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THE LOGIC OF FADDISM.
443 the areas showed that the pigment, which was very black, occurred in rounded or irregular granules, massed together in some spots. It was scattered throughout the cutis, but lay principally in its central portion ; some of it was definitely within lymphatics, and in many places the granules were surrounded by an inflammatory exudation of cells. The atrophic process involved the entire cutis. Unfortunately the quantity of pigment was so small that it could not be tested chemically. Dr. Gottheil states that he has never seen any such lesions following subcutaneous injection of drugs, though spots of blue pigmentation without atrophy are not uncommon as a result of hypodermic introduction of various drugs. There are only two other cases on record, so far as he was able to ascertain, in which the same combination of pigmentation with atrophy has occurred as a result of injection of drugs ; in one of these the offending substance was morphine, in the other cocaine. Dr. Gottheil’s patient said that she had seen similar spots in other victims of cocainism. The nature of the pigmentation is doubtful ; possibly the granules are steel particles, but this fails to explain the rarity of the lesion and the concomitant atrophy.
symptoms, gave up eating meat. The troubles disappeared and he became forthwith a vegetarian on principle as well as in practice. But, alasI in about three years the same troubles reappeared, notwithstanding his strict adherence to a " raw food dietary." Then he read somebody’s book, with the result that he returned to the use of meat, and presto1 his troubles disappeared again. He has apparently since stuck to the use of meat, which he found suited him better than vegetarian food-though the same indispositions the cure of which he now attributes to meat food had previously disappeared on his taking to vegetarianism;y and he expresses the opinion that, so far as he is concerned, beef-steak is the most easily digested and most easily assimilated of foods (p. 168). The fact is, that in a lack of general applicability lie the uselessness and danger of all faddist methods, while Mr. Sinclair errs beyond that point, in that he lays down as principles things that are clearly unsound. For instance, he asserts: ’’ That anyone could die of lack of food without feeling a desire for food, is absurd on the face of it." Again, discussing alleged deaths under the fasting cure, he says that might die very frequently"[under the treatment] "without that being any argument against the cure." That would depend upon whether the relation of cause and effect He and thinkers of his calibre fail to see were established. that the converse proposition is equally true—viz , that people may get better under any kind of "cure"without that being any argument for the cure. The multiplication by the food faddist of plans to avoid dyspepsia is for the most part an imitation of the policy of the householder who, hearing of a patent stove that was warranted to save half his coal, bought two stoves that he might save all of it.
"people THE
LOGIC OF FADDISM.
THAT some people eat too little and that others eat too much; that most people occasionally, and some habitually, eat unsuitable food, or eat suitable food in an improper manner or under improper circumstances ; that food that is suitable for one person may be quite unsuitable for another person, or even for the same person at another time and under other conditions ; and that from these deviations from normal conduct arise many of the ills that flesh is heir tothese, surely, are truisms. And from concentration of attention on truisms without due regard to perspective most fads take their birth. Mr. Upton Sinclair, who focussed public attention with regard to the Chicago stock-yards in the direction previously indicated in these columns by our Special Sanitary Commissioner, has views on fasting1 as a cure for nearly every ill, and his opinions have received wide publication in lay magazines and in the daily press. They have lately appeared in book form. Suffice it to say that he advocates in many circumstances abstinence from food of all kinds for a period lasting until the return of hungerwhich, according to him, within a day or two of beginning the fast, disappears and remains in abeyance for a varying period of time. In response to a circular of inquiry sent out by Mr.’ Sinclair as to the results in those known to have followed his method, he received reports of benefit in 27 cases of indigestion, 14 of constipation, and in smaller numbers of colds, tuberculosis, poor circulation, headaches, acsemia, scrofula, bronchial trouble, syphilis, liver trouble, general debility, chills and fever, blood poisoning, ulcerated leg, neurasthenia, locomotor ataxia, sciatica, asthma, excess of uric acid, epilepsy, pleurisy, impaction of bowels, eczema, catarrh, appendicitis, valvular disease of heart, insomnia, gas poisoning, grippe, and cancer. We are by this time quite prepared for the familiar phrase that follows: " 45 of the cases having been diagnosed by physicians." We have some curiosity to know how it happened that "out of the 109 persons who wrote" [in reply to Mr. Sinclair’s questions] " 100 reported benefit and 17 no benefit" (p. 103), and suggest that statements of this kind, even if capable of some explanation not clear to the ordinary reader, may have led to the neglect by responsible journals to take his work seriously -a conspiracy of silence in which Mr. Upton accuses THE LANCET and the New York Times to participate. Mr. Sinclair, believing the meat which he had hitherto been taking to have been the cause of his headaches, dyspeptic and other 1
&c.
The Fasting Cure. By Upton Sinclair, author of the "The Jungle," London: William Heinemann. 1911. Pp. 261. Price 25s. 6d. net.
MALIGNANT
CHORDOMA, INVOLVING
BRAIN AND
SPINAL CORD.
I
IN the Jmwnal of Nervous and Mental Disease for January of this year is a paper of considerable pathological interest by Dr. Smith Ely Jelliffe and Dr. John H. Larkin, of New York. It records the occurrence of a tumour of great rarity -viz., chordoma, a malignant cartilaginous growth of notochordal origin, invading the base of the skull and brain, with multiple metastases in the spinal cord and column. The present case is the seventh recorded in the literature. The patient was a young married woman of 36, with 9. clean bill of health up to the onset of the illness to be described, who suddenly developed a sixth nerve palsy on the left side. Severe headache followed, with neuralgic pains in the distribution of the left trigeminal nerve, extending sometimes to the back of the head. Not long after, persistent vomiting set in and the patient began to lose flesh rapidly. Some months after the commencement of the affection it was found that the right eye was completely blind, while vision was very defective in the left. The pupils were widely dilated and inactive to every form of stimulus. There was total external ophthalmoplegia as well, the eyes being immobile in the central position. On the left side considerable ptosis was noticed. Facial movements were good, and audition was normal. The limbs were somewhat wasted and muscular power was diminished, but no sensory changes could be detected. Both ankle- and knee-jerks were absent, and there was a slight degree of Rombergism. Within a comparatively short time, however, the symptoms became much more severe. Gradually increasing somnolence set in, with mental confusion and dreamy delirium; further cranial nerve involvement, in the shape of a left facial palsy, indicated a spread of the basal Then tumour, the condition having been so diagnosed. followed a motor and sensory palsy of the left fifth nerve, a left hemiplegia and hemiansesthesia, and a progressive
symptoms, gave up eating meat. The troubles disappeared and he became forthwith a vegetarian on principle as well as in practice. But, alasI in about three years the same troubles reappeared, notwithstanding his strict adherence to a " raw food dietary." Then he read somebody’s book, with the result that he returned to the use of meat, and presto1 his troubles disappeared again. He has apparently since stuck to the use of meat, which he found suited him better than vegetarian food-though the same indispositions the cure of which he now attributes to meat food had previously disappeared on his taking to vegetarianism;y and he expresses the opinion that, so far as he is concerned, beef-steak is the most easily digested and most easily assimilated of foods (p. 168). The fact is, that in a lack of general applicability lie the uselessness and danger of all faddist methods, while Mr. Sinclair errs beyond that point, in that he lays down as principles things that are clearly unsound. For instance, he asserts: ’’ That anyone could die of lack of food without feeling a desire for food, is absurd on the face of it." Again, discussing alleged deaths under the fasting cure, he says that might die very frequently"[under the treatment] "without that being any argument against the cure." That would depend upon whether the relation of cause and effect He and thinkers of his calibre fail to see were established. that the converse proposition is equally true—viz , that people may get better under any kind of "cure"without that being any argument for the cure. The multiplication by the food faddist of plans to avoid dyspepsia is for the most part an imitation of the policy of the householder who, hearing of a patent stove that was warranted to save half his coal, bought two stoves that he might save all of it.
"people THE
LOGIC OF FADDISM.
THAT some people eat too little and that others eat too much; that most people occasionally, and some habitually, eat unsuitable food, or eat suitable food in an improper manner or under improper circumstances ; that food that is suitable for one person may be quite unsuitable for another person, or even for the same person at another time and under other conditions ; and that from these deviations from normal conduct arise many of the ills that flesh is heir tothese, surely, are truisms. And from concentration of attention on truisms without due regard to perspective most fads take their birth. Mr. Upton Sinclair, who focussed public attention with regard to the Chicago stock-yards in the direction previously indicated in these columns by our Special Sanitary Commissioner, has views on fasting1 as a cure for nearly every ill, and his opinions have received wide publication in lay magazines and in the daily press. They have lately appeared in book form. Suffice it to say that he advocates in many circumstances abstinence from food of all kinds for a period lasting until the return of hungerwhich, according to him, within a day or two of beginning the fast, disappears and remains in abeyance for a varying period of time. In response to a circular of inquiry sent out by Mr.’ Sinclair as to the results in those known to have followed his method, he received reports of benefit in 27 cases of indigestion, 14 of constipation, and in smaller numbers of colds, tuberculosis, poor circulation, headaches, acsemia, scrofula, bronchial trouble, syphilis, liver trouble, general debility, chills and fever, blood poisoning, ulcerated leg, neurasthenia, locomotor ataxia, sciatica, asthma, excess of uric acid, epilepsy, pleurisy, impaction of bowels, eczema, catarrh, appendicitis, valvular disease of heart, insomnia, gas poisoning, grippe, and cancer. We are by this time quite prepared for the familiar phrase that follows: " 45 of the cases having been diagnosed by physicians." We have some curiosity to know how it happened that "out of the 109 persons who wrote" [in reply to Mr. Sinclair’s questions] " 100 reported benefit and 17 no benefit" (p. 103), and suggest that statements of this kind, even if capable of some explanation not clear to the ordinary reader, may have led to the neglect by responsible journals to take his work seriously -a conspiracy of silence in which Mr. Upton accuses THE LANCET and the New York Times to participate. Mr. Sinclair, believing the meat which he had hitherto been taking to have been the cause of his headaches, dyspeptic and other 1
&c.
The Fasting Cure. By Upton Sinclair, author of the "The Jungle," London: William Heinemann. 1911. Pp. 261. Price 25s. 6d. net.
MALIGNANT
CHORDOMA, INVOLVING
BRAIN AND
SPINAL CORD.
I
IN the Jmwnal of Nervous and Mental Disease for January of this year is a paper of considerable pathological interest by Dr. Smith Ely Jelliffe and Dr. John H. Larkin, of New York. It records the occurrence of a tumour of great rarity -viz., chordoma, a malignant cartilaginous growth of notochordal origin, invading the base of the skull and brain, with multiple metastases in the spinal cord and column. The present case is the seventh recorded in the literature. The patient was a young married woman of 36, with 9. clean bill of health up to the onset of the illness to be described, who suddenly developed a sixth nerve palsy on the left side. Severe headache followed, with neuralgic pains in the distribution of the left trigeminal nerve, extending sometimes to the back of the head. Not long after, persistent vomiting set in and the patient began to lose flesh rapidly. Some months after the commencement of the affection it was found that the right eye was completely blind, while vision was very defective in the left. The pupils were widely dilated and inactive to every form of stimulus. There was total external ophthalmoplegia as well, the eyes being immobile in the central position. On the left side considerable ptosis was noticed. Facial movements were good, and audition was normal. The limbs were somewhat wasted and muscular power was diminished, but no sensory changes could be detected. Both ankle- and knee-jerks were absent, and there was a slight degree of Rombergism. Within a comparatively short time, however, the symptoms became much more severe. Gradually increasing somnolence set in, with mental confusion and dreamy delirium; further cranial nerve involvement, in the shape of a left facial palsy, indicated a spread of the basal Then tumour, the condition having been so diagnosed. followed a motor and sensory palsy of the left fifth nerve, a left hemiplegia and hemiansesthesia, and a progressive