examples of this variety of food. The hydrocarbons are compounds of hydrogen and oxygen, combined with but a small proportion of oxygen. To this group belong the fats and oils which constitute a necessary portion of our aliment. In addition to these three principal varieties of organic substances, we consume organic acids present in vegetables and fruits, and pectine, which occupy a humbler position in regard to nutrition, but which probably assist in the generation of animal heat. form water, starch and sugar being familiar | in the stomach, the contents of which acquire an acid reaction. Albumen, unchanged in the mouth, is acted upon in the stomach by the acid gastric juice, and in the small intestine by the alkaline pancreatic fluid. The latter secretion completes the change of starch into sugar, continues to render albumen soluble, and by emulsifying fat renders it capable of entering the lacteals. The bile assists in the absorption of fat, and, by its antiseptic properties, preserves the contents of the tube from decomposition. Soluble albumens, now termed peptones, diffuse through the intestinal wall into the portal radicles, and, borne to the liver, are further elaborated before being received into the general circulation; for the peptones themselves are not yet identical with blood albumen, and, in fact, are even deleterious substances. It is the office of the portal blood and the liver to transform peptones into nutritive blood albumen, and to remove from the blood, in the form of urea, an excess or waste of albumen. Urea, a very soluble substance, escapes from the system by the kidneys. The soluble sugar enters the gastric and intestinal blood vessels, by which it gains the liver, in which gland it is changed back to an insoluble starch, called glycogen, and stored up in the cells of the organ to be given out in small quantities as needed, in order to fulfill its proper part in the working of the human organism. Surphus albumens are rendered innocuous by the liver. Surplus sugars are stored Albumen is a substance of extremely complex composition, and exhibits certain physical and chemical differences according to its derivation. Thus, the albumen of the egg is not identical with that of milk, of meat, or of the blood. The albumen of serum differs from that of the blood-globules, and the albumen of animal from that of vegetable bodies. Chemists have distinguished sixteen separate forms in which albumen occurs. Animal and vegetable organisms, then, are alike made up of albumen, fat, and sugar, together with water and inorganic salts. From the foregoing brief statement we may draw the deduction, which is fortified by experience, that a mixed animal and vegetable diet is most nutritious and healthy for human beings. From a regimen thus arranged we may most surely derive the several varieties of essential alimentary principles. The hydrocarbons and carbohydrates differ among them-up by the same organ. Fat is absorbed by the selves just as do the albumens. The work of nutrition, therefore, is to transform these numerous varieties, drawn from widely-different sources, into those forms of albumen, sugar, and fat which are met with in the human body. Albumen under its ordinary forms, starch, and fat are insoluble in water. The problem of digestion, therefore, is to render these substances soluble in the gastric and intestinal fluids. Before animal or vegetable albumen can be converted into the albumen of the human tissues and secretions it must be changed into that condition in which it can pass into the veins and absorbents. The work of digestion is begun in the mouth, or buccal cavity, and is continued by the action of several fluids in the stomach and small intestine. The conversion of insoluble starch into soluble sugar commences in the mouth by the action of the alkaline saliva, but is suspended lacteal vessels, and gradually assimilated as it traverses the absorbent system on its way to the general circulation. The detritus of food, that which escapes solution in the digestive fluids, forms the mass of the fæces. Calculations have been made by various authorities concerning the minimum amount of food required for the maintenance of health and the performance of physical and intellectual labor. A consultation of such tables will convince one that most people in this country consume albuminous food greatly in excess of the needs of the organism. Conventionality and habit are, to a great extent, responsible for this evil practice, while individual tastes also have a decided influence. Doubtless here, as elsewhere, nature generously allows a wide margin, but the habitual transgression of her bounds will surely be punished. Few would be able to restrict themselves so closely as Cornaro, who lived freely in his youth, but at the age of 40, after a severe illness, adopted a rigid diet consisting of but 12 our.ces of solid food with fourteen ounces of wine. Later in life he found that he was able to support his life and strength with no more solid meat than an egg a day. On this spare diet he attained the age of 98. Nor is such severe abstinence demanded. The appetite in health generally furnishes a good, rough guide to the demands of the system. Certain habits conduce to good digestion. In the first place, meals should be taken at certain hours. The custom which many business men allow themselves to fall into of altering their lunchhour according to their business engagements is one that rarely fails, sooner or later, to disturb digestion. A second mistake is that of rapid eating. It has often been observed that the proper performance of necessary functions is more or less pleasurable. Healthy people should enjoy good appetites. This being the case, the partaking of a meal of wholesome, palatable, and well prepared food is attended by enjoyment, and the natural tendency is to eat leisurely and prolong the pleasure. It is injurious to eat to repletion, for reasons which have already been given, and this is especially the case when physical or mental labor must be transacted after the meal. The personal equation, moreover, is often an important element in considering the dietary. For some occult reason articles of food which are wholesome and readily digested by most cannot be eaten by some persons with impunity. The list of such substances is a long one, but among those most apt to excite difficulty may be mentioned shell-fish, pork, and certain berries. Spices are obnoxious to some individuals. Pickled and smoked meats are apt to be ill borne. It should be remembered that digestibility is not always associated with the nutritive value of a food. Some articles, comparatively innutritious are readily assimilated, while others, which contain a larger proportion of alimentary principles, may be difficult of digestion. Thorough mastication is essential, dividing the food into small particles so as to facilitate the operation of the digestive fluids. A proper preparation of food for the table is of much importance. The palatability and digestibility of most of the articles which we consume depends largely on cookery. Vegetables, which contain a preponderance of starch, should be thoroughly cooked, to the end that the starch-cells may burst their albuminous envelope and be readily accessible to the action of the saliva and pancreatic juice. The majority of meats are most nutritions when boiled or stewed. Boiled meat is best placed first in boiling water for five minutes in order that the surface may be coagulated and the juices retained. The pan is then drawn aside and the contents kept at a temperature of about 50 degrees below the boiling point of water. If the meat is placed first in cold water, which is raised gradually to the boiling-point, the juices escape, a soup or broth results, but the meat is left hard, stringy, and insipid. In roasting, also, the object should be to quickly coagulate the surface albumen, thus allowing the inner parts to be changed slowly and gradually, preserving the palatable properties of the juices. Baked and fried meats, though tempting to the taste, are more difficult of digestion. Different aliments differ much as regards digestibility. This variation depends partly upon their composition, partly, as we have just observed, upon the mode in which they are cooked, while, again, various conditions of age, sex, size, season of the year, mode of life, etc., affect the quality of animal food. The flesh of young animals, though tender, taxes the digestive powers more than that of older members of the same species, veal and lamb being less digestible than beef or mutton. On the other hand, the meat of aged animals is tough, unpalatable, and indigestible. Pork is unwholesome during the summer. Mutton is usually a more digestible meat than beef, though by reason of idiosyncrasy some cannot tolerate the former. Contrary to the general rule, bacon is better borne than fresh pork. Calves' liver, which is generally prepared by frying, though a very palatable dish to most people, is too rich for a delicate stomach. The flesh of chickens and turkeys is digested more readily than that of ducks and geese. The fish usually sold in our markets are savory and nutritious, though fried fish may not be acceptable to a weak stomach. Though, as a rule, they possess less nutritive value than the meat of quadrupeds, yet, when properly prepared, they are well able to support bodily vigor, and furnish an admirable addition to the dietary. The process of salting or smoking impairs their digestibility. Some of the shell-fish are highlyesteemed delicacies, but, as has been said, are peculiarly liable to excite derangement of the stomach and reflex or toxic phenomena. Un- | powers. The former, however, often occasions cooked oysters are almost invariably well flatulence, while the latter possesses comparatolerated. Poisonous effects are, above all, tively little nutritive value. Plants of the cabproduced by mussels. Soft-boiled eggs are ex-bage tribe contain a large proportion of water, cellent food, generally well borne and digested. and are, therefore, comparatively innutritious. Hard-boiled eggs require greater labor on the They are apt to derange the stomach and bowels, part of the stomach and exert a constipating but have the advantage of possessing antiscorinfluence. Good milk is frequently our main butic virtues. Spinach is agreeable, wholereliance in disease. Buttermilk is nutritious, some, and slightly laxative. Rhubarb should be though containing little fat, and by many is avoided by those in whom a tendency to the well-relished and borne. deposition of the oxalate of calcium is present. On account of the large proportion of sulphur which it contains, the onion is a valuable article of diet, .though rather difficult of digestion. Celery, asparagus, and lettuce are savory and wholesome vegetables. Stewed tomatoes are appetizing and are valued on account of their piquant flavor, though not very nutritious. Fruits, while not contributing much directly to nutrition, are beneficial on account of the acids they contain, and prevent the occurrence of scorbutic manifestation in those who are compelled to live largely upon dried and salted meat. In Vegetable food contains a lower proportion of nitrogenized matter than that derived from the animal world, though a selection from the richest articles of the class is, no doubt, able to sustain life. It is, upon the whole, however, preferable that the customary diet should embrace materials taken from each kingdom. The grains and legumens, with certain tubers, are those most widely employed. Wheaten bread is an article of universal consumption. Though less palatable, perhaps, its digestion is more easily accomplished when it has become slightly stale. Toasting improves its digestibility and renders it very acceptable to invalids or convalescents. Oatmeal is a wholesome and valuable food for healthy people. It has some laxative effect, which is of advantage to those who suffer from constipation. children it is apt to cause diarrhoea, and from the abundance of carbohydrates which it contains may even give rise to dyspepsia in adults. An eruption upon the skin is sometimes due to the ingestion of oatmeal. Indian corn contains a larger portion of fatty matter than other grains. Rice is distinguished by its large amount of starch. Peas and beans are char acterized by the comparatively large amount of albumen which enters into their composition. Their food value is, consequently, high, but they are very apt to produce flatulence and colic. Potatoes abound especially in starch, and are, therefore, unfitted to act as the chief constituent of a meal. The best manner of cooking them is by boiling or roasting them in I shall not enter into the question of the their skins. This converts them into a soft, worth of alcoholic beverages, as the subject is mealy mass, which is readily digested, whereas, too extensive for the scope of this paper. when their substance is close and watery, their Suffice it to say in this connection that, accorddigestion is much less easily accomplished. ing to my belief, while alcohol has its place in The sweet potato, roasted or boiled, is palat- the treatment of depressed nutritive states, able and wholesome, but very hard to digest. individuals in the enjoyment of ordinary Carrots and turnips are extensively used in health have no urgent need for the use of malt the preparation of soups and stews, and are ac- or spirituous liquors. After the labor of the ceptable to those endowed with good digestive | day is done, however, the temperate enjoyment The sugars are essential articles of food, valuable in the generation of force and concerned in the production of fat. Various farinaceous materials, such as sago, tapioca, and arrowroot, from their easy transposition into sugar, are useful members of our dietary. Tea and coffee, taken in moderation, are beneficial, and conserve bodily force. Strong, green tea, however, embarrasses digestion and occasions constipation. The excessive use of coffee, likewise, has an unfavorable influence upon digestion and may produce unpleasant nervous symptoms. Chocolate possesses decided foodvalue, since it contains about 20 per cent. of albumen, about 50 per cent. of fat, and 10 per cent. of starch, together with a distinctive alkaloid, theobromine, which is related to caffeine and theine. The large proportion of fat in chocolate will often render it unsuitable to weak stomachs. at the dinner-table of a good ale, light wine, | tion, the nature and value of the foods usually or a little spirits and water may promote found upon our tables, and the manner in digestion and result in no harm. which we should approach the table, we open the way for a clear comprehension of the relation of diet to nutrition and malnutrition, of the way in which disease may be engendered by bad dietetic habits, or relieved by an appropriate regimen. Scarcely a subject can be found of more interest to the physician and importance to those whom he advises. For in an enormous proportion of cases ill health can be traced to infringements of the natural laws governing the consumption of food. On the other hand, a skillful management of the invalid's dietary, though a difficult task, is often followed by the most gratifying results. I have already said something as regards the importance of regular meal-hours. For various reasons this rule is far too often transgressed. A slothful or luxurious morning nap too often betrays one into the habit of late rising and its consequence, a hurried, scanty breakfast, is succeeded by a run for the most convenient street-car. At mid-day lunch may be postponed to the exigencies of business, and the same reason may detain one at his place of business after the hour for closing has arrived. If to these blameworthy habits is added the haste, bustle, and nervous tension under which much of the business of this country is transacted, we have found, without proceeding further, conditions directly provocative of digestive failure. A rush down town in the morning, a rush of business all day long, with, perhaps, some alcohol and too much tobacco, a rush home in the evening with an overwrought nervous system, is a manner of life common to many eager business-men in American communities. Such habits almost inevitably impair the appetite and develop nervous dyspepsia, insomnia, and other ills. Ultimately, the victim rushes into an untimely grave. An orderly arrangement of time can generally secure a regular meal-hour. Breakfast leisurely eaten, a walk to the place of business, if not too far, a light lunch at 1 P.M., and a dinner about 6.30 PM, partaken slowly, accompanied by light, cheerful talk, would seem to be a more agreeable, as it is certainly a more healthful, arrangement of the day. The principal meal of the day is advantageously postponed until the day's work has been performed. An elaborate dinner during business hours is a needless sacrifice of time. A hearty meal should not be followed by close application, either to physical or intellectual work. Nervous force should be allowed to preside undisturbed over the digestive function, which cannot be the case if the body or the mind is busily engaged in work. Furthermore, the late dinner can be followed by social recreation, either at home or abroad, by a satisfactory digestion which has been mainly accomplished at the arrival of bed-time, and which predisposes to a good night's rest. In thus glancing at the physiology of diges From our preceding study we may learn. that a moderate-sized meal, leisurely enjoyed and thoroughly digested,-a meal in which the nutritive principles of the food are incorporated by the tissues,-is of far more actual worth than an abundant meal badly digested. In the latter case discomfort certainly follows, and the system probably fails to appropriate enough to supply its need. If a vigorous appetite stimulates one to consume an amount of food far in excess of the demands of the system, the immediate result is torpidity, soon followed by increased blood-pressure and abnormal activity of the eliminative organs. The practice of habitually eating and drinking to excess imposes a constant strain upon the organs of digestion, circulation, and elimina. tion. This strain eventuates in the production of functional disorders, which, in the course. of time, become organic, in the elaboration and retention of toxic products and the genesis of various toxic states. Improper habits, as regards diet, is the most prolific cause of dyspepsia. Eating hastily, with a pre occupied mind, masticating imperfectly, eating at irregular intervals, the consumption of excessive quantities, midnight lunches, will, in most cases, sooner or later entail mischief. Nature usually gives the transgressor ample warning of the danger of the course he pursues. Attacks of acute indigestion, accompanied by vomiting, colic, and diarrhoea, call attention to an oppressed alimentary tract. If such warnings are neglected, chronic dyspepsia is gradually established. Appetite becomes capricious, and is no longer a safe guide as to the kind and quantity of food to be consumed. The patient becomes timor ous in his eating, is afraid of one article or another, attempts a rigid regulation of his diet, and, by a constant direction of thought to his digestive apparatns, in all probability aggravates his trouble. Flatulence ensues, with palpitation of the heart, nervous alarms, constipation, while fermentive decomposition of the contents of the stomach occasion heartburn and water-brash. Gradually the presence of ill-elaborated products excites a gastric catarrh, the gastric juice becomes altered in composition, the walls of the stomach become coated with a thick mucus, which mixes with the food and offers an obstacle to the penetration and action of the gastric juice. The difficulty progresses from stomach to bowel, the intestinal fluids are modified, the tube becomes catarrhal, and this process may spread to the common bile duct and result in attacks of jaundice and the formation of biliary concretions. Fermentative decomposition is continued, and involves albuminous, fatty, and starchy materials. The blood is contaminated in a two-fold manner, being robbed, on the one hand, of its proper and sufficient pabulum, while, on the other, various deleterious, or even noxious products are thrown into the circulation. Anæmia and toxæmia result from embarrassed digestion, while insufficient nutrition is a factor co-operating in the production of chlorosis. An impoverished blood imperfectly nourishes the various tissues and organs, so that we daily meet with pale faces, flabby muscles, weak action of the heart, functional murmurs, headaches, neuralgia, and other evil consequences of chronic indigestion. The sexual powers decline, and, in women, menstrual difficulties are induced. Diseases of the skin, often of a very obstinate character, such as seborrhoea, acne, rosacea, lichen planus, and furunculus are, in many instances, connected with digestive failures. An even more formidable array of diseases is due to impairment of the functions of the liver. A part of the work of this important organ consists in the removal of the excrementitious products from the blood. It decomposes noxious products, and recombines them in such form that they are rapidly eliminated by the kidneys and bowels. In persons of vigorous appetite and naturally strong digestive powers, who habitually indulge to excess in the pleasures of the table, the liver is constantly overworked. The difficulty is intensified if, as as is frequently the case, these individuals lead sedentary lives. Instead of being carried on to the formation of urea, the metamorphosis of waste products is stopped at the production of uric acid, an insoluble substance not easily eliminated. Brick dust sediments appear in the urine, and various difficulties arise, due to the retention of uric acid in the circulation. This condition, now generally known lithæmia, makes its presence known by attacks of asthma, palpitation of the heart, angina pectoris, various affections of the skin, and terminates, if not checked, in a paroxysm of rheumatism and gout. Arterial pressure is heightened, the heart hypertrophies, and the kidney contracts. Finally, we have increased production of excrementitious materials, with diminished capacity for elimination; toxic substances accumulate, until they are present in sufficient quantity to overwhelm the nervous system. Much the same vicious progress is inaugurated in those born with incapable livers, though the incessant watchfulness which this defect compels may preserve the sufferers from the graver consequences of lithæmia. Cardiac depression and melancholia are among the effects of hepatic disorder. An improper diet, especially one in which vegetables are deficient, is the main cause of scurvy. An insufficient diet has much to do with the production of rachitis. Uric acid is an irritant to the genito urinary tract. From its insolubility it tends to deposit in the kidney or bladder. The presence of calculi excites pyelitis, pyelonephritis, or cystitis. Although vegetable aliment would seem to be sufficient to meet the demands of the system, judging from analyses of the composition of the chief vegetable products, yet it has been found to occasion premature atheromatous degenerations. It contains a larger proportion of mineral matter than does animal food. These salts accumulate in the blood, and are deposited in the arterial walls. In the treatment of disease much good can be accomplished by a properly arranged diet. If the disorder has been originated or is perpetuated by faulty digestion of a certain class of aliments, articles belonging to that class should be given in diminished quantity, or altogether prohibited; at least, for a time. It will also be found beneficial to indicate to the |