bestowed on the subject of it. It is always necessary to treat the patient, and sometimes what is seemingly necessary for his ailment is very poor treatment for him, if too long kept up. We especially note this in respect of the employment of wine and stimulants, and in the conduct of cases of Bright's disease and of chronic gout,
I think well of the skim-milk treatment in cases of chronic tubal nephritis. But it is not always well borne by the patient. He may fail to be sufficiently nourished by it, and a time comes when the diet must be altered. There is a large variety of foods available in this condition: bread, biscuit, butter, light farinaceous pudding, sometimes with egg in it, potatoes, spinach and other green vegetables, with cooked fruit. The albuminuria is often not materially increased in chronic cases if fish be given once a day, or the yolks of two eggs be added to the diet. Fat bacon may also be taken. And on alternate days we may sometimes give a little mutton or chicken, without any apparent harm to the disease, and with material benefit to the patient. The condition of the urine must be carefully noted in making these amendments. Certainly, in some cases, the "large white kidney" is an expression of a frail and feeble constitution, and has not always the same significance. A better level of general nutrition, directed in relation to the renal adequacy, may much aid in helping the kidneys to recovery. It is surely wrong to starve the patient while aiming only to rid him of his ailment. Of course, age, habits, constitution, and tissue-proclivity must be had regard to in all such cases.
The treatment of acute phases of dysentery by absolute milk diet I believe to be excellent; and I agree with those Indian authorities who forbid the least addition of animal broth or of farinaceous matters to it, possibly for many consecutive weeks.
In many cases of gout and gouty habit of body I often find inadequate diet prescribed, and a frail, painful condition of body as the result. In such cases, again, each person is to be studied as to his previous habits, inherited proclivities, and textural condition. The prohibition of meat and wine is often bad, and gouty manifestations will be held in check, not seldom, by a good diet and the use of some trustworthy wine. The tendency now is to make all gouty persons avoid meat, and drink whisky in routine fashion, or to take to water-drinking. The latter plan has its place, but many sufferers from gout, in both sexes, are better with some wine. If they starve themselves of what they formerly took, perhaps in moderation, and of what their progenitors took perhaps too freely, they will not so much have gout as gout will have them—as has been quaintly remarked. Such persons must attain their highest level of good health, and live above their
