diet, bulky and yet not calculated to produce fermentative changes. Such qualities are found in fruits, nuts, cereal compounds and salads. Probably the best drink is buttermilk, which seems to have a salutary effect on the action of both the bowels and the kidneys. Next comes koumyss or zoolak, upon which some elderly folk have been known to subsist almost entirely for years. It is easily made at home and can be thus supplied fresh and sound and is within the reach of all, poor as well as rich. Of the cereals, Indian meal is in some respects the best, in the form of either bread or porridge. Overmuch yeast bread is objectionable, disturbing digestion and encouraging rigidities. The question of the red meats must be studied with regard to the peculiarities of the individual, but is needed very little, usually not at all. Of fluids, these are best taken in abundance, but where the heart is weak it is not wise to take them freely before exercise, as at this time they throw a perilous strain on the cardiac structures. Medicated waters are oftentimes useful, but the less inorganic drugs enter the system the better. The habit of constantly using lithia salts, exerting as they do a certain form of irritation, is to be condemned. If arteriosclerosis is present the vaso-dilator drugs are useful, especially in the forms of natural mineral waters; aconite suits many better than nitrites.
The care of the skin is of paramount importance, and the first desideratum is to employ systematic and thorough rubbing and brushing of the surface from head to heel. The flesh brush or mitten made of coarse toweling, used by the patient for half an hour at a time night and morning, serves many admirable ends and is better than too much bathing. A good plan is for the patient before rising to employ this skin stimulus and mild exercise thoroughly while in the recumbent position; if preferred and he is strong enough it is better done while sitting. The skin of old age tends to become harsh, rigid and dry, and after this effleurage it is well to rub into the body a certain amount of some oil, and it will be found that the skin will take up thus sometimes an enormous quantity. Olive oil or cocoa butter is perhaps best, but preparations containing lanolin are excellent, especially if it is desired to increase the weight and aid accumulations of fat. Sometimes crude petroleum is found useful where stimulation of the surface is required. If the skin be hypersensitive, thought must be given and changes advised in these procedures until the skin becomes inured to a suitable amount of mechanical stimulus. Old people are sensitive to cold because their surface resistance is lowered and their heat-producing powers are waning. The tendency shown by many to stay indoors and keep themselves overprotected and over-clothed is a grave error. This habit should be overcome gradually but firmly, and the patient should be in the open air as much as possible, the clothing used being sufficient, but never too much.
