90 



to which naturally much more attention can be g'iven in a small family 

 than is possible in a large institution, but even in the latter it is 

 worthy of more consideration than is sometimes giyen. 



So far as eyidence was obtained in the course of these investigations, 

 however, the rejection of food could be attributed less to any failure 

 in the matter of preparation than to other causes. In general a close 

 supervision was kept over the work of preparing food, the cooking- 

 was well done, and seasoning or flavoring was as carefully attended to 

 as was possible under the circumstances. This has been particularly 

 mentioned in the discussion of study No. 364, on page 23. It is 

 believed that in this respect the conditions at this hospital would com- 

 pare most favorably with those in similar institutions elsewhere. 



It is true, however, that the food may be well prepared and attract- 

 ively served and still be rejected in considerable proportion unless it 

 has a familiar appearance and taste, because people generally prefer 

 the kind of food to which they have been accustomed; and frequently, 

 especially when ordinarily they have been used to little variety, they 

 do not at lirst relish what is novel to them. Such considerations sug- 

 gest that for the most successful and economical feeding of persons in 

 institutions it is essential to take account of their previously acquired 

 food habits. Obviously, however, with a large number of individuals 

 of widely varying habits, it would be difficult to prepare a satisfactory 

 diet that would in all respects be familiar to each one. But it is easy 

 to exclude materials which are more or less unfamiliar or distasteful 

 to many of them, and which would very likely be left uneaten. 

 Failure to do this may have been the reason for the large amount of 

 some of the foods rejected in these studies; for instance, wheat break- 

 fast foods were left uneaten in large proportions in nearly every study, 

 though oatmeal was evidentlj^ relished. 



On the other hand, monotony in the diet is especially to be avoided, 

 as this has a decided tendency to diminish the relish for food. This 

 effect has been observed to follow where there is a uniform it}" in the 

 rotation of the menu — that is, where the same menu is used on the same 

 day in successive weeks, as is frequently the case in institutions. 

 Under such circumstances a large number of persons associate the 

 days of the week with the kind of food that will be served, and the 

 pleasurable sensation that acts as a sort of stimulation to appetite 

 when the nature of the meal is more or less of a surprise is lost. 

 Under such circumstances the amount eaten is generally smaller. 

 These conditions were present to an appreciable extent in some of the 

 studies here reported. 



In addition to such conditions which fail to stimulate and may even 

 take away desire for food, there may be a natural variation in appetite 

 from da}^ to day, which may result from difl'erences in either physi 

 cal or mental conditions, and this would affect the quantity of food 



