4 o UNIFORMITY OF DIETS. 



which is low for some is more than sufficient for 

 others. Some will be half-starved while others will be 

 well fed perhaps over-fed. Some of our hospital 

 authorities are painfully inflexible in these matters, 

 and are continually trying to discover a diet that shall 

 equally suit patients of all ages and every kind of 

 disease. The diet tables are changed every few years, 

 and the physicians and surgeons continually blamed 

 for ordering extras.* Under the uniformity system it 

 is clear that, to the little people and the light weights 

 is accorded a not perfectly fair advantage in the 

 struggle for existence. It is of some importance for the 

 physician, among other particulars, to take carefully 

 into his consideration, when prescribing and regulating 

 the proportion of food and stimulant, the weight and 

 vigour of the individual patient. For although it is 

 true that in proportion to their weight, small animals 

 require much more food than large ones, a heavy man 

 should, as a general rule, have a more liberal diet 



* Surely the time has come when the Medical Staff of our great 

 public charities should be permitted to exercise a little more influence in 

 the management of the institutions in which they are the chief workers 

 than heretofore. In some of our London hospitals any single member 

 of the Committee, or the Secretary, who may be completely un- 

 acquainted with disease, and quite unable to judge of the requirements of 

 the sick, exercises more control in the management of the institution than 

 the entire Medical Staff. In some cases, the Medical Officers are far 

 too much in the position of servants, who are expected to execute the 

 orders given by the authorities under whom and for whom they are sup- 

 posed to work. It is, however, very doubtful if such relationship 

 between those who manage the institution and those who are responsible 

 for the treatment of the sick is the most advantageous that is possible. 



