TREATMENT OF DISORDERS OF METABOLISM. 461 



illustrative way in the present work. A careful consideration, 

 however, of the principles laid down under the preceding heads 

 will, it is hoped, enable the student to extend his knowledge 

 practically on his account. 



The general treatment of disorders of metabolism involves 

 the regulation of the whole manner of living : of the food and 

 air, the work done, the excretions, and, above all, the careful 

 balance of these. Muscular and nervous exercise must be 

 ordered in fair proportion, to prevent obesity and gout on the 

 one hand, or exhaustion and degeneration on the other. 



When an actual instance of metabolic disorder demands 

 treatment, we must first attempt to discover its cause, and to 

 remove it by the same measures which might have prevented 

 it. Thus the cause of gout may be swept from the system in 

 many instances by a timely and thorough reform of the diet, 

 and stimulation of the bowels, liver, and kidneys by a com- 

 bined cathartic and cholagogue, followed by a saline, as recom- 

 mended under the head of the Liver. Lead poisoning may 

 be cured in the same way, by hastening the excretion of 

 the metal by Iodide of Potassium. When these or other 

 disorders of metabolism, such as rheumatism, syphilis, and 

 tuberculosis, have become chronic, great benefit is derived from 

 change of air and treatment by natural baths. We can some- 

 times remove fatty degeneration, that marked instance of 

 imperfect metabolism, by removing its cause an imperfect 

 blood-supply, local or general, e.g. by Iron. In other cases 

 we may attempt to destroy, if we cannot remove, the cause ; 

 thus it is possible (but not certain) that Mercury partly cures 

 syphilis by directly destroying its virus ; Quinine malaria ; and 

 Salicin rheumatism. 



As a rule, however, in the more pronounced, the so-called 

 specific, forms of disordered nutrition, such as tuberculosis, 

 cancer, and syphilis, all that we can do is to counteract the 

 cause, and relieve or remove its effects ; that is, to treat 

 symptoms. The specific fevers, such as typhoid and scarlatina, 

 must be similarly treated symptomatically, for their course 

 cannot be arrested. The pyrexia is combated by febrifuges or 

 antipyretics, which we shall discuss fully in another chapter ; 

 the waste is repaired by nourishment ; and other symptoms are 

 relieved as they arise. Inflammation and its effects abscess, 

 effusions into cavities, growths, adhesions, and so on will be 

 treated by local stimulants or alteratives, such as poultices ; 

 friction with alcoholic, aromatic, and oily preparations; douching, 

 baths, blisters, etc., to which we shall return in chapter xiv. ; 

 or they may demand surgical interference. In other kinds of 

 metabolic disorders, such as tuberculosis (phthisis, consumption), 



