62 FOTHERGILL'S MEDICAL PAPERS CHAP. 



days, or in two or three weeks, or in as many months, or yet 

 seldomer. 



It is often treated, he continues, as a nervous distemper, 

 but he thinks that the headache proceeds from the stomach, 

 and that it is due to the effect in some constitutions of reiter- 

 ated errors in diet, both as to the quality and quantity of the 

 food, associated with costiveness. He supposes that the 

 aliment operates by altering the quality of the bile secreted. 

 FothergiU's treatment is to give an emetic, with warm water, 

 and a mild cathartic to follow. Thus he prescribes aloes, with 

 rhubarb and liquorice root, infused in lime-water, and spirit 

 of lavender ; also mineral waters drunk for a proper length 

 of time. But dieting is of the first importance. Butter, 

 especially when melted, fat meats, spices, black pepper, meat 

 pies, rich baked puddings, and strong liquors are harmful. 

 In quantity, a just medium is to be found by abstaining at 

 the first sensation of satiety ; the how much must be deter- 

 mined by each individual. 



He goes on to a review of English habits of diet. More 

 people, he thinks, suffer by immoderate eating than by hard 

 drinking; the latter practice being now generally banished 

 to the vulgar. He recalls that the famous Dr. Mandeville, 

 when dining with the earl of Macclesfield, was often asked : 

 ' ' Doctor, is this wholesome ? " " Does your Lordship like it ? " 

 "Yes." " Does it agree with your Lordship ?" "Yes." "Why 

 then it is wholesome." Fothergill's own constitution, being 

 " a good deal below the middle point of general strength," 

 has obliged him to be careful in his own diet ; moreover, he 

 has spent most of his life in observing the effects of food on 

 the infirm and invalid. Different nations, he goes on, subsist 

 on very various foods, yet enjoy reasonable health. In the 

 East they live on rice and vegetables ; some nations on fish, 

 others on mixed diets ; some use fermented liquors, some 

 none. Our organs of digestion are so constructed that we 

 can gradually accommodate ourselves to every species of 

 aliment. But this is not the case in regard to the quantity 

 of food ; if it is insufficient, we decay ; if too much, fatal 

 oppression ensues. 



The English meals, he says, are breakfast, dinner, and 

 supper. At the first, tea, coffee or chocolate is drunk ; those 

 who are not robust should limit the heat, the strength, and 

 the quantity of these drinks, and little sugar should be added. 

 As to the bread and butter or sugar which are taken at the 

 same time, strong organs are requisite to digest much bread. 

 The husbandman may do it, but in weak stomachs the bread 



