management alone. It is, in fact, the old story with regard to all
new things: there is no discovery, from the steam-engine down to
chloroform, which cannot be shown to have been partially foreseen,
and yet the claims of Watt and Simpson to originality remain
practically uncontested. And so, if I may be permitted to compare
small things with great, will it be with this. The whole matter was
admirably summed up by Dr. Ross, of Manchester, in his remarks in
the discussion I introduced at the meeting of the British Medical
Association at Worcester, which I conceive to express the precise
state of the case: 'Although Dr. Mitchell's treatment was not new
in the sense that its separate recommendations were made for the
first time, it was new in the sense that these recommendations were
for the first time combined so as to form a complete scheme of
treatment.'"

As regards the acceptance of this method of treatment I have to-day no
complaint to make. It runs, indeed, the risk of being employed in cases
which do not need it and by persons who are not competent, and of being
thus in a measure brought into disrepute. As concerns one of its
essentials--massage--this is especially to be feared. It is a remedy
with capacity to hurt as well as to help, and should never be used
without the advice of a physician, nor persistently kept up without
medical observation of its temporary and more permanent effects.

CHAPTER II.

GAIN OR LOSS OF WEIGHT CLINICALLY CONSIDERED.

The gentlemen who have done me the honor to follow my clinical service
at the State Infirmary for Diseases of the Nervous System[2] are well
aware how much care is there given to learn whether or not the patient
is losing or has lost flesh, is by habit thin or fat. This question is
one of the utmost moment in every point of view, and deserves a larger
share of attention than it receives. In this hospital it is the custom
to weigh our cases when they enter and at intervals. The mere loss of
fat is probably of small moment in itself when the amount of restorative
food is sufficient for every-day expenditure, and when the organs are in
condition to keep up the supply of fat which we not only require for
constant use but probably need to change continually. The steady or
rapid lessening of the deposits of hydro-carbons stored away in the
areolae of the tissues is of importance, as indicating th