76 



and the extra I'ation for them was so limited as compared with the 

 total amount fed that in calculating the results each stud}^ was treated 

 as if the patients were all non workers and all received the same diet. 

 In the study excepted — No. 374 — the proportion of working patients 

 was large, and some of them did a considerable amount of outdoor 

 work; consequentl}', account was kept of the amount of extra ration 

 served, and the results of the study have been computed for the 

 workers and nonworkers separatel}', as well as for the group as a whole. 



AMOUNTS OF FOOD CONSUMED AND ADEQ,UACY OF THE DIET. 



With the ordinary individual in good health and of sound mind, 

 the normal bodily demand for nutrients and energy depends largely 

 upon his muscular activity; and in discussing the results of dietary 

 studies of such persons it is customary to compare the results obtained 

 with dietary standards for men having about the same amount of mus- 

 cular work as that of the persons studied. Standards of this sort, 

 which have been ver}^ conmionly used in this countrj^ and in England, 

 are given in Table 31. 



Of course, such standards are at best tentative. They are general 

 indications rather than exact measures of the actual physiological 

 demands of persons in health, and their uncertainty in this respect is 

 still greater when they are applied to persons in demented or other 

 abnormal condition. Data concerning the actual physiological needs 

 of insane hospital patients of different classes are as yet very inade- 

 quate; hence, it is not certain to what extent dietar}^ standards for 

 persons in health may be compared with the results of studies with 

 persons not in normal mental condition. Some authorities believe 

 that the l)odily demands of the insane do not materially differ from 

 those of persons in health with a corresponding amount of muscular 

 activity, while others think that acutely insane patients may require 

 more nourishment, and the chronic classes probably somewhat less 

 than is required by normal persons. It is believed, however, that a 

 comi)arison of the results of these studies with the conimonly accepted 

 standards, and with the results of studies with similar patients in other 

 institutions, will give a tolerabl}^ clear idea of the sufficiency of the 

 diet for the bodily needs of the patients. Such a comparison can be 

 made with the aid of the data included in Table 31. 



The ten studies of the first group in the table above comprise those 

 with patients from middle life to old age, largely chronic insane, 

 orderly, and quiet. The proportion of patients who did any consider- 

 able amount of work was small. The amount actually eaten in these 

 ten studies varied from 64 grams of protein and 2,078 calories of 

 energy per man per day to 105 gi-ams and 2,964 calories. It is inter- 

 esting to note, however, that aside from these two extreme cases, 

 the results for the individual studies agree in the main fairly well with 



