Although one would say that the typical diet ought to be one which is entirely digested, is completely absorbed and simply suffices for the wants of the system, yet in practice this is not so. The intestinal canal of man, and of the precursors of man, has not been developed at all under theoretically perfect external circumstances, but has been so developed as to deal with the more or less imperfect foods which could be obtained. In the course of this development the appendix, which is in the horse a large and useful part of the gut, has in man become atrophied and now appears to be only a source of danger, although it is quite possible it may have some function of which we are at present ignorant. The fact that cooking is so common, and that the hard parts of the food which would stimulate the intestine mechanically are softened and deprived of their irritating power, tends to render the movements of the bowel more sluggish, and civilized peoples are very apt to suffer from constipation. I think one may safely say that more than one half of the inhabitants of this country require a certain amount of aid to the action of the bowels. This may be afforded by taking more or less indigestible articles of food in the dietary, so that the whole cannot be absorbed, but must pass through the intestine and be evacuated. In the long practice I had at St. Bartholomew's Hospital, I found that a fortnight was by no means an uncommon period for patients to go without evacuation of the bowels. Many of those lived upon a dietary consisting chiefly of fine white bread, butter and tea, which, of course, left very little residue. But the intestine is not merely an absorbing viscus, it also excretes, and some of the substances that ought to be eliminated by it are apt, in cases of constipation, to undergo absorption and to cause weakness, discomfort and ill-health. For this reason, therefore, it is necessary to have a dietary which is not typically perfect, but contains seeds, husks, or vegetable fibres, and if these do not keep up the peristaltic action sufficiently, they need to be supplemented by excess of sugar, by salts, especially sulphates, or by resins or glucosides having a purgative action. Many people object to the constant use of purgatives, and say that their employment is not natural, totally forgetting that the necessity for them arises from the unnatural mode of life which the patients lead, and the fact of their having well-cooked and soft food from which all the naturally irritating properties have been removed. If such patients were to go back to the habits of primitive man, and live in the woods upon such berries or other edible things as they could pick up, they would probably not want any aperient pills.