This condition is due to the overproduction of bile which may be absorbed into the blood to inactivity of the body and a resultant sluggish circulation of blood; to overwork of the liver due to overeating; and to insufficient breathing of pure air. It may also result from constipation and the resultant absorption of toxic matter, as previously described.

It may be occasioned also by obstruction of the opening of the bile duct into the intestines from an excess of mucus in the duodenum. In such cases exercises for the intestines are clearly indicated.

In the bending, twisting, and squirming movements which the infant in the cradle makes, the liver is regularly squeezed and relaxed. The same is true of the free movements of an active child at play. If during adult life these same free movements of bending and twisting the trunk were continued daily and correct habits of free breathing of pure air were established, there would be little call for “liver tonics.”

The transformation of carbohydrates in the liver is an important part of its work and in case of inactive liver the sugars and starches should be limited in the diet. Protein stimulates the activity of the liver, yet it is a mistake to allow a diet too rich in protein. The best method is to cut down the quantity of food.

Two glasses of water an hour before breakfast, followed by brisk exercise for the vital organs and deep breathing, are the best remedies.

The daily action of the bowels is imperative.

In extreme cases a fast of two or three days, with a copious use of water, is recommended. Following this fast the diet should consist of easily digested foods, eliminating those containing starch and sugar in too great proportions, as bread, cereals, and potatoes. The amount should be as limited as is consistent with the actual necessity for rebuilding and for energy.

The taking of fats should be restricted in biliousness. The presence of fat in the duodenum stimulates the flow of pancreatic juice, which in turn stimulates the secretion of bile, thus overworking the liver.

Lemon stimulates the action of the gastric glands and thus tends to increase the liver activity.

It has been thought that eggs and milk cause sluggish liver action. There is no physiological reason for this if too much food is not eaten. The fact is often lost sight of that milk is a food as well as a beverage and that when milk constitutes an appreciable part of the diet other foods should be limited accordingly.

Gallstones occur most often in persons after middle life, especially in those of sedentary habits.

A substance called cholesterin is normally present in solution in bile and in the tissues. When, through inactivity of the liver, or when because of sedentary habits the bile remains too long in the system, the cholesterin is precipitated, and, mixed with mucus, it forms gall-stones.

A diet composed mostly of starch and fat favors their formation.

All dietetic measures should be combined with exercise to promote the flow of bile into the intestines.

Two glasses of hot water should be taken in the morning and before retiring. Several glasses of cold water should be drunk through the day.

Sweets and starches should be largely eliminated from the diet; sweet fruits and root vegetables must be avoided.

Fresh green vegetables and acid fruits may be taken. Potatoes contain calcium, but because they contain much more potassium, which lessens the liberation of calcium, they may also be used.

For foods rich in calcium which should be avoided see page 219.

Foods causing calcium oxalate deposits should be avoided as they may cause the formation of gall-stones. For a list of these see p. 219.

Meat, if taken, must be lean and eaten only once a day. Beef and chicken are the preferable meats. Fresh fish may be used.

Alcohol must not be taken and coffee and tea must be limited in strength and quantity.

Active exercise must be practiced daily and full elimination secured from the bowels.

The person afflicted with gall-stones must not sit too long or in a cramped position.

The presence of fat in the duodenum increases the flow of pancreatic juice which, in turn, stimulates the flow of bile, so olive oil is often recommended in case of gall-stones. It is questionable whether it is of benefit, because, as stated, much fat upsets the liver.

Watch the water supply. Hard water which contains lime should be boiled to precipitate the calcium.

DERANGEMENTS OF THE KIDNEYS

The office of the kidneys is to eliminate from the system certain nitrogenous elements in solution; the work of the kidneys, in most conditions, is aided by copious drinking of water.

The influence exerted on the function of the excretory organs by the components of the food has not been given the attention it merits.

If the fluids are not taken in sufficient amount and much animal food is eaten, the urine becomes more concentrated and may irritate the kidneys or the bladder and give rise to calculi (kidney stones) or to the deposit of uric acid. Watery vegetables, juicy fruits, milk, water, and most beverages, by increasing the output of urine, lessen its acidity and density.

A diet limited to certain articles of food by the likes or dislikes of the individual, as the starches and sugars, too large consumption of acid fruits or too fatty foods may cause the appearance in the urine of abnormal amounts of various substances, as sugar, phosphates, calcium oxalate, or fatty acids.

Acid fruits in moderation aid digestion and favor suitable elimination, but when eaten to excess, as lemons, taken two or three or more a day by those striving to reduce flesh, the urine is increased in acidity, and irritation of the bladder may ensue.

Too great an amount of food tends to overwork the kidneys as well as the liver and various derangements result; these must be treated dietetically as well as by medicine.

In inflammation of the kidneys (nephritis), the secretion of urine is lessened or may cease. The kidneys and digestive system must not be overworked and all food must be eliminated save milk until the kidney function is restored. It may be diluted with lime or Vichy, or skimmed milk or buttermilk may be used.

Water flushes the kidneys and if the urine increases in amount when water is given its use may be continued. When the amount of urine is diminished or the kidneys are not functioning at all, water, or any fluid or food that gives the kidneys work, must be given only on the advice of a physician, as serious harm may be done unless the inflamed kidneys are given as near perfect rest as possible. Sometimes even milk must be reduced to one pint a day.

In the event that the kidneys do not excrete, the pores of the skin must be kept freely open by sweat baths to assist in the elimination of urea.

Dr. Hall recommends a milk and cream diet of from three to seven pints a day, for a few days, according to the case—two parts of milk to one of cream. If the urine is scanty, he reduces it to one and one-half pints a day, taken in four or five installments. After the three to seven days of milk diet he gradually introduces starches and fats into the diet.

This is an inflammatory condition of the kidneys in which albumin appears in the urine. It results from irritation and may be acute or chronic.

The appearance of albumin in the urine does not always indicate disease. It may be temporary, merely indicating that the diet, for the time being, is too heavy or contains an excess of protein, especially meat. Several tests from one to two weeks apart are often necessary to determine whether the condition is merely temporary or is due to inefficient action of the kidneys.

When for any reason the kidneys have difficulty in eliminating the nitrogenous waste of the system, the dietitian must eliminate protein food as closely as may be consistent with the body necessities. Besides restricting the amount of nitrogenous foods, the kidneys must be assisted in eliminating the nitrogenous waste and the products of inflammation by a copious drinking of water, unless the kidneys are so inflamed that complete rest is indicated.

Hot water and hot drinks are best in the morning, such as toast water, barley water, cream of tartar, lemon and acid drinks. Unless a dropsical condition is present one may drink freely of cool water.

In acute cases the patient is put on a diet of from two to three pints of milk a day, given one-half pint every three or four hours, diluted with one-third as much hot water. Complete rest is imperative.

In chronic cases, exercise, judiciously directed to the extremities, particularly to the legs and the back, will do more than anything to aid the elimination of an excessive accumulation of fluid as in dropsy. This condition is usually accompanied by constipation and poor circulation, and exercises directed to the liver and bowels aid in carrying off the excess of fluid by way of the intestines; this will rest the kidneys. A cure requires patience and perseverance.

In chronic cases it is also well to follow a milk diet for a number of weeks. The quantity of milk for an exclusive milk diet must depend on the age and size of the patient as well as on his ability to exercise. If he is confined to his room, from ten to sixteen glasses of milk a day are sufficient. If he is taking a great deal of exercise, he may take from eighteen to twenty glasses of milk a day. If he loses weight on the milk diet, bread and rice may be added, or potato soup, cereals, tapioca, and various gruels.

If the milk is not well borne, malted milk or predigested milk with butter and cream may be substituted. If the casein in the milk is not well digested, cheese must not be used. An egg once or twice a week and fruit and fresh vegetables may be given, but meat should be omitted.

A. F. Pattee gives the following diet in Bright’s disease.

DIET

This diet is tentative only and may be modified to suit the individual. If improvement is manifest after a month or two of the restricted diet, steak, roast beef, and eggs may be gradually added. If, when the urine is examined, the use of meat causes a return of albumin, it must be dropped.

In these cases, active outdoor exercise, full, deep breathing systematically practiced at intervals, a calm quiet attitude of mind and care not to overeat and to keep the bowels active will materially aid recovery.

Interference with the action of the kidneys is apt to result in a retention within the system of the elements which they, in normal condition, eliminate from the system—such as urea, uric acid, urates, sulphates, phosphates, etc. They are the result of the oxidation and the breaking down of the proteins of the body. If the kidneys do not eliminate these the result is a systemic poisoning, and the dietetic treatment must be such as will aid them to act freely.

Fruits should be used freely. The citrus fruits (lemons, oranges, limes, etc.) are the best; they neutralize acids and promote the alkalinity of the blood.

When the system shows an excess of uric acid, the chances are that the individual has not been living on a diet containing too large a proportion of protein, but that he has been eating more than he requires of all kinds of foodstuffs. His system thus becomes weakened and he does not breathe deeply nor exercise sufficiently to oxidize and throw off the waste.

Meats, eggs, and legumes should be eliminated from the diet. A free drinking of water, milk with limewater, cereals, buttermilk, kumyss, barley water, toast water, lemonade, orangeade, vegetables, and fruit should form the diet.

Exercise and free breathing of fresh air are imperative. All food should be thoroughly masticated.

When this condition appears it is due to too great an amount of animal or nitrogenous food. It causes dizziness, ringing in the ears, general nervousness, and insomnia.

Uric acid does not render the urine acid but when the acidity of the urine is increased, due to too much animal food, the tendency of the uric acid to form a crystalline deposit is increased. This deposit, as “gravel,” may occasion attacks of renal colic or become the basis, when mixed with mucus, for kidney stones or stones in the bladder.

Headaches if due to uric acid will often cease when animal food is lessened.

Too much candy or sweet foods, or too much fat, eaten in connection with much protein, by deranging the liver function, change the character of the urine and favor the production of uric acid, causing such chronic ailments as bronchitis, asthma, severe nerve depression, gout, and neuralgia.

The natural relief is obtained by control of the diet, supplying less protein. One may either eliminate the proteins from the diet, or may cut down the entire quantity of food. Free elimination through a free action of the kidneys, the pores of the skin, and the lungs, is necessary.

Systematic exercise, deep breathing, copious drinking of water, and fresh air day and night, are the best aids. Exercise and deep breathing promote a free elimination of waste through the pores of the skin, and the free drinking of water creates a greater elimination through the kidneys, thus throwing off the excess of acid.

The skins of fruits contain various acids which favor the alkalinity of the blood. Therefore it is better, when there is an excess of uric acid, to eat unpeeled fruits. Apples, eaten raw and unpeeled, because of the acids, are of benefit. Citrus fruits, such as lemons, oranges, and grapefruit, are advised. Pears, and other sweet or bland fruits, because of the lack of acid, are less valuable.

Pea pods when young may be cooked with the peas. String beans, spinach, celery, and asparagus are of value.

All rich sauces and gravies must be avoided.

Osler remarks that “gout is evidence of an overfed, overworked, and consequently clogged machine.”

It is usually the result of high living. It most often attacks people past middle age, who have indulged in large quantities of food, especially the nitrogenous foods which are not thoroughly oxidized due to sluggish circulation and shallow breathing. The process, imperfectly carried on, allows the accumulation of the waste material which cannot be excreted by the kidneys unless completely transformed by oxidation. These insoluble materials are deposited in the joints, act as irritants, and occasion the attacks of pain, swelling, and tenderness which usually mark the acute condition.

It is most common in those who habitually overeat, take little exercise, or who have frequently indulged in alcohol.

Sugar and fat in quantities are injurious as the oxidation of the protein is not carried on as completely when these are in excess. In fact, the entire system is more sluggish. Fat also interferes with gastric digestion as it passes through the stomach unchanged, and if the particles of food have a coat of the fat liquefied by the heat of the stomach, it is difficult for the gastric juice to exert its power.

The use of meat and sugars tends to make the urine acid and the use of vegetables favors its alkalinity, rendering it less acid. Therefore it becomes necessary to eliminate meat from the diet, to cut down the fats and carbohydrates, and to eat freely of fruits and vegetables.

Alcohol is absolutely prohibited.

In acute cases a diet of bread and milk, or toast and milk, with light vegetable broths, should be followed for from one to three days.

In chronic cases the diet may consist of the following:

It is not sufficient to eliminate the foods to be avoided. To reduce the quantity of food is also necessary; yet this must be watched as the diet should not be so rigid as to cause a lowering of vitality. Eating between meals should not be allowed.

In an acute attack the diet should be confined to milk, vegetables, and fruits.

This is the result of a serious disturbance of nutrition. Since its presence is made manifest by the appearance of sugar in the urine, it is considered among the derangements of the kidneys. However, one should not be apprehensive of diabetes if the urine test for a day shows sugar. This may be due to an excess of carbohydrates, particularly of sugar, in the diet a day or two previous and all trace of it may disappear in a day or two. If continued tests show an excess, nutritional disturbances are indicated. The treatment is almost entirely dietetic.

The most usual form of diabetes is diabetes mellitus. It is supposed to be due to a disturbance in the metabolism of sugar. It may be aided by defective pancreatic ferments, the lack throwing more work on the liver in the metabolism of sugar.

The difficulty which confronts the dietitian is to prescribe a diet restricting the carbohydrates which will keep up the body weight and not disturb the nutritive equilibrium. The patient has a craving for sugars and starches, but the system cannot make use of them, and the heat and energy must be supplied by fats.

The diet must consist largely of protein and fat. One danger lies in the tendency of acetic and other acids to accumulate in the blood, which affects the nervous system.

While, as a rule, the craving for certain foods is an indication that the system needs the elements contained in them, the desire of the diabetic patient for sugars and starches must not be indulged more than absolutely necessary, because of the inability of the system to utilize them.

There is often a distaste for fat, but its use is imperative when it is well borne, because the weight and general vitality must be maintained. If all carbohydrates are eliminated from the diet, the system will often suffer severely. Therefore the dietitian must determine the diet suited to the individual case, since complicated conditions may exist and the diet for one patient will work harm to another. The fleshy patient can stand a rigid diet, eliminating sugars and starches, much better than one who is thin and emaciated. A thin, weak patient often cannot endure too rigid a diet.

The following list of foods contain least carbohydrates: clear soup of meat without vegetables, all acid fruits, eggs, clams, and lobsters, fresh fish of all kinds, fresh meat of all kinds, and most smoked meat, olive oil, butter, peas, beans, all fresh vegetables (except carrots, parsnips, squash), onions, artichokes, cauliflower, cabbage, and asparagus.

Fats may be supplied in the yolks of eggs, cream, butter, cheese, bacon, and oily nuts, as butternuts, Brazil nuts, almonds, hazel nuts, walnuts, pecans; all should be well chewed.

In beginning a diet, the change must not be too sudden. Potatoes, when they agree, may be used in small quantities as a substitute for bread. At least a week’s time should be allowed for the elimination of all sugar and starch. Begin by eliminating sugars and next bread, cereals, anything made with flour, and potatoes.

Sometimes it is necessary to begin with an all milk diet for a day or two.

Van Noorden gives the following diet, free from carbohydrates, which has been in general use in Europe and America.

Breakfast

Lunch

Dinner

Supper, 9 P. M.

Van Noorden includes alcohol, in whisky, in his diet and most physicians follow the theory that alcohol aids in the digestion and absorption of fats; the need is recognized since fats must be supplied, yet the sweet wines and beers contain sugar while the sour wines contains acids, which may disturb digestion.

DERANGEMENTS OF LUNGS AND BRONCHI

In this affection the free entrance of air into the lungs as well as its free exit is hampered by a condition of the bronchial muscles, the mucous membrane of the bronchi, and the muscles of the diaphragm. The muscles contract spasmodically without due or proper relaxation. This causes a congestion and swelling of the mucous membrane of the bronchi which still further hamper the ingress and egress of air.

Any digestive derangement which causes the formation of gas distends the stomach and intestines, interferes with the free action of the diaphragm, and prevents the free movement of the abdominal muscles.

The chemical action of the undigested and fermenting substances in the digestive tract irritates the nerves and may cause the spasm of the muscles. Digestive derangements will often cause the onset of an attack of asthma in those afflicted with this disorder.

The correction of the conditions in the stomach and intestinal tract will often ameliorate the attacks. Care must be taken not to overload the stomach and intestines, to eat easily digested foods which agree in the particular case. All food found to cause any digestive disturbance should be avoided.

Constipation must be remedied by gentle exercises and massage of the abdomen as free elimination removes material which might aid in inciting an attack.

Many asthmatics are comparatively comfortable during the day, the attacks coming on toward evening or during the night. In this case, the evening meal should be light and easily digested, the heavy meal being taken at noon.

Hot stuffy rooms increase the disorder and plenty of fresh air should be secured both by night and by day.

Many of these individuals make no exertion, fearing to bring on an attack.

Exercise, particularly of the lungs in breathing, should be gradual at first and be increased as improvement is shown. Exercises directed to expansion of the deeper cells of the lungs and to equalize the circulation throughout the entire system will call the excess of blood from the bronchial tubes and in many cases will cause the difficulty to disappear. A forceful, equalized circulation, with regulation of digestion, will do more for asthma than any known agency.

Derangements in digestion, common in this affection, are due to several conditions.

The increased temperature is caused by the efforts of the system to counteract the poisons produced by the action of the bacillus. The increase in temperature in the stomach lessens the secretions and the peristaltic action, causing the food to ferment and to be vomited or to pass practically undigested into the intestine, thus throwing an excess of work on the intestinal secretions.

The bacilli-laden sputum, if swallowed, is apt to produce disorders of the stomach. This still further complicates the question of digestion.

Malnutrition, because of these derangements, increases the unfavorable outlook for the patient in this disease. Hence the diet, especially in chronic cases, is of great importance.

When means are ample, the question is much simplified, because by travel, change of scene, and pleasant surroundings the appetite is stimulated and greater variety in the diet can be gained. For those in moderate circumstances, save when free sanatoriums exist for the care of the tuberculous, it is most difficult to keep the diet from becoming monotonous and wearisome.

The appetite, especially in young people, is apt to be capricious, and it is important that the food be served daintily to tempt the patient to eat.

Growing children crave sweets and as these furnish energy they may be allowed to tuberculous children, in moderation, if they seem to be well assimilated. Any interference with digestion, however, must be guarded against.

It is better to give food in smaller quantities and oftener in order to guard against disturbed digestion from overloading the stomach. For this reason also it is better to give the heartiest food during the forenoon when the temperature is lowest.

Milk, butter, cream, olive oil, bacon, and cod-liver oil furnish the fat needed by the system in the most easily digested form and should be taken freely, if there is no irritation in the stomach which will prevent their assimilation. Variation in their use will often secure greater tolerance.

In chronic cases in which there is little or no fever, the fats are generally well assimilated and are beneficial.

The disease causes great wasting, and fats are especially important in counteracting this tendency. They may be given in alternation or be omitted from the diet for a day or two to avoid turning the patient against them.

If diarrhea exists fats must be given guardedly and if fats produce diarrhea they must be lessened or omitted until the diarrhea is controlled.

If one gains in flesh the chances are very strong that the case has been wrongly diagnosed, or that the disease, if present, is being overcome.

Milk, when it agrees, should form a large part of the diet. A glass may be taken with meals and two glasses between meals. The milk should be sipped slowly; lime water or carbonated water may be added to aid milk digestion.

Buttermilk, made by means of buttermilk tablets, from milk from which the cream has not been removed, or buttermilk mixed with one-fourth cream, kumyss, or cream and water, if relished, may take the place of milk.

Eggs are also important aids in the diet, especially the yolk, because of the fat and iron it contains. If they disagree they may be taken with a few drops of lemon juice, orange juice, or grape juice, as these partially digest the egg.

The beaten and strained whites are very easily digested, and in that form may be taken in quantity of from six to twelve a day.

Tender, juicy meats, especially beef and mutton, may be taken, also meat juices and beef soups.

Highly seasoned foods should be avoided.

Fresh fish, clams, and oysters are permissible. Cereals, especially the coarse ones, that stimulate the bowel movements, if constipation exists, are valuable; oatmeal, rice, and corn-meal mush are especially good; also Graham or bran bread, and zwieback made with bran. If there is diarrhea bran should not be used.

Easily digested vegetables are of value, especially if cooked in little water so that most of the salts and other nutrients, which are so frequently boiled out of the vegetable, are retained. Baked apples or raw fruits, especially oranges, may be taken the first thing in the morning, or used as a dessert. Grapes, peaches, and other fruits in season may be taken in moderation.

Tea and coffee are best omitted.

The following constitutes a typical menu in ordinary cases. It must be varied to suit the individual case.

This menu approximates the number of calories desirable in cases of tuberculosis that have not advanced to a stage in which complete rest is necessary. In that case a liquid or semiliquid diet is given.

When it is necessary that the diet be less expensive, beans, lentils, and eggs may take the place of meat at some meals, and oleomargarine may be substituted for butter. Milk and eggs, however, in the quantity advised, should be taken if possible.

If signs of overfeeding appear, due to the lessened activity of the digestive organs, shown by biliousness, coated tongue, etc., the food may be lessened in quantity until the condition is corrected.

If the tongue becomes coated the mouth should receive the care directed on page 95.

In all cases of weak lungs and chronic lung trouble, the diet should consist of easily digested foods. Those that cause flatulence should be avoided, as the distended stomach presses on the diaphragm and interferes with proper breathing and with the heart action.

DERANGEMENTS OF THE NERVES

No disturbance in any part of the body requires less medicine than a disturbance in the nerves. The correction must come through general hygienic treatment and directing the mind to optimistic thoughts.

Regular exercise, alternated with regular rest periods, the formation of the habit of complete nerve relaxation, the general regulation of an easily digested, nutritious diet, with deep breathing exercises, are the best remedies. The patient should be out of doors as much as possible and, unless too weak, should be employed at light work for mental diversion.

In cases of Neurasthenia, or “tired nerves,” all vital organs are more or less affected, because the nerves do not properly direct digestion, absorption, assimilation, or elimination.

The excessive use of stimulants, tea, coffee, or alcohol, is often an exciting cause, because of overstimulation of an already exhausted nervous system.

Complete rest of body and mind must be secured.

The diet should be light and of easily digested foods, but must be nutritious and taken regularly and systematically. Each case needs individual treatment, and the diet must be that most easily assimilated by the individual.

A free, correct breathing of fresh air, day and night, is imperative.

It is important also to thoroughly masticate all food and drink freely of water.

A change of thought, induced by a change of scene or companions, is helpful.

One of the most essential treatments of neurasthenia is to surround the patient with love and tenderness, but the patient should be led to avoid self-pity. This sets up a disagreeable trend of thought which relaxes nerve and vital forces and disturbs nutrition. Sympathy, good cheer, and an attitude of courageous optimism are the best nerve tonics.

Due to the weakened condition of the nerves, troubles which at other times seem trifles are as mountains and very real. Patience and intelligent sympathy, not apparent pity, are the best of medicines.

The tone of the nervous system is quickly altered by the state of mind of the individual. The reaction is a double one, constituting a “vicious circle.” The nerves, disordered from worry, excessive fatigue, or other drains on the vitality, as a persistent pessimistic outlook on life, do not stimulate the natural digestive processes. The faulty digestion may fail to prepare a sufficient amount of food for use by the system. The nerves are thus underfed, which still further increases their inability to send motor and secretory impulses to the digestive and eliminative organs. Emaciation, general debility, and anemia may result.

Hence the importance, in the relief of any nervous condition, to see first that the attitude of mind be calm and quiet with the substitution of thoughts of hope and cheer for those of gloom and depression. The afflicted one must make a brave struggle because the tired body affects his thoughts as well as his thoughts his body.

There is no one food or set of foods which directly affect any nervous trouble unless this trouble be localized by disturbance in some particular organ. Then the effort must be to correct the difficulty in that organ.

Rest is imperative.

If thin, a fat-building diet should be followed to store energy-building reserve in the nerve centers.

In many cases of nerve debility the nerves seem to be stronger in the latter part of the day. When this is the case the hearty meal should be eaten at this time.

The condition of the blood is affected by the lack of its necessary ingredients, which may occur through faulty digestion as well as through improper diet. The resultant anemia of the nerves may produce neuralgic pains in any one or several of the tissues and organs, as the stomach, the intestines, the muscles, or the liver, etc. Neuralgia of the liver is sometimes mistaken for gallstone colic.

When underlying conditions of disease have been excluded by means of careful tests of the urine and blood, the diet becomes of importance and may result in the disappearance of the pain.

These pains occur chiefly in those who take little exercise and use improper food, which does not give the correct proportion of the needed elements to the system.

Exercise, as the body is usually weak, should be begun moderately but as soon as possible be made brisk and active to stimulate the vital organs to a more perfect performance of their function.

Plenty of oxygen must be secured by day and night and thorough elimination be maintained.

The diet must be nutritious and richer than is ordinarily taken. Milk, butter, cream, bacon, olive oil, and all fatty food should be freely used if assimilated. Beefsteak, roast beef, fresh vegetables, and eggs are valuable. Cocoa or chocolate, a glass of milk with a beaten egg, or a cup of broth into which an egg has been beaten may be regularly taken between meals.

If the digestion is feeble, light foods should first be taken and increased as the system becomes able to assimilate more hearty food.

Coffee, tea, highly spiced foods, alcohol, fried food, rich pastry, and much candy or sweet stuffs should be avoided.

Pain referred to the liver, if not caused by gall-stones, usually indicates overwork of that organ, and fats, sweets, and starches should be avoided to give the liver rest.

Pain referred to the stomach is often caused by tobacco smoking or improper food, as too much candy or preserves, or too strong tea or coffee. Attention to the diet will usually relieve this variety of pain. If the pain comes on when the stomach is empty, due to a disorder of the nerves, the food should be lessened in quantity, be light, easily digested, and taken at shorter intervals.

Many conditions of the system due to dietetic errors which result in impoverished blood are accompanied by pains in the stomach. These are often neuralgic.

Poor assimilation of foods or indigestion produces pain because the tone of the nervous system is affected from the poor blood.

Neuralgia of the stomach often occurs in anemic conditions associated with constipation. In these cases a good, nutritious, but easily digested diet and better elimination will often cure, but as the changes in the blood and nerves are slow, one must be patient and persistent.

There is no better nerve tonic than pure air, exercise, cheerful thoughts, and rest.

Sweets, fried food, rich sauces, pastry, and highly seasoned food should be avoided.

When neuralgia of the stomach, due to an underlying condition such as rheumatism, gout, or diabetes occurs, the diet appropriate to the condition will often affect the cure of the neuralgia.