roundings, habits, work, and amusements. In cases resulting simply from overwork, the rest attained by six months of travel and outdoor recreation will suffice, and this is the hackneyed advice. But when this is not possible, the hours of work may be shortened an hour given to rest daily, while some form of exercise, as bicycling, riding, rowing, golf, fishing, hunting, tennis, swimming, or gymnastics may at the same time be undertaken, choosing that which appeals most strongly to the taste of the patient. Change in the habits-even to the extent of forming somewhat irregular habits in sleeping, and to the pursuit of literary work in place of outdoor sports-has proved curative, but such an unusual course can be advised with safety only by a physician.

What would usually be called overeating is generally advisable, more especially in the thin and pale. A glass of milk, an eggnog, a cup of cocoa, a raw egg, or a cup of strained oatmeal should, one or the other, be taken between the regular meals and at bedtime. Sleeplessness should never be treated with drugs, unless by a physician's orders, as hypnotic drugs are A usually unnecessary and injurious in these cases. warm bath with a cold compress to the head, and a glass of warm milk or of beer, before retiring, are often sufficient. Drugs, as a whole, play little part in the cure of nervous exhaustion, except to relieve certain symptoms. Cod-liver oil is frequently of value, while iron, in pallor and anæmia, also supplies an es

sential constituent of the blood and is indicated. Indigestion improves more certainly under the general measures suggested, than by dieting, drug, or local treatment (see Nervous Dyspepsia, p. 462).

Various forms of water cure are of worth. One of the simplest is the hot followed by the cold spray, which may be taken in the morning from a hose and sprinkler made for attachment to the ordinary bathroom faucet. For the chronic cases, those too sick to follow the ordinary life, and for many weak, thin, and poorly nourished women, who can thus only escape from their manifold household worries, the "rest cure" originated by Weir Mitchell of Philadelphia is the most successful treatment. This implies the complete isolation of the patient in bed, usually in a wellordered hospital, for six to eight weeks, and treatment with large amounts of nourishing food given at frequent intervals, with different forms of water cure, and with massage and electricity, while the patient gives up all responsibility to the doctor and nurse, and is shielded from emotion or cares and worries by separation from friends and family. Gain in flesh in nervous exhaustion commonly goes hand in hand with general improvement. A gain of sixty and even eighty pounds sometimes results from the rest cure. Exercise in nervous exhaustion may be readily carried to excess. Exercise should never be followed by more than a healthy fatigue, and should be combined with a daily hour of rest on the bed or couch. Walk

ing, or merely rest, in the open air is sometimes preferable to exercise for women.

The special disorders which we have noted as often leading to nervous exhaustion can, of course, be discovered and treated properly only by a physician, and the sooner patients suffering from symptoms suggestive of this disease submit themselves for thorough examination, the better. No two cases are exactly identical in symptoms, causation, or treatment required, but information concerning duration before treatment is very important in every case.

HICCUP; HICCOUGH.-While this curious disorder usually lasts but a short time, it sometimes persists for days and weeks, and becomes an alarming and, rarely, a fatal malady. Frequently there is no cause apparent, it appearing in persons seemingly in perfect health. The irritation of the mouth and throat, caused by hot drinks, pepper, a strong pipe, etc., are frequent sources of the trouble. Indigestion is another common cause, particularly in children. Excitement and some kinds of nervous diseases, particularly hysteria, induce it. In certain inflammations of abdominal organs it is common, also in kidney disease.

Treatment.-Among the more simple remedies are holding ice in the mouth or drinking cold water, sticking out the tongue, and tickling the nose with a straw until one sneezes several times. A most effectual remedy consists of stopping up both ears with the tip of one finger of each hand while one drinks from a cup held [Text continued on page 295.] 293

BASE OF THE BRAIN

The illustration opposite shows some of the Lobes of the Cerebrum, the Cerebellum, the Medulla Oblongata, and certain Arteries of the brain.

The large arteries that distribute blood to all parts of the brain unite and form an irregular ring, known as the "Circle of Willis" (See center of figure). A rupture of a branch of any of these arteries causes apoplexy or cerebral hemorrhage, with the production of a clot on, or in the substance of, the brain.

The Internal Carotid Arteries, which ascend along the side of the neck, divide to form the Middle Cerebral, the Anterior Cerebral, and the Posterior Communicating Arteries. In the illustration the carotid arteries are shown severed at the point where they reach the brain.

Some of the cranial nerves are shown cut off as they leave the brain, the stumps being numbered on the right-hand side of the figure.

The medulla oblongata is that part of the brain which is continuous with the spinal cord; it is united with the rest of the brain by the Pons Varolii.

A cerebral hemorrhage may cause a rupture of brain fibers, or pressure upon the nucleus of a cranial nerve and cause paralysis. The Olfactory Nerves convey the sense of smell; the Optic Nerves, that of sight.