CONSUMPTION OF THE LUNGS. 251 



nourishing food until it becomes evidently dangerous to persist in so 

 doing. As soon as this is evident, the so-called law of nutrition is 

 utterly ignored, or, rather, it is flagrantly violated. In selecting suit- 

 able nourishment for consumptives, articles commended, time out of 

 mind, by rude experience, are found to be in complete agreement with 

 the current physiological laws of assimilation and nutrition. All the 

 food which is regarded as especially proper for phthisical patients con- 

 tains large quantities of fat or of fat-generating matter, and a compara- 

 tively small portion of protein substances. This accords with our 

 experience, that the production of urea, and hence the destructive 

 assimilation of nitrogenous constituents, is augmented by an increase 

 of the supply of protein substances, while, by a simultaneous free sup- 

 ply of fat or fattening food, the destructive assimilation and consump- 

 tion of the organs of most importance in the body are diminished. Thus 

 the use of milk, to which little children owe the plumpness of their 

 limbs, and from which corpulent persons do well to abstain, cannot be 

 sufficiently urged upon consumptive persons. It is altogether useless, 

 however, and indeed wrong, to remove the casein of the milk, and to 

 give it in the form of whey, unless, indeed, the whey agree with the 

 patient better than the milk, which is rarely the case. I often order 

 my patients to drink a pint of milk " warm from the cow," three tunes 

 a day, but have no other object in so doing than that of preventing 

 the milk from being skimmed, which is impossible immediately after 

 milking. The milk of animals which pasture in the mountains, such as 

 goat's milk, but, above all, ass's milk, is in especial repute, and it is 

 desirable to send patients, who can travel without danger, to places 

 where there are dairies where a supply of good fresh milk is to 

 be obtained. Where this cannot be done, the " milk-cure " must be 

 practised at home. The name is of importance, in order that the 

 patients may have faith in the treatment, and follow it out punctually. 

 I have treated a great number of patients who, as soon as they found 

 that they increased appreciably in weight, for half a year at a time 

 drank three or four pints of milk daily without repugnance. 



The use of cod-liver oil is also highly commendable, and, when it 

 agrees well with the patient, may be combined with plenty of milk. 

 It is more than doubtful whether this oil, which is hardly ever with- 

 held in phthisis, at all events in Germany, exerts any specific influence 

 upon the disease. The quantity of iodine in it is so trifling, that it 

 cannot be taken into account, hence it is probable that all its beneficial 

 effects are solely due to the large amount of fat which it affords. This 

 is all the more likely, as dog's fat is a popular remedy for consumption, 

 as ancient and well-tried as cod-liver oil. 



Of late years I have obtained very good effects from an extract of 



