Gouty adults require meat but once in twenty-four hours. The bill of fare should be varied from day to day, but as simple as possible at each meal. Rich sauces are to be eschewed, and a lemon, an infusion of herbs and pepper, bread-sauce, or a puree of vegetables, adopted in their place. Sugar, at the end of meals, generates an excess of organic acid, and it is to be avoided. If cheese is eaten, it should be new, and is best toasted and creamed.

Dilute alkaline waters containing soda, such as Apollinaris or the weaker Vichy, are a rational drink during meals; but it is probably best to keep to pure water. Those who live idle lives require no alcohol, and it should not be an habitual accompaniment to meals.

Red gravel is evidence of a constitution so closely allied to gout, that nothing need be said further about its appropriate regimen.

In Bright's disease of the kidneys, in contracted liver, and, in short, in all degenerative lesions, alcohol has a baneful influence. Its action upon the tissues is directly the same as theirs. Moreover, if we agree with its latest expositor, Dr. Sibson, that Bright's disease is closely associated with increased arterial tension, alcohol (whose effect is also to increase tension) must be peculiarly poisonous. '

For the cure of these diseases, independent of the nutrition of the rest of the body, a milk diet has been proposed, and it seems to offer a fair prospect, if the patients can be persuaded to persist in it. How safely a milk diet may be adopted in middle life is shown by the example of Dr. Cheyne, a Bath physician of the last century, who, at about fifty-five, restricted himself entirely to milk and biscuits, and yet was able to fulfill the duties of his laborious profession. He took at first of the former six pints, of the latter twelve ounces; but he shortly diminished the quantity to half, and, after sixteen years' experience, found it fully sufficient, and indeed capable of further reduction in quantity.2

Weak and slow digestion is a condition which enforces an especial care for meat and drink. The cause of the imperfection lies in a deficiency in the supply of nerve-power to the stomach, so that it both secretes 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 moderate meals are usually sufficient to keep up the strength.

1 Sibson's " Harveian Lectures," British Medical Journal, February 10,1877.

2 "The Natural Method of Curing Diseases of the Body," etc., by George Cheyne, M.D.,1742.

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 preparations 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. Vegetables are very necessary; cauliflowers, Jerusalem artichokes, beet-root, 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 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 teaspoonful 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 favor, 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 prevents 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.