The difficulty in the beginning with this sort of practice is in finding a ready way to get patients interested and in making them remember to do the substitute thing, the thing that starts a new channel in the brain. A square talk will bring some to a realizing sense of how their habits operate against their health and happiness; others may be aroused by having their pride appealed to; with others love of children makes a beginning possible; some by being encouraged strive to live up to their ideals, while for those who have no purpose beyond a dollar, the thought that they ought to become a reflection of the best there is in them that they may be loved and cared for. when old, will start them right. Habit is often stronger than the best sort of an impulse at first, but after several good talks for a foundation and some failures, it will suddenly dawn upon the person who tries that he is beginning to think and act in the better way and that the habit which has robbed him of his peace for years and made him miserable in soul and body is fading away. The Appian Way for this particular set of impulses through his brain, that started, he doesn't know where or when, has filled up at last from disuse. Mental emancipation is simply a revelation to the person who tries and wins.

Worry-heads wear their habits much as a man does his hat in the house, not because he needs it but because he does not concern himself to take it off. A little philosophy is all that is required to start a

When the worry is over something that cannot be helped allowing it to dominate one's life only to make it miserable profits nothing.

Hurry is certainly more a habit than a necessity. Want of system, procrastination and the American way of doing things are at the bottom of it. The hurry variety rush off to church even and then home again as if the devil were after them. Perhaps he is. They are a thread-bare lot usually both mentally and physically. They should be told to go to bed half an hour earlier than they do, to get up fifteen minutes earlier

than they do, to go everywhere fifteen minutes sooner than they would, to take the next car instead of running for the one in sight, to walk downstairs and ride up. All roads lead to Rome, but the man in the sulky doesn't always get there first. The man in the yellow wagon with the tin pails rattling under the seat, whose horse keeps the "same strong" right along, in a twenty years' race often proves the winner. Hurriers should be made to realize that there is time enough for them in this world to work out the thing for which they stand as exponents in the highest degree, and they have no need to break their necks, nor break their backs while doing it. The periodical drunkard, if he is not a degenerate, has only to be taught to put his left hand in his pocket for a bit of dry chocolate, instead of putting on his hat with his right and going across the street for a drink

his release is already begun. When he discovers that he can satisfy his mental or nervous craving in this way and that the effect is as grateful as beer, if he has any forbearance at all, or any character left to nail to, he will quit. And the man who cultivates the blues, not

only has the habit but has a regular hour for it. He was fairly himself when the freshness of the morn and the first warmth of the sun were his, and again when the full splendor of the day was on; but when the shadows began to lengthen the cloud on his mind deepened. He went to look at nature at for him the wrong time. By changing the hour and giving him something definite to do, in time he was cured. Even beautiful nature has to be used and abused that we may be disciplined. Every expression line in our faces is the reflection of self-building or self-denial in some direction. The man with the telephone temper has only to put a picture of himself in a rage on the wall over the instrument and every time he looks at it he is bound to laugh or feel ashamed. The picture will save him from a break until his mind and not this habit is master.

The ability to establish mental discipline where deficient, and gain the mastery

over one's self, with the greater happiness and usefulness that goes with it, is something that can be acquired by nearly every one who is willing to strive for the development of the best there is in him-the best there is in life and living. Abnormal mental states not only aggravate ills, the result of physical causes, but they create and maintain others entirely their own, and until controlled, no amount of other treatment will set "a body" right. The physician who fails to recognize habits as causative in making a diagnosis and in treating them intelligently will often record failures in his chosen field of work. To train the good grandfather in his patients until he is more than a match for the bad one is certainly the work of every physician who has at heart the best health of his people. Not but that we expect the bad grandfather to have his inning-we do. 'Tis absurd to think he is never going to grace the arena with his presence and gain a fall out of the good grandfather occasionally; but when it comes to the final test, the question of character, and the good grandfather or the bad grandfather and something else, the better man must win.

THE COFFEE HEART.

THE largest part of the coffee grown in the world is consumed in the United States, and some of our life insurance societies are beginning to realize how its excessive use increases the risks of life.

Its effect is in shortening the long beat of the heart, and medical examiners for insurance companies have added the term "coffee heart" to their regular classification of the functional derangements of that organ. These physicians advise that the use of coffee be limited to not more than two cups a day. Coffee topers, they say, are plentiful, and are as much tied to their cups as the whisky toper. The effect of the coffee upon the heart is more lasting, and consequently worse than that of liquor.

THERE is no lack of good, bad and indifferent advice about bathing. Nor is there any lack of variety in the character of such advice. With so much volume and variety it would be strange if much of it were not vague and contradictory. Those who are most profuse in their proffers of advice on this subject seem to labor under a handicap of either theory or prejudice, or of a combination of the two. These they either inherit, or acquire by means of a very restricted experience. Many of them lose sight of the fact that bathing has at least two distinct objects-cleanliness, and psycho-physiologic reaction. This latter is often expressed by the terms metabolism, tissue metamorphosis or trophic stimula

tion.

two.

A bath that is adapted to the first object has but little potency toward effecting the second. Certain forms of baths accomplish both results, to a certain extent, and many people have hardly given the matter sufficient thought to distinguish between the To such a bath is a bath whether hot or cold, momentary or prolonged; although such people generally consider it necessary to spend a considerable time in the bath. They put themselves a-soak much as they do their laundry clothes. There are extremists as in case of all other sanitary and hygienic practices. Many people bathe too often, or perhaps too much would better describe their prolonged séances in the water, in their peculiar way, and many others bathe too little in any way.

These extremists vary all the way from those who never wet the skin except of the face, hands and feet, from one year's end to another, to those who spend hours, daily, in the bathtub. Many of these classes have no conception of the real meaning or function of the bath. A neglected

skin fails to do its proportion of the necessary offices of the body, it fails to do its share of the elimination of waste, and, what is more important, fails to do its duty as an aid to the oxidizing work necessary to the integrity of the organism. Oxidization underlies all the vital processes and cannot be interfered with or diminished except at serious cost. If one organ or set of organs fails to do its share of this work, the burden is made heavier on other organs, and in time these break down from overwork. They grow tired, lag in their functions, fall below the normal, become engorged, hypertrophied, the condition soon resulting in a low form of chronic inflammation; and this, in time, is followed by a fatal termination. If it be the liver, the result may be called fatty degeneration, cirrhosis or possibly carcinoma. If it be the kidneys, then it is fatty kidney, Bright's, contracted kidney, or what not. The overworked organ gives out and the patient dies prematurely, the death certificate alleging the induced complaint instead of the real cause, which was neglect of the cutaneous function; to use plain terms, a lack of oxidation and elimination.

In a state of nature, to which it is about as fashionable as it is useless to advert, the bath came every time it rained. Our hirsute ancestors probably were strangers to huckabacks and the thick luxurious scratchy Turkish towels that are now so common. They probably needed no towels; but they no doubt bathed as a matter of real animal enjoyment, and were as much at home in the water as on land. For our comparatively effeminate condition we can draw but feeble conclusions and learn only general lessons from their habits. The bath rules in the Garden would not be applicable at Manhattan Beach.

BATHING FOR CLEANLINESS.

One's skin is a very potent and important regulator of temperature and second only to a few other emunctories for the elimination of the waste products. This

assertion is made with deliberation, notwithstanding the contrary opinion so strenuously urged by a talented writer in a recent contribution in the columns of THE GAZETTE. Its three million—or is it thirty million?-mouths are miniature sewers and aid in keeping the waste matters so constantly forming washed out of the system. Any interference with their function throws this work upon other eliminative organs, as already set forth, and causes physical disaster. To prove this it is only necessary to note the immediate effects of the thorough bath. Take a patient whose secretions are loaded with noxious excrementa, whose nerve centers are depressed, whose breath is decidedly offensive and whose general condition is that of manifest toxemia or auto-infection; place him in a very hot bath, using suitable detergentssoap or the alkalies,-follow this with a dash of cold water and plenty of friction. Result, all the symptoms are promptly relieved, foul breath "sweetened," depression gone and nerve centers returned to normal conditions. It is usless to attribute these remarkable effects to "suggestion"-which has become a refuge argument for many writers, who cannot explain certain phenomena on any rational basis-or to friction, heat, cold or magnetism. The chief effect is elimination. For eliminative purposes the hot bath stands preeminent, and this bath may begin with a hot air exposure as in the Turkish hot room. This exposure will make thorough work of opening up the sewer mouths and flood gates of the skin. The copious imbibition of water in advance will aid the process by supplying the necessary liquid for the work of flushing the sluice-ways. When perspiration has been vigorously established the body may be showered with hot water or placed in tub of the same for a few minutes, and every part well rubbed, pinched, pulled and kneaded to aid in squeezing out the detritus that may have become impacted from inspissation or from lack of sufficient liquid in the system. This process completed, a cold plunge of very brief duration does

wonders at restoring the normal tone and putting the human animal in happy touch with itself and the rest of the world.

THE INTERNAL BATH.

Until very recently little has been thought or said of the internal bath, as an important factor in studying the function of the bath. It is not necessary to take it up as a hobby, to the neglect of other forms of bathing, as has been done by the vendors of special varieties of colon-flushing apparatus; but it deserves much more attention at the hands of the profession and of hygienists than it has yet received. In fact, the internal bath does not consist in merely flushing the colon with a good deal of flourish and some force, as the hobbyists teach, since the colon is but a segment of the internal surfaces that need the laving process. Every inch of mucous membrane, every artery, arteriole, vein and venule, every glandular structure, viscus, secretory or excretory apparatus, muscle, tendon and even bone in the entire organism is affected by the process.

The colon is but one avenue, and not the most effective one towards its accomplish

ment.

Most people neglect this internal bath much more than they do the external ablution. Their bodies are much of the time in

the condition of a city without a sufficient water supply to flush its sewers.

This involves the question of water-drinking, which is the more essential method of the internal bath.

The subject demands a more extended consideration.

THE CARE OF THE AGED.*

BY EWING MARSHALL, M.D., OF LOUISVILLE,

KY.

No subject should be more delicately handled than that of growing old. The number of years a man or woman has lived is no criterion as to his or her physical con

* Reported to the Louisville Clinical Society.

dition. The French adage that "A man is as old as his arteries" tells the story, especially if you include the heart as a part of the arterial system.

Temperance through youth and maturity. certainly predisposes to longevity. A man. though he has lived eighty years, if he has a good arterial system, has by no means outlived his usefulness.

It has been my pleasure and profit to come in contact with a number of such cases.

My next-door neighbor, eighty-seven years of age, trims his own vines and fruit trees; climbs upon ladders and does other things that most men of sixty would fear to attempt.

It may have simply been coincidence, but all of the hale, elderly people that I have come in contact with have partaken moderately of liquors, especially of wine with

their meals.

Now my whole being revolts at intemperance, and a drunken man has my intensest pity, but I am convinced that moderation in the use of liquor certainly does not diminish the chances for longevity. Of course age alone should not be the test, but the usefulness or the helplessness ought to weigh equally with us in our advice on this subject. A mental blank with a strong physical frame is a curse rather than a blessing.

Again I would say that temperate use of liquor has seemed to predispose not only to longevity but also to useful old age. Occupation is also a sine qua non. As long as the mind and body have systematic use so long will their condition be predisposed to health. Mental and physical exercise alike should be used but not abused. Neither mind nor body is benefited by exhaustion at any period of life, and the best development comes from the greatest amount of exercise always short of exhaustion. Exhaustion is a menace, first, in that it may suddenly terminate the individual's existence, and second, that it may permanently cripple some organ. How frequently we see permanently injured hearts from imprudence practised during convalescence from some taxing disease. We can

equally imagine that other organs are injured in the same way though the power to demonstrate it is lacking. Probably many a great mental machine has been sacrificed by a too early return to severe mental labor after a debilitating disease. Much more must the aged be guarded from any form of exhaustion, as they have greatly reduced recuperative powers. Let me repeat, then, mental and physical exercise alike should be used but not abused.

Diet is a subject fraught with pitfalls. No iron-clad rules can be laid down. Individuls reaching an advanced life, as a rule, should not suddenly or greatly alter their way of living. Where they have been practically total abstainers from alcoholic liquors, and from one cause or another are without appetite, I question very much the propriety of making a false appetite with stimulants. All stimulants to the aged should be given in a guarded way; especially any tonics with nux vomica or its alkaloid strychnia in them. I believe many a hemorrhage into the brain or elsewhere has been superinduced by such measures. Their brittle vessels are not prepared for the sudden tension placed upon them. Where little or no exercise is taken, with a sluggish condition of the bowel, it becomes a burden for the system to have a great mass of material poured into the stomach. We sometimes see a morbid appetite in the aged as we do at the other periods of life, but I always look on this boulimia as an index of some serious trouble that is brewing, and it sooner or later announces itself. Lack of appetite is a much less serious symptom with me, and generally by improving the action of the skin and bowel, and gradually increasing the mental and physical exercise, a proper appetite is restored.

THE NEGLECT OF THE DOCTRINE OF HEREDITY BY TEACHERS. PROFESSOR SMEDLEY, of Chicago, has investigated the height, weight, vital capacity, nervous energy and strength of some seven

thousand children in public schools. His conclusion, as reported, follows: "The whole physical, mental and moral future of children depends upon their training during the early adolescent period. It is then they show the greatest aptitude for learning. With the departure of the plastic period their characters have been formed."

From the first part of this opinion, one would suppose that heredity plays no part in "the physical, mental or moral future of children," and that all of us are born with equal mental-and physical-capacity. Oliver Wendell Holmes must have been mistaken when, in referring to certain defects, he said: "The doctor should have been called in a hundred years ago." Huxley, in attaching so much importance to heredity and in insisting that all men are not born with equal mental powers, must have been talking upon a subject of which. he had no knowledge. It seems strange that the leaders of scientific opinion consider heredity a paramount factor in man's physical make-up, while many teachers ignore it altogether. To anybody who uses his eyes, the truth of the doctrine of evolution in general, and of the hereditary character of almost all congenital variations, is proved every day.

A NEW AID IN DETERMINING THE LOCATION OF WELL WATER.

ONE of the recent improvements which the United States Geological Survey has introduced in its excellent series of geologic maps is an arrangement of lines by which the depth of the rock layers which are known to produce water can be determined. These lines are drawn to show the depth below the surface of both the upper and lower faces of the water-bearing rocks in the section covered by the map and add a valuable feature to these already useful publications. The information on which the introduction of the water lines is based is being gathered by skilful geologists who are making a thorough study of the under