 
 means of ridding themselves of the matters 
 in question as the natives did. His answer 
 was most emphatic. " Of course we do," he 
 said, " and we would be fools not to. Every 
 person in my house was worth ten shillings a 
 year to me." Lately I was told of an intelli- 
 gent artizan near Montrose who puts the same 
 value on each member of his household, using 
 the material with excellent effect in his 
 garden. I have the best evidence of the 
 value of this material on a larger scale from 
 the head gardeners at Dalkeith Palace and 
 Mentmore, both of whom have used the dry 
 earth system for many years. 
 
 But the valuable material thus lost is not 
 done with when it is sent down the water- 
 closet. It is only put out of sight. It loses 
 its value at once, and is converted into a 
 most costly nuisance. I need not dwell on 
 loss of amenity of many of our streams 
 and estuaries ; nor on the money spent on 
 
ON WASTE OF WATER 13 
 
 attempts to purify the sewage after it leaves 
 the houses ; nor on the plumbers' bills for 
 the construction and endless reconstruction 
 of the apparatus within doors, and for exclud- 
 ing bad air from without : nor on the mere 
 money spent on doctors' bills ; these are too 
 well known to every householder, and the 
 cost in money and worry is incalculable. 
 But we must add the serious loss of life and 
 deterioration of health which arise from the 
 same causes. Some thirty years ago I tried 
 honestly to appreciate what proportion of 
 death and of ill-health in my practice in Edin- 
 burgh was due to bad air from defects in 
 drainage, and I have very often spoken of it 
 since that period. I could not make it below 
 one-third of the whole. This may be too 
 high an estimate, or it may be, if all could be 
 known, too low, but the possibility of such 
 an estimate being made must show that the 
 matter is a most serious one. In the earlier 
 years of my experience, the evils from water- 
 closets were confined mostly to the towns ; 
 
14 ON SANITARY AND OTHER MATTERS 
 
 but gradually, as they were introduced into 
 the large country houses, farmhouses, and 
 manses, the same sort of cases were seen in 
 invalids from the country, and, on the prob- 
 able cause being pointed out and inquired 
 into, the same errors and imperfections were 
 found to exist in the country houses as in the 
 towns, and often in the highest degree in the 
 largest houses. I often visited, profession- 
 ally and otherwise, in such houses, and in a 
 very large proportion of them, where I had 
 the means of ascertaining the facts, the sani- 
 tary conditions were very bad. A great deal 
 of money has been spent in recent years both 
 in town and country, and generally the 
 inhabitants have been assured that perfect 
 arrangements have at last been made. But 
 the same assurances have been given before, 
 and have by and by proved to be ill-founded. 
 Something new and unexpected constantly 
 turns up, and I have looked on perfection by 
 our present methods as impossible. Even 
 the houses of first-class engineers and 
 
ON WASTE OF WATER 15 
 
 medical men are not exempted. To show my 
 own feeling on this matter I may mention 
 that with some difficulty I have managed to 
 keep my own house unconnected with a huge 
 pipe, constructed at an expense of some 
 ;^400,ooo, which has been laid along six or 
 seven miles of the adjoining stream, to carry 
 all the sewage of the district and the polluted 
 water from the mills to the sea. I willingly 
 pay my share of the imposed tax in consider- 
 ation of the improved amenity of the stream, 
 but I objected most strenuously to have any 
 connection whatever with the pipe and in- 
 numerable drains emptying into it, and, after 
 some trouble, I am allowed to have my own 
 way. All sewage matters are used up on 
 the premises, and much to the satisfaction of 
 my gardener, a very intelligent Scotchman. 
 The contractor who made the slight changes 
 necessary in the drains tells me that mine is 
 the only place along the stream which is not 
 included in the general system. A neigh- 
 bouring doctor told me that he had spent 
 
i6 ON SANITARY AND OTHER MATTERS 
 
 £^o on a somewhat complex arrangertient 
 for cutting off his house and stable from the 
 common pipe. The risk is not from the 
 sewage matters which run to the sea, but 
 from the ascending bad air in the pipe. Air 
 holes have been made at intervals to give 
 ventilation, but the smell from these is so 
 disgusting that several of them have had to 
 be shut up, where near any road or path. 
 One of these was within a hundred yards 
 of my premises, and during two summers, 
 before it was shut up, the smell was intoler- 
 able. As my place is above this it would 
 have got the full benefit if any opening was 
 made on my premises ; and I know of no 
 opening above me at all. There is a pretty 
 steady rise of five hundred feet from the sea 
 to the end of the pipe, and the foul air natur- 
 ally seeks an outlet at every terminal point. 
 There seems to be little or no movement of 
 air in the pipe itself, even where the smell 
 escapes. The only way I can see that a 
 current of fresh air could be carried through 
 
ON WASTE OF WATER 17 
 
 the main pipe is, that a communication be 
 made from it with every mill chimney on the 
 river. This I recommended to the head of 
 one of the largest of the mills some time ago 
 for his own safety, as his house is one of the 
 highest in the district. It is not safe to 
 prophesy, but I look for trouble by and by. 
 We certainly have, at huge expense, brought 
 on ourselves the risks which we have seen 
 are so real in a large town under the present 
 system, and that in a very aggravated form. 
 The ventilation in the large sewers of a 
 town is infinitely superior to that of a practi- 
 cally closed pipe, six or seven miles in length. 
 From a sanitary point of view the dry 
 earth system is perfect, and has been found 
 to be so both in cold and in hot climates. 
 It is surely worth something to those who 
 adopt it to know that their own families 
 run no risks from foul gases, and that they 
 cannot contaminate their neighbours. I 
 have known in Edinburgh that the mischief 
 from bad drainage in a house did not affect 
 
1 8 ON SANITARY AND OTHER MATTERS 
 
 the inhabitants of that house, where there 
 were only old people, but those of the 
 house next to it, where there were children. 
 Had such diseases as scarlet fever or typhoid 
 broken out in either house, their aggravation 
 from bad air might have been disastrous. 
 I had a very sad instance of this many years 
 ago. A family took a house in the country 
 for the summer. They were very healthy, 
 and had long acted on my advice as to food, 
 etc. The eldest son, a fine lad of eighteen, 
 took scarlet fever a few days after leaving 
 home. The only source of infection known 
 was a letter from a fellow-student who was 
 recovering from scarlet fever. In it he men- 
 tioned that as he was writing his fingers 
 were peeling from exfoliation of the skin, 
 and no doubt the paper he wrote on was 
 infected. The case at once showed itself 
 to be a bad one, and I went for several 
 afternoons to see him with the local doctor. 
 One day I found the father also very ill. 
 He was a very healthy man, just in his 
 
ON WASTE OF WATER 19 
 
 prime, and a member of a long-lived family. 
 He had sat down to dinner in the middle 
 of the day, but in the evening I found him 
 in an absolutely hopeless condition, and he 
 was dead when I returned next evening. 
 I stopped the night with the son, who died 
 next day. During the night I chanced to 
 see the bath, and found abundant proof that 
 it was not cut off from the outside drainage. 
 There was no marked bad smell, but a heavy 
 odour and an enormous quantity of small 
 flies which first attracted my attention. 
 Here was a sufficient cause for converting 
 what should have been two mild cases into 
 about the worst I have ever met with. 
 
 In the other form of waste of water to 
 which I wish to draw attention, viz. an 
 unnecessary quantity of it used in baths, 
 it is more difficult to estimate the amount 
 lost. But if we consider the large quantity 
 necessary for an ordinary bath, which may 
 be used daily by several individuals, and 
 also that baths are now the rule, even in 
 
20 ON SANITARY AND OTHER MATTERS 
 
 small houses, the amount of water may 
 equal that used in water-closets. Taking 
 the individual, one who has his daily bath 
 uses for it very much, perhaps ten times, 
 more than is requisite for one flushing of 
 the water-closet, and as in both operations 
 there is abundant room for unnecessary 
 waste, it may well be that between them 
 they use up half the quantity of water con- 
 sumed in a town ; but take it at a smaller 
 figure, say one-third, and this, I believe, is 
 ludicrously small, the cost to the community 
 for water would, by a change of system, be 
 enormously lessened. The dry earth closet 
 requires no water ; what is required for 
 washing out the enamelled pail is not worth 
 mentioning, and the substitute I propose 
 for the bath demands very little. This is 
 a towel lightly wrung out of cold or tepid 
 water, for which if used every day the 
 water of one bath would more than suffice 
 for a twelvemonth. This is a change which 
 it is rather dangerous to speak of, the 
 
ON WASTE OF WATER 21 
 
 morning tub or bath being so firmly estab- 
 lished as to be looked on almost as a 
 religious rite by the average Englishman. 
 But it is more a luxury than a necessity, 
 except to the strong and too-well-fed, on 
 whom it acts as a ' pick-up,' as a dram 
 does for the man who has indulged too 
 freely over night, or the pipe before break- 
 fast for one who abuses tobacco. The only 
 point I made in a long conversation with 
 the headmaster and teachers of a large 
 public school (see Plea, p. 106) was on 
 this very matter. It was conducted in a 
 friendly spirit, but on my suggesting that 
 a cold morning bath did not suit all boys, 
 the Head fired up at once, and to clinch 
 matters said that for himself he never felt 
 right till after his cold bath, I replied 
 that I felt all right in the morning, and 
 had no need for anything to set me up. 
 He thought for a minute, and then said, 
 ' You have me there.' From the weakly, 
 especially those of the nervous tempera- 
 
22 ON SANITARY AND OTHER MATTERS 
 
 ment, it takes out too much ; and I have 
 known many, young ladies especially, who 
 have been greatly benefited by stopping it. 
 When baths for the working classes were 
 first spoken of, I ventured on the remark ■ 
 that to benefit by them it would be neces- 
 sary, in the first place, to feed many for 
 whom they were intended, and I have seen 
 no reason to recall this judgment. Much 
 money has been spent and often with very 
 little advantage. 
 
 For the purpose of cleanliness a warm 
 bath once a week, preferably at night, 
 is sufficient for the delicate, and the 
 change from what is considered a bracing 
 cold bath every morning makes all the 
 difference between good health and poor 
 health to many ; but for all a good rub 
 with a towel wrung out of cold or tepid 
 water as is most agreeable, every morning 
 or occasionally, is perfectly sufficient. It 
 cleans the skin better than a dip into cold 
 water and a wipe with a towel. If the 
 
ON WASTE OF WATER 23 
 
 water is used cold, and the process repeated 
 as often as is agreeable, the bracing effect is 
 quite equal to that of a cold tub or bath. 
 
 I am but too well aware that changes 
 such as I indicate are so contrary to the 
 current ideas of the day, and would interfere 
 with so many vested interests, that so long 
 as there is no necessity for some change few 
 will take any interest in the matter. But 
 the necessity may come any day — in some 
 parts of the country it is upon us already — 
 and, if the population of towns increases as 
 it is doing, it must come sooner or later. 
 If the simple methods of saving water which 
 I have recommended be adopted, there will 
 be left in the pockets of the public what, if 
 paid into the nation's exchequer, would 
 amply suffice to enable the imperial jingoes 
 of the period to indulge annually in a great 
 war, involving the loss of tens of thousands 
 of our soldiers, and of tens of millions of 
 our money. 
 
II 
 
 ON THE MODERN SYSTEM OF TREAT- 
 ING AND NURSING INFECTIOUS 
 DISEASES. 
 
 Infectious diseases may be considered in 
 two categories, those which it is possible to 
 stamp out, and those in which, under present 
 circumstances, this cannot be done. The 
 best example of the former class is smallpox, 
 which by a perfect system of vaccination 
 may be, and in some communities or sections 
 of communities has practically been stamped 
 out, as in the Prussian army of the present 
 day. Of the other class of diseases, although 
 they may be kept out of a country where 
 they have never yet been known, it has been 
 found quite impracticable to prevent their 
 breaking out afresh from time to time, the 
 
INFECTIOUS DISEASES 25 
 
 foci of infection being so numerous, and 
 capable of remaining latent for an indefinite 
 period. This class comprises, amongst others, 
 the common diseases of childhood, as scarlet 
 fever, measles, and hooping-cough. I shall 
 take scarlet fever as a typical representative, 
 and confine my observations to it. 
 
 It may be safely taken as a fact that no 
 one dreams of stamping out scarlet fever in 
 an old country, or even of the possibility of 
 keeping it out of any limited community or 
 family ; and the main object of the sanitary 
 authority or physician must be how to 
 arrange that the disease may give least 
 trouble and expense to the public. Up to 
 recent years each family was left to shift for 
 itself, and the nursing was usually done by 
 the healthy members. Now, every case of 
 scarlet fever has to be notified to the proper 
 authority by the doctor, who receives a 
 moderate fee for his trouble. It is the duty 
 of the sanitary inspector to visit the house, 
 and, unless isolation can be done to his 
 
26 ON SANITARY AND OTHER MATTERS 
 
 satisfaction, to remove the patient to one 
 of the hospitals now prepared all over 
 the country for the reception of infectious 
 diseases. The other members of the family- 
 are usually denied access to the sick one, 
 who is under the care of a nurse, and is not 
 permitted to leave till all risk of infecting 
 others is supposed to be over. This new 
 system cannot be carried out without con- 
 siderable expense, and with no little annoy- 
 ance to the patient and friends. The ques- 
 tion I wish to consider is, whether this 
 expense and trouble are necessary and serve 
 the ends for which they are intended. 
 
 This question I will best answer by a 
 short statement of my method of dealing 
 with scarlet fever for the last fifteen or 
 twenty years of my active professional life. 
 When the disease got into a family, I 
 advised — provided that I knew the house to 
 be in a sanitary condition, that the children 
 were healthy, and had been brought up 
 properly as to food, etc. — that every facility 
 
INFECTIOUS DISEASES 27 
 
 should be given for the spread of the disease 
 over all who were liable to it. In almost 
 every case where this advice was followed 
 the others took the disease. In one case a 
 daughter of the family would not take it, 
 though she did her best to get it, sitting 
 beside the others, handling and kissing 
 them. Two years later she took it, no one 
 knew how, when the family was in the 
 country for the summer, and she caused 
 more inconvenience than did all the others. 
 I never had occasion to regret following this 
 method, and I often got thanks from the 
 parents for saving them from much subse- 
 quent trouble and anxiety. In a few cases I 
 knew that the house was not in a sanitary 
 condition, or that the children were badly 
 fed, or that both conditions existed. Under 
 these circumstances I at once ordered the 
 unaffected to leave the house, and this 
 often stopped the spread of the disease. 
 In one case the bad condition of the 
 house was only revealed by the severity 
 
28 ON SANITARY AND OTHER MATTERS 
 
 of the disease ; two were taken ill at the 
 same time, and one of them died. In my 
 experience scarlet fever is a mild disease for 
 healthy children in a healthy house, and 
 with proper treatment, which should consist 
 chiefly in giving little food and of the simplest 
 kind, till the fever is gone and the risk of 
 albuminuria is past, and especially in with- 
 holding any aperient at the beginning of the 
 illness. It is apt to be much more severe in 
 later life. Of this I have had several sad 
 instances among my own relations and 
 friends. The knowledge that the disease has 
 been passed through saves much anxiety 
 during an epidemic, or when by some chance 
 a protected family has come in contact with 
 the disease. 
 
 Another and most important question is 
 whether it be possible to avoid infection from 
 some accidental cause. Most certainly it is 
 not. Cases often occur where the source of 
 infection is absolutely unknown, others where 
 it is discovered too late for its being avoided. 
 
INFECTIOUS DISEASES 29 
 
 In my own practice a lady, who had been 
 confined three days before, and her husband 
 showed the scarlet rash on the same day. 
 Neither had had scarlet fever when young. 
 The lady, as generally happens under the 
 circumstances, died. The husband's case 
 was a mild one. His conjecture was that 
 they had been infected in a town cab just a 
 week before. There are strict rules against 
 any public conveyance being used for carry- 
 ing infected persons, but it is impossible to 
 have this rule carried out perfectly, and I 
 have more than once known the breaking of 
 the rule to be connived at by the sanitary 
 authority. I give a very glaring instance. 
 I was asked, many years ago, to see a case 
 of scarlet fever in a hotel in the Highlands 
 at the tourist season. There was great 
 anxiety, for obvious reasons, with all parties 
 concerned, that nothing should be known 
 outside. The case was a mild one. A 
 fortnight later I was called to a nearer 
 town on the same railway. On entering a 
 
30 ON SANITARY AND OTHER MATTERS 
 
 carriage on my return I was startled to find 
 my patient wrapped up in a blanket, with 
 her father, the nurse, and the local doctor 
 who was also the sanitary authority. The 
 high position of the father, and the presence 
 of the doctor would prevent any one from 
 suspecting an infraction of the law, and there 
 was safety in the openness of the removal. 
 The party left at a station farther on, near 
 which a lodging had been got. In a case 
 nearer Edinburgh the doctor, who was also 
 the sanitary authority, did not give notice of 
 a case of scarlet fever in the family of a dairy 
 farmer, whose doctor he was, and nothing 
 was known of it till cases of fever among 
 consumers of the milk brought it into notice. 
 Not to dwell on the undesirableness of a 
 system which puts temptation in the way of 
 officials to break the law, no one, I think, can 
 deny that the present plan of dealing with 
 infectious disease is complex, costly, attended 
 with much annoyance to all concerned, and 
 utterly inefficient. 
 
INFECTIOUS DISEASES 31 
 
 The kind of nursing necessitated by the 
 removal of children to a hospital has very 
 grave disadvantages. The nurse must be a 
 woman of uncommon good sense and kindli- 
 ness to enable her to take the place of the 
 natural attendants at the sick-bed, the mother 
 or sister or a trusty servant with whom the 
 children are familiar. I have met with many 
 excellent nurses, but they certainly do not 
 form the majority ; and the call for so many, 
 owing to the present methods, has brought 
 into the field numbers who are utterly unfit 
 for the office. Many of them are unbearable, 
 both to doctor and patient, from their want 
 of sense, flippancy, and self-conceit. I met, 
 lately, an excellent nurse now managing a 
 home for a specialty, after having charge of 
 a hospital ward for many years. She told 
 me that should she want assistance she 
 would get, not a trained nurse, but a woman 
 with common sense who would do as she 
 was bid. I was pleased lately to notice that 
 Mrs. Earle, well known from her delightful 
 
33 ON SANITARY AND OTHER MATTERS 
 
 work, Pot-pourri from a Surrey Garden, 
 comes down strongly upon the trained nurses 
 of the day, and with her I leave them. 
 
 Another evil arises from calling in outside 
 nurses. The females of the household lose 
 their capacity for nursing, partly from want 
 of opportunity, but also from nervousness, 
 and a feeling of unfitness for a natural duty, 
 not having the training now considered 
 necessary. In the matter of nursing I can 
 speak, if not with authority, at least from much 
 experience. When sickness got into a family, 
 except in some special cases, I did not in the 
 first place advise that an outside nurse should 
 be brought in. This may be a necessity 
 now when usually no end of medicines, and 
 stimulants and food are ordered to be given 
 at certain hours, often during the night. 
 The note of these, which it is one of the chief 
 duties of the nurse to keep, may be very 
 handy for the doctor, though I never once 
 have had occasion to use it. But in most 
 families I found some one able and willing 
 
INFECTIOUS DISEASES 33 
 
 to do all the simple duties required, or these 
 were shared with others. The infliction of 
 a trained nurse on a family, so common 
 nowadays, I occasionally hear bitterly com- 
 plained of, and sometimes in not very tem- 
 perate language ; at the same time I know 
 well that the services of a good trained 
 nurse may be invaluable — if you can get her. 
 
Ill 
 
 HOW TO PROFIT BY LIFE AT SEA 
 
 The number who go to sea in search of 
 heahh or pleasure is now very great, and is 
 increasing every year. It is to these especi- 
 ally that I wish to give some hints as to how 
 they may derive most benefit or pleasure 
 from the voyage. What I inculcate may 
 also be carefully considered by those whom 
 circumstances oblige to travel by sea on 
 business, or as a necessary and often an 
 unwelcome part of their journey, when 
 they have to remove to some distant part 
 of the world. 
 
 First, as to the vessel. There is neither 
 rest nor pleasure to be found on an ocean 
 greyhound which travels at the rate of 
 
HO IV TO PROFIT BY LIFE AT SEA 35 
 
 eighteen or twenty knots an hour and up- 
 wards, nor in a crowded ship where mere 
 numbers make quiet and peace out of the 
 question. The old ten or twelve knot 
 steamer was infinitely superior as to comfort, 
 and fortunately this sort of vessel is still to 
 be found on many lines where cargo is the 
 chief factor in the trade, and the carrying of 
 passengers is only a secondary consideration. 
 The accommodation in these vessels is al- 
 most always in the centre of the ship where 
 the motion is least. The food I have found 
 to be at least equal to, and sometimes better 
 than that of the large passenger boats. The 
 fare is less than in the fast boats, and as 
 the time of the voyage is very much longer 
 a much better return is got for the money 
 expended. A slow boat with few passengers 
 has thus, for one whose time is of little value, 
 and who is in search of health, or who finds 
 pleasure in merely being at sea, enormous 
 advantages over the fast and crowded liner. 
 I have spent fully two years of my life at 
 
36 ON SANITAR Y AND THER MA TTERS 
 
 sea, and I never dream of going on a quick 
 ship when there is the chance of sailing on a 
 slow one. 
 
 Another very important matter, when one 
 goes to sea for health or pleasure, is to have 
 a cabin for oneself. A good airy cabin is 
 of course best, if it can be had ; but a small 
 cabin is better than a share of a much 
 larger one. This holds specially if the 
 vessel is in any measure crowded. There 
 is much room yet for improvement even 
 in single cabins, but the present arrange- 
 ments in double rooms are most imperfect. 
 One bunk atop of another is intolerable, and 
 every bed should at least have head room, or 
 comfort is not to be thought of A port 
 which can ordinarily be kept open is a great 
 luxury, but ventilation is much better under- 
 stood than when I first went to sea seventy 
 years ago. 
 
 The greatest error committed at sea is 
 indulgence in rich food and too much of it. 
 This is so universal that it can only be 
 
HOW TO PROFIT BY LIFE AT SEA 37 
 
 accounted for by pure ignorance of the con- 
 sequences on the part of the transgressor. I 
 never yet heard of a vegetarian ship, though 
 such a one would be a blessing to many who 
 cannot resist the temptations of a rich table. 
 It is the business of a company to see that it 
 has a good name for giving its passengers 
 a full supply of the best provisions available, 
 and for having a first-class cook. The meals 
 are the main events of the day, and the 
 freshness of the sea-air and the open-air life 
 help to sharpen the appetite of those who 
 are not troubled with sickness, or who have 
 got over this unpleasant but often salutary 
 incident of life at sea. 
 
 If one wishes to get real and permanent 
 benefit from a sea voyage all these tempta- 
 tions must be resisted ; and if not yielded to 
 the temptation to exceed soon passes off, and 
 it is found that there is much more pleasure 
 to be got from a frugal meal taken slowly and 
 well masticated, than when hunger demands 
 the stomach to be stuffed as if to fill a craving 
 
38 ON SANITAR Y AND OTHER MA TTERS 
 
 vacuum ; or when bitters or other stimulants 
 and tasty dainties have to be taken to induce 
 any appetite whatever. 
 
 Unfortunately for themselves those who 
 live freely and indulge in stimulants and 
 tobacco seldom suffer from sea-sickness, and 
 as they have the same temptations as others 
 to indulge at table, life at sea is to many of 
 them anything but salutary. I remember, 
 many years ago, that the death of two of 
 England's best-known engineers was ascribed 
 to high living on board their yachts ; and 
 thus what under different circumstances was 
 calculated to lengthen their active and useful 
 lives brought them to a sudden and prema- 
 ture termination. Fifty years ago a sailor 
 brother of mine, a very strong man who had 
 been at sea for several years, had a severe 
 attack of yellow fever in one of the Mexican 
 ports. He recovered, and on going to sea 
 again he was astonished at his suffering from 
 sea - sickness. He was told that this very 
 often occurs after yellow fever. Certainly 
 
HO W TO PROFIT B Y LIFE A T SEA 39 
 
 many who suffer most from sea-sickness are 
 those who live temperately, and these, if care- 
 ful after the fit is over, have no more suffering 
 during a long sea voyage, whereas if they 
 think it necessary to make up for what they 
 have lost by taking more than their ordinary 
 food, they may be again ill whenever the sea 
 is even slightly rougher. Two years ago I 
 took a trip to Spitzbergen with a large 
 party. There seemed to be amongst the 
 passengers an idea that a voyage in the 
 Arctic regions required an abnormal quantity 
 of victuals. I never saw such feeding on 
 board ship before, and the stewards said they 
 had not seen it either. The steamer was 
 a big 4000 - ton ship, but had not enough 
 ballast, and on the slightest swell occurring 
 she tumbled about heavily. Far the larger 
 number of passengers got sick again and 
 again, and were no better sailors at the end 
 of a three weeks' cruise than at the begin- 
 ning. It was certainly well for them in the 
 end that they had these unpleasant experi- 
 
40 ON SANITAR Y AND OTHER MA TTERS 
 
 ences, but many of them no doubt will not 
 care to try a sea voyage for pleasure again. 
 In the same vessel I had made, long ago, 
 a two days' voyage to Bordeaux, the ship 
 being on her way to the Pacific. The 
 weather was calm. The dinner lasted two 
 hours and was freely indulged in. Amongst 
 others was a busy doctor from the West of 
 England, out for a short holiday, who ate 
 very freely and with much apparent satisfac- 
 tion ; he wished to make the best of his 
 trip. He was to return in two or three days 
 by another ship, and on the day before he 
 sailed he called on me. He looked very un- 
 happy, said he was quite out of sorts, and he 
 looked forward to the voyage with no pleasure 
 whatever. I ventured to hint that he had 
 brought all his misery on himself, and that 
 a good fit of sea-sickness would be the best 
 ending to his short holiday. I have seen 
 much misery at sea, and have suffered from 
 it myself in my earlier days times without 
 number, but I am not aware that I ever saw 
 
HO W TO PROFIT B V LIFE A T SEA 41 
 
 a case of permanent injury from this cause. 
 It is best, however, that the sickness should 
 end at sea, as, if it does not, there may be a 
 period of illness and fever after getting to 
 land ; though this is often caused by the 
 attempt to keep up the strength by food or 
 stimulants before the stomach has quite 
 recovered its normal condition. 
 
 I have seen very little benefit from any 
 ' cure ' for sea - sickness. Great care in 
 diet for some days before sailing is better 
 than taking a pill the day before, as is often 
 recommended ; a very moderate amount of 
 plain food, if one has an appetite for it, may 
 be taken, but if there is no appetite no food 
 should be taken till appetite comes, and 
 nothing but water, hot or cold, as is most 
 agreeable. If one has the least feeling of 
 being ill, it is best to give in at once, and 
 go to bed and remain there till he feels 
 safe. The only exception I would make 
 to this rule is if there is no proper ventila- 
 tion, when an effort may be made to get 
 
42 ON SANITARY AND OTHER MATTERS 
 
 into the fresh air, and if possible keep there. 
 Of remedies, I have known none of any 
 certain value except liquorice or liquorice 
 and peppermint lozenges. These allay 
 the irritation of any acrid matters in the 
 stomach, or of bile, which after a time is 
 apt to regurgitate into the stomach from 
 continued retchings ; and they also render 
 these when returned much sweeter. 
 
 When coming from the East in i860 
 we took on board a young native lady at 
 Smyrna. We had a long rough passage, 
 and this lady suffered terribly. In the Bay 
 of Biscay I was appealed to to try some- 
 thing for her relief I gave her a few drops 
 of chloroform dissolved in a teaspoonful of 
 brandy, and added to a wineglass of water. 
 This had a good effect, and we were no 
 longer disturbed by her cries. It is well 
 that a second dose was not called for. 
 
 When one has been ill for many days 
 and feels quite exhausted a small glass of 
 champagne sometimes acts like a charm, 
 
HOW TO PROFIT BY LIFE AT SEA 43 
 
 but this or any stimulant taken too early 
 does much more harm than good. I have 
 more frequently known benefit from a wine- 
 glass of stout taken with a morsel of cheese 
 and biscuit. The first dose of this is 
 often rejected, but soon a second is called 
 for and retained, and other food may 
 gradually be taken. If a little self-denial 
 is now exercised, recovery of strength is 
 often remarkably rapid, and the health is 
 frequently much benefited, as it usually is 
 after most acute diseases if properly treated. 
 Exercise is of great importance during a 
 long sea voyage, but those who indulge in 
 full living get lazy, and take no exercise 
 at all. In most of my long cruises I do 
 much more walking than any one else. 
 When in active work at home, I considered 
 that I got double the rest and general 
 benefit at sea that I would have got in the 
 same time on land. I have heard of a 
 busy man being ordered a rest of six weeks 
 every year if he wished to have the full 
 
44 ON SANITARY AND OTHER MATTERS 
 
 benefit from his holiday, and this, I am 
 sure, is an excellent rule. But if the 
 holiday is taken at sea I would look upon 
 four weeks as a full equivalent. A voyage 
 of two or three days is of little value, and 
 the time, if no more can be had, would 
 often be better spent in bed. Perhaps the 
 greatest benefit got by a busy and fatigued 
 man from a long sea voyage is that it takes 
 him away from all his work with its anxieties 
 and worries, and gives him the knowledge 
 that these are left behind for a fixed period, 
 during which no letters or telegrams can 
 follow him. It is often best that he should 
 go alone, and have no one interested in 
 his concerns to whom to talk ; friends are 
 easily made at sea. The brain is very 
 much left to lie fallow, small trifles take 
 up the attention, and mental work can only 
 be done by a very limited number, even 
 if it is attempted. I believe it is a fact 
 that almost no literary work of any kind 
 is done at sea, not even when the subject 
 
HO W TO PROFIT B Y LIFE A T SEA 45 
 
 is of life and adventures on the ocean. I 
 have more than once had occasion to find 
 that a diary soon comes to resemble a ship's 
 log, a useful but not a very attractive form 
 of literature. 
 
 I do not dwell on the pleasures to be 
 found on a voyage. These depend very 
 much on the temperament of the individual. 
 For myself, the ennui that is undoubtedly 
 more or less felt by most is much more 
 than made up for by watching the innumer- 
 able changes of the sky and ocean ; the 
 wonderful colours of the sunset, varying 
 infinitely with the locality, the weather, and 
 the season ; the grandeur of the clouds, 
 especially in the tropics ; and, as soon as we 
 escape from our own dull atmosphere, the 
 magnificence of the stars and planets, which 
 appear, not as with us in one equally dis- 
 tant firmament, but as if dropping from the 
 sky, and each one showing its comparative 
 distance. The appearance of new stars as 
 one gets farther south is most interesting 
 
46 ON SANITARY AND OTHER MATTERS 
 
 to those who know the stars and constella- 
 tions at home. Those, however, who take 
 any interest in star-gazing are very few 
 indeed, and most do not know a single 
 star or a constellation, unless it may be 
 the Plough, which is always with us. Many 
 seamen even pay very little attention to 
 the stars. Of this I have known some 
 curious instances. I came from Rio in the 
 second finest ship of a large company. The 
 captain was a man well up in years, and had 
 been at sea all his life. He had been 
 very successful, having never met with any 
 serious mishap, but of the stars he knew 
 nothing, and said he did not need to, as all 
 he wanted could be got from tables. But 
 he was a most careful navigator for all that. 
 Some dozen years ago the vessel I was on 
 arrived at Key West late in the evening. I 
 had come up from the South, and, as usual, 
 had been watching the stars. I noticed 
 that the Southern Cross was at its culmina- 
 tion just on the horizon, and it looked a 
 
HO W TO PROFIT B Y LIFE A T SEA 47 
 
 very fine object, appearing much larger than 
 when high in the heavens. I alluded to 
 this to the captain, who laughed at me, 
 and said the Cross could not be seen in 
 that latitude. Another American captain 
 said the same, and asked where were the 
 pointers. I said they were not up yet, but 
 would be soon. They soon appeared, and 
 then both allowed I was right. I suggested 
 that, with other attractions of their vessels, 
 they should advertise that Key West is the 
 only point of American soil where the 
 Southern Cross is sometimes visible. 
 
 Many of us are capable of admiring and 
 receiving pleasure from a vivid representa- 
 tion of Nature, whether it be given in apt 
 language in a glowing description, or on the 
 canvas of a favourite artist ; but a well- 
 trained eye and a loving heart are needed 
 to understand how infinitely superior to the 
 best of these copies are the real visions 
 vouchsafed to us by Nature herself These, 
 if looked for, are to be seen almost anywhere. 
 
48 ON SANITAR Y AND OTHER MA TTERS 
 
 and nowhere have I enjoyed them more 
 than on London's foggy river, especially 
 when viewed from an upper window about 
 sunrise on a winter's morning. Under no 
 circumstances can the promotion of a taste 
 for these pure delights be better forwarded 
 than on a long ocean voyage. 
 
IV 
 
 ON RICE-MEAL 
 
 I HAD always believed — and this is a general 
 belief — that rice, which is the principal food 
 of the natives in many parts of India, is 
 mostly a pure starch, and contains little from 
 which to form a strong body of muscle and 
 bone. I was undeceived as to this when on 
 a recent voyage to Rangoon. I had asked 
 if brown bread was to be had on board, and 
 was told it was not, and that there was no 
 wheaten flour to make it from. A few days 
 after I was surprised to see it on the table, 
 and of excellent quality. On inquiring of 
 the baker, a very intelligent Scot, he told me 
 the bread was made from white flour and rice- 
 meal, four parts of the former to one part of the 
 
 4 
 
so ON SANITARY AND OTHER MATTERS 
 
 latter. He had used this for more than twelve 
 months when brown bread was asked for. 
 
 This rice-meal is got in the process of 
 cleaning rice in the rice mills of India. 
 From the rough paddy the husk is first 
 rubbed off; part of it is used in the mill as 
 fuel, and the rest is thrown into the sea. 
 What is next removed is the rice -meal. 
 This is sent to England, and is given to 
 the pigs, or made into oil-cake for fattening 
 cattle. On my return voyage the vessel 
 brought nearly looo tons of it in bags to 
 Liverpool and London, where it is in great 
 demand. I was told lately of a vessel 
 bringing home 6500 tons. It is not known 
 to any of the corn -dealers in Edinburgh. 
 Two years ago it was selling at about £'^ 
 a ton ; since then, owing to the high price 
 of all feeding -stuffs, it has been quoted at 
 from £/^\ 15s. to ;^5. I brought some of it 
 home, and it makes excellent brown bread, 
 when used in the above proportions. I have 
 also some of the partly cleaned rice, from the 
 
ON RICE-MEAL 51 
 
 further cleaning of which the rice-meal is 
 obtained in quantity varying from 7 to 16 
 per cent. In a specimen of the partially 
 cleaned rice which I got from the largest 
 mill in Rangoon, a considerable portion of 
 the rich meal has evidently been lost in 
 cleaning off the husk, as only 10 or 12 
 per cent of the grain, and this of the smaller 
 size, has retained its natural red colour, 
 which is somewhat darker than the natural 
 grain of wheat. Hence it is probable that 
 the rice could give even a higher proportion 
 of meal than 1 6 per cent. 
 
 I have had an analysis made of this meal 
 by the chemist of Messrs. Duncan and Flock- 
 hart, Edinburgh, and, although it had lost 
 some of its flesh -and -bone -making ingredi- 
 ents, it was found to contain \2\ per cent 
 albuminoids, and 4|- per cent phosphoric 
 acid, which, in union with lime, as phosphate 
 of lime, makes up the greater part of the ash 
 amounting to 7f per cent. The meal is thus 
 very rich in albuminoids and phosphates. 
 
52 ON SANITAR Y AND OTHER MA TTERS 
 
 On the bank of the Irrawaddy I happened 
 to see about a ton of rice which had been 
 freed from the husk, but still retained its 
 red colour ; and I was told in Rangoon that 
 the natives sometimes clean the rice for 
 themselves, and use it in the form in which 
 I saw it. Since my return I met an engineer 
 who has for some time been in charge of 
 railways in Assam, and he told me that red 
 rice is used by the natives, who are a finer 
 and stronger race than the Hindus. Since 
 his return to Assam he has sent me fourteen 
 specimens of different forms of rice used in 
 the country. Some of these are quite white, 
 and seem to have all the outside part rubbed 
 off, others retain more or less of this. The 
 roughest of all (marked 'Hill Berain') I have 
 got analysed — No. I. I also got an analysis 
 of the red grains picked from the specimen 
 of rice mentioned above from which the rice- 
 meal was got by grinding — No. II. No. Ill 
 is an analysis of the rice-meal. 
 
on rice-meal 53 
 
 Analysis 
 
 No. I. — Rough Rice from Assam 
 
 Starch 52.85 per cent. 
 
 Albuminoids . . .9.89 „ 
 Phosphoric acid . . .0.96 „ 
 Ash 1. 18 „ 
 
 No. II. — Picked Red Grain 
 
 Starch 52.7 per cent 
 
 Albuminoids . . . 7.09 „ 
 Phosphoric acid . . . 0.465 „ 
 Ash 1.27 „ 
 
 No. III.— Rice-Meal 
 
 Starch 38.2 per cent 
 
 Albuminoids . . .12.47 » 
 Phosphoric acid . . . 4.50 „ 
 Ash 7.73 „ 
 
 The friend who sent me the numerous 
 specimens told me that the Assamese do not 
 grind their rice, but knock off the husk by 
 letting a heavy beam of wood fall upon it. 
 The roughest specimen of the lot, of which I 
 give the analysis, has all the appearance of 
 having been treated in this way, and it is 
 richer in albuminoids and phosphoric acid 
 
54 ON SANITARY AND OTHER MATTERS 
 
 than is the specimen given in Analysis II. 
 The varieties of rice are known to be very- 
 numerous, and their values as food must 
 also differ very much. Parkes, an excellent 
 authority, gives 5 per cent as the pro- 
 portion of albuminoids in the common white 
 rice used in this country. 
 
 It will be seen from the analyses that 
 rice-meal contains twelve and a half per cent 
 of albuminoids, and the two specimens of 
 rice with the husk only removed give an 
 average of eight and a half per cent. It 
 is possible, although I much doubt it, 
 that a specimen of the best rice with its 
 outer surface removed may be of equal value 
 for food as another of poor rice with every- 
 thing retained ; but certainly rice of any 
 quality is much more valuable economically 
 when left with its rich exterior, than when it 
 is deprived of this, and that for the sake of 
 appearance only. It may be also that the 
 rough rice will be found to be more agree- 
 able to the palate than is the white rice ; 
 
ON RICE-MEAL SS 
 
 just as many, and I myself among them, 
 prefer brown or wheaten bread to the com- 
 paratively insipid white bread in common 
 use. I heard lately of a family in the West 
 of Scotland who had been in the habit of 
 getting red rice from Ceylon, as they prefer 
 it to the ordinary white rice. I have been 
 favoured with two specimens of this, and it 
 has the same appearance as the rice from 
 Rangoon, which has lost its husk, and from 
 which the rice-meal is got by grinding. 
 
 In this country the value of rice as a food 
 is reduced still further by the mode of cook- 
 ing. It is usually boiled in a large quantity 
 of water. This takes out most of the albu- 
 minoids, and, as the water is thrown away, 
 these are lost. In India the water used is 
 just enough to swell the rice, and everything 
 is preserved. 
 
 I have endeavoured to get the Govern- 
 ment of India interested in the rice-meal 
 question. It is a pity that the best part of 
 the rice should be sent to this country for 
 
S6 ON SANITARY AND OTHER MATTERS 
 
 cattle, when it is so much needed in India, 
 especially for the young. As a matter of 
 pure economy it is important that it be 
 retained in the country. Two parts of our 
 brown wheaten bread go as far as three parts 
 of white bread, both in satisfying the appetite 
 and in supplying the wants of the system. 
 If the same ratio holds as to red rice and 
 white rice, a great money-saving would be 
 effected by substituting the former for the 
 latter. The price of rice-meal got in clean- 
 ing white rice for this and other countries is 
 also less than that of white rice ; but this 
 is of small importance compared with its 
 value as a food. 
 
 A time of famine may be the best for 
 introducing a change in the habits of the 
 people. As red rice is already used in many 
 parts of India, its general use and also that 
 of rice-meal should not be a great difficulty. 
 When we consider that brown bread is so 
 little used among ourselves, though its use 
 is increasing among the upper classes, and 
 
ON RICE-MEAL 57 
 
 that as yet the best of far' the larger 
 quantity of wheat consumed in this country 
 goes to the pigs, we need not be surprised 
 that in India also this thriftless system pre- 
 vails, to the deterioration of many millions of 
 people. In this country the matter is of less 
 importance as, overfeeding being the rule, 
 the poor white loaf may often do less harm 
 than the richer brown one. In a poor 
 country like India, where the people are 
 underfed, the case is very different. 
 
 This paper was partly published in 
 
 Chambers's Journal for April 28, 1900. A 
 
 gentleman in Rangoon who is interested in 
 
 rice, and who had seen an extract from the 
 
 journal in a local paper, sends me some 
 
 interesting particulars from which I quote 
 
 the following : — 
 
 In the rice trade the value set upon the grain 
 is based chiefly upon the extent to which it is 
 cleaned and polished, and thus the most valuable 
 grain commercially is that which has had the 
 outer cuticle entirely removed in process of clean- 
 
58 ON SANITARY AND OTHER MATTERS 
 
 ing. This seems curious when we consider that 
 it is really a case of sacrificing the nourishing 
 properties of rice, for the sake of giving the grain 
 a pleasant appearance. For certain markets the 
 grain, after being cleaned to the highest standard, 
 is artificially coloured with ' blue ' for the sake of 
 appearance. The rice-meal which contains the 
 bulk of the nourishment is sold at home for 
 feeding purposes, and in the East there is no 
 demand for it except to a limited extent for 
 feeding cattle in the dry season. 
 
 For Bombay and the famine districts a demand 
 has lately arisen for what is called 1 5 parts 
 cargo rice in place of cleaned rice. This consists 
 of xfths of rice with husk removed, and xS^th 
 of paddy mixed in, so that the native now gets 
 the pure rice without any cleaning. 
 
 This last statement is most interesting, 
 and goes to show that the introduction of un- 
 cleaned or partially cleaned rice could easily 
 be effected among all the natives of India. 
 Whether they could be induced to use the 
 rice-meal got from cleaning the enormous 
 quantity of rice sent to this and other coun- 
 tries is quite another question, but, for the 
 young especially, it is a most important one. 
 
V 
 
 THE STORY OF AN EYE 
 
 Some forty years ago my left eye was 
 severely injured by a blow from the cork of 
 a soda-water bottle. This we know would 
 not have given much trouble had it been 
 treated properly by a few days' complete 
 rest. It did not get rest, and soon I had to 
 give up work entirely, and keep in a dark 
 room. Inflammation of the eye set in, and it 
 was fully six weeks before I could again use 
 it, in fact I very nearly lost the eye. It 
 seemed, however, to get all right, and kept 
 so till about eight years ago, when cataract 
 appeared, with short sight to an extreme 
 degree. In three years the cataract was 
 pronounced to be ready for extraction ; but I 
 
6o ON SANITARY AND OTHER MATTERS 
 
 was Strongly advised to let it alone so long as 
 the other eye, which had some traces also of 
 thickening of the lens, was sufficient for all 
 the ordinary purposes of vision. For some 
 years before this, besides the gradual loss of 
 sight in the left eye, there had come on in it 
 a constant feeling of discomfort, difficult to 
 describe, but such as to take away much of 
 the pleasure of outdoor life. It was absent 
 entirely only when I was in absolute dark- 
 ness ; keeping the eyelids closed even in a 
 very moderate light did not give perfect 
 relief I often said I would willingly lose 
 the eye, if I could get relief only by doing 
 so. This continued for five years longer, the 
 discomfort getting rather worse than better, 
 but the cataract in the other eye remained 
 very much in the same condition. In both 
 eyes it was of the rare form known as the 
 black or central cataract. 
 
 At last my friend Mr. George Berry, to 
 my great satisfaction, agreed to operate, and 
 neither he nor I apprehended any unusual 
 
THE STOR Y OF AN EYE 6i 
 
 difficulty. The incision in the cornea gave 
 no pain whatever, thanks to the use of 
 cocaine, and the iridectomy which followed 
 gave no pain to speak of But now, when 
 slight pressure was put on the eye to assist 
 the escape of the lens through the wound, 
 it was found that though free below it was 
 adherent above. On stronger pressure 
 being used the vitreous humour began to 
 escape, showing that if the lens was to be 
 removed at all it must be by mechanical 
 means. Its removal was effected at last 
 after several attempts with different instru- 
 ments, and with considerable force. The 
 whole operation took from ten to fifteen 
 minutes. 
 
 The pain felt during these attempts at 
 extraction was very severe, and such as I 
 never experienced before. It was unbear- 
 able, and but for my great anxiety to get 
 the lens extracted and my confidence in 
 Mr. Berry, I fear that I would have called 
 out and asked that the attempt be given up. 
 
62 ON SANITAR Y AND O THER MA TTERS 
 
 I could not have stood it much longer, and 
 I was fast coming to think that success was 
 impossible, I believe that Mr. Berry was 
 coming to the same conclusion. Had we 
 anticipated the difficulty, certainly no attempt 
 would have been made, and removal of the 
 eye would have been a welcome remedy for 
 my long-endured misery. 
 
 The pain was different from any I have 
 ever experienced. It was different entirely 
 in kind from the slight pain of cutting the 
 iris. At the moment, the idea occurred 
 to me that it was a blue pain, and that 
 of cutting the iris, or skin, or any other 
 muscular texture was a red pain. I men- 
 tioned this at the time to Mr. Berry who 
 told me that he believed some connection 
 between pain and colour had been noticed. 
 A friend, to whom I spoke of this, told me 
 that she had seen some remarks on the con- 
 nection of pain and colour in one of the 
 weekly journals a few years ago, but I 
 have not been able to verify this. The only 
 
THE STOR Y OF AN E YE 63 
 
 pain I can compare it with is that of a blow 
 on the testicle, which also is very unbear- 
 able. 
 
 Of the local after-treatment of the eye 
 itself, I need say but little. It was left of 
 course in a very damaged condition, for 
 which little could be done except to give 
 absolute rest. The slightest movement 
 even of the other eye caused for several 
 days pain and strong scintillations of light, 
 and the dread of any injury from the outside, 
 either by myself or any one else, kept me 
 nervous to a degree I could not have 
 imagined. Sneezing, yawning, coughing 
 were not to be thought of, and had to be 
 resisted. Even involuntary winking of the 
 other eye caused pain for several days. I 
 was much pleased, however, to find that after 
 the operation the feeling of loading and 
 oppression in the eye and head which had 
 existed for so many years had entirely left, 
 and there has not been a trace of it since. 
 
 But my chief reason for publishing this 
 
64 ON SANITARY AND OTHER MATTERS 
 
 Story of an eye, is to tell how I have lived 
 since the operation, and how not only the 
 eye but other parts of the body have been 
 affected by the mode of living. Ever since 
 I remember I have been more or less 
 troubled with rheumatic gout. This I 
 certainly inherited from my mother, most of 
 whose family suffered more or less from it. 
 Two of her five brothers died suddenly from 
 heart disease ; another, a medical man — he 
 was surgeon of the ship which carried 
 Napoleon to Elba — suffered for many years 
 from very severe palpitation, which ultimately 
 carried him off. Another was quite decrepid 
 from gouty deposits, his hands especially 
 being contracted and useless. The fifth 
 died younger than the others of so-called 
 gout in the stomach. Only one lived to 
 sixty. They were all strong men, and lived 
 freely. Of my nephews, several have 
 suffered from rheumatic iritis, some of 
 them more than once. On myself the 
 effects of this dyscrasia were best seen on 
 
THE STORY OF AN EYE 65 
 
 my hands and feet ; the joints of the former 
 
 have long been knotty and painful, and 
 
 Dupuytren's induration of the palmar fascia 
 
 has long been well marked in either hand. 
 
 I have been troubled with irregular action 
 
 of the heart all my days ; but this is now rare 
 
 since I have known how to keep my stomach 
 
 in order, and how to use self-massage, which, 
 
 when applied vigorously over the region of 
 
 the heart, at once gives relief 
 
 For a few days after the operation I was 
 
 offered nothing but slops, and of this I took 
 
 but little. The nurse then urged me to take 
 
 more solid and stronger food, on the plea 
 
 that this was necessary for the healing of the 
 
 wound in the eye. To her the after care of 
 
 the patients was mostly left, and as she had 
 
 been head nurse in the eye -ward of the 
 
 Infirmary for fifteen years, and was a woman 
 
 of more than common ability, she was well 
 
 qualified for her duties, and the surgeons 
 
 had, justly, great confidence in her. For the 
 
 first time, I daresay, she had an intractable 
 
 s 
 
66 ON SANITARY AND OTHER MATTERS 
 
 patient. My great fear for the eye was that 
 rheumatic iritis might supervene, and this, 
 in addition to the mischief that the long and 
 severe operation had done already, would 
 have made a satisfactory cure hopeless. I 
 resolved, therefore, to restrict my food to a 
 less quantity than usual, and to abstain almost 
 entirely from flesh food of any sort except 
 milk, and this in very moderate quantity. I 
 have long known that milk, the best food for 
 the infant and the growing youth, is not a 
 good food for the aged — it contains too much 
 saline matter, especially of lime. This was 
 brought home to me by Mr. Berry finding 
 that the cause of my sensation of something 
 in the eye was from the presence of very 
 minute chalk stones, in the ducts of the 
 follicles at the loose junction of the mucous 
 surface of the globe of the eye with that of 
 the eyelid. The removal of four or five of 
 these gave immediate relief. I have taken 
 less milk since, or only in the form of cheese, 
 in the manufacture of which much of the 
 
THE STORY OF AN EYE 67 
 
 salts remains in the whey. This light and 
 spare diet suited me perfectly, but in order 
 to be able to get my own way quietly I left 
 the comfortable home after nearly three 
 weeks, and the drive of six miles over rough 
 roads rather damaged my still very tender 
 eye, and perhaps somewhat retarded the 
 cure. By and by it was seen that the cor- 
 nea just opposite the pupil was so thickened 
 that another iridectomy was necessary, and 
 for this I returned to the home four months 
 after the first operation. The nurse now 
 saw that my spare diet had suited me very 
 well, and during the week I was again with 
 her I was allowed perfect freedom as to food. 
 She was an excellent cook, and her good things 
 would be apt to tempt a less stubborn patient. 
 But, even with the rational system of 
 diet which I rigidly followed, I doubt very 
 much if I could have escaped the much- 
 dreaded iritis but for a full and persistent use 
 of self-massage, which I continued for more 
 than seven months. During these months 
 
68 ON SANITAR Y AND OTHER MA TTERS 
 
 I learned much of the value of massage, par- 
 ticularly as to the power it gives us of reliev- 
 ing local parts while the rest of the body is 
 still more or less affected by rheumatism. I 
 have used it both locally and generally for 
 many years, and with much benefit, but never 
 with the force and for the time I have done 
 lately. For many days after the operation 
 no general massage of the body could be 
 attempted, as the least strain set up pain 
 and flashes of light in the eye, but as soon 
 as it could be done I rubbed any part which 
 I could most easily reach. I soon found that 
 so long as I kept the mouth open, a consider- 
 able degree of local pressure caused no strain 
 and did not affect the eye at all. The eye 
 itself is one of the few parts of the body 
 which cannot be rubbed with any force, as it 
 can neither be taken between the fingers, 
 nor has it anything firm behind it to resist 
 pressure ; but one can help the circulation in 
 the eyelids and the muscles of the eye, by 
 drawing the lids outwards over the edge of the 
 
THE STORY OF AN EYE 69 
 
 bones of the orbit all round, without pressing 
 on the eyeball at all. This I was soon able 
 to do, and I believe that the paralysed state 
 of the upper eyelid, which for many days was 
 complete, was relieved sooner than it other- 
 wise might have been. It was long before I 
 could put pressure on the bony edge and 
 interior of the orbit, where pain was very con- 
 siderable till I could rub freely and deeply 
 without causing uneasiness in the eye itself 
 In this way I relieved entirely the rheumatic 
 pains of both orbits, for the right eye was 
 at first as much affected as the left. Four or 
 five weeks after I got home, and two months 
 after the operation, I first attempted to go 
 out of doors. The weather was veiry cold 
 and windy. I protected most carefully the 
 left side of the face and head, but in doing 
 so I left the other side too exposed. The 
 consequence was that the rheumatic pains 
 returned to the right eye, and for a time I 
 suffered more from it than from the other, 
 * By giving justice to each eye in the matter 
 
70 ON SANITAR Y AND OTHER MA TTERS 
 
 of massage I have since kept both almost 
 entirely free, but I still continue to massage 
 the whole face and head many times a day. 
 The general massage I do mostly at night, 
 and all along I have spent from one to two 
 hours every night at hard work on my per- 
 son. By using hard pressure I found several 
 rheumatic points both of bone and muscle 
 which I had not known of before, and I am 
 now much freer from rheumatism than I 
 have been during the greater part of my life. 
 The local changes in this respect are much 
 greater than I could have expected, and 
 were in fact quite unlooked for. All the 
 joints of my fingers were stiff and tender, 
 and were more or less enlarged by gouty 
 deposits. They are now quite free and supple, 
 and the deposits have mostly disappeared, 
 almost entirely so indeed except in the first 
 joint of the little finger, on which there has 
 been a deposit ever since I remember, and on 
 the second joints of both thumbs, which also 
 were very early affected. 
 
THE STOR Y OF AN EYE 71 
 
 As already mentioned, I have long had 
 good specimens in either palm of ' Dupuy- 
 tren's contraction of the palmar fascia.' In 
 both the deposit has got softer and smaller, so 
 that the natural lines, made so much of by 
 the learned in palmistry, have again become 
 much more distinct. I expect that the indu- 
 ration will soon disappear. 
 
 Another improvement is worth mention- 
 ing. I have had for at least thirty years a 
 numbness in both feet, so that there was a 
 feeling of some soft substance between the 
 sole of the foot and the ground. For a time 
 I much feared that this might be progressive. 
 It is now almost gone, and I would perhaps 
 not notice it, did I not know of its long 
 existence. The result has been much helped 
 by the use of a very powerful form of massage, 
 viz. strong friction of one foot, especially of 
 the sole, by the other. The heel can be 
 used as well as the joint of the great toe. 
 This gives strong exercise to the muscles of 
 the leg and thigh, and does for the lower 
 
n ON SANITAR V AND OTHER MA TTERS 
 
 limbs what massage by the hand and fingers 
 does for the upper. This may be assisted 
 also by having the bed shortened by a hard 
 pillow, or any solid article resting on the 
 bottom of the bedstead, which resists the 
 feet when pressed against it. This hint I 
 got from a lady I had to visit in the West for 
 Professor Simpson, more than fifty years ago. 
 In her lodging there was no sofa long enough 
 for her, and she was constantly and with some 
 irritability pressing her feet against the foot 
 of it. She wrote me by and by that this had 
 proved quite a godsend to her. She was fre- 
 quently laid up for six weeks at a time, and 
 at the end she had very much lost the use 
 of her legs. On this occasion she could at 
 once walk as usual. 
 
 What is still more remarkable. I have 
 gradually come to see better with my right 
 eye which has had the lens somewhat affected 
 with cataract for nearly ten years. I can now 
 read with it the smallest print without the 
 glasses which I have used for many years. 
 
THE STOR V OF AN E YE 73 
 
 Long ago, when in poor health, I was 
 much annoyed by constant noises in my 
 ears. These were not noticed while travel- 
 ling in a railway carriage, or when in a 
 steamer over the screw or near the engine, 
 and if I could keep this up for several days 
 the noises did not return for some time. As 
 my health improved they got much slighter 
 and gave little trouble. For the first time 
 they are almost entirely absent. 
 
 I am now also free from eczema on any 
 part of the body. This I would look on as 
 a doubtful advantage, were it not that I have 
 a very tender skin, and I am sure that the 
 eczema would soon return if it were needed ; 
 but so long as I live carefully, so as to leave 
 the mucous surfaces free from an excess of 
 blood, and the blood free from an excess 
 of plastic matters, I have no fear of a return 
 of the — under other circumstances — whole- 
 some eczema. 
 
 Another form of massage, or an equivalent 
 to it, which I use very freely, is taking 
 
74 ON SANITAR V AND OTHER MA TTERS 
 
 a succession of deep inspirations. This 
 assists, in a very active way, the circula- 
 tion through the heart and lungs, to which 
 direct massage cannot be applied. In so 
 doing it necessarily assists the circulation 
 of the whole body. I remember reading, 
 some years ago, an article in one of the 
 magazines by an Indian officer who had 
 found wonderful advantage from this, espe- 
 cially in headaches, but also in many other 
 complaints which are now believed by many 
 to arise from uric acid in the blood. I tried 
 this in my own case too soon after the 
 operation, while the eye and the muscles of 
 the orbit were in a state of complete collapse. 
 Two or three deep breaths at once brought 
 on pain and flashings of light, much as strain- 
 ing did at the same time. This was, no doubt, 
 caused by an increase of tension in the parts, 
 which were so collapsed that no increased 
 circulation through them was possible. 
 
 How far it may be necessary for me to 
 keep up self-massage both local and general 
 
THE STORY OF AN EYE 75 
 
 for the future remains to be seen, but it 
 cannot require so much to keep off local 
 pains and deposits as it has taken to remove 
 them ; and as it is mostly done in bed, I 
 know no better exercise for an old man, 
 especially in a cold climate. At the same 
 time I have no intention of giving up 
 exercise in the open air, which I have always 
 taken even in cold and wet weather with the 
 help of a mackintosh and warm clothing. 
 Nor have I any temptation to increase either 
 the quantity or the quality of my food. I 
 enjoy every morsel I eat in a way that I 
 believe is done by very few, and I have no 
 desire for more. Though my nitrogenous 
 food, in the form of bread, milk, or its 
 equivalent in cheese, and fish or flesh, which 
 is a very small item indeed, does not amount 
 to more than eight ounces daily, I have a 
 great variety in green vegetables and fruit in 
 all forms, raw, cooked, or preserved, and,/flf^ 
 Dr. Haig, I have a good cup of coffee or tea 
 in the morning, and usually a cup of tea in 
 
76 ON SANITARY AND OTHER MATTERS 
 
 the afternoon. The tea is made from the 
 twentieth of an ounce of tea ; the uric acid or 
 xanthine which this contains is, I beUeve, 
 more than neutralised by the hot water 
 taken with it, and the feeling of comfort is, 
 no doubt, due as much to the stimulus from 
 this as from the tea. A retired medical 
 officer ^from India told me lately that he 
 knew of a gentleman, long a martyr to 
 indigestion, for which he had tried many 
 cures, who went out to Ceylon to grow tea. 
 He took to drinking very weak tea in large 
 quantities and at all hours of the day, and 
 to this he ascribed his getting rid at last of 
 his dyspepsia. Strong tea, taken often or 
 in large quantities, no doubt does a great deal 
 of mischief. If I take a fancy for a glass of 
 wine I indulge it, but the desire for it rarely 
 lasts for more than two or three days, 
 and often at some months' interval. See 
 ' Stimulants ' in Fads. 
 
 Among the other important benefits 
 which have come to me during the last few 
 
THE STOR Y OF AN E YE n 
 
 months I must not omit a great improve- 
 ment in my sleep. The shock of the opera- 
 tion, and the constant dread of anything 
 approaching the eye, brought on a curious 
 nervous condition, which I had not before 
 experienced. In the hope of relieving this 
 I had recourse to a remedy which has now 
 very much gone out of fashion, and that, 
 perhaps, from its having been too much run 
 upon some forty years ago. This is bromide 
 of potassium, a remedy which I prefer still 
 to all the numerous drugs for soothing 
 the nerves and promoting sleep which 
 have since been brought out. I took thirty 
 grains at bedtime for three weeks. The 
 first dose acted like a charm. I slept very 
 much better than, with very rare exceptions, 
 I have done since I was a youth, and this 
 has continued, after giving up the night dose. 
 To me it is an enormous gain. For long I 
 dreaded going to bed, and the night seemed 
 interminable. 
 
 I have been able to satisfy myself that 
 
78 ON SANITARY AND OTHER MATTERS 
 
 the breaking up of the muscular and other 
 textures, so as to set free the used-up 
 material, is done directly by the massage 
 of the part, and not, or only slightly, 
 by the force used in the process. The 
 action of the kidneys was at once increased 
 by general massage of the body, while local 
 massage of the fingers, for instance, or over 
 the eye or forehead, where there was little 
 but the bone to act upon, was followed by 
 no such effect, although the force used was 
 very great, and continued for a considerable 
 time. It is well that this is so for one who 
 cannot use self-massage, as the chief benefit 
 may be got from a good masseur. In my 
 experience, however, these are very few 
 compared with the number who practise 
 the art, and if such a one can be got the 
 cost comes to be very considerable. I 
 doubt if any one has ever spent the time 
 and the force that I have done on myself 
 since the first operation, and I do not 
 know of . such results having ever been 
 
THE STOR Y OF AN E YE 79 
 
 obtained, but even one such experience is 
 worthy of being recorded. At the end of 
 it I am stronger, in my Hmbs especially, 
 than at the beginning. I am a few pounds 
 lighter perhaps, but the loss has been 
 entirely in the abdominal organs, and this 
 is certainly no evil but the reverse. 
 
 In contrast with this story of an eye, so 
 far as feeding is concerned, I may shortly 
 give the experience of a lady who had the 
 misfortune to suffer from a badly inflamed 
 eye, following a serious accident. She was 
 attended by an able surgeon, who for a time 
 had to leave her to the care of an excellent 
 experienced nurse. The nurse considered 
 that it was absolutely necessary for the 
 healing of the eye that the patient should 
 take a full supply of what she considered 
 the proper food. She insisted on this 
 being taken, though the patient knew it 
 could do nothing but harm, as she had a 
 disgust for all food, and her tongue was 
 coated with a great thickness of fur. Un- 
 
8o ON SANITARY AND OTHER MATTERS 
 
 fortunately she had no sickness, and did not 
 get rid of the superfluity in this way. 
 The presence of a mass of undigested and 
 fermenting food in her stomach brought 
 on severe and constant pain in the bowels, 
 with an intense feeling of depression and 
 wretchedness. These were only relieved on 
 the return of the surgeon, when she was 
 allowed to live more rationally ; and, after 
 a long course of treatment, she recovered 
 perfectly the use of the eye. She would 
 have been spared much unnecessary distress 
 had she been allowed to live as nature so 
 clearly indicated. On the other hand, my 
 
 friend General , when inquiring about 
 
 my eyesight, told me he had just heard of 
 a strange cure. A youth whose sight was 
 beginning to fail, was told by an excellent 
 oculist that his case was hopeless, and he 
 would very soon be entirely blind. He was 
 about to give up his work, which required 
 good sight, when a lady friend gave him 
 a sum of money, and sent him to a well- 
 
THE STOR Y OF AN EYE 8i 
 
 known oculist in Germany, who on examin- 
 ing his eyes said at once that he would 
 cure him perfectly in six weeks. The 
 means used astonished the General. The 
 youth was put on a very restricted, almost 
 wholly vegetarian diet, and was told to get 
 well massaged about the head, shoulders, 
 and neck, and also to do this frequently for 
 himself. After six weeks of this treatment 
 in hospital, and with the aid of glasses, 
 the sight was completely restored. I was 
 pleased to be able to tell my friend, that 
 these were precisely the means I had been 
 employing since the operation on my own 
 eye in order to prevent further mischief, 
 and also with success. 
 
 Postscript (ten months after the first 
 operation for cataract). — Since the above 
 history was written, I have gradually reduced 
 self-massage, but I still go over the whole 
 body several times a day. I have had no 
 rheumatic or other pain in the eyes or orbits 
 for two or three months, and very rarely any- 
 
82 ON SANITARY AND OTHER MATTERS 
 
 where else, although the weather has been 
 most unfavourable. I can rub the joints of 
 the fingers very strongly without any incon- 
 venience, and no one could, I think, discover 
 in them any deposit whatever. I still take 
 the same quantity of nitrogenous food, and 
 find it sufficient. As I continued rather 
 thin I have, for the last eight weeks, taken to 
 breakfast some bacon, which I find suits me, 
 and during that time I have put on five 
 pounds. I am now just my usual weight. 
 I believe I could fatten up readily if I 
 wished, but cui bono ? I wish I could 
 induce those who have received much 
 benefit from massage in the Weir-Mitchell 
 treatment to be satisfied, and to adopt a much 
 more restricted regimen, so soon as they 
 have recovered their appetite and put on 
 a reasonable amount of flesh. The result 
 would certainly be more satisfactory. The 
 same remark applies quite as much to cases 
 of phthisis, now treated with open air and 
 feeding. The good results from the former 
 
THE STOR Y OF AN E YE 83 
 
 are most gratifying, but I have frequently 
 known all the benefit neutralised by an 
 enforced adherence to the latter. This 
 holds especially in cases complicated with 
 haemorrhage from the lung. I have seen 
 two very bad cases within the last few 
 weeks, and I gave others, in Plea, p. 60, 
 and Fads, p. 120, which I met with before 
 the great value of open-air treatment was 
 known. The constant living in the open 
 air seems to have, in many cases, the same 
 effect on the appetite as has massage in the 
 Weir-Mitchell treatment. 
 
 Though a single experience, the history 
 of my own case for the last ten months gives 
 ample proof that the amount of nitrogenous 
 food supposed by the physiologists to be 
 necessary, even for an idle man, for a healthy 
 condition of the vital organs, is ludicrously 
 above the mark. As any one can see for 
 himself, the food consumed by the great 
 majority of the healthy, say on board ship 
 or at a hydropathic establishment, is much 
 
84 ON SANITARY AND OTHER MATTERS 
 
 greater even than that allowed by the 
 physiologists. This being so, we have not 
 far to go for a true cause why the most 
 perfect machine of nature's workmanship 
 breaks down on the average before it has 
 lived half of its allotted time. 
 
VI 
 
 ON THE RAPID AND PROGRESSIVE 
 DETERIORATION OF THE YOUNG 
 
 The Times of October 24, 1898, gives a 
 letter from the doctor of one of the great 
 English schools on the physical condition 
 of the last hundred boys admitted. The 
 examination was made within a few days 
 after admission, and ' was as carefully and 
 thoroughly performed as if each life were 
 about to be insured for a large sum of 
 money.' ' The boys were typically healthy 
 lads between thirteen and fifteen years of 
 age, and in most cases the parents were not 
 cognisant of any bodily defect in their 
 sons.' ' They may be reasonably accepted 
 as probably typical of any other set of boys 
 
86 ON SANITAR Y AND OTHER MA TTERS 
 
 of like position and training, similarly col- 
 lected without choice or discrimination.' 
 
 An analysis is given of the physical con- 
 dition of those hundred boys. It does not 
 include ' minor imperfections as stammering, 
 tendency to chilblains, defective teeth, and 
 many other failings.' The number of 'de- 
 formities ' amongst them amounted to sixty- 
 three, and ' they comprised lateral curvature 
 of the spine, pigeon-breast, knock-knee, and 
 flat-foot,' with some congenital malforma- 
 tions which were not important. 
 
 Besides these deformities there were 
 twenty cases of defective sight, nine of 
 defective hearing, and twenty-two of albu- 
 minuria. The chest measurement of sixty- 
 eight was below the average. It is manifest 
 that the averages by which these measure- 
 ments are estimated were calculated at a time 
 when the boys were better developed than 
 now. If new averages were made out, the 
 figures would be lower than these so-called 
 normal development figures which are taken. 
 
DETERIORATION OF THE YOUNG 87 
 
 What was once the average is now so no 
 longer; the standard of fifty years ago is 
 now quite out of reach. 
 
 The only hint given as to the cause of 
 these abnormal conditions is, that ' the de- 
 formities in the majority of cases have 
 arisen after the child has left the nursery, 
 and are due to faulty development from 
 imperfect physical training, as well as from 
 vicious postures in the process of education.' 
 
 The publication in the Times of the re- 
 sults of such an examination by an official 
 expert was calculated to make a strong 
 impression on the public, as well as on the 
 parents of boys sent to our great public 
 schools. The doctor says in his letter that 
 ' the importance of the facts disclosed is 
 supreme, and even from a national point of 
 view,' and also that, ' the large number of 
 cases of defective sight and of albuminuria 
 will astonish many.' A few letters followed 
 in the Times, one from a medical man of 
 thirty years' standing, who is not surprised 
 
88 ON SANITARY AND OTHER MATTERS 
 
 at the deformities in youth, as children are 
 no longer treated as children, but as little 
 adults, and are nourished, or attempted to 
 be, on so-called foods which tempt the 
 palate, and do little towards construction or 
 supporting the frame.' He regrets that the 
 simple but perfect foods which formerly 
 figured in the nursery and the schoolroom, 
 such as milk, oatmeal, and other cereals, 
 with really nutritious bread, are now little 
 valued. 
 
 In the Spectator for November 12, 1898, 
 there was a letter from another medical man, 
 who ascribed the deterioration of youths to 
 their being overworked, both physically and 
 mentally ; one of these he thought they 
 might stand, but not both. I ventured to 
 send a letter to the same paper, in which 
 I said I had long known the bad state of 
 matters with boys, both in the preliminary 
 and public schools, but I ascribed it mainly 
 to overworking the stomach by giving too 
 much and too rich and exciting food. I 
 
DETERIORATION OF THE YOUNG 89 
 
 went into this very briefly, and added that 
 if some change in the manner of rearing 
 our first-class boys did not come, and come 
 soon, England would have to look elsewhere 
 for her leaders than to our great public 
 schools. This, I fear, was considered too 
 strong language for the readers of the paper, 
 and the letter was returned with thanks. 
 
 I have mentioned in Plea for a Simpler 
 Life, p. 4, that the excuse given for the 
 change from a depleting to a repleting 
 system of treating disease was found in a 
 supposed alteration in the human body, 
 which rendered it less able to bear lowering 
 measures than formerly. I and others could 
 find no proof of this whatever, and except 
 for a short time at first, I have not heard 
 this excuse mentioned. But I have long 
 known that there is a very marked and pro- 
 gressive deterioration of our youths, and 
 especially of the wealthy classes, and I have 
 pointed out to parents that this is caused 
 mainly by the unscientific system of feeding 
 
90 ON SANITARY AND OTHER MATTERS 
 
 which gradually spread to the children from 
 the elders, who were the first to follow 
 the new mode of living introduced aboyt 
 sixty years ago. What the effect has been, 
 after two generations, is now seen in the 
 report above quoted. As there has, so far 
 as I have seen, been no attempt by either 
 doctors or masters of other large schools to 
 controvert this official statement, and that 
 after a period of nearly two years since the 
 report was published, it may be taken as a 
 true presentment of a deplorable situation. 
 
 It is a curious circumstance that the sup- 
 posed deterioration of the race, which was 
 given as an excuse for changing the old plan 
 of treating disease and introducing a new 
 and opposite one, should have been brought 
 about in reality by that very system which 
 was intended to prevent it. Now that the 
 fact of a great falling off in the stamina of 
 our youth is established beyond dispute, it is 
 to be hoped that something will be done to 
 check it in time, but that cannot be done to 
 
DETERIORATION OF THE YOUNG 91 
 
 any good purpose till there is some agree- 
 ment as to the causes which have led to this 
 national calamity. But here as yet there is 
 no agreement whatever. If I may judge 
 from what was told me by the headmasters 
 of two of our great schools, the almost uni- 
 versal idea of the parents, especially of the 
 mothers, is that the diet of their sons must 
 be a fuller one than that necessary for the 
 rest of the boys, and especially that they 
 must have more butcher's meat. Till the 
 parents can be disabused of this idea there 
 can be no hope of any improvement. I have 
 been trying for many years to show that this 
 idea is exactly the opposite of the truth, and 
 I will state shortly the scientific reasons why 
 it is so, and why the physical condition of 
 our better -class boys is bound to become 
 worse and worse from generation to genera- 
 tion. 
 
 For the growth of the human body a 
 regular supply of proper food is necessary 
 from the earliest period of its being. Before 
 
92 ON SANITARY AND OTHER MATTERS 
 
 the birth of the infant this is got directly 
 from the blood of the mother. After birth it 
 is furnished by the mother's milk, which if of 
 good quality has all the ingredients necessary 
 for the growth and daily wants of the child, and 
 this for an indefinite period. The healthiest 
 children are reared in this way, and should 
 have no need of any assistance from drugs 
 or chemical foods whatever. Many of the 
 children I have had to do with for more 
 than half a century, and who are now come 
 to man's estate, have not had medicine of 
 any kind, and have had no need for it, even 
 when going through the ordinary diseases of 
 childhood. I do not here go into the very 
 wide subject as to how the child is to be fed 
 after the use of milk only is given up, but 
 shall endeavour to point out what elements 
 are absolutely necessary in the food of a 
 growing youth, and how terribly these are 
 wanting in the foods which are in the present 
 day considered the best and fittest. 
 
 Food has a double duty to fulfil. It must 
 
DETERIORATION OF THE YOUNG 93 
 
 supply what is wanted to form the various 
 textures of which the body is composed, and 
 to make up their daily waste ; this is the 
 function of the nitrogenous element in food. 
 It has also to provide enough carbon to give 
 the heat and force necessary for warmth, and 
 for carrying on the circulation, respiration, 
 and other vital functions of the body. For 
 both these purposes nature provides abundant 
 materials, the most important being wheat 
 and other cereals, milk and the flesh of 
 various animals and fishes, besides fruits 
 and vegetables, some of which give excellent 
 articles of food, and most of them salts, which 
 are also necessary in the human economy. 
 The subject of food is a very wide one, but we 
 have only to consider it in connection with 
 the growing child and youth, and with the 
 changes in their diet during the last half 
 century. 
 
 In the middle of the nineteenth century 
 the food of the children of the upper classes 
 was still very simple, even after a fuller table 
 
94 ON SANITAR Y AND_ OTHER MA TTERS 
 
 was getting common for the elders. Milk, 
 porridge of oat or wheaten meal, eggs, fish 
 where it could be got, and perhaps a bit of 
 fowl occasionally, were the staple foods for 
 children while in the nursery, or fairly into 
 their teens. But the new idea of the neces- 
 sity for ' keeping up ' was extending, and was 
 gradually coming to affect those of tender 
 years, till it is now in full force among the 
 young of all ages, and has reached an 
 extreme which it will be very difficult to 
 surpass. It is true that the stage of growth 
 demands a comparatively fuller allowance of 
 flesh -forming foods than does that of full- 
 grown manhood ; but the means now used 
 to attain this end have been so perverted 
 that a quite opposite effect is produced, 
 and one result is the very low condition 
 of boys from twelve to fifteen who now 
 come up for admission into our large public 
 schools. 
 
 I have been told that in most large and 
 many small schools, the food given to the 
 
DETERIORATION OF THE YOUNG 95 
 
 boys is insufficient, and that the butcher's 
 meat, especially, is of so bad a quality and so 
 badly cooked that it cannot be eaten. This 
 is a calumny on the masters of the boys' 
 houses which I cannot entertain for a 
 moment, and it is only given as a cause of 
 the weakened condition of the boys, when 
 the real cause will not be looked at. The 
 real cause, and I have said so for well-nigh 
 fifty years, is that too much strong animal 
 food is given, and that this, while it certainly 
 gives enough flesh-forming material, gives 
 next to nothing for the bony skeleton and has 
 also a stimulating element which over-excites 
 several of the most important functions, 
 and thus wears out the system instead of 
 strengthening it. (Seei^a;aJy of an Old Phy- 
 sician, chap, xiv.) The ' old - fashioned ' 
 foods for children which I have mentioned 
 contain all that is required for the growth 
 and upkeep of the growing boy, and they 
 have none of the stimulating element what- 
 ever. This is a most important difference, 
 
96 ON SANITARY AND OTHER MATTERS 
 
 and must be gone into more fully. Besides 
 what is required for forming and keeping up 
 the body, food, as I have said, must also 
 provide what is necessary for giving heat 
 and force. This is done by the burning up 
 of carbon, and is quite analogous to the pro- 
 duction of steam by coal, though the combus- 
 tion in the human body is done much more 
 slowly, and at a much lower temperature, 
 98|-°, instead of above 212". The carbon is 
 taken into the body in the form chiefly of 
 starch, sugar, and fats, as butter, suet, etc. 
 Carbon also enters into the composition of 
 all flesh matters, and the oxidation of this 
 may add something to the heat and force of 
 the body. 
 
 Good milk contains all that is necessary 
 for the growth and maintenance of the body. 
 It is thus in itself a sufficient food — and in 
 this it stands alone — for the infant and the 
 youth. Besides giving all that is wanted 
 for the soft textures, it contains lime and 
 phosphorus, which go to form the bones of 
 
DETERIORATION OF THE YOUNG 97 
 
 the skeleton and the teeth.^ Oatmeal and 
 wheaten flour are excellent foods, and when 
 taken with a moderate quantity of milk form 
 perfect foods. They are rich in albumen 
 and starch, and also in salts for the bones. 
 Eggs are very nutritious. They consist 
 mainly of albumen, but the yolk contains an 
 oily substance which is apt to disagree with 
 some, who of course should not use them. 
 Fats, butter, suet, etc., are carbonaceous, 
 and are productive of heat and force when 
 oxidised in the body ; or if in excess of the 
 immediate wants they are deposited as fat, 
 and give a reserve of heat and force which 
 may be called upon later when wanted. All 
 these foods are excellent, supplying in due 
 
 ^ It is well to mention that what makes milk the best food for 
 the infant and youth, makes it an improper food for the aged. 
 For them the lime of the milk is not wanted, and it can only do 
 mischief by causing deposits in various textures. This seems to 
 be forgotten by many medical men, who order milk in huge quan- 
 tities to middle-aged and old men. This is in some respects an 
 improvement on the giving of much strong flesh food, and may 
 be looked on as an approach to a better system ; but it has yet 
 to be learned that the best food may be almost as injurious as 
 the worst, if given in too great quantity. 
 
 7 
 
98 ON SANITARY AND OTHER MATTERS 
 
 combination all the demands of the body ; 
 and if taken in proper quantity by a growing 
 lad he will find himself, when at his full 
 development, in sound health and fit for all 
 the duties of his manhood. This may be a 
 counsel of perfection which, at the present 
 time, few will be inclined to follow, and 
 many will not be permitted if wishing to 
 do so. 
 
 Let us now inquire how the young of 
 the last two generations have been brought 
 up, and what has been the chief cause of 
 their undoubted degeneration. 
 
 This may be stated in a very few words. 
 The best articles of food are not given, or 
 are altered so as no longer to supply the 
 wants of the body, and another food is 
 given which does not supply fully the 
 daily wants, and which has a stimulating 
 influence which contributes further to 
 weaken the body by undue and premature 
 excitement of its appetites and passions. 
 
 Oatmeal and wheaten flour are, as we 
 
DETERIORATION OF THE YOVNG 99 
 
 have seen, excellent foods for the young. 
 The former has the flesh- and .bone -making 
 ingredients, and cannot be spoiled by any 
 manipulation, as the grain of the oat is 
 homogeneous all through. It is getting 
 more into use among the upper classes, 
 though mostly not as a meal, but as an 
 addition to an already too full breakfast. 
 Wheaten flour has the same good properties 
 as oatmeal, as it is got by grinding the 
 whole grain of wheat as nature gives it. 
 But in order to produce the white loaf, 
 which is now so much used by rich and 
 poor, every particle of the darker exterior 
 is rubbed off in grinding, and the best of 
 the flesh- and bone -forming ingredients is 
 removed and goes to the pigs, thus con- 
 verting one of the best natural foods into 
 a very poor one for the growing child and 
 youth. 
 
 The other food which has come very 
 much into use for the young for the last 
 two generations, is butcher's meat. The 
 
100 ON SANITARY AND OTHER MATTERS 
 
 OX makes a good body of flesh and bone 
 from despised grass and other vegetable 
 substances, but the bone -making material 
 goes to the skeleton of the animal, and is 
 almost totally wanting in the flesh, which 
 is thus a poor food for a growing youth. 
 It no doubt affords a full supply of flesh- 
 forming materials, but, especially in its 
 strongest and most favourite forms of roast 
 beef, beef- tea, and extracts of beef, it 
 contains a non-nutritious, but very stimu- 
 lating element, the effect of which on the 
 young is very disastrous. This is found in 
 its concentrated form in Liebig's Extract, 
 which Liebig allowed to have no nutrient 
 element whatever. But it is one of those 
 substances which lessen the waste of the 
 body, as do tea, alcohol, and other stimu- 
 lants, so that if less food be taken it makes 
 it go farther, but, on the other hand, if 
 more food is taken it interferes with its 
 digestion and leads to repletion with all its 
 evils. The more sapid or tasty a food is, 
 
DETERIORATION OF THE YOUNG loi 
 
 it brings more blood to the stomach, and 
 tends to keep it and the other abdominal 
 organs in a congested condition. This, 
 while it lessens the taste for simpler and 
 better articles of diet, leads to a demand 
 for more food of the same kind, as well as 
 for strong drink. It also increases very 
 much the risks from the infectious diseases 
 of childhood. These I have long known 
 to be very trifling for properly-fed children, 
 if at the same time the air of the house is 
 not contaminated with sewage gases. 
 
 But the greatest evil of a rich animal diet 
 is that it excites prematurely the passions 
 which should be in abeyance till puberty is 
 arrived at. The bad habits this leads to 
 were almost unknown in the early years of 
 last century. I have the best authority for 
 stating that they were then unknown in some 
 and probably in all public schools ; they are 
 well known now to the masters and teachers 
 of schools, and also to the doctors of lunatic 
 asylums, which they help very much to fill. 
 
I02 ON SANITARY AND OTHER MATTERS 
 
 Unfortunately the asylum doctors consider 
 the bad habits to be not the cause of mental 
 derangement but a consequence of it. This 
 is an absurd contention to one who knows at 
 how very early an age the most common of 
 the habits is formed, and how frequently it 
 is lost, if only the exciting flesh food is with- 
 drawn. The latter fact, which I am pleased 
 to say I have frequently verified, goes to 
 prove that high feeding may be an indirect 
 cause of lunacy, but that evil habits are not 
 its consequence. This is another question 
 I have to raise with asylum doctors, but 
 like others I fear they will take no notice of 
 it. They have the fashion of the day with 
 them, which I have not as yet. 
 
 We have seen how lowering is the high 
 system of living to the youth individually, 
 but the same applies to the female, both 
 young and old ; and this accounts very much 
 for the progressive deterioration of our boys 
 from generation to generation. The mother 
 being badly fed herself has little to spare for 
 
DETERIORATION OF THE YOUNG 103 
 
 her unborn infant; she has no reserve especi- 
 ally of bone-forming matter, and what little 
 she may have goes to form the bony skeleton ; 
 for the less immediately important teeth she 
 has very little indeed. If she tries to feed 
 her child her milk has the same deficiency, 
 and it is well that so many mothers of the 
 upper classes give up this very important 
 duty. If a really good nurse is got as a sub- 
 stitute, this may prevent deterioration going 
 farther in the individual child, but I have 
 frequently known that a strong country 
 woman who was rearing a strong healthy 
 child on plain fare, soon failed from being put 
 on a full flesh diet, with plenty of stout into 
 the bargain. Innumerable foods for infants 
 are now in the market, but, if not given in 
 too great quantity, I believe that good cow's 
 milk is on the whole the best, and undiluted 
 even with water if it suits the case. If a 
 child is thirsty or feverish plain water is 
 far the best remedy, but it is seldom had 
 recourse to. 
 
I04 ON SANITARY AND OTHER MATTERS 
 
 It is most unfortunate that the present 
 mode of feeding youths at school has got 
 such a hold of the great masses of the 
 country, especially of the upper classes, that 
 the masters are powerless to change it, al- 
 though knowing well its evil effects. I tell 
 in Plea for a Simpler Life, p. io6, how a head- 
 master, who long thought that the prevailing 
 plan of treating his boys was the right one, 
 came to know that he was mistaken, but 
 found that it was impossible to make any 
 change. This was many years ago, the 
 master is now dead, but the same system 
 still goes on. Another, the headmaster of 
 one of the large English schools, wrote me 
 not long ago, ' We are absolutely bound hand 
 and foot by doctors and mothers who insist 
 on an enormous amount of food being given.' 
 I have long been a preacher in the wilder- 
 ness of a more natural, and infinitely more 
 scientific, method of feeding the young, and I 
 have despaired of seeing any improvement 
 in my day. Now that the bad results have 
 
DETERIORATION OF THE YOUNG 105 
 
 got to SO extreme a degree, as told by M.D. 
 in the Times, it is to be hoped that it will 
 attract the notice of the public, whose opinion 
 and action alone can remedy what is perhaps 
 the worst of the many evils of the day. 
 
VII 
 
 ON ATHLETICS, ETC. 
 
 It is well that each of us should keep his 
 body in good working condition. It is also 
 well that the means whereby this is brought 
 about should be such that this condition be 
 permanent, and not merely temporary, and 
 leading sooner or later to an unsound habit of 
 body, and, after a period of apparent health 
 and activity, to exhaustion and premature 
 decay. 
 
 For a considerable time athletics have 
 been considered of so great value to the 
 growing youth that in some of our public 
 schools and colleges the choice of a master 
 has been determined, not only by his teach- 
 ing powers, but also by his known character 
 
ON A THLETICS, ETC. 107 
 
 as an athlete ; and there is room for the 
 belief that in some instances this latter has 
 been the more potent element of the two. 
 
 Even in the case where safe measures as 
 to food, etc., are resorted to in order to 
 induce an athletic condition of the body, 
 the question may be put whether this is 
 necessary, or even desirable, for the great 
 mass of schoolboys and others who have no 
 intention of making athletics a profession, or 
 who wish only for the eclat to be gained by 
 being victorious in games which require an 
 unusual exertion of the muscles of the body. 
 It is manifest that few can attain this pre- 
 eminence, but it is aimed at by numbers 
 whose natural powers can never enable them 
 to reach the wished -for goal. To most of 
 these the strain may do more harm than to 
 the few whom they strive to imitate. To 
 all, whether naturally strong or feeble, the 
 effort after perfection causes unnecessary 
 and excessive exertion, which must in some 
 measure exhaust the body, and lead to 
 
io8 ON SANITARY AND OTHER MATTERS 
 
 premature decay. I am by no means forget- 
 ful of the aphorism that it is better to wear 
 out than to rust out. This, like many other 
 wise sayings, contains a basis of truth, but 
 it mentions only two extremes, and ignores 
 what is often better than either, that there 
 may be safety in a middle course. This is 
 too often forgotten, and perhaps more than 
 ever in the present day. Another most 
 serious evil arising from the constant excite- 
 ment of striving for the mastery is that it 
 induces a bad habit in the youth which 
 unfits him for the more sober duties of life, 
 and inclines him to keep up excitement, 
 which has become his daily bread, by some 
 sort of gambling in its numerous evil forms. 
 Up till the period of the two last genera- 
 tions many boys delighted in a walk in the 
 country simply, or with the object of making 
 a collection of eggs or butterflies or plants. 
 This I have not met with for many years, 
 except in students of Botany, to many of 
 whom it is more a duty than a pleasure. 
 
ON ATHLETICS, ETC. 109 
 
 There were plenty of games in my young 
 days which gave sufficient exercise and 
 pleasure with a minimum of excitement, and 
 which, along with a wholesome mode of 
 living, led to the forming of a healthy mind 
 in a healthy body, and had none of the 
 elements which, as I have shown in the last 
 paper, are leading to the deterioration of our 
 youth to an extent which few as yet are 
 conscious of, even in their own boys. 
 
 But if an athletic state of the body, when 
 brought about by healthy means, is not 
 wholly a blessing, when reached, as it is 
 mostly in this country at the present day, 
 by a system of living which is the reverse 
 of healthy, it becomes an unmitigated danger 
 to its possessor, and, if kept up for any 
 length of time, ensures for him a broken- 
 down system and a shortened life. 
 
 It has been sufficiently proved that the 
 highest condition of body can be attained 
 on a moderate amount of vegetable food with 
 or without milk, combined with regular and 
 
no ON SANITARY AND OTHER MATTERS 
 
 continued exercise not pushed to any extreme 
 degree. It has also been fully proved by 
 numerous well-known examples that youths 
 and men who live strictly on vegetable food 
 can stand prolonged exertion much better 
 than others in whose diet animal food is a 
 large ingredient. I am not aware that this 
 has been tested in any of our great public 
 schools, in all of which flesh food is freely 
 given at least once a day. 
 
 I do not intend here to discuss the 
 numerous and very sad consequences of a 
 prolonged course of training ; this I have 
 done elsewhere. But I wish to mention a 
 few of the cases which have come under my 
 own observation. 
 
 Some twenty-five years ago, I went, for 
 the last time, to the annual dinner of the 
 Edinburgh College of Physicians. The 
 dinner was then, and I believe is still, one 
 of the most sumptuous given by any public 
 body in the city. I sat next to an old 
 medical friend, and we got upon the different 
 
ON A THLETICS, ETC. in 
 
 methods of bringing up the young. He 
 well knew my ideas, but he said he did not 
 agree with them, and that he gave his sons, 
 of whom he had several, as much butcher's 
 meat as they could eat. I resolved to keep 
 a watch, so far as I could, on their sub- 
 sequent history. He himself died long ago, 
 and it is seldom that I have come across 
 any of the family. But recently I heard 
 accidentally that one of the sons, who was 
 in an excellent position as partner in a lead- 
 ing legal firm, had to give it up, as he was 
 seized with general paralysis when still a 
 comparatively young man. He was well 
 known as one of the first athletes of his day, 
 and as he was so up to quite a recent period, 
 his health had presumably held good till he 
 was laid aside by a hopeless form of disease. 
 Very long ago a clergyman came to see 
 me from the North of England. He had 
 been one of the first men in his college as 
 an athlete, he had kept up his training 
 mode of living, and had led a very active life 
 
112 ON SANITARY AND OTHER MATTERS 
 
 in his parish. For a short time before I 
 saw him he had been troubled with a severe 
 pain in the back for which his doctor could 
 find no cause. An abscess soon manifested 
 itself over the sacrum, and on being opened 
 a large quantity of pus escaped. This was 
 the first of a series of abscesses which showed 
 themselves in different parts of the body, 
 and came rapidly to a huge size. One or 
 two of these were opened by Mr. Syme, 
 and an enormous quantity of pus came from 
 each of them. Then came a huge collection 
 in the groin which Mr. Syme declined 
 to open. He considered the case to be 
 hopeless, as the patient was now reduced to 
 an extreme degree of debility, with a small 
 bright-red tongue, and aversion to take any 
 food. Mr. Syme said I might keep him up 
 for a little with wine or other stimulants, but 
 that opening the abscess would probably be 
 fatal at once. Next day it was giving so 
 much pain from distension that to ease him 
 I was obliged to open it. An enormous 
 
ON ATHLETICS, ETC. 113 
 
 quantity of pus escaped — I should say quite 
 half a gallon. A few days after this I found 
 him asleep from chloroform, which he took 
 occasionally when pain was very severe. 
 He had felt a sudden pain in one of his 
 eyes, which had been for years of no use 
 to him in consequence of an accident. On 
 calling next day I found that the eye had 
 already burst. This, if I remember rightly, 
 was the last of the sudden collections of pus. 
 Altogether, he must have lost many quarts 
 of pus. I did not care to give him wine, 
 and he had no wish for it ; and for several 
 weeks he lived on a very minute quantity 
 of milk, which he took occasionally in sips, 
 more to moisten his tongue than as food. 
 To the surprise of us all he gradually began 
 to improve and to take a little simple food, 
 and he was able to leave for home after 
 being fully three months in Edinburgh, but 
 with only one eye, with a stiff shoulder, and 
 with his right thigh drawn up at a very 
 considerable angle to his body. Some 
 
114 ON SANITARY AND OTHER MATTERS 
 
 months later I went to see him at his 
 vicarage, and found him in excellent health. 
 This case I met with early in my practice, 
 and it encouraged me much to expect good 
 results, even in very hopeless-looking cases, 
 by the simple expedient of leaving them 
 almost absolutely to nature. 
 
 In a recent trip to the East I had, on the 
 return voyage, the opportunity of witnessing 
 the effect of my method of treatment on a 
 young man who had broken down and was 
 coming home in the hope of getting better 
 advice. He was in an excellent position, 
 which would have still improved had he 
 kept his health. He had enjoyed good 
 health till four years ago, when bad dyspepsia 
 came on. He was still a fine powerful- 
 looking man, and had been one of the first 
 athletes in the place, his specialty being 
 boat-racing. Quite recently his doctor told 
 him that he had some very serious organic 
 disease in the region of the stomach. I had 
 frequent talks with the captain of the vessel 
 
ON ATHLETICS, ETC. 115 
 
 on the way out, and he had adopted my 
 views with some enthusiasm. He knew 
 that I had come to sea for a rest, and that 
 I wished to have no patients. The invalid 
 had been treated with no end of drugs, 
 from which he had derived no benefit, and 
 he had found for himself that the only ease 
 he got was by lessening the amount of food, 
 as to which he had no advice whatever. 
 One day after he had read my Plea and had 
 some talks with the captain, he told me that 
 he had resolved to abstain from all food, and 
 I encouraged him to do so. This at once 
 relieved him of the pain from which he 
 always suffered after his meals. For a week 
 or ten days he took nothing like a meal, 
 but I noticed that when he came to the 
 table he would take a small bit of bread or 
 cake. As he was his own doctor I did not 
 object to this, though I saw he sometimes 
 suffered in some degree, and I told him he 
 would be taught by his errors ; occasionally 
 when he had pain I made him lie down 
 
ii6 ON SANITARY AND OTHER MATTERS 
 
 and gave him some massage, which always 
 relieved him. I found then that there was 
 thickening of a portion of the bowel, which 
 I have often found in cases of severe and 
 long-continued dyspepsia, but this was the 
 only form of local disease which I could 
 discover. He improved very much, even 
 in strength, and had he gone on in the same 
 way till the end of the voyage he would 
 have been comparatively well. He was so 
 much better after a fortnight that he went 
 ashore with friends, and took a good French 
 breakfast in a hotel at Algiers, where we 
 stopped for coaling. He was much pleased 
 to find that this did him no harm ; next day, 
 however, he again took a good breakfast, 
 which brought back his painful dyspepsia, 
 and he had to return to a very limited diet, 
 on which he again improved. On leaving 
 the vessel at Liverpool after another eight 
 days, he told me he felt better than he had 
 done for two years, and he was still a strong, 
 healthy -looking man. I warned him of the 
 
ON ATHLETICS, ETC. 117 
 
 difficulty which he was sure to have in 
 continuing his restricted diet, especially with 
 his lady friends. He soon found this was so. 
 In London they insisted on his seeing a 
 doctor, who prescribed the right food but 
 in too great quantity, and his dyspepsia 
 returned. He wrote to tell me this, and 
 I could only advise him to take little food, 
 or none at all, as he found necessary. I 
 soon heard that he had gone to live with 
 a relative in the south ; she insisted on his 
 seeing a doctor, who put him at once on 
 full diet. This, he wrote me, he compelled 
 himself to take, though he suffered intensely 
 after each meal. After a week, on the day 
 he wrote, he had severe haemorrhage from 
 the stomach, and he again asked what I 
 thought he should do. I said that I did 
 not regret the haemorrhage, which would 
 probably relieve the pain, and would certainly 
 prove that feeding would not do, and that 
 this would no longer be pressed upon him. 
 He wrote soon that he did feel better, and 
 
ii8 ON SANITARY AND OTHER MATTERS 
 
 that he had taken to massage, which I had 
 recommended to him from the first. I did 
 not hear firom him for two years, when he 
 came to see me in London. He was then 
 free from dyspepsia, but did not look at 
 all the fine strong man he was when I last 
 saw him. I am very sure that a month's 
 abstinence from food when I first saw him 
 would have put him all right, but, as I have 
 said, he did not consult me, though I quite 
 encouraged him, when he asked me, to 
 continue his abstinence. The dyspepsia no 
 doubt saved him from the fate of many 
 athletes who get no pull-up till it is too late. 
 I had a curious, and almost a unique ex- 
 perience with the numerous ladies on board 
 the vessel in connection with this case and 
 another. A young man was returning from 
 India whose health had broken down from 
 malarial fever, when superintending the form- 
 ation of a tea garden in an unhealthy 
 district in the south of India. He had been 
 obliged to give up his post, and had resolved 
 
ON ATHLETICS, ETC. 119 
 
 not to return. The captain advised him to 
 sit next to me at table, and to live as he saw 
 me doing. This he did most strictly, and 
 he gradually improved. The ladies were 
 perfectly wild at me for encouraging two 
 poor invalids to live so abstemiously, but 
 after seeing the improvement in both from 
 day to day, they changed completely, and 
 the two convalescents were no longer objects 
 of pity during the remainder of the voyage. 
 
 To be a first-class athlete one must have 
 an excellent constitution to begin with, and 
 on a more wholesome system of diet his 
 life ought to be a long one. I have met 
 with numerous cases of extreme full living 
 where the parties had no pretensions to 
 athleticism, and some of them, though fully 
 occupied, took little or no exercise of any 
 sort. Two of them came to grief from huge 
 abscesses opening at the lower end of the 
 sternum. Both were so very stout and 
 loaded with fat that the source of the abscess 
 could not be ascertained. One of them sur- 
 
I20 ON SANITARY AND OTHER MATTERS 
 
 vived his first attack. He had the same irri- 
 table small red tongue as in the first case I 
 have mentioned, he could take little or no 
 food, and got excessively reduced in bulk. 
 Unfortunately, as soon as he was able, he 
 resumed his full feeding, and by and by an 
 abscess again showed itself in the same 
 locality. As I saw he was not to get over 
 this attack I brought another doctor to see 
 him. He was a great friend of the patient, 
 who was a most genial man and was a co- 
 elder with him in the church. On telling 
 him what I believed to be the cause of his 
 friend's illness he got rather angry with me, 
 and could not believe that his friend was 
 such a glutton as I suggested, I had his 
 wife brought in, and asked her only one 
 question, viz, how much butcher's meat her 
 husband took to his dinner. The answer 
 was, " Always three pounds," This was 
 sufficient, and he agreed with me that the 
 case was hopeless. 
 
 In the second case of abscess in the same 
 
ON ATHLETICS, ETC. 121 
 
 region the patient was even larger in bulk 
 than the other. He was a medical man of a 
 very healthy family, many members of which 
 I knew well. I had looked after his family 
 for many years when he was in India, and I 
 never heard of his being ill till I got a sum- 
 mons to London to see him. Before I could 
 get away I heard of his death. These were 
 two of three huge men I have met with. 
 The third was also a strong healthy man, 
 but, like the others, a very full liver ; he died 
 after much suffering from cancer in the 
 bowel, while still also, like them, in the prime 
 of life. 
 
 I have known in the course of a long life 
 many much stronger and healthier men than 
 myself, who seemed to have a much better 
 chance than I ever had of enjoying a long 
 and happy life, but who indulged too much 
 in the pleasures of the table, and who 
 died in their prime. Several of these were 
 medical friends who laughed at my enforced 
 meagre diet, on which I did more work than 
 
122 ON SANITARY AND OTHER MATTERS 
 
 any one of them, I have also known many 
 whose stomach failed them in time and who 
 soon adopted a more restricted diet, and did 
 not resort to drugs to enable them to go 
 on longer in the old way. Most of these, I 
 am pleased to say, are now of a good age, 
 and are still at work, or have given it up 
 not from necessity but from choice. Some 
 had been obliged to give up work when 
 treated in the ordinary way, but on adopting 
 a more rational mode of living found that, 
 had they done this earlier, they might still 
 have enjoyed the pleasures and fruits of an 
 active life. One was a medical man with an 
 excellent business as a specialist, who had 
 retired about twelve months before he wrote 
 to me, owing to serious heart troubles. 
 These left him in great measure when he 
 got his stomach into a less irritable con- 
 dition, and he now can look on what remains 
 of them with an easy mind. Another was a 
 well-known artist who had got almost to the 
 summit of his profession. He was, as many 
 
ON ATHLETICS, ETC. 123 
 
 artists are, of a highly nervous temperament, 
 and he suffered acutely from time to time 
 from gastric attacks, which laid him up for 
 some days. He soon recovered his appetite, 
 and at once returned to his ordinary diet. 
 On reducing this both as to quantity and 
 quality he gradually got into better health, 
 after having been laid aside for many years, 
 and by and by he resumed his art in a 
 moderate degree as an amusement. I am 
 indebted to him for a bit of work, which 
 some of his artist friends tell me is quite 
 equal to anything he did when at his best. 
 
 It is interesting to notice to how great an 
 extent health may be restored after a long 
 period of error, if only the wrong mode of 
 living be given up, and the invalid turns to 
 a better. Nature in this respect is not a 
 hard master, and soon restores the erring 
 one to a happier condition, provided that he 
 now gives up all breaking of her laws. I 
 have found this to hold in so many extreme 
 cases, that I have become unwilling to give 
 
124 ON SANITARY AND OTHER MATTERS 
 
 a hopeless prognosis in almost any case what- 
 ever, unless manifestly at death's door. If 
 health cannot possibly be restored, some pro- 
 longation of life may be granted, and cer- 
 tainly an easier death. This I have seen, with 
 many other instances, in at least two cases 
 of general paralysis, one of the most hope- 
 less terminations of the life of a healthy man 
 who has yielded to excess. In both instances 
 this excess had been very moderate, and they 
 had strong healthy constitutions to begin 
 with. Their digestive organs did not fail 
 them even after the signs of paralysis were 
 well marked, and both continued to indulge 
 their appetite beyond what was prudent, till 
 a sudden attack of apoplexy rendered them 
 more amenable to my urgent request that 
 they would adopt a much stricter regime. 
 On this both lived for many years, and re- 
 tained their mental powers up till the last. 
 One lost the use of his limbs, but was able to 
 spend much of the good weather in his chair 
 in the open air. The other could move 
 
ON ATHLETICS, ETC. 125 
 
 about with tolerable freedom, but he was 
 long annoyed with a degree of paralysis of 
 the throat, and he died suddenly when swal- 
 lowing too large a morsel at table. 
 
 In concluding this paper, which has 
 wandered somewhat from the question of 
 athletics, I wish to impress on young and 
 old that moderation in food and in exercise 
 is the best rule to follow, and leads to the 
 longest, happiest, and most useful life. As 
 to food, this rule must be observed by the 
 individual, as soon as he has emancipated 
 himself from the well-meant, but often dis- 
 astrous, influence of his parents, doctors, and, 
 it may be, of his wife. To many a one, ex- 
 cessive exertion is a necessity, but he will do 
 his work, whether mental or bodily or both, 
 with greater ease and for a longer period, if 
 he continues his moderation in diet. When 
 he makes a breakdown he will have a much 
 better chance of recovery from rest alone, 
 and he may be able to resume his work. 
 He will have now learned that for the work's 
 
126 ON SANITARY AND OTHER MATTERS 
 
 sake he must take it more leisurely in the 
 future. This golden rule of moderation, and 
 its reward, can nowhere be seen so simply put, 
 and with such exquisite beauty of language, 
 as in the few lines from Milton which appear 
 on the title-page of some of the latest editions 
 of Plea for a Simpler Life. 
 
 " I yield it just," said Adam, " and submit. 
 But is there yet no other way, besides 
 These painful passages, how we may come 
 To death, and mix with our connatural dust ? " 
 
 " There is," said Michael, " if thou well observe 
 The rule of not too much, by temp'rance taught. 
 In what thou eat'st and drink'st, seeking from thence 
 Due nourishment, not gluttonous delight, 
 Till many years over thy head return : 
 So may'st thou live, till like ripe fruit thou drop 
 Into thy mother's lap, or be with ease 
 Gathered, not harshly pluck'd, for death mature. 
 
 Paradise Lost, Book XI. 
 
INDEX 
 
 Athletics, supposed value of, 
 
 1 06 ; evils from, no 
 Athletic condition reached in 
 
 two ways, 109 
 
 Baths, waste of water in, I ; 
 water necessary for, 2 ; wet 
 towel a substitute for, 20 
 Bromide of potassium, 77 
 Butcher's meat bad food for the 
 young, 99, etc. ; excites the 
 appetites and passions, 102 
 
 Cataract, an operation for, 60 ; 
 pain (blue) from, 61 
 
 Deformities in 100 boys, 86 
 Deterioration of youth, 98, etc. ; 
 causes of, 98 ; necessarily pro- 
 gressive, 103 
 Dupuytren's contraction of pal- 
 mar fascia, 65, 71 
 
 Eaf th closets, 2 ; earth neces- 
 sary, 3 ; plant requisite, S ; in 
 India, 7 ; value of product, 1 1 
 
 Eczema, 73 
 
 Food for the young, 93, etc. ; 
 for infants, 1 03 
 
 Headmasters, helplessness of, 
 104 
 
 High feeding, evils of, 80 ; hem- 
 optysis from, 117; abscess 
 from, H2, 119; life shortened 
 by, 121 ; benefit from giving 
 up, 123 
 
 Infectious diseases, 24 ; two 
 categories of, 24; isolation of, 
 25; is prevention possible? 28; 
 nursing of, in hospital, 31 
 
 Life at sea, 34, etc. ; common 
 errors, 36 ; benefits from, 44 ; 
 pleasures of, 45 
 
 Milk a perfect food, 96 ; im- 
 proper for the aged, 66, 97 
 Moderation, value of, 125 
 
 Nature not a hard master, 123 
 Nitrogenous food, amount con- 
 sidered necessary, 83 
 
 Oatmeal and wheaten flour as 
 foods, 99 
 
 Phthisis, over-feeding in, 83 
 
 Rheumatic iritis kept off by 
 diet and massage, 65, 67 
 
 Rice-meal, 49, etc. ; analysis of, 
 S3 ; value of, 50 
 
 Sea-sickness, how to avoid, 41 ; 
 
 remedies for, 42 
 Self-massage, 67, 71 ; results 
 
 of, 70, etc., 81 
 Sight, preservation of, by diet 
 
 and massage, 80 
 Spectator, letters to, 88 
 
 Tea, 7S 
 
 Times, letters to, 86 
 
 Trained nurses, 31 
 
 Vegetarianism for best condition 
 of body, 109 
 
 Waste of water in water-closets, 
 
 2 ; in baths, 19 
 Water-closets, water required 
 
 for, 2 ; evils from, 12, etc. 
 Weir-Mitchell treatment, 82 
 Wet towel, a substitute for bath, 
 
 20 
 
 Printed *> R. & R. Clakk, Limited, Edinburgh. 
 
BY THE SAME AUTHOR. 
 In Crown Octavo. Cloth. Price 2s. 6d. 
 
 PLEA FOR A SIMPLER FAITH 
 
 Second Thousand. 
 PUBLISHED BY KEGAN PAUL & CO., LONDON. 
 
 The author's object is to point out that Christianity, as a 
 system of dogmatic apart from moral teaching, has in the 
 light of science no foundation to rest on, and must be given 
 up. The Jewish Bible was till recent years held to give 
 almost the only history of the early ages. Now we have 
 contemporary history going back thousands of years before 
 the supposed creation of Adam. The religion of the in- 
 dividual depends on his birthplace and environment. 
 Each one naturally considers his own cult the best. The 
 literature for and against Christian dogmas is enormous, 
 and bewildering to the ordinary mind. This little book 
 gives facts, from orthodox experts, on which is founded an 
 argument both simple and sufficient. This affects all so- 
 called religions, which, founded each one by a wise reformer, 
 soon degenerate, and, instead of bringing peace to the earth, 
 lead to discord, and to conflicts both external and internal. 
 Leaving these cults, the book points out how man is 
 governed in all his relations, physical, economic, and moral, 
 by fixed law, not, as Paul has it, by the law of Moses, but 
 by law impressed on Nature by a First Cause, who is con- 
 stantly revealing Himself to His creatures in this way, and 
 in no other. Hence the duty of man is to search out God's 
 law, and to work in harmony with it.