384 -/HE TREATMENT OF DISEASES. 



so many different restaurants English, French, German, and Italian that if a 

 man cannot manage to get a little variety now and then, it must be his own fault. 

 In some places you can even have your dinner served up to the accompaniment of 

 vocal and instrumental music, which, we suppose, is to be regarded as a stimulant 

 to the mucous membrane of the stomach. 



The practice of taking bitters before meals with the view of increasing 

 the appetite is a common one. It is undoubtedly a bad habit, but in certain 

 functional derangements of the stomach an occasional gin-and-bitters or sherry- 

 and-bitters may have its advantages. We may mention, en passant, that the 

 custom of taking what has been called an " epigastric spurrer," is by no means 

 confined to our own country. In France the oysters and chablis or sauterne 

 with which a dinner bien monte is preceded, may be regarded as an institution. 

 In Denmark and Sweden dinner is invariably prefaced by a mouthful of caviare, 

 or salt fish, or a dram of raw spirits. In Russia dram-drinking and condiment- 

 eating preparatory to the prandial meal, are customs very widely disseminated, 

 and in the United States we hear that pickled oysters and small cubes of salted 

 cod are frequently to be seen on the marble bars of their palatial hotels, although 

 these latter are probably to be regarded less as incentives to eating than as 

 provocatives to drinking. 



Probably the drug most frequently employed with the view of stimulating 

 the jaded appetite is quinine. Two table-spoonfuls of the tonic quinine mixture 

 (Pr. 9) should be taken about half an hour before meals, or two table-spoonfuls 

 of quinine wine will do equally well. The infusion of quassia may also be used 

 for this purpose, and its efficacy is greatly enhanced by the addition of three 

 or four drops of tincture of nux vomica. Nux vomica is one of the pleasantest 

 bitters we know, and will often succeed admirably, even when given in plain water. 

 Other tinctures and infusions employed for a similar purpose are those of calumba, 

 gentian, chirette, and cusparia. These infusions should be given in two table- 

 spoonful doses, while the dose of tinctures is a tea-spoonful in water. The tincture 

 of nux vomica it will be remembered is a much more powerful drug, and the 

 close of this should not exceed eight drops. The different preparations of hop 

 are useful, but are, we think, best taken in the form of bitter beer. Absinthe, 

 or wormwood, is largely employed on the Continent. With many people, especially 

 those who are predisposed to constipation, two or three table-spoonfuls of compound 

 decoction of aloes, or " Baume de Vie," will succeed better than anything. We 

 have given a formula for a "dinner-pill" (Pr. 65), which in many cases acts 

 admirably. For elderly people, pepsin taken in five-grain doses half an hour 

 before meals is useful. We need hardly say that for patients who are anaemic, 

 or suffering from what is usually called "poorness of blood," iron is the remedy 

 (Pr. 1 or 2). 



LOSS OF VOICE (APHONIA) HOARSENESS. 



By the term " aphonia " we mean loss of voice. It may vary in degree from 

 slight impairment to complete dumbness, and it may be temporary or permanent. 

 It may be due to mere functional disorder or to some structural change in the 



