152. Dr. N. D. Bardswell and Mr. J. E. Chapman. [Nov. 26, 
In the case of every patient that was observed, we first determined the 
diet which was physiological for the individual, when in ordinary health, up 
to his average body weight, and at physiological rest. This physiological 
diet was then increased in certain definite amounts of proteid, fat, or carbo- 
hydrate. The actual diet prescribed was carefully constructed so as to give 
the nutritive value decided upon. This diet was given in measured and 
weighed amounts, and anything left was also weighed or measured. In this 
way an accurate record of the food actually consumed by the patient was 
arrived at and its nutritive value calculated. Careful clinical observations 
were made on all the patients, especially as to the improvement in the morbid 
process in the lungs, gain of weight, and improvement in general health. In 
a large proportion of cases, metabolic observations were also made. Some- 
times these observations were made during a four-day period once a month; 
in other cases they were made daily for periods varying from a week to three 
months. The points especially studied were :— / 
(1) The absorption of fat and nitrogen. 
(2) The amount of the excretion of nitrogen. 
(3) The form in which the nitrogen was excreted, viz., whether simple or 
in the more highly elaborated forms, and their percentage relation. 
(4) The amount of intestinal putrefaction, as evidenced by the ratio between 
the aromatic and the alkaline sulphates excreted in the urine. 
Conclusions of Research 1.—The following are satisfactory principles upon 
which to construct dietaries for tuberculous patients :— 
(1) The physiological diet (viz., the diet which contains the exact amount 
of carbon and nitrogen necessary to balance the amounts of the substances 
excreted) for every tubercular individual when in normal health and at 
physiological rest, should first be ascertained, and this physiological diet 
should form the basis of the diet prescribed for the treatment. | 
(2) The amount of proteid in the physiological diet should be increased by 
30 per cent., and this increase should be maintained until the disease is 
obsolete. 
(3) If the patient is much under weight, the calorie value of the physio- 
logical diet should also be increased 30 per cent. in the purely energy-giving 
foods, viz., in fats or carbohydrates, or in both. This increase should be 
maintained until the weight becomes stationary, at a point a few pounds in 
excess of the patient’s normal weight. A decrease of 15 per cent. can then 
be made, and the diet thus altered should be continued until the disease is. 
obsolete. 
(4) The meals must not be too bulky, but somewhat inclined to concen- 
tration, so as to give the comparatively large amount of nourishment in a but 
