78 
D. D. CUNNINGHAM. 
advancing, but the amount of nutritive material ingested was 
correspondingly reduced, and was so small as to be within the 
control of the remaining digestive tissues. On admission into 
camp a larger amount of food was supplied ; the digestive and 
absorptive apparatus which had formerly sufficed was now rela- 
tively greatly reduced, and the surplus food-elements became 
mere sources of irritation. It has long been recognised that 
great caution is necessary in regard to food-supply after even 
comparatively slight starvation. Where changes in the tissues 
have only been slight, careful dietetic treatment, so as to avoid 
irritation, may suffice to tide over the danger, and ultimately 
effect a cure. Where, however, extensive destruction of the 
tissue-elements of the mucous membrane has taken place, it is 
clear that no dietetic treatment, however carefully carried out, 
can be expected to effect recovery ; dietetic treatment may save 
a weakened mucous membrane ; it cannot make a new one. 
All the phenomena observed in the present series of investiga- 
tions point to the absolute necessity of great caution in regard 
to dietetic experiments, dietetic systems of punishment, &c. 
They show that it is not safe to push such procedures in the 
belief that, so long as no evident active evil results present them- 
selves, we can at any time pull up and restore things to their 
normal state. The fact that in so many cases the fatal diarrhoea 
and dysentery first manifested itself in people after their 
admission into the relief camps is very significant. The people 
in such cases were admitted into camp, showing, no doubt, 
symptoms of extreme general mal-nutrition, but suffering from 
no active symptoms of disease. The mischief had, however, 
been irrevocably accomplished, and it only require a change — a 
favorable change too — in conditions to cause it to manifest 
itself. 
The insidious character of the mischief has a most important 
bearing on the practical question of the management of famines. 
Due to it relief camps may, to a great extent, be rendered useless 
by the people failing to have recourse to them until it is too late. 
They, too, are likely to be deluded by the idea that, where no 
active symptoms have appeared, no permanent damage has been 
done, and that they may safely delay until their distress has 
counter-balanced their natural inertness and dislike of disturbing 
their ordinary habits. 
Calcutta ; October^ 1878 . 
