DISORDERS OF METABOLISM. 459 



Alcohol, Quinia, Kesorcin, Kairin, Chinolin, and Salicin, also 

 diminish the activity of the natural metabolic ferments. 



Complex Measures. Some of the most powerful means at our 

 disposal for influencing nutrition are a combination of the pre- 

 ceding measures. The best illustration of this is the treatment 

 carried on at a foreign bath, we shall say at Aix-les-Bains, in 

 Savoy. Here an English patient enters a new, a purer, and a 

 warmer atmosphere. His food is reduced in quantity and 

 changed in quality ; he has to take active muscular exercise ; he 

 enjoys a daily bath, which is really a complex arrangement of 

 washing, rubbing, douching, and frequent change of surface 

 temperature; and he has to drink a definite amount of the 

 waters, which contain Soda, Lime, Magnesia, Iron, and Iodine. 

 Such a combination of measures is manifestly powerfully 

 alterative. 



Tonics, which increase the tone or general muscular and nutri- 

 tive vigour, belong, as we have seen, to several of the preceding 



III. PATHOLOGICAL RELATIONS. 



The disorders of metabolism are many and complex. 

 Diseases so wide apart as gout, syphilis, and malaria, and dis- 

 orders so different in their cause and effects as fever and fatty 

 degeneration, are linked together by the fact that they are all 

 affections of nutrition. In this place we can refer but to a few 

 of them, and that very briefly. 



The cause of metabolic disorder is most frequently found in 

 the ingesta. An excessive supply of lymph to the active cells, 

 an unnatural richness of the blood in proteids from indulgence 

 in food, or an insufficient supply of oxygen from insufficient 

 exercise, will disturb general metabolism as they disturb hepatic 

 metabolism, and contribute to the production of the diseases 

 known as obesity and gout. Deficiency of plasma is a result of 

 anaemia, as we saw in the last chapter ; and since it generally 

 accompanies aglobulism and deficiency of oxygen, the result is 

 feebleness of metabolism throughout the entire body. Meta- 

 bolism is also disturbed by sudden and extreme alterations of 

 external natural influences, such as the temperature, moisture, 

 pressure and electrical condition of the air ; and local changes 

 of temperature give rise to chills, colds, and rheumatism. 

 The opinion, however, is daily growing that fever and many 

 other disorders of metabolism are often due to the entrance 

 into the tissues of unnatural, extraneous, or infective substances, 

 whether inorganic, organic, or organised, such as foul air, the 

 contagia of measles, scarlatina, and other exanthemata, and 

 the organisms of malaria, syphilis, and tuberculosis. It is 

 suggested that these organisms interfere with metabolism by 



