tant points concerning metabolism under different conditions and in various morbid states are now in course of elucidation.
To recount all the important researches on the physiology and chemistry of dietetics would unduly prolong this historical review. I have mentioned the principal contributions that have first opened up the various lines of inquiry pertinent to the subject. By the researches of a host of investigators along these lines have been accumulated the data and developed the principles that underlie the theory of dietetics as we have it to-day. The evolution of the subject is still far from complete, and points of even fundamental importance are yet to be worked out. So elementary a standard, for example, as the optimum daily ration of protein, is even yet unsettled. The establishment of rational principles of feeding in disease has been very incompletely accomplished. The whole subject is in a transitional stage; investigation is, however, proceeding rapidly, and results with important practical bearings are being constantly gained.
American conrtibutions to the subject have been noteworthy, such as the work of Beaumont, Atwater and Cannon. Honor is especially due to the United States Department of Agriculture for the special encouragement it has since 1894 given to the study of problems relating to the food and nutrition of man; under its auspices a vast amount of research has been systematically fostered all over the country and the results published and distributed in an extensive series of bulletins.
The scientific and rational principles of dietetics have not become well assimilated into the conceptions of the public, or even of the medical profession. Dietetics is a fruitful field for fallacy, fancy and fad. There are a few diseases that have a specific dietetic treatment, such as diabetes, acidosis, scurvy, beri-beri, gout, etc., in which, as also in infant feeding, the profession follows rational principles. With many diseases the appropriate dietetic principles are ignored, or have not been as yet worked out, or do not differ from those of health. In this field the dietetic management is to a certain extent a matter of caprice, guesswork and error. Faulty practises are in vogue, such as the general use as food of meat extractives and soups, although well known to be devoid of nutritive value. Mystic potencies and occult dangers are erroneously ascribed to articles of food. The distrust of food engendered in the ancient days of medicine still lingers, and there is no doubt that countless lives have been sacrificed to the fear of feeding in disease.
The medical students and practitioners of the present and future need to be more thoroughly grounded in the scientific and rational basis of dietetics. Only by a thorough appreciation and application of its principles can this subject be raised from a position of empiricism to that scientific dignity which it is the aim of modern medicine to attain, or the powerful agency of diet be utilized in its maximum efficiency for the benefit of mankind.
