HOSPITAL ACCOMMODATION IN EPIDEMICS.

Whatever accommodation is provided, experience has shown that in epidemic times this accommodation is exhausted, for in most infectious maladies, as already stated, isolation in hospital controls but does not arrest. It is, therefore, important that sufficient land is available for extension.

The extension by means of huts or portable buildings is seldom satisfactory, and I am of opinion that it would be better where land is available to erect permanent shelters very similar to the glass and iron or glass and wood shelters of sea-side places, that is to say, light airy structures, one side entirely open facing the south, the three other sides being in part made of glass. During the whole period from May to the middle of October, the temperature will seldom fall so low as to render it undesirable for patients with plenty of bed clothing to sleep under such open structures. From May to October as a rule, the infectious diseases mentioned are most prevalent, so that this extension would take in the majority of cases. When the nights are cold but the days moderate in temperture, it might be advantageous to convey, by wheeling the beds to the shelters most of the subacute cases by day, and re-transfer them at night. During their absence a thorough purification could be made of the wards. In this way even temporary night overcrowding during the pressure of an epidemic, would not be likely to produce evil results.

To summarise the chief points of my address:

1. The provision of due hospital accommodation in every district is a duty and necessity.

2. The local authorities and the public must not have too great expectations of the result of this hospital accommodation in arresting epidemics of scarlet fever, of diphtheria, or of measles. Epidemics are pandemic in their nature, and depend on some obscure and general cause. Probably most of the contagious living particles have a life external to the body, a life the phases and history of which are at present unknown.

3. The increasing and great fatality of measles, the general neglect of precautions to prevent its spread, point to the urgency of the joint measures of compulsory notification, and the provision of hospital accommodation for that disease.

4. The expense of efficient attractive hospital accommodation may be, without injury, slightly decreased by departing from the rules sanctioned by tho Local Government Board by giving ample floor space, but a less cube than 2000 cubic feet to children.

5. The suggestion in times of pressure as to the treatment of fevers in shelters admitting sunshine and air from the south side may, I trust, have careful consideration and practical trial.

POPULAR LECTURE,

BY SIR CHARLES A. CAMERON, Professor of Chemistry and Hygiene, R.C.S.I., and Superintendent Medical Officer of Health, Dublin.

THE MAYOR OF NEWCASTLE in the Chair.

Delivered September 8th, 1896.

WHY, WHAT, AND WHEN WE EAT.

ABSTRACT.

THE lecturer after some preliminary observations in the course of which he referred to his having been present at the first Congress held by the Institute, and having presided at its Portsmouth Congress, said that he would endeavour to explain with the use of as few technical terms as possible, what food was composed of, why we used it, and what were the best times to consume it. The world was, so far as we knew, composed of about seventy elements, or simple bodies. They constituted the raw materials so to speak, with which nature built up all its rich and varied structures. The billowy ocean, the atmosphere, the vast mountain chains, the spreading fields of emerald green, the forests with their almost infinite variety of vegetable life, the nearly innumerable forms of animals, the solid crust of the earth, in a word the great globe and all which it inherits may be resolved into these few elements. What was an element? Any substance which resisted every attempt to extract from it. something different from itself. For example, from chalk, two distinct bodies could be extracted, namely lime and a gas termed carbonic acid. From lime, a brilliant metal, calcium, and a gas termed oxygen could be obtained, whilst carbonic acid yielded carbon or charcoal, and oxygen gas. No one has yet extracted other bodies from calcium, carbon and oxygen, and they are therefore, at present at least, regarded as elements. Very many of the elements occurred in insignificant quantities and in very rare minerals, whilst on the other hand, the objects of everyday life, such as animals and plants, soils, ordinary rocks, air and water, were composed of little more than a dozen of the elements. Oxygen alone made up about half the weight of the surface of the globe, and probably of its interior. Disregarding traces of a few elements, animals and plants were composed of oxygen, hydrogen, carbon, nitrogen, phosphorus, sulphur, calcium, magnesium, potassium, sodium and iron. In the mineral kingdom these elements existed, in combination with each other forming water, carbonic acid, ammonia, and saline and earthy matters. It was the function of plants to organize these inert lifeless matters into vegetable structures, such as starch, sugar,

gum, wood, albumen, and various other matters, of which some were used as food by animals. The lecturer explained at considerable length, how it was that the mineral bodies were converted into organic substances. Matter was indestructible, but its form admitted of protean changes. So also was it the case with the forces of nature, heat, light, magnetism, and heat could be converted into electricity, electricity into magnetism. The great orb of day was the source of all the force or energy which operated upon earthy matter. The plant was a mere though most wondrous mechanism. It no more originated energy or force, than a steam engine, minus fuel, did. It however absorbed from the Solar beams the energy with which it decomposed water, carbonic acid, ammonia and other minerals, and recombining their elements, produced organic matter. The energy used by the plants for this purpose was not, could not, be annihilated or lost,-it remained stored up in a latent or hidden form in the vegetable matter. If the vegetable matter were converted into mineral matter, the latent energy would re-appear in some form or forms. Supposing the vegetable matter were burned in a furnace, the energy would appear as heat and light. If it were used as food by an animal, it would also be converted into mineral matter, with simultaneous evolution of heat and motive power. In the conversion of carbonic acid and water into vegetable matter, a large portion of the oxygen which these compounds contain is evolved into the air in a free state. The oxygen thus set free is capable of combining with the substances from which the plant ejected it, and of reproducing carbonic acid and water. Whenever it does this it sets free the energy which the plant had used to decompose the water and carbonic acid. A man requires to have a temperature of 98.6° F., and force is necessary to maintain the beating of his heart, his respiration and other vital functions, and to enable him to move about and perform work. The force stored up in his food supplies this heat and energy, becoming at the same time converted into mineral matter. Plants absorb carbonic acid and evolve oxygen; animals absorb oxygen and expire carbonic acid: the former organize, the latter disorganize. The food is used to repair the waste of the body, for it is chiefly the body that burns away, evolving heat and motion. This is the philosophy of food. The best kinds develop the most heat and energy, and if flavour be good are the dearest aliments.

Sir Charles next described the classification of food. The most abundant were the carbohydrates, which were composed of only three elements, oxygen, hydrogen, and carbon, the two former in the proportions in which they form water. The starches and

sugars were the chief carbohydroles. They formed fats in the body, 2 lbs. of carbohydrate producing 1 lb. of fat. The sugars were the natural food of the young, and their instinctive longing for them should be gratified. It was nonsense to say that sugar destroyed the teeth. Fats were composed of the same elements as the carbohydrates, only they contained more hydrogen and carbon and much less oxygen. They constituted a very valuable portion of our food, and their absence from a diet was a great defect. They evolved much heat and energy by their combustion in the body. The third great class of foods were the albumenoids, which in addition to the elements present in carbohydrates, contained nitrogen, phosphorus, and sulphur, and were always associated with small quantities of earthy and saline matters. Formerly, their importance was overestimated, but still they are indispensable to life, and a man requires at least 4 ozs. of them daily to keep him alive. A hardworking man will require nearly 4 lb. of albumen, rather more than lb. fat, and nearly 1 lb. of carbohydrates. If he takes less fat, he requires more carbohydrates and vice versa. 1 lbs. of wheat flour contain sufficient albuminous matter for a man, but not sufficient fat or carbohydrates, to supply which about 2 lbs. are required. 1 lbs. of peas supply sufficient nitrogenous matter, but 2 lbs. are required for carbon. A diet of peas would therefore be wasteful. A mixed diet is the best, and the structure of man's teeth and digestive organs showed that he was omnivorous. Much information was given as regards purity of not only food but air, for nearly cwt. of the latter was daily taken in the body. The process of digestion was briefly explained, thorough mastication was essential, as it enabled the food to be more easily dissolved in the stomach. The lecturer descanted for some time on the importance of attending to the condition of the teeth in the case of children, and urged those who had lost their teeth to provide themselves with artificial ones. The ptyaline or nitrogenous ferment in the saliva converted starch into sugar. In the stomach the food was churned up and mixed with a nitrogenous ferment termed pepsin, which made the nitrogenous food (proteids) into soluble bodies or peptones. In the duodenum or lower stomach fats and starch were made soluble by the action of pancreatin, another nitrogenous ferment. After these changes the food became a milklike liquid which passed into the blood and became assimilated. Regularity of time of eating was of great importance, as nature was orderly and periodicity was one of its prime laws.

The subject of the cooking of food was next discussed. If we wanted soup, meat should be put into cold water and slowly heated, delaying the process of boiling as long as possible. In

this way all the soluble matters pass into the water, because the sudden application of boiling water has not coagulated and rendered the albumen insoluble. If we want meat, not soup, then we should plunge the raw meat into boiling water, and so coagulate its albumen and prevent it from dissolving in the water. Too much attention could not be bestowed upon the cooking of food, and reasons were given why the process rendered food more digestible, as, for example, by bursting of starch granules and liberating the soft starch from its very hard envelopes. The best time to take food was early in the day, at which time the vital functions and power of assimilation were at the maxima. Late meals were not as a rule so well digested as early ones. He did not believe in a man working hard for several hours before breakfast.

The subject of obesity was treated upon partly in a humorous manner. The beauty of woman was partly due to a layer of fat below the skin, which gave her the beautiful curves and softness of outline which were so much admired. As youth declined, fat usually increased, and gave that soft and comely appearance to many women who at mature age were handsomer than in their scraggy youth. It however sometimes happened that obesity became so excessive as to become an actual disease. When a man was obliged to sit on two chairs, to have to go downstairs backwards and to be unable to enter a cab, fat certainly became a great infliction. To prevent undue accumulation of fat nothing was so efficacious as exercise; the more exercise a man took the more fat he consumed. Who ever saw a fat professional pedestrian? Letter carriers and lamp lighters were rarely fat; the advantages of open-air exercises were not confined to fat persons-fat or lean people were improved in health and strength by them. The games in which ladies were now adepts, such as, for example, tennis, were great hygienic agencies. They induced the ladies to stay out in the pure fresh air by which their blood was thoroughly arterialized and purified, whilst their exercise developed their muscles. He almost thought that they were becoming taller and stronger than they were in the days of his youth, and they might ultimately progress into the remarkably tall and athletic women so graphically described by Bulwer Lytton in his "Coming Race." The lecture was illustrated by several experiments, one of which showed how people appeared when they ate too much and took no exercise, the lecturer remarking that the Mayor's face had lost its rosy hue and the Sheriff's face had become green. Votes of thanks to the lecturer and the chairman brought the proceedings to a close.