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Dietary Reference Intakes (DRI)
The Dietar y Reference Intakes (DRI) include two sets of The DRI also include the Tolerable Upper Intake Level
­nutrient intake goals for individuals—the Recommended (UL) that represents the estimated maximum daily amount
­Dietary ­A llowance (RDA) and Adequate Intake (AI). The RDA of a ­nutrient that appears safe for most healthy people to con-
ref lects the average daily amount of a nutrient considered sume on a regular basis. Turn the page for a listing of the UL
­adequate to meet the needs of most healthy people. If there for selected vitamins and minerals. Note that the absence of
is insufficient evidence to determine an RDA, an AI is set. a UL for a nutrient does not indicate that it is safe to consume
In a­ ddition, the Estimated Energy Requirement (EER) repre- in high doses, but only that research is too limited to set a UL.
sents the average dietary energy intake considered adequate Chapter 1 describes these DRI values in detail.
to maintain energy balance in healthy people.

Estimated Energy Requirements (EER), Recommended Dietary Allowances (RDA), and Adequate Intakes (AI) for Water,
Energy, and the Energy Nutrients

Linolenic Acidc
EERb (kcal/day)
Reference BMI

RDA (g/kg/day)
Height cm (in.)

Weight kg (lb)

Carbohydrate

Linoleic Acid

RDA (g/day) d
RDA (g/day)

Total Fiber
Reference

Reference

AI (g/day)

AI (g/day)

AI (g/day)

AI (g/day)
AI (L/day)

Total Fat

Protein

Protein
Water a

Energy
Age (yr)
Males
0–0.5 — 62 (24) 6 (13) 0.7e 570 60 — 31 4.4 0.5 9.1 1.52
0.5–1 — 71 (28) 9 (20) 0.8 f 743 95 — 30 4.6 0.5 11 1.20
1–3g — 86 (34) 12 (27) 1.3 1046 130 19 — 7 0.7 13 1.05
4–8 g 15.3 115 (45) 20 (44) 1.7 1742 130 25 — 10 0.9 19 0.95
9–13 17.2 144 (57) 36 (79) 2.4 2279 130 31 — 12 1.2 34 0.95
14–18 20.5 174 (68) 61 (134) 3.3 3152 130 38 — 16 1.6 52 0.85
19–30 22.5 177 (70) 70 (154) 3.7 3067h 130 38 — 17 1.6 56 0.80
31–50 22.5i 177 (70)i 70 (154)i 3.7 3067h 130 38 — 17 1.6 56 0.80
>50 22.5i 177 (70)i 70 (154)i 3.7 3067h 130 30 — 14 1.6 56 0.80
Females
0–0.5 — 62 (24) 6 (13) 0.7e 520 60 — 31 4.4 0.5 9.1 1.52
0.5–1 — 71 (28) 9 (20) 0.8 f 676 95 — 30 4.6 0.5 11 1.20
1–3g — 86 (34) 12 (27) 1.3 992 130 19 — 7 0.7 13 1.05
4–8 g 15.3 115 (45) 20 (44) 1.7 1642 130 25 — 10 0.9 19 0.95
9–13 17.4 144 (57) 37 (81) 2.1 2071 130 26 — 10 1.0 34 0.95
14–18 20.4 163 (64) 54 (119) 2.3 2368 130 26 — 11 1.1 46 0.85
19–30 21.5 163 (64) 57 (126) 2.7 2403j 130 25 — 12 1.1 46 0.80
31–50 21.5i 163 (64)i 57 (126)i 2.7 2403j 130 25 — 12 1.1 46 0.80
>50 21.5i 163 (64)i 57 (126)i 2.7 2403j 130 21 — 11 1.1 46 0.80
Pregnancy
1st trimester 3.0 +0 175 28 — 13 1.4 46 0.80
2nd trimester 3.0 +340 175 28 — 13 1.4 71 1.10
3rd trimester 3.0 +452 175 28 — 13 1.4 71 1.10
Lactation
1st 6 months 3.8 +330 210 29 — 13 1.3 71 1.30
2nd 6 months 3.8 +400 210 29 — 13 1.3 71 1.30
NOTE: BMI is calculated as the weight in kilograms divided height, and physical activity level. The values listed are based gFor energy, the age groups for young children are 1–2 years

by the square of the height in meters. For all nutrients, values on an “active” person at the reference height and weight and and 3–8 years.
for infants are AI. The glossary on the insert defines units of at the midpoint ages for each group until age 19. Chapter 8 hFor males, subtract 10 kcalories per day for each year of age

nutrient measure. Dashes (—) indicate that values have not
been determined.
aThe water AI includes drinking water, water in beverages, and
water in foods; in general, drinking water and other beverages
con­tribute about 70 to 80 percent, and foods, the remainder.
and Appendix F provide equations and tables to determine
estimated energy requirements.
cThe linolenic acid referred to in this table and text is the
omega-3 fatty acid known as alpha-linolenic acid.
d The values listed are based on reference body weights.
above 19.
iBecause weight need not change as adults age if activity is
main­tained, reference weights for adults 19 through 30 years
are applied to all adult age groups.
jFor females, subtract 7 kcalories per day for each year of age

Conver­sion factors: 1 L = 33.8 fluid oz; 1 L = 1.06 qt;
1 cup = 8 fluid oz.
bThe Estimated Energy Requirement (EER) represents the
aver­age dietary energy intake that will maintain energy
balance in a healthy person of a given gender, age, weight,
eAssumed to be from human milk. above 19.
fAssumed to be from human milk and complementary foods
and beverages. This includes approximately 0.6 L (~2½ cups) SOURCE: Adapted from the Dietary Reference Intakes
as total fluid including formula, juices, and drinking water. series, National Academies Press. National Academies of
Sciences.

A
Recommended Dietary Allowances (RDA) and Adequate Intakes (AI) for Vitamins

RDA (mg/day)a

RDA (μg/day) b

RDA (μg/day) c

RDA (μg/day) d
RDA (mg/day)

RDA (mg/day)

RDA (mg/day)
RDA (μg/day)
Pantothenic

AI (mg/day)

AI (mg/day)
Vitamin B12
AI (μg/day)

AI (μg/day)
Vitamin B 6
Riboflavin

Vitamin A

Vitamin D
Vitamin C

Vitamin K
Vitamin E
RDA (mg/

RDA (mg/
Thiamin

Choline
Niacin

Folate
Biotin

day)e
acid
day)
Age (yr)
Infants
0–0.5 0.2 0.3 2 5 1.7 0.1 65 0.4 125 40 400 10 4 2.0
0.5–1 0.3 0.4 4 6 1.8 0.3 80 0.5 150 50 500 10 5 2.5
Children
1–3 0.5 0.5 6 8 2 0.5 150 0.9 200 15 300 15 6 30
4–8 0.6 0.6 8 12 3 0.6 200 1.2 250 25 400 15 7 55
Males
9–13 0.9 0.9 12 20 4 1.0 300 1.8 375 45 600 15 11 60
14–18 1.2 1.3 16 25 5 1.3 400 2.4 550 75 900 15 15 75

From Whitney/Rolfes, Understanding Nutrition, 13E. © 2013 Cengage Learning.

19–30 1.2 1.3 16 30 5 1.3 400 2.4 550 90 900 15 15 120
31–50 1.2 1.3 16 30 5 1.3 400 2.4 550 90 900 15 15 120
51–70 1.2 1.3 16 30 5 1.7 400 2.4 550 90 900 15 15 120
>70 1.2 1.3 16 30 5 1.7 400 2.4 550 90 900 20 15 120
Females
9–13 0.9 0.9 12 20 4 1.0 300 1.8 375 45 600 15 11 60
14–18 1.0 1.0 14 25 5 1.2 400 2.4 400 65 700 15 15 75
19–30 1.1 1.1 14 30 5 1.3 400 2.4 425 75 700 15 15 90
31–50 1.1 1.1 14 30 5 1.3 400 2.4 425 75 700 15 15 90
51–70 1.1 1.1 14 30 5 1.5 400 2.4 425 75 700 15 15 90
>70 1.1 1.1 14 30 5 1.5 400 2.4 425 75 700 20 15 90
Pregnancy
≤18 1.4 1.4 18 30 6 1.9 600 2.6 450 80 750 15 15 75
19–30 1.4 1.4 18 30 6 1.9 600 2.6 450 85 770 15 15 90
31–50 1.4 1.4 18 30 6 1.9 600 2.6 450 85 770 15 15 90
Lactation
≤18 1.4 1.6 17 35 7 2.0 500 2.8 550 115 1200 15 19 75
19–30 1.4 1.6 17 35 7 2.0 500 2.8 550 120 1300 15 19 90
31–50 1.4 1.6 17 35 7 2.0 500 2.8 550 120 1300 15 19 90
NOTE: For all nutrients, values for infants are AI. The glossary on the inside back cover b
Folate recommendations are expressed as dietary folate equivalents (DFE).
defines units of nutrient measure. c
Vitamin A recommendations are expressed as retinol activity equivalents (RAE).
a
Niacin recommendations are expressed as niacin equivalents (NE), except for d
Vitamin D recommendations are expressed as cholecalciferol and assume an absence of
recommendations for infants younger than 6 months, which are expressed as preformed adequate exposure to sunlight.
niacin. e
Vitamin E recommendations are expressed as α-tocopherol.

Recommended Dietary Allowances (RDA) and Adequate Intakes (AI) for Minerals
RDA (mg/day)

RDA (mg/day)

RDA (mg/day)

RDA (mg/day)

RDA (mg/day)

RDA (μg/day)

RDA (μg/day)

RDA (μg/day)

RDA (μg/day)
Molybdenum
Phosphorus

Manganese
Magnesium
AI (mg/day)

AI (mg/day)

AI (mg/day)

AI (mg/day)

AI (mg/day)

AI (μg/day)
Potassium

Chromium
Selenium
Chloride

Fluoride
Calcium
Sodium

Copper
Iodine
Zinc
Iron

Age (yr)
Infants
0–0.5 120 180 400 200 100 30 0.27 2 110 15 200 0.003 0.01 0.2 2
0.5–1 370 570 700 260 275 75 11 3 130 20 220 0.6 0.5 5.5 3
Children
1–3 1000 1500 3000 700 460 80 7 3 90 20 340 1.2 0.7 11 17
4–8 1200 1900 3800 1000 500 130 10 5 90 30 440 1.5 1.0 15 22
Males
9–13 1500 2300 4500 1300 1250 240 8 8 120 40 700 1.9 2 25 34
14–18 1500 2300 4700 1300 1250 410 11 11 150 55 890 2.2 3 35 43

From Whitney/Rolfes, Understanding Nutrition, 13E. © 2013 Cengage Learning.

19–30 1500 2300 4700 1000 700 400 8 11 150 55 900 2.3 4 35 45
31–50 1500 2300 4700 1000 700 420 8 11 150 55 900 2.3 4 35 45
51–70 1300 2000 4700 1000 700 420 8 11 150 55 900 2.3 4 30 45
>70 1200 1800 4700 1200 700 420 8 11 150 55 900 2.3 4 30 45
Females
9–13 1500 2300 4500 1300 1250 240 8 8 120 40 700 1.6 2 21 34
14–18 1500 2300 4700 1300 1250 360 15 9 150 55 890 1.6 3 24 43
19–30 1500 2300 4700 1000 700 310 18 8 150 55 900 1.8 3 25 45
31–50 1500 2300 4700 1000 700 320 18 8 150 55 900 1.8 3 25 45
51–70 1300 2000 4700 1200 700 320 8 8 150 55 900 1.8 3 20 45
>70 1200 1800 4700 1200 700 320 8 8 150 55 900 1.8 3 20 45
Pregnancy
≤18 1500 2300 4700 1300 1250 400 27 12 220 60 1000 2.0 3 29 50
19–30 1500 2300 4700 1000 700 350 27 11 220 60 1000 2.0 3 30 50
31–50 1500 2300 4700 1000 700 360 27 11 220 60 1000 2.0 3 30 50
Lactation
≤18 1500 2300 5100 1300 1250 360 10 13 290 70 1300 2.6 3 44 50
19–30 1500 2300 5100 1000 700 310 9 12 290 70 1300 2.6 3 45 50
31–50 1500 2300 5100 1000 700 320 9 12 290 70 1300 2.6 3 45 50
NOTE: For all nutrients, values for infants are AI. The glossary on the inside back cover defines units of nutrient measure.
Tolerable Upper Intake Levels (UL) for Vitamins

Vitamin B 6

Vitamin A

Vitamin D
Vitamin C

Vitamin E
(mg/day)c
(mg/day)a

(μg/day)a

(μg /day)b
(mg/day)

(mg/day)

(mg/day)

(μg /day)
Choline
Niacin

Folate
Age (yr)
Infants
0–0.5 — — — — — 600 25 —
0.5–1 — — — — — 600 38 —
Children

From Whitney/Rolfes, Understanding Nutrition, 13E. © 2013 Cengage Learning.

1–3 10 30 300 1000 400 600 63 200
4–8 15 40 400 1000 650 900 75 300
9–13 20 60 600 2000 1200 1700 100 600
Adolescents
14–18 30 80 800 3000 1800 2800 100 800
Adults
19–70 35 100 1000 3500 2000 3000 100 1000
>70 35 100 1000 3500 2000 3000 100 1000
Pregnancy
≤18 30 80 800 3000 1800 2800 100 800
19–50 35 100 1000 3500 2000 3000 100 1000
Lactation
≤18 30 80 800 3000 1800 2800 100 800
19–50 35 100 1000 3500 2000 3000 100 1000
a
The UL for niacin and folate apply to synthetic forms The UL for vitamin E applies to any form of supplemental
c

obtained from supplements, fortified foods, or a α-tocopherol, fortified foods, or a combination of the two.
combination of the two.
b
The UL for vitamin A applies to the preformed vitamin only.

Tolerable Upper Intake Levels (UL) for Minerals

Molybdenum
Phosphorus

Manganese
Magnesium

Vanadium
(mg/day)d

Selenium
(mg/day)

(mg/day)

(mg/day)

(mg/day)

(mg/day)

(mg/day)

(mg/day)

(mg/day)

(mg/day)

(mg/day)

(mg/day)
Chloride

Fluoride
Calcium

(μg/day)

(μg/day)

(μg/day)

(μg/day)
Sodium

Copper

Nickel
Iodine

Boron
Zinc
Iron

Age (yr)
Infants
0–0.5 — — 1000 — — 40 4 — 45 — — 0.7 — — — —
0.5–1 — — 1500 — — 40 5 — 60 — — 0.9 — — — —
Children
1–3 1500 2300 2500 3000 65 40 7 200 90 1000 2 1.3 300 3 0.2 —
4–8 1900 2900 2500 3000 110 40 12 300 150 3000 3 2.2 600 6 0.3 —
9–13 2200 3400 3000 4000 350 40 23 600 280 5000 6 10 1100 11 0.6 —
Adolescents
14–18 2300 3600 3000 4000 350 45 34 900 400 8000 9 10 1700 17 1.0 —
Adults
19–50 2300 3600 2500 4000 350 45 40 1100 400 10,000 11 10 2000 20 1.0 1.8
51–70 2300 3600 2000 4000 350 45 40 1100 400 10,000 11 10 2000 20 1.0 1.8
>70 2300 3600 2000 3000 350 45 40 1100 400 10,000 11 10 2000 20 1.0 1.8
Pregnancy
≤18 2300 3600 3000 3500 350 45 34 900 400 8000 9 10 1700 17 1.0 —
19–50 2300 3600 2500 3500 350 45 40 1100 400 10,000 11 10 2000 20 1.0 —
Lactation
≤18 2300 3600 3000 4000 350 45 34 900 400 8000 9 10 1700 17 1.0 —
19–50 2300 3600 2500 4000 350 45 40 1100 400 10,000 11 10 2000 20 1.0 —
d
The UL for magnesium applies to synthetic forms obtained from supplements or drugs SOURCE: Adapted with permission from the Dietary Reference Intakes for Calcium and
only. Vitamin D, © 2011 by the National Academies of Sciences, Courtesy of the National
NOTE: An upper Limit was not established for vitamins and minerals not listed and for Academies Press, Washington, D.C.
those age groups listed with a dash (—) because of a lack of data, not because these
nutrients are safe to consume at any level of intake. All nutrients can have adverse effects
when intakes are excessive.
 Nutrition for Health
seventh edition and Health Care

Linda Kelly DeBruyne

Kathryn Pinna

Australia ●
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United Kingdom ●
United States
 Nutrition for Health and Health Care,
Seventh Edition
Linda Kelly DeBruyne, Kathryn Pinna
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Linda Kelly DeBruyne

Kathryn Pinna

iii
 About the Authors
Linda Kelly DeBruyne, M.S., R.D., received her B.S. and M.S. degrees
in nutrition and food science at Florida State University. She is a founding member
of Nutrition and Health Associates, an information resource center in Tallahassee,
Florida, where her specialty areas are life cycle nutrition and fitness. Her other
publications include the textbooks Nutrition and Diet Therapy and Health: Making
Life Choices. She is a registered ­dietitian and maintains a professional membership in
the Academy of Nutrition and Dietetics.

Kathryn Pinna, Ph.D., R.D., received her M.S. and Ph.D. degrees in nutrition
from the University of California at Berkeley. She taught nutrition, food science, and
human biology courses in the San Francisco Bay Area for over 25 years and also
worked as an outpatient dietitian, Internet consultant, and freelance writer. Her other
publications include the textbooks Understanding Normal and Clinical Nutrition and
Nutrition and Diet Therapy. She is a registered dietitian and a member of the American
Society for Nutrition and the Academy of Nutrition and Dietetics.

v
 Brief Contents
Chapter 1 Chapter 13
Overview of Nutrition and Health 1 Nutrition Care and Assessment 379

Chapter 2 Chapter 14
Digestion and Absorption 39 Nutrition Intervention and Diet-Drug
Interactions 403
Chapter 3
Carbohydrates 67 Chapter 15
Enteral and Parenteral Nutrition Support 433
Chapter 4
Lipids 95 Chapter 16
Nutrition in Metabolic and Respiratory
Chapter 5
Stress 469
Protein 125
Chapter 17
Chapter 6
Nutrition and Upper Gastrointestinal
Energy Balance and Body Composition 147 Disorders 489
Chapter 7 Chapter 18
Weight Management 173 Nutrition and Lower Gastrointestinal
Disorders 513
Chapter 8
The Vitamins 199 Chapter 19
Nutrition and Liver Diseases 545
Chapter 9
Water and the Minerals 237 Chapter 20
Nutrition and Diabetes Mellitus 565
Chapter 10
Nutrition through the Life Span: Pregnancy and Chapter 21
Lactation 271 Nutrition and Cardiovascular Diseases 595
Chapter 11 Chapter 22
Nutrition through the Life Span: Infancy, Nutrition and Renal Diseases 625
Childhood, and Adolescence 303
Chapter 23
Chapter 12
Nutrition, Cancer, and HIV Infection 653
Nutrition through the Life Span: Later Adulthood 351
vii
viii
 Contents
Preface xvi
The Vascular System 50
Acknowledgments xx The Lymphatic System 51
Transport of Lipids: Lipoproteins 51
Chapter 1
Overview of Nutrition and Health 1 Gastrointestinal Hormones and Nerve Pathways 53
Gastrointestinal Microbes 53
The System at Its Best 54
Six Classes of Nutrients 6 Nutrition in Practice Food Safety 57
kCalories: A Measure of Energy 6

Chapter 3
Dietary Reference Intakes 8
Acceptable Macronutrient Distribution Ranges 10 Carbohydrates 67

National Health Goals 11 Monosaccharides 68

National Trends 11 Disaccharides 69
Polysaccharides 69

Dietary Ideals 13
Dietary Guidelines for Americans 14
Fitness Guidelines 16
The USDA Food Patterns 18 Sugars 74
MyPlate 23 Alternative Sweeteners: Sugar Alcohols 78
Alternative Sweeteners: Nonnutritive Sweeteners 79
The Ingredient List 24
Nutrition Facts Panel 25 Carbohydrates: Disease Prevention
Claims on Labels 27 and Recommendations 81
Nutrition in Practice Finding the Truth about Carbohydrates: Food Sources 84
Nutrition 34
Carbohydrates: Food Labels and Health Claims 86
Nutrition in Practice The Glycemic Index in Nutrition
Chapter 2 Practice 90
Digestion and Absorption 39
Chapter 4
The Digestive Organs 40 Lipids 95
The Involuntary Muscles and the Glands 42

Digestion in the Mouth 45

Digestion in the Stomach 46 Triglycerides 97
Digestion in the Small and Large Intestines 46 Fatty Acids 98
Phospholipids 101
Sterols 101
The Small Intestine 48
Absorption of Nutrients 49

ix
 Chapter 7
Fats and Heart Health 103
Recommendations 106 Weight Management 173

Finding the Fats in Foods 108 Genetics and Weight 174

Cutting Solid Fats and Choosing Unsaturated Environmental Stimuli 177
Fats 110
Nutrition in Practice Figuring Out Fats 117
Over-the-Counter Weight-Loss Products 180
Chapter 5 Other Gimmicks 180
Protein 125
Obesity Drugs 180
Surgery 181
The Structure of Proteins 126
Nonessential and Essential Amino Acids 127
A Healthful Eating Plan 182
Physical Activity 185
Behavior and Attitude 186
Protein Turnover 129 Weight Maintenance 188
Nitrogen Balance 129

Nutrition in Practice Fad Diets 195

Protein Deficiency 132 Chapter 8

Malnutrition 133
Protein Excess 134 The Vitamins 199
Protein and Amino Acid Supplements 135
Protein Recommendations and Intakes 136
Vitamin A and Beta-Carotene 203
Protein Quality 137 Vitamin D 207
Protein Sparing 138 Vitamin E 211
Protein on Food Labels 138 Vitamin K 212
Nutrition in Practice Vegetarian Diets 141
The B Vitamins 214
Chapter 6 Thiamin 216
Riboflavin 216
Energy Balance and Body Composition 147 Niacin 217
Pantothenic Acid and Biotin 218
Feasting 148 Vitamin B6 218
The Economics of Fasting 149 Folate 219
Vitamin B12 220
Energy In 152 Non–B Vitamins 222
Energy Out 152 Vitamin C 222
Estimating Energy Requirements 155 Nutrition in Practice Phytochemicals and Functional
Foods 229
Defining Healthy Body Weight 156
Body Composition 159 Chapter 9
How Much Body Fat Is Too Much? 160 Water and the Minerals 237

Health Risks of Underweight 161 Water Balance 238

Health Risks of Overweight and Obesity 162 Fluid and Electrolyte Balance 240
Guidelines for Identifying Those at Risk from Acid–Base Balance 241
Obesity 163
Other Risks of Obesity 163
Sodium 243
Nutrition in Practice Eating Disorders 166 Chloride 244

x Contents
 Potassium 244
Calcium 245 Energy and Nutrient Needs 316
Phosphorus 249 Hunger and Malnutrition in Children 320
Magnesium 249 Lead Poisoning in Children 321
Sulfate 251 Food Allergy 322
Hyperactivity 324
Iron 251 Childhood Obesity 325
Zinc 256 Mealtimes at Home 330
Selenium 258 Nutrition at School 334
Iodine 259
Copper 260 Growth and Development during Adolescence 336
Manganese 260 Energy and Nutrient Needs 336
Fluoride 261 Food Choices and Health Habits 337
Chromium 261 Nutrition in Practice Childhood Obesity and
Other Trace Minerals 261 the Early Development of Chronic Diseases 345
Nutrition in Practice Vitamin and Mineral
Supplements 267 Chapter 12
Nutrition through the Life Span: Later
Chapter 10
Adulthood 351
Nutrition through the Life Span: Pregnancy
and Lactation 271 Slowing the Aging Process 353
Nutrition and Disease Prevention 355

Nutrition Prior to Pregnancy 272

Prepregnancy Weight 272 Cataracts and Macular Degeneration 356
Healthy Support Tissues 273 Arthritis 356
The Events of Pregnancy 274 The Aging Brain 357
Nutrient Needs during Pregnancy 276
Food Assistance Programs 281
Weight Gain 282 Energy and Energy Nutrients 360
Weight Loss after Pregnancy 283 Vitamins and Minerals 362
Physical Activity 284 Nutrient Supplements for Older Adults 363
Common Nutrition-Related Concerns of Pregnancy 285 The Effects of Drugs on Nutrients 364
Problems in Pregnancy 286
Practices to Avoid 288 Individual Preferences 365
Adolescent Pregnancy 291 Meal Setting 365
Depression 365
Nutrition during Lactation 292 Food Assistance Programs 365
Contraindications to Breastfeeding 294 Meals for Singles 366

Nutrition in Practice Encouraging Successful Nutrition in Practice Hunger and Community

Breastfeeding 300 Nutrition 373

Chapter 11 Chapter 13

Nutrition through the Life Span: Infancy,
Childhood, and Adolescence 303
Nutrient Needs during Infancy 304
Breast Milk 306
Infant Formula 309
The Transition to Cow’s Milk 311
Introducing First Foods 311
Looking Ahead 314
Mealtimes 315
Nutrition Care and Assessment 379
How Illness Affects Nutrition Status 380
Responsibility for Nutrition Care 381
Identifying Risk for Malnutrition 382
The Nutrition Care Process 383
Historical Information 385
Dietary Assessment 386
Anthropometric Data 389

Contents xi
 Biochemical Analyses 392 Chapter 16
Physical Examination 395 Nutrition in Metabolic and Respiratory Stress 469
Nutrition in Practice Nutritional Genomics 399
Hormonal Responses to Stress 471
Chapter 14 The Inflammatory Response 472
Nutrition Intervention and Diet-Drug
Interactions 403 Determining Nutritional Requirements 474
Approaches to Nutrition Care in Acute Stress 476

Care Planning 404

Approaches to Nutrition Care 406 Chronic Obstructive Pulmonary Disease 477
Respiratory Failure 480

Energy Intakes in Hospital Patients 408 Nutrition in Practice Multiple Organ Dysfunction
Modified Diets 409 Syndrome 486
Variations in the Diet Order 413
Chapter 17
Food Selection 414 Nutrition and Upper Gastrointestinal
Food Safety 414 Disorders 489
Improving Food Intake 414

Drug Effects on Food Intake 416 Dry Mouth 490

Drug Effects on Nutrient Absorption 416 Dysphagia 490
Dietary Effects on Drug Absorption 417 Gastroesophageal Reflux Disease 494
Drug Effects on Nutrient Metabolism 418
Dietary Effects on Drug Metabolism 419
Drug Effects on Nutrient Excretion 420 Dyspepsia 496
Dietary Effects on Drug Excretion 420 Nausea and Vomiting 497
Drug-Nutrient Interactions and Toxicity 420 Gastroparesis 497
Gastritis 498
Nutrition in Practice Complementary and Alternative Peptic Ulcer Disease 498
Therapies 424

Gastrectomy 500
Chapter 15 Bariatric Surgery 503
Enteral and Parenteral Nutrition Support 433 Nutrition in Practice Nutrition and Oral Health 509

Oral Supplements 434 Chapter 18

Candidates for Tube Feedings 435 Nutrition and Lower Gastrointestinal
Tube Feeding Routes 436
Enteral Formulas 438 Disorders 513
Administration of Tube Feedings 441
Medication Delivery during Tube Feedings 445 Constipation 514
Tube Feeding Complications 446 Intestinal Gas 516
Transition to Table Foods 446 Diarrhea 516

Candidates for Parenteral Nutrition 448 Fat Malabsorption 519

Venous Access 449 Bacterial Overgrowth 521
Parenteral Solutions 450 Lactose Intolerance 521
Administering Parenteral Nutrition 454
Managing Metabolic Complications 455 Pancreatitis 523
Cystic Fibrosis 524
Candidates for Home Nutrition Support 457
Planning Home Nutrition Care 457 Celiac Disease 526
Quality-of-Life Issues 458 Inflammatory Bowel Diseases 528
Nutrition in Practice Inborn Errors of Metabolism 463 Short Bowel Syndrome 531

xii Contents

Irritable Bowel Syndrome 534
Diverticular Disease of the Colon 535
Colostomies and Ileostomies 536
Nutrition in Practice Probiotics and Intestinal
Health 542
Chapter 19
Nutrition and Liver Diseases 545
Fatty Liver 546
Hepatitis 547
Consequences of Cirrhosis 549
Treatment of Cirrhosis 552
Nutrition Therapy for Cirrhosis 552
Nutrition in Practice Alcohol in Health and Disease 561
Chapter 20
Nutrition and Diabetes Mellitus 565
Symptoms of Diabetes Mellitus 566
Diagnosis of Diabetes Mellitus 567
Types of Diabetes Mellitus 567
Prevention of Type 2 Diabetes Mellitus 569
Acute Complications of Diabetes Mellitus 569
Chronic Complications of Diabetes Mellitus 571
Treatment Goals 573
Evaluating Diabetes Treatment 574
Nutrition Therapy: Dietary Recommendations 575
Nutrition Therapy: Meal-Planning Strategies 577
Insulin Therapy 580
Antidiabetic Drugs 583
Physical Activity and Diabetes Management 584
Sick-Day Management 585
Pregnancy in Type 1 or Type 2 Diabetes 586
Gestational Diabetes 586
Nutrition in Practice The Metabolic Syndrome 591
Chapter 21
Nutrition and Cardiovascular Diseases 595
Consequences of Atherosclerosis 597
Causes of Atherosclerosis 597
Symptoms of Coronary Heart Disease 599
Evaluating Risk for Coronary Heart Disease 599
Lifestyle Management to Reduce CHD Risk 600
Vitamin Supplementation and CHD Risk 603
Lifestyle Changes for Hypertriglyceridemia 605
Drug Therapies for CHD Prevention 605
Treatment of Heart Attack 607
Stroke Prevention 608
Stroke Management 608
Factors That Influence Blood Pressure 609
Factors That Contribute to Hypertension 609
Treatment of Hypertension 611
Consequences of Heart Failure 614
Medical Management of Heart Failure 615
Nutrition in Practice Helping People with Feeding
Disabilities 620
Chapter 22
Nutrition and Renal Diseases 625
Consequences of the Nephrotic Syndrome 627
Treatment of the Nephrotic Syndrome 627
Causes of Acute Kidney Injury 630
Consequences of Acute Kidney Injury 630
Treatment of Acute Kidney Injury 631
Consequences of Chronic Kidney Disease 633
Treatment of Chronic Kidney Disease 635
Kidney Transplants 640
Formation of Kidney Stones 642
Consequences of Kidney Stones 643
Prevention and Treatment of Kidney Stones 643
Nutrition in Practice Dialysis 648
Chapter 23
Nutrition, Cancer, and HIV Infection 653
How Cancer Develops 654
Nutrition and Cancer Risk 655
Consequences of Cancer 658
Treatments for Cancer 658
Nutrition Therapy for Cancer 661
Prevention of HIV Infection 665
Consequences of HIV Infection 666
Treatments for HIV Infection 668
Nutrition Therapy for HIV Infection 669
Nutrition in Practice Ethical Issues in Nutrition
Care 675
Contents xiii
Appendix A Aids to Calculation A-2 Chapter 19
a.1 Conversion Factors A-2 Man with Cirrhosis 556
a.2 Percentages A-2 Chapter 20
a.3 Weights and Measures A-3
Child with Type 1 Diabetes 585
Appendix B WHO: Nutrition Recommendations B-1
Woman with Type 2 Diabetes 587
Appendix C Choose Your Foods: Food Lists for
Chapter 21
Diabetes C-1
C.1 The Food Lists C-1 Patient with Cardiovascular Disease 614
C.2 Serving Sizes C-1 Chapter 22
C.3 The Foods on the Lists C-1 Woman with Acute Kidney Injury 632
C.4 Controlling Energy, Fat, and Sodium C-2 Man with Chronic Kidney Disease 640
C.5 Planning a Healthy Diet C-3
Chapter 23
Appendix D Physical Activity and Energy
Woman with Cancer 664
Requirements D-1
Man with HIV Infection 671
Appendix E Nutrition Assessment: Supplemental
Information E-1
E.1 Weight Gain during Pregnancy E-1 How To Features
E.2 Growth Charts E-1 Chapter 1
E.3 Measures of Body Fat and Lean Tissue E-2 Calculate the Energy a Food Provides 7
E.4 Nutritional Anemias E-8
Chapter 3
E.5 Cautions about Nutrition Assessment E-12
Reduce Intakes of Added Sugars 76
Appendix F Enteral Formulas F-1
Chapter 4
Glossary GL-1
Make Heart-Healthy Choices—by Food Group 110
Index I-1
Chapter 5
Calculate Recommended Protein Intakes 136
Case Studies
Chapter 6
Chapter 10
Estimate Energy Requirements 156
Woman in Her First Pregnancy 294
Chapter 7
Chapter 11
Apply Behavior Modification to Manage Body
Boy with Disruptive Behavior 324 Fatness 187
Chapter 12
Chapter 9
Elderly Man with a Poor Diet 366 Cut Salt Intake 243
Chapter 13 Add Calcium to Daily Meals 249
Nutrition Screening and Assessment 396 Add Iron to Daily Meals 257
Chapter 14 Chapter 11
Implementing Nutrition Care 407 Protect against Lead Toxicity 322
Chapter 15 Chapter 12
Injured Hiker Requiring Enteral Nutrition Support 448 Turn Convenience Foods into Nutritious Meals 368
Patient with Intestinal Disease Requiring Parenteral Stretch Food Dollars and Reduce Waste 375
Nutrition 456
Chapter 13
Chapter 16
Measure Length and Height 390
Patient with a Severe Burn 477 Measure Weight 390
Elderly Man with Emphysema 480 Estimate and Evaluate Changes in Body Weight 392
Chapter 17
Chapter 14
Woman with GERD 496 Estimate Appropriate Energy Intakes for Hospital
Nutrition Care after Gastric Surgery 503 Patients 408
Chapter 18 Help Hospital Patients Improve Their Food
Patient with Short Bowel Syndrome 533 Intakes 415
Young Adult with Irritable Bowel Syndrome 535 Prevent Diet-Drug Interactions 421

xiv Contents
Chapter 15 Chapter 18
Help Patients Improve Intakes with Oral Supplements 435 Follow a Fat-Restricted Diet 522
Help Patients Cope with Tube Feedings 442 Chapter 19
Plan a Tube Feeding Schedule 444 Help the Cirrhosis Patient Eat Enough Food 554
Administer Medications to Patients Receiving Tube Chapter 20
Feedings 446
Use Carbohydrate Counting in Clinical Practice 578
Express the Osmolar Concentration of a Solution 449
Chapter 21
Calculate the Macronutrient and Energy Content
of a Parenteral Solution 453 Implement a Heart-Healthy Diet 604
Reduce Sodium Intake 613
Chapter 16
Estimate Energy Needs Using Disease-Specific Stress Chapter 22
Factors 475 Help Patients Comply with a Renal Diet 640
Chapter 17 Chapter 23
Improve Acceptance of Mechanically Altered Foods 493 Increase kCalories and Protein in Meals 662
Manage Gastroesophageal Reflux Disease 496 Help Patients Handle Food-Related Problems 663
Alter the Diet to Reduce Symptoms of Dumping
Syndrome 502
Alter Dietary Habits to Achieve and Maintain Weight Loss
after Bariatric Surgery 505

Contents xv
 Preface
We are pleased to present this seventh edition
Nutrition for Health and Health Care
Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Changes for This Edition Chapter 7

xvi
Chapter 8
Chapter 16

Chapter 17
Chapter 9

acid regurgitation, heartburn, bloating, pernicious

anemia.

Chapter 18
Chapter 10

Chapter 11
Chapter 19

Chapter 20
Chapter 12

Chapter 13

Chapter 14

Chapter 21
Chapter 15

specialized nutrition support oral nutrition

support

Preface xvii
Chapter 22

protein-energy wasting.

hypocitraturia

Chapter 23

MindTap: Empower Your

Students

Features of this Text

Access Everything You Need

in One Place

Empower Students to Reach

their Potential

xviii Preface
Control Your Course—
and Your Content
Get a Dedicated Team, Whenever
You Need Them
Ancillaries
●●
A test bank is available through Cengage Learning
Testing Powered by Cognero, a flexible online system
that allows instructors to author, edit, and manage test
bank content from multiple Cengage Learning solu-
tions; create multiple test versions in an instant; and
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instructor wants.
Instructor Companion Site
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Preface xix
 Acknowledgments

xx
 Overview of Nutrition
and Health
Chapter Sections and Learning Objectives (LOs)

1.1 Food Choices

LO 1.1 Describe the factors that influence personal food choices.

1.2 The Nutrients

LO 1.2 Identify which of the major classes of nutrients are organic and which
yield energy.

1.3 Nutrient Recommendations

LO 1.3 Describe the four categories of the Dietary Reference Intakes (DRI),
the Estimated Energy Requirement (EER), and the Acceptable Macronutrient
Distribution Ranges (AMDR).

1.4 National Nutrition Surveys

LO 1.4 Describe the ways in which the kinds of information collected by
researchers from nutrition surveys are used.

1.5 D
 ietary Guidelines, Fitness Guidelines,
and Food Guides
LO 1.5 Explain how each of the dietary ideals can be used to plan a healthy
diet, and how the Dietary Guidelines and USDA Food Patterns help make diet
planning easier.

1.6 Food Labels

LO 1.6 Compare the information on food labels to make selections that meet
specific dietary and health goals.

1.7 Nutrition in Practice: Finding the Truth about Nutrition

LO 1.7 Discuss how misinformation and reliable nutrition information can be
identified.

chapter

Rosenfeld/Flirt/Corbis
1
 Every day, several times a day, you make choices that will either
health

wellness

1.1 Food Choices

health: a range of states with physical,
nutrition
mental, emotional, spiritual, and social
components. At a minimum, health
means freedom from physical disease,
mental disturbances, emotional
distress, spiritual discontent, social
maladjustment, and other negative
states. At a maximum, health means
wellness.
wellness: maximum well-being; the cultural competence
top range of health states; the goal
of the person who strives toward
realizing his or her full potential Preference
physically, mentally, emotionally,
spiritually, and socially.
nutrition: the science of foods and the
nutrients and other substances they
contain, and of their ingestion, digestion,
absorption, transport, metabolism,
interaction, storage, and excretion. A
broader definition includes the study of bioactive food components phytochemicals
the environment and of human behavior
as it relates to these processes.
cultural competence: an awareness
and acceptance of one’s own and
others’ cultures, combined with the
skills needed to interact effectively
Habit
with people of diverse cultures.
bioactive food components:
compounds in foods (either nutrients
or phytochemicals) that alter client patient
physiological processes in the body.
client

2 CHAPTER 1 Overview of Nutrition and Health

 FIGURE 1-1 The Health Line phytochemicals (FIGH-toe-CHEM-ih-
cals): compounds in plants that confer
No matter how well you maintain your health today, you may still be able to improve tomorrow. color, taste, and other characteristics.
Likewise, a person who is well today can slip by failing to maintain health-promoting habits. Some phytochemicals are bioactive
food components in functional foods.
Nutrition in Practice 8 provides details.
Wellness— foodways: the eating habits and
optimal physical,
mental, emotional, culinary practices of a people, region,
spiritual, and social health
or historical period.

Superior
ethnic diets: foodways and cuisines
level of typical of national origins, races,
health
cultural heritages, or geographic
Good
level of locations.
health

Moderate
level of
health

Marginal
level of
health
Death Poor
from level of
disease health

Associations

Ethnic Heritage and Regional Cuisines

foodways

ethnic diets Photo 1-1

Values
Monkey Business Images/Shutterstock.com

ecolabels

halal Ethnic meals and family gatherings

nourish the spirit as well as the
body.

Food Choices 3
 TABLE 1-1 Selected Ethnic Cuisines and Food Choices
Protein
Grains Vegetables Fruit Foods Milk

Asian Millet, rice, Baby corn, bamboo Kumquats, Pork; duck and Soy milk
rice or wheat shoots, bok choy, loquats, lychee, other poultry;

Becky Luigart-Stayner/
noodles leafy greens (such as mandarin fish, octopus,

Encyclopedia/Corbis
amaranth), cabbages, oranges, sea urchin,
mung bean sprouts, melons, pears, squid, and
­scallions, seaweed, persimmon, other seafood;
snow peas, straw plums soybeans, tofu;
mushrooms, water eggs; cashews,
chestnuts, wild yam peanuts

Mediterranean Bulgur, cous- Artichokes, Berries, dates, Fish and other Feta, goat,
cous, focaccia, cucumbers, figs, grapes, seafood, mozzarella,
Italian bread, eggplant, fennel, lemons, ­melons, gyros, lamb, parmesan, provo-
pastas, pita grape leaves, leafy olives, oranges, pork, ­sausage, lone, and ricotta
Photodisc, Inc./
Getty Images

pocket bread, greens, leeks, pomegranates, chicken, fava cheeses; yogurt

polenta, rice onions, peppers, raisins beans, ­lentils, and yogurt
tomatoes almonds, walnuts beverages

Mexican Hominy, Bell peppers, ­cactus, Avocado, Beans, refried Cheese, flan
masa (corn cassava, chayote, bananas, guava, beans, beef, (baked caramel
Photodisc/Getty Images

flour dough), chili ­pepper, corn, lemons, limes, goat, pork, custard), milk in
tortillas (corn jicama, onions, mango, oranges, ­chorizo, chicken, beverages
Mitch Hrdlicka/

or flour), rice summer squash, papaya, plantain fish, eggs

tomatoes, winter
squash, yams

Social Interaction

Emotional State

Marketing

Availability, Convenience, and Economy

4 CHAPTER 1 Overview of Nutrition and Health

 Photo 1-2

wavebreakmedia/Shutterstock.com
Age

Nutrition is only one of the many factors

that influence people’s food choices.

Body Weight and Image

Medical Conditions

Health and Nutrition

whole foods: fresh foods such as

whole foods
vegetables, grains, legumes, meats,
and milk that are unprocessed or
minimally processed.
processed foods processed foods: foods that have been
intentionally changed by the addition
of substances, or a method of cooking,
preserving, milling, or such.
ultra-processed foods: foods that have
ultra-processed foods been made from substances that are
typically used in food preparation, but
not consumed as foods by themselves
(such as oils, fats, flours, refined
starches, and sugars) that undergo
further processing by adding a little,
if any, minimally processed foods, salt
and other preservatives, and additives
such as flavors and colors.

Food Choices 5
 Review Notes
●● A person selects foods for many different reasons.
●● Food choices influence health—both positively and negatively. Individual food selections
neither make nor break a diet’s healthfulness, but the balance of foods selected over time
can make an important difference to health.
●● In the interest of health, people are wise to think “nutrition” when making their food choices.

1.2 The Nutrients

nutrients

nutrients: substances obtained from

food and used in the body to provide
energy and structural materials and to Six Classes of Nutrients
serve as regulating agents to promote
growth, maintenance, and repair.
Nutrients may also reduce the risks of
some diseases.
essential nutrients: nutrients a person
must obtain from food because the body
cannot make them for itself in sufficient
quantities to meet physiological needs.
essential nutrients
organic: in chemistry, substances or
molecules containing carbon–carbon Carbohydrates, Fats, and Proteins
bonds or carbon–hydrogen bonds. The
four organic nutrients are carbohydrate, organic
fat, protein, and vitamins.
energy-yielding nutrients: the nutrients energy-yielding nutrients
that break down to yield energy the
body can use. The three energy-yielding Vitamins, Minerals, and Water
nutrients are carbohydrate, protein,
and fat.
inorganic
inorganic: not containing carbon or
pertaining to living organisms. The two
classes of nutrients that are inorganic
are minerals and water.
calories: a measure of heat energy.
kCalories: A Measure of Energy
Food energy is measured in
kilocalories (1000 calories equal calories
1 kilocalorie), abbreviated kcalories or
kcal. One kcalorie is the amount of heat
necessary to raise the temperature of
organic
1 kilogram (kg) of water 18C. The scientific
use of the term kcalorie is the same as
the popular use of the term calorie. Metabolism

6 CHAPTER 1 Overview of Nutrition and Health

Another random document with
no related content on Scribd:
case they would have been too obtuse to notice it.
“We all wish that.” Lady Wargrave pursued her advantage
pitilessly. “And I am sure I speak for his Grace as well as for the rest
of us.” She trained a look of malicious triumph upon the perplexed
and frowning face of her brother.
As became a consummate tactician who now had the affair well
in hand, Charlotte gave the Duke a moment to intervene if he felt
inclined to do so. But she well knew, a kind of instinct told her, that
the attack had succeeded completely. The housekeeper made such
a feeble attempt to parry it, that for the time being her champion was
dumb. Nor was this surprising. In the opinion of both ladies the
sinister charge of collusion had now been proved to the hilt.
Lady Wargrave having given her brother due opportunity for a
further defense of Mrs. Sanderson, which he had quite failed to
grasp, proceeded coldly and at leisure to administer the coup de
grâce.
“I am afraid, Mrs. Sanderson,” she said, “that in these
circumstances only one course is open to you now.”
She was too adroit, however, to state exactly what that course
was. She was content merely to suggest it. But Harriet did not need
to be told what the particular alternative was that her ladyship had in
mind.
“You wish me to resign my position,” she said, in a low calm
voice. She turned with tears in her eyes to the eldest daughter of the
house. “I beg leave to give a month’s notice from today, my lady. If
you would like me to go sooner, I will do so at any time you wish.”
The words and manner showed a consideration wholly lacking in
the measure meted out to herself. There was so little of pride or of
wounded dignity that the tears were running in a stream down the
pale cheeks. Uppermost in Harriet Sanderson was still a feeling of
profound veneration for those to whom she had dedicated the best
years of her life.

IV
 The ladies of the Family had won the day. Mrs. Sanderson was
going. It was an occasion for rejoicing. She had intrigued
disgracefully; moreover, it had long felt that this clever, unscrupulous,
plausible woman had gained a dangerous ascendancy over the head
of the house. But Aunt Charlotte, it seemed, with the tactical skill for
which she was famous, had driven her into a corner and had forced
her to surrender.
In the opinion of Sarah, Mrs. Sanderson had behaved very well. It
was, of course, impossible to trust that sort of person; but to give the
woman her due, she had appeared to feel her position acutely; she
had promised, moreover, to undo as far as in her lay the mischief
she had caused. The ladies saw no inconsistency in that. They had
formed a low opinion of Mrs. Sanderson—for what reason they didn’t
quite know—but now that she had received her congée and they
were to have their own way at last there would be no harm in taking
up a magnanimous attitude towards her.
As far as it went this was well enough, but a serious and solemn
task had been imposed upon various people by the circumstances of
the case. It now seemed of vital importance to those concerned that
Jack should become engaged to Marjorie without further delay. With
that end in view the ladies of the Family were now working like
beavers. But all they had done so far had not been enough. In vain
had the lure been laid in sight of the bird. In vain had they used the
arts and the subtleties of their sex. For several weeks now Jack and
Marjorie had been thrown together on every conceivable pretext, yet
the only result had been that the future head of Bridport House had
re-affirmed a fixed intention of taking a wife from the stage.
Three days after Lady Wargrave had gained her signal triumph
over Mrs. Sanderson, the Duke was at home to an odd visitor. In
obedience to the written request of his Grace’s private secretary,
Sergeant Kelly presented himself about noon at Bridport House.
Fortunately, Joe had been able to arrange for a day off for the
purpose. Thus the dignity of man, also the dignity of the Metropolitan
Force, were upheld by impressive mufti. He had discarded uniform
for his best Sunday cutaway, old and rather shining it was true, but
black and braided, with every crease removed by Eliza’s iron; a pair
of light gray trousers, superbly checked; a white choker tie and a
horse-shoe pin; while to crown all, a massive gold albert, a recent
gift from Mary, was slung across a noble expanse of broadcloth
waistcoat.
“Good morning, Sergeant Kelly,” said a musical voice, as soon as
the visitor was announced. The Duke in the depths of his invalid
chair looked at him from under the brows of a satyr. “Excuse my
rising. I’m a bit below the weather, as you see.”
Joe, secretly prepared for anything in the matter of his reception,
was impressed most favorably by such a greeting. Somehow the
note of cordiality was so exactly that of one man of the world to
another, that Joe was conscious of a subtle feeling of flattery. He
was invited to sit, and he sat on the extreme verge of a Sheraton
masterpiece, pensively twisting between his hands a brand-new
bowler hat purchased that morning en route to Bridport House.
“Sergeant Kelly,” said the Duke, speaking with a directness that
Joe admired, “I liked your letter. It was that of a sensible man.”
“Good of your Grace to say so,” said Joe, a nice mingling of
dignity and deference.
“I agree with you that the matter is extremely vexatious.”
Joe took a long breath. “It’s haggeravating, sir,” said he.
“Quite so,” said his Grace, with a whimsical smile. “But as a
matter of curiosity, may I ask what had led you to that conclusion?”
“Just this, sir.” Joe laid the new bowler hat on the carpet, squared
his shoulders and fixed the Duke with his eye. “The aristocracy’s the
aristocracy, the middle-class is the middle-class, and the lower
h’orders are the lower h’orders—there they are and you can’t alter
’em. Leastways that was the opinion of the Marquis.”
“I’m not sure that I know your friend,” said the Duke with
charming urbanity, “but I’m convinced his views are sound. If I read
your letter aright, you are as much opposed to the suggested
alliance between your daughter and my kinsman as I am myself.”
 “That is so, your Grace. It simply won’t do.”
“I quite agree,” said the Duke, “but from your point of view—why
won’t it? I ask merely for information.”
“Why won’t it, sir?” said Joe, surprisedly. “Don’t I say the
aristocracy’s the aristocracy?”
“In other words you disapprove of them on principle?”
“No, sir, it’s because I respect ’em so highly,” said Joe, with a
simple largeness that bore no trace of the sycophant. “I’ve not
reggerlated the traffic at Hyde Park Corner all these years without
learning that it won’t do to keep on mixing things up in the way we’re
doing at present. Things are in a state of flux, as you might say.”
“Profoundly true,” said the Duke, with a fine appearance of
gravity. “And I have asked you to come here, Sergeant Kelly, to
advise me in a very delicate matter. In the first place, I assume that
you have withheld your consent to this ridiculous marriage.”
“That is so, your Grace. But the young parties are that
headstrong they may not respect their elders. I told the young
gentleman what my feeling was, and I told the girl, but I’m sorry to
say they laughed at me. Yes, sir, society is in a state of flux and no
mistake.”
“Well, Sergeant Kelly, what’s to be done?”
“I should like your Grace to speak a word to the parties.
Seemingly they take no notice of me. But perhaps they might of you,
sir.”
The Duke smiled and shook his head.
“Well, sir, they only laugh at me,” said Joe. “But with you it would
be different.” And then with admirable directness: “Why not see the
girl and give her your views in the matter? She’s very sensible and
she’s been well brought up.”
The Duke looked at his visitor steadily. If his Grace was in search
of arrière pensée, he failed to find a sign of it in that transparently
honest countenance.
 “A bold suggestion,” he said, with a smile. “But I don’t know that I
have any particular aptitude for handling headstrong young women.”
Joe promptly rebutted the ducal modesty. “Your words would
carry weight, sir. She’s a girl who knows what’s what, I give you my
word.”
The Duke could hardly keep from laughing outright at the sublime
seriousness of this old bobby. But at the same time curiosity stirred
him. What sort of a girl was this who owned such a genial grotesque
of a father? It would impinge on the domain of comic opera to instal
such a being as the future châtelaine of Bridport House. Still, as his
visitor shrewdly said, society was in a state of flux.
“My own belief is,” said Joe, “that she’s the best girl in England,
and if your Grace would set your point of view before her as you
have set it before me, I’m thinking she’d do her best to help us.”
The Duke was impressed by such candor, such openness, such
simplicity. After all, there was just a chance that things might take a
more hopeful turn.
“She’s not one to go where she’s not wanted, sir,” said Joe. “And
my belief is that if you have a little talk with her and let her know how
you feel about it, you may be spared a deal o’ trouble.”
“You really think that?” said the Duke with a sigh of relief.
“I do, sir. Leastways, if you ain’t, Joseph Kelly will be
disappointed.”
Such disinterestedness was not exactly flattering, yet the Duke
was touched by it. Indeed, Sergeant Kelly’s sturdy common sense
was so reassuring that he was invited to have a cigar. At the request
of his host, he pressed the bell, one long and one short, and in the
process of time a servant appeared with a box of Coronas. Joe
chose one, smelt it, placed it to his ear and then put it sedately in his
pocket.
“I’ll not smoke it now, sir,” he said urbanely. “I’ll keep it until I can
really enjoy it.”
 He was graciously invited to take several. With an air of polite
deprecation he helped himself to three more. Then he realized that
the time had come to withdraw.
The parting was one of mutual esteem. If the girl would consent
to pay a visit to Bridport House, the Duke would see her gladly. But
again his Grace affirmed that he was not an optimist. Society was in
a state of flux, he quite agreed, democracy was knocking at the gate
and none knew the next turn in the game. Still the Duke was not
unmindful of Sergeant Kelly’s remarkable disinterestedness, and
took a cordial leave of him, fully prepared to follow his advice in this
affair of thorns.
As soon as the door had closed upon the dignified form of
Sergeant Kelly, the Duke lay back in his chair fighting a storm of
laughter. Cursed with a sense of humor, at all times a great handicap
for such a one as himself, its expression had seldom been less
opportune or more uncomfortable. For there was really nothing to
laugh at in a matter of this kind. The thing was too grimly serious.
Still, for the moment, this amateur of the human comedy was the
victim of a divided mind. He wanted to laugh until he ached over this
solemn policeman upholding the fabric of society.
“By gad, he’s right,” Albert John ruminated, as he dipped gout-
ridden fingers in his ravished cigar box. “Things are in a state of
flux.” He cut off the end of a cigar. “My own view is that this
monstrous bluff which these poor fools have allowed some of us to
put up since the Conquest, more or less, will mighty soon be about
our ears. However,”—Albert John placed the cigar between his lips
—“it hardly does to say so.”
For a time this was the sum of his reflections. Then he pressed
the bell at his elbow and the servant reappeared.
“Ask Mr. Twalmley to be good enough to telephone to Mr.
Dinneford. I wish to see him at once.”
 CHAPTER VII
A TRAGIC COIL
I
Mary, breakfasting late and at leisure, before her ride at eleven,
had propped the Morning Post against the coffee-pot. Milly was
arranging roses in a blue bowl.
“I’m miserable!” Mary suddenly proclaimed. She had let her eyes
stray to the column devoted to marriage and the giving in marriage,
and at last she had flung the paper away from her.
“Get on with your breakfast,” said the practical Milly. “I’ve really
no patience with you.”
Mary rose from the table with big trouble in her face.
“You’re a gaby,” said Milly, scornfully. “If everybody was like you
there’d be no carrying on the world at all. You’re absurd. Mother is
quite annoyed with you, and so am I.”
“I’m simply wretched.” The tone was very far from that of the fine
resolute creature whom Milly adored.
The truth was Mary had been following a policy of drift and it was
beginning to tell upon her. Nearly a week had gone since the visit to
Laxton had disclosed a state of things which had trebly confounded
confusion. Besides, that ill-timed pilgrimage had given duty a sharper
point, a keener edge, but as yet she had not gathered the force of
will to meet the hard logic of the matter squarely.
In spite of a growing resolve to make an end of a situation that all
at once had become intolerable, she had weakly consented to ride
that morning with Jack as usual. So far he had proved the stronger,
no doubt because two factors of supreme importance were on his
side. One was the promise into which very incautiously she had let
herself be lured, to which he had ruthlessly held her, the other the
simple fact that she was deeply in love with him. It had been very
perilous to temporize, yet having been weak enough to do so, each
passing day tightened her bonds. The little scheme had failed.
Laxton had caused not the slightest change in his attitude; he was
not the kind of man to be influenced by things of that kind; only a
simpleton like herself would expect him to be! No, the plain truth was
he was set more than ever on not giving her up, and it was going to
be a desperate business to compel him. To make matters worse his
attraction for her was great. There was a force, a quality about him
which she didn’t know how to resist. When they were apart she
made resolves which when they were together she found herself
unable to keep. The truth was, the cry of nature was too strong.
Milly looked up from her roses to study a picture of distraction.
“You odd creature.” A toss of a sagacious head.
The charge was admitted frankly, freely, and fully.
“I don’t understand you in the least.” A wrinkling of a pert nose.
“I don’t understand myself.”
Milly looked at her wonderingly. “I really don’t. You are quite
beyond me. If you were actually afraid of these people, which I don’t
for a moment think you are, one might begin to see what’s at the
back of your absurd mind.”
“Why don’t you think I’m afraid of them?” Mary in spite of herself
was a little amused by the downrightness.
The question brought her right up against an eye of very honest
admiration.
“Because, Miss Lawrence, it simply isn’t in you to be afraid of
anybody.”
Princess Bedalia shook a rueful head. “You say that because you
don’t know all. I’m in a mortal funk of Bridport House.”
“That I won’t believe,” said the robust Milly. “And if a fit of high-
falutin’ sentiment, for which you’ll get not an ounce of credit, causes
you to throw away your happiness, and turn your life into a sob-story,
neither my mother nor I will ever forgive you, so there!”
“You seem to forget that I am the housekeeper’s niece.”
“As though it mattered.” The pert nose twitched furiously. “As
though it matters a row of little apples. You are yourself—your big
and splendid self. Any man is lucky to get you.”
But the large, long-lashed eyes were full of pain. “We look at
things so differently. I can’t explain what I mean or what I feel, but I
want to see the whole thing, if I can, as others see it.”
“We are the others—mother and I,” said Milly, stoutly. “But as we
are not titled snobs with Bridport House stamped on our notepaper, I
suppose we don’t count.”
“That’s not fair.” A curious look came into Mary’s face, which Milly
had noticed before and, for a reason she couldn’t explain, somehow
resented. “They have their point of view and it’s right that they should
have. Without it they wouldn’t be what they are, would they?”
“You speak as if they were better than other people.”
“Why, of course.”
“I shall begin to think you are as bad as they are,” Milly burst out
impatiently. “You are the oddest creature. I can understand your not
going where you are not wanted, but that’s no reason why you
should fight for the other side.”
“I want them to have fair play.”
“It’s more than they mean you to have, any way.”
“One oughtn’t to say that.” The tone had a quaint sternness,
charming to the ear, yet with a great power of affront for the soul of
Milly.
“Miss Lawrence,” said that democrat, “you annoy me. If you go
on like this before mother she’ll shake you. The trouble with you”—a
rather fierce recourse to a cigarette—“is that you are a bit of a prig.
You must admit that you are a bit of a prig, aren’t you now?”
 “More than a bit of one,” sighed Mary. And then the light of humor
broke over her perplexity. In the eyes of Milly this was her great
saving clause; and in spite of an ever-deepening annoyance with her
friend for the hay she was making of such amazingly brilliant
prospects, she could not help laughing at the comic look of her now.
“You are much too clever to take things so seriously,” said Milly.
“You are not the least bit of a prig in anything else, and that’s why
you made me so angry. Be sensible and follow your luck. Jack
should know far better than you. Besides, if you didn’t mean to keep
your word, why did you give it?”
This was a facer, as the candid Milly intended it to be.
“Because I was a fool.” At the moment that seemed the only
possible answer.

II
The argument had not gone farther when a rather strident “coo-
ee” ascending from the pavement below found its way through the
open window.
“Diana, you are wanted.” The impulsive Milly ran on to the little
balcony to wave a hand of welcome to a young man in the street.
It was the intention, however, of the young man in the street, as
soon as he could find someone to look after his horses, to come up
and have a talk with Mary. To the quick-witted person to whom he
made known that resolve, he seemed much graver than usual. It
hardly required any special clairvoyance on the part of Milly to
realize that something was in the wind.
Three minutes later, Jack had found his way up and Milly had
effaced herself discreetly. This morning that warrior was not quite the
serenely humorous self whom his friends found so engaging. Recent
events had annoyed him, disquieted him, upset him generally, and
the previous afternoon they had culminated in a long and
unsatisfactory interview at Bridport House.
 Those skilled in the signs might have told, from the young man’s
manner, that he had cast himself for a big thinking part. This morning
he was “all out” for diplomacy. He would like Mary to know that his
back was to the wall, and that he must be able to count on her
implicitly in the stern fight ahead; but the crux of the problem was,
and for that reason he felt such a great need of cunning, if he let her
know the full force and depth of the opposition the effect upon her
might be the reverse of what he intended. Even apart from the stab
to her pride, she was quite likely to make it a pretext for further
quixotism. Therefore, Mr. John Dinneford had decided to walk very
delicately indeed this morning.
His Grace, it appeared, had asked to see the lady in the case.
Jack, however, scenting peril in the request, had by no means
consented lightly to that. Diplomacy, assuming a very large D, had
promptly assured him that his kinsman and fiancée were far too
much birds of a feather; their method of looking at large issues was
ominously alike. Mary had developed what Jack called “the Aunt
Sanderson viewpoint” to an alarming degree. Aunt Sanderson, no
doubt, had acquired it in the first place from the fountain head; its
authenticity therefore made it the more perilous.
“Uncle Albert sends his compliments and hopes you’ll be kind
enough to go and see him.” The statement was made so casually
that it was felt to be a masterpiece of the non-committal. He would
defy anyone to tell from his tone how he had fought the old wretch,
how he had tried to outwit him, how he had done his damnedest to
short-circuit a most mischievous resolve.
“Now.” The diplomatist took her boldly by a very fine pair of
shoulders, and so made a violent end of the pause which had
followed the important announcement. “Whatever you do, be careful
not to give away the whole position. There’s a cunning old fox to deal
with, and if he finds the weak spot, we’re done.”
“You mean he thinks as I do?”
“I don’t say he does exactly, but, of course, he may. When you
come to Bridport House, you are up against all sorts of crassness.”
 “Or common sense, whichever you choose to call it,” said the
troubled Mary.
“Don’t you go playing for them.” He shook the fine shoulders in a
masterful colonial manner. “If you do, I’ll never forgive you. Bridport
House can be trusted to take very good care of itself. We’ve got to
keep our own end going. If we have really made up our minds to get
married, no one has a right to prevent us, and it’s up to you to let his
Grace know that.”
Again came the look of trouble. “But suppose I don’t happen to
think so?”
“I think so for you. In fact, I think it so strongly that I intend to
answer for both.”
She could not help secretly admiring this cool audacity. At any
rate, it was the speech of a man who knew his own mind, and in
spite of herself it pleased her.
“Now, remember.” Once more the over-bold wooer resorted to
physical violence: “You simply can’t afford to enjoy the luxury of your
fine feelings in this scene of the comedy. As I say, he’s a cunning old
fox and he’ll play on them for all he’s worth.”
“But why should he?”
“Because he knows you are Mrs. Sanderson’s niece.”
“In his opinion that would make one the less likely to have them,
wouldn’t it?” She tried very hard to keep so much as a suspicion of
bitterness out of her tone, yet somehow it seemed almost impossible
to do that.
“He’s not exactly a fool. Nobody knows better than he that your
Aunt Sanderson is more royalist than the king. And my view is that
he and she have laid their heads together in order to work upon your
scruples.”
“Pray, why shouldn’t they? Isn’t it right that they should?”
“There you go!” he said sternly. “Now, look here.” In the intensity
of the moment his face was almost touching hers. “I’m next in at
Bridport House, so this is my own private funeral. But I just want to
say this. A man can’t go knocking about the world in the way I have
done without getting through to certain things. And as soon as that
happens one no longer sees Bridport House at the angle at which it
sees itself. White marble and precedence were all very well in the
days of Queen Victoria, but they won’t build airships, you know.”
“I never heard of a duchess building airships.”
“It’s the duke who is going to do the building. The particular hobo
I’m figuring on has got to take a hand in all sorts of stunts at this
moment of the world’s progress which will make his distinguished
forbears turn in their graves, no doubt. It seems to me he’s got to do
a single on the big time, as they say in vaudeville, and the finest girl
in the western hemisphere must keep him up to his job.”
“‘Some’ talk,” said Mary, with a smile rather drawn and
constrained.
“You see”—the force of his candor amused her considerably
—“I’ve drawn a big prize in the lottery, and if I let myself be robbed of
it by other people’s tomfool tricks, I’m a guy, a dead-beat, an out and
out dud.”
“But don’t you see,” she urged, laughing a little, although
suffering bitterly, “how cruel it would be for them, poor souls? We
must think of them a little.”
“Why should they come in at all?”
“I really think they ought, poor dears. After all, they stand for
something.” She recalled their former talk on this vexed subject.
“What do they stand for?—that’s the point. They are an inbred lot,
a mass of conceit and silly prejudice. I’m sorry to give them away like
this, but, after all, they are only very distant relations to whom I owe
nothing, and they have a trick of annoying me unspeakably.”
“I won’t have you say such things.” The stern line of a truly
adorable mouth was a delight, a challenge. “You are one of them,
whether you want to be or whether you don’t, and it’s your duty to
stand by them. Noblesse oblige, you know.”
 “And that means a scrupulous respect for the feelings of other
people, if it means anything. No, let us see things as they are and
come down to bedrock.” And as the Tenderfoot spoke after this
manner, he took a hand of hers in each of his in a fashion at once
whimsical, delicate, and loverlike. Somehow he had the power to put
an enchantment upon her. “You’ve got to marry me whatever
happens.”
“Oh, don’t ask me to do that.” Black trouble was now in her eyes.
“Don’t ask me to go where I’m not wanted.”
“Certainly you shan’t. We can do without Bridport House, and if
they can do without us, by all means let ’em.”
“But they are in a cleft stick, aren’t they? If you insist, they will
simply have to climb down, and that’s why it would be cruel to make
them. Don’t be too hard upon them—please!” A sudden change of
voice, rich and surprising, held him like magic. “Somehow they don’t
quite seem to deserve it. They have their points. And they are really
rather big and fine if you see them as I do.”
“They are crass, conceited, narrow, ossified. They think the world
was made for ’em, instead of thinking they were made for the world.
It’s time they had a lesson. And you and I have got to teach ’em.” He
took her wrists and drew her to him. “We’ve got to larn ’em to be
toads—you and me.”
“On these grounds you command me!” The flash of glorious eyes
was a direct challenge.
“No, on these—you darling.” And he took her in his arms and
held her in a grip of iron.

III
“Please, please!”
Reluctantly he let her go—provisionally and on sufferance.
But there was something in her face that looked like fear. The
observant lover saw it at once, and the invincible lover tried to dispel
it.
 “Why take it tragically?” he said. “It’s a thing to laugh at, really.”
She shook a solemn head. “We must think of them—you must at
any rate. You are all they have, and you are bound to play for them
as well as you know how—aren’t you, my dear?” The soft fall of her
voice laid a siren’s spell upon him. His eyes glowed as he looked at
her.
“No, I don’t see it in that way,” he said. “Somehow I can’t. It’s my
colonial outlook, I daresay—anyhow there it is—simply us two. The
bedrock of the matter is you and me? And when you get down to
that, other people don’t come in, do they?”
Again she shook a head rather woeful in its defiance. “Poor Aunt
Harriet came to me yesterday. I wish you could have seen her. This
means the end of the world for her. She almost went down on her
knees to implore me not to marry you.”
The Tenderfoot snorted with impatience. “That’s where this old
one-horse island gets me all the time. Things are all wrong here.
They’re positively medieval.”
“You forget”—the tone of the voice was stern dissent—“she’s
been thirty years a servant in the Family.”
“That should make her all the prouder to see her niece married to
the head of it.” He was determined to stand his ground.
“Yes, but she understands what it means to them. She has
thought herself into their skins; she lives and moves and has her
being in Bridport House. Dear soul, it makes me weep to think of her!
She almost forced me to give you up.”
“You can’t do that, not on grounds of that kind.”
“Why can’t I?”
“Because I won’t let you.” She was bound to admire this
masculine decision. “Your Aunt Sanderson is a woman of fine
character and Uncle Albert has a great regard for her, but why let
ourselves be sidetracked by prejudice? You see this is the call of the
blood, and—under Providence!—it means the grafting of a very
valuable new strain upon a pretty effete one. I mean no disrespect to
Bridport House, but look what the system of intermarriage has done
for it. From all one hears poor Lyme was better out of the world than
in it. And that parcel of stupid women! And, of course, I should never
have been here at all if another couple of consumptive cousins
hadn’t suddenly decided to hand in their checks. So much for the
feudal system, so much for inbreeding and marrying to order. No, it
won’t do!”
In spite of her own deep conviction, she could not hope to shake
such force and such sincerity. She was bound to admit the strength
of his case. But the power of his argument left her in a miserable
dilemma, from which there seemed but one means of escape. There
must be no half-measures.
“Let us be wise and make an end now,” she said very softly.
“It’s not playing fair if you do,” was the ruthless answer. “Besides,
as I say, Uncle Albert wants to see you.”
“I am quite sure it would be far better to end it all now.”
“You must go and see Uncle Albert before we decide upon
anything,” he said determinedly.
“I don’t mind doing that, if really he wishes it.” There was a queer
little note of reverence in her tone, which the Tenderfoot, having
intelligently anticipated, was inclined to resent as soon as he heard
it. “I don’t know why he should trouble himself with me, but I’ll go as
he asks me to. But whatever happens we can’t possibly get married,
unless——”
“Unless what?” he demanded sternly.
“Unless the head of the house gives a full and free consent, and
of course he’ll never do that.”
“It remains to be seen, doesn’t it?”
“Oh, no, it’s all so clear. Poor Aunt Harriet has made me realize
that. I never saw anyone so upset as she was yesterday; she nearly
broke down, poor dear. She has made me see that there is so much
at stake for them all, that it simply becomes one’s duty not to go on.”
 “Rubbish! Rubbish! Rubbish!” The Tenderfoot suddenly became
tempestuous. “Mere parochialism, I assure you. I’ve been back six
months, and every day it strikes me more and more what a lot we’ve
got to learn. Our so-called social fabric is mainly bunkum. Half the
prejudice in these islands is a mere cloak for damnable
incompetence. Forgive my saying just what is in my mind, but this
flunkeyism of ours—try to keep the daggers out of your eyes, my
charmer!—fairly gets one all the time. In one form or another one’s
always up against it.”
“It isn’t flunkeyism at all.” The air of outrage was nothing less than
adorable.
“Let me finish——”
“Under protest!” Her face was aglow with the light of battle.
“It’s perfectly absurd to take a mere pompous stunt like Bridport
House at its own valuation.”
“I won’t have you vulgar—I won’t allow you to be vulgar!”
“Be it so, Miss Prim—but I don’t apologize. One’s uncles,
cousins, aunts, they are all alike, whether they are yours or mine.
They simply grovel before material greatness—the greatness that
comes of money—that begins and ends with money.”
“Don’t be rude, sir!” The stamp of a particularly smart riding boot,
and a flash of angry eyes were as barbs to this fiat.
“They are all so set on things that don’t matter a bit, that they lose
sight altogether of the one thing that is really important.”
“Pray, what is that?” The eyes held now a lurking, troubled smile;
for him at that moment, their fascination verged upon the tragic.
Suddenly both the slender wrists were seized by this forcible
thinker. “Why the time spirit, you charmer. And that just asks one
simple question. Do you love me—or do you not?”

IV
She tried to keep her eyes from his.
 “You can’t hide the truth,” he cried triumphantly. “And if you think
I’m going to lose you for the sake of some stupid piece of prejudice
you don’t know what it means to live five years in God’s own
country.”
She seemed to shrink into herself. “Don’t you see the
impossibility of the whole thing?” she gasped.
“Frankly, I don’t, or I wouldn’t be such a cad as to badger you. If
you marry me an effete strain is going to be your debtor. Just look at
them—poor devils! Look at the two who died untimely. That’s the
feudal system of marriage working to a logical conclusion. And if I
put it squarely to my kinsman, Albert John, who is by no means a
fool, he’d be the first to admit it. No, it doesn’t matter what your
arguments are, if you override the call of the blood sooner or later
there’s bound to be big trouble.”
The conviction of the tone, the urgency of the manner were
indeed hard to meet. From the only point of view that really mattered
it was impossible to gainsay him, and she was far too intelligent to
try. Suddenly she broke away from him and in a wretched state of
indecision and unhappiness flung herself into a chair.
“The whole thing’s as clear as daylight.” Pitilessly he followed up
the advantage he had won. “There’s really no need to state it. And
once more, to come down to bedrock, far better to make an end of
Bridport House and all that it stands for—just what it does stand for I
have not been able to make out—than that it should perpetuate a
race of inbred incompetents who are merely a fixed charge on the
community.”
“Oh, you don’t see—you don’t see!” The words were rather
feeble, and rather wild, but just then they were all she could offer. Yet
in spite of herself, and in spite of the half-promise the intensely
unhappy Aunt Harriet had wrung from her on the previous afternoon,
the clear-cut determination of this young man, his force and his
breadth, his absolute conviction were beginning to tell heavily.
“You are going to Bridport House to have a word with my
kinsman. And if you’re true blue—and I know you are that—you will
make him see honest daylight. And it ought to be easy, because he
has only to look at you—the finest thing up to now that has found its
way on to this old planet, in order to realize that he’s right up against
it.”
He knew his own mind and she didn’t know hers. Such a man
was terribly hard to resist.
“He says any morning at twelve. I suggest tomorrow.”
“You insist?” She was struggling helplessly in meshes of her own
weaving.
“I insist. And my last word is that if you let the old beast down us,
as of course he’ll try to do, I go back to B. C. and remain a single
man to the end of my days. And I’m not out for that, as long as there
is half a chance of something better. So that’s that.” In the style of
the great lover he laid a hand on each shoulder, looked into the
troubled eyes and kissed her. “And now, if you please, we will witch
the world with noble horsemanship.”
 CHAPTER VIII
A BUSY MORNING
I
The next morning was a busy one for his Grace, and it also marked
a tide in the affairs of Bridport House. Soon after ten the ball
opened with the inauspicious arrival of Lady Wargrave. The head of
the Family had just unfolded his newspaper and put on his
spectacles when her ladyship was announced.
As the redoubtable Charlotte entered the room, the hard glitter of
her eyes and the forward thrust of a dominant chin were ominous
indeed. Bitter experience made her brother only too keenly alive to
these portents.
Without any beating about the bush she came at once to the
point.
“What’s this I hear, Johnnie? Sarah tells me you have revoked
that woman’s notice.”
“Woman!” temporized his Grace. “What woman?” The tone was
velvet.
She glowered at him.
“There’s only one woman in this household, my friend.”
The Duke laid down his Times with an air of extremely well
assumed indifference. Were the parish pump and the minor
domesticities all she could find to interest her, while all sorts of
Radical infamies played Old Harry with the British Constitution?
Lady Wargrave, however, was well inured to this familiar gambit.
“Come, Johnnie,” she said tartly, “don’t waste time. The matter’s
too serious. Sarah says you have asked Mrs. Sanderson to stay on.”