Fresh vegetables, fruits, especially prunes, figs, apples, dates, oranges, etc., are needed to maintain regular bowel movements.

In early childhood, epilepsy is commonly associated with a rachitic condition. A proper diet will accomplish more for the relief of this ailment in childhood than in adult life.

In such mental diseases as acute insanity, melancholia, dementia, and mania, food is frequently refused, and consequently emaciation and great feebleness follow. Food is refused for various reasons. In dementia, paresis may render swallowing difficult. In other cases chronic gastritis causes distress after eating, which is exaggerated by the patient and made a pretext for refusing food. A few patients are afraid of poisons, but will sometimes eat if they see the raw food prepared. Others will not eat food prepared in certain ways, or will not take food from certain individuals. These and many other peculiarities necessitate a careful study of each patient and an adaptation of food or methods of service to the individual. Occasionally a patient is seen who will eat if his attention can be fastened on the food for a sufficient length of time.

However, in spite of various attempts to induce these patients to eat, food must at times be forced upon them. Forced feeding is accomplished by administering liquid nourishment through an esophageal or nasal tube. The discomfort attending this procedure, which is looked upon by some clinicians as a discipline of value, will induce the most reasonable ones to eat.

If patients become very violent when the attempt is made to force food upon them, they must be held by assistants until a gag can be placed between the teeth, and the tube inserted. The whole process of feeding does not require more than four or five minutes when carried out skilfully.

The nasal tube can be used without applying a gag and is therefore preferred by many. There is, however, danger of introducing it into the trachea instead of into the esophagus. Moreover, there is greater danger of regurgitation alongside of the small tube than alongside of the larger one. On the other hand, a gag has been known to break the teeth of violent patients and usually hurts the mouth. Still, the stomach-tube is the best to use, because of the greater certainty of passing it into the esophagus.

The patient should be sitting or reclining when the tube is passed; his legs and arms being firmly held by assistants. When the mouth is forced open and the gag is placed, the patient's head must be steadied by a nurse and the tube must be pushed rapidly into the stomach. If the patient suffers from gastritis, it may be necessary to wash the stomach before food is introduced; but usually this need not be done. A quart of warm milk with slightly cooked or raw eggs, or a little oatmeal jelly, barley, Mellin's food, malted milk, or similar liquid nourishment added, should be poured into the stomach. Instead of milk, meat-juice, broths thickened with rice, or puree of potato or peas, may be used. When starches are employed, it is best to add one or two tablespoonfuls of a malt extract, which possesses diastatic power, or taka-diastase, as food given to a patient in this way is not mixed with his own saliva and digested by it. Patients who are in good health may not need to be fed more than twice daily; but those who are weak or losing flesh rapidly should be fed three or four times.

Many feeble patients improve in their mental state as they gain in flesh. When such results can be hoped for, patients should be given as large an amount of food as their digestive organs will dispose of.

Those who suffer from mental disease must be watched while eating. Attention must be paid to the size of the mouthfuls that they take. Many will bolt large pieces of food that cannot be easily digested, and may excite persistent indigestion. Patients occasionally choke themselves in this way. Death results, too, from the lodgment of food in the larynx. For such patients food must be finely divided or liquid. They must not be permitted to wash down with water or other beverage, food that has been imperfectly chewed.

For those who suffer from mental disorders the problem is therefore rather one of feeding, than of the character of the food.