THE HISTORY OF DIETETICS 427 



tant points concerning metabolism under different conditions and in 

 various morbid states are now in course of elucidation. 



To recount all tbe 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, pro- 

 ceeding 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 encour- 

 agement 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 pub- 

 lished 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 medi- 

 cal 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, scurvjr, 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, guess- 

 work 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 count- 

 less 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. 



