The low protein ration of Dr. Chittenden seems to have been rendered possible, partly by the use of coffee and tea. There seems to be no question but that it would be better to use the same or even a considerably greater quantity of nitrogen in the form of protein. In this connection, it may be remarked that tea and coffee and even chocolate, used as beverages, may be ignored so far as nutritive value is concerned, except for sugar, cream and milk employed.

Tolerance and noticeable physiologic effects of these beverages, differ greatly in different individuals. There is a physiologic antagonism between the methyl-xanthins and tobacco and alcohol, the former constricting, the latter relaxing the arterioles. Some have claimed that this alternation of effect causes arterio-sclerosis, others have incriminated especially one or the other action. At any rate, the direct influence does not seem to be well established for either set of drugs, either by positive or negative evidence.

While, theoretically, it seems best to abstain entirely from the methyl-xanthin beverages, especially in the case of sedentary livers not exposed to emergencies of any kind, practical experience shows that most persons can take reasonable quantities of them, say three cupfuls of rather weak tea and coffee together, in the course of a day. The addition of milk or cream tends to precipitate both tannin and caffeine. The real flavor of either tea or coffee is test enjoyed from weak beverages. The use of enough tea, coffee or chocolate merely to flavor milk, gelatin, custard, ice cream, etc., often enables the administration of greater amounts of nourishment than would otherwise be possible and is therefore allowable even when there is contraindication to the use of notable amounts of these beverages.

. Tobacco is indigenous to America but was not used by the aborigines of the temperate regions except in very small quantities and mainly as a ceremonial. A most curious side light on human nature is afforded by the fact that pipes are rare articles on prehistoric Indian village sites but are plentiful on sites of the transition period in which the Indians came under European influence.

Tobacco chewing almost inevitably results in chronic gastritis, its devotees vomit readily from nervous and mental causes and their appetite is diminished. Disgust for tobacco usually occurs during any acute illness and still the patient is handicapped not only by the digestive disturbance but by the lack of support of the indulgence.

Cardiac palpitation and possibly even muscular degeneration is liable to occur from the excessive use of tobacco in any way and great individual differences in tolerance are noted. Inexplicable differences also exist with regard to different degrees of tolerance for different grades of tobacco and to its use in pipes, cigars and cigarettes. It should be borne in mind that while the effect of tobacco is nearly the same for all methods of use, chewing actually introduces nicotine into the system while smoking decomposes most of the nicotine, the depression being due mainly to carbon monoxid and cyanogen compounds and in cigarettes, often to acrolein due to the oxidation of glycerine added to prevent drying.

Paradoxically, it often happens that mild tobacco, as in the form of cigarettes, produces more harm than strong tobacco, as in cigars and pipes, because the former are inhaled. A practical distinction must be made between the craving for tobacco effects, for the flavor of the smoke and a mere habit of passing the time. Dry smoking may amount to tobacco chewing or may be a harmless pastime. Many persons dislike the effect of even the flavor of tobacco, yet amuse themselves with lighted cigars and cigarettes which are held mostly in the fingers or which are puffed outward when held in the lips. The absorption of nicotine also differs according to whether the butt is kept dry or is moistened with saliva and drawn into the mouth. An old pipe becomes impregnated with nicotine and other condensation products from the tobacco, so that its effects are liable to be greater than those of a fresh pipe or a cigar or cigarette.

By rolling absorbent cotton into the end of a cigarette or placing it in a mouthpiece, considerable quantities of smoke may be filtered out.

While the evil effects of excessive use of tobacco, especially by the young, are incontestable, practical experience shows that moderate use of mild tobacco by adults is not especially harmful. One or two mild cigars or ten or fifteen cigarettes - remembering that the cheaper American grades are less harmful than the more expensive Turkish and Egyptian tobaccos - may usually be allowed. On the whole, it is less harmful to smoke than to be subjected to intense nervousness and, even in acute sickness, it is often advisable to allow slight indulgence in tobacco.

The use of tobacco is often preferable to the habit of eating between meals or of indulging in alcoholics and soft drinks. On the other hand, a man who indulges himself in one way is likely to do so in others. The anaphrodisiac action of tobacco is often valuable to combat the nervousness of enforced continence.

Alcoholic beverages may be divided into those produced by the fermentation of malted grain - beer, ale and porter - ; those produced by fermentation of fruits - wines from grapes, cider from apples and other beverages occasionally made from other fruits - ; and those produced by distillation of fermented grain or direct fortification with alcohol.

Of the malt liquors, beer contains 1.5 - 5% of alcohol, some dextrin and maltose or glucose and a little protein. Porters and mild ales contain about 6% of alcohol, Scotch ale 9%. The carbohydrates vary inversely as the alcohol. Malt liquors contain .4 - 1% of nitrogen, and variable quantities of lactic, succinic and acetic acids and are often still fermenting.

Red wines owe their color to the maceration of the skins and contain considerable tannin while white wines are prepared from the pulp and contain practically no tannin. The amount of sugar present depends partly upon the original content of the grapes, partly upon the stage at which the fermentation of sugar into alcohol is stopped. All wines contain tartrates. Of less than 12% alcoholic strength are claret, Sauterne, Rhine, Moselle, Burgundy, most American, Australian, Greek, Hungarian and Italian wines and champagne. Of about 14 - 17% strength, are sherry, port, Madeira, Marsala, and some Californian wines.