CEREALS AND CEREAL GRUELS.

Either the grain itself or the specially prepared flour may be used. When the grains are used they should be spread on a clean table and all foreign substances removed. If the whole grains be used, it is well to wash them, after picking them over, with two or three changes of cold water. Cereals are best cooked in a double boiler. The lower part should be filled about one-third full of water and, if more is added during the soaking, it should always be boiling hot. The cereal should be boiled over the fire for ten or fifteen minutes. The water should be boiled first and then salted. The cereal is added gradually and the whole stirred to prevent it from burning. It should then be placed in the double boiler and steamed until thoroughly cooked. Cereals, like other starchy foods, require thorough cooking. Most recipes allow too short a time. Oatmeal, especially, should be mentioned. It develops a better flavor if cooked for three hours or more, and is better when it is prepared the day before and reheated when used. It should be just thin enough to pour when taken out of boiler, and when cooled should form a jelly.

Any cereal mush may be thinned with water, milk or cream and made into a gruel, or the gruel may be made directly from the grain or flour. Gruels should be thin, not too sweet nor too highly flavored, and served very hot. Milk gruels should be made in a double boiler. Gruels can be made more nutritious by the addition of whipped egg, either the white or yolk or both, and the various concentrated food products.

When cereal flours are used, the flour should be rubbed to a smooth paste with a little cold water and added slowly to boiling water, stirring constantly until it is thoroughly mixed.

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LENGTH OF TIME TO COOK CEREALS.

Cornmeal mush: Boil 10 minutes, then steam for 3 hours or more. Oatmeal: Boil 10 minutes, then steam for l-1/2 hours or more. Irish oatmeal: Boil 10 minutes, then steam for 8 hours or more. Wheatena: Boil 10 minutes, then steam for 10 hours or more. Gluten mush: Boil 30 minutes. Steamed rice: Steam for one hour. Boiled rice: Boil for twenty minutes or until soft.

Arrowroot Gruel.—Dissolve half a teaspoonful of sugar and a quarter of a teaspoonful of salt in a cupful of water and heat. Mix half a teaspoonful of arrowroot flour with a little water and add to the heated water. Boil for twenty minutes, stirring constantly; then add a cupful of milk, bring to a boil, strain, and serve hot.

Barley Gruel.—Proceed as above, using a tablespoonful of Robinson's Barley flour instead of arrowroot.

Oatmeal Gruel.—As above, but use oatmeal, and boil for half an hour or longer before adding the milk.

Farina Gruel.—Proceed as in making arrowroot gruel, using instead a tablespoonful of farina, and boil ten minutes before adding the milk.

Cracker Gruel.—Brown the crackers, and reduce to a powder by means of a rolling-pin. Add three tablespoonfuls of the powdered crackers to half a cupful of milk and half a cupful of boiling water; cook for ten minutes; then add one-fourth of a teaspoonful of salt and serve.

Cornmeal Gruel.—Take a tablespoonful of cornmeal and moisten with a little cold water. Stir this into a pint of boiling water to which a pinch of salt has been added. Cook for three hours in a double boiler, or for thirty minutes directly over the fire. In the latter case it must be stirred constantly.

Gluten Gruel.—Mix a tablespoonful of gluten flour with one-fourth of a cupful of cold water and stir this into one cupful of boiling salted water. Cook directly over the fire for fifteen minutes; then add one clove and cook over boiling water for a half hour.

Tapioca Jelly.—Soak a cupful of tapioca of the best quality in a pint of cold water for two hours; when soft, place in a saucepan with sugar, the rind and juice of one lemon, a pinch of salt, and another pint of water; stir the mixture until it boils; turn into a mold and set away to cool; if desired, a glassful of wine may be added.

Chestnut Puree.—One pound of chestnuts (not horse-chestnuts) are peeled, and boiled in water until the second (inside) skin comes off easily. The chestnuts are placed in a sieve until all the water drains off. They are then washed in a dish and afterwards passed through a sieve. Melt three ounces of butter in a stew-pan on the fire, add a little salt and sugar,—enough to cover the point of a knife, and then the chestnuts. Stew them for half an hour, stirring frequently; pour in enough bouillon so that the mush does not get too thick.

[NURSING DEPARTMENT 653]

Brown Bread.—Take one-half cupful scalded milk, one-half cupful of water, one teaspoonful of salt, one-half teaspoonful of butter, one-half teaspoonful lard, two tablespoonfuls of molasses, one-half cupful of white flour, sufficient graham flour to knead, and three-quarters of a yeast cake dissolved in one-quarter of a cupful of lukewarm water. Prepare the same as white bread. Instead of graham flour, equal parts of graham flour and white flour may be used in kneading.

Whole Wheat Bread.—Dissolve a quarter of a yeast cake in a tablespoonful of lukewarm water. Pour half a cupful of hot water over half a cupful of milk and when lukewarm add the yeast and half a teaspoonful of salt. To this add a cupful of whole-wheat flour and beat for five minutes. Cover and allow this to stand in a warm place for two hours and a half. Then add whole-wheat flour gradually, mixing the mass until it can be kneaded. Knead until elastic; shake and place in baking pans. Cover and allow to stand in a warm place until it doubles in bulk. Prick the top with a fork and bake for one hour. The oven should not be as hot as for white bread.

Cream-of-Tomato Soup.—One can tomatoes, one-fourth teaspoonful soda, one-half cupful of butter, one-third cup of flour, 3-1/4 teaspoonfuls of salt, one-half teaspoonful of white pepper, one quart of milk. Stew the tomatoes slowly one-half to an hour, strain and add soda while hot; make a white sauce and add the tomato juice. Serve immediately.

Cream-of-Celery Soup.—One and one-half cupful of celery, one pint of water, one cupful of milk, one cupful cream, two tablespoonfuls of butter, one-half cupful of flour, one-half teaspoonful of salt, one-eighth teaspoonful of white pepper. Cook the celery in the boiling water until very soft; strain and add the hot liquid; make a white sauce and cook until it is thick cream.

Cream-of-Potato Soup.—Three potatoes, two cupfuls milk, one-half cupful of cream, yolks of two eggs, one teaspoonful of salt, pepper, one-half teaspoonful of onion juice. Cook the potatoes until soft, drain, mash, add the hot liquid, and strain; add the beaten yolks and seasoning. Cook in a double boiler until the egg thickens, stirring constantly. Serve immediately.

Oyster Stew.—One cupful of milk, one pint of oysters, one-fourth teaspoonful of salt, one tablespoonful of butter, pepper. Heat the milk. Cook and strain the oyster juice. Add the oysters, which have been rinsed, and cook until the edges curl. Add seasoning, butter and hot milk. Serve at once This soup may be thickened with a tablespoonful of flour cooked in butter as for white sauce.

Peptonized Milk.—Cold Process.—Mix milk, water and peptonizing agents, and immediately place the bottle on ice. Use when ordinary milk is required. This is particularly suited for dyspeptics and individuals with whom milk does not, as a rule, agree. The flavor of the milk remains unchanged.

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Peptonized Milk.—Warm Process.—Put in a glass jar one pint of milk and four ounces of cold water; add five grains of extract of pancreas and fifteen grains of bicarbonate of soda. After mixing thoroughly, place the jar in water as hot as can be borne by the hand (about 115 degrees). This should be heated for from six to twenty minutes. At the end of this time it may be placed upon ice until required. The contents of one of Fairchild's peptonizing tubes may be used in place of the pancreas extract. If the milk is to be kept for any length of time, it should be brought to a boil, to prevent the formation of too much peptone, which renders the milk bitter.

Hot Peptonized Milk.—Mix together the usual peptonizing ingredients and add a pint of fresh cold milk; after thoroughly shaking the bottle, place it on ice. When needed pour out the required amount, heat it, and drink it as hot as it can agreeably be taken. If required for immediate use, the ingredients may be mixed together in a saucepan and slowly heated to the proper temperature.

Peptonized Milk Punch.—In the usual milk punch recipes the specially peptonized milk may be used in place of ordinary milk. Take a goblet one-third full of finely crushed ice; pour on it a tablespoonful of rum and a dash of curacao, or any other liquor agreeable to the taste. Fill the glass with peptonized milk; stir well, sweeten to taste and grate a little nutmeg on top.

Peptonized Milk Gruel.—Mix with a teaspoonful of wheat flour, arrowroot flour, or Robinson's barley flour with half a pint of cold water. Boil for five minutes stirring constantly. Add one pint of cold milk and strain into a jar; add the usual peptonizing ingredients, place in warm water (115 degrees) for twenty minutes, and then put upon ice.

Junket or Curds and Whey.—Take a half-pint of fresh milk; add one teaspoonful of Fairchild's Essence of Pepsin and stir just sufficiently to mix. Pour into custard cups and let it stand until firmly curdled. It may be served plain or with sugar and grated nutmeg. It may be flavored with wine which should be added before curdling takes place.

Junket with Eggs.—Beat one egg to a froth, and sweeten with two teaspoonfuls of white sugar; add this to a half-pint of warm milk; then add one teaspoonful of essence of pepsin and let it stand until curdled.

Milk Punch.—Shake together in a lemonade-shaker a glass of milk, a tablespoonful of rum, brandy, or good old whisky and two teaspoonfuls of sugar. After it has been poured into a glass a little nutmeg may be grated over the top.

Whey.—Take a half-pint of fresh milk heated luke-warm (115 degrees), add one tablespoonful of essence of pepsin and stir just enough to mix. When this is firmly coagulated, beat up with a fork until the curd is finely divided and then strain. For flavoring purposes lemon juice or sherry wine may be added.

[NURSING DEPARTMENT 655]

Cream of Tartar Whey.—Add a heaping teaspoonful of cream of tartar to a pint of boiling water. Strain, sweeten to taste, and serve cold.

Wine Whey.—Cook together a cupful of milk and half a cupful of sherry wine. As soon as the curd separates, strain and sweeten. This may be eaten hot or cold.

Milk Mixture.—This is made of cream, two parts; milk, one part; lime water, two parts; sugar water, three parts (seventeen and three-fourths drams of milk sugar to a pint of water).

Milk-and-Cinnamon Drink.—Add a small amount of cinnamon to the desired quantity of milk and boil it. Sweeten with sugar and add brandy if desired.

Albuminized Milk.—Shake in a covered jar or lemonade-shaker, a cupful of milk, a tablespoonful of lime water and the white of an egg. Sweeten, flavor as desired and serve at once.

Milk-and-Cereal Waters.—A most valuable method of preparing milk for invalids with whom it disagrees is to mix equal parts of milk and thoroughly cooked barley, rice, oatmeal, or arrowroot water and boil them together for ten minutes. This may be served plain, or flavored by cooking with it a cut-up raisin, a sprig of mace, or a piece of stick cinnamon, which should be strained out before serving.

Irish Moss and Milk.—Soak about two tablespoonfuls of Irish moss for five minutes and wash thoroughly in cold water. Add to a cupful of milk and soak for a half an hour; then heat slowly, stirring constantly, and then boil for ten minutes, preferably in a double boiler; strain, pour into cups and cool. This may be served while hot and may be rendered more nutritious by the addition of the white of an egg stirred into it just before serving.

Eggs.—Eggs and all other albuminous food should be cooked at as low a temperature as possible in order to avoid rendering them tough.

Soft-Cooked Eggs.—Place in a pint of boiling water, remove from the fire, and allow to stand for eight or ten minutes. If the egg is very cold to start with it will take a little longer.

Hard-Cooked Eggs.—Place in water, bring to a boil and then set on the back part of the stove for twenty minutes.

Eggs should be served as soon as cooked and the dishes should be warm and ready.

Rules for Custards.—The eggs should be thoroughly mixed but not beaten light, the sugar and salt added to these, and the hot milk added slowly. Custards must be cooked over moderate heat; if a custard curdles, put it in a pan of cold water and beat until smooth. Custards should always be strained.

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Soft Custard.—Take a pint of milk, the yolks of two eggs, two tablespoonfuls of sugar, and a pinch of salt. Mix all except the milk in a bowl. Heat the milk to the boiling-point and add, stirring constantly. As soon as mixed, pour into the saucepan in which the milk has been heated and cook from three to five minutes, stirring constantly until it thickens. Strain and pour into a cold bowl and flavor with from half to one teaspoonful of vanilla, a teaspoonful or more of sherry, or other flavoring material as desired. Custards may be cooked to advantage in a double boiler.

Soup Stock.—To make stock, use a chicken or several pounds of bones with some meat attached, or a pound of lean meat and one quart of water. Cut-up vegetables may be added as desired. For flavoring add a sprig of parsley and of celery, a peppercorn, a small onion, and a scant teaspoonful of salt. Any of the flavoring vegetables may be omitted as desired or others added. The meat should simmer for several hours, until but half the quantity of water remains. Then add the other ingredients, simmer half an hour longer, strain and cool. Remove the fat.

Chicken Broth.—Take one pound of chicken and a pint of cold water. Clean the fowl, cut it into pieces, and remove the skin. Separate the meat from the bone and chop the meat very fine. Place with the bones (if large they should be broken) in the water and soak for an hour. Cook over hot water for four or five hours at a temperature of 190 degrees. Strain and add salt. Water must be added from time to time to keep the quantity up to a pint. Remove the fat. If the broth is to be reheated use a double boiler.

Meat Broth: Beef, Veal, Mutton, or Chicken.—Cover one pound of chopped lean meat with one pint of water, and allow it to stand for from four to six hours. Then cook over a slow fire for an hour until reduced to half the quantity. Cool, skim, pour into a jar and strain.

Veal Broth.—Pour a pint of water on a half-pound of finely chopped lean veal and allow it to stand for three hours. Boil for a few minutes, strain and season with salt.

Clam or Oyster Juice.—Cut the clams or oysters into pieces and heat for a few minutes in their juice. Strain through muslin and serve while hot. In straining great care must be taken that sand does not pass through the muslin. The juices should be diluted and may be frozen.

Clam Broth.—Wash three large clams very thoroughly, using a brush for the purpose. Place in a kettle with a half a cupful of cold water. Heat over fire. As soon as the shells open, the broth is done. Strain through muslin, season and serve.

Mutton Broth with Vegetables.—Allow one pound of neck of mutton to each pint of water; add carrots, turnips, onions, and barley; let all simmer together for three hours.

[NURSING DEPARTMENT 657]

Mutton Broth Without Meat.—Cook two "shank-ends" in a pint of cold water, and vegetables as directed in the foregoing recipe; simmer for three hours and strain.

Beef Tea.—Cut up a pound of lean beef into pieces the size of dice; put it into a covered jar with two pints of cold water and a pinch of salt. Let it warm gradually and simmer for two hours, care being taken that it does not at any time reach the boiling point.

Beef Tea with Oatmeal.—Mix thoroughly one tablespoonful of groats with two of cold water; add to this a pint of boiling beef tea. Boil for ten minutes, stirring constantly, and strain through a coarse sieve.

Beef Juice.—Broil quickly pieces of the round or sirloin of a size to fit the opening of a lemon squeezer. Both sides of the beef should be scorched quickly to prevent the escape of the juices, but the interior should not be fully cooked. As soon as they are ready pieces of meat should be squeezed in a lemon squeezer previously heated by being dipped in hot water. As it drips the juice should be received into a hot wine glass; it should be seasoned to the taste with salt and a little cayenne pepper, and taken while hot.

Cold Beef Juice.—Cover one pound of finely chopped lean beef with eight ounces of cold water and allow it to stand for eight or ten hours. Squeeze out the juice by means of a muslin bag; season with salt or sherry wine and drink cold or slightly warmed. It may be added to milk, care being taken that the milk be not too hot before the juice is added.

Raw Meat Juice.—Add to finely minced rump steak cold water, in the proportion of one part of water to four parts of meat. Stir well together and allow it to stand for half an hour. Forcibly express the juice through muslin, twisting it to get the best results.

Beef Essence.—Chop up very fine a pound of lean beef free from fat and skin; add a little salt, and put into an earthen jar with a lid; fasten up the edges with a thick paste, such as is used for roasting venison in, and place the jar in the oven for three or four hours. Strain through a coarse sieve, and give the patient two or three tablespoonfuls at a time.

American Bouillon (American Broth).—Place in a tin vessel that can be sealed hermetically alternate layers of finely minced meat and vegetables. Seal it and keep it heated in a water bath (bainmaire) for six or seven hours and then express the broth.

Bottle Bouillon.—Cut beef, free from fat, into squares. Place these in a stoppered bottle, put the bottle in a basin of warm water, heat slowly, and boil for twenty minutes. There will be about an ounce of yellowish or brownish fluid for each three-quarters of a pound of meat used. The flavor is that of concentrated bouillon.

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Methods of preparing raw beef.—Meat given raw should always be perfectly fresh and very finely divided. Scrape the meat with a sharp knife, which will separate the coarser fibers. If the resulting mass is stringy pass through a fine sieve. This may be seasoned with salt and pepper and served on toast, crackers or bread and butter. It may be rolled into small balls and swallowed. These may be flavored as desired. They may also be slightly browned by rolling about rapidly in a hot saucepan, care being taken not to change any but the outside of the ball, and that but slightly. Scraped beef may be served as a liquid or semi-solid food. Mix it with an equal quantity of cold water until it is quite smooth. Place in a double boiler and cook until thoroughly heated, stirring constantly. Add a little salt and pepper and serve at once. This may be made thicker by adding less water.

Raw-beef Soup.—This is made by chopping up one pound of raw beef and placing it in a bottle with one pint of water and five drops of strong hydrochloric acid. This mixture is allowed to stand on the ice over night and in the morning the bottle is placed in a pan of water at 110 degrees and kept at about this temperature for two hours. It is then placed in a stout cloth and strained until the mass that remains is almost dry. The filtrate is given in three portions daily. If the taste of the raw meat is objectionable, the meat may quickly be roasted on one side and the process completed in the manner previously described.

Barley Gruel with Beef Extract.—One-half teaspoonful of "Soluble Beef," two cupfuls of hot water, one tablespoonful of barley flour, one saltspoonful of salt. Dissolve the beef in the hot water, and mix the flour and salt together with a little cold water. Pour the boiling stock on the flour and cook for ten minutes. Strain, and serve very hot.

Beef Broth with Poached Eggs.—Prepare the broth in the proportion of half a teaspoonful of "Soluble Beef" to one cupful of hot water and add a poached egg.

A Nutritive Drink for Delicate Women and Children.—This is made by mixing one-fourth to one-half teaspoonful of "Soluble Beef," five ounces of boiling water and one-half ounce of cream; season with salt and pepper to suit the taste.

Beef Broth with Grain.—Take one teaspoonful of "Soluble Beef," one quart of water, one tablespoonful of rice, and salt to taste. Dissolve the "Soluble Beef" in the hot water and add the well-washed rice. Simmer slowly until dissolved and absorbed by the rice, adding more beef broth if too much boils away. If not entirely dissolved the broth should be strained before using.

Beef Tea Egg-Nog.—This requires one-eighth teaspoonful of "Soluble Beef," one-half cupful of hot water, one tablespoonful of brandy, and a pinch of salt. Beat the egg slightly and add the salt and sugar. Dissolve the "Soluble Beef" in the hot water, add to the egg and strain. Mix thoroughly, adding wine, and serve.

[NURSING DEPARTMENT 659]

Chicken Jelly.—Half a grown chicken should be well pounded, and boiled in one quart of water for two hours until only a pint remains; season and strain. Serve hot or place on ice, where it will jelly.

Veal-bone Jelly.—Place ten pounds of veal bones and ten quarts of water or weak bouillon over the fire and bring to just a boil. Skim and add two pounds of barley and a little salt. Simmer for five or six hours and then strain. If too thick dilute, before serving, with bouillon. Stir in the yolk of an egg in a cup and serve.

Meat Jelly.—This is made by cooking good boneless, lean beef on a water bath with a little water for sixteen hours or until it becomes gelatinized. Of the artificial preparations on the market for making bouillon the most reliable is Leibig's Extract of Meat (10:250 gm.) or Cibil's Bouillon (one teaspoonfnl to 250 gm.), Inaglio's Bouillon Capsules are also very convenient. If it is desired to make a bouillon more nutritious one teaspoonful of meat peptone may be added.

Jelly for Dyspeptics.—Remove the skin and meat from one calf 's foot; wash the bone and place in cold water on the stove; when it begins to foam skim off the refuse which gathers on top. After rinsing off the scum with cold water put the bones into a pot with one-quarter kilo of beef or half an old hen, one-quarter liter of water, and little salt, and boil slowly for from four to five hours. Pour the jelly thus formed through a fine sieve and place overnight in a cellar. Next morning remove the fat and clarify the cold jelly by adding one egg with its shells mashed, beating and stirring steadily. Then, with the addition of a little cornstarch, subject the whole to a temperature not over 60 degrees F., or the white of the egg will curdle. Constantly beat and stir. If the jelly begins to get grainy, cover and let it cool until the white of the egg becomes flaky and separates. Then strain again several times until it becomes perfectly clear; add 5 gm. of extract of meat, pour the jelly into a mold, and let it cool again. The gravy from a roast may be utilized and is very palatable. It must be stirred in while the mass is still warm and liquid. This jelly is usually relished with cold fowl, but spoils easily in summer; it must therefore be kept on ice.

Gluten Bread.—Mix one pound of gluten flour with three-fourth of a pint or one pint of water at 85 degrees. (With some of the prepared flours—Bishop's, for example—no yeast is required). As soon as the dough is mixed put it into tins and place them immediately in the oven; should be made into small dinner rolls and baked on flat tins. The loaves take about one and one-half hours to bake, and the rolls three-fourths of an hour. Either are easily made. The addition of a little salt improves the bread. (When any special brand of flour is used, the directions that accompany it should be followed closely).

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A GENERAL DESCRIPTION OF THE FOUR LEADING SCHOOLS OF MEDICINE: ALLOPATHY, HOMEOPATHY, OSTEOPATHY AND ECLECTICISM.

ALLOPATHY.—Literally the word Allopathy means "other suffering," from the Greek "allos" meaning other, and "pathos" meaning suffering. A more liberal translation would be,—other methods of treating suffering. The term was first used during the latter part of the eighteenth century by Hahnemann, the founder of the Homeopathic School, to distinguish the ordinary or regular practice of medicine as opposed to Homeopathy.

Notwithstanding the comparatively recent origin of the term, however, the methods and theories of Allopathy are based empirically upon the results of the practice of medicine since the time of Galen, and logically upon the scientific facts disclosed by modern research and study. In its broad and popular sense, Allopathy is the preservation of health and the treatment of disease by the use of any means that will produce a condition incompatible with the disease.

The application of the theories and methods of this "old school" necessitates a thorough knowledge of anatomy, pharmocology, pathology, bacteriology, physiology and other sciences. At the present time much stress is also laid upon the means for the prevention and the eradication of diseases and their causes. The inefficiency of drugs is recognized and besides the articles of the Materia Medica the "regular" physician makes use of antitoxins, vaccines, surgery, electricity, baths, etc., in treating diseases. Everyday examples of their methods may be seen in the use of quinine in Malaria, antitoxins in Diphtheria and vaccines in Smallpox, etc.

HOMEOPATHY.—This school was founded by Hahnemann, who lived in Germany over a hundred years ago. Everyone now admits that he was a great scholar. In translating a materia medica he was very much struck with the article on cinchona, where it seemed to state that taken continuously in large doses it would produce all the indications of ague. He tested other remedies in the same way and finally announced his law "Similia Similibus Curantur."

Definition given by a Medical Dictionary of Homeopathy.—"A system of treatment of disease by the use of agents that, administered in health, would produce symptoms similar to those for the relief of which they are given." For instance, ipecac given in large doses, will produce certain kind of vomiting. If the same kind of vomiting, with the other symptoms agreeing, occurs in disease ipecac would be given for the trouble.

[LEADING SCHOOLS OF MEDICINE 661]

But if the vomiting was produced by ipecac, that same medicine would not be given to stop it, but treatment given for an over dose of the drug, ipecac. According to the principles of Homeopathy a medicine is selected which possesses the power (drug diseases) of extinguishing a natural disease by means of the similitude of its alterative qualities, (similia similibus curantur); such a medicine administered in simple form at long intervals, and in doses so fine as to be just sufficient without causing pain or debility, to obliterate the natural disease through the reaction of vital energy.

A great many medicines are used in this way by all schools, but the "regular" school claims it is not an universal law. Some homeopathic doctors claim that the antitoxin treatment for diphtheria, etc. is an application of the homeopathic law. The poison that produces the diphtheria is taken and from this by a thorough and precise process the serum is made and injected into the body of a person who has diphtheria.

Hydrophobia is successfully treated in the same way. A homeopathic doctor has a right to use any sized doses he wishes, but he claims experience has proven that large doses are not often necessary and that the medicine usually acts better attenuated.

ECLECTICISM.—An eclectic physician is a member of a school or system that claims to select "that which is good from all other schools."

This school uses very few mineral remedies, but uses many vegetable remedies. They have introduced a great many vegetable remedies into medical practice and very many of them are useful.

The homeopathic school has benefited very much by the experience of the eclectic system. This school uses remedies in large and small doses. Many of them use the homeopathic attenuated drugs.

OSTEOPATHY.—"The name 'Osteopathy' is made up of two Greek words: 'Osteon,' which means 'bone,' and 'pathos,' which means suffering (to suffer). 'Pathy,' our English equivalent for this word, by usage has come to mean "a system of treatment for suffering or disease. Hence, viewed strictly from its derivation, this term, Osteopathy, would carry only the meaning of bone suffering, 'bone disease' or 'bone treatment.'"

Definition.—"Osteopathy is that science of treating human ailments which regards most diseases as being either primarily produced or maintained by an obstruction to the free passage of nerve impulses or blood and lymph flow, and undertakes by manipulation to remove such obstruction so that nature may resume her perfect work."

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Explanation.—"While it is a distinctive theory of osteopathy that disease conditions, not due to a specific poison, are traceable to mechanical disorder in the body, or some part of it, and that the correction of such disorder is not only the rational treatment, but is necessary to the restoration of a permanent condition of health, yet as a palliative treatment appropriate manipulations are occasionally employed to stimulate or inhibit functional activity as conditions may require. Osteopaths also employ such rational hygienic measures, common to all systems of healing, as has been proven of undoubted value, and take into account environmental influences, habits and modes of life, as affecting the body in maintaining or regaining health."

The "American School of Osteopathy" is located in Kirksville, Missouri.

The course of study required is of three years duration, of nine months each, and the degree of D. O. (Doctor of Osteopathy) is given to the graduates.

OPERATIONS.

There has been a great change in regard to operations among the laity of late years. There is much less opposition and prejudice. The people are being educated to the necessity for operating in many diseases. A great deal of the opposition was due to the doctors themselves. There have been doctors who would operate at every opportunity. Some doctors could not treat a woman for diseases of the womb and ovaries without suggesting that an operation was necessary. There have been a great many healthy organs removed, or at least organs that could have been saved by proper treatment. Fortunately such doctors are becoming less in number and there is more discrimination being used. On the other hand there has also been too much conservatism. Many persons have spent years in suffering who could have been relieved by an operation. Years ago a person suffering from terrific attacks of gall stone colic continued to suffer all their natural life. Now an operation is performed and relief is obtained at very little risk to life. The same is true of cancers, tumors, etc. These, if taken early, can be removed safely and successfully in very many cases and lives saved and suffering relieved.

If an operation is needed the family should go to their family physician, in whom they have confidence. He can do the operation or direct the family as to what surgeon to choose. Bad results of operations are, sometimes, due to the operator. It is the duty of the family to choose a competent and honest surgeon. There are plenty of them all over the world,—and very few competent surgeons operate simply for the money they receive. As a rule they earn all and more than they are paid. There are more surgeons today than ever and they are also more competent, for our medical schools prepare them in the hospitals for that kind of work.

[OPERATIONS 663]

The surgeons connected with our hospitals, public and private, are doing a great work in relieving the ills of humanity, others in private practice are doing great work. Here and there one is found who operates only for the money, but persons who employ such a doctor are usually entitled to the results they receive. Your family physician, even if he is not a surgeon, is the best person to consult when an operation may be necessary. He will send you to some honest and competent man. Operations usually should be performed as early as possible. In malignant disease the operation must be done early. This applies to cancers of the lip, face, tongue, breast, womb, ovaries, stomach and the abdominal cavity.

Then again, operations are far less dangerous now than before the days of aseptic and antiseptic surgery. Cleanliness on the part of the surgeon, nurses and patient is the first law of success in all operations. Any case that becomes infected through fault of the surgeon or attendants is no longer looked upon as a thoroughly successful operation, even though the patient recovers.

As in other branches of medicine, there are now many specialists in surgery. In the major operations it is best to employ a specialist, but in the minor cases the "family doctor" should be competent. If he does not care to perform the operation himself he can advise and direct you in selecting a competent surgeon. Always seek his advice early; do not wait until the patient is weak or dying before you decide to allow the operation, as then the chances are it cannot help. If you are in doubt as to the necessity of the operation consult more than one surgeon. There is a possibility of a wrong diagnosis in some cases.

SPECIAL OPERATIONS.

ADENOIDS.—Should be removed early when they obstruct the breathing. In another part of the book the reasons are given. The same advice is given for tumors and malformations in the nose passages. Such conditions should not be allowed to go on until the parts are permanently deformed or diseased. These operations are done very frequently and successfully now, and many people are saved years of worry and suffering. For more extended account see department of nose and throat.

APPENDICITIS.—There has been a great deal of discussion about this disease. It is no doubt true that many healthy appendices have been removed, but it is also true that many lives have been saved by operation. There is more discrimination now than formerly in this disease. Blood tests, etc., aid in telling when an operation is necessary in acute cases. There is very little danger in a chronic case if the operation is done during the interval of the attacks.

CATARACT.—The operation for this trouble is gloriously successful and the blind are daily recovering their sight through this operation.

MASTOID.—Operations on the Mastoid cells are frequently performed now and save many lives. When there is swelling behind the ear or there is much pain there a careful examination should be made. Chronic cases of Mastoid disease usually demand this operation.

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OVARIES, TUMORS OF THE.—The operation for tumors is very successful. If the ovary is simply enlarged by congestion, medicine will frequently reduce it; but when the enlargement is due to a tumor, it should be removed if it continues to enlarge. Sometimes there is cancer of the ovary. If so, it should be operated upon early. Tumors of the womb, such as fibroids, are often observed. They sometimes require removal if they grow large. The symptoms will indicate when an operation is needed. These tumors often grow so large as to necessitate the removal of the womb.

PERINEUM AND CERVIX.—The perineum and cervix are sometimes torn during labor and should be immediately repaired. The perineum is the support for the organs of generation and if it is not solid the ovaries, tubes, womb and vagina will sag and fall. Neglect of this simple operation at the proper time results in backaches, headaches, etc. Many women have suffered for years and doctored for other complaints when proper attention to the real trouble would have saved all that expense and pain. Your physician should be requested, in advance, to attend before he leaves to any laceration that may occur during labor. At this time it causes little or no pain. If postponed until next day or later it would be painful and require an anesthetic. Many cases of cancer are caused by neglected lacerations.

PILES.—It is often necessary to operate both for external and internal piles. The result is usually complete relief and cure.

CANCERS.—Cancers should be operated on early. A sore on the womb, lip or tongue, or lump on the breast that continues for a little time without getting better, is dangerous. It may soon spread in the surrounding tissue and general system. Operations on the womb and breast, performed in time, are very successful. Such tumors or sores should not be neglected. A lump in the breast should be examined early. The womb should be examined if there is a discharge from the vagina that continues. In such a case the family doctor can determine what should be done. A sore on the lip, tongue, face, etc., that continues and refuses to heal should cause suspicion and be shown to a physician.

PLEURISY.—"Water in the chest" sometimes follows pleurisy. This, if not absorbed, must be drawn off and is quite easily done. After some cases of pneumonia the lung does not clear up properly and pus forms in it. An operation is sometimes necessary to evacuate it. This should be performed before the patient becomes very much exhausted. Some people allow it to continue too long and thus lessen the chances of recovery when an operation is at last performed.

SQUINT.—There is no need for any person being cross-eyed if attention is early given to the trouble. Sometimes properly fitted glasses will correct this trouble, but an operation is often necessary and is very successful and not serious or painful.

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TRACHEOTOMY AND INTUBATION.—The operation of tracheotomy, opening of the wind-pipe, is performed where there is choking from a foreign body in the wind-pipe or when it has become suddenly closed in diseases such as croup and diphtheria. It is always an emergency operation and is only resorted to when it is evident that unless severe measures are taken the patient will choke to death. Intubation is more frequently practised in disease when the breathing has become difficult owing to the growth of membrane in the larynx. A tube of the proper size is placed in the wind-pipe and allowed to remain there until the disease has lost its force and the membrane no longer obstructs the air passage. This tube allows the patient to breathe freely as it furnishes an opening for the air and an attendant notices the change immediately. Intubation should be performed before the patient has become weak.

TONSILS.—A person who is subject to enlarged tonsils should watch them carefully. If they contain pus for any length of time they should be removed, for they not only obstruct the breathing, but are a menace to the health. Enucleation is usually the best method of removal. Enucleation means the operation of extracting a tumor in entirety after opening its sac, but without further cutting. Removal of the tonsils is a simple operation, usually not requiring the use of anesthetics and most physicians advise the removal of an enlarged or troublesome tonsil.

CALCULI OR STONES.—Calculi or stones are removed from the gall bladder, gall ducts, kidneys, ureter and bladder by operations, when it has been ascertained that the patient cannot "pass them." Many physicians prefer to locate the calculus by use of the X-rays before deciding to operate, and there can be no doubt as to the wisdom of this. In these, as in all operations, success depends largely upon the general condition of the patient. They are not considered dangerous operations, but the final decision as to their necessity should rest, in each case, with a competent physician or surgeon.

KIDNEYS, STOMACH, PROSTATE, ETC.—Little can be said in this brief paragraph concerning the many operations that are now performed upon the different organs. What applies to one applies, in general, to all. Operations are now performed, and successfully, for pus in the kidney, floating kidney, etc. Ulcers and cancers are removed from the stomach and reproductive organs. In some cases it has been necessary to remove the organs in their entirety. Pieces of the intestines have been removed with gratifying results in cases of ulcers and injuries. Enlarged prostate nearly always necessitates an operation before relief can be expected. It is impossible here to say much concerning the chances for recovery in each individual case, since they are decided by the strength and temperament of the patient, the care and skill of the surgeon and nurses, and whether the patient has submitted to the operation soon enough in the course of the disease. Let it suffice here to say that the majority of the above-mentioned operations are successful and result in the relief and often the complete recovery of the patient.

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THE HOT SPRINGS OF ARKANSAS.

Government Ownership.—The ownership and control of the Hot Springs of Arkansas by the United States Government is absolute, and its endorsement of them for the treatment of certain ailments is unequivocal. After due investigation, congress took possession of the springs in the year 1832, and it retained around them a reservation ample to protect them from all encroachments, It was the first National park reservation of the country. They are set apart by this act as "A National Sanitarium for all time," and "dedicated to the people of the United States to be forever free from sale or alienation."

The Army and Navy Hospital at Hot Springs.—In the year 1883 the United States Government built a hospital known as the army and navy hospital at Hot Springs, Arkansas, on the Southwestern slope, near the base of Hot Springs mountain, since which time the soldiers and sailors of the army and navy have been sent there for treatment for such ailments as the waters may reasonably be expected to cure, or relieve. In his circular for the guidance of the officers of the army in sending the sick there, the surgeon-general of the United States enumerates the ailments for which the sick should be sent to the army and navy hospital at the Hot Springs. It says, "Relief may be reasonably expected at the Hot Springs in the following conditions: In the various forms of gout and rheumatism after the acute or inflammatory stage; neuralgia, especially when depending upon gout; rheumatism, metallic, or malarial poisonings, paralysis, not of organic origin; the earlier stages of locomotor ataxia; chronic Bright's disease (early stages only), and other diseases of the urinary organs; functional diseases of the liver; gastric dyspepsia, not of the organic origin; chronic diarrhea; catarrhal affections of the digestive and respiratory tracts; chronic skin diseases, especially the squamous varieties, and chronic conditions due to malarial infection." Approved, GEO. H. TORNEY, Surgeon-General U. S. Army. J.M. DICKERSON, Secretary of War.

Privileges of Ex-Soldiers of the Civil and Spanish-American Wars.—Honorably discharged soldiers of thc Civil war, and the Spanish-American war, can obtain admission to the army and navy hospital at Hot Springs in the following manner, and under certain conditions:

First.—Write to the Surgeon-General, United States Army, Washington, D. c., for blank applications and instructions.

Second.—Upon receiving the blank application, fill it out properly, and return it to the Surgeon-General, when, if there is room in the hospital, he will forward to the applicant papers entitling him to admission to the hospital. The conditions are that such ex-soldier shall pay forty cents per day during the period he remains at the hospital. Such payment entitles him to board, lodging, baths, medical treatment and medicine.

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Free Baths for the Indigent People of the United States.—By act of congress approved December 16th, 1878, the government maintains a free bath house for the indigent people of the United States of both sexes. No baths will be supplied except on written applications made on blanks furnished at the office of the bath house, making full answer to the questions therein propounded: then if the applicant is found to be indigent, in accordance with the common acceptations of the word, the manager will issue a ticket good for twenty-one baths, which may be reissued on the same application if necessary. The daily average of baths given at the free bath house for the year 1909 was more than six hundred.

The government is very broad and liberal in construing the meaning of the word indigent; and the fact that the applicant for free baths has some property, seems not to act as a bar to the privilege of free baths. Ninety per cent of the patients admitted to the Army and Navy Hospital are either cured or relieved. Taking into consideration the large number of old civil war veterans treated at the hospital, whose ailments have become chronic, this is a very remarkable showing.

Physicians' and Medical Regulations.—The United States Government, through the interior department, regulates and controls the practice of medicine in connection with the hot waters. A local federal medical board passes on the applications of physicians who wish to prescribe the hot waters. All who meet the requirements of the board are placed on the accredited list. Copies of this list are hung in all the bath houses and only those whose names appear thereon are permitted to prescribe the hot waters. For the benefit of visitors these lists are also kept at the office of the superintendent of the reservation near the Army and Navy Hospital. These regulations apply only to those who take medical treatment. Others get the baths without formalities of any kind. In addition to the Army and Navy hospital and the government free bath house, there are twenty-five bath houses operated by private parties, eleven of which are situated along the western base of Hot Springs mountains on the government reservation, and fourteen are on private property at various other points throughout the city. The relations of all the bath houses to the government are the same. They each pay the water rental to the Interior Department of the United States. The government's interests are looked after by a superintendent of the reservation, who is appointed by the President of the United States. He has charge of all improvements going on, on the reservation and enforces all government rules and regulations concerning the bath houses.

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Cost of Living at Hot Springs.—Hot Springs is not located in a good agricultural section, and it is not a manufacturing city; therefore, the boarding and lodging of visitors is their only source of income. Upon nearly every house in the city is displayed the notice that board is furnished, or furnished rooms are for rent, with or without light housekeeping. A few places furnish board and lodging for $4.50 per week; the most general charge, however, is from $5.00 to $6.00 per week. Renting rooms, arranged for light housekeeping, is the cheapest method of living at Hot Springs. The above prices are intended to show the minimum cost of living.

Where to obtain additional reliable information relating to baths, board, etc., at Hot Springs, Arkansas.—First. Apply to the superintendent of the United States reservation, corner of Central and Reserve Avenues, Hot Springs.

Second. The business men of the city have an organization known as the "Business Men's League," which is intended and prepared to furnish reliable information by letter or personal application to the secretary and managers of the Business Men's League. Persons visiting Hot Springs should not rely upon advice, information, or propositions from strangers either on the train or in the city.