Graves' Disease is one of the diseases which, on account of the obvious derangement of certain parts of the nervous system, is usually included amongst nervous diseases. The diet, in some cases of this disease, assumes much importance because of the rapid wasting which takes place. And this is especially true of cases in which violent attacks of diarrhoea occur repeatedly. Such cases are probably the most serious of all cases of this disease; they are certainly the most anxious that we have to deal with. When diarrhoea is present, the simplest milk food is practically all that is admissible, and this should be combined with lime-water, and in cases in which the diarrhoea is very severe, should even be peptonized. In ordinary cases of Graves' disease it has not been usual to pay any greater attention to diet than the general or special symptoms render necessary. Lately, however, a substance called Rodagen, an extract of milk obtained from goats from which the thyroid gland has been removed, has been used in the treatment of Graves' disease. Apparently it is not very effective in controlling the symptoms, although, according to Dr. Hector Mackenzie, it was seen in some cases to be followed by improvement, at least, in the general condition of the patient. Its use, however, and its mode of preparation have suggested to Dr. Mackenzie the desirability of trying the effect or helpfulness of a dietary in those cases, obtained from sources into which thyroid secretion does not enter. So he does not give his patients with Graves' disease milk in any quantity, and they have no beef, mutton, or veal. They are allowed all kinds of fish, fat bacon, chicken, eggs, fresh fruit, cream, butter, bread, and carb-ohydrates generally. And under this dietary - free, it will be seen, from anything into which thyroid secretion can enter, he believes that his patients do well. And, of course, if the practical effect is good, it certainly has theoretical considerations to recommend it.
So far as dietetics are concerned, a most important class of nervous diseases is that large class, perhaps increasing in numbers, under the strain and stress imposed upon the nervous system in present day modes of life, of disorders of the function of different parts of the nervous system without any organic or structural change appreciable by our present methods, in the anatomy of that system. To this large class of cases the term "neurasthenia" is now generally applied, but it is almost certain that as our experience of such cases enables us to recognize the different directions in which disorder of the nervous system may distribute itself, this class will naturally subdivide itself into several groups or varieties. Even now we are able to perceive varieties, somewhat indistinctly it is true, and to trace a gradation from comparatively trivial, unimportant disturbances of the nervous system, through profound and prolonged disorder, to cases in which it is difficult to draw a distinct line between so-called neurasthenic states and the grave functional disturbances of the nervous system which we know as mental disorders. It is desirable to refer briefly to the varieties of neurasthenia, in order to discriminate, as clearly as may be, between those cases in which dietetic rules and regulations are useful, and even curative, and those in which they are of comparatively little use.