be either
badly retained or not retained at all, and may give rise to tenesmus.

The question of stimulus is a grave one. In too many cases which come to
me, I have to give so much care to break off the use of all forms of
alcoholic drinks that I am loath to resort to them in any case, although
I am satisfied that a small amount is a help towards speedy increase of
fat. Its use is, therefore, a matter for careful judgment, and in
persons who have never taken it in excess, or as a habit, I prefer to
give, with the other treatment, a small daily ration of stimulus: an
ounce a day of whiskey in milk, or a glass of dry champagne or red wine,
seems to me useful as an adjuvant, and as increasing the capacity to
take food at meals. Nevertheless, alcohol is not essential, and for the
most part I give none, except the small amount--some four per
cent.--present in fluid malt extracts. Even this is found to excite
certain persons, and it is in such cases easy to substitute the thicker
extracts of malt, or the Japanese extract, made from barley and rice.

So soon as my patient begins to take other food than milk, and
sometimes even before this, I like to give iron in large doses. In
hospital practice the old subcarbonate answers very well, being cheap,
and not unpalatable when shaken up in water or given in an effervescent
draught of carbonated waters. In private practice large doses of salts
of iron, as four to six grains of lactate at meal-time, are
satisfactory; but the form of iron is of less moment than the amount.

Very often I meet with women who cannot take iron, either because it
disturbs the stomach, causes headache, or constipates, or else because
they have been told never to take iron. In the latter case I simply add
five grains of the pyrophosphate to each ounce of malt, and give it thus
for a month unknown to the patients. It is then easy to make clear to
them that iron is not so difficult to take as they had been led to
believe, and when it has ceased to disagree mentally I find that I am
able to fall back on the coarser method. If iron constipate, as it may
and does often do when used in these large doses, the trouble is to be
corrected by fruit, and especially pears, by the pill of the watery
extract of aloes and ox-gall already mentioned, by extracts of cascara
or of juglans cinerea, which may be added to the malt extract ordered
with the meals, or by enemata of oil, or oil and glycerin, or a glycerin
supposito