DIETETICS 207 especial care for meat and drink. The cause of the im perfection lies in a deficiency in the supply of nerve power to the stomach, so that it both se cretes its solvent fluid and also rotates its contents too slowly ; and the more it is loaded the slower it goes. Of the medicinal means of curing such a state this is not the place to speak ; but none of them will avail without the aid of a rational dietary. Time must be given to the oppressed organ wherein to empty itself of every complete meal, and such a period of rest given as will allow of the recovery of force ; or if the meals are frequent they must be very sparing. The observations of Busch (Virchow s Archiv. xiv.) show that a period of five hours elapses in the healthy subject before a fully filled stomach can empty itself, and in the dyspeptic the process is still longer. Whenever, therefore, the organ is loaded as healthy people rightly load it, a man should allow at least seven or eight hours to elapse before sitting down to another meal. And he must never eat till the need for food is announced by appetite. Perhaps a more generally applicable and easier obeyed law is not to make full meals at all, but to stop short at the feeling of repletion, and, when that has gone off, again to take in the supply allowed by circumstances. Three mode rate meals are usually sufficient to keep up the strength. Meat should be once cooked. Mutton, feathered fowl, venison, lamb, and beef are digestible in the order they here are placed in. The more difficult dishes should have the longest time allowed to them. Of the farinaceous articles of diet, bread and biscuits are the most easily penetrated by the gastric juices, and all their prepara tions are safe. The best bread is the " aerated," which is free from decomposing yeast. Macaroni is good if soaked till quite macerated. Pastry is difficult of solution. Yegetables are very necessary ; cauliflowers, Jerusalem artichokes, beetroot, French beans, soft peas, stewed celery, turnip-tops, spinach, are the most readily disposed of. When the usual mixture of meat and vegetables is found to induce flatulence, it is a good expedient to eat vegetables only at one meal and meat and bread only at another. The principle on which this plan is based is that starchy food is dissolved mainly by the alkaline saliva, whereas meat is dissolved by the acid gastric juice. In a vigorous person both these are copious enough to render immaterial their mutual neutralization, but when they are scanty, their separate employment is a physiological economy. Consumption is a disease whose treatment is almost wholly dietetic. The children of a mother whose pedigree exhibits proof of a consumptive tendency may with propriety be put to a healthy wet nurse immediately on birth, and, on being weaned, be fed from a Channel Island cow. The milk should be boiled and then cooled down to tepidity. A small tea-spoonful of " saccharated solution of lime " may be advantageously added to each quart of milk when the coming teeth require the elements of their nutrition to be added to the diet. The rules already given for the healthy management of the young should be adhered to with unusual strictness, and any departure from them should be made only to provide for some peculiar necessity of the case according to medical advice. In cases of consumption it is difficult to say that drugs are useless, but certainly those that come nearest to aliments have most evidence in their favour, such as iron, cod-liver oil, and the phosphates of lime. Their effect on the appetite must be sedulously watched, and the end must not be sacrificed to the means ; that is to say, if they spoil the appetite, they must be left off. The reason for administering oil is to afford an easily assimilated basis of renewed organic growth, to take the place of the abnormal tendency to form tubercular matter. If anything pre vents its easy assimilation it is obviously useless. The use of climate in the treatment of phthisis may be tested by its dietetic action ; if it improves the appetite, it is doing good; if it injures the appetite, it is doing harm. In chronic jaundice the function of the liver is best restored by the free use of green vegetables at all meals. Diabetes, when it has once assumed a chronic form, is never really cured, but life may be much prolonged by the employment of a diet from which sugar and starch are excluded as far as practicable, and the patient nourished on animal food. The best fare for diabetic patients is that given by Professor Bouchardat in his work Du Diabete sucree, Paris, 1852. In functional nervous diseases, such as hysteria and hypochondriasis, the appetite, muscular elasticity, and mental powers will often be observed to be deficient in the early part of the day, and to recover their tone in the evening. At this latter time, therefore, it is advisable to make the principal meal. Scurvy is a notable example of a disease of which, more than any other, the prevention depends on the adoption of a suitable diet. Its symptoms so far resemble those of general starvation that from the earliest time of its appearance in history it has been suspected that it is due to a dietary defective in some necessary ingredient ; and practical observation soon showed that this was fresh vegetables. It was found on every long voyage that the crew suffered from scurvy in proportion to the length of time they were restricted to dry food, and that they recovered rapidly as soon as they got access to a supply of succulent plants. This requisite for health is obviously the most difficult of all things to procure aboard ship, and efforts were made to find a substitute capable of marine transport. From the time of Hawkins 1 (1593) downwards the opinion has been expressed by all the most intelligent travellers that a substitute is to be found in the juice of fruits of the orange tribes, such as oranges, lemons, &c. But in its natural state this is expensive and troublesome to carry, so that skippers and owners for a couple of centuries found it expedient to be sceptical. The pictures of scurvy as it appeared during the 18th century are horrible in the extreme. But the statute of 1795, passed through the exertions of Captain Cook and Sir Gilbert Blane, has enforced the carrying of lime-juice. This invaluable preventive has shown its influence all the more decidedly by the disease still appearing occasionally under strong promoting circumstances, and to a certain extent in spite of the antidote ; but it is so modified as to be usually more of the nature of a warning or demonstration than of a serious invasion. Some indeed have questioned and even denied altogether the blessings derived from the enforced use of lime-juice. But they make a very scanty show when weighed with those whom they undertake to oppose; and it is superfluous here to enter into the arguments and results of observation constituting the ponderous Report of the Committee appointed by the Lords Commissioners of the Admiralty to Enquire into the Causes of the Outbreak of Scurvy in, the recent Arctic Expedition, &c., and presented to both Houses of Parliament, May 1th 1877," which seema to settle for ever the preventive powers against scurvy of the use of lime-juice. The committee alluded to was appointed in consequence of one of those exceptional outbreaks of scurvy induced by exceptional circumstances. The ships sent on the explor ing expedition of 1875 were amply provided with lime-juice, and with printed expositions of its value. During the voyage out and in the long inaction of the winter the men s health was so well preserved by general attention to
1 Sir Rd. Hawkins s Voyage, edited by Hakluyt Society, p. 60.