NUTRITION INVESTIG ATION^^ WITH THE INSANE. 505 



is required to maintain crood physiral condition which not only entails 

 pecuniary loss, but also inipos«>.s unneces.sary tax on the digestive 

 functions and frcquentl}' impairs the health of the consumers. On 

 the other hand, if the food supply is too limited and the shrinkage 

 and waste are large, there is danger of underfeeding, which is more to 

 be avoided than the opposite. HA-gienic economy requires not onlj^ 

 that the food shall meet the physiological deniaiid in respect to the 

 quantities of nutrients and energy, but also that it shall l)o suited to 

 the digestive powers and other physiological peculiarities of the users. 

 This is of special importance in the case of the aged and infirm and 

 with invalids and young children. Pecuniary economy requires not 

 onh' that there shall be a minimum of shrinkage and waste, but also 

 that the food shall l)e such as to furnish the needed nutriment at the 

 lowest cost consistent with the comfort and well-being of the persons 

 fed. The attractiveness and palatal^ility of the food should also receive 

 due consideration, because often the adequacj' of the diet as well as the 

 happiness of the eater may be thus enhanced. 



NATURE OF THE INQUIRY AT ST. ELIZABETHS. 



The plan of investigation at St. Elizabeths comprehended an 

 examination of the statistics of the food supply with regard to the 

 kinds, amounts, and nutritive values of the materials; determinations 

 by weighings and measurement of the amounts of food actually con- 

 sumed by the different classes of the hospital population and of the 

 amounts and kinds of dining room and kitchen wastes; observation of 

 the methods of handling, cooking, and serving the food; experiments 

 on the feeding of patients of different classes to determine their 

 actual physiological needs and the best waj^s of supplying them 

 without unnecessary waste; and, Hnally, learning how the proper 

 officers and employees ma}^ be enabled not only to carr}^ out but 

 also to devise methods for improvement. 



In an institution like a hospital for the insane, where there are so 

 many different classes of patients, and especiall}' in one Avher(> there 

 are many different dining rooms and kitchens, to complete such an 

 investigation as this Avould ordinarily require considerable time. 

 Fortunately for rapid progress at the Government hospital, it was 

 possible to make very satisfactory arrangements for the prosecution 

 of the inquiry, and these were readily agreed to by Dr. Richardson, 

 who thoroughly appreciated the requirements of the woik. Mr. H. 

 A. Prtitt, Avho for several years had been associated with the work at 

 Middletown, Conn., which forms part of the nutrition invc^stigations 

 of the Department of Agriculture, which are under the writer's direc- 

 tion, and with the dietary investigations made in the hospitals for the 

 insane in the State of New Yoi-k, also under the writer's direction, 

 was given charge of the studies at St. Elizabeths. The data which he 



