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189
Over and above this provision there must be healthy activity
of those physiological processes which have to do with mastication
and preparation, with absorption, assimilation, metabolism
and excretion. Healthy and complete nutrition is something more
than mere feeding.
We must therefore take a wide and comprehensive view of
nutrition, which must be estimated not only in terms of bulk and
weight, but of the ratio of stature to weight, of the general
appearance and "substance" of the body and of its carriage
and bearing; of the firmness of the tissues; of the presence of
subcutaneous fat; of the condition and process of development
of the muscular system; of the condition of the skin and the
redness of the mucous membranes; of the nervous and muscular
systems as expressed in listlessness, or alertness, apathy or keenness
; of the condition of the various systems of the body ; and of
the relative balance and co-ordination of the functions and powers
of dig-estion, absorption, assimilation of food, and of the excretion
of waste products. In brief, it may be said that malnutrition is
usually due to one of four causes :—
(a) Physical defect.
(b) Debility following- illness.
(c) Faulty hygiene and unsuitable food.
(d) Shortage of food.
"More than one-half of the chronic complaints which embitter
the middle and latter part of life," said Sir Henry Thompson,
the surgeon, "is due to avoidable errors in diet." One
cause of error is lack of knowledge in the choice of good and evil
in regard to food—its selection, nutritive value, preparation and
consumption. But there are other aspects of the dietetic habit
which have a large share in the production of disease: (a)
irregularity of meals and the consumption of food or drink
between them; (b) the unvaried monotony of the average dietary;
(c) the failure to masticate food owing to defective teeth or the
habit of bolting food; (d) drinking too much with meals; (e) bad
teeth; (f) chronic constipation; and (g) the abuse of tea, spices
and alcoholic beverages. These seem to be trivial matters, but
it is out of the smaller habits and neglectfulness of men that
disease is born.