Simplicity in diet, with or without complete abstinence from meat, is often resorted to as a means of relief from bodily ailments, and such cases sometimes afford striking illustrations of the adequacy and benefits of a relatively low intake of food. Cases of this sort, perhaps, are more frequently observed among elderly people, where the daily requirements are not so great as with younger and more active persons, but they offer evidence in support of our main thesis that dietary habits are no guarantee of bodily requirements. I have in mind the details of an exceedingly interesting case reported with much care by Dr. Fenger;1 the case of a man who at 61 years of age, after a long period of poor health, brought himself quickly into a condition of sound health by a daily diet characterized by extreme simplicity and with an exceedingly low fuel value. The daily diet made use of during the fifteen years the subject was under examination consisted of the following articles:

1 Dr. 8. Fenger: BeitriLge zur Kenntnist des Stoffwecheels im Greitenalter. Skandinsvisches Archir far Phjrtiologie, Band 16, p. 222, 1904.

1880-1892: 1 egg» 1 quart of oatmeal soup, 2 quarts of skim milk, 1½ ounces of red wine, ¼ ounce of sugar.

1892-1894: 2 eggs, 1 quart of oatmeal soup, 2 quarts of skim milk, 1½ ounces of red wine, ¼ ounce of sugar.

1894-1900: 8 eggs, 1 pint of oatmeal soup, 2 quarts of skim milk, 1½ ounces of red wine, ¼ ounce of sugar, 2 ounces of plum and raspberry juice.

1900-1908: 8 eggs, 1 pint of barley soup, 8 pints of sweet milk, 1 pint of buttermilk, 1½ ounces of red wine, ¼ ounce of sugar, 2 ounces of plum and raspberry juice.

It will be observed that during these fifteen years the subject partook of no meat whatever, and further, that the diet was wholly in fluid form. At the close of this long period, the subject, being then 75 years of age, was reported as well and in good health, with satisfactory physical condition for a person of his years. He was a man of small body-weight, only 42 kilograms, but during this period of voluntary restriction in diet, he suffered no loss. It is perhaps worthy of comment also that all through this lengthy period no salt was taken other than what was naturally present in the simple foods made use of. The point to attract our attention especially, however, is that for fifteen years, during which the quality and quantity of this man's food was carefully observed, body-weight, general good health, and physical vigor were all maintained, together with freedom from the ills of previous years and with a daily diet characterized by extreme simplicity. The chemical composition of the diet was likewise peculiar, particularly in its exceedingly low fuel value. The following table shows the amounts of proteid, fat, and carbohydrate consumed daily during the four periods designated:

Especially noticeable here is the low intake of fat and carbohydrate, with the corresponding low fuel value, and also the relatively high consumption of proteid, averaging 2.0 grains daily per kilogram of body-weight. Dr, Fenger concludes that for a man of this age and weight, with the relative inactivity characteristic of old age, a heat value in the intake of 30 calories per kilogram of body-weight is quite sufficient for the needs of the body. This may be quite true, but to maintain nitrogen equilibrium under such conditions requires a larger intake of proteid food than is desirable. It will be observed that in the last period of four years a very decided change in the diet was instituted; proteid was diminished somewhat, but the noticeable change was the decided increase in fat, produced in large measure by the substitution of whole milk, with its contained cream, for skim milk. In the words of Dr. Fenger, this change was necessitated by the appearance of gout in the subject. From superficial examination of the dietary of the preceding eleven years there would seem no occasion for criticising the subject for high living, and yet I believe we are quite within the limits of reason in saying that the proteid exchange for a subject of this body-weight was altogether too- high. The heat requirements of the body were being met in an unnecessarily large degree from the breaking down of proteid material, with consequent formation of exeessive nitrogenous waste, among which uric acid was plainly conspicuous.

One comment to be made here is that meat and other rich purin-containing foodstuffs are not the only source of gout and uric acid. Excessive proteid katabolisra, both exogenous and endogenous, is a possible source of danger in this respect, and the above subject, though living on an exceptionally simple diet, was consuming far more proteid per kilogram of body-weight than was necessary or desirable. Increase of fatty food naturally served to diminish the rate of proteid katabolism, and this could have been advantageously accompanied by a still greater reduction in the amount of proteid ingested, and a larger addition of non-nitrogenous foodstuffs. In old age, there is naturally a Blowing down of the metabolic processes, and both nitrogen equilibrium and body equilibrium can be satisfactorily maintained by a relatively small intake of food and with gain to the body; but there is every reason to believe that economy in proteid food can be more advantageously adopted than economy in non-nitrogenous foodstuffs.

Finally, we may call attention to the many possibilities of an intelligent modification of the daily diet to the temporary needs of the individual. The season of the year, summer and winter, the climate, the degree of activity of the body, the state of health, temporary ailments, etc., all present special conditions which admit of particular dietetic treatment. In hot summer weather, for example, there is plainly less need fur food than in the cold winter season, especially for fat with its high calorific value. During the cold part of the year, the lower temperature of the surrounding air, with the tendency toward greater muscular activity, calls for more extensive chemical decomposition in order to meet the demand for heat. and the energy of muscular contraction. There is perhaps no special reason for any material change in the amount of proteid food consumed in the two seasons, except in so far as it may seem desirable at times to take advantage of the well-known stimulating properties of proteid to whip up the gernal metabolism of the body, in harmony with the principle that all metabolic processes may need spurring to meet the demands of a greatly lowered temparature in the surrounding air.