132. It is not extraordinary that a discrepancy of opinion should exist upon a question which involves so many fluctuating circumstances. Controversy upon this, as upon many other subjects of diet, has engendered a disbelief in its importance; and this scepticism has given a plausible pretext for indulgence on the one hand, and protracted fasting on the other, as the wishes or habits of mankind may have rendered most agreeable. It will, therefore, be difficult to convince the public of the necessity of those regulations which are so essential for the maintenance of health or for the cure of disease. We have been told that the best time for dining is, "for a rich man, when he can get an appetite, and for a poor one, when he can get food.'" But appetite in health is regulated by habit, and in disease it acts but as an imperfect monitor. Certain general principles, therefore, deduced from observation and experience, must be laid down for our guidance; and these again in their application must be modified and adapted to the circumstances of every particular case.

133. All physicians concur in advocating the importance of regularity, both as it regards the number of meals and the periods at which they are taken. Those who have weak stomachs will, by such a system, not only digest more food, but will be less liable to those affections which arise from its imperfect assimilation, because, as Dr. Darwin has justly observed, they have, in such a case, both the stimulus of the aliment they take, and the periodical habit, to assist the process. The periods of hunger and thirst are undoubtedly catenated with certain portions of time, or degrees of exhaustion, or other diurnal habits of life; and if the pain of hunger be not relieved by taking food at the usual time, it is liable to cease till the next period of time or other habits recur. As these periods must vary in every individual, according to the powers of digestion, the degree of exercise taken, the age, and the rapidity of growth1, as well as the quality of the food, it frequently becomes necessary, in civilised life, to have recourse to intermediate meals, or luncheons, in order to support the powers of the stomach during the long interval which may occur between the conventional periods of repast.

But to the dyspeptic patient, in search of health, such indulgences are rarely to be permitted; unless, indeed, the circumstances under which he is placed leave him no option between long fasting and supplementary refection. I am more anxious to impress this precept upon the minds of invalids, as the anxiety of friends, and the popular errors which exist upon the subject of diet, are too apt to establish the mischievous belief, that "a little and often" will be more likely to restore the languid stomach to its healthy tone than moderate meals at more protracted intervals. The specious aphorism of Sir William Temple, that " the stomach of an invalid is like a schoolboy, always at mischief unless it be employed," has occasioned more dyspeptic disease than that respectable physician could ever have cured, had he been as successful in practice as Æsculapius, and his life been protracted to the age of an antediluvian. The theory upon which this objection rests has already been explained (116). The natural process of digestion is thus disturbed, and the healthy action of the stomach, as evinced by the return of moderate appetite, is entirely prevented.

In answer to this reasoning, the patient will sometimes tell you, that frequent refreshment is essential to his comfort; that a sensation of faintness obliges him to fly to such a resource, in order to rescue himself from the distress which it occasions. This, in general, is an artificial want, created by habit, and must be cured by restoring the patient to regular meals, which is to be effected by gradually lengthening the intervals of eating. The animal machine possesses almost miraculous powers of accommodation, but then it must be trained according to its own laws; if you would conquer nature, you must obey her. But since no general rule is without its exceptions, so it may be observed, that there are cases of disease, in which the stomach is unable to bear any considerable quantity of aliment at one time, whence it becomes indispensable to repeat it at short intervals, in order to afford a sufficient proportion of nutriment; but as the patient acquires strength, such a system should be gradually abandoned.

1 Dr. Roget illustrates this subject by the caterpillar, which grows very quickly, and must repeatedly throw off its integuments during its continuance in the larva state; it accordingly consumes a vast quantity of food compared with the size of its body; and hence we find it provided with a digestive apparatus of considerable size.

134. Although the advantage of regular meals at stated periods is generally admitted, it has been much disputed how many should be allowed in the day: some physicians have considered one, others two, three, or even five necessary. It is, perhaps, impossible to lay down a general ride that shall apply to every particular case. In some persons the food rarely remains longer than three hours in the stomach; in others, four, five, or even six hours. It is evident, then, that the repetition of the meals ought to be regulated by this circumstance, always avoiding the extremes of long fasting and repletion. Some nations have been satisfied with one meal a day; but the stomach would thus be oppressed with too large a quantity, and in the interval would suffer from the want of some nourishment in it. Such a plan, therefore, is neither calculated for persons of robust health, and who are engaged in much bodily exertion, and consequently require large supplies, nor for those of a weak habit, who are not able either to take or to digest such a quantity of aliment in a single meal as will be sufficient to supply the waste of the body during twenty-four hours.

Celsus recommends the healthy to take food rather twice in the day than once; and Sanctorius says, "that the body becomes more heavy and uneasy after six pounds taken at one meal, than after eight taken at three; and that he who makes but one meal in the day, let him eat much or little, is pursuing a system that must ultimately injure him." When Plato returned that memorable answer to the philosophers, who inquired whether he had seen anything remarkable in Trinacria? "Vidi monstrum in natura, hominem bis saturatum in die" he referred rather to the quantity, than to the repetition of the meals of Dionysius. In my own opinion, an invalid may safely take three frugal meals; or, on some occasions, even four, provided a certain quantity of exercise be insisted upon. It is reported, that when Alexander the Great turned away his cooks, on proceeding upon a march, he observed that he had no further occasion for such assistants, as he carried with him superior cooks; - a long morning's journey to create an appetite for his dinner, and a frugal dinner to give a relish to his supper.

135. I shall now consider the nature of the different meals, and the periods at which they can be taken with the greatest advantage; repeating, however, that all general rules must be modified in their application according to particular circumstances.