attacked by the leucocytes and become mingled with the blastema, through which they become suffused with a certain molecular activity imparted to them through the influence of the nucleus. This pabulum thus constructed is appropriated by the individual tissue cells as it is carried through the capillaries. Thus the leucocytes become the distributers of tissue pabulum throughout the organism, and aside of this they possess the power to antagonize spe

cific pathogenic germs. Their function becomes impaired whenever special exertion on their part is required for the purpose of attacking foreign substances in the blood circulation or whenever insufficiently converted food is submitted to their further physio-chemical elaboration, and such impairment demonstrates itself in their abnormal structure. Thus the blood is the indicator by which we may determine the physiological action and effect of air, food, drink, medication or auto-intoxication. In diagnosing disease by blood examinations we must combine the data derived from the following procedures:

First, estimation of hemoglobin.

Second, alkalinity and specific gravity. Third, count of red and white corpuscles.

Fourth, study of fresh blood specimen. Fifth, study and count of stained blood specimen.

The hematologist should be able to make a diagnosis from blood in mostly all diseases. There are but few physicians who are unable to recognize anemia by insufficiency in hemoglobin and decrease of red corpuscles from the normal number. The degree of anemia is determined by a pathological count of the white cells. Chlorosis is easily differentiated from anemia by noting a larger deficit in the amount of hemoglobin than in red corpuscles. A pathological count of the leucocytes also becomes necessary. Malaria is positively diagnosed by the finding of the malarial parasite and and according to the structure of the plasmodium we can positively determine the appearance of paroxysms. Septicemia is

easily recognized by the finding of specific bacteria in the blood, and, again, the severity of the case may be determined by a pathological count of the leucocytes. Syphilis in its various stages is readily recognized by the finding of crenated red corpuscles with ameboid movement, and subsequently the finding of nucleated red corpuscles and neutrophiles in the stained specimen. A thorough understanding of physiology, pathology, bacteriology, and microscopy in all their various branches, and the continuous work in these scientific branches of medicine, are the requirements for a hematologist. The trend of advancement in medicine is favorable towards this latest and ever-improving science, and this is no more than the fulfillment of the rationale of thought.

FOOD AS AN ETIOLOGICAL FACTOR IN DISEASE.

EVER since the original episode of eating "forbidden fruit" in the Garden of Eden, according to Dr. Georgia Merriman in the Med. Record, man has been troubled by what he ate; thus giving the patent-medicine man, proprietary pharmacies, and quacks the field of stomach and kidney specialists.

Is it not time that the whole medical fraternity, from center to circumference, attempt to recover the legitimate ground by scientific investigations along these lines of inquiry?

If the amount of strength, heat, and power, mental or physical, to be developed from a certain amount of food can be measured in the chemical laboratory, may not the dosage for food become as exact as the dosage for medicine?

Correct dietaries for the brainworker, the manual laborer, and the average citizen in good health have been accurately estimated by the scientific experts in government employ; but the perfectly adjusted diet for patients afflicted with gout, rheumatism, and allied diseases, caused by retention in the system of alloxuric bodies, intended to

be either dissolved or eliminated, is still unknown to the average practitioner. One forbids the use of beef, cheese, and eggs, because of the xanthin and hyperxanthin developed in their metabolism; while another forbids all food which produces nucleo-proteids, or purin-nitrogen, and a still larger proportion permit all kinds of food to be ingested, depending upon drugs to aid in their rapid elimination.

The trend of hygienic thought to-day is toward preventive remedies. The etiological germ is fast disappearing under an antiseptic therapy, the laity have resorted to patent and secret remedies, and the general practitioner continues his old humdrum practice founded upon theories long since exploded.

Is not this the opportune moment for the physiological chemist to furnish some reliable data upon which each physician may construct a suitable diet for each patient, or group of patients, if he have enough to group them? All honor to original investigators like Röhmann, Haig, Kossel, Salomon, Horbaczewski, Flatow, and others; but is not the dearth of general conclusions most manifest?

Is it wise to allow rheumatic patients or those suffering from uric-acid diathesis to continue consuming food which will certainly increase the amount of colloid urates, while you are concentrating all your efforts upon their elimination? In other words, is it not reprehensible for any doctor to be ignorant of the preventative methods of treatment as well as the eliminative? The list of diseases caused by the continued use of indigestible foods is increasing daily. Some of the most-learned nasal and throat specialists are now advocating the theory that certain forms of nitrogen are present in lithæmia, gout, migraine, acute coryza, la grippe, and many, if not all, neuralgias. But as expressed by another: "The average medical man clings to an old idea in pathology or treatment with a tenacity that blinds his eyes and deadens his ears to the heralding of a new theory, though born to point the way to the living truth, and if,

perchance, it demolishes the images of a blind idolatry, lucky indeed is it if the very truth be not sacrificed upon the altar of conservatism, or crucified upon the cross of unbelief.

The point I wish to make is this, that in my opinion the time is ripe for an entire revolution in the administration of drugs. The proper digestion and the proper ingestion of food constitute the most successful field of therapy now known to man.

Then, why should not every well-informed physician write a prescription for food, which would exclude the articles of diet known to cause the conditions producing the disease he is trying to cure? I have found a written dietary almost indispensable in securing a change of food, and oftentimes order the exact quantities to be taken.

The fact that albumin from animal foods leaves a larger percentage of uric acid than albumin from vegetable sources need not necessarily make vegetarians of all, even though it does behoove those suffering from indigestible xanthin bodies to restrict their use of animal nitrogenous combines. The field of inquiry, in this direction, is so fertile that post-graduate courses in dietaries for every disease would be a boon to mankind.

Individual experimentation is slow and inaccurate. In the accurate government experiments, under the direction of Professor O. A. Atwater, it was found that dietary idiosyncrasies played no essential part in the perfect nutrition of man as to quantitative analyses, but the digestive powers varied with the individual. Have we not overlooked this fact in trusting blindly to the use of drugs in latter-day therapeutics? The powerful alterative effect of medicine was highly esteemed by the old-time practitioner. Do we not seek the same end by alkaline treatment to-day? In my specialty of stomach diseases I have found that other diseases disappear under the wisely chosen diet and exact régime necessary to supplement the proper administration of drugs for the diseased organ. An exhibition of

alkalies, such as sodium bicarbonate combined in tablet form with oil of gaultheria, is followed by decided relief of all symptoms of rheumatism, gout, acute coryza, la grippe, and asthma; and the general improvement continues if the diet is restricted to zwieback, or well-cooked, that is, twice cooked, wheat, barley, or oats, with nuts finely divided, and green watery vegetables. All bread, potato, and uncooked starch cells are excluded. Fruits and salads are used ad libitum. Dr. Conklin's ideas of the uses of fats in the system are sustained by results from their administration, and a logical sequence from his premise might be that the larger percentage of nitrogenous material, combined by nature with so great a proportion of fat, aids in the more perfect metabolism of the alloxuric bodies, thus rendering nut foods safer than an excess of meat or egg.

ECONOMY IN THE USE OF FOODS.

"As the world becomes more densely populated and civilization more artificial, the study of economics," writes Ina E. Holroyd, in The Industrialist, "becomes of vital importance. Where there is a superabundance of food, and living is in the simplicity of nature, the instinctive wants of humanity for food are easily supplied; but where the population becomes congested in a country, or for any cause the food supply is cut short, then the question of economy in its uses becomes more pressing and its solution is not only a duty but a necessity.

"In our own republic, where every man is born to the highest privileges and where the stability of the government depends upon the integrity and intelligence of a free people, there should be the amplest provision made for their instruction in all branches of economics; for the status of a country depends upon its material prosperity and the development of its people. Our industrial schools, where domestic economy is a part of the regular curriculum, are one of the evidences that our people are endeav

oring to instruct along this line. The special cooking schools are doing a good work, the only fault to find being that they are too few.

"Economy, not only in the use of food but also in its choice, should be taught, so that each may know how and what to buy to provide for the necessary requirements of the system in the most economical way. Each should know, also, the chemistry of the materials and of their preparation and their specific uses in the system; for the great waste of food is not in the amount of actual matter thrown away, though this is large, but in the use of the wrong kinds of food. In the first instance the waste is so manifest as to be in itself an aid in correcting the evil; but in the latter the waste is more subtle, being in the lack of nourishment and not readily observed by untrained minds.

"What we need is practically trained women of scientific study, who have the courage of their convictions to direct common thought into this channel of domestic economy. Let it be given all the dignity of schools and universities, and the coming generation will find public opinion so aroused in this line of thought that it will be considered a disgrace to any woman to set before her family food of which she has no knowledge in regard to its comparative nutritive properties or suitability to their needs.

"Our needs are largely met by instinct. The Esquimau eats quantities of fat to enable him to resist the cold while the tropical inhabitant lives upon glutens and fruits easily obtained and easily digested. But while instinct will select those foods absolutely essential to preserve life under certain conditions, yet it is not a safe guide in selecting food for the best development of the higher manhood. The Esquimaux are a stupid and degenerating race and the rice-eaters are an effeminate people. Whether a change of diet would infuse new life into the one and strength into the other is a question; but intelligent investigation will make many discoveries of value to the economist.

"It has been ascertained that a man in

active life requires about five ounces of nitrogenous food and twenty ounces of carbonaceous for muscle-making nutriment, while the brain and vital energies are nourished by phosphates, the amount required varying in proportion to the activities, but being much less in quantity than that of the nitrates. The phosphates which give vitality are concentrated in the germs of all seeds, so that an understanding of the properties of different foods will show which are best adapted to our needs and, therefore, most economical.

"If we have food containing just the proper proportion of the necessary elements we shall eat only enough to supply the system with the necessary nourishment, but if we have food containing ten times as much of the carbonates as of the nitrates, then we shall eat twice as much of the carbonates as is required to get the necessary supply of nitrates, and this extra amount is largely a waste. It then follows that to be most economically and well fed we must have food containing the required amount of carbon, nitrates and phosphates, and when the proper portion in these supplies is not observed there is waste of both food and energy. Life has its limitations in every line of activity and we have to choose which we will follow or be blindly tossed on the waves of accident; and if vital energy is uselessly expended there will be that much less force to expend along the lines of worthy activity. Sound minds cannot emanate from unsound bodies; they will be more or less warped by the aggravations of the flesh and manhood will fall below its high estate. This question of food and its waste thus becomes one of moment to the State; and political and moral philosophy may well make it a study, for not only the material but the moral advancement of our country depends largely upon its wise and practical solution.' When the American woman learns to apply chemistry and physics to everyday life many of the briars in this working-day world' will disappear; for she will then waste neither time nor material in preparing what is not needed.

"We select our food largely from habit, not from thoughtful consideration. We have always been accustomed to fine wheat bread upon our tables and it seems a necessity, yet in that form bread is only a broken reed to lean upon. The flour has lost nearly 95 per cent, of its nutritive properties in the process of grinding and bolting; but make bread of the unbolted wheat flour and it becomes the staff it is said to be; for it then contains all the elements for sustaining life. Mr. Bellows says that it takes fifteen barrels of fine wheat flour to afford as many of the elements required to sustain life as are afforded by one barrel of unbolted wheat flour. Consider, for a moment, the waste in this one item of our daily living! To supply this lack in our bread we must eat other things, selected with the same disregard to their properties, and again there is great waste, often from thoughtlessness but oftener from ignorance of the principles of nutrition and economy.

"There is space here to mention only a few articles in which the comonm diet of the people might be economically improved, and we need not depend entirely upon theoretical principles; for practice has shown the value of many articles and science only shows us the why and broadens our understanding of their uses. Throughout the southern states cornmeal is a staple of diet the use of which was an economic consideration with the planters; for it was soon discovered that "hoe-cake" and "dodgers" would satisfy the cravings of hunger for a longer time than any other form of bread. Dried peas and beans are nutritive but lacking in carbon, so we rationally prepare them with pork and have a palatable dish. Vegetable soups with a little meat stock are nutritious and cheap, but are not so much used in this country as in some others, probably for the reason that economy of food has never been so much a necessity in this land of bountifulness. The question, however, is being more and more studied, for no other branch so closely affects the common people as this one of economy of food.

"Food cannot be selected entirely by chemical analysis; we must profit by experience, as well as by progresive investigation; for what is meat for one under some conditions is poison to another under different conditions, and we are not to eat unsavory food just because it may contain certain required ratios of nitrates, phosphates, etc. Our food should not only be nutritious but palatable and agreeable to the senses. Let our tables present the most esthetic appearance consistent with our condition. There is economy in this, for eating made agreeable and performed in a refined manner is less voracious. Yet what is palatable depends much upon education, and our children should be trained in the use of wholesome foods with simple and not highly seasoned

sauces.

"As soon as careful thought is given the subject, it becomes a simple matter to supply a family with the most nutritious and appetizing food with one-half the outlay usually made. When this saving is considered in the aggregate it is astounding.

"We may trust the women of our country to adopt any economical measure that can be shown to be needful for the better and higher advancement of the race; and where can she so quickly and surely effect a change as in this, her own particular domain?

"If countries have declined and lost their power among nations from extravagant indulgences, why may not a country rise to the highest pinnacle of strength and influence by the frugal use of such nutrients as give the greatest activity and highest expression of vital energy?"

thing before attempting even a concert selection. If the digestion of a vocalist be normal, it is always best to eat about two hours before singing. The body should rest for three-quarters of an hour after eating, and, if possible, no faculty should be used arduously during that time. Reading interferes with digestion, and any mental exertion delays the process just so much longer. The animal which eats a good dinner and then lies down teaches a very good lesson, especially to vocalists. The food should be slowly digested and allowed to replenish every exhausted part of the system, then the voice is prepared to do good work.

The stomach should be empty when great vocal effort is to be made, but it should not be in the weak state that follows want of food. Every organ needs strengthening just so often, and if allowed to go too long without proper nourishment will not perform its functions without unnecessary and injurious effort. The body replenished by food responds to the will with power and ease, and the vocalist appreciates how necessary a good physical condition is to a successfully sung aria. Attempting to sing on a heavy dinner is impossible. The voice with a few minutes' practice after eating is usually very good, but there is no room to breathe, and the tones waver, while the phrases are broken by the inability to control the breath. The lungs require room to expand, and if the room is not there the effect is immediately observed.

Adelina Patti uses so little breath that it seems as if she needed none at all, and this is the way every voice should be used. The facility with which she uses art spares her body any strain, and she exhausts about onethird of the amount of vital force when she

WE find this question thus answered in London Health:

Among the questions which vocalists have to settle for themselves is that of eating. Some of the greatest singers of the world cannot sing for hours after they have eaten, while others must eat almost the last

they use. She steps from the stage into the green-room capable of going through the scenes again, while others are too prostrated to speak. Her voice is fresh, and will remain so for years to come, simply because she is not demanding anything of the body or throat. The voice should be the last organ to show declining power, and rightly used