141. There is no circumstance connected with diet, which popular writers have raised into greater importance; and some medical practitioners have even deemed it necessary to direct that the quantity of food, appropriated to each meal, should be accurately estimated by the balance. Mr. Abernethy says, that "it would be well if the public would follow the advice of Mr. Addison, given in the Spectator, of reading the writings of L. Cornaro; who, having naturally a weak constitution, which he seemed to have ruined by intemperance, so that he was expected to die at the age of thirty-five, did at that period adopt a strict regimen, allowing himself only twelve ounces of food daily." When I see the habits of Cornaro so incessantly introduced as an example for imitation, and as the standard of dietetic perfection, I am really inclined to ask with Feyjoo, - did God create Lewis Cornaro to be a rule for all mankind in what they were to eat and drink? Nothing can be more absurd than to establish a rule of weight and measure upon such occasions.

Individuals differ from each other so widely in their capacities for food, that to attempt the construction of a universal standard, is little less absurd than the practice of the philosophical tailors of Laputa, who wrought by mathematical calculation, and entertained a supreme contempt for those humble and illiterate fashioners who went to work by measuring the person of their customer; but Gulliver tells us, that the worst clothes he ever wore were constructed on abstract principles. How then, it may be asked, shall we be able to direct the proportion of food which it may be proper for an invalid to take? I shall answer this question in the words of Dr. Philip, whose opinion so exactly coincides with my own experience, that it would be difficult to discover a more appropriate manner of expressing it. "The dyspeptic should carefully attend to the first feeling of satiety. There is a moment when the relish given by the appetite ceases; a single mouthful taken after this oppresses a weak stomach. If he eats slowly, and carefully attends to this feeling, he will never overload the stomach." But that such an indication may not deceive him, let him remember to eat slowly.

This is an important condition; for when we eat too fast, we introduce a greater quantity of food into the stomach than the gastric juice can at once combine with; the consequence of which is, that hunger may continue for some time, after the stomach has received more than would be sufficient, under other circumstances, to induce satiety. The advantage of such a rule, over every artificial method by weight and measure, must be obvious; for it will equally apply to every person, under whatever condition or circumstances he may be placed. If he be of sedentary habits, the feeling of satiety will be sooner induced; and if a concurrence of circumstances should have invigorated his digestive powers, he will find no difficulty in apportioning the increase of his food, so as to meet the exigencies of the occasion. 142. Although it must be admitted, that we all take more solid food than may be necessary for supporting the body in its healthy state: yet it is important to know, that too great a degree of abstinence will also tend to weaken and distress both mind and body.

Men who in the earlier ages, from a mistaken notion of religion, confined their diet to a few figs, or a crust of bread and water, were so many visionary enthusiasts; and the excessive abstinence to which some religious orders are subjected, has proved one of the greatest sources of modern superstition. The effects of feeding below the healthy standard, are also obvious in the diseases of the poor and ill-fed classes in many parts of England and Ireland; and these are still more striking in those districts where the food is chiefly or entirely vegetable, and therefore less nutritious. It is also well known, that the obstinate fasting of maniacs often occasions a disease resembling the sea scurvy.

143. Those who are induced from their situation in life constantly to exceed the proper standard of diet, will preserve their health by occasionally abstaining from food, or rather, by reducing the usual quantity, and living low, or maigre, as the French call it1. A poached egg, or a basin of broth, may on such occasions be substituted for the grosser solids. The advantage of such a practice has not only been sanctioned by experience, but demonstrated by experiment. The history of the art of "training" will furnish us with some curious facts upon this subject. It is well known that racehorses and fighting-cocks, as well as men, cannot be preserved at their athletic weight, or at the "top of their condition," for any length of time; and that every attempt to force its continuance is followed by disease 1. A person, therefore, in robust health, should diminish the proportion of his food, in order that he may not attempt to force it beyond the athletic standard. I am particularly anxious to impress this important precept upon the mind of the junior practitioner, as I have, in the course of my professional experience, seen much mischief arise from the neglect of it.

A person, after an attack of acute disease, when his appetite returns, is in the condition of a pugilist who is about to enter upon a system of training; with this difference, that he is more obnoxious to those evils which are likely to accrue from over-feeding. In a state of debility and emaciation, without any disease, with a voracious appetite, he is prompted to eat largely and frequently; and he is exhorted by those not initiated in the mysteries of the medical art, to neglect no opportunity to "get up his strength." The plan succeeds for a certain time, his strength increases daily, and all goes on well; but, suddenly, his appetite fails, he becomes again unwell, and fever or some other mischief assails him. To the medical practitioner the cause of the relapse is obvious: he has attempted to force his strength too suddenly and violently beyond that athletic standard which corresponds with the vital condition of his constitution. This remark will forcibly apply to the treatment of cases of debility after inordinate fluxes and hemorrhages.

1 Baglivi tells us that in Italy a large proportion of invalids recovered their strength during the period of Lent.

1 When a sheep becomes fat, the butcher knows it must be killed, or it will soon decline.

144. Any sudden transition from established habits, both with regard to the quantity and quality of food, is injudicious. This precept is the more important, as persons who have too freely indulged, and begin to feel the bad effects of their excesses, are disposed to alter their habits without the preliminary preparations. They leap at once from the situation which gives them pain or fills them with alarm, instead of quietly descending by the steps which would secure the safety of their retreat.

145. It has been already stated that, after long fasting, we ought to be careful how far we indulge. Persons who have been inclosed in coal mines for several days without food, in consequence of the accidental falling in of the surrounding strata, have not unfre-quently lost their lives from the too assiduous administration of food after their extrication. During the period of my studentship at Cambridge, Elizabeth Woodcock was buried under the snow for the space of eight days: on her being found, she was visited by those to whom so extraordinary an adventure presented any interest; and I can state, from my personal knowledge of the fact, that she died in consequence of the large quantity of sustenance with which she was supplied. In the first volume of the Memoirs of the Philosophical Society of Manchester, the case of a miner is recorded, who after remaining for eight days without food, was killed by being placed in a warm bed, and fed with chicken broth.

146. The advantages which are produced by rendering food grateful to invalids are so striking, that the most digestible aliment, if it excite aversion, is more injurious than that which, though in other respects objectionable, gratifies the palate. If feelings of disgust or aversion are excited, the stomach will never act with healthy energy on the ingesta; and in cases of extreme dislike, they are either returned, or they pass through the alimentary canal almost unchanged. On the other hand, the gratification which attends a favourite meal is, in itself, a specific stimulus to the organs of digestion, especially in weak and debilitated habits. In the eighth edition of my Pharmacologia, I published a case which was related to me by Dr. Merriman, highly illustrative of the powerful influence of the mind upon these organs. A lady of rank, labouring under a severe menorrhagia, suffered with that irritable and unrelenting state of stomach which so commonly attends uterine affections, and to such a degree, that every kind of aliment and medicine was alike rejected.

After the total failure of the usual expedients to procure relief, and the exhaustion of the resources of the regular practitioner, she applied to the celebrated Miss Prescott, and was magnetized by the mysterious spells of this modern Circe. She immediately, to the astonishment of all her friends, ate a beefsteak, with a plentiful accompaniment of strong ale; and she continued to repeat the meal every day, for six weeks, without the least inconvenience! But the disease itself, notwithstanding this treacherous amnesty of the stomach, continued with unabated violence, and shortly afterwards terminated her life. On the other hand, I could cite several cases to show, that the most nutritive and digestible aliment may be rejected by the stomach, if any impression against its salubrity be produced. I remember a case, in which, from some groundless suspicion, the idea of the food having been poisoned by copper was introduced, the persons at table became sick, one or two absolutely vomited, and the remainder complained of distress in the stomach and bowels. The following is another striking instance of the powers of the imagination.

A Cambridge student called upon a friend, and observed a glass of sherry on his table, which he immediately swallowed; the gentleman, in whose apartment this occurred, determined to play off a hoax upon his visitor, and turning towards him the label of a half-pint bottle of antimonial wine, declared that he had swallowed a portion of its contents. The student left the room, and instantly vomited. These facts show in a striking manner to what an extent the digestive organs are influenced by the nervous system, and were it not otherwise obvious, they would point out the vast importance of serenity and cheerfulness during the discharge of their functions:

"Unquiet meals make ill digestion".