Insufficient attention is sometimes paid to the effects of over-drinking in forming dietaries. Quite apart from the abuse of alcohol in the form of whisky, beer, and the like, il'1-health not infrequently results from excessive tea or coffee drinking, more especially the former. It is no uncommon thing to find patients who drink tea in large quantity, three, four, or five times daily, the tea not being freshly prepared, which increases its liability to cause ill-health in the form of palpitations, indigestion, anemia, insomnia, and general weakness. In patients with atony or dilatation of the stomach special precautions have to be taken not to over-distend that organ by excess of fluid.

The injurious effects of over-eating are of far-reaching importance. It has been said that more harm results from over-eating than by over-drinking. Be that as it may, there is no question that over-indulgence of the appetite is the most important factor in the development of many serious diseases. Occasionally the excessive ingestion of protein food induces a temporary albuminuria; similarly, glycosuria, pentosuria, and obesity arises from over-indulgence in sugary and starchy foods. Apart from these conditions, however, there is no question that prolonged over-eating tends to promote serious disease of the cardiac, vascular, and renal systems, and is also an important factor in the development of the common diseases of metabolism gout and rheumatism. It cannot he too strongly emphasised that very many of the cases ordinarily met with of heart disease, kidney disease, cerebral haemorrhage, and the like, are a direct outcome of long-continued errors in feeding. These points are more fully dealt with in the sections dealing with these various disorders. Excess of proteins, and more especially animal proteins, is, generally speaking, a more serious defect than excess of carbohydrates and fat. This is due to the fact previously pointed out, that proteins are incompletely oxidised, and any increase in the products of imperfect metabolism of proteins tends to the accumulation of the waste products in the blood, and these act as poisons, acting injuriously in the different directions already indicated. In this connection we must bear in mind that an excess of carbohydrates and of fats may produce similar results through shielding the proteins from complete oxidation.

There is no end to the forms in which over-eating is met with in everyday practice. The appropriate dietary for any given case can only be framed after full knowledge of the feeding habits of each individual. In this connection it is wise not to lay too much stress on what the patient says. Few will admit that they habitually over-eat, and the most that many gourmands will admit is that they "enjoy their food." The patient's statements have therefore to be qualified by the impression gained by the practitioner from the general appearance and history of the patient. The writer finds it useful to get the patient to give in writing a full statement of his or her ordinary diet for one or two days.

A word should be said about seasonal over-indulgence. To err is human, and to err occasionally in feeding is not only human, but is for the time being exceedingly pleasant. In the spring-time the advent of vegetables leads to a slight over-indulgence, with resulting development of indigestion, or, as in the case of rhubarb, to calculus formation. In early summer the too frequent indulgence in the luscious sugar-coated strawberry induces lumbago, neuritis, pruritus, and other so-called gouty manifestations. Similarly, in the autumn, ill-health may arise from too freely partaking of pears, plums, and other autumn fruits.

It may be useful to give a few general rules that should be kept in mind when framing a dietary.