Digestion deals with the processes of food ingestion, assimilation, and ultimate waste elimination. Health and life are dependent upon the harmonious working of the digestive apparatus. Its disturbed function creates disease; its interruption for a longer time carries death with it.

It appears worth while to consider here some of the points which serve to keep the digestion in good shape, in order thereby to preserve health.

For this purpose we may divide our subject matter into the following items: (1) Food intake: quantity required in growth, manhood, old age; (2) State of the body for this act; (3) Period of assimilation; (4) The final act of waste elimination (defecation).

The quantity of food required is very definite and is greater in the period of development and manhood than in middle age or old age. During the time of growth a large quantity of the nourishment is utilized for the upbuilding of the body. In manhood the greatest activity is manifested, and this again requires additional nutritive material. In middle and advanced age the activities are gradually reduced and the food requirements are accordingly lessened. With the beginning of middle age there is often a tendency to corpulence; for occasionally at this period with the reduction of work there is no decrease in the quantity of food intake. The surplus of nutritive material is then stored up in the body in the form of fat.

1 An address delivered before the employees of New York City, October 11, 1916, at the Municipal Building, New York. Medical Record, Nov. 18, 1916.

The diet should be watched and arranged somewhat differently for these different periods of life.

In most instances in health our instinct guides us correctly and the appetite is a sufficient monitor to go by. Transgressions may, however, occur in both directions by faulty habits (overeating on the one hand and too scanty nutrition on the other). Thus opulence and high living give rise to an overabundance of the food intake, while poverty and avarice in the parent's house or in the boarding establishment may lead to subnutrition. Both hypernutri-tion and subnutrition practised for a longer time may become established as a habit, i.e. the appetite here becomes deranged and is no more a fit guide for the best purposes of the organism.

In order to look for good health we must guard against either of these faults.

How shall we know whether we eat just right? The quantity of food physiolpgically required is known, and for the physician it is a simple matter to make a computation and to state whether somebody eats enough, too much, or too little.

The layman, however, can likewise easily find the right measure. First, his appetite may be used as a guide; second, everybody should eat about as much and as often as his neighbors and associates;third,everybody can see whether his body and strength are in good condition. If everything is harmonious and goes on smoothly, this alone is sufficient. If not the scale may be utihzed and weighing yourself once a week or so will soon show whether there be too much or too little food taken.

What kinds of foods should be taken? Here, again, the answer is: look at your neighbors, do the same, and you will not go wrong.

The following rules may, however, be given in a general way. Arrange for a great variety of food, which should embrace most nutritive substances easily digestible and also difficult of digestion. To select a diet in health consisting merely of easily assimilable foods would be a great mistake as it would serve to decrease the efficiency of our digestive apparatus.

Eating being one of the most important functions of the organism should not be done haphazard, but performed with care. A moderate amount of work preceding the meal increases the appetite and enhances the digestive function.

A few more rules regarding diet in health may here be added. There is a tendency in this country toward eating too much meat, which often leads to constitutional disturbances. Some people here take meat regularly at each meal. As a rule meat should be partaken of once or twice daily in quantities of about one-quarter of a pound for an adult, but not much above this. Plenty of vegetables should be served with it. Bread and butter, fruits, and salads should be used liberally. Water should be taken with each meal, and if thirst be present also in between. Its importance cannot be too much appreciated.

Water itself is one of the principal ingredients of the organism. It contains, besides, in small quantities, mineral salts of different kinds which are utilized in the body economy. Food digestion, assimilation, and elimination require for (these processes water as an intermediary, without which life is impossible. Fresh cool spring water at meal time increases the appetite and augments the pleasure of eating.

Too great fatigue destroys the appetite and banishes the joy of eating. The latter is then done mechanically, almost with disgust, and the process of digestion is thus disturbed right from the start. During meal time rest of the mind and body is essential. A comfortable seat, a nicely set table, pleasant company, wholesome food and drink (fresh spring water) are important factors in increasing the worth of the meal. General conversation not requiring much concentration of mind is rather useful. Direct business talk should be avoided. The meal should be ingested leisurely and time given to the enjoyment of the different courses (food articles). The eating should be performed neither too quickly nor too slowly. Both deviations lead to manifold digestive disturbances. A short period of rest following the meal is advantageous. A mild cigar and pleasant conversation contribute toward the enjoyment of this after-table act.

The real act of digestion begins after the ingestion of food. The alimentary canal may be likened to a factory in which all the material brought in is sorted and changed in such a manner that it can enter the circulation and by means of that stream of communication reach all the body tissues.

Assimilation Of Food

Unfit substances or the remnants of food which cannot be utilized any more are carried along the digestive canal to be eliminated at the end. The tissues of the body likewise throw off dead or waste material. They accomplish this through the eliminative systems (lungs, kidneys, skin, and alimentary tract, including the liver) reached by all the tissues through the blood stream. The digestive canal is thus one of the principal avenues for the traffic also of waste products of the body itself.

The assimilation is greatly favored by keeping the body in good trim. For this the organism must be in a state of contentment, which can be reached by satisfactory mental and bodily work. Every occupation should be performed with a good will and pleasure, and should not be carried on to over-fatigue and annoyance. Thus assimilation will be helped and good health made possible. Plenty of fresh air and a certain amount of muscular exercise (walking, horseback riding, rowing, gymnastics) are of importance. In the same way after the working hours rest and a sufficient amount of sleep (eight hours daily) are essential for good digestion and perfect health. Both exercise and rest, properly apportioned, enhance assimilation as well as elimination.

The final act of digestion consists in the expulsion of all the remaining unutilizable food substances and some waste products from the alimentary tract (defecation). This usually occurs once daily in normal individuals. Regular attendance to this natural event is likewise important for the well-being of the organism. With regard to this act the call of nature should be obeyed at the right time. Frequent neglect to perform this duty as well as too much devotion to it lead to irregularities of the bowel and ultimately to ill health. In health the best principle is to let things take their natural course. Too much interference with it often leads to abnormal conditions and disease.

To sum up, the care of good digestion embraces the following items: simple life, in which work and rest for mind and body are harmoniously divided; regularity of meals, frugality, great diversity of wholesome foods taken, in just the right proportion; an abundance of water; proper attention to the call of nature. Good digestion is also the best promoter of good health and a long life. There is no elixir of youth for old age, or a rejuvenation remedy. In keeping our organism, however, in good trim, in looking out for its steady and harmonious activity, we succeed in delaying and perhaps also shortening the advancing state of invalidism and the dissolution period, with death at its end.

Life is not complete without death. The latter is a natural event at some time for each living being and its advent should not be begrudged.