The cause of consumption is the tubercle bacillus. It is present in many persons and they do not know it. They are looked upon as delicate, and may be thus delicate ten years or more. This term of probation may be years before it leads to a fatal issue. Let the patient be exposed at any time to contagious surroundings and the end may rapidly come. For a long time he has been tuberculous, now he may become a consumptive. What we call secondary infection here supervenes. The pulmonary tracts become infected, the tissues break down, pus forms, and chills are frequent. If possible, treatment should commence before this secondary infection is under way. In addition to diet, the sufferer must have fresh air, sunlight, cheerful surroundings, rest more or less absolute, depending on the stage of the disease, good nerve in the patient, and, probably above all, good digestion. If the microbes have invaded the abdominal organs, the case is almost hopeless. Forced feeding and no alcohol are the great essentials. Alcohol checks digestion and must not be used except possibly as a stimulant to hold for a short time the last flicker-ings of life.

The consumptive should have one good meal a day, and that meal should be a mid-day dinner well up in nitrogen, fats, carbohydrates, and fluids, with plenty of anything to the taste of the patient. Fruit should be served to him throughout the twenty-four hours ad libitum, and as much milk and raw eggs as he will eat. Remember, in feeding the yolks of eggs to the consumptive or to any invalid, that the raw yolks in some cases consume too much of the hydrochloric acid of the gastric juice. Reduce the number of eggs or stop altogether, and give more meat. Meats stimulate gastric digestion and there is less suffering from too little hydrochloric acid in the gastric juice. After all, "one man's meat is another man's poison." Some cannot eat eggs in any shape.

Flick says, very properly, select food for its nutritive value plus the ease with which it can be transformed into tissue. Milk, of all foods, he declares, is the one which gives the best returns in nutrition for the smallest consumption of energy. Eggs come next to milk, and then come beef and mutton, and peas and beans and such vegetables which are high in nitrogen. The reason for the dinner, or meat, pea, and bean meal once a day only is, that these consume much energy in their transformation into tissue. Milk and eggs should not be taken closer to the dinner than two hours before or after. Six raw eggs and three quarts of milk should be the allowance during waking hours. Some patients will even take more than this supply; some can scarcely take as much. The more the better, if it be digested.

This highly nitrogenous diet is especially important for consumptive persons in the East and West Indies and other tropical regions, where the tubercle bacillus is widespread and very fatal in its attacks. Although the natives live almost continuously in the open air, they are gregarious and their habitations are uncleanly; besides which, their diet, consisting chiefly of rice and other cereals and fruits, contains very little nitrogen. Thus they are probably suffering from nitrogen starvation, which renders them very vulnerable to the attacks of the tubercle bacillus. This matter demands thorough study by all physicians in tropical countries, and is of especial importance to army and navy surgeons in getting up the tropical rations.

Nuts, as will be seen on reference to their nutritive value, are good food for consumptives and may be eaten and nibbled constantly. Pastry, puddings, cakes, and such have no place in the consumptive's diet. They break up the desire for more valuable foods. Dr. John F. Russell, of the New York Post-Graduate Hospital, claims the most wonderful results from large amounts of the juices of various fresh vegetables added to the general tuberculosis diet. I trust good may come from this investigation.

Remember, in all of these cases competent medical supervision is essential. With this proper medical supervision, with determination and good digestion, the majority of these cases will either recover or be restored to a fair condition of health.