While regularity in meals is advantageous, it is never necessary to make oneself a slave to the clock by insisting on punctuality to the minute and, if for any reason, any one meal is antici-ticipated or postponed, it is best to change the others correspondingly, so as to leave the usual time, ordinarily 5 - 6 hours, as an interval.

It is not wise to eat heartily simply because it is meal time in the absence of appetite but it is not advisable for a person in ordinary health to skip a meal entirely, unless there is some derangement of digestion. A fair compromise is to eat a few crackers or a slice of bread and butter, or some similar portion of a meal.

The tendency to bring all the meals of the day into the period between 9 and 6 leaves scant time for physiologic rest.

Variety in diet is an important factor in stimulating appetite and digestive secretion. Variety, however, does not necessitate the use of improper, imported or expensive food stuffs. A fair degree of uniformity of diet in the organic nutrients, and even in the groups of food stuffs such as breads, cereals, meats etc., should be followed, but different kinds of bread, crackers, meats, fruits etc. should be freely used and different methods of cooking and flavoring should be employed. Cereals, eggs and milk and cream can easily be changed from substantial courses to dessert, by changes in flavoring, the addition of fruit, jelly etc. Benefit ascribed to change of climate and scene is often really due to a change of cook and of cooking. Often perfectly wholesome and even expensive and well cooked food, fails to fulfill its function, because of lack of ingenuity of the cook in affording variety and pleasing flavor.

While the physician need not be a cook, he should understand the general methods of preparing foods, and should know the ingredients of compound dishes, just as thoroughly as he knows the meaning of Galenical terms and the ingredients of tinctures, compound powders, pills etc. If he is ignorant of what he eats himself and has no conception of what enters into a doughnut, salad, dressing etc., he can not intelligently direct the diet of patients. He should study the cook book exactly as he should the Pharmacopoeia or a work dealing with pharmacognosy or materia medica, not that he need master the art either of cooking or pharmacy, but that he may have an intelligent, general conception of both subjects.

During digestion, especially for the first two or three hours after a hearty meal, the alimentary tract requires both a liberal blood supply and an abundant innervation. The former is not usually compatible with full functional activity either of the brain or the muscles, nor the latter with deep sleep. However, the system usually becomes accustomed to fairly active physical exertion and even not too engrossing mental activity, after a moderate meal. Thus, it is well to eat two or three hours before any exceptionally difficult mental or physical exertion and to rest or ^even take a nap after a hearty meal, but not to eat heartily just before bed time. Sleepiness is, however, often combatted by taking a light lunch just before going to bed. Any apparent inconsistency in these statements is reconciled by appreciating the fact that a balance of blood supply and innervation is what is wanted, not an excess in either direction.

The glutton who does not suffer immediately from his excesses should be viewed in the same unfavorable light as the alcoholic "tank" and an attack of indigestion, diarrhoea or appendicitis due to overeating should be considered as inexcusable as drunkenness.

For strictly hygienic reasons, a meal should be a cheerful occasion, especially for children, and there is no objection to making it a social function, on occasion. Meals should be eaten leisurely, to allow ample time for mastication and insalivation and for deglutition without provoking oesophageal paresis or spasm from undue haste. On the other hand, the meal should not usually be unduly protracted and, even if it is a means of entertainment, palatability should not entirely supplant digestibility and nutritive value of food.

Unless there is a deliberate attempt to cloy the appetite, as in obesity, the stomach should not be filled with water, soup etc. at the beginning of a meal. A moderate amount of liquid, say* 250 - 500 c.c, may, however, usually be taken by persons in health at each meal and, if there is a tendency to accumulation of mucus or lack of sufficient secretion, digestion occurs more rapidly if liquid is used. As an approximate rule, the stomach contents, one hour after a meal, should consist of 50% of water that can be removed by filtration.

With the same general exception as before, plainer foods should be eaten first, "good things" last. An elaborate dinner usually consists of a double meal, the first dessert being represented by compotes, sherbet etc. Such meals are usually too elaborate and often represent an entire day's ration. There is no reason for using fruit first at breakfast, but the usual arrangement should be followed as for other meals.

While, for persons in health, there is usually no objection to the occasional use of sweet drinks, candy, fruit and nuts between meals they should not be used in large quantity nor so soon l>efore a regular meal as to spoil the appetite.

It should be remembered that"good things" are, on the whole, richer in caloric value than plain foods. An ice cream soda or sundae (sondhi) represents 200 - 400 calories, a half pound of candy about 900, a half pint of unshelled peanuts, about 900. The last also furnishes almost 20 grams, a third of the day's ration, of protein. Even fruit contains a considerable amount of sugar. Most persons, even physicians, fail to realize that an allowance should be made for such indulgence, in the ration for the regular meals.

The average individual spends approximately equal amounts for raw material for food and for clothing prepared for use, each aggregating about 1/10 of the total per capita income for persons in moderate circumstances. The average individual of moderate income, reckons the durability and serviceability of clothing pretty closely, in relation to its price but absolutely ignores the similar relation of gross price and caloric or protein value of food. 20 cents a day a person, is a liberal allowance for food (unprepared) even sufficient to provide for considerable variety and palatability. Anything over this figure is purely a luxury. The cost per pound of an article of food has no necessary relation to its cost per unit of food value. Many of the cheaper cuts of meat are dearer than the more costly cuts, by reason of oeconomic waste and, even if the caloric value is high, it is so usually on account of fat which is trimmed off by most persons and which is not available for food beyond a total of about 150 grams a day. The average family is said to spend just about 1/10 of the total expenditure for food, for butter and the average individual uses a pound a week, representing nearly or quite a quarter of his total caloric needs, more fat than is needed altogether and nearly half of the maximum amount that can be ingested without serious physiologic waste and disturbance of digestion.

Considering both financial and physiologic oeconomy, the most oeconomic dietary consists of sugar, about 100 grams, cereal flours and meals in bulk or large packages, about 200 grams, small amounts of lean meat and milk, and reasonable quantities of fresh vegetables and fruits. Such a dietary, perfectly plain but wholesome and adequate, can be obtained on a per capita allowance of 10 cents a day for groups of 10 or more persons.

Various exclusive dietaries have been suggested for different conditions: vegetarianism, meat diet for obesity, milk diet for many fevers and metabolic states, eggs alone, grape cures, oatmeal, etc. German authorities especially, have laid down explicit and arbitrary diets for gastric ulcer, as a precursor of faecal tests, etc. These are not described in the present work as many are entirely irrational while all require the personal equation of the patient. It is just as irrational to treat a given disease with one food stuff as with one drug and to lay down an arbitrary schedule of quantities of food as of doses of drugs.