No. 216.J 417 



impurity of atmosphere, want of natural exercise, and mental dis- 

 quietude. To estimate the separate effect of each of these causes, 

 may be difficult, but their combined influence is unquestionable." 

 After a considerable experience in Dispensary and Hospital practice, 

 I hesitate not to declare, and believe I shall be supported in the opin- 

 ion by my colleagues in the institutions with which I have been and" 

 am now connected, that this disease is the great scourge of the pauper 

 population. It exhibits itself in the skin, in the eyes, the viscera of 

 the abdomen and of the chest, in the muscles, and in the bones; in 

 fact, every organ of the body, which is dependent for its healthy 

 condition upon a sound state of the blood, (and there is no exception) 

 may and does give evidence, differing in each case, of the influence 

 of this degeneration, and the great prevalence of its producing causes. 



The question will very naturally arise in the reader's mind 

 whether much of the ills to which the poor are heir, is not produced 

 by the necessarily restricted quantity, and impure quality, of their 

 food. To this, I reply, that food in the varied imperfections of quality 

 and amount, unquestionably constitutes one of the most frequent and 

 powerful of the causes of human diseases generally. It is, under 

 some of the circumstances of animal organization, no less important 

 to the maintenance ot life and sound health, than air, with, however, 

 this great and essential difference, viz.: that an individual may exist 

 several days without any additional food, but not three minutes with- 

 out air. Further, if he is deprived of but one of the ingredients of 

 the atmosphere, oxygen, instant death is th^ consequence. 



I believe, hov^ever, it will be found, in a vast majority of cases, 

 were food is properly accounted a cause of illness, this is produced 

 by too great a quantity being eaten, or by an alteration of its prop- 

 erties by the refinements of cookery, and the addition of stimulating 

 condiments. Plethora, and its long train of ills, are the results of 

 over feeding, and over stimulation, but these are not the diseases of 

 the poor. Among them we rather find cachexia,* scrofula, and all 

 the consequences of debility and vitiation, which are far more attri- 

 butable to an imperfection and paucity in the nesessaries of life, 

 more especially of air, clothing and cleanliness. Dyspepsia, almost 

 ■wholly the eflfect of improper dieting, is scarcely ever found in dis- 

 pensary practice, while no disease is more common with the wealthier 

 classes. All the ills for which the poor seek advice, whether pecu- 



*A bad habit of body, known by a depraved or vitiated state of the solids and fluids. 



[Am. Inst.] BB 



