Some people, unfortunately, and more especially men, tend as they get older to care more and more for the pleasures of the table. As the mental horizon narrows and other interests wane, the subject of the daily meals is apt to bulk larger and larger in their thoughts, until it may become the dominant interest in life, and the daily planning of the meals assume the importance of a great event. All are familiar with the rotund bald-headed old gentleman met with in a certain class of hotel, who appears to have some difficulty in killing time between meals, but rarely fails to turn up when they are due, and then consumes much more food than is good for him.

Though some gourmands of this description manage to dispose of their excess fairly satisfactorily, most of them would enjoy much better health, and get far more pleasure out of life, if they ate and drank in accordance with their physiological requirements, for their excesses generally lead to a long train of disagreeable symptoms, such as irritability, depression, pains, and not infrequently to serious disease.

By restricting the diet in cases of this kind to within reasonable limits, we can often effect a great improvement in health. In order to enlist the co-operation of our patients we should endeavour to bring home to them the gravity of their physiological delinquencies. If, for example, we find a man of 65 or 70 consuming as much food as, or perhaps even more than, he did forty years previously, we should explain to him the folly of expecting his senile tissues to cope with an excess of food as successfully as in the heyday of their youthful vigour.

In no class of case can more good be got from dietetic restriction than in the bronchitis of the aged, and especially when this affection is complicated by obesity. A large number of these patients are allowed to die through non-enforcement of strict rules of diet. It is not merely that over-eating begets bronchitis : the bronchitis, and the emphysema which goes along with it, curtail the respiratory capacity, and so prevent the excess of food from being burnt off. In cases of this kind life can often be prolonged for many years simply by restricting the total quantity of food taken. The only hope of saving the obese bronchi tic patient is by systematic semi-starvation, while in cases of acute bronchitis, whether in the old or young (but especially the former), this plan should always be adopted.

Another class of elderly or aged patient greatly benefited by the cutting down of the diet is that in which there is high arterial blood pressure, in conjunction with flushing, giddiness, and perhaps epitaxis. If a patient of this kind has been over-eating we can, unless advanced granular kidney be present, practically always greatly improve his condition by curtailing the diet.

In contradistinction to the usual view, we hold that for elderly and aged gourmands it is generally even more necessary to cut down the allowance of starch and sugar than of animal food, though this should of course also be curtailed if excessive. It is especially in those cases in which the patient, besides partaking liberally of animal food, has been indulging freely in starch and sugar, that we can do most good.