be obstinate, I give thrice a day one-quarter of a grain of watery extract of aloes with two grains of dried ox-gall.  I find the simple milk diet a great aid towards getting rid of chloral, bromides, and morphia, all of which I usually am able to lay aside during the first week of treatment.[27] Nor is it less easy with the same means to enable the patient to give up stimulus; and I may add that in the treatment of the congested stomach of the habitual hard drinker the milk treatment is of admirable efficacy.  As I have spoken over and over of the use of stimulus by nervous women, I should be careful to explain that anything like great excess on the part of women of the upper classes, in this country at least, is, in my opinion, extremely rare, and that when I speak of the habit of stimulation I mean only that nervous women are apt to be taught to take wine or whiskey daily, to an extent that does not affect visibly their appearance or demeanor.

Meanwhile, the mechanical treatment is steadily pursued, and within four days to a week, when the stomach has become comfortable, I order the patient to take also a light breakfast.  A day or two later she is given a mutton-chop as a mid-day dinner, and again in a day or two she has added bread-and-butter thrice a day; within ten days I am commonly able to allow three full meals daily, as well as three or four pints of milk, which are given at or after meals, in place of water.

After ten days I order also two to four ounces of fluid malt extract before each meal.  The fluid malt extracts which now reach us from Germany have become less trustworthy than they formerly were.  Some of them keep badly, and are uncertain in composition, one bottle being good, another bad.  The more constant, and at the same time most agreeable, extracts are those now made in this country.  Although their diastasic powers are usually less than is claimed for them, and vary greatly even in the best makes, they so far have seemed to me on the whole more satisfactory than the imported malts.  It is very desirable that a thorough chemical study should be made of the various malt extracts, solid and liquid.  I am sure that some of them are defective in composition, or vary notably as to the amount of alcohol they contain.

No troublesome symptoms usually result from this full feeding, and the patient may be made to eat more largely by being fed by her attendant.  People who will eat very little if they feed themselves, often take a large amount when fed by another; and, as I have said before, nothing is more tiresome than for a patient flat on her back to cut up her food and to use the fork or spoon.  By the plan of feeding we thus gain doubly.

As to the meals, I leave them to the patient’s caprice, unless this is too unreasonable; but I like to give butter largely, and have little trouble in getting this most wholesome of fats taken in large amounts.  A cup of cocoa or of coffee with milk on waking in the morning is a good preparation for the fatigue of the toilet.