REPORT 
OF THE 
Chairman of the Committee on Retrenchment. 
INQUIRIES 
PRESENTED BY THAT COMMITTEE AND THE VISIT- 
ING COMMITTEE TO THE SUPERINTENDENT 
AND THE PHYSICIANS & SURGEONS 
OF 
THE NEW-YORK HOSPITAL, 
WITH THEIR REPLIES TO THE SAME. 
I’ HINTED BY ORDER OF THE HOARD. 
FRANCIS HART & CO. PRINTERS AND STATIONERS, 63 CORTLANDT STREET. 
1860. REPORT 
OF THE 
Chairman of the Committee on Retrenchment 
INQUIRIES 
PRESENTED BY THAT COMMITTEE AND THE VISIT- 
ING COMMITTEE TO THE SUPERINTENDENT 
AND THE PHYSICIANS & SURGEONS 
OF 
THE lEW-YORK HOSPITAL, 
WITH THEIR REPLIES TO THE SAME. 
PRINTED BY ORDER OF THE BOARD. 
FRANCIS HART & CO. PRINTERS AND STATIONERS, 63 CORTLANDT STREET. 
1860. The Committee on Retrenchment respectfully submit to the 
Governors of the New York Hospital, the accompanying reply of the 
Physicians and Surgeons to the queries addressed to them by this 
Committee on the 27th of June last; together with the answer of the 
Superintendent to certain inquiries of the Visiting Committee, as to the 
increased cost of maintaining patients. 
John David Wolfe. 
J. W. Beekman. Extracts from the Minutes of the Visiting Committee, May 27, 1 859. 
Present, Najah Taylor, James TV. Beekman, and Frederick A. Conk- 
ling. 
The Superintendent was requested to report in writing to this Com- 
mittee on Friday next, such facts as may he in his possession, in relation 
to the Minutes of the Inspecting Committee of May 4, 1859, and to the 
Report of the Committee on Retrenchment, so as to explain why the 
expenses of the Hospital have been increased. 
From the Minutes of the Visiting Committee, June 3, 1859. Present, 
Najah Taylor, James TV. Beekman, and Frederick A. Gonkling. 
As requested on the 27th of May, the Superintendent read a Report 
on the increased expenditures of the house during the past 20 years, 
which was accepted and referred to the Board of Governors. 
Extract from the Minutes of the Board of Governors, June 7, 1859. 
The Report of the Superintendent referred to the Board by the 
Visiting Committee in their Minutes of 3d instant, was referred to the 
Committee on Retrenchment, and the Committee were requested to 
present a written Report thereon at the next meeting. 
From Minutes of December 6th, 1859. 
The Committee on Retrenchment presented a Report from the Phy- 
sicians and Surgeons to them, on the subject under consideration. On 
motion, the Report was referred back to the Committee, with instructions 
to have one hundred copies of that of the Superintendent, together with 
the one now presented, printed for the use of the Governors. To the Medical and Surgical Faculty of the 
New York Hospital. 
Gentlemen: 
The Committee on Retrenchment in the government of 
the New York Hospital, beg leave to submit for your consideration 
the accompanying documents, and to request the favor of a reply in 
writing. 
John David Wolfe, 
Chairman. 
James W. Beekman, 
Secretary. 
To 
Joseph M. Smith, M. D. 
Chairman of Faculty. 
New York Hospital, 
June 27, 1859. QUERIES, 
1. What is the usual quantity of extract of Beef prescribed per day ? 
2. What is the usual quantity of Beef-tea ? 
3. What is the difference between Beef-tea and Extract of Beef? 
4. What is the difference between Beef-tea and House-soup, as to its 
nourishing a,nd medical properties ? 
5. State what is the largest quantity of Beef, Extract of Beef, or Beef- 
tea ever prescribed in one day for one patient; describing the case 
and its results. 
6. Would not Mutton in the shape of broth or soup answer the place of 
Beef? i’qnnt 
*ON THE INCREASED EXPENDITURES OF THE NEW-YORK HOSPITAL, EM- 
BRACING THE PERIOD EXTENDING FROM 1839 TO 1859, AND IN EX- 
PLANATION THEREOF; MADE AT THE REQUEST OF THE VISITING 
COMMITTEE, BY JAMES DARRACH, SUPERINTENDENT, JUNE 3d, 1859. 
To the Visiting Committee of the New- York Hospital:— 
Gentlemen : The Report presented to the Board of Governors of the New 
York Hospital, at the meeting held Way 4th, 1859, by the chairman of 
the Committee on Retrenchment, sets forth the following facts : 
First.—During the nineteen years ending on December 31st, 1858, 
there has been a progressive annual increase in the cost of providing 
for the patients treated at the New York Hospital, estimated per 
patient, per week. 
Second.—During the same period, from 1839 to 1859, there has 
been a progressive annual increase in the consumption of animal food 
and of stimulants, and a diminution in that of farinaceous food, by the 
patients treated at the New York Hospital, estimated per patient, per 
day. 
On the sth day of May, 1859, being the next day after the presen- 
tation of the above report, the Inspecting Committee record the following 
minute : 
“ The house diet appears to be mainly composed of meat. It has 
been suggested whether an addition of vegetables to the list would not 
make it more economical, and also palatable to the patients. The 
Visiting Committee are requested to consult with the attending physi- 
cians and surgeons as to this point, as the character of the house 
diet has a material bearing upon the current expenses of the 
Hospital. A comparison is suggested with the house diet of some years 
ago, in order to ascertain if any change has been made which produces 
so great an increase in the expenses. 
* With great pleasure I here record my thanks to Dr. John L. Vandervoort, librarian to the New York 
Hospital, for the prompt assistance which he has at all times rendered to me in the study of the topics dis- 
cussed in these papers, and tor some illustrative facts to which he directed my attention. Also to Dr. G. A. 
Quimby, house surgeon, for like aid. 2 
As Superintendent of the New York Hospital, at the request of the 
Visiting Committee, I will offer such explanations of the subjects 
involved in the above report and minute, as my experience and study 
have presented to me, and such only as may be offered without invading 
the province or prerogative of others. 
When, in December, 18-54, 1 had accepted my official trust, and had 
entered upon its duties, my attention was soon arrested and directed to 
the following question : 
Why is so much animal food required in a hospital ? 
The necessary details had not been secured for a proper, and to me, 
satisfactory answer ; neither did the records furnish the material 
required for the necessary data. I therefore recommended to the 
Visiting Committee a system of written orders, in book form, which was 
adopted, and is now in use, though not fully enforced until the close of 
the year 1857. These recorded orders were found inexplicable, without 
the examination of the case books of this institution, in connection with 
medical literature, and the corresponding facts occurring in other 
hospitals. 
In this manner, the question and its collaterals have been studied 
during the last three years. The results which follow are presented 
with great deference, but, at the same time, with the strong conviction 
that they will conduce to accurate opinions on the subjects involved. 
Annual, progressive increase of cost in the maintenance of patients 
is the first presentation by the Chairman of the Committee on Retrench- 
ment. 
This increase of cost has been explained to myself, and, I think, will 
be to others, by the past “market rates” when due weight is given to 
the annually enhancing value of all dietetic articles. The market rates 
for three years, (1855, ’56, and ’57), are shown in table A, which is 
compiled from the weekly report of Washington market, published in 
the New York Evening Post, by taking the prices there reported, and 
making an annual average thereof. The maximum and minimum 
prices of each year examined are also given. This table shows a 
diminution in prices in the year 1856, as compared with J855, and 
again an increase in 1857—an augmentation and decrease coincident 
with the statistics of the hospital, and pointedly illustrative of the 
influence of those rates upon the cost of maintaining the patients during 
those years. This enhancement of cost (dependent upon market rates) 
is further shown by a comparison with the cost of institutions of corre- 
spondent character in table B. 
Comparisons of this institution with almshouses, or the Emigrant’s 
Refuge at Ward’s Island, are comparisons between incomparable objects, 
and therefore not proper. The design of a hospital is to renovate and 
establish the fallen vitality; that of an almshouse merely to keep 
vitality in existence. The policy of an hospital is to hold forth the 
hand of invitation ; that of an almshouse to stretch forth the palm of 
repulsion. For confirmation and avowal of the principles of almshouses, 
see table Gr and note A ; for illustration of their practice, see Senator 
Spencer’s report on the almshouses of the State of New York. 
The rate of increase in some institutions varies from year to year ; 
and as shown by the tabulation of costs,, and the ratio of its changes, the 3 
economy of the New York Hospital is placed in very favorable com- 
parison with its fellows. Their statements, with their comparative 
tables, are thought to be sufficient explanations of the annual progres- 
sive cost of providing for the patients of this hospital, considered inde- 
pendently of the annual increase in the quantity of animal food estimated, 
per patients, per day. 
This increase in the consumption of animal food, and of stimulants, is 
the second presentation in the report. 
Its explanation is, in part, in the correction of the estimates of quan- 
tities ; and that of the remainder, which popular notions concerning the 
diet of the sick may regard an extravagant excess, is in a combina- 
tion of coincident and concurrent circumstances. 
First.—The estimates of the reports, as to quantities per patient, are 
thought to have been made only upon the number of the patients then in the 
house, said number, at all periods at which it may be taken, whether daily, 
weekly, monthly, or yearly, being a variable quantity. The estimations 
include the food of the corps of officers and servants in the dividends, 
without including their number, a fixed quantity, in the divisors; the 
effect in the quotients is, to show a large cost and quantity per patient, 
when the number of these is small, and vice versa. This effect is irregu- 
lar and erroneous, and is illustrated as follows : 
The persons fed at the New York Hospital, other than patients, are 
76, occupying 27,740 days in each year. The days occupied by patients 
in 1858 were 80,615 ; hence, those occupied by servants and officers in 
1858, were equal to 34 per cent, of the days occupied by the patients. 
The days occupied by patients in 1853 were 109,781, and hence the 
days occupied by the officers, &c., for that year, were only equal to 24 
per cent, of the time occupied by the patients. 
These examples are sufficient to show the effect in the results. Be- 
tween the two years, 1853 and 1858, they show a variation of 10 per 
centum; and thus it is made to appear, that the individual patient eats 
10 per cent, more meat in 1858 than in 1853, though the actual 
amount given him at each period may have been the same. 
For several years this error in the estimates of quantities, as between 
the extreme periods noted in the report, is aggravated, because the 
number of patients, as well as the daily average, has been decreasing, 
while the number of officers has not decreased, but at one or two periods 
increased. The same illustration is applicable to the results as to wages, 
as well as to quantities. 
This mode of estimation, without including the fixed number of officers 
and servants, creates an error in judgments, which is frequently lost 
sight of, and, in results, is not sufficiently separable from other circum- 
stances to allow the opportunity of a defined value, which really exists, 
and with perceptible effect. Table C, which will be explained here- 
after, presents corrected estimates of the quantities consumed per patient. 4 
EXPLANATION OF APPARENT EXCESS. 
First Circumstance.—The surgery of this hospital has changed during 
the past twenty years. The minor surgery has diminished; it receives 
attention at the dispensaries, and the surgical departments of Bellevue 
Hospital; while, upon the other hand, the introduction of railroads, the 
increased use of omnibuses, the multiplication of steam-power machinery, 
the construction of much more, and more massive architecture, the in- 
vention and domestic use of burning fluids, and the free use of firearms 
by boys and men, have greatly multiplied severer injuries; moreover, 
the use of anaesthetics has so greatly expanded the range of operative 
surgery, that multitudes of cases, which heretofore the surgeon dared 
not attempt, are now continually within the wards of this hospital, hav- 
ing been the subjects of extensive and exhausting operations. 
The case books, in the library of the institution, fully substantiate this 
assertion; the arrangement and classification of the cases contained 
therein, would require much more time and space than is necessary to 
present their evidence. 
Its truth is evident-to every reader of the newspapers, and is sensibly 
impressed upon the minds of all persons conversant with metropolitan 
hospitals during the last few years. The facts asserted are topics of 
ordinary conversation in the office and wards of this hospital. 
But the question recurs—How does this change in the character of 
the surgery affect the consumption of animal food ? It has even been 
suggested “ that the sick men in their wards eat more meat than the 
healthy ones do in prisons, refuges, and asylums; yes, even more than 
those suffering from the same ailments formerly.” It is so. This brings 
me to a second circumstance—one which throws more light upon our 
inquiries than all others; and whose cause is a topic of great interest 
both in its nature and practical bearings, but is outside the range of our 
present inquiry. 
Second Circumstance.—There has been a change in therapeutics dur- 
ing the last nineteen years. 
Therapeutics have passed from the depletion and low diets practised 
twenty years ago, to the stimulants and full diets of the present day ; 
and also from farinaceous, to animal food. 
The preliminary statement is properly made here—that this change 
in therapeutics is one based upon a change of professional views of vital 
operations; of course, involving the whole treatment of disease, bleed- 
ing, &c , technically called “ Antiphlogistic treatment.” 
This change commenced, so far as medical literature is concerned, 
in 1839, though the practice upon which the literature is based must 
have preceded, yet recently, its announcement. 
[1826.] J. A. Her,vis, Fellow of the Royal College of Physicians, in 
his treatise on Diet, Philad. ed., 1826, page 67, says, as a conclusion : 
“ It follows, then, that in our climate, a diet of animal food cannot, 
with safety, be exclusively employed ; it is too highly stimulating: ‘ the 
springs of life are urged on too fast.’ ” 
This is the expression of a doctrine which has been popularly believed, 
and is now not without its followers ; but in the day in which it was 
announced, (1826,) the practical inference, both with the profession and 
Paris, 5 
the laity, combined with the then approved doctrines of inflammation 
and fever, was, that the prohibition of the subjects of inflammation or 
fever from partaking of any animal diet was necessary. 
[1839.] William Stokes, M. R. I. A., Honorary Fellow of King’s and 
Queen’s College of Physicians, in a monograph published in the Dublin 
Medical Journal, March, 1839, stands forth as the herald of this thera- 
peutic change, and announces the introduction of stimulus in the form or 
wine. 
He remarks : “ If we compare the inexperienced man with him who 
has had a long continued practice in fever, we may often observe that 
the former employs a too vigorous antiphlogistic treatment in the com- 
mencement of the disease, and delays the exhibition of stimulants until 
the powers of life are sunk too low, while the latter is much more cau- 
tious in husbanding the strength of his patient, and shows much less 
hesitation in resorting to wine and other stimulants It is in determin- 
ing on the use of wine in fever, that the junior or inexperienced man 
feels the greatest difficulty. This is to be explained by referring to the 
general character of the doctrines which have prevailed within the last 
quarter of a century, and which are only now beginning to yield to a 
more rational pathology. A doctrine of an exclusive solidism, which 
referred all diseases to visible changes of organism, which taught that 
inflammation was the first and principal phenomenon, and that fevers 
were always the result, or accompanied with some local inflammation, 
was, however disguised under various denominations, the doctrine taught 
to the majority of the students. Their ideas were thus exclusively ana- 
"tomical; inflammation formed the basis of their limited pathology. 
Utterly ignorant of the nature mf essential fevers, they applied, in 
diseases of debility, the treatment of acute local inflammation, and de- 
layed stimulation until nature could not be stimulated. Let it not be 
supposed that I seek to make a favorable contrast between the education 
I received and that given to others; far from it. I confess that it was 
not until several years after I commenced practice, that I became fully 
aware of the erroneousness of what is termed the anatomical theory of 
disease ; and I feel certain, humiliating though the confession may he, 
that the fear of stimulants in fever, which I was imbued with, was the 
means of losing many patients.” 
“ Some years ago, I would not have dared to give this man (the sth 
cited case) wine, from the apprehension of its increasing gastric inflam- 
mation.” These ca«es serve as illustrating the line of treatment which 
was adopted in our last typhus, (1838.) In no epidemic did I ever be- 
fore give so much wine. I never had such success. 
Such is the announcement of the commencement of this change in 
medical therapeutics ; I advance now to that of Surgery. 
[1843] Another step in this progressive change is presented to us 
under date 1843, in the clinical lectures on Surgery, delivered at St. 
George’s Hospital, Ed., 1846, page 41, by Sir Benjamin Brodie. Speak- 
ing of Erysipelas after operation, he says : 
“ I was educated in the belief that the thing to be most apprehended 
after an operation was some kind of inflammation, and the way to pre- 
vent inflammation was to keep the patient on low diet; and as long as I 
acted in accordance with these views, I was meeting with erysipelas at 6 
every turn of my practice. Many years have now elapsed since 1 became 
convinced that these views were erroneous ; that an operation is a shock 
to the system, making a great demand upon the vital powers; 
that the effects of a shock are often much aggravated by loss of blood; 
that a scanty diet actually makes the patient more liable to certain kinds 
of inflammation than he would he otherwise; that our rule of practice 
ought to be rather to sustain his powers, by allowing him wholesome 
nourishment, and not to add to the influence of other depressing causes 
that still worse one—starvation. I assure you, and assert it most posi- 
tively, if yon attend to the rule I have just laid down, although you may 
not prevent erysipelas altogether, you will find it to he rare, instead of a 
common occurrence ; and 1 can scarcely express to you how much greater 
has been the comfort of my life, and how much less cause for profes- 
sional anxiety, than was the case formerly.” 
Of Pyemia he remarks : “ This disease, when once begun, is little 
under the dominion of remedies, but much may be done toward prevent- 
ing its existence ; and all the experience which 1 have have had on the 
subject would lead me to believe that, like erysipelas, it has its origin 
in a low, asthenic state of the system ; and that those persons who are 
especially liable to it, are those who have been most lowered by hemorr- 
hage at the time of the operation, or by too scanty diet before or after- 
wards.” Of Gangrene he makes similar remarks. 
[1850.] Dr. lb. Mayne, in the Dublin Quarterly Journal of Medicine, 
article xiv., Nov. 1850, on chronic dysentery, remarks : 
“It is, however, upon a judiciously regulated regimen that the physi- 
cian must rely in his efforts to combat this truly formidable disease. In 
order to afford the patient the remotest chance of recovery, his system 
must be supported from the earliest stages of chronic dysentery. Arrow 
root, sago, and such articles of food, well calculated as they are for the 
relief of intestinal irritation, are but badly adapted for the formation of 
healthy blood. Eggs and milk are particularly suitable to dysenteric 
patients ; the majority of them not only bear stimulants, but absolutely 
require them; and thus brandy and milk, egg-flip, and even wine, are 
occasionally necessary.” 
“ Dr. Graves, of Dublin, has remarked : ‘ That in chronic dysentery 
meat is far too much refrained from, and that many cases which obsti- 
nately resist the most varied remedies most assiduously employed, get 
well rapidly after a liberal allowance of meat given them.’ To the truth 
of this assertion I can bear the most ample testimony, having often suc- 
ceeded in this way, after the failure of all other measures.” 
[1855.] Oesterlen, in his Therapeutics, 6th ed., remarks: 
“In many gastric and nervous affections, a breakfast of animal food 
is more serviceable than tea or coffee.” Again, “ While the British, in 
their hospitals, have long been accustomed to use a highly nutritious 
diet, the French have gradually learned that typhus fever patients are 
frequently more benefited by milk and soup than by leeches, Seltzer 
waters, and the like.” * * * “ After the siege of Paris in 1811, the 
mortality of the wounded among the French and Germans was one to 
seven, they being treated upon the more or less debilitating plan ; while 
amongst the Russians, who managed better, and were almost literally 
stuffed with food, it was only one in twenty-seven.” Pie adds the fol- 
lowing proverb to his remarks : 7 
“ The poor may be healed with beef; the rich with water soups.” 
Chosat states, “ Many patients die who have been long inmates of 
hospitals, and consequently subjected to restricted, poor diet, of diseases 
similar to those attendant upon death from inanition—such as diseases 
of the eye, of cellular tissue, and inflammation, and sloughing of it, the 
-emanation of an offensive odor from the surface, with frequent mani- 
festations of a similar jmoneness to suppurative action, sloughing, and 
purulent depots.” 
[1855.] Dr. Charles Hooker, of Connecticut, in his “ Heport on the 
Diet of the Sick,” to the American Medical Association, and published 
in their “ Transactions” for 1855, says 
“ Solid food should constitute the greater portion of the food.’ 
“ It is, moreover, obvious that the course of diet commonly recommended 
in disease is ill adapted to regulate gastric secretion, and restore its 
natural action. Indeed, the frequent irregular slop diet employed 
could hardly fail seriously to derange the digestive functions in persons 
of the most robust health. In febrile diseases, the general dryness of 
the tongue, and whole interior of the mouth is noticed as a symptom; 
but instead of solid food, to increase the secretions about the mouth, too 
commonly the patient is fed on gruel, rice water, and other slops. The 
natural, rational remedy for this symptom is thus neglected.” 
■“ Even, therefore, in violent cases of phrenitis and other inflammatory 
diseases, * * in which increased nutrition is not required, * * even 
depletion maybe required; yet food—light, nutritious food—should be 
regularly administered to promote natural digestive action and secretion; 
and in diseases of an opposite character, attended with general wasting 
debility, and also to support the strength and repair the waste of the 
body. In such diseases, * *in the early stages, a main object of treat- 
ment is to regulate and invigorate the digestive organs. The return of 
appetite calls for nutritious diet, consisting, in part, of different kinds of 
solid animal food. The continued use of solid food is preferable to 
broths and other fluids. * * Physicians with whom I meet arc some- 
times shocked with the idea of allowing beef-steak, mutton-chop, and 
other solid meats, in the low stages of typhus fever and typhoid 
dysentery. But are we, in such cases, to fear too much nutrition V’ 
[1857.( Dr. Erasmus Wilson, F. R. S., on diseases of the skin, in 
1857, says: 
“ The diet most suitable for cutaneous diseases, and especially those 
of a chronic kind, is a nutritive animal diet;” and, further, speaking of 
certain forms attended with emaciation and mal-nutrition, “ Now, these 
are the cases for cod liver oil.” 
During this year, (1857), and onward to the present time, medical 
literature is, perhaps, less occupied with the fact of the change in thera- 
peutics, than with the great controversy which has sprung up as to the 
causes of this change ; one side affirming the change to be owing to a 
superior knowledge of diagnosis, while the other asserts that the type 
of disease has altered ; and although inflammations and other diseases 
still affect the human subject, yet they do not assume that sthenic form 
of fifteen or twenty years ago, * * but requiring stimulants and rest; 
in fact, the treatment for debility. 
[1859.J Christison sets forth the same evidence of the change, by 8 
presenting his experience of forty years, and calling in review the 
various epidemics which passed under his notice during that period, 
regarding the cause of the change as existing in the change of type. 
Having now shown, from medical literature, the great change in 
therapeutics, involving the nature of the diet for the sick, by quotations, 
with the withdrawal of the lancet from general practice, in 1839, and 
advancing gradually to the relinquishment of gruels and barley water, 
to the adoption of “ nourishing” farinaceous diet, and in 1852 of animal 
diet for tuberculous diseases, and in 1855 to 1857 to the free use of 
“ beef-steaks, mutton-chops, and other solid animal diet.” I now propose 
to show, very briefly, this same change in the practice of hospitals other 
than this. 
Their dietetic regimens, as well as that of this hospital, as late as 
1843, were arranged according to the former therapeutic views, under 
titles like the following, “ Common Diet,” “ Broth Diet,” “ Thin, low, 
or fever Diet,” “ Milk Diet.” This arrangement of specific diets was 
for the convenience of prescriptions, and while the dietaries have 
remained unchanged, so far as known, the prescriptions have neglected 
the low and made use of the full, or meat diets. 
The dietaries taken from Pereira may be seen in table F. 
Neglecting earlier hospital practice, I present examples from the 
more recent. 
[1857.] Report of the Royal Free Hospital. 
After detailing a case of pneumonia, the reporter adds: “ The fore- 
going case is interesting, not only from the complication of an emphy- 
sema, which terminated satisfactorily, but the treatment was different 
from the old plan.” Again, “ The subjoined case is one of pleuro- 
pneumonia of both lungs, pursuing a steady course toward cure, with 
mild treatment, supporting the patient with brandy and beef tea, sub- 
sequently changing the latter for full diet.” 
Report of Westminster Hospital, April, 1857. 
“ We to-day give some examples of pneumonia, in an uncomplicated 
form, and we do so for the purpose of illustrating the treatment at our 
different hospitals. It will be seen how little venesection is resorted to ; 
in fact, we seldom or never see a case requiring its use in London, 
although it may be necessary in the strong and robust in the country 
districts. Of course, cupping occasionally is quite essential. One of 
the striking features in the treatment is, supporting the strength by 
wine, brandy, and beef tea. Better recoveries are made under such 
circumstances. We feel sure physicians must remember the long and 
tedious convalescence which followed the old plan. 
Very many more hospitals in Europe, and many in our own country, 
might be cited; but it is deemed unnecessary, though the multiplication 
of citations would embrace so many and such distant parts of the world. 
I am told there stands on the soil of Ireland, whence come so many of 
our patients, who require this strong feeding and stimulus, in the city 
of Dublin, a monument of recent erection, commemorative not only of a 
great light in medicine, the associate of Dr. Stokes, but also proclaiming 
to the passers by the great therapeutic change of the last twenty years, 
inscribed, 9 
EGBERT JAMES GRAVES, M.D., &c., 
DIED, MARCH 2CITH, 1853, 
He fed fever." 
[1816.] This same change has occurred in the practice of the Ncav 
York Hospital jxiri passu with the evidence already adduced from other 
sources. 
The pharmacopseia of the New York Hospital, published in 1816, (see 
note B for the full record of this dietary), on page sth, reads as follows : 
“ The plan of diet was changed at different times, between the years 
1789 and 1806, in order to discover, by actual trial, that one which 
united economy with health.” 
In the dietary adopted November 14th, 1806, is prescribed the follow- 
ing for the dinners of the patients : 
“On Mondays, Wednesdays, Fridays, and Saturdays, rice with 
molasses or milk, and an ounce of butter to each patient; on Sundays, 
Tuesdays, and Thursdays, meat and soup, with vegetables.” 
“ This was gradually, from the exercise of allowable discretion, 
changed, until the actual bill of fare was brought to the following: 
“On Sundays and Wednesdays, mush and molasses ; on Mondays 
Tuesdays, Thursdays, Fridays, and Saturdays, heads, necks, shoulders, 
and shins of beef made into soup, with aromatic herbs, palatable season- 
ing, Indian dumplings, and other additions of nourishing and wholesome 
vegetables.” 
In the progress of the inquiry as to the diet of the New York Hospi- 
tal, the following minute is next found : 
[1833.] Visiting Committee, Dec. 3d, 1833. 
Present—Philip Hone, Henry J. Wyckoff, and B. W. Rogers. 
The Inspecting Committee having, by their minutes of November 
14th, called the attention of this Committee to the expediency of alter- 
ing the course of Diet, so as to dispense with the use of rice as a daily 
supply to the patients, this Committee have conferred with the attend- 
ing physician, whose opinion is contained in the following report; which 
is hereby respectfully submitted to the Board of Governors for their 
consideration. 
To Philip Hone, Esq., Chairman of the Visiting Committee. 
Sir,— Having, agreeably to your request, inquired into the grounds 
of complaint made by the patients in the medical department of the 
hospital against the use of rice, I am convinced that this article of food 
should be discontinued as a part of the stated diet of the house. At present, 
it is furnished for dinner three times a week ; but instead of being con- 
sumed by the patients, it is in many, if not in most cases, thrown away 
as unpalatable and disgusting. In recommending that the rice be with- 
drawn from the routine of fare, I would respectfully suggest that a diet 
of meat, either beef or mutton, or these alternately, be supplied daily, 
tor all who are in a condition to take substantial food, and that the use 
of rice be left to the special prescription of the physicians. With great 
respect, I am, sir, &c. Joseph M. Smith. 
New York, Dec. 2d, 1833. 
At the Governors meeting, held the same day, (Dec. 3d, 1833,) the 
recommendation of Dr. Smith on the subject of diet, referred to the Board 
by the Visiting Committee, having been considered, 10 
Resolved, That the subject be referred back to said Committee, with- 
instructions to request the physicians and surgeons to prepare and adopt 
a diet table for the use of the hospital. 
On December 13th, 1833, the Visiting Committee record the following 
minute : 
“ The Committee having communicated to the physicians and sur- 
geons the resolution of the Board of Governors, of the 3d Inst., on the 
subject of diet, have received the following communication, and have 
directed the Superintendent to change the diet of the patients accord- 
ingly.” 
“ The undersigned physicians and surgeons of the New York Hospital, 
having taken into consideration the subject of tin? ordinary diet of the 
institution, are of opinion that the usual ration of soup and meat may, 
with propriety and advantage, he substituted for the rice now furnished 
on three days of the week, and that no further alteration appears to them 
to be necessary.’ 
F. U. Johnston. 
Joseph M. Smith. 
John C. Oheesjman. 
Alexander H. Stevens. 
John B. Beck. 
Thomas Cock. 
Valentine Mott. 
J. KearnHy Rodgers. 
[1843.J In Lee’s edition of Pereira, who was authority upon the sub- 
ject of diet, and who had not, in 1843, advanced beyond the low diets 
for fevers ; there is the following comment upon the dietary of the New 
York Hospital. 
“ The principal objections to the dietary of the New York Hospital are, 
the want of variety in the food, which is often of great benefit in the 
treatment of the sick, and, the small allowance of meat.” 
[1852.] On the 6th of April, 1852, a special Committee of the Board 
of Governors, on the increased expenditures, make a long and very min- 
ute report, in which they state : 
“ It is represented that the ship or typhus fever, during the past year, 
has been virulent in the extreme, and far more so than in 1847 ; and 
from the great prostration of the patients, an unusual amount of stimulus 
has been necessary, the amount of brandy per patient having been a pint 
daily for five days, and half a pint of wine daily for ten days. The dele- 
terious state of the atmosphere, produced by those patients, has aggra- 
vated the diseases of other patients, and has produced new manifes- 
tations of surgical ailments, such as erysipelas, hospital gangrene, &c.— 
diseases requiring stimulants and special diet. To this may be added 
the great increase of unusually bad surgical cases, generally caused by 
railroad accidents, camphene burns, &c.—all tending to add to the im- 
purity of the house.” 
“ Your Committee have been induced to make these explanations, not 
only because they account in some measure for the increased expenditure 
of the past year, but because they prove the wisdom of the recent action 
of the Board in refusing to receive any cases of ship or typhus fever.” 11 
“Your Committee are satisfied tfiat it will tend both to improve the 
atmosphere of the house, and to lessen very considerably the expenses.” 
These anticipated results have not followed, because of the change in 
therapeutics which was going on. And the practice of this very year 
tended more fully to disappoint these anticipatons in regard to diseases 
generally. 
This same report states the expressions of the physicans and surgeons 
thus : 
“ They were of opinion that large prescriptions were necessary in 
typhus or ship fever, but the amount of liquor and special diet which 
had been consumed during the past year was much beyond their expec- 
tation.” 
I would here step aside from the narrative to remark, that the surprise 
of the physicians and surgeons, as thus expressed, was natural. The 
results wei’e new and surprising. 
[1853.] On the 25th of February, 1853, the minutes of the Visiting 
Committee record the fact, that the cost of maintenance of each patient 
is more than four dollars per week. 
On the sth of April, 1853, the Visiting Committee report the result of 
investigation as to the expenses of the institution, and after citing other 
causes of expense, say : 
“ To this may be added the expense arising from ‘ special diet.’ ” 
To this evidence of the progressive change, taken from the minutes of 
the Visiting Committee and of the Board of Governors, I will now add 
that of the case books of the institution. 
An examination of those of the medical division, kindly made at my 
request by Dr. S. S. Harris, junior assistant in the medical division, 
satisfied him that, during the period extending from the year 1820 to 
1837, there is not on record a single prescription of beef tea,—an article 
now in such common use, that 5,630 prescriptions are recorded in the 
ward books for the year 1858, which is equal to from 10,000 lbs. to 
39,000 lbs. of beef as purchased, the former amount being the minimum, 
the latter the maximum, according to the kind of beef tea ordered. (See 
note 1.) 
Dr. Harris selected three forms of disease as the subjects of examina- 
tion—typhus and typhoid fever, pneumonia, and rheumatism—during the 
period,named, and has given the medication and diet when recorded; 
where the diet is not given, the medication indicates its kind, whether 
low or full diet. He has also selected the similar cases most recently 
treated, (1858—59.) These cases, from the extreme periods, are arranged 
in parallel columns in table D. 
The therapeutic change may be read from this table, and understood 
by him that runneth. 
An examination of the medical case books, containing the records for 
the month of October, 1840, to January, 1841, each inclusive, was made 
by myself, and the result given in table H. The interest in this table is 
partly, perhaps mainly, that the prescriptions for stimulus and diet indi- 
cate the initiation of this therapeutic change in this institution ;—the un- 
settled and timid state of the medical mind at that period ;—also its 
cautious feeling of its steps along ;—and, as conviction from rational 12 
experience breaks in, tire honesty and courage with which that mind 
submits to yield up long-entertained opinions and practice. 
As the dates advance, more firmness is manifested, and the prescrip- 
tions of stimulus and beef tea multiply and move from near the end, 
nearer and nearer to the commencement of the treatment. 
During the earlier part of the year 1840, there are occasional, but very 
rare, prescriptions of beef soup. On the 3d November, in that year, is 
the fir st record of the words “ beef tea” in the medical case books of the 
New York Hospital. 
So early as this date, the prescriptions of stimulants and beef tea and 
animal food do not appear except in cases of extreme prostration, and 
then very moderately, unless when death appeared nigh. 
As we advance to the year 1857, the indications of these stimulants 
and strong diets are earlier in the treatment, and used in a widening and 
far wider range of diseases. 
A parallel progress is exhibited in the case books of the surgical 
divisions. 
Table C exhibits this same progression by its figures representing the 
annual consumption of meat at the New York Hospital, Pennsylvania 
Hospital in the city of Philadelphia, and the Marine Hospital on Staten 
Island ; and in table B, by the contemporaneous progressive cost at 
several hospitals. These tables also present a coincidence of dates with 
the dates presented in the quotations from medical literature, the reports 
from other hospitals, and the records in the case books of this hospital. 
By table 0, the increase is shown to commence in 1847, and progress 
slowly, with slight fluctuations, to 1854. Since then, the progression has 
ceased. The deficiency in 1855, and excess in 1857, are owing to some 
error, which is as yet unexplained. I have no doubt the excess of 1857 
belongs to 1855, and that the error arises by misplacing in the account, 
some quantity in 1856 belonging to 1855, and again adding the quantity 
of 1856 to 1857, as well as its own proper item. 
Another evidence of this change is found in the extensive use of cod 
liver oil. This oil, long known in the northern parts of Europe, is 
brought more to the attention of the medical profession by Dr. Bennet, 
in the year 1841, for its valuable therapeutic agency in scrofulous diseases. 
Prom this peiiod. it dates its popular use in all diseases of debility, 
attended with emaciation. Its value as a medicine has been attributed 
by different writers to each of its various constituents ; but the profession 
at this day regard its chief value as a nutrient. Its permanent and 
efficient action in this character has given to it a widening sphere of use 
during this period of change. It is now freely prescribed by the physi- 
cians of dispensaries as a nutrient. It is cheap food to that class of the 
sick who are unable to procure butter and meat, being prescribed at the 
dispensary as an article of pharmacy, to be used as an article of diet— 
but a dear one to the dispensaries. 
In whatever direction I have been able to examine the question pro- 
posed to myself in 1855—why do the sick in hospitals eat so much 
meat ?—the conviction is pressed upon me, that the essential answer is 
found in the fact of this therapeutic change. Consequently it answers 
the problem of increased cost of maintenance of patients in hospitals, 13 
so far as that increase is independent of changes in market rates. 
Moreover, as this therapeutic change has demanded an increase of quantity 
in animal food, the change has been aggravated by a cotemporaneous 
advance in market rates of all dietetic articles. The actual advance 
has been with a ratio less than the advance of the market rales. 
So prevalent is the idea that sick people require very little or no 
meat, that it has been recently said, “ the number of the servants and 
officers of the house were not more than an equivalent for the number 
of the patients not eating meat, because of their sickness, therefore the 
mode of estimation which may be admitted for ascertainment of cost, 
is proper for ascertaining the quantity consumed by each patient.” 
To ascertain how near this equivalent was a true one, man for man, 
and consequently the principle of estimation based upon it, I had the 
census of the non meat-eaters taken through several successive days;— 
the census of the patients in the house ranging about 225 : Eight were 
found not eating meat,—a number scarcely an equivalent for seventy-six 
officers and servants, daily good at the trencher. 
The objection in Pereira to the dietary of the New-York Hospital, 
because in 1843 it contained too little animal food, was a just one, 
judged by a comparison with otlier dietaries. Notes A and B, and 
tables C and F, afford the materials for the comparison. 
According to table 0, the patients, previous to 1843, received about 
nine ounces of raw meat, including bone, daily, and that was the meat of 
“ heads, necks, and shins.” It has been ascertained by averaging 1,716 
boilings of meat in 13 different workhouses in England, that the average 
loss was 30 8-100ths per cent.; by the average of 10 boilings at this 
hospital, the average loss was 12 83-100ths per cent, (table H) by boil- 
ing, and the loss from bone one-seventh of the weight purchased. By the 
deduction of the loss ascertained in this hospital, and without taking into 
consideration the soap fat, which, during the last four years, averages in 
sales 5,228 lbs. per annum, though a large proportion of this should be 
deducted, being raw, dry fat, cut from the meat before cooking, the 
patient who, by table C, is charged with nine ounces of raw meat in 1843, 
is found, by the adjoining column, actually to receive only 6 71-100 th 
ounces of cooked meat without bone ; and he who is charged, in 1857, 
with 17 7-100 th ounces, receives of cooked meat, without bone, 13 20- 
100 th ounces, from which at least one fourth is to be further deducted 
for the meat used for beef tea. By the column in table C, marked, 
“ reduced to cooked meat without bone,” will be found the quantity per 
day, since the year 1838, which by proper estimation, entered the 
stomach of each patient. 
The amounts there given will not create much surprise, and will be 
found to be much less than 22 ounces, which was thought an unreasonable 
amount. There are other losses than those incident to the cooking, 
noted above, to which food is subject before it is consumed by the 
patients. On this subject, Pereira very justly remarks, “ The loss 
sustained in preparing and serving cooked meat in large public institu- 
tions is very great, and may appear to the unpracticed observer 
extraordinary ; but there are so many sources from which loss arises, 
that the surprise would be soon removed by attentive consideration of 14 
the subject.” Comparisons of expenditures of apparent quantities of con- 
sumption, between private families and large institutions, often lead to 
very erroneous conclusions. While the loss in the preparation and dis- 
pensing of food in the small family may be at the same rate as in the 
large institution, yet the qantities being so much greater in the one than 
the other, the aggregate loss astonishes and naturally awakens suspicion 
of want of skill or neglect in the management. From all the opportuni- 
ties of comparisons of this nature within my reach, I am inclined to the 
belief that the results are favorable to the economy of the New York 
Hospital, even in its most expensive years. In such institutions, the 
gross loss increases rapidly as the gross quantity increases ; just as 15 
per cent, of 1,000 is a much larger quantity than 15 per cent, of 10, the 
one being Ijr lbs., and the other 150 lbs.: as loss, the amount arrests and 
fills the attention more quickly. 
With these deductions for loss, the present quantity in use in this in- 
stitution per patient, is slightly greater than that found in the dietaries 
in table F. and somewhat less than the consumption in the other hospitals 
as shown in table O. 
Being now done with explanation, I respectfully crave the indul- 
gence of the Committee to a very few words upon the collateral practical 
question of the necessities and requirements arising out of the thera- 
peutic change which has passed under notice. 
As the treatment of disease has changed, in large measure, from the 
open to the closed lancet—from the corked to the uncorked wine and 
brandy decanter—from the nusery-lamp preparations of panada and 
gruel, to beef steak and mutton chop—from the apothecary and nurse to 
the butcher and cook—dispensaries (the places of medication alone, ex- 
cept in so far as the recent increasing use of Cod Liver Oil for food may 
make them otherwise), must henceforth and will be contracting the range 
of their services ; while the services of the hospitals, the places not only 
of medication, but also of food and rest, must and will be enlarged, if 
the indigent sick are to be supplied, that “ the poor may be healed with 
beef.” 
It is not intended by this remark, so to exalt the value of solid food, 
as to throw into shade other hygienic agencies, but merely to place in its 
proper position the true value of good food for the sick. We believe 
with Dr. Ansell,late surgeon to to the Western General Dispensary of Lon- 
don, that “Exercise in pure air, good diet, God Liver Oil, attention to the 
secretions and excretions,” [of course including the batlij are so many 
“ hygienic and therapeutic remedies auxiliary to each other, and offering a 
fair chance of renovating the blood, improving the nutrition and curing 
the disease [tuberculous ”], and with Dr. Stokes, when he writes: 
“ By wine, food, and other stimulants, we support nature until the strug- 
gle is past, so that, to use the words of an ancient author, ‘We cure the 
patient by preventing him from dying !” 
This is the legitimate work of an hospital. It cannot fulfill its office 
unless it liberally, not wastefully, furnish meat and wine for the sick 
and wounded. Oil and wine, with no other measure than the require- 
ments of the occasion, were the medication on the highway of old;— 
a provided temporary domicile and nurse, the hospital of that day. 15 
Since then, while yet the penumbra of that dark eclipse which had 
rested upon the mental world tarried, overshadowing the scientific mind 
with the theorisms of the schools and the theoristic reasonings of Aris- 
totle, between those days of oil and wine for the sick and the present 
time, Dr. Jackson writes, in 1803 ;* “ It is usual to consider the sick in 
three classes, requiring three different modifications of diet. There is 
an acute stage, in which solid food has no place. The form of diet for 
this class is termed low. In the first stage of convalescence, when act- 
ual disease has ceased, when appetite has returned, and where it may 
be indulged to a certain extent, a measure of diet is allowed, suitable in 
quantity to the wants of the patient, termed half-diet. In more ad- 
vanced stages of recovery, where the functions of health are restored, 
the measure is somewhat increased, and is termed full diet, or the high- 
est gradation allowed in hospitals,” 
Such are the theorisms and doctrines under which we have lived and 
formed our opinions of hospital management. But now, when Christi- 
anity, using the Novum Organum of Lord Bacon, is winning us away 
from theorism and Aristotle, and we are beginning to run with alacrity 
in the ways of practical obedience to the teachings of a rational experi- 
ence,—in March, 1859, Dr John Tudor, Surgeon to the Dreadnought 
Hospital ship, writes : “ Out of fifteen cases of importance, it will be 
observed that only one death occurred. * * * The general and im- 
mediate treatment which I adopt in operations consists in—first, the 
most liberal and nutritious diet which a patient can take, and stimulants 
to any extent which I may consider requisite ; at the same time carefully 
watching the effect, protecting the digestion, and sedulously regulating 
the secretions in general. I believe it to be a mistake sometimes com- 
mitted, to change unnecessarily the diet immediately after, and for sev- 
eral days following, an operation ; a period, according to my judgment, 
when the patient, from the effect of the shock, is most dependent upon 
our support; and when, a fortiori, the sustaining powers should be 
most carefully maintained. And I must here do the managing commit- 
tee of this hospital the justice to remark, that they implicity rely upon 
the judgment of their medical officers. 
I was surprised to find the high rate of mortality following surgical 
operations in Paris hospitals, and, from inquiries made on the spot, I 
am inclined to believe that this might be greatly diminished by the 
adoption of a more liberal dietary, and substituting good sound stimu- 
lants in place of the miserably thin wine given to the patients.” 
All of which is very respectfully submitted by, 
Gentlemen, your obedient servant, 
J. Darrach, Supt. 
* Remarks on the constitution of the medical department of the army, with a detail of 
hospital management, &c., by Robert Jackson, M.D. 8 vo. London, 1803. 16 
During the period in which the therapeutic change was occurring in 
the practice of medicine, changes were also made in the dietaries of 
asylums, prisons, and almshouses and hospitals. 
Experience in these institutions had shown that the health of the 
inmates required a larger amount of meat and solid food than had pre- 
viously been allowed, and demanded a review of their dietaries. 
In this review and re-arrangement of the dietaries, a leading principle 
controlled and led to the adoption of a minimum amount of such food. 
That principle is stated by the Poor Law Commissioners thus: “ that 
in the dietary of the inmates of workhouses, the object is to give them 
an adequate supply of wholesome food, not superior in quantity or 
quality to that which the laboring classes, in the respective neighbor- 
hoods, provide for themselves.” 
In January, 1843, the inspectors of prisons in Great Britain, in their 
report on dietaries to the Secretary of State, express the same principle, 
thus : 
Note A. 
“ The dietaries are given as the minimum of what we recommend for 
each class,” &c. 
“ The principle which we are of opinion ought to be acted on in fram- 
ing a scale of prison diet, and that which we have endeavored to carry 
into effect as far as possible in the annexed scale, is that that quantity 
of food should be given, in all cases, which is sufficient, and not more 
than sufficient, to maintain health and strength at the least possible cost.” 
The dietaries thus recommended were finally adopted, the minority 
not regarding them as sufficient. Prisoners are divided into ten classes, 
principally classed according to duration of sentence. 
I. and 11. classes are allowed no meat—sentence less than 14 days. 
111. On two days, 1 pint soup each ; on two days, 3 ounces cooked 
meat, without bone ; on three days, bread and potatoes, or gruel— 
sentence exceeding 14 days, and not exceeding 6 weeks. 
IV. On four days, 3 ounces cooked meat, without bone; on three days, 
1 pint soup—over 6 weeks. 
V. On four days, 4 ounces cooked meat, without bone; on three 
days, 1 pint soup. 
Yl. On four days, 3 ounces cooked meat, without bone; on three 
days, 1 pint soup—not employed at hard labor. 
VII VIII IX. and X These four classes do not vary from the others 
in lessening the quantity of meat The soup was to contain 3 ounces 
of cooked meat, without bone, to the pint. 
Diet of the New York Hospital, taken from the N. Y. H. 
Note B. 
Pharmacopoeia. 1816. 
As in the army and navy, so, in this institution, various experiments 
had been discreetly made to ascertain the best mode of sustaining and 
supporting those under its care. 17 
The plan of diet was changed at different times, between the years 
1789 and 1806, in order to discover, hy actual trial, that one which united 
economy with health; or, in other words, the one which combined a 
proper regard to frugality in administering the funds of the hospital, 
with a due respect to the comfort of the patients. 
On this subject, the physicians and surgeons zealously co-operated with 
the governors, and after divers expedients had been fairly tried, the fol- 
lowing bill of fare was agreed upon, Nov. 14, 1806, as the diet-table for 
the patients. 
In this allowance, it is understood that bread and salt are issued to 
the satisfaction of the patients. 
FOR BREAKFAST, DAILY. 
Bye coffee, with half a gill of milk, and sweetened with sugar; or- 
Indian gruel, sweetened with molasses or sugar. The difference between 
gruel and mush has only reference to its consistence. 
On Mondays, Wednesdays, Fridays and Saturdays, rice, with molasses 
or milk, and an ounce of butter to each patient. On Sundays, Tuesdays, 
and Thursdays, meat and soup with vegetables. 
DINNER. 
SUPPER. 
On Mondays, Wednesdays, Fridays and Saturdays, the same as for 
breakfast. On Sundays, Tuesdays, and Thursdays, common tea, sweet- 
ened with sugar, and half a gill of milk. 
It is understood that roasted and boiled meats, and other things than 
those above mentioned, are only dispensed to the patients by the special 
order of the physicians and surgeons. 
Such is the standing rule governing the diet of the New York Hos- 
pital ; certain alterations have nevertheless been made informally in 
this respect. For example, during the interruption of the coasting trade 
by the war which existed between June, 1812, and February, 1815, it 
was found necessary to diminish the quantity of rice. Sugar and 
molasses also grew extravagantly dear. In lieu of rice and its condi- 
ment, soup of beef with savoury herbs, esculent roots, and maize dump- 
lings, has been generally substituted. 
Further alterations have been gradually made from the exercise of 
allowable discretion, and for the purpose of a salutary change for the 
patients. These modifications bring the actual bill of fare to the follow- 
ing particulars, to wit : 
BREAKFAST, DAILY. 
Bohea tea, with milk and sugar, with the addition of an ounce of 
butter for each person on Sundays and Wednesdays, those being the 
days when there is no animal food for dinner. 
On Sundays and Wednesdays, mush and molasses; on Mondays, 
Tuesdays, Thursdays, Fridays, and Saturdays, heads, necks, shoulders, 
DINNER. 18 
and shins of beef made into soup, with aromatic herbs, palatable season- 
ing, Indian dumplings, and other additions of nourishing and wholesome 
vegetables. 
Mush and molasses or mush and milk, as best suits the convenience of 
the household. 
SUPPER, DAILY. 
If more milk than the ordinary allowance, or if spirits, beer, or wine 
are by the prescribing physician or surgeon judged necessary for any 
patient, the quantity and kind ordered by him are recorded in the hook 
of the house physician or house surgeon. These entries are laid before 
the superintendent, whose duty it is to issue the articles accordingly. 
For convenience of practice, and the methodical treatment of patients, 
their dietetic regimen is distributed under three heads ; 
I. DIETA TENUIS. 
SPARE DIET. 
It consists of panado, barley-water, gruel of maize or oatmeal, toast- 
water, apple-infusion, chicken-water, and infusions of various aromatic, 
farinaceous, and saccharine vegetables, such as balm, sage, lintseed, 
tamarinds, tigs, and of thin ptisanes. 
11. DIETA MEDIA 
COMMON DIET 
This has already been detailed at full length. It is the ordinary 
allowance of the hospital, and is understood to- be dealt out to the 
patients, unless otherwise directed by the prescribe!’. 
111. DIETA LAUTA. 
FULL DIET. 
Milk boiled or crude, with toasted bread, mush, rice, or thickened with 
flour, or combined with eggs into pudding or custard. Eggs raw, 
poached, boiled, or fried, with their numerous modifications into nutri- 
tious compounds. Broiled chicken, ham, fish, beefsteaks, oysters, roast 
beef, mutton in its various rich alimentary forms, wine-whey, mulled 
wine, spiced wine, the discreet use of wine with water, a glass drank pure 
now and then by convalescents and patients extremely debilitated, or 
taken as a vehicle for Peruvian bark, and an accompaniment for other 
medicines. Ale, beer, and porter in due proportion, and under suitable 
directions as to their quantity and their repetition. Spirits cautiously 
ordered and carefully administered, according to the habits, exigencies, 
and symptoms of the patient; with such other nutritious articles as the 
judgment of the prescribe!- may direct, or the state of the market, or the 
condition of the larder may afford. Gravy, butter, and sweets; rich, 
well-seasoned soups and jellies ; coffee and chocolate. By way of 
relish, the fruits of the season. 19 
Table A, 
Showing the average prices, and the minimum and maximum prices of 
the articles of dietetic consumption, for the years 1855, 1856, and 
1857, made from the weekly prices current for Washington Market, 
published in the Evening Post. 
1865. 
1856. 
1857. 
Average for 
Minimum and 
Average for 
Minimum and 
Average for 
Minimum and 
ARTICLES. 
tlie year. 
Maximum. 
the year. 
Maximum. 
the year. 
Maximum. 
Porter House Steaks,. 
19 a20 
16 «25 
15 «17 
14 a20 
17 al9 
16 a25 
Sirloin “ 
14f-16i 
14 -18 
13 -16 
12 -17 
14|-164 
14 -20 
Rump “ 
124-144 
12 -16 
12 -14 
10 -16 
12 -14 
10 -18 
Roast Pieces, 
134-174 
12 -18 
11 -16 
8 -18 
10 -16 
8 -20 
Corned Beef, 
10 -13 
10 -14 
8 -12 
7 -12 
9 -12 
7 -15 
Mutton, 
iH-ui 
8 -18 
9 -14 
6 -18 
94-124 
6 -16 
Yeal, hind quarters,.. 
11 -15 
10 -16 
12 -13 
10 -20 
124-15! 
12 -16 
“ foi-e “ 
8|-10| 
10 -12 
8 -12 
6 -18 
9 -10| 
8 -14 
“ Cutlets, 
18f-20f 
18|-25 
16 -20! 
15 -25 
174-184 
15 -25 
Pork Carcases, per 100 
18-41 9.57 
$6 -$11 
$8 -$9 
$8 $10-so 
|9-4-9-43 
6..'!o_10.5 a 
“ retail, 
Hi 
10 -12 
HI 
11 -12 
12 -13 
10 -14 
Hams, smoked, 
14 
12 -15 
124-134 
124-15 
121-13 
12 -14 
Corned Pork, 
11! 
11 -12 
Hi 
11 -12 
104-11 
10 -12 
Shoulders, 
lOf-llf 
9 -12 
10 -Hi 
10 -12 
104-H4 
10 -12 
Sides, 
11 -13 
11 -14 
13! 
124-14 
124 
124 
Pickled Pork, 
10f 
10 -12 
10 -Hi 
10 -12 
104-11 
10 -12 
Jowls, 
91 
9 -10 
10 
10 
10 
9 -11 
Sausages, 
10* 
10 -12 
Hi 
11 -12 
12 
11 -13 
Smoked Beef, 
13 
12 -14 
104-11? 
11 -15 
14 -144 
12 -15 
Lard, per tub, 
Hf 
11 -13 
Hf-12f 
104-15 
134-14 
10 -16 
State Butter, 
214-23* 
17 -34 
19'-24 
18 -29 
19 -274 
18 -29 
Or. Co’y “ 
26 -34 
23 -36 
26 -29 
23 -38 
25 -28 
24 -31 
Del. “ “ 
24 -36| 
22 -34 
2l4-25f 
18 -30 
19 -254 
18 -28 
Eggs, for $1.00 
60 - 
40 -80 
60! 
36 -88 
48 
28 -66 
Striped Bass, 
9f-12 
8 -15 
124-164 
8 -25 
14 -174 
10 -26 
Cod Fish, 
4|-5! 
4-8 
5i- 8 
4 -10 
64- 6| 
5 -10 
Black Fish, 
8 -10 
8 -10 
81-10! 
8 -12 
8-94 
8 -10 
Pickerel, 
12 
12 
12A-14 
12 -20 
12 -15 
10 -18 
Salmon Trout, 
12 -15 
12 -15 
14 -19 
15 -25 
13|-17 
12 -20 
Eels, 
8 -15 
104-124 
8 -15 
12 -12| 
12 -15 
Flounders, 
5 |- 8 
4-8 
8 - 9i-| 
6 -10 
7-8 
6 -10 
Perch, 
6§- 8 
6 -10 
74- 94 
6 -12 
10 -104 
8 -12 
Smelts, 
12 -124 
10 -15 
18 -25 
10 -25 
134-16 
12 -31 
Musk along, 
214 
15 -18 
Frost Fish, 
6 
6 
Fowls, per pair, 
754-143 
75 -150 
“ per lb 
10|-16 
10 -19 
144-17! 
9 -20 
H*-15 
9 -20 
Broilers, per pair, 
902-137 
50 -200 
71 -120 
38 - 150 
66 -87 
50 - 150 
“ per lb 
121-16 
10 -16 
Turkeys, 
15 -17 
10 -22 
17 -194 
10 -22 
13 -17 
10 -20 
Geese, per lb 
IO3—14f 
9 -16 
11!-13| 
10 -14 
10 -14 
8 -16 
“ per pair, 
76 -150 
75 -250 
HI -204 
75 - 250 
Ducks, “ 
913-178 
624-200 
152 -182 
75 - 200 
71 - 154 
62 - 175 
“ per lb 
16 -21 
12 -25 
Canvas-back, per pair, 
250 
250 
Rednecks, “ 
125 
125 
Quail, per doz 
1801-228! 
100 -350 
286 -298 
150 - 600 
250 - 296 
125 - 600 20 
Showing the average prices, and the minimum and maximum prices of 
the articles of dietetic consumption, for the years 1855, 1856, and 
1857, made from the weekly price currents for Washington Market, 
published in the Evening Post. 
Table A.— Continued. 
1855. 
1856. 
1857. 
Average for 
Minimum and 
Average for 
Minimum and 
Average for 
Minimum and 
AKTICLES. 
the year. 
Maximum. 
the year. 
Maximum. 
the year. 
Maximum. 
Partridges, per pair,.. 
92.y-149f 
75 a 150 
88 a 118 
88 a 125 
87 «1004 
75 «112 
Woodcock, “ 
72 -81f 
624- 100 
“ per doz. 
420|-580f 
300 - 675 
4204-580* 
300 - 675 
456 -561 
400 -600 
Eabbits, per pair, 
41 -54 
37 -624 
59 -68 
50 -75 
Eng. Snipe, per doz. . 
236 - 289 
225 - 400 
2904-3364 
225 -450 
Grouse, per pair, 
100 - 125 
100 - 125 
Wild Pigeons, per doz. 
197 -245 
75 - 300 
146 -1754 
100 - 250 
166 -210 
138 -300 
Hares, per pair, 
50 -86 
50 -86 
Potatoes, per 4 peck,. 
22 -234 
12 -15 
12 -15 
12 -18 
12 - 17 
12 - 25 
Sweet Potatoes, 
32* 
18 -50 
27 -28 
18 -38 
36 - 374 
18 - 50 
Mercer “ perbbl. 
275 -350 
250 -350 
Turnips, per bunch,.. 
6 
4-8 
“ per 4 peck,.. 
154 
12 -25 
17 -18 
12 -38 
14 
9-25 
Beets, per basket, 
126 -150 
81 - 200 
“ per bushel, 
' 
81 -89 
50 - 125 
100 -123 
100 -125 
“ per bunch, 
6f 
6 -12 
6 
6 
7-8 
6-12 
Parsley, “ 
44 
2 -25 
5|- 6f 
2-8 
6-84 
4-12 
Carrots, “ 
4f 
4-6 
5-64 
4-8 
4-6 
4-6 
“ each, 
3 - 34 
3-6 
Onions, per quart, ... 
8 - 
6 -12 
6-84 
6-9 
9 
9 
Salad, per head, 
14- 34 
1 -124 
3|- 7| 
34- 64 
34- 6| 
3 - 12 
Cabbage, per head, .. 
5-8 
2 -31 
7 -10 
2 -124 
104- 15 
4 - 25 
Celery, per bunch, — 
12§—13f 
6 -374 
11 -144 
8 -18 
12 - 13 
10 - 21 
Pumpkins, each, 
6 -15 
6 -15 
23 -49 
6 -13 
364- 384 
12 - 15 
Squash, “ 
3-44 
3-6 
Spinach, 4 peck, 
17 
6 -31 
6| 
6-9 
124- 134 
6-18 
“ per peck, ... 
18 -21 
18 -25 
Salsify,per doz. b’nch’s 
78 -122 
75 - 150 
78 - 122 
75 - 150 
88 -125 
88 -125 
Lima Beans, per qt... 
18 
18 
Tomatoes, 4 peck, 
184-25 
12 -25 
25 
25 
“ per box,... 
125 -130 
100 -200 
“ per basket, 
118|-1624 
100 -200 21 
Table B 
Showing the c 
the years 
for 1857. 
cost, per week, 
s noted, at tlie 
, per 
New 
patient, 
-York 3 
of the 
Hospital 
articles named, 
[ and Seaman’s 
and for 
Retreat 
YEARS. 
1839 
1840 
1841 
1842 
1843 
1844 
1845 
1846 
1847 
1848 
Food, 
1.29 
1.12 
.98 
.81 
.80 
.80 
.70 
.77 
.92 
.97 
Fuel and Lights, 
Honsek’g articles 
.33 
.28 
.29 
.24 
.25 
.26 
.23 
.23 
.25 
.19 
.16 
.22 
.22 
.17 
.15 
.13 
.17 
.12 
.18 
.14 
Milk, 
-12 
.16 
.17 
.14 
.12 
.09 
.11 
.10 
.09 
.09 
Wages 
.81 
.81 
.84 
.79 
.79 
.74 
.74 
.74 
.76 
.82 
Medic’es & Surgy. 
.35 
.32 
.31 
.29 
.31 
.37 
.31 
.24 
.22 
.36 
Kepairs, 
.18 
.28 
.14 
.25 
.23 
.24 
.25 
.40 
, .19 
.25 
Incidentals, 
Cabinet, 1 
.14 
.08 
.08 
.06 
.07 
.04 
.03 
.05 
.03 
.03 
Library, s 
Burials, S 
.03 
.03 
.07 
.08 
.10 
.10 
.09 
.06 
.06 
.06 
Total, 
$3.41 
$3 30 
$3.10 
$2.83 $2.82 
$2.77 $2.63 
$2,61 $2.64 $2.85 
Seam m’s 
Retreat. 
Continued. 
YEARS. 
1849 
1850 
1851 
1852 
1853 
1854 
1855 
1856 
00 
oi 
1858 
1857 
Food, 
1.00 
1.05 
1.07 
1 13 
1.17 
1.84 
1.65 
1.65 
1.85 
1.63 
1.67 
Fuel and Lights, 
.28 
.27 
.28 
.34 
.34 
.45 
.51 
.56 
.48 
,43 
.26 
Housek’g articles 
.17 
.11 
.39 
.16 
.19 
.36 
-24 
.13 
.18 
.13 
.28 
Milk, 
.15 
.14 
.13 
.10 
.09 
.12 
.12 
.11 
.17 
.17 
.01 
Wages, 
.73 
.86 
.92 
.92 
.85 
1.01 
113 
1.00 
1 07 
1.17 
1.40 
Medic’es&Surg’y 
.31 
.42 
.50 
.36 
.27 
.64 
.49 
-30 
.37 
.37 
.24 
Repairs, 
.28 
.28 
.24 
.21 
.12 
.23 
31 
-24 
.22 
.23 
.19 
Incidentals, 
.04 
.14 
.11 
.04 
.04 
.09 
.23 
.07 
.05 
.05 
-20i 
Cabinet, I 
* 
Library, 
.06 
-01 
.07 
.01 
.12 
CO 
Burials, 
Total, 
$2.92 $3.28 
$3.65 $3.26 
$3.07 
$4.74 
$4-68 
$4.06 
$4.40 $4.30 
$4.39 
* Stock, Loan and Interest. 
Table B.— Continued. 
Showing the expense per patient of some of the London Hospitals for the 
year, from the British Medical Journal, 
Each department of St. George’s Hospital, £46. 
St. Mark’s, (a small hospital,) £35. 
St. Bartholomew's, £53. 
The other Hospitals vary between these figures. 22 
Table B.—Continued. 
Showing the cost, per week, per patient, of the articles named, 
and for 
YEARS. 
1850 
1851 1852 
1853 
•1854 
1856 
1857 
1858 
Medicines and Surgery,.. - 
.35 
.39 { .40 
.53 
.52 
.50 
Household expenses, (food) 
.99 
1.17 1.28 
1.77 
1.71 
1.78 
Furn’re, fuel, light, wash’g. 
.50 
.49 .74 
.67 
.67 
.61 
Live Stock, 
•08* 
.01 .04 
.04 
.02 
.07 
Repairs, improvem’ts, &c.. 
.36 
.04 .45 
.13 
.31 
.13 
Salaries and Wages, 
-67 
.94 .74 
-85 
-85 
.86 
Medical Library, &c 
- 09* 
.10 | .12 
.09 
-23 
.24 
Total, 
$3.05 
$3.12 $3.77 
$4.08 
$4.31 
$4.19 
the years noted, at the Pennsylvania Hospital. 
Table B.—Continued. 
Showing the weekly expense of maintaining patients in the Albany City 
Hospital for the years noted. 
1851 and 1852 $5.64 
1852 and 1855, 4.28 
1853 and 1854, 4.58 
1854 and 1855, 5.99 
1855 and 1856, 4.59^ 
Table B.—Continued. 
Table of Expenses of the Massa- i 
Average cost, &c., 
of each seaman at the Sea- 
chusetts General Hospital. 
men’s Retreat, Staten Island, N. Y. 
TVeekly expenses. 
Weekly expenses, 
Annual 
Tear. 
including repairs. 
excluding repairs. 
Tear. 
Average daily. 
Expense. 
Average per week. 
1835 
$4.53 
1846 
1.24 
$247.72 
$3.83 
1836 
5-84 
1847 
1.56 
301.53 
3.72 
1837 
5.30 
1848 
1.77 
295.21 
3.21 
1838 
5-38 
1849 
1.69 
282.03 
3.21 
1839 
5.76 
1850 
1.75 
285.90 
3.15 
1840 
4.32 
1851 
2-01 
338-52 
3.23 
1841 
3.90 
1852 
1.96 
324 42 
3.18 
1842 
5.34 
1853 
1.63 
319-42 
3.76 
1843 
5.00 
4.56 
1854 
1.72 
402-91 
3.92 
1844 
4.77 
4 77 
1855 
1.28 
353-19 
4.69 
1845 
5 52 
5.02 
1856 
1.32 
380-89 
4.67 
1846 
6.43 
6.11 
1857 
1 52 
346 60 
4-39 
1847 
5 81 
5.64 
1858 
1.43 
364-01 
4-40 
1848 
4.98 
4.73 
1849 
5.04 
4.55 
1850 
5.16 
4.90 
1851 
5 38 
4.84 
1852 
4.87 
4.54 
1853 
5 22 
4.87 
1854 
5.73 
5 46 
1855 
6 21 
5.64 
1856 
6-11 
5-50 
1857 
6-45 
5.90 
1858 
6.53 
5.67 23 
Table B.—Continued. 
Showing the cost at the Marine Hospital on Staten Island, of the articles 
named, for the years noted, used in maintaining patients, per patient, 
per week. 
1849 
1850 
1851 
1852 
1853 
1854 
1855 
1856 
1857 
Food, 
1.01 
.91 
.70 
.67 
.66 
1.60 
1.67 
2.14 
1.94 
Fuel and Light, 
.22 
.17 
.16 
.16 
.24 
.48 
.58 
-53 
.50 
Housekeeping articles, 
.21 
.14 
.18 
.20 
.28 
.18 
.16 
.23 
15 
Milk, 
.13 
.18 
.14 
.14 
.14 
.29 
.39 
-34 
.31 
Wages, 
1.31 
1.84 
.90 
.89 
1.00 
1.76 
2-26 
3.35 
3.28 
Medicines and Surgery, 
-24 
.17 
.14 
.15 
.19 
-20 
.23 
-26 
.18 
Bepairs, 
.06 
.18 
.21 
-02 
.03 
.06 
-20 
.10 
-35 
Incidentals, 
.44 
.58 
-16 
31 
.47 
.37 
.27 
-28 
.27 
Unclassified expenses, 
.26 
.26 
.64 
-62 
1.03 
1.11 
1.34 
Burials, 
Improvements, - 
.05 
.04 
.03 
.21 
.10 
.63 
-27 
.24 
.30 
1 
Total, 
$3.88 
$4.21 
GO 
OO 
Ci 
$2.90 
$4.28 
$5.83 
$7.03 
$8.64 
$8.32 
Cost of hoard of seamen at the Sailor’s Home, under care of the Seaman’s 
Table B.—Continued 
Friend Society. Average number per month is 80 souls=24oo 
days. 
Poultry, 400 lbs. 
Meats,.. 2500 lbs. =2900 oz. per day. 
Vegetables, $3O. 
Bread, 1500 lbs. 
Flour, 6 bbls. 
30 bushels Potatoes, at 50 cents 24 
Table 0. 
Showing the consumption of Beef, Pork, Mutton, and Veal, at the New 
York Hospital, by patients, officers, and servants ; and that at the 
Pennsylvania Hospital, in Philadelphia, and the Marine Hospital on 
Staten Island, New-York. 
New-York Hospital. 
Estimated in ounces, per day. 
$ 
Penn. Hospital. 
Est. in oz. per day. 
$ 
Marine Hospital. 
Est. in oz. per day. 
Reduced to 
Reduced to 
Reduced to 
Mutton 
# Total 
cooked meat 
cooked meat 
cooked meat 
Beef. 
and Veal. 
Meat. 
without 
Meats. 
without 4. 
Meats. 
without 4- 
bone. 
bone. ' 
bone. ' 
oz. 
oz. 
oz. 
oz. 
oz. 
oz. 
oz. 
oz. 
1840 
6 * 
3 
9 
6i¥d 
1841 
6 * 
3 
9 
67L 
1842 
3 
Q 4 
0 
6-2- 
1843 
6 * 
3 
9 
641 
1844 
5Sjj * 
3 
gi-a 
641 
/ 
1845 
5** * 
2-i9utt 
gao 
6-2- 
1846 
6 * 
3 
9 
641 
1847 
7 * 
3-m 
102 a 
■ 74a 
1848 
8 * 
4 
12 
g9A 
1849 
lOia 
44a 
15-- 
11** 
1Q-ACL 
lOilhr 
1850 
8 
5.aa 
133-- 
944 
14foV 
lOfFo 
134a 
944 
1851 
gas * 
444 
133J1 
944 
16 * 
12-*- 
12** 
9 7 - 
1852 
gdta * 
42a 
1320 
9** 
15** * 
H«4 
13*o 
10** 
1853 
9 
51Q 
14** 
1044 
12** 
924 
1854 
10 
5 
15 
Ilia 
1746 * 
1341 
20-*- 
1400- 
1855 
970 
44a 
131U!. 
1044 
15** * 
11** 
19-4- 
I441 
1856 
12M) 
25-a 
15m 
1144 
15-8.0- 
1144 
27aji 
20 i* 
1857 
l3at> 
San 
17ia 
1340 
1744 * 
12** 
23** 
l7iii 
1858 
12aa 
15** 
11** 
293* 
21*2 
* Include meat used for beef tea. 
t Not known whether inclusive or exclusive of officers, &c. 
§ Keduced by loss at New-York Hospital, 13 per cent, from cooking, then 1-7 for bone. 25 
Table D. 
Showing the treatment of three several diseases at the periods noted, 
as to medication and diet. 
Typus and Typhoid Fever 
1. Venesection, calomel, pulv. jalap, 
1. Hyd. mass, castor oil, serpentaria. 
spts. mend, castor oil, sage tea. 
2. Carb. ammonia, serpentaria, calomel, 
2. Castor oil, spt. mind, spt. am. cam- 
castor oil, arrow-root, a little wine. 
phor, brandy, beef-tea. 
3. Pulv. doveri, calomel, antimony, Ipe- 
3. Hyd. mass. spts. mind, snake-root. 
cac, buchu, blister, snake-root, aloes, 
wine, carb. ammonia. 
4. Calomel, blister, pulv. Rhei. cups- 
4. Mild diet, beef-tea. 
5. Wine whey, arrow-root, snake-root, 
5. Pulv. doveri, farina, beef-tea, wine. 
camphor, carb am. wine, brandy, 
blisters, morphia 
6. Venesection, calomel, antimony, cas- 
6. Spts. mind, ipecac cups to temples. 
tor oil, blister, arrow-root, barley 
water, camphor, snake-root, pulv. 
doveri. 
Y. Calomel, spts-nitre, castor oil, cups, 
Y. Spts. mind spts. nitre, beef-tea, milk, 
antimony, blister, snake-root, arrow- 
wine, acid. 
root, gruel. 
8. Cups, antimony, calomel, castor oil, 
8. Castor oil, serpentaria 
blister, arrow-root barley water, 
gruel. 
9. Blister, arrow-root, wine whey. 
9. Wine, beef-tea, castor oil. 
10. Calomel, antimony, ipecac, arrow-root, 
10. Beef-tea, wine whey, brandy, ammo- 
barley water. 
nia. 
11. Spts. mind, antimony, blister. 
11. Beef-tea, wine whey, chicken soup. 
12. Calomel, pulv. doveri, snake-root, cas- 
12. Camphor mixt. ammonia, beef-tea, 
tor oil, spts. mind, venesection, wine. 
brandy, spts. mind. 
IB. Spts. mind, aloes. 
13. Mild diet, camphor, of ium, wine, milk, 
farina, snake-root, brandy, ammonia, 
beef-tea. 
14. Antimony, blister, snake-root. 
14. Eccopt. mixt. spts. mind, snake-root,. 
wine, ammonia, brandy, opium. 
15. Calomel, pulv. doveri, spts. mind. 
15. Wine whey, brandy cinchonm, and 
wine, snake-root. 
iron. 
16. Spts. mind, snake-root. 
16. Brandy, beef-tea. 
1Y. Calomel, antimony, opium, castor oil, 
lY- Serpentaria, wine. 
inf. amara, snake-root. 
18. Antimony, spts. mind. mixt. eccopt. 
18. Opium, serpentaria, beef-tea, brandy, 
castor oil, snake-root. 
tr. cincho. 
19. Calomel, antimony, aloes, spts. mind. 
19. Brandy, wine, sinapism. 
castor oil. 
20. Calomel, antimony, senna, aloes, pulv. 
20. Spts. nitre, spts. mind, serpentaria, 
wine, brandy. 
dov. spts. amm. castor oil. carb. iron 
inf. amara. 
21. Calomel, antimony, senna, opium, 
21. Castor oil, snake-root. 
snake-root, spts. mind. inf. amara. 
22. Spts. mind, snake-root, mixt. eccopt. 
22. Serpentaria, quinia, opium, camphor, 
brandy, cups, calomel. 
23. Spts. mind, snake-root, mixt. eccopt. 
23. Spts. mind. spts. nitre, wine ' whey 
beef-tea, morphia, brandy, antimony, 
Treated from 1820 to IBS'? 
Treated during 1858-59 26 
Table D.—Continued. 
Typhus and Typhoid Fever.—Continued. 
Treated from 1820 to 183*7. 
Treated during 1868-59. 
24. 
Calomel, antimony, snake-root, spts. 
mind. pulv. dov. inf. amara. 
24. 
Spts. nitre, tr. aconite. 
25. 
Calomel, antimony, snake-root, spts. 
mind. pulv. dov. mixt. eccopt. &c. 
25. 
Spts. nitre, spts. mind, brandy, beef- 
tea. 
26. 
Pill hyd. senna, pulv. dov. antimony, 
spts. mind. inf. amara, scilla. 
26. Serpentaria, quinine, opium, 
Rheumatism 
Treated from 1820 to 1837. 
Treated during 1858-59 
1. Sup. tartrate potassa, senna, anti- 
1. Hyd. mass, rochelle salts. 
mony, ipecac, antiphlogistic diet. 
2. Spts. mind, colcliicum, hyosciamus, 
2. Pot. iod. sal rochelle. 
diet same. 
3. Calomel, opium, senna, tr capsic, gua- 
8. Sal rochelle, morphine. 
iac. diet same. 
4. Spts. mind, senna, pulv. dov. aloes, 
4. Inf. senna, pulv. dor. ipecac. 
diet same. 
5. Pill aloe acid sulph. amm. 
5. Sal rochelle, senna, hi carb pot. tr. 
aconite, tr. hyosc. blister. 
6. Calomel, senna, snake-root, opium, 
6. Mass. hyd. sal rochelle, tr. aconite. 
diet same. 
1. Hyosciam. colchicum, calomel. 
I. Sal rochelle, tr. aconite, pill. 
8. Calomel, senna, opium, guaiac. capsi- 
8. Sal rochelle, tr. aconite. 
cum, diet same. 
9. Magnesia, sulph. tr. opium, snake-root, 
9. Sal rochelle, tr. aconite, pot. iod. mixt. 
capsicum. 
guaiac. 
Pneumonia, 
Treated from 1820 to 1837 
Treated during 1858-59. 
1. Venesection 150 |, calomel, jalap, 
1. Silk jacket, and turpentine to chest, 
squills. 
tr. scilla, syr. tolu., snake-root. 
2. Venesec. ipecac castor oil, blister, spts. 
2. Oiled silk jacket, Stokes’ expect, bi- 
mind, calomel, digitalis. 
carb. pot. inf. amara. 
3, Venesec. calomel, pulv. purg. castor 
nil 
B. Spts. mind, and ipecac. 
Uli. 
4. Ipecac, tart, antimony, (sympt of del 
4. Inf, snake-root, dry cups, spts. mind. 
trem.) opium, aloe. 
and ipecac. 
5. Ipecac, blister, amm. spts. nitre, calo- 
5. Spts- mind, ipecac. Stokes’ expect. 
mel, tart antimony, venesec. 
6. Calomel, morphia, ammonia, wine 
6. Wet enps, oiled silk jacket, spts. mind. 
whey, blister. 
*7; Calomel, morphia, castor oil, barley 
1. Wet cups, Stokes’ expect, spts. mind. 
water, gruel, spts. mind. spts. nitre, 
and ipecac, hyoscyamus. 
pulv, dov. arrow-root, tr. opium. 
8. Calomel, antimony, cold toast, water, 
8. Spts mind, ipecac. 
opium, spts. mind. 
*9. Blister, cups, calomel, opium, morphia, 
9. Stokes’ expect, oiled silk jacket, carb 
wine whey. 
amm. 27 
Table D.— Continued.' 
Treated from 1820 to 1837. 
Pneumonia.—C ontinued. 
Treated during 1858-59. 
10. Castor oil, cups, blisters, antimony, 
10. 
Mind, and ipecac. Stokes’ expect, inf. 
morphia, venesec. calomel, ipecac. 
amara, iron. 
11. Spts. mind, sulph. magnesia, blister, 
11. 
Pill catb. oiled silk jacket, spts. mind. 
antimony. 
and ipecac, beef-tea, brandy. 
12. Scilla, digitalis, blister. 
12. 
Stokes’ expect, brandy. 
13. Antimony, blister, capsicum. 
13. 
Dry cups, oiled silk jacket, wine, beef- 
tea, brandy, Stokes’ carb. amm. 
Spts. mind, oiled silk jacket.. 
14. Syrup scillse, tr. sanguinariae, ipceac, 
14. 
blister. 
15. Scillae, opium. 
15. 
Spts. mind, ipecac, oiled silk jacket 28 
Table E. 
Showing the practice of the New-York Hospital at the point of change 
from one system of practice to the other, viz: In October, Nov- 
ember, December of 1840, and January of 1841, as to the stimu- 
lants and diet. 
The first date is that of admission, and the prescription is given with the 
day of record thereof. 
Remittent Fever. 
Remittent Fever—Continued. 
1840. 
1840. 
1. S.S. Oct. I—2d, Soup and gruel— 
4th, same diet—l 6 th, 
cured. 
2. CS. “ 2—6 th Effervesc’g drinks 
—l6th, cured. 
3. S.McI. “ 3—Barley water & gruel 
—6th ditto—7th. .dit- 
to— 11th, nourish- 
ment—2oth, cured. 
4. GP.H. “ B—Win8—Wine—11th, wine & 
beet-soup 17 th, 
wine, quinine, and 
good diet. 
5. MB. “ B—Nov.8—Nov. sth, improved 
her diet by ordering 
not to eat meat. 
6. R.G. “ 19—21, stimulants freely, 
died at 12 o'clock. 
7. J.H.D. “ 22—Sick two weeks, wine 
freely, and nourish- 
ing diet—24th, wine 
and nourishment—3o 
cured. 
8. J.K. “ 28—7 th day, porter daily 
—l7 th day, wine 
moderately 19 th 
day, wine—Nov. 12, 
died. 
9. G.E.W. “ 30—Lemonade—Nov. 2, 
do.—6th, cured. 
9£. E. M. “ 31—Diluents and gruel. 
10. J.S. Nov. I—Mild nourishment and 
wine—cured. 
11. J.P. “ I—Gruel 
12. SB.R. “ 2—Diluents. 
13. J.G. “ 3—Wine freely, beef-tea, 
carb. am—6th died. 
14. B.H. “ 6—Gruel. 
15. S. B. “ “—Bth, animal broth, as 
cond’t’n permits, died 
16. M.R. “ 7—9 th, gruel 12th, 
chicken soup—lBth, 
well. 
Admitted. 
17. JL. Dec. 7—llth, generous diet* 
18. J.H. “ 14—21st beef-tea and wine 
—Jan, 6th, 1841, im- 
proved diet & porter. 
19. J.M. Mild diet—died Nov. 
7th. 
Admitted. 
1840. 
Anemia. 
D.B.N. Oct. 18—Mucilagenous drinks 
and nutritious diet. 
Peritonitis. 
20. J.S. Dec. 17—20th wine moderately 
—27 th brandy—29th 
carbonate of ammo- 
nia, brandy. 
Otitis. 
21. S.L.W. Oct. 15— Gruel—16th, gruel 
—2lst, gruel—2Bth, 
cured. 
Delirium Tremens. 
22. J.M. Dec. B—Abstin’ce8—Abstin’ce from fluids 
and solids of every 
kind but ice. 
Rhuematism. 
23. M D. Nov. 19—21st—diet unstimu- 
lating. 
24. J.Q. Oct. 10—Good diet,—30, ditto 
Nov *7 cured. 
25. A.Y. “ 21—Good diet. 
26 J.G. *■ —Nourishing diet. 
Asthenia. 29 
Table E.— Continued. 
Asthenia—Continued. 
Diarrhoea. 
1840. 
1841. 
■2*7. CL. Nov. 24—Generous diet and 
Admitted. 
41. P.S. Jan. 9—Flaxseed tea and ar- 
Admitted. 
porter. 
28. S.P. Dec. 3—Good nourishment. 
row-root—15th, wine 
whey 20th, wine 
whey and beef-tea— 
-24, ditto—30, died. 
1840. 
Poison—Arsenic. 
Colica. 
29 Dec. 7—Gruel. 
42. N.R 
Noy. 7—Gruel. 
1840. 
30. Oct. —On the Bth day stop 
quinine—good nour- 
ishment. 
Intermittent Fever. 
Scarlatina. 
43. T.D. Dec. 11—Arrow-root, flaxseed 
tea undiluted—17th, 
gruel. 
31. J.D. “ 3—Complicated with ery- 
sipelas—Nov. 20th, 
generous diet. 
32. S.F. “ 23—Farinaceous diet 
Noy. 6, cured. 
33. J.S. “ 6—7 th gruel—l3th nour- 
ishing diet—22 cur’d. 
34. A.W. Noy. 9—Chill broken by qui- 
nine. He was, how- 
ever, in feeble condi- 
Purpura. 
1841. 
44. J.H. Jan.- B—Warm8—Warm tea and lemon- 
ade. 
tion-nourishing diet, 
iron. 
Pneumonia. 
Dysentery. 
1840. 
36. S.Y. Oct. I—Arrow-root 16th, 
cured. 
45. T.D. Oct. 4—Sick three weeks pre- 
vious to date—11th, 
all symptoms have dis- 
appeared. The cure 
no doubt has been ef- 
36. A.M. “ 26—Arrow-root—Nov. 7, 
cured. 
37. S.R. “ “—Arrow-root 10th, 
cured. 
fected by the “ Vis 
medicatrix naturae,” 
as he has taken no 
medicine since his ad- 
mission—l7th cured. 
38. F.W- “ 12—Arrow-root—Oct. 16 
39. J.D. Nov. s—Arrow-root and port 
wine—9th, brandy— 
27th, table-spoonful 
of brandy every two 
hours. 
cured. 
46. D.B. Oct. s—9th,5—9th, wine moderately 
—loth, wine more 
freely—llth, wine & 
soup—17 tb stop wine 
—2lst, stop medicine 
and give good nour- 
ishment —November 
Febris Congesta. 
1840. 
2, cured. 
40. M.A.T. Nov. 12—after 2 or three days 
treatment was vari’d 
Typhus and Typhoid Fever. 
by addition of wine, 
subsequently, br’dy, 
carb. amm. stimu- 
47. 8.8. Oct. 25—Arrow-root—29th do 
& wine freely—3oth, 
wine—Nov. 2d, wine 
lants freely given 
during the "last four 
days. 
very freely— died 1 
a. m. 30 
Table E.— Continued. 
Typhus and Typhoid Fever—Continued. 
Typhus and Typhoid Fever—Continued. 
1840. 
1841. 
48. M.D. Nov. 9—Barley water—llth, 
beef-tea—l2th, wine 
freely—24th, wine & 
good diet—Dec. 20th 
getting fat. 
49. J.S. Dec. 14—19 th, wine whey and 
beef-tea—26th ditto, 
Jan. 2d, wine stopt. 
50. J.H. “ 14—20th, nourishment— 
21st, wine in arrow- 
root—23d, wine and 
56. S.B. Jan. 14—17 th, wine whey and! 
beef-tea. 
57. H.A. “ 13—20 th, beef-tea—24th 
convalescing. 
58. B.G. “ 18—Wine whey—23d pint 
of wine in 24 hours 
—25 more than a pint 
of wine—29 th stimu- 
lants freely—Feb. Ist 
died. 
69. A.F. “ 20—Arrow-root. 
generous diet—Jan. 
2d stopt chicken-Jan. 
6th, takes full diet. 
51. R.C. Dec. 16—19 th, wine whey— 
good nourishment— 
Jan. 2d chicken soup. 
52. T.L. “ 21—28 wine—January 2d 
chicken soup. 
53. F.M.C. “ “—Barley water—29th 
barley water and ar- 
Scorlutus. 
1840. 
60. J.W. Dec. I—Fresh1—Fresh meat, vege- 
tables, acid drinks. 
Hematemesis. 
54. J.T. “ 24—Barley water—Jan. 
Bth wine and chicken 
row-root. 
61 A.T. Nov. 20—23d Wine modera’y. 
soup—6th, full house 
diet. 
62. J.L. Oct. s—Oct. 7th gruel—l3th 
died. 
63. P.S. “9 —l2 barley water--14th 
died. 
Gastro -Enteritis. 
1841 
55. G.D. Jan. 12—20 th, wine whey— 
28th, diet of ward. 31 
House Diet at the Massachusetts General Hospital 
Table T. 
The General House Diet of the patients 
will be prescribed from time to time by 
the Resident Physician, under the direc- 
tion of the Trustees, and the special diet 
by the Physicians and Surgeons, and their 
prescriptions must be rigidly adhered to. 
In regard to House Diet, it is not meant 
that every article included within this 
term, will be on the table every day ; nor 
that patients are to order any of the ar- 
ticles at their own pleasure, but that they 
are to partake of such as are prepared for 
the day, and placed on the table. 
When patients believe that particular 
articles are necessary for them, they will 
mention this to the Medical Officer under 
whose care they are placed, and he will 
order the same, if he thinks it necessary. 
He will also give specific orders for diet 
in any case in which he thinks them requi- 
site ; and he will likewise limit the quan- 
tity in such way, as he believes necessary 
for the welfare of his patient in any case. 
If the nurses observe that any patient 
takes food or drink in excess, it shall be 
their duty to make the same known to the 
medical gentleman under whose charge 
such patient is placed. 
When any particular diet is ordered for 
more than a day or two, it shall be noted 
on the card on the patient’s bed, so that 
the medical attendant, may be reminded 
of it; and articles particularly expensive 
shall not be continued longer than neces- 
sary for the patient’s welfare. 
Ration of a sick Seaman in the French Service is as follows, quoted 
from “ Treatise on Marine Hospitals of the United States, Philadel- 
phia, 1814 
White bread, - - 20 ounces. 
Egg, .... i 
Mutton, ... 8 ounces. 
Chicken, - - -1-7 part. 
Mutton, instead of chicken, 4 ounces. 
Prunes, - - 4 “ 
Rice, - - - 2 “ 
Butter or sugar, - - i “ 
The Physician or Surgeon of the Hospital has the power to order the substitution 
of any article he wishes to prescribe; they can likewise order any comfort in addition 
to it. 
From the same Treatise. 
The plan of victualling in the Pennsyl- 
vania Hospital, was an exceedingly simple 
and good one. There were three differ- 
ent diets prepared in the house. 
Ist. The full or generous diet. 
2d. The common diet of the house. 
water to one-half,strained through a col- 
ander, and seasoned with salt. 
This plan gave but littletrouble to the 
cook, and was sufficiently comfortable for 
the sick. 
3d. The low diet. 
The Physician or Surgeon ordered one 
of these diets for his patient,- and tvhen 
he deemed the soup of the common diet 
too gross for his condition, he substituted 
the vegetable soup. Under the full diet 
was comprised, oysters, eggs, porter, and 
wine. 
Besides this there was a soup made 
every day, called the vegetable soup. 
Recipe : Potatoes pared and cut into 
small pieces, 3 parts; onions cut in pieces, 
1 part; crusts of bread, 1 part; boiled in 32 
Subjoined are the Diet-Tables of the Metropolitan Hospitals for the sick, of the Royal Ordnance Hospitals, and of the 
Royal Navy Hospitals and Marine Infirmaries. 
LONDON HOSPITAL. 
Common Diet. 
Middle Diet. 
Low Diet. 
Milk Diet. 
1 pint Porter- 
i “ 
—men. 
— women. 
8 oz. Bread. 
12 oz. of Bread. 
3 oz. Beef with 
Potatoes thrice 
a week; 8 oz. Mutton with 
Potatoes twice a week. 
8 oz. Potatoes and Soup with 
Vegetables twice a week. 
The same, except that 4 oz. of 
meat shall be given in- 
stead of 8 oz. 
Broth. 
1 pint of Milk. 
Gruel or Broth. 
1 Dint of Milk. 
ST. 
BARTHOLOMEW’S HOSPITAL. 
Common Diet. 
Broth Diet. 
Thin or Fever Diet. 
Milk Diet. 
Milk Porridge. 
Milk Porridge. 
Milk Porridge. 
Milk Porridge. 
12 oz. Bread. 
2 pints of Milk, with Tapioca, 
Arrow Root, Sago or Rice, 
as may be prescribed. 
Barley Water. 
1 oz. Butter. 
Bread Pudding 3 times a'week 
when ordered. 
12 oz. Bread. 
6 oz Mutton or Beef. 
1 pint Broth, with Peas or 
Potatoes 4 times a week. 
2 pints Beer for men. 
1 “ “ “ women, 
1 oz. Butter twice a week. 
12 oz Bread. 
2 pints Broth 
1 “ Beer. 
1 oz. Butter. 
12 oz. Bread. 
1 pint of Milk, with Tapioca, 
Arr w Root, Sago or Rice, 
as may be prescribed. 
Barley Water. 
GUY’S HOSPITAL. 
Full Diet. 
Middle Diet. 
Low Diet. 
Milk Diet. 
Fever Diet. 
6 oz. Bread. 
1 “ Butter. 
Tea and Sugar. 
4 lb. Beef fjr Beef Tea, 
or Arrow Root, or Sago 
when ordered. 
For each diet, 
Gruel or Barley 
Water, as re- 
quired. 
li oz. Butter. 
1 quart Table Beer. 
8 oz. Meat when dressed. 
14 oz. Butter. 
1 pint Table Beer. 
4 oz. Meat when dressed, 
and J pint of Broth. 
1 “ Butter. 
Tea and Sugar. 
i lb. Beef for Beef Tea, 
or Arrow Root, or Sago 
when orde ed. 
1 “ Butter. 
2 pints Mi k. 
i lb. B ef for Beef Tea, 
or Arrow Root, or Sago 
when ordered. 
Table F.— Continued. 33 
Meat Diet. 
Soup Diet. 
Milk Diet. 
Simple Diet. 
Cancer Diet. 
Daily, 
12 oz. Bread. 
1 pint Milk. 
12 oz. Bread. 
6 oz Bread. 
6 oz. Bread. 
12 oz. Bread. 
4 lb Meat. 
4 lb. Potatoes. 
1 pint Milk. 
Physician’s Patients. 
' 4 lb. of Potatoes, 4 oz. 
dressed meat, Beef or 
Mutton, roast and 
boiled alternately, 4 
days, 4 oz. meat in 
Soup 3 days. 
Surgeon's Patients. 
f lb. of Potatoes, 4 oz. 
dressed meat, Beef or 
Mutton, roast and 
boiled alternately. 
1 pint Gruel, alternately 
■with 1 pint Barley 
Water. 
1 pint Milk. 
1 pint Soup, made with 4 
oz. Beef, alternately 
with 1 pint of Broth 
with Barley. 
1 pint Milk. 
£ pint Milk, with Rice Pud- 
ding 4 days, «nd with 
Bat'er Pudding 8 
days. 
1 pint Barley Water. 
1 pint Gruel. 
1 pint Gruel. 
J pint Milk or 1 pint 
1 pint Gruel or Barley 
Water. 
Gruel. 
Extra Diet. 
Ordinary Diet. 
Fish Diet. 
Fever Diet. 
Broth Diet. 
Milk Diet. 
12 oz. Bread. 
12 oz. Bread. 
12 oz. Bread. 
Barley Water, ad lib. 
12 oz. Brer d. 
12 oz. Bread. 
2 pints Beer—men. 
1 pint Beer. 
Breakfast, ... 
Dinner, 
“ “ women. 
1 pint Milk. 
1 “ Tea. 
12 oz Meat, roasted, 
weighed with the 
1 pint Tea, 
i “ Milk. 
i the Meat allowed for 
extra diet. 
1 pint Tea. 
i « M Ik. 
4 oz. pl’n boiled AYhite 
F sti, a* Whiting, 
1 pint Tea. 
i “ Milk 
Arrow Root, &c , must 
be spe- ially directed. 
1 pint Tea. 
i < Milk. 
1 “ Broth. 
6 oz. light Pudding. 
1 pint Tea. 
i “ Milk. 
1J pints Rice Milk, 4 
days, i lb. Bread or 
Rice Pudding 3 days. 
bone before it is 
J lb. Potatoes. 
Plaice, Flounders or 
dressed, 4 days, 
boiled S days. 
£ lb Potatoes. 
Haddock. 
1 pint Gruel. 
1 pint Gruel. 
1 pint Tea 
1 pint Gruel. 
i “ Tea. 
i pint Milk. 
Supper, 
1 pint Gruel. 
i “ Milk. 
\ ' “ Milk. 
£ “ Milk. 
MIDDLESEX HOSPITAL. 
ST. GEORGE’S HOSPITAL. 
Table F,—Continued. 34 
Full Diet. 
Milk Diet. 
Dry Diet. 
Fever Diet. 
Daily, 
2 pints Beer. 
12 oz. Bread. 
14 oz. Bread. 
12 oz. Bread. v 
14 oz. Bread. 
2 pints Beer. 
2 pints Beer. 
Breakfast, 
Water Gruel. 
1 pint Gruel. 
Water Gruel. 
Water Gruel. 
Dinner, 
£ lb. of Beef, when dressed, 
1 “ M Ik 4 times a week, 
4 oz. Butter, 4 times a week. 
\ lb. Beef, for tea. 
twice a week. 
Rice Pudding thrice a week. 
Rice Pudding and 4 oz. But- 
4 oz. Butter or 6 oz. Cheese, 
ter 3 times a week. 
thrice a week. 
£ lb. Mutton, when boiled, 
thrice a week. 
1 pint Broth, 4 times a week. 
Supper, 
1 pint Milk. 
Full Diet. 
Ordinary Diet. 
Low Diet. 
Milk Diet. 
Fever Diet. 
Breakfast, 
1 pint Tea. 
1 pint Tea. 
1 pint Tea. 
1 pint Tea. 
1 lb. Bread. 
1 lb. Bread. 
i lb. Bread. 
1 lb. Bread. 
1 lb. Bread. 
Dinner, 
J lb. Meat. 
J lb. Meat. 
i pint Beef Tea. 
1 pint Milk. 
Gru 1. 
f lb. Potatoes. 
J lb. Potatoes. 
2 pints Beer, (if ordered.) 
1 pint Beer, (if ordered.) 
Supper, 
1 “ Broth. 
1 “ Broth or Gruel. 
1 pint Gruel or Milk, (if or- 
i pint Miik. 
Gruel or Barley Water. 
- 
dered.) 
NORTH LONDON HOSPITAL. 
Full Diet. 
Middle Diet. 
Low Diet. 
Milk Diet. 
Daily, 
16 oz. Bread. 
16 oz. Bread. 
8 oz. Bread. 
17 oz. Bread. 
1 pint Milk. 
1 pint Milk. 
} pint Milk. 
2 pints Milk. 
j lb. Meat and 
1 lb. Potatoes, 
1 pint Soup or Rice. 
Oatmeal for Gruel. 
4 days. 
1 pint Soup or Rice, 3 days. 
DREADNOUGHT HOSPITAL SHIP. 
Table F.—Continued. 
ST. THOMAS’ HOSPITAL. 35 
Full Diet. 
Middle Diet. 
Low 
Diet. 
Spoon or Fever Diet. 
Incurables’ Diet. 
FIXED. 
CASUAL. 
C5 Daily, 
14 oz. Bread. 
10 oz. Bread 
i lb. Bread. 
i lb. Bread. 
i lb. Bread. 
i lb. Meat. 
1 lb. Potatoes. 
i pint Milk. 
Breakfast, ... 
1 pint Milk Porridge 
1 pint Milk Porridge 
1 pint Tea, with Sugar 
1 pint Tea, with Sugar 
1 pint Porter. 
or Rice Gruel. 
or thin Gruel. 
and Milk. 
Dinner, 
i lb. Meat, roasted 
i lb. Meat, roasted, 
No fixed diet for dinner. 
1 pint Broth, or £ lb. of 
boiled, or Chops. 
boiled or Chops. 
Bread or Rice Pud- 
$ lb. Potatoes. 
| lb. Potatoes. 
ding, or 1 pint Beef 
Supper, 
1 pint Milk Porridge 
1 p'nt Milk Porridge 
1 pint Tea, with Sugar 
Tea, or a Chop, or 
1 pint Tea, with Sugar 
or Rice Gruel. 
or thin Gruel. 
and Milk. 
Fish. 
and Milk. 
Full Diet. 
Middle Diet. 
Milk Diet. 
Low Diet. 
Fever Diet. 
Daily, 
1 pint Beer or £ pint Porter. 
14 oz. B- ead. 
]4 oz. Bread. 
1 lb. Bread. 
8 oz. Bread. 
Breakfast, 
1 pint Milk Porridge. 
1 pint Milk Porridge. 
1 pint Milk. 
1 pint Gtruel. 
1 pint Gruel. 
Dinner, 
i lb. Meat, 
i ib. Potatoes. 
i lb. Meat. 
i lb Potatoes. 
do. 
1 pint Broth. 
2 pints Barley Water. 
Supper, 
i pint Milk Porridge. 
1 pint Milk Porridge. 
do. 
1 pint Milk Porridge. 
1 pint Milk Porridge. 
In addition to the substances specified in the foregoing Diet Tables of the Metropolitan Hospitals, other articles (as chops, steaks, fish, wine, spirit, porter &c.,) are 
permitted) when specially ordered by the Medical officers, These are denominated extras. 
Table F.— Continued. 
WESTMINSTER HOSPITAL. 
KING’S COLLEGE HOSPITAL. 36 
Showing the quantity of food allowed to each person, weekly, at the following Institutions. J. S. Gould’s Report, 1852. 
Meat. 
Bread. 
Potatoes. 
Rice. 
Beans. 
Salt Fish. 
Meal. 
Tea. 
Coffee. 
Molasses. 
.SoKcZ J’ood 
week. 
lbs. oz. 
lbs. oz. 
lbs. oz. 
lbs. oz. 
lbs. oz. 
lbs. 
oz. 
lbs. oz. 
lbs. oz. 
lbs. oz. 
gills. 
lbs. oz. 
2 8 
9 
9 
H 
6 
2 
8 
i 
1 
12 13 
Nurseries, Randall’s Island, N. Y... 
2 6| 
7 
4 
3 
2+ 
9 13+ 
Alms-Houses, (males,) N. Y 
5 8 
9 8 
1 
7 
12 
i 
2* 
16 12 
Alms Houses, (females,) N. Y. .. 
3 0 
8 
1 
5 
12 
i 
2| 
13 9 
Penitentiary, Blackwell’s Isl’d, N Y. 
7 8 
8 12 
6 
6| 
10 
11 
i 
2+ 
4+ 
18 5 
Alms-House, Philadelphia, ... - . 
2 8 
10 8 
2 7 
6+ 
3 
4 
i 
2* 
3 
16 4 
Moyamensing Prison, Philadelphia, 
Eastern Penitentiary, “ 
8 12 
18 12 
5 7 
8 12 
4 
5 
4| 
14 
I 
5 
House of Refuge, “ 
2 10+ 
12 
2 
6+ 
10 
ifV 
3 
15 13 
4 11 
10 8 
2 4 
i 
12 
CO 
Wjtc 
19 3 
14 
7 
7 
2 5 
8 12 
1 11 
6| 
U 
2 
I 
2f 
2 
15 3+ 
7 
4 13 
i 
12 
7 
13 9 
6 
8 12 
8 
2 
8 
I 
3 
15 14 
8 
1 
2h 
3 
5 
8 
9 
Boston House of Correction, 
7 
7 
4 8 
2 
3/ 
1 
18 10 
Massachusetts State Prison, 
6 8 
10 8 
10 8 
12 
4 
7 
2 
28 8 
2 7| 
7 
1 
2 
4 
31 
i 
1 
ll u 
7 
7 
2 10 
3+ 
i 
16 10 
1 3 10+ 
! 4 2 
7 
14 
5 
8 
2 10 
If 
3 
14 15 
7 7 
8 
3 
9 
5 
2 
i 
1 
2 
15 2 
Oatmeal. 
17 13^ 
Pcnbonville Prison, England, 
1 12 
8 12 
7 
H 
Wh. Flour. 
16 1 
7 
6 2 
1 
15 
1 
i| 
7 
7 14 
2+ 
1 
15 0 
13 8 
Table G. 37 
Table H. 
Showing the results of 10 boilings of meat, in the kitchen of the New- 
York Hospital, from the 14th to the 25th of May, 1859, each 
inclusive. 
Date. 
Weight before boiling. 
Weight after hailing. 
May 14, 1859, 154 lbs 134 lbs. 
16, “ 135 “ 121 “ 
17, “ 102 “ 90£ “ 
18, “ 106 “ 87 “ 
19, " 104 “ 83 “ 
20, “ 121 “ 102 “ 
21, “ 151 “ 136 “ 
23, “ 141 “ 130 “ 
24, “ 151 “ 130 “ 
25, “ 147 “ 131 “ 
1312 lbs. 1144 i 
H44i 
168loss=l21snno9o per cent. 
SOTE I, 
During the period from May 28th, 1859, to June 10th, 1859, each inclusive, there 
was 261 lbs. of beef given out for beef tea. During the same period, there are on 
record 122 orders for beef tea, which is equal to 21a0in lbs. of beef for each order. 
The results of two experiments, made at different times, showed that, in making 
extra beef tea by boiling in the jug, there was required 8 lbs. of beef to the quart 
The last experiment yielded but 14 oz. of tea, by liquid measure. Messrs. J. D. Wolfe and J. W. Beekman, of Committee on Re- 
trenchments, &c., &c. 
Gentlemen,—The physicians and surgeons of the New York Hos- 
pital, to whom certain queries and documents were submitted, through 
their senior physician, Dr. J. M. Smith, beg leave to reply to the 
queries addressed to them, 
1. That the different liquid preparations of beef used in the hospital 
are entered in the books under the general name of “ beef tea,” so that 
it would be difficult to separate the quantity of “ extract of beef” pre- 
scribed from that of “ beef tea ;” nor is this thought necessary for the pur- 
poses which the Committee are supposed to have in view. Nor is it 
easy to say how much of these preparations is “ usually prescribed per 
day,” as the quantity must necessarily vary with the number of patients 
in the house, and the nature of the cases. The number of orders for 
beef tea recorded in the hospital books varied during the first seven 
months of the present year from 60, in the month of March to 206 in 
the month of July, on the medical side; and from 175 to 297, in the 
same months, on the surgical side ; and the whole number of orders on 
record, for the year 1858, was 5,630. Each order is estimated to be for 
one pint. 
2. The difference between beef tea and extra beef tea, as recognized 
at this hospital, is, that the former is made by macerating in cold water 
lean muscle of beef, cut into small pieces, in the proportion of one pound 
of meat to one pint of water, for an hour or more, and then boiling it for 
a short time ; while the extra beef tea is made by putting the beef, pre- 
pared in the same way, into a jug, in the proportion of one ounce of water 
to two and a half pounds of meat, corking it, and boiling the jug for 
several hours. This latter preparation is sometimes called “ extract of 
beef,” but is usually called “ extra beef tea,” in the hospital orders, and 
is one which is only used in more urgent cases. Other modes of making 
liquid preparations of beef are used by physicians in general practice, 
but these are believed to be the ones exclusively used in the hospital, 
at least on ordinary occasions. 
It is perhaps proper to mention in this connection, that the solid part 
of the beef remaining after the preparation of the ordinary beef tea, con- 
tains much nutritious matter, and might form a convenient as well as 
advantageous article of diet, with a proper proportion of potatoes, and 
perhaps other vegetables, and thus prove a matter of some economy. 39 
3. The difference between beef tea and house soup is, that the latter 
article is made with a much smaller proportion of beef to the water, 
that the fat and hones are not separated from the muscle, and also that 
it contains different kinds of vegetables, and, consequently, is both less 
nutritious and more apt to disagree with the stomachs of patients; and 
hence, though good as an article of ordinary diet, is unfit to take the 
place of even common beef tea in patients requiring that article. 
4, The largest quantity of any liquid preparation of beef probably 
ever prescribed in one day in the New York Hospital, for one patient, 
was two quarts, and this amount is said to have been given to a woman 
in the surgical department, from Avhom a large tumor had been removed, 
and who is said to have recovered from an extreme degree of exhaus- 
tion. It is stated by the Superintendent of the hospital, in a communi- 
cation from him, in which this case is introduced, that the beef tea, in 
this instance, was prepared in the proportion of one quart to six pounds 
of lean meat, or eight pounds of meat as purchased, which would give 
the impression that sixteen pounds of beef were consumed by a single 
patient during twenty-four hours. It is this exceptional case—excep- 
tional in the quantity used, but more especially in the quantity of beef 
said to have been consumed in its preparation—which has given rise to 
the inquiries recently instituted by the Governors on this subject, and it 
is not strange that such a circumstance should have attracted their at- 
tention. But it will be recollected that, with proper management, the 
same amount of lean beef (16 lbs.) will yield eight quarts of beef tea, in- 
stead of only two, and that such cases are of comparatively rare occur- 
rence, and hence form no basis for an estimate for the regulation of a 
large hospital. Indeed, it may be remarked, the quantity of food taken 
by a patient in health, or even by a patient with some mild form of dis- 
ease, does not constitute any criterion for judging as to the quantity 
which patients in a state of extreme exhaustion may require. Allow- 
ance must also be made for what must necessarily be lost in feeding one 
so much exhausted as the patient in this case was said to have been ; and, 
in estimating the entire quantity used in a hospital, that spilled in giving 
it to delirious patients, and also that used for enemata, must be taken 
into the calculation. 
5. With regard to the substitution of mutton, in the shape of broth or 
soup, for beef, as food for the sick, they would remark, that it is more apt 
to disagree with delicate stomachs, especially if the fat is not very care- 
fully removed from it, and also that it has a peculiar flavor, which is 
offensive to many persons. They feel, too, that the almost universal 
practical decision of the profession in favor of preparations of beef instead 
of mutton for this purpose, is entitled to much weight in the decision of 
the question as to their comparative merits, and are, therefore, of the 
opinion, that there would be rather a loss than a gain by the attempt to 
substitute mutton for beef for the general use of the sick in hospitals. 
With regai d to the documents drawn up by the superintendent, which 
were submitted to them at the same time with the queries, to which re- 
plies have now been given, the physicians and surgeons would add, that 
they consider the report a valuable one, as presenting a full and correct 
statement of the change which has taken place in the practice of medi- 40 
cine during the last twenty years, in the increase in the amount of nutri- 
tious food and tonic and stimulating drinks required in the treatment of 
many cases of disease, and as thus affording a satisfactory explanation of 
the necessity for the increased expenditure in this department which has 
been called for at the New York Hospital, to meet this change in the 
demands of patients ; and that the elaborate tables which accompany this 
report, show that the increase in this branch of expense is one which has 
been shared by other institutions of the kind in this city, and in other 
parts of the country. Respectfully, your obedient servants, 
Joseph M. Smith, 
Gubdon Buck, 
Jno. Watson, 
Jno. H. Griscom. 
H. D. Bulkley, 
T. M. Halsted, 
T, M. Markoe, 
Wm. H. Van Buren, 
Thomas F. Cock, 
Willard Parker. 
New York, Dec. 6, 1859.