560 DISEASES OF THE STOMACH. 



oxaluria is more frequent in England, where the people cat and drin,; 

 more and better food and liquor than in Germany, and that in the 

 latter country it is almost only seen among people of the better 

 classes, who enjoy the pleasures of the table. Little inclination as I 

 have for chemico-physiological hypotheses, I still believe that, from 

 these facts, we may consider it as probable that the oxalic diathesis 

 and oxaluria are to some extent caused by the supply of nutriment to 

 the body exceeding the requirementa. At the same time, I will not 

 dwell on the question as to whether, while this misproportion exists, 

 the consumed products can only be brought to a low degree of oxida- 

 tion ; or whether the abnormal increase of substances at a low grade 

 of oxidation in the excrements of the body, such as oxalic acid, uric 

 acid, etc., depends upon other complicated and still wholly unknown 

 causes. I think I can support the observation that, in general, persons 

 who become fat with good living remain healthier than those who pro 

 duce but little fat under like circumstances, and particularly more so 

 than those who, continuing their mode of life, lose fat While, as a rule, 

 the former only suffer from certain inconveniences dependent on their 

 corpulence, the latter often complain of all kinds of distresses, which 

 physicians usually associate with portal obstructions or haemorrhoids, or 

 deduce from gouty, rheumatic, or catarrhal diseases. This renders it 

 probable that, in many cases where there is the above-mentioned dis- 

 proportion between the supply and demand, and this is not at once 

 removed by increased production of fat, the products of the change of 

 tissue are modified, and that the above-described difficulties depend on 

 an abnormal nutrition of the different organs by the blood, which is 

 overloaded with quantitatively or qualitatively abnormal excremental 

 material. After a long continuance of the hypochondriasis, the dis- 

 turbance of digestion, the pharyngeal and bronchial catarrh, pain in 

 the joints, especially the smaller ones (of which groups of symptoms, 

 first one, then another becomes prominent, or is even exclusively pres- 

 ent), such persons usually become feeble, pale, and thin, so that they 

 appear to have a severe and grave affection. The urine, which is usually 

 concentrated and acid, does not always show characteristic changes. But, 

 in most cases, abundant sediments of uric-acid salts are occasionally de- 

 posited. According to my experience, tonic treatment, and the use of 

 wine, and preparations of quinine and iron, to which we may be tempted 

 by the weakness, pallidity, and emaciation of the patient, are almost al- 

 ways injurious ; while the use of alkaline-saline mineral waters haa 

 the happiest results, particularly when combined with cold washing, 

 or cold douches (as is often done by Dr. Muller, in Homburg), or if sea- 

 bathing be tried after the water-treatment. I have no great experi- 

 ence in oxaluria and the oxalic diathesis, but those cases that I have 



