starch in the stomach. Our readers may recall the fact that a number of years ago a committee of American chemists were asked to report upon the dangers of taking a predigested starch into the stomach. Glucose was becoming such a generally distributed article, and was so largely used in the manufacture of confectionery, that this committee was asked to report upon its effects on the system. The report was both exhaustive and conclusive that no deleterious effects would follow its use, even in large quantities. But Professor Bartley has recently taken exception to this report. This is a very important question, for it is a fact that to-day the best candies in the world contain a large amount of glucose; while the most popular beer on the market has recently been shown to contain a larger proportion of glucose than any other brewed in this country.

It is very interesting to analyze some of the statements of Professor Bartley. For instance, he says that milk-sugar and cane-sugar are "intended" as foods in preference to grape-sugar, because the former require digestion before they can be absorbed. From this it is safe to reason that the more difficult a food is to prepare for absorption, so much the more was it "intended" as a food; therefore, boiled pork and cabbage were "intended" as foods in preference to the more easily digested eggs and milk!

Professor Bartley then speaks against cooked fruits, jellies, preserves, and fruit pies, because, he says, the cane-sugar is changed into glucose by heating it with the acid fruits. As is well known, "prolonged boiling" with an acid is necessary to make this change; while it is a practical fact that the housewife only brings her pears and peaches to a boil. Professor Bartley further declares that the reason why some persons can eat raw apples" without stint and without after-distress," and yet "cannot eat apple-pie without distressing after-effects," is because the latter contains this inverted sugar! This is almost ludicrous. It occurs to us there is more difference than this between ripe, raw apples and the average apple-pie with its historic crust! An equally absurd illustration is where he declares, "some persons can drink lemon-juice and water, but are sickened by lemonade or lemon-pie." As if lemonade were cooked! For he declares that it is the heating with the acid which changes the sugar into glucose; therefore, he must always take his lemonade "after prolonged boiling!" While lemon-pie, it occurs to us, has something more in it than digested starch to make it indigestible.

Professor Bartley is evidently averse to the "sweets," for he deals the candy manufacturers a death-blow. The professor relates instances of persons who were made ill by eating candy containing this variety of sugar, and whom he restored to health by refusing them all articles containing sugar, and by giving them "pepsin and hydrochloric acid with laxatives." This is like curing a man of some severe pain simply by combing his hair (and by the use of hypodermic injections of large doses of morphine)!

But this article is written with the view of showing how easily any number of theories may be overthrown when all the facts are made known. Professor Bartley says that digested starch is absorbed too quickly while in the stomach, and, thereby, "may prove too great a task on the liver," and "the blood may be overcharged with dextrose." The professor reasons that when milk-sugar or cane-sugar is taken it is digested below the stomach, and there more slowly absorbed. The whole drift of his article is to frighten those who take a predigested starch, for fear of causing diabetes!

In the light of the recent investigations of Dr. Kellogg, the absurdity of any such view is at once apparent. We now know that nature herself is digesting our starchy foods in the stomach, and that if these digested starches or if this glucose could in any way cause diabetes, we would ere this have been a race of diabetics.

For a long time there has been a growing sentiment throughout Germany that diabetes has not been properly treated. Hirschfeld says he believes that diabetic coma is favored by the exclusion of carbohydrates in the diet. Schmitz allows his diabetic patients a small quantity of albumen, while he orders the free use of food containing starch, and fat in large amount. Grube impregnates the system with the carbohydrates. Williamston, of Manchester, says that home-made bread is much better than especially-prepared diabetic bread. A number of American physicians are following out this line of treatment with better results than they have had heretofore.

In the light of all this, we must conclude that saliva continues its action on starchy foods in the stomach until nearly, if not all, the starch is changed into glucose; that glucose is simply a normal product of digestion, and no more injurious than a digested proteid; and that the treatment of diabetes is bound to undergo a marked change in the near future.

The Nervous Mother.'

BY JOHN MADISON TAYLOR, M.D.,

Professor of Diseases of Children, Philadelphia Polyclinic; Neurologist to the
Howard Hospital, etc.

A

GRADUALLY ripening experience in the nature, peculiarities, and disorders of children leads me to value more and more early the exceptional opportunities for studying nervous women. Indeed, there seems to me so vital a connection between the condition of the offspring and the overshadowing much enfolding influence of the mother that I am at times inclined to rate this as of first importance in forming judgments on the little ones. Therefore, at your invitation to address you on a subject most condensed yet comprehensive among childish disorders (as the small compass of an hour admits), I am led unhesitatingly to choose the mother herself, to whom attention may, after all, be most usefully directed, in securing remedies for their offspring.

We all love to contemplate our eidos, or highest conception of the mother, the unspeakable beauty of which has alternately lured and baffled thinkers and poets since time was. Nothing is too good or can be claimed as too lovely in the way of description or praise for the ideal type of maternity, and that I leave to the consideration of those better or wiser, or, at least, bolder than I. My theme is pre-eminently the practical one of discussing with you the ordinary every day, more or less flawful, and, indeed, too often accidental mother. One word, then, as to how women come to arrive at this distinction, privilege or martyrdom, as it is variously viewed by the owner. And let me say, beginning life a most pronounced optimist, I remain such with only the inevitable chipping off of sharper-cut edges. The better part of a score of years spent in ministrations to the ailments of overwrought humanity, the condition of whose disrepair most usually has to do with varying shades of individual blame-worthiness, has compelled me to note the less beautiful factors which mould and fashion an originally wholesome personality. It is then with regret I admit that the average mother too often disappoints me,

1 Part of a lecture delivered before the Newman Society of the University of Pennsylvania, January 15, 1895, and reprinted from the University Medical Magazine for July.

though I hasten to avow that of superb beautiful mothers it has been permitted me to meet not a few. There is a crying need for a special training for those who possibly may become mothers, it is certainly demanded for those who are about to become such. But, first and last, this crowning embellishment and glory of womanhood comes in great measure as a surprise, nor always is it heartily welcomed, and only rarely does it bring unalloyed joy. An enormous amount of trouble and expense is taken to avoid the title, or at least the frequent repetition of the blessing, and a good deal of thrusting out of sight conscience as to the methods used. I am tempted to speak at length on this phase of modern civilization, but leave it with the remark that as soon as specific instruction in the duties, privileges, and glories of maternity shall replace much of the pseudo-science which is fashionable in our halls of learning, so soon will we make great strides towards the solution of the common troubles and disappointments to which we doctors are subject while striving to do our utmost duty in furthering the expansion and betterment of our race.

It is safe to assume, then, that the mother realizes very little her responsibilities, be she of high or low degree, except it may be she has hastily devoured (and failed to assimilate) certain little books which are being offered in great numbers purporting to be "mothers' guides." Let us say nothing in disfavor of those treatises, because, poor as they often are, it is at least the only systematic teaching she is liable to get.

Again, this shortage in information is more marked in two directions, among the very poor and the very rich, while the maidens of the great middle class get more or less object teaching and opportunities to functionate as vicarious parent or caretaker to brothers and sisters, and thus early learn the practical duties of motherhood.

There seems to me one particularly promising avenue through which motherhood ideas shall be acquired. The kindergarten offers by far the best opportunities for children to learn their duties to themselves and each other from the fundamental basis. Froebel's beautiful concept or system includes as assumed motherhood as the point of both departure and return. Thus the child learns its primal duties and privileges, and always in relationship to the mother, and not the least important part of the programme is that the concept of a perfect, all enfolding, infinitely wise and tender parent is produced. The feminine child will grasp this in

a more practical way than the male, and consciously or unconsciously will form herself on similar lines. Such a girl will grow up a more womanly woman, will develop a wholesomer femininity than can be expected of any accidental methods. When in due course of nature children come to her they will find motherliness of infinite variety and scope passing the bounds of reasonable expectation. Thus through the expansion of this now happily widely growing system of education seeds of gravest importance are scattered, much of which will fructify in unexpected fashion and to the great advantage to mankind.

The first glimpse we doctors get of the family circle is often a scene of chaos and excitement begot of an emergency well defined or merely suggested, tangible and serious or purely fanciful. Medical practice is comparatively a simple matter in a wellordered hospital with full opportunity for deliberate investigation and with skilled observers and helpers ready at hand. Into an ordinary household, however (where the customary march of the hours is rhythmical and well ordered from one comfortable domestic step to the next, where the capacities of the feminine head are chiefly taxed in keeping this admirable procession where each one knows his place in easy motion), let there come the horrible spectre of disease, and the whole equipoise may well be catastrophically lost. These are the trial times of the soul, when the inherent qualities of character quickly reveal themselves. It is a mercy medical men are trained to be discreet and silent, as well as prompt and decisive. The shallow woman, given over to pettiness and self-love, whose acquired cleverness, moreover, enables her to pass current in the familiar exigencies of society, where alone her training and experience are acquired, has her thin veil of artificialities rudely jostled aside by the shadow of death. If she be a weakling, contemptible cowardice is probably shown. If strong, a selfish revolt at the discomforts about to fall upon her may be evidenced in a way to disgust the most forbearing. If, however, the mother be merely uninformed and ignorant, but well endowed with possibilities and, with all, eager to assume her proper place, then is the task to direct and aid an easy and pleas

ant one.

And here let me say we medical men not seldom earn the right to be "doctors' or teachers, so often does it fall upon us to teach the graver duties and accountabilities, so largely are we called upon to mould and train the unformed human character.