Many neuralgias are not influenced by dietetic treatment. Many others are due to the faulty metabolism of arthritic diseases, gout, rheumatism, anemia, and diabetes, to chronic alcoholism and indigestion, to improper and insufficient food, or to mental or to physical strain. Regimen and a suitably restricted diet are of much value in the treatment of such cases. For the gouty, anemic, and diabetic the diet and mode of life appropriate to each must be prescribed.

In most cases of neuralgia due to faulty ways of living, a fresh-air life in sunshine, and gentle, regular exercise are essential; sometimes hydrotherapy and climatic changes are also needed to improve nutrition and restore the nerves to a normal state of health.

If a patient is in poor flesh and persistently losing, a diet should be prepared that will cause a gain in weight. It should be generous, varied, and tempting. Fats, butter, cream, and oils often are required in these cases. When there is much indigestion, a milk diet for a week or two will frequently correct it, and simultaneously pain will disappear. By degrees a generous diet may be substituted for the restricted one.

Sour stomach resulting from the eating of sugar, fats, rich gravies, sauces, or pastries is a common cause of frontal headache in many persons. These foods must be forbidden. As a rule, coffee, tea, and soup increase the tendency to acid fermentation in the stomach, so that they should also be forbidden. Alcoholic beverages too are detrimental, especially beer and wines.

Intercostal neuralgias, especially such as affect chiefly or only the left side, are almost uniformly due to flatulent indigestion, to constipation, or to both. These conditions must be prevented by an appropriate diet, especial care being taken to prevent overloading the stomach and bowels.

Gastralgia frequently causes a dread of eating, even when there is no persistent digestive disorder. Patients place themselves voluntarily on an extremely restricted diet and thereby help to cause emaciation and great feebleness. As a rule, other functional nervous disorders also aid in producing malnutrition. In severe cases of gastralgia it is often difficult to persuade patients to take as much food as they should. They must be taught by demonstration that it is not a particular article of food that provokes the paroxysms of pain. A rest cure for the neurasthenia of which gastralgia may be a symptom is sometimes necessary. When nervous dyspepsia exists, at least a milk diet, better still the entire regimen of the ' rest cure,' should be prescribed. In mild cases in which the attacks are infrequent a prolonged restriction of diet is unnecessary. For a few days after an attack, little food, and that of the simplest kinds, should be eaten.

There are other cases in which hearty eating precipitates an attack of pain when the patient is excessively fatigued or mentally depressed. In other individuals, idiosyncrasies as to foods are its immediate cause; therefore those that provoke gastralgia must always be avoided. When mental depression or physical fatigue exists, and is a predisposing cause of the pain, the hearty eating of even the simplest food must be prohibited.

There is no one diet that is suited to all cases of gastralgia. It must be adapted to the especial needs of the individual case.