TROPHOPATHY 
IN THE 
FATTY and FIBROID DEGENERATIONS: 
A JOINT PAPER 
BY 
EPHRAIM CUTTER, A.M., M.D., LL.D,, 
AND 
JOHN ASHBURTON CUTTER, M.D., B.Sc. 
Read by the Junior Writer before the Section of Practice of 
Medicine, Materia Medica and Physiology of the 
American Medical Association, at its 
Fortieth Annual Meeting, 1889. 
Published in full in " The Medical Bulletin f January, 1890 ; the " Virginia Medical 
Monthly," Richmond, January, 1890 ; the " New England Medical Monthly," 
February, 1890 ; the " Southern Practitioner," February, 1890 ; The 
Journal of the American Medical Association, March, 
1890 ; and in Abstract in the " Dietetic Gazette," 
December, 1889, and " The Doctor," 
September, 1889. 
NEW YORK: 
THE ARISTON, BROADWAY AND FIFTY-FIFTH STREET. 
1890. TROPHOPATHY 
IN THE 
FATTY AND FIBROID DEGENERATIONS. 
(the following is an abstract ) 
RHE animus of this contribution is the belief of 
the writers that trophopathy (trophos, food, 
pathos, disease) has more to do with the cause and 
cure of the so-called incurable diseases than the pro- 
fession gives credit to; and to show that our belief is 
founded on facts, we will immediately proceed to the 
consideration of the subject in the concrete by the 
reading of some histories of patients that have been 
under our care: 
Case I. Bright's Disease, Cirrhosis of the Liver, 
and Enlarged Heart.-January, 1886, a man aged 
forty-six went under treatment for the troubles as 
noted in the heading. His case appeared entirely 
hopeless; but believing that a physician has never 
the right to act as a judge and condemn a man to 
death, his case was undertaken, with the happy result 
that to-day he is now in robust health, and would be 
present at this meeting if our letter notifying him of 
our desire that he should come here for your inspec- 
tion had not miscarried. This man had full-fledged 
Bright's disease besides his other troubles ; we do not 
consider any case full-fledged Bright's disease unless 
there are in the urine albumin, casts, and fatty epi- 
thelia. We are continually getting cases which may 
have any one or two of these three signs ; such cases 
are hovering on the border line of health and well- 
marked disease, and are very amenable to treatment. 4 
Such wavering from health would oftener be detected 
if physicians would make more thorough examina- 
tions of the urine; taking six specimens from six 
consecutive days, it is wonderful to see the variance 
from day to day. 
Case II. Bright's Disease of Kidneys and per- 
haps of Lungs.-The late Dr. Louis Elsberg went 
under the senior writer's care one year before his 
death, for full-fledged Bright's disease. He was 
dieted, but would take no medicine. The abnormal 
condition of the urine was changed to that of health. 
He was then warned that he must not eat all of 
the starches and sugars which are so often catered 
to our tastes; but the warning was disregarded, 
and the medical world knows how his life went 
out, as a candle is snuffed, by what was thought 
to be pneumonia, but perhaps was Bright's disease 
of the lungs. 
Case III. Bright's Disease of Kidneys and 
Lungs; Improvement; Death on endeavoring to 
handle his own case.-A millionaire was treated for 
two months and with much improvement; then, 
feeling too poor, he undertook the care of his case, 
ate wrongly, overworked, and was poisoned with 
sewer gas. The troubles came back with full force, 
and he died. 
Case IV. Acute Fatty Degeneration of the Kid- 
neys, Placenta, and Cerebral Blood Kessels.- 
Primipara, 1880. Albumin, casts, and fatty epithelia 
were found in the urine. Placenta was covered 
with plates of cholesterin; rupture of cerebral blood 
vessels two days after delivery; convulsions for 
thirty-six hours ; after the convulsions she was given 
beef tea ad libitum, and in a few days beefsteak broiled. 
She improved steadily ; on the solicitation of her 
parents hop tea was allowed, but she needed no 
medicines beyond the food medicine. This was in 
1880. She is well to-day and has borne two more 
children; the face, which was drawn to one side, is 5 
even now. (See N. E. Medical Monthly, February, 
1888, E. Cutter.) 
Case V. Fibrous Consumption, Bright's Disease, 
and small Fibroid Tumor of the IVomb.-Lady, mid- 
dle-aged, went under treatment for the troubles just 
noted, with the result of cessation of cough, healing 
of lungs, disappearance of the morphological and 
chemical evidences of Bright's disease. The tumor 
has migrated, gone. 
Case VI. 1886. Bright's Disease.-This case 
had an unusual number of casts and fatty epithelia in 
the urine, besides the albumin. Treated, cured and 
remains so. 
Case VII. 1886. Bright'sDisease.-Man, aged 
sixty. There was a disappearance of the evidences 
of his disease while under treatment; re-appearance 
occurred to a certain extent; June 18, 1889, there were 
no casts, no fatty epithelia, and but a trace of albumin 
in urine. Is treasurer of a great missionary society, 
and has a heavy responsibility to carry, besides doing 
much literary work. 
Case VIII. 1877. Bright's Disease. Cured. 
Remains so, 1886,-It was decided to infuse blood 
into veins, but, on finding patient could eat tripe, 
was placed on it, and, the stomach accepting it, 
transfusion was postponed. It took two years 
to get her well; she ate tripe, beef, and drank milk 
warm from the cow. 
Case IX. 1882. M. B., aged twenty-four. Un- 
married. Uterine Fibroid, interstitial, hard, invest- 
ing the 'whole lUomb and extending above the Na- 
vel.-She followed the food directions faithfully, 
and was rewarded by the entire disappearance of 
the tumor. Gynecological agnostics who say when 
a case of fibroid tumor is reported as cured by 
galvanism or by food, or by both, " The cure was 
effected by the menopause," will not get much 
comfort from the history of this case, if it be a 6 
comfort to them to know that their predictions of 
failure are at times realized. 
Case X. 1882. Mr. , aged sixty. Fibroid 
of Stomach, 'with enlarged Liver.-After hard work, 
and by nourishment per rectum, the patient's condi- 
tion was so improved that he could take food by the 
mouth. He was cured, and remains so, 1889. He 
would be here to-day for inspection, if business 
did not prevent. 
Cases XI., XII., and XIII. All of Bright's 
disease, 1879, t88i, and 1884. Cases XI. and 
XII. aged about sixty years at time of treatment; 
Case XIII. aged twenty-four.-All are cured and 
here to-day for inspection. 
Case XIV. 1876. Woman, aged forty-two, sick 
in bed from grief at the death of her last surviving 
daughter; cardiac hypertrophy and insufficiency of 
left auriculo-ventricular valve; anginapectoris ; four 
hard, marble-like tumors behind the uterus; severe 
stinging pain in pelvis; father died of cancer of 
the stomach.-Patient was fed against the appetite 
with beef, with the following results : 1. Heart nor- 
mal in size. 2. Valvular insufficiency hardly per- 
ceptible. 3. Angina pectoris gone. 4. Uterine 
disease relieved; tumors gone, uterus mobile, dis- 
charge normal. 5. Urine clear as champagne, 
1.015-1.020 specific gravity; no odor; no deposit 
on cooling. 6. Restoration to active duties as 
housekeeper and mother of the family. This case 
"is a living argument that we cannot ignore," 
being present at Newport to-day. 
Many more cases could be given. Moreover, 
we would like to go into the etiological part of 
the subject, but must leave the consideration of 
that for another time. 
These cases were treated on a general plan after 
the following directions : Food, first and last, held to 7 
as the hope ; for we believed that unless the nutrition 
was placed on a normal basis there was little chance 
of changing diseased into healthy tissues. As the 
whole body is constantly undergoing change, we ar- 
gued that if Nature could be given the greatest pos- 
sible chance she would do her best to lay down healthy 
structures in place of the diseased. Medicines were 
not eschewed; instead they were used as oils for the 
machine, and in every possible way the healthy nutri- 
tion was helped along. There is such a thing as 
giving too much and also too little medicine; every 
case is a law tinto itself. To treat cases of chronic 
disease requires a thorough knowledge of anatomy, 
histology, physiology, pathology, materia medica, 
climatology, diathesis, temperament and trophology. 
The patient must be watched by the clinical mor- 
phology of the blood, sputum, faeces, urine, and 
skin. The aim must be to get every gland in the 
body working accurately and easily, with the mini- 
mum expenditure of nerve force; and, our experi- 
ence for it, if you can get the patient's nutrition 
on a healthy basis, if he will cease worrying and 
stop introspection, will place his hand in yours 
and allow you to lead him on, trusting you as a 
child does his mother, and you, putting faith in 
the means at hand, will also look forward to a 
cure, then, gentlemen, we believe that you will have 
the happy result of curing those commonly called 
incurable. 
There is great difference of opinion as to the use 
of foods in treating disease; but the question is not 
of opinions but of the case which is being treated. 
A careful study of the patient once, twice, thrice a 
week or oftener is necessary, and the facts observed 
by morphological and chemical examinations will 
unerringly tell the practitioner whether he is right 
or wrong in the dietary he is using for his patient. 
Moreover, as cases improve, the foods allowed may 
be carefully increased in number and variety; and 8 
here of frequent examinations is im- 
pressed, to ascertain whether the healthy states 
induced dieting have become confirmed ; 
if not, the c<§e.7mtlsf'be put back again till the 
system is ready for 'the more varied dietary. 
Bibliography (Partial List). 
Dr, Ephraim Cutter. 
Feeding Patients against the Appetite. Medical Register, 
1887. 
Diet in Cancer. Albany Medical Annals, July and August, 
1887. 
Food as an Chemic, Pathologic, and Physiologic. 
American Journal of Dental Sciences, December, 1879 ; 
January, 1880. 
Is Flour our Proper Food? Transactions of New Hamp- 
shire State Medical Society, 1875. Also, The Doctor, 
January and February, 1890. 
The Clinical Morphologies of the Blood, Sputum, Urine, 
etc. The Author, 1888. 
Therapeutical Drinking of Hot Water. New York, W. A. 
Kellogg, 1883. 
Seventy Cases of Consumption. Transactions American 
Medical Association, 1880, pages 339-408. 
Food. An Open Letter to the late J. Marion Sims, M.D., 
LL.D., and published in Gaillard's Medical Journal, 
February, 1881. 
Tubercle Parasite. Scientific American, June 3d, 1882. 
Food in Motherhood. London, David Stott, 1890. 
Dr. John A. Ctitter. 
Clinical Morphology versus Bacteriology, with some Thera- 
peutic Deductions. Read before the Mississippi Valley 
Medical Association, September, 1889. Published in 
the Medical Bulletin, October, 1889; Weekly Medical 
Review, Virginia Medical Monthly, Albany Medical 
Annals, Southern Practitioner, the Alabama Medical 
and Surgical Age, New England Medical Monthly, and 
The Doctor.