CORNELL UNIVERSITY LIBRARY David Albert Hauck Endowment THE? Relation of Food to Health and Premature Death. By GEO. H. TOWNSEND, LL.B., With the collaboration of FELIX J. LEVY, A.M., M.D. H. G. NICKS, M.D., JtBcturer on Hygiene , Marion Sima College of Medicine . Attending Physician Woman' s Hospital ; IHrector Physical Depart- ment T. M. C.A., St. Louis. AND GEO. CLINTON CRANDALL, B. S. M. D. Professor of General Medicine, Marion Sims College of Medicine, St. Louis. ST. LOUIS, MO. Witt Publishing Company. 1897. Cornell University Library The original of tliis book is in tlie Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924012176867 PREFACE. This is an age of wonderful strides in production, but we fear tfiat man, in improving everytliing else, has, in a great measure lost sight of himself. To the scientist who understands something of the wonderful development of nature, when free from hindrance, there is nothing so utterly astonishing as the weakness and folly of the hu- man race. Believing that ignorance of self is the mother of our devouring evils — disease, vice and crime — the author, with the assistance of his collaborators, has un- dertaken to blaze out a road to a better and higher life, and however painstaking the effort, it would be too much to expect that our labors would produce results that ap- proached the ideal. It is hoped, however, that this book will be of service in pointing out the devious windings into which appetite and surrounding influences often al- lure the thoughtless — resulting in their discomfiture and premature death. Physical, mental and moral perfection can only ex- ist when our lives come into harmony with natural laws, and when we cease to antagonize nature, the work will be done. If we have made plain the most common transgres sions of nature and how to minimize their effects, our pur- pose will have been accomplished. Geo. H. Townsend. St. Louis, Mo,, July, 1897. CONTENTS. Chapter. Pages, I. Introduction .... 1-13 II. Digestive Organs and Processes of Digestion .... 14-40 III. Classification of Foods - - - 41-43 IV. Water .... 44.51 V. Bread, Wheat Foods - - 53-74 VI. Rye, Corn Breads, Corn Foods, Buckwheat ... - 75-80 VII. Oats, Barley .... 81-89 VIII. Potato, Sweet Potato, Rice - 91-97 IX. Peas, Beans, Lentils, Asparagus, Tapioca, Sago, Cabbage, Cauli- flower, Beets,, etc. - - - 99-110 X. Tomato, Lettuce, Celery, Greens Onions, Pumpkins, Radish, Rhu- barb, Cucumbers, Melons - - 111-123 XI. Sugar 125-128 XII. Vegetable vs. Animal Foods - - 129-135 XIII. Animal Foods, Milk, Cream, Butter Butter-milk^ Cheese, Milk Food 137-150 XIV. Meat, Beef,. Viscera, Mutton,. Veal 151-160 XV. Pork, Fowl, Fish, Shell Fish, Egg, Fat - -■ - - - - 161-173 XVII. Fruit, Apple, Peach, Pear,, Quince, Grape 175-190 XVIII. Plum, Cherry, Berries, Banana, Lemon, Orange, Date, Figs, Cocoanut, Nut Foods - - 191-206 XIX. Condiments, Drinks - - - 207-223 XX. Infant Feeding .... 225-243 XXI. Diet in Puberty - - - 245-256 CONTENTS. XXII. Dietetic Errors and Dietaries - - 2S7-27S XXIII. Composition of Foods - - - 277-286 XXIV. diosyncrasies and Idiosyncrasia - 281-298 XXV, Causes and Significance of Pain - 299-305 XXVI. Feeding the Sick and Diet in Acute Diseases 307-314 XXVII. Causes of Indigestion - - - 315-334 XXVIIl. Diseases of the Stomach - - - 335-355 XXIX. Diseases of the Intestines, Pancreas and Liver .... 357-373 XXX, Chronic Diseases, Kidney, Diabetes Tuberculosis, Heart, Blood Ves- sels, Rickets, Anaemia, Asth- ma, Leanness, Obesity, Head- ache 375-375 XXXI. Acute Diseases, Cold, Malaria, Scar- let Fever, Diphtheria, Hemorrh- age, Measles, Pneumonia, Skin diseases, Yellow Fever, Blood Poisoning, Whooping Cough, Scrofula, Pleurisy, Erysipelas, Apoplexy, Mumps, Lockjaw, Ty- phoid Fever, Influenza - - 397-414 XXXI 1. Accidents and Emergencies - - 415-422 CHAPTER I. AFFLICTIONS AND PREMATURE DEATH RESULT FROM IGNORANCE. Each age has its philanthropists, those who toil not merely for their own aggrandizement, but for the better- ing, the uplifting of the human race. These make the world better for having lived in it. Such ought to be the desire of every person, and while it is sad to say that it is not the fact, this is truly an age in which proportionately more people are interested in the welfare of the race than at any period in the history of the world. It ought there- fore to naturally follow, that the world should now be making greater strides towards ideal conditions than ever before. Perhaps we are doing this; but it is a matter which many well informed people would gravely question. No doubt but that all will agree, that no movement has ever been inaugurated for the elevation of man, which shows results commensurate with the effort expended. Why is this.' There can be but one answer; it is because all efforts of every kind and character have been directed toward relieving, curing or reforming the individual; whereas, had all the efforts of even ten generations been directed toward preventing evil and disease we would now have an ideal race; but this would require a volume of it- self, whereas the object sought, is to call attention to, and emphasize the fact that, it is ignorance of the laws governing our physical existence, creation, birth, and living, that makes reform movements necessary — movements which seek merely to overcome results of forces without dealing with their causes. This would be denied by nearly every man or woman engaged in trying to reform the world. 2 INTRODUCTORY To illustrate; there are three ways of dealing with drunkenness: (1) Drugs or dipsomania cures. (2) Moral influences, signing the pledge, etc. (3) Prohibition — restraint by law. Now the advocates of each of these methods claim that they deal with the causes of drunkenness, and yet men will not stay cured, nor keep the pledge, neither will they regard the law, and it is a lamentable fact that the army of drunkards is being constantly recruited from the families of the most zealous temperance advocates of the country. Something is wrong; for neither drugs, moral suasion nor law, have succeeded in arresting drunkeness, because the diet and habits of the people cause them to transmit nervous tendencies to each generation, and these are continually crying out for stimulation of some kind. The truth of the matter is that most reformers have ignored the fact, that the hqdy, to a gireiM extent, controls the mind, and therefore, the conduct. We are animals, without the governing instincts of brutes, and so limited in reason and Tcnowledge, as to be unable to properly regulate our conduct. A man born under proper conditions, and given correct knowledge of living, will need neither moral suasion nor prohibition to keep him from the liquor habit, and so far as this world is concerned, will not need any reform movement, or dread of future punishment to make him a good citizen. Some years ago, the writer became profoundly interested in social and economic questions and the elevation of the race through popular edcuation, especially on the principles of living and the proper rela- tion of the individual to society. After studying every phase of human conditions and character, he became im- bued with the belief that more good could be accomplish- THE FIRST INTERVIEW 3 ed by teaching the people the principles governing their physical existence than could be done in any other way. In order to bring this knowledge to them, all sources oiin- formation have been sought, and especially from those phy- sicians whose training and experience warrant them in speaking with some degree of assurance. The facts ob- tained from all sources are given as one interview. Venturing forth in quest of knowledge, the book- maker sought the most learned specialists who have made a life study of food in its relation to health and disease. The first interview with a distinguished specialist in dis- eases of the stomach began with the explanation that the bookmaker was desirous of dispelling some of the dark- ness in which our physical existence is enveloped. "That," replied the doctor "is a great task, and worthy of the best effort that can be given it." WHERE ALL OUR ILLS COME FROM. "Some people declare that the masses cannot be moved to a more rational mode of living." "That is worse than the facts warrant, for there are people who are really anxious to learn more about the principles which govern their existence." "But isn't it also true that many people don't care to know anything?" "Yes, and it is a strange thing that people are will- ing to suffer pain, lose the time of being sick, and then have to pay their money to doctors, when it could all be avoided." "If that be true, what will become of the doctors?" "Oh well, the people could better afford to pay the doctors to keep them well like the Chinese than have to pay them and be sick; but when the people learn that their ills do not come from God, or from Adam, or even 4 NDIVIDUAL RESPONSIBILITY from nature, and learn that they are mostly self inflicted, or at farthest, come from their parents, they will learn how to dispense with both physic and physician." •'That's a good deal to say." "Yes," said the doctor, "but I do not hesitate to say that it is not more than the truth." "How could the people be brought to such a condi- tion .' "They must first realize their individual responsibil- ity." - "How can they be brought to that.?" "By presenting facts to them in a clear and forcible manner, which we will do. Now suppose I say, that practically every person commits suicide, and that a great many also commit manslaughter." "If you did 1 should say that you were either jesting or crazy." "But it is a fact, which I will pro.ve. Let me ask you what would happen if you were to drive recklessly through the streets and in doing so run over several peo- ple and maim or kill them.'" "I would be arrested for manslaughter." "Yes, and it would make no difference, except in the degree of punishment, whether you did it wilfully or negligently, you would be liable both civilly and crimi- nally for injuring or killing another in such a manner. Now suppose your family had typhoid fever, and you should throw out some excrement and poison the well or stream from which your neighbor is supplied and sickness or death results, (which has occurred thousands of times) would it not be just as bad as to negligently kill him by an infectious disease, as to kill him by negligently running over him.-*" RtSULTS OF NEGLIGENCE 5 "Yes, I suppose it would, only the proof more diffi- cult." "But that does not alter the fact, nor atone for the criminality of negligently spreading infectious diseases and death, which is continually being done, but this is not worse than other life destroying negligence which is even more appalling in effect." "1 can not deny your facts nor your conclusions, for they are overwhelming," "Let me give you another illustration. A friend of mine was called to see a child four years old who had a serious intestinal disorder. The child was soon convales- cent, and the doctor said his visits need not continue, but at the same time cautioned the parents to be exceedingly careful about the child's diet for 'two or three weeks.' " "What happened.'" "Well, the day after the doctor's last visit the family had saurkrout for dinner and allowed the child to eat all it wanted under the belief that it would not hurt it," "And that probably killed it." "Yes, it was taken ill at once and the doctor called, but when he found what it had eaten, and the condition the child was in, he bluntly told its parents that they had killed their child." "That was certainly a most distressing thing for the parents." "So it was, but not worse than occurs in nearly every family, although it may not be quite so immediate- ly apparent." "I suppose they excuse themselves on the ground that they did not know any better.'" "Very likely, but that is a poor excuse, for the know- ledge could have been obtained. This suggests the ques- tion? Is a person who is so careless and indifferent to 6. SUICIDE— DURATION OF LIFE things pertaining to Hfe and health, that he killis some one less culpable than one who negligently takes life in some other way?" "Doctor you put things so strongly, I think you could alnaost arouse the dead, and yet every word you have said is true." * "But what I have said only relates to the injury in- flicted on others, and bad as it may seem, self-destruction is far more common and its effects almost endless." "You don't say! What are you trying to make me believe we are?" "Oh, don't get excited, for 1 want to bring out an- other point by asking you a question." "What is it?" "How would you define suicide?" "Well if one wilfully destroys his life, by makirig it shorter than nature intended, that would be suicide." "It would make no difference whether the method was quick or slow, would it?" . "No, if it did it would be making a distinction with- 'out a difference." "Now 1 suppose that everyone will admit that the moral law is higher than the law of the state, and M it recognizes negligence that injures another, the same as i^ wilfully done, the moral responsibility must be equally great. Here is another thing; it must be true, thai: each- individual exists for a purpose, and if so who can measure the wrong of thwarting natupe, by cutting off the natur- al term of life?" "Doctor, you have proven that self-destruction is universal, and now you have gone farther and proven that it is practically suicide." "Yes; wrongs are great or small in propoftiou to their effect, and it is difficult to see wherein an. untimely INCONSISTENCY OF HUMAN CONDUCT 7 death from one cause, that could . have been avoided-, is not as bad as from any other. If the laws of our being were not so grossly violated one hundred years would be an average duration of life, and a hundred and fifty years not uncommon. The or- dinary diseases of life should be wholly unknown, and though it may shock our slumbering senses, the facts make it necessary to say, that we take our own lives and are none the less culpable, because we do it ignorantly — the ignorance of negligence and careless indifference." "That is good reasoning, and it is very strange that no one has ever written of it before." "Yes it is, and the quotation from Shakespeare's Mid- Summer Night's Dream: 'what fools these mortals be' might be aptly applied. Just think, a young man will spend six or eight years in a university studying every- thing in the heavens and on earth except how to live, and if he doesn't kill himself before he finishes a course at college, he frequently does so in a few years after- wards. Here is another curious fact, a mother will sac- rifice her life for the welfare of her child, but before it was born, she did not think it worth while to endow such vigor and character on her babe as to make it fit to live, and though she may love her infant babe far beyond any feeling that could be suggested by words, the chances are one to five that she will hill it before it is a year old by im- proper feeding . ' ' "Then you are a believer in the scriptural text that the iniquity of parents shall be visited unto the third and fourth generations." "Yes, in a measure that is true, but not absolutely; that is, not all iniquities are transmitted. Nature con- stantly strives to correct the mistakes which iitijure. Were it otherwise! the weaknesses and vices continually 8 LACK OF KNOWLEDGE taken up by each generation would soon extinguish the race, if none were cut off." "What is the chief factor in producing the physical and moral imperfections of the race, doctor?" "Well, part of our present social evils are no doubt due to false economic conditions, but if every individual was born right and properly educated even these ■ would disappear." "But as things now exist there must be other great factors besides economic ones that affect the individual." "Yes, many things affect his existence, such as ex- ercise, ventilation, sanitation, clothing, and each are so important, that thousands of lives are annually sacrificed because the natural laws of which they are a part, are violated; but while these affect many, the most important thing of all is food; it affects the whole world." "Since you speak of it, I realize the force of what you say, for I asked a teacher about the quantity and proper proportions of the ordinary foods that would be required for health and vigor and he couldn't tell. He said the physiologies and books of hygiene only gave a little gen- eral knowledge, with very little practical information." "I am not surprised that a teacher couldn't," said the doctor, "a great many physicians could not do it, for they are not employed to keep people well, but to drug them when they are sick, and so long as people prefer to pay for taking medicine, the doctors are powerless and unable to do anything better, however much they might desire it; but the doctor of the future will be employed mainly to prevent disease." "Doctor, since you have said what you have, the question occurs to me, how do people live at all?" "By mere accident or chance. They eat what they want, that is, what their appetite craves, or what may be RIGHT LIVING EASY 9 offered them, no matter whether it suits their require- ments or not. If it makes them suddenly sick, there is not much danger, but if their food is wrong for a number of years, and if its evil effects are not quick in mani- festing themselves, the doctor will finally have a much more serious case to cure, if indeed a cure is not beyond his power." "Then, if I understand you, the people live almost universally in a haphazard way and if they get sick, rely on nostrums and doctors to cure them." '•'Exactly so." "How do you account for it?" "It is partly due to the fact that people believe that proper living is galling; that all the pleasures of life , would be cut off if they had to live by rule; but prob- ably a far greater number are under the impression that their work the weather, or natural causes, produce their ills, when in fact they are self-inflicted," "Well, I have heard these reasons so continuously that I almost come to pity those people who are always saying that something or other in their lives, either their work, the weather, or some accidental circumstance made them ill and wretched." "Is there nothing in this?" "Not much. Most persons can eat almost any food in proper quantity at a proper time if properly prepared, and as to weather and work killing people, who live in accord with natural law, such would be as hard to find as a dishonest alderman" said the doctor, with a somewhat significant twinkle in his eye, then continuing, "it is no harder to live properly than it is to speak or write gram- matically; one doesn't have to think of all the inflections of every part of speech in writing, for correct use of lan- guage come? by knowledge and practice, and good usage 10 USE OF KNOWLEDGE is only difficult to the illiterate. Just so as to living, if you really understand foods and tfieir relation to life, it is easy to be well." "But people often say that they don't live up to what they already know, and what is the use of learning more?" "People who say that it is no use to learn because they do not live up to their knowledge are unconscious of their own ignorance. It is true that no one applies all he knows to each act of his life, and this fact is illustrated in our daily conversation, for however well educated, few persons speak correctly at all times; but would any one say, that because of this being a fact that it is useless for one to get an education? "Nobody but an idiot would say so." "Here is another fact, few live up to their moral en- lightenment, but according to the reason urged for not learning more about our bodily existence, all the efforts put forth to christianize and enlighten the world are useless. We might go still farther and say, that but few people do business as systematically as they know how; is a busi- ness education, therefore, of no use?" "Doctor that is well put, and emphasizes the impor- tance of training." "Yes, knowledge is the main spring of action and the people who will not be controlled are those who are suffer- ing from some defect the result of their own or others' violation of physical laws." "Then you think people who have right knowledge of living will not go far wrong, if they are not already badly warped by somebody's transgression?" "They will not, for it is absolutely certain that un- der no circumstance will the people go as far in their vio- lation of what they know will injure them, even though EFFECTS OF IGNORANCE 11 their inclinations lead them against their knowledge, as they would certainly do, if they were entirely ignorant of the effects of such imprudence." "Then knowledge is useful to recover from errors in living?" "Yes, when we are ignorant we not only injure our- selves, but not knowing the cause of the injury, we are likely to continue until we are beyond any remedy. No language can sufficiently emphasize the fact, that there is nothing of so much value t@ us, as knomng how to live, and to know how and what to eat comes first. "Are we to understand that all the ailments of life come from improper food?" "No, not all of them, but most of them do. Some come from hereditary tendencies, some are thrust upon us, such as infectious dLseases, but if people were to eat the right kind of food in proper quantity, and properly prepared, sickness would scarcely be known at all." "Has physical weakness much to do with our career as individuals?" "Yes, everything; it retards moral and intellectual development, causes a craving for stimulants, drives people to crime, makes labor a burden when it should be a pleasure, causes life to be partially or wholly a failure, and frequently makes the individual a burden to society instead of a blessing. All of which are forcibly illustra- ted by our penal institutions, alms houses and asylums." "There is no doubt, doctor, but what the people need enlightenment upon the subject of proper living more than any other?" "Yes, unless it be the question of heredity and pre- natal influences, but as you want to deal with questions for immediate results there is no field which could possi- bly offer you a greater opportunity for labor." 12 EFFECTS OF IGNORANCE "What would you suggest as a proper scope for a book that would, in your opinion, be of most benefit to the people?" "The qualities and properties of everything used as food should be given, and the best methods of preparing each food product. It would also be well to point out the -■eficiency, if any, of each food and what would be suit- able uiivlsr different conditions to make a complete diet. It would be advisable to mention those foods that have particular value as remedial agents, and suitable diet in all diseases." "Whom should we urge to study a book of this kind.?" "I suppose most people would say that those who are ill need it most, and while it is urgent for them, the great- est good can be done by interesting those who are as yet too young to have suffered irreparable ill from bad exam- ple. As this is beyond question the most important of all edu- cation it should be taken up and taught in our public schools as the most essential branch of the school course." "Then you don't regard school physiologies as of much practical benefit?" "As to that, it certainly isn't objectionable to study physiology and hygiene, but the only trouble is that much of it has no direct bearing on living, and too many suppose they are well informed when they have not learn- ed any more about living than they would have done about house building, by simply exaniining a house and finding thatitwasmadeof brick, mortar, stone, wood and metal," "That will shock some of the teachers." "1 hope not, for 1 was a teacher myself and studied and taught from the school physiologies, but what I did not know would have filled a large book. Too much at- EFFECTS OF IGNORANCE 13 Tcntion cbnnot be given to this, because experience teaches that those who are now healthy are gradually perhaps imper- ceptibly breaking their natural vigor, so that with them it is only a question of time before they will have the commou ailments with which everyone is familiar. If these can be reached they can be saved much distress, while those who are diseased and broken might not be worth but lit- tle after you have taken away all the causes which afflict them. It is a good plan to help all the people, you can, but do not devote all your energy towards working over spoiled material." "Then you think it better to save the coming and future generations." "Yes I would seek them but let the others seek me.' CHAPTER II. DIGESTIVE ORGANS, AND THE PROCESSES OF DIGESTION. "Doctor, in beginning the study of any subject, it is of course very important to start right." "That is true, and if we are to understand the source of health as well as disease, we must know something about the digestive organs and how they work to keep us well, and under what circumstances they will not, or can not work, and thus allow us to get sick." "A great many people don't understand what is meant by digestion." "Digestion is the process by which the various particles of food we eat are dissolved and changed by the digestive secretions and processes into suitable elements for the various uses of the body." "Are the particles taken into and absorbed by the system made very fine.'" "Yes, the particles that are absorbed are so fine that they must be magnified several hundred times before they can be seen by the naked eye." "This is very interesting. Doctor, where does the process begin.'" "It commences where a great many kinds of trouble begin." "That must be in the mouth.'" "Yes, in the mouth and in the kitchen, and unfor- tunately, most people in this, as in other things, use their mouths and kitchens much but not well." "What do you mean by that.'" 14 FUNCTIONS OF SALIVA 15 "That they talk without thinking, eat without chew- ing, cook without knowing how, and eat more than they eat properly." "That is because they don't know how to do any better?" "That's a charitable view and no doubt true in part." "At any rate one is astonished, at how little people know about living and that is true even of the educated classes." "Yes it is. A good many people would dispense with their mouths for eating if they could, and shovel their food into their stomachs just as they would load a wagon with hay, When they get sick, they charge it to anything or everything except their own folly." "Then the great fault is in eating too fast?" "Well, as already stated, digestion is first of all a process of dissolving, and a good many people treat their stomachs as though they had better teeth in them than in their mouths. It is time for people to learn that they on- ly have one set of teeth, and that if they continually im- pose on their stomachs, by compelling them to do the work that should be done by the teeth, sooner or. later, their stomachs will get stubborn and not work at all." "Yes, Doctor, but you forget, don't you, that many kinds of food are ground before they reach the mouth?" "That would seem to be a good point, but somehow ■the creator of man did not ailticipate mills, and conse- quently, arranged an important process of digestion in connection with the uses of the teeth, which cannot be avoided without positive injury." "Then there is no safe way of cheating the teeth out of their grinding business?' "None whatever." 16 MOUTH DIGESTION "What is the important process that you have just mentioned?" "No doubt, you have noticed that when you chew anything, your mouth is soon filled with a slippery ropy fluid, usually known as saliva." "Yes, where does it come from?" "It is a secretion that comes from glands within, and adjoining the mouth each of which has a tube draining into the mouth." "Have these glands names." "Yes, the principal ones are known as parotid, sub- maxillary and sublingual glands and there are small glands scattered through the lining membranes of the mouth and tongue. These are called buccal (mucous and serous) glands." "Do they all secrete the same kind of fluid?" "Well, it is all a digestive agent, though the charac- ter of the secretion of each is different?" What are the various uses or saliva?" "It was formerly supposed that the saliva had no other use than to moisten the food, and no doubt every one has noticed that as soon as they commence to chew anything, the saliva commences to flow; for that reason, it appeared that the saliva was only intended to make the food soft so it could be swallowed easily, but with the aid of modern chemistry, we have learned that saliva is a digestive agent, which must be mixed with the food dur- ing the grinding of the same by the teeth." "What is the nature of the secretion?" "It is an alkaline solvent that dissolves that part of the food known as starch, gum, pectose and similar sub stances." "In what is an alkali different from an acid?" FUNCTIONS OF SALIVA 17 "Probably, the nearest we could describe it would be to say that it is the opposite of acid. If we mix them in proper proportions, according to the strength of each, both will become inert." "Then digestion of all foods containing starch be- gins in the mouth?" "It begins there if the saliva be mixed with the food ;^-ut the fact that so many people swallow their food with- out chewing it, especially all soft foods, such as warm bread, mashed potatoes, pudding, oatmeal and all similar foods, there is not ordinarily sufficient saliva added to digest any quantity worthy of notice. ' ' "Then the old saw, 'who eats slowly lives long' must be true." "It is." "Has the saliva any effect on foods other than the starches.'" "Not as a digestive agent, but it aids in keeping the particles of food that are crushed by the teeth from ad- hering together." "How much saliva is ordinarily secreted in a day.'" "Those who have carefully estimated it, say that eight to ten ounces are daily secreted." "That would hardly include tobacco and gum chew- ers, would it?'' "No, chewing tobacco is a perverted use, and tobac- co chewers have saliva with which to bathe a consid- erable portion of the earth but very little for their food." "Of what temperature does the saliva act on starch?" "At 103° to 112° F. It does not act below 85° F. any extent, nor over 168° F." "Then moderate temperature is an important thing n digestion?" 18 FOUL MOUTHS "Yes, this explains part of tiie ill effects of ices and very hot drinks." "What is the other part?" "Direct damage to the mucous membrane." "Is there anything else about the mouth that aids digestion?" "Nothing that aids it, but something that doesn't aid it." k "What is that?" "Filth. Some people keep their mouths like garbage boxes. They allow all kinds of food to lodge and decay until it even rots their teeth, r.nd then they have a mouth tainted with decaying food and decomposing • bones, which is a harbor for the various kinds of bacteria. ' ' "What harm does this do?" "When food is eaten, these foul accumulations and bacteria are carried to the stomach, and no doubt are often great factors in disturbing the stomach and general system, and one of the sights calculated to make one pity the human race is to see persons cut holes in their flesh to make themselves beautiful with jewelry and yet carry a mouth and teeth coated with putrid matter so offensive in odor that it is disagreeable to be near them." "What becomes of food when it leaves the mouth?" "It passes down a tube called the oesophagus (gul- let) into the stomach." "Do people understand how their stomachs are con- structed?" "No, a great many people suppose their stomachs are copper lined, or at least their habits lead one to that conclusion." "Why do you say that?" "Because they have no regard for their stomachs and give themselyes no concern as to the character or quantity of what they put in them." STRUCTURE OF STOMACH 19 "In what particular?" "It is not an uncommon thing to see people eat soup scalding hot and then drink ice water to cool it. Others make a catch basin of their stomachs and pour in several gallons of beer or large quantities of stronger liquors." "There are but few who do not use mustard, pep- per, horseradish and other intense irritantSjWhile those who are continually taking poisonous drugs are legion. This is not all, the stomach is not supposed to rebel no matter how coarse or tough the food, nor how incompatible the mixtures that ignorance pours into it, and as a result of all this, if the. aches, pains, diseases, misery and deaths could be measured by volume they would make a pyra- mid from the earth to Jupiter." "Suppose you tell us something about the stomach, doctor.?" "1 can do that best by first showing you a photo- graph of it. (See page 20 for illustration.) It is gen- erally described as an irregular shaped sack or pouch, and will hold in normal condition from two up to three and a half pints, although in one case the stomach of a grown person was known to hold only a half pint. Abnormal size is very common, because the majority of the people use their stomachs as a receptacle for the most outlandish collection of indigestible material which a pam- pered civilization can supply. This stretches them so that they are made to retain several gallons of liquid and food un- der which the system groans with the weight of its torture. The modern stomach exposed to view looks much like a fourth of July balloon. The inside of the stomach is lined with mucous membrane, very similar to that of the mouth. This is arranged in many folds running length- wise. If the membrane be examined by a microscope, innumerable pits are seen. These pits indicate the pres- ence of gastric glands," e L A, stomach. B, pyloric end of stomach. C, liver turned up to expose stomach. D, large intestine. E, rec- tum. F, annus. so EXPERIMENTS IN DIGESTION 21 "Do the gastric glands perform an important part in digestion?" "They do, for they secrete what is commonly known as gastric juice." "Are there other glands in the stomach?" "Yes, mucous-forming cells that secrete mucus." "Is the gastric juice anything like saliva?" "Not in the least, for the gastric juice is acid and the saliva alkaline." "Then it is the acid that dissolves the food?" "That depends upon the kind of food you mean. Properly speaking, it is not the acid alone, but the secre- tion of acid and a substance called pepsin, acting togeth- er, that dissolves tissue forming foods, but not starch. There is another substance in the gastric juice called ren- net. This is also called a milk-curdling ferment." "How did they ever find out anything about what was in the stomach, and what goes on in the process of digestion?" "Well, not much was known prior to 1822." "What was discovered at that time?" "That was the time when a man by the name of Alexis Saint Martin had his stomach accidently torn open by the discharge of a musket." "What was the wound like?" "The front part of the sixth rib was blown away, the lung and diaphragm torn; but after a long convales- ence he recovered except that there was a large fistulous operjing into the stomach. This at first had to be ban- daged, but after a time a portion of the mucous mem- brane of the stomach prolapsed until it hung down over the opening, thus acting as a sort of a curtain to the stomach." "That was remarkable." 22 EXPERIMENTS IN DIGESTION "Yes, it furnished Dr„ Beaumont who treated Saint Martin, a practical method of observing the process of digestion. "Who was Dr. Beaumont?" "A surgeon in the service of the United States." "How did he describe the digestive process?" "Dr. Beaumont, in writing of his observation on the stomach of Saint Martin, states that when food first enters the stomach the movements of the stomach are feeble and light, but as digestion goes on, they become more and more vigorous, until the action of the stomach thoroughly churns the contents within it. The food travels from the upper opening along the lower or greater curvature, to the pylorus, (the end where the food is dis- charged into the intestines) returns by the upper or lesser curvature, while at the same time the movements of the stomach turn its contents inward so that every particle of food in the stomach comes in contact with the freshly secreted gastric juice. As digestion proceeds, the contents of the stomach becomes more and more acid, and the contracting force of the stomach becomes greater, so that it constantly throws its contents inward from its own walls as well as downward towards the opening 'ntothe small intestines." "When does the contents of the stomach pass out?" "Under normal conditions, some of it passes out, or rather is ejected, as soon as it becomes sufficiently liquefied. Just what governs the expulsion of the food from the stomach is rather difficult to determine; it is not merely the fact of its becoming a liquid, as water, no matter what its temperature, remains in the stomach several minutes and is then discharged into the intestines, where absorption takes place. It also frequently happens that solid food is not dissolved at all in the stomach, and if WHEN FOOD LEAVES THE STOMACH 23 the irritation is not great enough to cause vomiting, it passes into the intestines, but just at what time or con- dition, has not been determined. It appears that under some conditions, solids readily pass out of the stomach, while in others liquids remain a long time, so that the discharge of food from the stomach is not entirely a ques- tion of liquefaction, (i. e., becoming a watery liquid.) The ordinary length of time which water remains in the stomach when there is litttle or no food in it, is about 15 minutes, but it may remain hours, when the activity of the stomach walls is impaired." "Does the stomach always empty itself.'" "It should, but sometimes it must be vomited to do so. Food has been known to remain in the stomach several days and then be vomited." "Of what use is this knowledge, doctor.?" "Well, I only wanted to explain that part of one meal may remain in the stomach undigested until it is time to eat another." "What will then happen.'" "After several hours, if the food is not digested, de- cay will set in, and when one meal disagrees it may not be noticeable, but the decaying portion remaining in the stomach will almost certainly destroy the digestion of the next one; whereas, had the stomach been empty, diges- tion would readily have taken place. This is the reason why it is more or less difficult to tell what agrees and what disagrees with us, because the undigested meal may not be noticeable until another meal is added, or not at all until symptoms of sickness occur." "Doctor, you stated that the stomach did sometimes permit undissolved food to pass out into the intestines, does any harm come from it.'" i4 CHEMICAL PROCESS OF DIGESTION "Yes, great harm, and such ailments as cramps, colic, diarrhoea and catarrh of the gall bladder, causing gall stones, are common results from coarse substances passing through the stomach into the bowels." '•Has there been any extensive investigation made about digestion since that of Dr. Beaumont?" "Yes, investigations have been going on almost con- stantly ever since, and have been much aided by what we might properly term Modern Chemistry. A German physiologist in 1831, discovered that saliva digests starch, i. e., turns it into grape sugar, sometimes termed maltose. Since then, repeated experiments have been made upon man and animals. Thousands of tests have been made by siphoning the gastric juice and partly di- gested food from the stomach, and also almost every conceivable test has been made on dogs and other animals." "Doctor, you say saliva is alkaline while the gastric juice is acid. A while ago you stated that these were antagonistic and that the alkali neutralized the acid. Now. how can digestion be carried on by two elements directly opposite to each other, one neutralizing or destroying the effect of the other.?" "That is a good question, and a right nnderstanding of the answer would clear up many of the doubts add difficulties concerning food, or rather our diet. In the first place, it would be well to remember that the saliva makes its appearance in the mouth; that it has great effect on the digestion of starch, or starchy food; that it should be mixed with the starchy foods as thoroughly as possible. Then, when the food reaches the stomach, the gastric juice only begins to flow. It will thus be seen that there is considerable time for the digestion of the starch before any quantity of gastric juice has been se- CHEMICAL PROCESS OF DIGESTION 25 creted in the stomach, or to put it another way, the starch digestion begins in the mouth and continues after reaching the stomach until the stomach has secreted a sufficient quantity of the acid gastric juice to counteract the effect of the alitaline saliva which the food received in the mouth. Ordinarily, it would require from IS minutes to a half hour for the stomach to become sufficiently acid to neutralize the amount of saliva that ought to be mixed with the food during its mastication before it reaches the stomach. As the stomach gradually becomes more and more acid, the starch digestion gradually lessens until it entirely ceases. Then the action of the stomach walls becomes quite intense, and gastric digestion properly begins," ''What do you mean by gastric digestion.'" "1 have tried to make it plain that the saliva has no solvent action upon proteid or tissue forming foods. It is this class of foods that are dissolved or at least should be, in the stomach, by the secretions therein." "What class of food do you call starches?" "Generally speaking, all the vegetables with the possible exception of peas and beans, are essentially starch, and even peas and beans contain a per cent of ■ that substance. The foods acted upon in the stomach are lean meats of every kind, eggs, milk, cheese, fish, and the vegetable casein in peas and beans and the gluten found in wheat and in other cereals." "Is digestion completed in the stomach?" "Not by any^means. By far the most important part takes place below the stomach — in the small intes- tines." "Then, according to the statement you make, the stomach is not of much use, and knowing something of 26 REMOVAL OF STOMACHS FROM DOGS the trouble and pain it gives it looks as though we were constructed on immature plans." "Not at all. The stomach has its use and a most important one, although Czerney in 1876, at Heidelburg, Germany, removed the entire stomach of two dogs. No mention is made as to the effect on one of the dogs, but the other lived from 1876 to 1882, when he was killed for the purpose of making an- examination as to his condition. At the time his stomach was removed, the dog weighed 5,850 grams (22 lbs.), a month after he weighed consid- erably less, but during the year his weight increased to 7,000 grams (29 lbs.)" "Has any person ever lived with the stomach re- moved.'" "There is no such case on record, although the pyloric end of the stomach, (i. e. the end on right side) has been cut out and the intestines sewed to the stomach. Such operations have seldom been successful, but it is probably due to the fact that they have never bee^ made until the patient was almost dead of some malignant dis- ease, such as cancer or ulcer." "You have made no mention. Doctor, of fats. What action has the gastric juice or saliva on them.?" "Until within a few years it was supposed that the gastric juice had no effect whatever upon the fats, but modern investigation has changed that view somewhat, and it is now understood that the gastric juice is capable of breaking down or disintegrating fat cells thereby set- ting the fat particles or globules free. This, no doubt, is a great aid to intestinal digestion. It is also believed that the fat is to some extent changed into fatty acids and glycerine by the gastric juice." "Has the gastric juice any other action.'" EFFECTS OF GASTRIC JUICE ON FATS 27 ■'It converts cane sugar into grape sugar, thus pre- paring it for absorption into the system." "Is there anything besides starch that is not greatly acted upon by the gastric juice?" "Yes, cellulose." "Where is it digested.'" "It is digested somewhere in the apparatus of the lower animals, but nowhere in man; in fact, it keeps starch from digesting, because starch is encased in small cellulose cells, and unless the cells are ruptured by cook- ing or by mastication, starchy cereals and vegetables are almost wholly indigestible." "How long does food ordinarily remain in the stom- ach?" "From one to four hours, frequently longer." "What are the modifying conditions?" "Much depends on the kind of food, upon the cook- ing, and the mixture of different kinds of foods." "Doctor, that is not plain to me, will you give ex- amples?" "Weil, meat and tough vegetables, like peas and beans, require longer time for digestion than something that is easily dissolved, like the white of an egg. Then as to cooking, the longer meats are cooked, especially if roasted or fried, the harder and more insoluble they be- come, as heat coagulates, that is, makes the albumen in meat more solid." "Is there anything else that makes meat difficult o, digestion?" "Yes, being saturated with fat, because the gastric juice of the stomach has only a limited effect on fat, and if eggs or lean meat be fried or saturated with it, the par- ticles might aptly be termed encased, and could onlv be acted on to a limited extent, if at all, by the digestive 2b CONDITIONS RETARDING DIGESTION agents of the stomach. This is the reason why fried lean meat is so hard to digest." "Is'this ail that determines the period of digestion.'" "No, there are many other things. The fineness of the particles of food has much to do with it, and it will not require any labor to demonstrate that a particle, say the size of a pea or bean would not be so quickly dis- solved, if it be dissolved at all, as a particle as small as very fine flour, so that the length of time food should re- quire for digestion depends much upon how finely it is masticated or artificially divided, and this applies equally to both meats and starches. Another factor is the ainount of acid in the stomach." "How does that affect the duration of digestion.'" "Well, some persons secrete very little acid, and are almost wholly unable to digest meats; others have such strong acid secretions that they digest meats very quickly, but that very fact might in a measure prevent starchy foods from being dissolved by the saliva, so that the kind of food and the amount of acid in the stomach are both elements affecting the period of digestion." "Is this all, doctor?" "No; perhaps one of the most important of all is the demand of the system for food." "How does this affect digestion?" "Well, if the system has previously been supplied with more food than it can use, nature has some way of protecting herself by not adding to the burden already carried. Of course, if the intestmes are loaded with matter and their action slow, the food would not be quickly drawn downward. It is believed that when the system is clogged or there is an excessive accumulation of matter in the bowels, that the stomach must neces- sarily be in sympathy, and it sometimes happens that TIME REQUIRED FOR DIFFERENT FOODS 29 toods remaining too long in the stomach and decaying there is the first symptom pointing to the fact that the di- gestive organs have been overloaded and that there is no demand for food." "Some people say that the amount of drinks or fluid taken into the stomach has much to do with the duration of digestion." "That is true. If the digestive juices are greatly diluted they must necessarily be much less active than if they have their full strength." "What about the temperature of the fluids taken into the stomach.?" "It also influences digestion, from the fact that the temperature of the stomach must be maintained at about the normal heat of the body, If cold drinks be poured into the stomach, as a matter of course, digestion will be delayed until the stomach can be re-warmed." "Do individual peculiarities have much to do with the time required for digestion of food.''" "Yes, some peopile have very active stomachs but yet have inherited some antagonistic tendency to certain foods" "I have often heard people say that when people are in serious trouble that they were likely to suffer from in- digestion, why is this.'" "Well, anything which affects the nervous system and in that way disturbs circulation, will affect digestion." "What is the theory of this. Doctor.?" "It is because the stomach requires a large supply of blood, and if the blood from any cause is in excess in other organs the supply of the stomach will necessarily be diminished. Great mental excitement keeps the flow of blood to the head instead of the stomach, and the same may be said of every vigorous exercise. There is stilj 30 STRUCTURE OF INTESTINES another cause for the various periods required for digest- ing the different foods, that is, their chemical effect on each other. To illustrate, tea contains a large amount of tanic acid. If strong tea should be drunk after eating the white of eggs, the tanic acid of the tea would precipitate the albumen of the eggs and make it entirely indigestible. This is about the same process as that of tanning leather" "Then you don't attach much importance to statements that certain articles of food are digestible in a certain time?" "No, although something like an ordinary average might be estimated, for instance,. well-done meat should ordinarily be digested in four or five hours, or six at the most, although sometimes it is. never digested. Meat properly cooked should be digested in about 3 hours, and experiments with raw meat show that under fair con- ditions, it will be digested in 2 J hours," "Then according to that, cooking meat makes it more indigestible.?" "As a general rule, it does, and as it is ordinarily cook- ed, it makes it much more so. The same may be said of eggs. Raw eggs could be digested in about two hours; hard fried eggs, if at all, in four to six hours." "How about vegetables.'" "Peas and beans being very tough require three to four hours. Ordinary bread, if good, about 2^ hours." "Do liquids require much time for digestion.''" "Water or fats and oils taken on an empty stomach would not ordinarily remain in the stomach but a few minutes." "How about milk.?" "IWilk is taken as a liquid but it becomes a semi-solid in the stomach, and requires one-half to two hours for PANCREAS, BILE 31 digestion. Of course, as already explained, these esti- mates are only mere outlines which are varied by many circumstances." "When digestion begins, does the food leave the stom- ach as fast as digested?" "No, although at intervals small amounts of dissolved food are ejected from the stomach, but the greater portion of it remains in the stomach until digestion has been suf- ficiently completed to allow the food to pass into the in- testines." "Then according to your explanation, the stomach is a sort of a reservoir, in which the food is prepared for fur- ther changes in the intestines." "Yes, it might be called something ofadissolving vat." "Why is this.?" "Well, the intestines are much more susceptible to for- eign substances than the stomach." "1 don't understand what you mean.''" "I will explain; the stomach is an organ of considerable size, while the intestines have smaller diameter and greater length." - "About how long.?" ' The small intestines about 20 feet or more, the large intestines about 5 feet. Where the intestines join the stomach is called pylorus. Where it joins the large in- testines, ileo-caecal valve." "What is their general structure like?" "It is a small tube containing muscular layers running lengthwise and also around the intestines. The blood vessels and glands are very numerous. The inside of the intestine being lined with a mucous membrane similar to that of the stomach, but in the stomach the folds run lengthwise while in the intestines they are crosswise." 32 GLANDS IN INTESTINES "What is the principal agent of intestinal digestion?" "Pancreatic juice, which is secreted by the pancreas." "Then according to that, the pancreas is the most im- portant of the digestive organs?" "Well, the digestive ofgans act as a unit, each being essential, although the pancreas furnishes the most indis- pensable part of the digestive fluids, because digestion can go on in the intestines if the food be fine enough, even though there be no preparation made in the stom- ach, or by the mouth. "What kind of an organ is the pancreas?" "It is a long, narrow gland of reddish cream color, but of course the color varies according to circumstances." "Where is it located?" •'It lies behind the stomach in the rear wall of the abdomen." "In what way is it connected with other organs?" "It has two tubes or ducts, emptying into the intestines three or four inches below the lower end of the stomach." "Doctor, you haven't explained the general character of the pancreatic juice?" "It is an alkaline fluid containing many chemical ele- ments." "How do these elements act in furthering the processes of digestion." "The pancreatic juice has three distinct properties. It dissolves all preteid foods, such as meat and eggs, also has a very active solvent, which quickly digests starch and it has still another element which splits up or decomposes the fats, splitting them up into extremely small particles making a creamy substance closely re- sembling soap." ACTION OF INTESTINES 33 "IS there any other digestive agent besides what you have already mentioned?" "Yes, there are others. The one most universally known but probably the least important, is bile." "I have often heard people speak of having bile on the stomach, is this true.'" "Not ordinarily at least, the bile duct from the liver or gall bladder empties into the intestines several inches be- \ov/ the stomach, and it is only when the proceedings of nature are reversed as in cases of extreme vomiting, that the bile is brought up through the stomach." "Of what use is bile in digestion.'" "The uses of the bile are still a subject of more or less dispute, although it is generally understood that the bile_ is a very important factor, in connection with the pan- creatic juice, in preparing fats for absorption. A number of experiments have been made upon the digestion of an- imals without bile, and it was found that a large per cent of the fats were not absorbed. This is said to be true al- so in jaundice where the flow of bile is obstructed or in some way deficient." "Has it any other uses.'" "Being strongly alkaline, it arrests the action of the stomach juices and aids in preparing the food as it comes from the stomach for pancreatic digestion; this being an entirely different process from that carried on in the stomach. Bile will dissolve small quantities of fats, and has long been used to remove grease stains from del- icately colored fabrics, but its action alone without the pancreatic juice is not very marked." "What other uses has the bile.'" "It is claimed that it will to a certain extent prevent abnormal fermentations or decay of the food in the in- 34 ABSORPTION, APPETITE AS A GUIDE testines and there is no doui)t but what bile acts as a laxative in the bowels. It also acts as an antidote to poison known as nicotine which is one of the active prin- ciples of tobacco. Numerous experiments have demon- strated the fact that it is about the only known substance which increases the flow of bile, although various drugs in a measure accomplish the same result by setting up an activity of the bowels; these are known as cathartics." "Is there any other secretions found in the intestines that affect digestion.-"' "There are numerous small glands throughout the in- testinal canal. These secrete an alkaline fluid but so far as has yet been determined they have no other use ex- ,cept to convert starches into sugar and perhaps aid in keeping the contents of the intestines from becoming ex- cessively acid through fermentative processes." "I don't see what is to be gained about all this talk about what goes in the intestines ? ' ' "Then you don't care to know how to keep alive. That is why a good many people don't live, they merely exist, at least they must have constant assistance from their doctor." "Then, what is to be learned by this.?" "First, that there is a limit to the size of the himps — the coarseness of the food that can be properly disposed of by the stomach." "Suppose this is violated, what is the effect.'"' "Very likely cramps or inflammation which will prob- ably cause serious injury and even death. The second thing to be taken notice of is that 25 feet of intestines re- quire something to incite their action; i. e., waste matter sufficient to give them something to do." ABSORPTION, APPETITE AS A GUIDE 35 "Suppose the diet does not furnish the necessary waste what will be the result?" "It would seem from the construction of the intestines having folds almost their entire length, that it would be diffi- cult to get anything through them. Can you explain how this is accomplished?" "By activity — peristaltic movement." "What is that?" "The peristaltic movement of the intestines is a wave- like movement similar to that of a caterpillar in motion." "1 perceive if there be so much movement there must be freedom?" "Now you have struck a great point. Tight waist bands and tight corsets hinder peristaltic action of the intestines, and the man or woman who reduces the size of a natural waist (which a very large per cent of women do) deserves to be called an artist with more vanity than sense." "Does any digestion take place in the large intestines?" "Not in the sense that it does in the small ones. The processes of the large intestines are those of decay and it is believed that particles of food that have not previously been acted upon are to some extent dissolved by the ac- tion of bacteria, a fermentative process," "How is the digested food taken up by the system?" "The entire length of the intestines contain little tongue-like projections called villi, which are attached to the folds of the mucous membrane. These take up the digested particles by a process called osmosis or absorp- tion from without, and they are carried into the circula- tion." "Do they immediately become blood?" "Som.e portion of the food so absorbed immediately 36 FREQUENCY OF MEALS enters into circulation as part of the blood, while other parts enter either the lymphatics or lymph glands or portal vein, and carried to the liver and probably modified to some extent by that organ from which it is taken upas needed," •'Doctor, will you kindly sum up the important things to remember about digestion," "First, food must be properlyprepared; second, it must be thoroughly masticated, ground fine and thoroughly mix- ed with saliva, especially if it contain starch; third, no fresh food should be taken into the stomach during the period of digestion; fourth, food should be properly proportioned, con- taining the different elements required for the purpose of sustaining life." "Doctor, you have not mentioned how often one should eat?" "That is somewhat a matter of habit. The savage tribes eat when they are hungry or when they can get food." "Would you advise people to be guided by their appe- tites.?" "Not by any means. It is better to have fixed habits, although if there be cause for hunger and need for food, this feeling should be gratified within reasonable limits." "What do you mean by cause for hunger.-"" "Hunger may be either normal or abnormal, that is, it may come because one eats but little food, and talkes a large amount of exercise, while abnormal hunger, which is even a more intense craving for food, results from dis- ease, or excessive stimulants such as condiments or al- cohol." "How can one tell whether the appetite is normal or abnormal.?" "By amount of food eaten and amount of exercise taken." FREQUENCY OF MEALS 37 "How often then should one eat?" "That is difficult to say, for it depends on habit, abil- ity to digest food and the activity of the person." '•Then a uniform practice of eating three times a day is not always best." "No, many persons would remain in better health when eating four or five times daily, but ordinarily three meals a day are sufficient, and some even claim that two meals agree better than three. This is especially true of brain workers. The two meals should be at the begin- ning and end of the day." "What class of persons should eat more than three times a day.'" "Persons of very weak digestion as convalescents from acute diseases, or people who are very fat." "Won't this have the tendency to make them take too much food.'" "On the contrary, the inclination is to take much less. Weak stomachs need food in very small quantities, and eating often satisfies the appetite." "Can you give general rules.'" "Yes, no one in active labor should go longer than six hours without food." "You say appetite should be considered, in what way.'" "In this way, if you were to eat a very light breakfast at six or seven o'clock in the morning and have active exercise, it would not be unnatural to be hungry at 10, and it would then be better to eat something than to wait until 12 for the regular meal." "I have always heard that it is bad practice to eat be- tween meals, now you advise that under some circum- stances it be done." 38 REGULATION OF MEALS "The objection to eating between meals is not well understood. What is meant by the general outcry against it, is that no food ought to be taken into the stom- ach while what has been previously eaten is in process of digestion." "O, I see, eating between meals if the stomach is not empty, is after all a bad practice.'" "Yes, it is very bad, for it keeps food in the stomach too long and very likely causes it to decay, because part of the amount previously eaten will probably be retained until the fresh food has been added. This necessitates the retention of the previous meal until the second is digested, and therefore causes increased, delay. The practice can- not be too strongly condemned." "Doctor, 1 am still confused. You say that a light breakfast at six or seven and active exercise might make it proper to take food at ten, what would you do about the regular meal if it came at 12.'" ' This is a matter which requires judgement. In such a case, a ten o'clock lunch should consist of some fruit that is easily dissolved, like a baked apple. If good fruit cannot be had, then a little milk, sugar, or even bread in small quantities." "Then the habit of eating meat, pickles and beer lunch is objectionable.'" "Extremely so; no liquor (if it is to be drunk at all) should be taken on an empty stomach, but to do so and to eat pickles and salads besides, is a species of folly so great that it is difficult to understand how a rational per- son can do it." "What should be the principal meal of the day.'" "Well, for most people the principal meal should be in the middle of the day, although breakfast may be a heavy REGULATION OF MEALS, SLEEP, TOBACCO 39 meal, if not convenient to eat anything but a lunch in the middle of the day. The evening meal should always be the lightest, because the system is most relaxed and the least capable of digestion." "How about eating at bed-time.'"' "If there has been active exercise and the hour for re- tiring late, a little food may be beneficial. To persons who have an inclination to insomnia (sleeplessness,) a little food will often be conducive to sleep and there is nothing we could more strongly recommend than Horlick's Malted Milk." "Why does it make one sleep?" "Taking a little food at bed-time has a tendency to draw the circulation from the head to the stomach, and whenever the excessive flow of blood to the head is di- verted, then sleeplessness will be supplanted by restful sleep." "I have always understood that eating food just before retiring had a tendency to keep one from sleeping at ail?" "There is some truth in this — depends upon thequan- tity and kind of food. A hearty meal always has a ten- dency to make one go to sleep, but if the meal is of such a character that it is a struggle to digest it, it almost nat- urally follows that the circulation will be disturbed much more than it ought to be; hence, the weird dreams and 'night mares' so called, are common incidents to late suppers of rich and indigestible food." "What is the significance of sleepiness after meals?" "Well, if there be great drowsiness after meals, it indi- cates either weak digestion or nervous exhaustion." "How does exercise aid digestion?" "Exercise aids by increasing the circulation and in that 40 EXERCISE AND DIGESTION way clearing the system of waste, and by burning up the food, thus creating a demand for a new supply." "Then the more exercise the better?" "Not at all, exercise to the extent of great fatigue weakens very much and if such be unavoidable, it is much better to take some rest before eating and also after." "Doctor, I have noticed that some people soon become ill if they do not sleep enough, why is this.'" "Lack of sleep in some way disturbs the nervous sys- tem and weakens its tone. It follows then that inasmuch as every organ of the body is controlled by the nervous system, when it is disturbed every other organ will most likely be so." "Some contend that the use of tobacco aids digestion." "If it aids one, it hurts ten thousand, for it both de- presses the action of the heart and affects the nervous system, and is therefore an unmitigated evil and univer- sally injurious to all persons in normal condition, although it might be useful in some cases as a drug." CHAPTER III. CLASSIFICATION OF FOODS. "The food we consume serves us in two ways; first it supplies material for tissue and also for the bones; second, it fu"nishes us fuel for bodily warmth and action." "What foods are required for these purposes.'" "While most writers divide foods into many classes, practically there are only two, that is, foods for building or repairing the body and foods for furnishing heat or force." "Then you would only divide food into two classes." "Yes, foods for building or repairing the body are called tissue-forming foods, they are also known by other names which are used to express the same thing." "What are the names?" "The most common name applied totissue-formingfood is the term proteid, or protein. Another term almost equally well-known If that of nitrogen or nitrogenous foods. Still another known as albumens or albumenoids. These various names are used interchangeably for the same purpose, and the reader should not be confused thereby." "What foods belong to this class?" "Lean meat, eggs, fish, milk and cheese are the foods most extensively known as tissue formingfoods, but peas, beans. lentils and wheat gluten have a larger per cent of tissue-forming substances in proportion to their starch, than is ordinarily required for the human system. Properly speaking, they should be classed with tissue formers." "What foods are known as fat or heat producers?" 41 42 CLASSIFICATION OF FOOD "All fats and oils, starch, sugar, gum, pectose and waste material are all termed force producers. The foods belonging to the starchy class, including gums and waste material are usually termed carbo-hydrates, while the fats are known as hydro-carbons." "In what classes of food do we find these different properties.'"' "All the animal fats and oils, vegetable and fruit oils, sugar, starch and vegetables generally " "Are there any foods that belong to both classes?" "Yes, many of the foods in common use belong to both classes, that is, are both tissue formers and force pro- ducers. Milk, meat and eggs, all contain fat, and are therefore force producers by reason of the fat they con- tain, while the cereals, especially wheat and oats, contain nearly the proper proportion of tissue forming and heat producing substances. Ordinarily, the animal foods are called nitrogenous and the vegetables non-nitrogenous or heat producers." "I understand that the system contains much mineral matter, that the bones are substantially all composed of it. Where does the supply come frorn?" "The largest element of bone formation is lime, called calcium, while salt known as chloride of sodium, pot- ash known as potasium, magnesia known as ma-jne- sium, and sulphur and iron and traces of other minerals, are found in various farts of the body. These various m.ineral el' ments are usually known as salts, or mineral matter, and exist in various compounds, generally known as chloride, carbonate and phosphate of sodium; chloride, carbonate, sulphate and phosphate of potassium; carbon- ate, sulphate and phosphate of magnesium; and phosphate of calcium." MINERAL SALTS 43 "Are there any other uses for mineral salts, in the body, except for bone formation?" "Yes, but it would be rather difficult to explain them to the laity." "What is the use then of ail this description then?" "Simply to show the necessity of eating food that sup- plies these elements." "Then it is a matter of great importance after all." "Yes, many diseases result from not knowingthisfact." "What are some of them?" "Rickets in children, anaemia, chlorosis, excessive growth and other ailments," CHAPTER IV. WATER THE PRINCIPAL ELEMENT OF THE BODY. "The human system is made up of many chemical ele- ments, the principal paft of which is water. The sec- ond largest element is carbon and next to it is nitrogen, while calcium is the largest element of the mineral sub stances. Those of less quantity are magnesium, sodium iron, sulphur and traces of other metals." •'Doctor, must our food contain all the elements of the body?" "That is the conclusion from the experiments that have been made, although some of the elements are so small no demonstration has ever been attempted. It is but natural to conclude though, that if water, carbon and ni- trogen and lime are indispensable that all the other ele- ments would be so." "I take it from what you say that water is the most important of all foods?" "That is true. There is nothing taken into the system so indispensable as water, for it constitutes about 70 per ct of the weight of the body,and as the evaporation from the body is large, and beinga vehicle for carrying off the waste and poisonous products of the system, more water is required than any other food, and if it is not fre- quently supplied, the blood would become too thick to circulate and death would result." "Doctor, I suppose you have seen the statement in ad- vertisements of liquors that water kills more people than whiskey?" "Yes," said the doctor, "and strange as it may seem, WATER 45 there is some probability that the statement is true; at least, it would be a good question for debate." "You don't mean to say that people drink too much water, do you. Doctor?" "As a rule, they don't. More drink too little than too much. It is not the quantity but the quality that kills, as the people of Hamburg learned in 1893 when they were scourged with the cholera." "Is there much impure water?" "Much! Why don't you ask whether there is any pure water, for such a question would be more in accord with the facts." 'What are some of the sources of polution?" "Wells are polluted from surface water by spilling dirty water on its covering, by filtration from barnyards, privies, feed pens and street sewage. River and lake waters by sewage, decaying vegetable matter, and refuse of all sorts thrown into them, but this belongs to sanita- tion to be treated in a separate volume and we should not venture out too far." "Cannot the people tell by seeing whether it is clear?" "No, the clear sparkling water may be laden with death dealing impurities which may be vegetable or chemical, and may even have typhoid or cholera bacteria in it, but by boiling, it can be made wholesome and many impurities may be removed by various methods of filtering." "But people object to boiled water, it tastes too vapid?" "That can be easily overcome by agitating, like mak- ing milk shake or lemonade; in fact, the aeration these drinks get by being shaken is partly what makes them so pleasant." 46 WATER •'Can you give some suggestion as to how much water a person should take in twenty-four hours?'' "We take much of our water in what we call our solid foods; but unless we eat watery foods, like green fruits, the smallest requirements would be at least three pints daily, in addition to what would ordinarily be con- sumed in the foods including milk, tea and coffee. Of course, exercise, temperature and the size of the individ • ual would all be varying circumstances and one would drink a great deal more water in very hot weather than in moderately cool or cold weather." "Do people injure themselves by drinking water?" "That is putting it mildly to say the least. Every tank and pitcher of ice water ought to be labeled with skull and cross bones." "Why so?" "Did you ever snow-ball? If you have, you have noticed that though your fingers would be for a timg nearly frozen, after a while they would sting and burn with heat." "Yes, I have noticed it. Is that the way ice water acts?" "It is. When the blood returns, that has been driven avay by the cold water, reaction takes place and if continued, the excessive flow of blood causes congestion, resulting in inflammation and general derangement of the stomach, usually known as ice water catarrh. It's a pro- lific source of what is "generally known as summer com- plaint, indigestion, cramps, dull headaches and general languor, and dilatation. of the stomach walls or enlargement of the stomach. There is another thing. Have you ever noticed if you take a large draught of ice water when you are very hot that you feel somewhat as if you were going to faint? Well, that results from the shock to the nerves EFFECT OF ICE WATER 47 in the blood vessels thereby affecting the activity of the heart and the fainting sensation is not caused by the heat as is generally supposed." "That may be all very true, doctor, but think how cool it keeps one." "Where did you learn that? That is one of the most absurd notions of the age. We get cool by what assists in radiation of heat, and whatever opens the pores of tiie skin and allows the heat to escape, makes the body cool. Trying to warm a tank of ice water in the stomach does not take away the heat from the system; but on the con- trary prevents its escape from the body." "Then you would advise the people not to drink ice water.?" "I would substitute cracked ice, which answers the place much better and is much more effective in rapidly lowering the temperature of the body. If ice be retained in the mouth until melted, the water becomes warm be- fore it reaches the stomach. This entirely avoids the evil effect of ice water and prevents congestion with its train of ills." "This does not give much water, does it doctor.'" "No, it is not the quanity of ice water that is drunk that gives such satisfaction, but the contact of cold to the mouth and throat, and melting ice seems to answer the demands of internal heat better than any other agent at our command." "But cracked ice is not always easily obtained." "Then it is better to only use part ice water and part of water much warmer, but people may drink ice water in very, very small quantities and very slowly. No one should drink more than a gill of very cold water at a time. No cold drink of any kind should be taken soon- er than three hours after meals. In hot weather where 48 EFFECT OF COLD DRINKS there is an inclination to drink too mucti, a little water should betaken with greater frequency." "Doctor, did I understand you to say that no cold water or cold drink should betaken soon after meals?" "Well, not only should no cold water be taken, but no cold drink of any kind should be taken at meal time nor before digestion is completed." "Why, I supposed the cold drinks would keep the food from souring too quickly and consequently be a good thing." "You must have been reading about the animals of prehistoric races, said to have been preserved for several thousand years by being frozen. The fact is, the water cannot remain cold in the stomach, and if it did there would be no digestion and no use of taking food at all. As soon as the ice cold drinks are poured in, digestion stops until the temperature can be brought up to normal heat. This has a tendency to exhaust the working capacity of the stomach and if the cold drinks are repeat- ed with great frequency, the stomach becomes perman- ently enlarged and digestion is paralyzed. This is one of the principal reasons why so many people are unwell and have diarrhoeas and lack force and energy in hot weather." "Then cold drinks are worse in hot weather than in cold weather?" "The principal is just the same, only the system is more ennervated in hot weather and the inclination to take cold drinks when we are warm is much greater than at other times; therefore, the injury from cold drinks is much more common in hot weather." "I have noticed that many people drink hot water, while some say it is best to drink nothing at all during meals." USES OF HOT WATER 49 "Clear hot water is occasionally a useful agent for such ailments as result from acute indigestion and where there is no chronic enlargement of the stomach. Hot water drinking having been advocated originally for a few minor ailments, has been taken up by the multitude as a cure-all for every disease of the digestive organs. We can consequently call it a fad and a pernicious one at that. It is used ignorantly in many ailments where it acts as a direct irritant. Its most potently evil effects have been witnessed in those of a highly nervous temper- ament known as neurotics who have extremely irritable stomachs. To such it seems to act as a temporary seda- tive but in reality it produces a hyper-sensitive condition of the mucous membrane, which in time prevents the proper digestion of solid foods and has a tendency to add to an already over burdened nervous condition resultiug in enervation and prostration. There are also unknown conditions of ulcerations of the stomach where hot water often produces severe hemorrhages. These are only a few conditions in which the miscellaneous and indiscreet use of hot water has an evil effect. There are others too numerous to mention, but these will suffice to put the public on guard against foolishly and ignorantly aping a fad." "If there be harm in drinking hot water under wnat conditions can it be used with benefit.?" A few instances where hot water may be successfully used are as follows: If upon awaking in the morning you find a sensation of fullness in the stomach, a heavily coated tongue, a slightly acid condition of the saliva you may know that your previous meal has left more or less of sour ferment in the stomach: Now, if ypu will drink half tea cup of hot water it will clear the mucous mem brane of excess of scid, inucus and debrie remaining 50 USES OF HOT "WATER from the previous meal, making the stomach fresh and sweet for the morning meal. The principle upon which this acts is as follows: People who invariable eat three meals a day do not always completely empty their stomachs. Now the indigested portion of the previous meal remaining in the stomach undergoes a certain amount of fermentation, and if another meal be added without first clearing the stomach, the sour ferment remaing from the previous meal, has a tendency to decay the fresh food of the succeeding meal, thereby generating abnormal fermentation and gases which distend the stomach, with symptons of flushed countenance, slight palpitation of the heart and much discomfort. This is what is usually known as indigestion." "Is there any way to make hot water more palatable?" "Yes, it can be made much more agreeable to the taste to take boiling water and agitate it like making lemonade. If too disagreeable to the taste, a little milk may be added." "What if it is not convenient to gethot water, doctor?" "Then cold water may be drank a half hour before meals or especially at bed time." "There is a popular notion abroad that hot water is a good drink at meal time?" "Well, it's only relatively good, that is, it is not as bad as most drinks such as tea and coffee, but it has no es- pecial merit to recommend it; on the contrary, any kind of fluid dilutes the digestive juices and makes digestion more difficult. The only so-called hot water drinks at meal time that may be said to have any merit is when as much milk is added as there is volume of water. Water makes the milk more easily digested and the merit may properly be said to be in the milk. Of course, if circum- stances make it necessary to drink at meal times or not at all, hot water is the least objectionable, but it has no HOT WATER. 51 medicinal effect of importance, unless taken long enough before meals to allow it to escape from the stomach." "About what temperature should hot water be drank?" "Ordinarily from 105 to 110 degrees Fahrenheit, never hot enough to scald the membranes. The notion that boiling hot water is necessary is a grievous mistake." Chapter v. BREAD. "Doctor, you say water in some form or other is the most indispensable of all foods, I suppose that meat is next in importance?" "No doubt the Esquimeaux would say so, while those who style themselves vegetarians say that it is not only the least important but the most injurious of all foods, but the truth of the matter is, all races have lived off of what they could get the easiest and liked the best; but for the European and their American descendants, it can be truly said that bread is the staff of life, or more strictly speaking, the staff of life Is wheat." "I have often heard bread called the staff of life, but never knew why. I suppose it must be more wholesome or more nutritious than other foods.''" "That might be true in theory, but as a matter of fact it is often much more unwholesome than other foods. Aside from the fact that bread is both cheap and palatable it furnishes nearly all the essential ingredients to support life." "Doctor, what are we to understand by essential ingredients.?" "First, heat or force producers — the starch and fat furnish these. Second, flesh formers or proteid food. This is furnished by the gluten of the flour. Third, min- eral matter necessary to form bones and tissues. Fourth, waste material. Of course, bread is more or less defi- cient according to the material of which it is made." "Some people think wheat the best, some rye and some Indian corn." 54 PROPORTION OF HEAT PRODUCING FOODS "Yes, the Russians and the Germans prefer rye or at least use rye, while most of the English speaking peo- ple prefer wheat bread, although in the Southern states corn bread is extensively used and preferred by many." "The chemist out to be able to say which is the best, what food elements doe^ each kind of bread contain?" Fine flour ordinarily contains: r Water 13.5 Force producers-! Starch 73.2 [Cellulose .75 f Fat 1.2 Flesh formers -| Gluten 10.5 1^ Mineral matter .85 It will be seen from this table that bread contains ordinarily about 7 or 8 times as much force producing food as that of tissue forming elements, a proportion con- siderably above what is usually estimated to properly nourish the human system." "But, doctor, haven't you already said that rice was mamly all starch, and are there not more people who practically live on rice than an other article of food.' If that be true, it doesn't seem reasonable to say that wheat bread really has too high a. proportion of starch. " "It is true that more people live on rice than any other food, but an American laborer with his mixed diet can do twice the amount of labor in a given time than a laborer of rice eating nations." "How about Mexico?" "The people of Mexico eat meat and the Mexican laborer is in no way superior to the laborer of India or China, so that it is very difficult to draw conclusions by analogy, but this fact remains. The climate of Mexico makes a laborer lazy, sluggish and slow, and also has that tendency in India or China." PROPERTIES OF BREAb 55 "Then on what does your statement rest when you say that ordinarily wheat bread has too high a proportion of starch?" "It rests on a century of actual experience and it has been settled beyond dispute that a man requires a larger per cent of tissue forming food ordinarily called proteid or nitrogenous fgod than is contained in fine wheat flour, if health and physical development are desired, al- though the exact proportion depends upon climatic con- ditions, amount of exercise and the peculiarities of the individual. In Europe, the proportion of tissue forming food to that of heat or force producing food is estimated at a ratio of about 1 to 3. Some place the ratio as high as 1 to4J." "How about our own country?" "Well, Americans are the most active people in the world, and for the most part have rather a bracing clim- ate, so that we can stand a diet as low in tissue formers as 1 to 6. Of course, this is speaking in a general way, extreme cold weather and active exercise might require even a higher ratio of heat producing food, while grow- ing children in moderate or warm weather would require a proportion more nearly in accord with the estimates for the Europeans." "What has climate and activity to do with heat or force producing food?" "It has a great deal. It was at one time supposed that great activity destroyed a great deal of tissue, but that has been found to be a mistake. Hard labor or exercise increases circulation, and very naturally more heat pro- ducing food is oxidized, or -burned up. The same reason holds good in cold weather. The need for heat increases respiration and circulation, and that burns up more fuel, which the heat producing food really is." 56 FOOD ELEMENTS NECESSA^RY "Ah I see, this furnishes quite a guide to living. The sedentary and fat require less fat and starch than the active. In cold weather it requires more than in hot weather." "Yes, that is the idea. The old soldier prefers a piece of fat bacon when he has a forced march, while to the aged and infirm it might be nauseous." "I suppose we have about reached perfection in bread making, have we not?" "I hardly think so; at least the masses are a long, long way from it, and there is probably no one article of food more responsible for indigestion, with its train of ills, than poorly made bread." "1 have heard some say that the best part of flour was bolted out — that our flour was too refined." "There is a good deal of truth in that, for there are three important elements taken out — the; bran, phos- phates, mineral matter, and a considerable portion of the gluten and nearly all of the cellulose." "Why are they taken out of the flour.?" "The bran is bolted out because it is unpalatable, and the phosphates are unavoidably taken out because they adhere to it. The gluten also adheres to the bran, but is mainly found in the heart of the grain- — the part that grows. It does not pulverize so readily as the starch, and is also bolted out with the bran and known as middlings. There is another reason why middlings from a commer- cial standpoint is not desirable in flour — it makes the bread darker, but more yellowish than dark." "Doctor, you haven't explained in what way the bran and phosphates increase the nutritive value of flour." "I am coming to that. The bran has no food value, or rather nourishment for man. It is, in fact, indigestible cellulose," PROPERTIES OF WHEAT AND USES 57 "Then, 1 don't see any use in eating indigestible food." "I'll tell you why. Man no doubt originally ate much coarser food than he does now, and it is probable that his tendency is toward concentrated food; but, even if we grant that, it will still be several thousand years, if at all, before he can live on concentrated food exclusively." "Then he needs indigestible cellulose in some form, as a sort of filling, for the same reason that a horse needs hay?" "Exactly. If there is not sufficient waste material, there is nothing to stimulate the action of the bowels, and constipation results, with all its attendant ills." "Why wouldn't coarse vegetables answer as well?" "But many people don't eat coarse vegetables, besides the waste matter can be too coarse. Many vegetables are stringy, and if hastily swallowed, which is a very com mon practice, they may really act as an obstruction rather than a stimulant to the bowels." "But many people are troubled with diarrhoea rather than constipation." "That's true; but most of those same people have con- stipation first, and the diarrhoea is only nature's way of getting rid of accumulated matter, and not a few persons have found that they lost their good health when their occasional diarrhoea ceased." "There must be other causes for diarrhoea besides con- stipation." "Yes. They \<^ill be discussed under the proper head. I merely mentioned it to emphasize the value of bran for all pfeople who have a tendency toward constipation." "Is bran in bread of use to everybody?" "Not by any means. If it greatly irritates the bowels, it should be avoided." 58 WHEAT BRAN IN CONSTIPATION "Then, according to your statement, wheat bran is the best waste material found in any of our foods." "I can hardly say that. The bran of other grains might be equally good. More depends upon its fineness than its name." "What part of wheat is the richest?" "That depends on what you mean by richest. A pound of wheat germs (wheat gluten) is more than equal to two and one-half pounds of lean beef, as flesh formers." "Is the wheat gluten ris easily digested as meat?" "For a good many people, it is easier. Many persons tolerate it better than anything else, and it furnishes a good food at any period of life, and for almost any condi- tion." "As I understand it, the starch of wheat makes the fat; is a force producer; the gluten is the flesh former; the bran furnishes the waste material. Now, is that all the good things you can say about wheat?" "No; the phosphates make the bones and furnish min- eral matter for the system." "Then, as a food, wheat seems absolutely perfect." "It is said to be the only perfect food, and it probably is more nearly so than any other food; but for all that, it has too small a per cent of fat and too little lime. Pigeons fed on wheat and distilled water only lived a few weeks, but when water containing a small per cent of lime was furnished, instead of distilled water, there was apparently nothing lacking, and the pigeons grew fat." "What would you suggest to add to it?" "Well, I will talk of that when I discuss the different kinds of bread and diet suitable to meet different condi- tions." "1 infer from what you say that Graham flour or bread WHEAT THE BEST FOOD DIFFERENT FLOURS ■ 5 9 made Uom it is much to be preferred to the ordinary fine flour bread." "That is not the idea. Graham flour is supposed to be made of the whole grain, bran and all. Recently a pro- cebs has been invented which saves all the valuable parts of the wheat without the objectienable and unpalatable bran in Graham flour. Wheat has three coats or en- velopes, and it is advisable to remove the first two, which still leaves enough cellulose for a healthful diet, without being in the least unpalatable. Being sweeter, many people prefer bread made of entire wheat flour." "Then, there is no general dislike to the new process common to brown or Graham bread," "No; the dislike to brown bread results mainly from the unpleasant sensation produced in the mouth by the coarse bran, and if it could be reduced to the fineness of flour, there would be no objectionable taste. This has led to the late method of removing the coarsest- part of the bran and the name 'entire wheat flour' substituted for Graham flour. It is not so white as bolted flour, but is really more palatable. Goodfellow gives the composition of fine flour and entire wheat flour as follows: Entire Wheat Flour. Flour. Water, 12 14 Proteids, 9-3 14.9 Carbo-hydrates, force producers, . 76.5 66.2 Fat, 0.8 1-6 Cellulose, 0-7 1-6 Mineral Matter, 0.7 1-7 "It will be seen, on comparison, that the entire wheat flour is richer in mineral matter, tissue forming elements' and. cellulose or waste matter.'' 60 ADVANTAGES OF ENTIRE WHEAT "How would you sum up the advantages and disad- vantages of entire wheat flour?" "1st. Better for growing children, especially if theie be constipation or tendency to rickets. 2d. The sedentary or corpulent. 3d. Vegetarians, or people who eat but little meat. 4th. People who suffer from constipation. Sth. Mothers during maternity, or while nursing children. 6th. Those who have a tendency- to decay of teeth. No kind of bread should be given children under ten months old." "Then, fine white bread is not so wholesome as the other?" "That is not a fair way to put it. Much depends on individual peculiarities and what other food is used with it. Generally speaking, the entire wheat flour is much superior to fine flour. If exercise be such as to cause great peristaltic action of the bowels with looseness or diarrhoea, the fine flour bread is preferable." "Doctor, you said a while ago that bread was a great source of indigestion. On what ground do you make the charge?" "Well, bread may be very easily dissolved in the stom- ach, or may be very difficult. It depends upon its phys- ical properties. If it be solid or sticky, it does not dissolve readily." "Then, that would include pancakes." "Yes, pancakes, dumplings, potpie, most pastry and all poorly baked bread. Any bread that will adhere together upon being pressed, forming a solid, doughy lump, is not easily digested and is a source of many disorders of the stomach." "There are many arguments about which is more wholesome hot or cold bread. Which is right?" "The wholesomeness of bread does not depend upon DOUGHY BREAD HOT BREAD CAKES 6 1 whether it is hot or cold. The objection to hot bread is that as a rule it contains more moisture, and is therefore much more doughy. Its particles do not separate so readily when put in the mouth. For this reason there is a tendency, almost universal, to swallow such bread in sticky lumps, and of course the particles do not separate easily when they reach the stomach. This causes them to be retained in the stomach so long that fermentation is set up. If bread not made with yeast is sufficiently well baked, there can be no objection to it merely because it is hot; but in yeast bread, unless very thoroughly baked, the ferment does not leave the loaf until six or eight hours after baking. Biscuit should be thin and baked until its particles will not stick together when mashed." "What about cake?" "Cake contains very wholesome ingredients, but made well nigh indigestible by cooking. Rich cakes might aptly be described as butter, sugar and eggs, stuck together with a little flour. The general objection is that there is an excessive amount of shortening which prevents the digestion of the flour, and this is especially true if the shortening be butter, because the amount of heat applied in baking cake changes the chemical nature of butter, and makes it very bad for people who have any form of dys- pepsia. There are still other objections: Heat coagu- lates any kind of albumen (by coagulation we mean con- densing or hardening), and the time required for baking cake necessarily so thoroughly toughens the egg it con- tains as to make it quite indigestible." "What about the sugar in cake.'" "It may sour all that is eaten with it." •'Can you recommend doughnuts.'" "No; doughnuts are as indigestible as cake, for the same reasons; but cookies are less objectionable than ordinary 62 FAULTS m BREAD MAKING LIGHT BREAD cake, because they are not so rich; but fritters are prob- ably the most indigestible of all cakes." "Many kinds of light bread take their name from the flour used and the methods of making light or spongy. Yeast bread is most usually made of fine white flour, i. e., flour made with bran and middlings bolted out," "Doctor, from what you say, I conclude that fl6ur or wheat foods are all good," "If not spoiled by the cook. It has been already men- tioned that bread is often unfit to eat." "Are there any reasons why bread is unsuitable for food, other than what you have mentioned?" "Yes, there are several faults common to ordinary bread making," "What are some of them.?" •'Too much yeast is used, and too long fermentation allowed. The more quickly bread can be fermented the more wholesome it will be, and if fermentation be too great, part of it is changed into acetic and lactic acid. Bread is sometimes less wholesome because of ingredients other than flour, which are added for various purposes. Potatoes are often used, so that the bread will absorb a large amount of water, making a heavy loaf with a small amount of flour. Alum is frequently used in bread to whiten it, and as it is an astringent mineral, likely to do injury, no one should eat bread containing it. Another extremely objectionable thing common to baker's bread is the unwholesome places in which it is made. No lan- guage of condemnation can be too strong to apply to the foul bakeries located in cellars and infested with rats, roaches, flies, vermin, bad air from foul closets, and op- erated by an unclean baker. The health officers of every city should see that all bakeries are kept in a san- itary condition." TOAST e^ "Can you give specific rules for bread malance or diarrhoea." "Is there no way of preventing this?" "No way except to get the people to understand that they must not eat stale fruit, but il they do it must be QQoked, so that all bacteria may be destroyed and decay arrested." "Why not can or dry peaches?" "That is a good way. They can be kept very well all the year. Good canned peaches are almost as good as fresh ones. What is known as pie peaches, containing green and solid lumps and more or less of the tough dirty skin of the peach, should liot be used by anybody." "In what does the peach differ from the apple?" "It does not contain as much sugar, but as a rule more gum. T-he principal part of the peach, exclusive of water 188 PEAR gum. The principal part of the peach, exclusive of water, is known as pectose, which is a sort of gum." "What kind of acid is found in the peach?" "Principally malic acid, the same as in the apple. Good peaches are almost as nutritious as apples, but much more care is needed in using them, because of the liability to either be green and toQgh, or over-ripe and tainted with decay. A choice peach not too green or too ripe, is one of the most delicious things with which nature has pro- vided man." "Doctor, a good many people prefer the pear to any other fruit." "That is doubtless because of its sweet taste; other- wise, it is not so rich as many of the other fruits." '"How does it compare with the peach?"' "Well, in a general way, it has about the same amount of water (83 f), but the pear has about twice as much sugar (8^), and half as much gum or pectose. The food value, although different in character, amounts to about the same as the peach. The pear has but little acid, and it may therefore be used with any kind of food, because there is not sufficient quantity of acid to even coagiilate milk to any noticeable extent." 'What would you consider the best way to use the pear?" "Aside from its use as a pleasant fruit, it makes the best preserves and jam of any of the fruits, or at least, it is highly prized for that purpose." "Some people declare the pear to be laxative, while others say it is astringent." "Some varieties are astringent, but the excessive amount of sugar in the pear sometimes causes an abnor- mal fermentation, and results in diarrhoea; then again, the pear is frequently tough and may cause disturbances on QUINCE GRAPE 189 this ac.^ount. The same care is needed in using pears on apcaunt of being either harder tainted with decay, as that of peaches. Owing to their large amount of sugar they should not be eaten by any one subject to sour stomach.'' "The quince ^s the most soHd of all the fruits, and un- less well cooked is not eatable at all. It contains a large amount of malic acid and a great amount of gum. When thoroughly cooked, many people prize it highly for its flavor. It is slightly astringent." "Is there any other use for it than as a stewed fruit?" "It makes a jelly of the finest quality." "Doctor, I suppose the grape is almost next to the apple?" . ' "Probably considering its universal use, it certainly ranks •high, and if, not next to the apple, it ought to be considered at least ; one of the most valuable of all our fruits." ^What nutriment is there in the grape?"- "That depends inuch on the variety. Some grapes have liiiich less water than others. A fair average prob- ably wo-uli be about 80^ water, the principal other in- gredient, besides waste, being sugar. In addition, to the sugar, the grape has considerable tartaric acid, and when we consider the seed and skin, it has a very large amount of waste matter, but with these out as they should be, the waste matter is small. The grape has not enough nitrogen in it to make this element worth mentioning, and like the fruits just discussed, it is strictly a heat-producing food. There is also considerable mineral matter, soda, potash, magnesia and iron, in addition to tartaric acid." "I have heard very well-informed people say that grape juice contained very nearly the same elements as blood?" "When they said that, no matter who they were, they i90 GRAPE were talking rank nonsense, because the grape kcks a great deal of furnishing the necessary eonstitutents of the blood." "What uses has the grape?" "It is a wholesome and pleasant fruit, if -properly eat-en." "How is that?" "The pulp should be dissolved and no one should swal- low either the seeds or the skin." "Has the grape any particular .value in disease?" "Yes, it has great value, but "this will 'be considered under the head of disease;" "What about wine?" "Wine properly belongs with spirituous liquors." '^Of what are raisins made?" "Raisins are dried grapes, also what are known as Eng- lish currants, ar« really ortly inferior raisins." "Are raisins healthful?" "They contain about the same properties as griipes, but owing to their toughness ,a*id their seeds, they should ,be cooked and thoroughly masticated, and any one who gives raisins to small children, does so at the risk of causing their death." CHAPTER XVIII. FRUITS CONTINUED. PLUM. "The plum is a nice fruit, makes most delieious pre- serves and jam." "But Doctor, a good many people think plums yery un- wholesome?" "Doubtlfess a good- many disorders have been produced by the pltim, because they are so often tough, acrid, and therefore unsuitable for food; but choice varieties of plums that have been ripened on the tree are both deli- cious and wholesome, provided of course, the tough skin- is not swallbwedl" "How dt) they compare with other fruits?" "They are very similar to the peach, only as a rule they are more acid. They usually contain a little less sugar, and about the same amount of gum. The per cent, of acid in the plum is ordinarily about 1| and nearly double that of the peach. Some varieties of the plum are quite astringent." "Are not prunes some variety of plums that have been dried?" "Yes, the prune is really a plum, but a sweeter variety than the ordinary Damson or Green Gage plum." "What value has the prune as a food?" "The prune contains a large amount of sugar, and it is supposed to be very laxative, but it has been much over- fated in this respect. It has no properties to cause it to be more laxative than most other fruits, and careful' ob- servation will show that it is not so in practice. Prunes should be very well stewed, as otherwise they are unfit 19t 192 CHERRY APRICOT STRAWBERRY to eat. The removal of the tough skip by straining the pulp adds greatly to their food value." "Doctor, how does the cherry rank as a fruit?" "The cherry is a favorite of many people, but it ought not to rank very highly, because a large per cent of it is tough skin and water, and it is rather strong in acid." . "Then you; do not recommend the cherry very strongly?" ^ "No, I do not. If the juice is fresh and used for mak- ing jelly, perhaps one could justly extol it, but it has a very thick skin, and a small amount of pulp, which leaves very little of the fruit suitable for use. Like other fruits, the sugar and acid vary much according to the variety, although it is very similar to that of the plum." "The apricot and the nectarine are very similar to the peach, but are not as rich. It does not need any ex- tended description, because it is so nearly like the peach." "Doctor, it rather seems as though you had slighted our berries?" "Well, the berries are in such great favor, especially the strawberry, that some enthusiasts have said that the 'Lord could have made a better berry than the strawberry, but he didn't.'" "What properties has the strawberry?" "It does not differ as much as one would suppose from other fruits. It contains some more acid than the aver- age apple, not quite so much sugar, and a good deal of. waste material or cellulose. The nitrogenous or tissue ■ forming element of the strawberry is proportionately higher than most of the other fruits. Ordinarily, it is about eighty-eight per cent water." "Is there any injury likely to result from using straw- berries?" "Yes, many persons are injured by using stale straw- USES OF STRAWBERRIES 193 berries. They do not keep but a short time, and like other fruits, when tainted they should be cooked, but the tendency is to merely add sufficient sugar to hide their decay." "Has the strawberry any action different from that of other fruits?" "Yes, it is more laxative, because of the stimulating effect the small seeds have on the intestines, and if straw- berries are used judiciously, they have very great value, as they come early in the season, at a time when their flavor and their acid. is needed to clear the system for hot weather. Strawberries make very delicious jelly and jam. They should not be used with milk, because their acid coagulates the milk, causing it to form little hard lumps or clots. Strawberries are charged with being the cause of hives and skin eruptions, but only in people who have some peculiarity — probably an excess of uric acid in the system." "Doctor, you spoke of the acids coagulating milk ; what kind of acid does the strawberry contain?" "The strawberry contains both malic and citric acid, also potash, lime and soda salts. It is therefore slightly diuretic as well as laxative." "Is the strawberry used in any other way, except as it is picked?" "Well, it may be cooked, and used for flavoring other foods." "The raspberry is one of the most palatable of the sum- mer berries, but it is so much like the blackberry and blue- berry they may all be discussed together." "In what way are these different from other fruits?" "They differ in this; they contain more seeds, or at least larger ones, and less water, and instead of being laxative, as are most fruits, they are astringent, and wine made of 194 ASTRINGENT BERRIES blackberries is one of tlie most common remedies for diarrhoea or summer complaint." "What properties have these berries as food?" "Aside from their acid, and mineral salts, which are similar to those of the strawberry, they contain little, ex- cept sugar and their agreeable flavoring matter, common to various other fruits." "To what do you ascribe their astringency?" "Tannic acid, or something equivalent to it." "What other berries besides the raspberry, blackberry and dewberry are astringent?" "The elderberry and blueberry. The elderberry is not extensively used, although it makes an agreeable wine, and is made by many people for home use. The blue- berry is a berry of commerce, of which there are several varieties. It has an agreeable flavor, and is not very pro- nounced in its action, because it contains little but seeds, sugar and flavoring matter." "Cranberry, gooseberry, and currant, are all popular fruits. The cranberry is more extensively sold than any of the others." "Why is this?" "Because it matures late in the season, and is easily kept all winter." "What are its properties?" "Malic and citric acid in large amounts, a little flavor- ing, and an exceedingly tough skin." "Can you recommend its use?" "On account of the strong acid and skin of thie cran- berry, it disagrees with most people. If used at all, it should be stewed and strained so that the tough skins come ofif. This would practically make a jelly of it. The acid is exceedingly acrid, somewhat astringent and of rather doubtful use. It is sometimes useful as a dis- GOOSEBERRY MULBERRY 1'9S infectant for inflammations, and is usually applied as a poultice." "The gooseberry is much more favorably known in Engfand than this country, as it requires a cool, moist climate for good fruit. It also has a tough skin and large 'seeds, and niothing to recommend it except its flavor and the sugar its contains. When green, it is very sour, but when fully matured and ripe, it contains quite a large per cent of sugar, more in fact than most other fruits. The currant is another tough-skinned fruit with large seeds. It does not differ greatly from the goose- berry, except that it never has so high a per cent of sugar. None of these berries should be used with their skins, and they are therefore more suitable for making jams and jellies, than for any other purpose." "The mulberry has never been so extensively grown as its flavor would certainly warrant. There are few berries as rich as the mulberry, and it ought to have been planted everywhere, instead of the cherry, although it does not produce so large a crop nor is it so sure to bear." "What are its properties?" "It is very rich in its flavoring matter, has a high per cent of sugar, and contains about one and a half per cent of tartaric acid, and is therefore more like the grape than any other berry. It also contains considerable potash." "Doctor, what is the leading fruit from the tropics?" "Well, it is difficult to say whether the banana or lemon." "For a food, which is best?" "The banana. It is the only green fruit extensively used in this country, upon which life can be sustained for any length of time." "Then, the composition will be interesting?" "Yes, the banana contains one per cent or two per cent ;196 BANANA ,pf tissue-forming food, or about one-eighth that of entire wheat flour. It contains quite a large amount of gum and sugar, amounting in. all to abotit fifteen per cent. The banana contains less water than most other fruits, being only about eighty per cent water, while most of the others range^from eighty-two to ninety per cent, ex- cept those which are principally seed." "Do you consider the banana a wholesome food?" "It does not agree with most people." "Why is that?" "That is because it is pulled green, and ripened by an artificial process, so that when the banana is ripened for market, it is really ripened by a process of decay." "Then this is the reason why bananas are so Hkely to disagree?" "Yes, being partly decayed, and containing a consider- able amount of sugar, they are likely to continue to decay, or sour fermentation set in after they are eaten. It is no uncommon thing for bananas to produce nettle-rash, es- pecially in children." "Is there any way of overcoming the difficulty?" "Only by allowing the banana to ripen, where if grows, and make it into meal. This is another peculiarity of the banana ; it is the only fruit that can be dried and ground into fl6ur, and when this is done the banana makes a valu- able food." ''I notice that its use has been mentioned in typhoid fevers?" "Yes, banana meal has been used with very good re- sults in many hospitals, both for typhoid fevdt- and other cases, but it must not be concluded from this that an ordinary tough banana can be used, because it would likely disagree with a well person, and be very dangerous to the sick." : BANANA LEMON 197 "Then you rather discx>urage the use of bananas?" "Yles,.. until there isisome way of getting the fruit to us in a better condition. It is truly a fine fruit and the time will' soon come when its use will be such as to warrant some more satisfactory way of bringing it to the people." '"I suppose. Doctor, that, you consider the lemon more of a medicine ,tban a fruit?" "The lemon has long been used for its flavor, and in a medicinal wayj but, modern chemistry so perfectly coun- terfeits all flavors that the use of fruits for such purposes is, almost discontinued, so that the lemon must hold its place for its valuable acids," "What are these?" . "Citric and malic acids. A lemon does not contain any properties that could really be called a food, and its use is really only, that of a cleanser. It is especially valuable to cleanse the stomach of mucus, when its juice is used with hot water an hour before meals. No sugar should bfe used. As a toilet article for the skin, hair, and mouth, it has no equal, for its juice cleanses the; skin of an excess of fat, and should be used to take away the "shine" on. the face/, the ladies so much dread, instead of face powders. It will also., remove blackheads, due to impaired circula- tion of the skin, and is truly nature's beautifier. The juice of the lemon when used without soap is an invaluable hair Wash to remove dandruff and oil, and will also cleanse and sweeten the mouth, when there is a bad, or 'dark brown' taste. For washing the hair, the juice of a fresh ripe lemon should be squeezed into a pint and a half or two pints of lukewarm water, and thoroughly rubbed into the scalp,i then dried with a rough towel." "Has the orange the same uses?" "No, it. is more of a food, because the orange contains a little, gum and some sugar." 19B ORANGE PINE APPLES "What acid does the orange contain?" "Mostly citric and malic acid> and citrate of lime." "Then the orange has uses unknown to the lemon?" "Yes, oranges are often valuable for invalids, when- lemons could hardly be used at all." "The tamarind has a high per cent of citric acid, also contains some tartaric acid, and a trace of malic acid. It is rich also in potash, and contains as high as 12^ of sugar. It is not extensively used, and does not there- fore deserve much consideratiohi" "The pineapple is one of the most delicious of all tropical fruits. It contains all of the fruit acids and some other substance very similar to papain, which is a digestive agent for all kinds of food. There is probably no other fruit generally known that has the same property for digesting other foods as that of the pineapple." "Then it is a good thing to eat?" "That is very questionable. The piraeapfJe contains- an extraordinary amount of tough fiber, which is exceed- ingly difficult to digest. "Then how should it be used?" "Well, the juice should be obtained in some way from the pineapple without the tough fibre, macerated in water a«d expressed by compression. It is now pre- scribed to considerable extent in certain diseases of the stomach. Zumo^Anana is a pineapple wine, beneficial when there is insufficient secretion of digestive juices, but contra-indicated where there is excessive secretioa "The Ume is probably the sourest fruit known. Citric acid is manufactured from it. Also, lime juice. It is very similar to the lemon. Citric acid is often used as a substitute for lemons. "The grape fruit is a large fruit, much larger than either orange or the lemonv It comtains similar pixjper^ LIME DATES (FIGS 199 ties to the lim€ and kmon with some bitter matter. It is not extensively used, but makes a cool and refreshing drink, and a few, people like the fruit." "Are theric no important fruits, other than what you have discHssec^' "Yes, dates and figs. The dried dates and figs of com- mserce are the richest of all the fruits." "What is the'average composition of them?" "They contain -more than two-thirds solid matter, about four per cent of flesh^forming substances ; and nearly fifty per cent sugar, considerable waste material, and mineral matter. The date contains very nearly the same properties as tlae fig, with .the addition of pectose or gum. These fruits dried contain nearly the same proportion of heat- pipoducing and tissue-forming substances as rice, and will therefore support life for a considerable length of time." "Are they used extensively as food?" "N-ot'so extensively as they should be, for figs are quite laxative, which is due, partly, to the seeds, and partly to the fact that figs, especially green figs, have a digestive agent similar to that of a pineapple, only less pronounced. They are used more by vegetarians than others, and de- serve a favorable place in our dietaries, but should always be cooked." "Olives are only used for two purposes in this country ; that is, we use -the loil made from the oliv« -and the green ^ve ifor piokks. The oil is valuable, but the pickles are tough, and have no use as food. Large doses of olive oil have been recommended :for the .removal of gall stones." "Citrons haare no other use except ior flavoring, but not many people like them for that purpose. They are tough arid well-n%h insoluble, and should not be eaten -for fopd." 266' CITRON PRESERVIN(5 fRUlTS ■ "Doctor. TbeTi^ve it would begood for ybu to siigge^' something about preserving fruits." ' ■:-"-» ■ - "Fruits are usually kept either by being drifettor canned.' Drying is ah easy process with proper "applia'n£e^. Sun- dried fruits are better than no.fiftiit at all; but' &ny slow' process of drying where the fruit is exposEjtf' to' the atmos- phere, furnishes the best opportunity ioif all kinds " ' ''Why is it that so many people do riot suc'ceed irf^pfop* erly preserving canned fruit?" 'rrlo-'- • ?ff • "Because it is not properly canned." "What is wrong with the ordinary method?" " - ' ' "The principle of canning fuit'merely involves- the- de- struction of bacteria, and then closing tiie cans so that neither they nor air can enter it:'' "■ '■ ' ■•''' "How should this be doi^e?" "It is best to cook the fruits in the cansj' so that ho bacteria can enter in filling them. If this- icannot *b« done, the -cans should be ^et' in- hot .water attef .they are filled. Probably where more failures are made tharf'stnyri CANNING FRUITS 201 where else, is with the lids. It is not only necessary to have the cans thoroughly sterilized by being boiled in water, but the lids must also be steriHzed. If fruit can- not be cooked in the cans, the lids should be sterilized and put on the cans with a small vent for escaping steam. If they are then immediately sealed, so that they are air-tight, there will be no trouble in properly preserving them. It must be borne in mind that nothing should touch spoons, lids or anything that comes in contact with the fruit after being sterilized in boiling water." ^ "What do you mean by sterile or sterilizing?" ' ' "Anything is said to be sterile when it has been sub- jected to a degree of heat sufficient to kill all kinds of bacteria." "How much heat is ordinarily required?" "There are very few microbes of any kind but what are killed after being subjected to boiling water for,, say, fif- teen minutes. A high degree of heat, if it be moist, sijch as steam, answers the same purpose, or better. The whole theory of preserving canned goods rests upon the destruc- tion of bacteria and the elimination of air; and as the mi-, crobes cling to every known substance, it is necessary to have the hands perfectly clean and all, the instr,ume,nts^ or vessels sterilized in which the fruit is hanclled, as al-, ready suggested. It is best t© cook the fruit in the cans with the lids on. , This can be done by filling the cans and setting them in a kettle of boilii:)g,:\yater, so that, the, cans are almost entirely covered. This prevents the' en- trance of bacteria from handling, and sterilizes the fruit in the jar." "Which do you consider the most important of the nuts that are used in this country?" "The peanut; The consumption of peanuts has -grown 202 PEANUTS to be enormous, and is destined to be many times greater than it is." "Why do you say that?" "Because the peanut is a palatable and rich food, and it supplies most of the necessary elements to susiam life." "What properties has the peanut?" "The largest ingredient of the peanut is its oil, amount- ing to about fifty per cent. It has, in addition, consid- erable gum, the equivalent of starch. The mineral mat- cent, waste material." ter amounts to nearly two per cent., and about four per "What about the tissue-forming substance?" "The nitrogenous part of the peanut is high, amount- ing to twenty-four per cent or more." "But, Doctor, it is said to be a great source of dyspep- sia." "It is at least fair to say that it is very difficult to di- gest." "Why is this?" "Because it is really a concentrated food; practically, it has no water, and consequently it is exceedingly -solid. It natulrally follows that the digestive juices will not pen- etrate the particles very qtiickly. Very few persons will masticate the peanut to finer particles than cracked wheat." "How can this difficulty "be overcome?" ^'Only by grinding. Extraordinary care in masticat- ing peanuts by keqping them in the mouth as long as possible, overcomes part of their objectionable texture." "Why do you think the peanut has a great future?" "Because nearly everybody likes it, and it supplies nearly everytliing necessary to live on, and is compara- tively cheap. It is only a question of time -until it is bet- tOT 'pi'^ared and inmished to us so that it can be used VARIOUS NUTS • 203 with other foods; for it seems admirably adapted to fur- nish both the necessary oil and flavor for the cereals, which are deficient in both.'' "What about other nuts?" "All nuts contain a large' per cent of oil. The chest- nut is the only one that contains a great amount of starch; probably the hickory nut is really the most palata- ble of all, and is rich in oil." "Are not pecans good?" "The pecan has a bitter shell which makes it disagree- able, if any particle be left in contact with it. It does not vary greatly in composition from the hickory nut. The only nut having special use is the almond." "What special use has it?" "As it does not contain any starch, has an agreeable flavor, and is quite a rich food, both in tissue-forming and heat-producing substance, it is very valuable in Bright's disease. It is exceedingly tough and solid, but probably not so much so as filberts and hazelnuts. These are also rich nuts, but need grinding more than any of the others, and unless they are ground, they are exceed- ingly indigestible." "Among nuts, what prominence would you give wal- nuts?" "The black walnut is raither a strong-flavored and very oily nut. The white walnut, or butternut, is still stronger in its flavor, but not so rich in oil. The English walnut, so-called, which is principally grown for market, is a rich, oily nut. It is not so firm as many of the other nuts, and Has some advantages over them. Probably the most oily of all nuts is" the Brazil nut. They are also quite firrn, but almost pure oil." "Are there no other nuts that you think worthy of no- tice?" 204 COCOANUT NUT FOODS "None, unless we except the cocoanut, which is becom- ing quite an article of commerce, especially its oil. It is now used extensively for making soap, and other pur- poses." "Do you consider the cocoanut a good article of food?" "I do not. It is one of the toughest and most indi- gestible of all articles used for food; even shredded co- coanut is extremely difficult to digest, and the only way that it can be ever used successfully as a food, is to pro- vide some way of pulverizing it to make it as fine as flour, or nearly so, which would not only make it digesti- ble, but more palatable, as well." "Then, Doctor, you are quite a friend to nuts, pro- vided they can be used properly; but your declaration that they are wholesome don't agree with common expe- rience." "Well, if the people would undertake to live on any of the cereals without their being ground or cooked, the re- sults would be worse than the ill effects commonly at- tributed to nuts. The Sanitas Food Co., of Battle Creek-, Mich., are making nut foods that are as much easier di- gested, compared with raw nuts, as Granose or Granola, compared with unground and uncooked wheat. Nuts have long been known as rich food, but owing to their solid texture, and the natural inclination to swallow them in uncrushed particles, they have, for many people, been considered rather indigestible. The Sanitas Food Co. have overcome this difficulty and given the world the most delicious and fattening foods ever manufactured. They answer every purpose of meat, and greatly strength- en the cause of vegetarianism." "Doctor, if you connect anything with vegetarianism it will prejudice it in the estimation of some people." "That ought not to be so. Much of the prejudice NUT FOODS 205 against vegetarianism is due to the fact that most vege- tables do not supply either enough fat or tissue-food. Tliese defects are supplied by using the entire grain of such, cereals as wheat in connection with, nuts, as they are rich, both in fat and tissue-forming elements." "Then nut fats are superior to animal fats?" "Yes. Heretofore cream has held first place among common fats, but the nut-cream and nut-butter, made by Sanitas Food Co., are superior to either cream, butter or animal fats." "In what particular?" "All animals are subject to disease — cows especially to tuberculosis — besides, cows are frequently kept in foul places, milked by soiled hands, and the milk kept in un- sanitary places and in vessels washed in water containing typhoid or other bacteria. These dangers are avoided in the nut foods; but there are still stronger reasons for' their use. The particles of fat are so minutely subdivided or emulsified, that they are readily taken up in the sys- tem. The animal iats will not sustain life, as they con- tain practically nothing but heat-producing elements. The nut foods will sustain life and more quickly fatten than anything yet discovered. Nut butter and almond butter are the most delicious and appetizing fats ever produced, and they will very likely displace cod liver oil as a fat- producing food for consumptives." "Why not combine nuts with grain foods?" "The Sanitas Food Co. has done so with great success. Long ago I was impressed with the belief that emulsified nurs could be combined with dextrinized or pre-digested starch so as to make the richest and best food for fatten- ing yet discovered. The Sanitas Food Co. has made such a food and named it Bromose. As a fat-producer and food-tonic, Bromose has produced most remarkable 206 NUT-FOODS results. Nuttose is another similar food, and might aptly be called vegetable meat. JGranose and Bromose used together have restored many invalids to vigorous health. Knowledge of these foods are of so much benefit that I have spoken of them at some kngtli." CHAPTER XIX. CONDIMENTS AND DRINkS. "Doctor, what do you mean by condiments?" "Well, the word has a general and well-understood meaning, but, for my use, I would explain it by saying that it should be pronounced by emphasizing the second syllable and sounding the 'i' long, making it oon-die- me'ftts." "Thenhow would you define it?" " I would say that it is the thing we eat with our food "But it is a hot subject." "That -is a hot criticism. Doctor." which beguiles us to death." "You mean by that, that condiments burn?" "Yes; take pepper; it irritates and burns the membrahes very much Uke fire." "But the doctors say it aids digestion." "So it would warm your hand to put it in the fire." "But that would destroy the hand." "So the pepper has a tendency to destroy the digestive organs." "If that be true, how can it aid digestion?" "Anything that irritates the mucous membranes of the stomach increases the gastric secretion, and this is what pepper does; but in doing this, it inflames the stomach, causes excessive secretion of acid, and an uncertain num^ ber of stomach disorders." "Is that why so many people want to drink ice water at meal times?" "It is one of the reasons. If a mouthful of pepper be sWallow'ed, the fiirsl impulse is to drink some cold water 807 208 PEPPER SALT as quickly as possible to relieve the burning sensation. "When the stomach is habitually irritated with pepper, mustard, alcoholic liquors, horse radish, or indigestible food, cold drinlss give a feeling of relief, but really only aggravate the irritation?" "Then pepper is injurious?" "It is most injurious, and should have no place in our dietaries, and should only be used as a drug." "Is pepper worse than other condiments?" "Probably not; mustard, sage leaves and horse radish are all bad, the two latter being worse, if anything, than pepper." "How about salt?" "Salt is much railed at by a certain class of hygienists, but is strongly defended by others." "Which side is right?" "If we are allowed to make comparison with the lower animals, it would seem that carniverous (flesh-eating ani- mals) care nothing for salt, while herbivorous (grass-eat- ing animals) in all countries are intensely fond of salt." "That would indicate that man. Hying largely on the vegetable foods, would require some salt?" "Yes; but not more than a quarter, and probably not more than one-tenth of what most people consume. Ex- cessive salt eating is a bad habit, but not so bad as the use of pepper. It has been demonstrated that salt retards digestion, causes skin eruptions and other derarigemerits of the system; and, while salt is useful, most persons would be benefited if they would cut down their salt eat- iilg to one-fourth of what they are in the habit of using." "Does vinegar belong to the same class?" "Vinegar is bad, but not wholly so ; for it has some uses." SPICES 209 "Haven't you already said that vinegar must be dis- carded?" "Yes; its uses are for the most part injurious, but still it has some use, when better acids are not obtainable." "Then why abandon it?" "The abundance of fruits we have furnish us acids so much superior to that of vinegar, the question of contin- uing the use of vinegar ought not to be considered at all, when fruits can be obtained." "Then you would use sour fruit on salads, instead of vinegar?" ' "Yes, or else not eat the salads at all." "Why is vinegar so objectionable?" "Because it Is a ferment filled with vinegar worms, which can be seen with the naked eye. If you will get some vinegar plant and examine it, you will not care for the vinegar afterwards." "What fruits would you recommend instead of vinegar?" "Limes, lemons, grape fruit, sour oranges, sour grapes, sour berries or even rhubarb." "How about spices?" "Some of the spices are not objectionable." "Which would you give first place?" "I would give the first place to nutmeg." ^Why so?" "Because it has an agreeable flavor, is mostly oil, and is not particularly objectionable in any way." "You favor nutmeg, but condemn other spices?" "All-spice is not verj' injurious, but its flavor is not pleasant. Few people care for all-spice as a flavor, but almost everybody likes cinnamon." "Then you would strongly recommend cinnamon?" "Well, I would not recommend cinnamon or pepper- mint for uses in food except as a medicine." "Why so?" 210 VINEGAR SPICES , "Because both cinnamon and peppermint kill bacteria to a certain extent, and are known as antiseptics. They would both have a tendency to arrest the processes of di- gestion. They also have a tendency to aiicst processes of decay, and both are useful to reheve a sour stomach. Owing to this fact, they are not desirable to mix with food for general use, but are valuable for special uses, where their antiseptic properties are needed." "How would you class cloves, caraway seed, ginger, etc.?" "Cloves are very astringent, but the small quantity used is not likely to do harm. Caraway seeds cause nausea in many people, which shows that they are irritating in their nature, and should not be used at all. Ginger is a very pleasant stimulating condiment. It is quite useful, too, when such stimulants are needed, but it is not desirable for habitual use." "Doctor, you are much against the ordinary spices used by the cooks, what about tomato catsup, pickles, etc.?" "As to tomato catsup, if it does not contain irritating substances other than the tomato, its use is not particu- larly objectionable, except where acids are harmful; but as to pickled cucumbers, onions, cabbage and olives, they are all tougB, and if one cares to be free from aches and pains, he should let all of them alone." "You have not mentioned olive oil. Doctor?" "There is no objection to olive oil, and it may, at times, be very useful, where such food is needed." "Are these all the spices or condiments in general use?" "All the important ones, althou^ anise, fennel, pars- ley, sorrel, are used to some extent, but not enough to be of any particular injury or benefit either." USE AND ABUSE OF SPICES 211; "Then you don't advise the use of flavoring or spices at all?" "There is one general objection to all of them, and that is this: they have a tendency to stimulate the appetite and cause one to eat too much, and as over-eating is a practice well-nigh universal and injurious, the things that favor it should not be encouraged." "Do I understand from this that you would not use fla- vorings at all?" "I did not mean that, but they should be used to make those foods we do not like, but ought to eat, more palata- ble." "Give us an illustration." "A great many people suffer from uric acid headaches, the result of meat diet and constipation. Now, such per- sons may not care for cei-eals or coarse vegetables, and would, therefore, not eat them, to any considerable ex- tent, because they do not like them. The proper use, then, for flavors, is to take the foods that such a person ought to eat, and flavor them so they would be agreeable. This would make the coarse cereals palatable, and if sub- stituted for their meat diet, their headaches would disap- pear, and their health be entirely restored." "Doctor, suppose we go and take something?" "All right; I will drink a glass of mineral water and then discuss drinks." "Doctor, since you do. not drink anything very stimu- lating, you probably have something caustic to say about Hquor drinking?" "I don't propose to commence on alcoholic liquors^ but on the drinks that pave the way for them." "That is a new idea. You don't mean to say that other drinks cause an appetite for liquor, do you?" 212 INCREASE OF NERVOUSNESS "Such a thing as an appetite for Hquor, strictly speak- ing, does not often exist." "What, then, is it?" "It is a mental condition which makes the individual crave stimulants." "Then it is a craving for the efifects and not the taste?" "That is it. A well 'person is free from nervousness, and does not want any stimulants." "Then our habits afifect the nervous system?" "Yes; nervousness apparently increases with each gen- eration. It is often attributed to worry, but the real cause is the habits of the people, and a large share of it is due to their drinking habits." "Then nervousness does not result merely from worry or overwork, as many people suppose?" "No; people are mainly worried because they are ner- vous. If we were not nervous, the ordinary cares of life would not cause us to worry." "Doctor, I am very anxious to know what you are go- ing to charge this to?" "To no one thing; but I wish to show the relation of other causes to nervousness." "Since you have already spoken of water, I suppose you will charge tea and coffee with a good deal?" "Yes, coffee in this country, and tea in other countries." "I thought the general opinion was that coffee was not injurious?" "General opinion is about as safe to guide us as it would be to have a mule put in a pilot house to steer a ship across the ocean. As an illustration, tnere are num- bers of people who are sick every week, or at least every month, and are foolish enough to say that nothing they eat or do, hurts them; and it has often struck me that it would be just as reasonable to say of a man who is hung STIMULANTS, THEIR EFFECTS 213 till-he is dead, that the hanging didn't injufe him, but that hfe merely died because he stopped breathing." "Why do you say such things?" "To get people to understand that when they are knocked over, something struck them." "What bearing has this on cofiEee?" "That effects have causes." "How can you prove that coffee has any bad effects?" "By drinking it or watching others." ■ "That doesn't throw any light on the subject." "Well, coffee is a stimulant, and the heart has only a limited capacity. When it is stimulated beyond that, it must be correspondingly weak, just as it was stimulated to increased activity by the coffee. Suppose we illustrate it in this way: We will take two tanks of water and con- nect them with a pipe. Now, if each tank be two-thirds full, the pressure will be equal ; but if the water be pumped from one to the other, the one will have its pressure in- creased just to the extent that the water is taken from the other, and the one from which the water is taken will have its pressure decreased." "Now are you sure that the effects of coffee are simi- lar?" ., , "It is very much like it; people who drink two or three cups of strong coffee could hardly get along without it. If' they do not have it, they will have the headache and be irritable, or, in other words, there is relaxation, a \y.eak- ness of circulation and .the machinery of the system re-; fuses to run properly until it is again brought under the influence of a new supply of coffee." "Well, I suppose I have seen hundreds of people of that kind, but I never thought it was serious." "Yes, it is; if coffee is necessary to keep any one go- 214 COFFEE ing, so to speakj such person might pFopcny be callM a coffee inebriate." "Well, how does that pave the way lot liquor?" "In this way: People who are affected by the use of cx)ffee become nervous to an extent that is- chronic, and the condition of the nervous system of the parents is likely to be transmitted to their children." "Then it is not so much of an appetite as it is a nervous condition?" "No; liquor drinkers, or at least very few of thein, will admit that they drink liquor because they like it It is purely an abnormal craving for some kind of stimularrt ' They don't feel right without it." "Then why don't everybody take to the use of strong' drinks?" "A very large per cent, do, but it must be remembered that not every one uses stimulants to make a serious- nervous condition. Besides this, nature constantly at- tempts to correct her own defects, and if it were not for the" fact that each ' generation keeps iniplosing upon na- ture, we would soon be an ideal race." "Has coffee no uses?" "Yes, coffee is useful as a drug, is very pleasant to the taste, and if water and milk are merely flavored' wi& cof- fee, and it is used as a flaVof more than something to tone up the nervous system, it is not seriously harmful^' and may be, at times, very useful. It may not injure every one, but the habit of drinking two or three Cups of cof-' fete (strong coffee at that) is most pernicious, and tiot oflly does serious harm, but is' very likely to do hafm to uff- bo>nl generations, as well as to lead to the use of stronger stimulants." "Are there any other ill eff€Cts from coffee?" COFFEE INEBRIETY 215 "A considerable quantity of strong coffee retards di- gestion and does injury in that way." "What property is it in coffee that affects the nervous system?" "The name given it is caffeine. It contains some other properties, but it is the caffeine that gives it its stimulat- ing-effects. The practice of giving coffee to children cannot be too strongly condemned." "W-bat are the symptoms of coffee inebriety?" "N«rvQUs 4remor, languor, prostration, sleeplessness, craviitg, with hea,daches when it is not supplied in suffi- cient strength or amount." ''If coffee be used at all, how should it be made?" "Coffee is the least harmful when the smallest, amount of its active properties are extracted. The longer it is steeped in water and the more it is boiled, the more in- jurious it is. It should not be strong, and should never be permitted to boil; nor should it be permitted to stand for great, ;iength of time, but the hot water should be poured on and left only for a few minutes, to. merely ex- tract the aroma of the coffee." "Doctor, hpw does tea compare with coffee?" "It is very similar to coffee,, and there is much discus- sion as to which is, the more wholesome or harmful." "What is your opinion?" "Tea,(in my opinion, is still worse than coffee. It is perh?ips; not quite so much of a .stimulant, but contains a high per cent, of tannic .acid. This makes tea an as- tringent^nd a great source of constipation. It therefore deranges the system, causes nervousness, insomnia, and ivas rmflre serious effect pn the digestive organs .than coffee." "In what way does it affect digestion?" "Well, it affects digestion directly, because of the fact 216 WHEN SPECIALLY INJURIOUS that the tannic acid of tea precipitates albumen in the foods. This may be better understood by saying that if tannic acid be applied to the white of an egg, which is albumen, it will make a tough substance of it quite like leather. It is, in fact, this process of applying tannic acids to skins that makes leather." "Is that the reason why, that when egg is used to clarify coffee it forms in lumps?" "Yes; that is the same principle. It clarifies the coffee by being coagulated and gathering the coffee grounds as it settles, aind when egg is used to clarify coffee or any other drink it should be strained." "Doctor, you say tea and coffee are both bad. They are certainly not worse than tobacco?" "No ; they are not worse than tobacco ; but tobacco does not belong to foods, and we <;annot 'discuss it now." "Is there any other objection to tea and coffee?" "Yes; both tea and coffee are especially injurious 'to persons who have what the physiciaps call the arthritic tendency." "What do you mean by that?"- "A large number of diseases result because the system does not perfectly clear itself of nitrogenous matter. These various ailments are styled uric acid diseases." "What are some of them?" "Probably the most universal one is sick headache Periodical sick headaches are almost certain to be the re- sult of uric acid in the blood." "Then tea and coffee add to the uric acid in the Sys- tem?" "Yes; people who have sick headache, asthma, bron- chitis, rheumatism, gout, epilepsy, and diseases of the stomach generally, should drink neither tea nor coffee." "Has tea any particular use?" COCOA 217 "It is sometimes used because of its astringent proper- ties in diarrhoea, or summer complaint, and is really more of a medicine than food." "Doctor, from what you say, I conclude that the abuse of tea and coffee is almost as far-reaching in its eiifects as that of alcoholic liquors?" "You are right; and it is really a pitiable sight to see people who are trying to save the world from its vices adopt such habits that they transmit such traits and char- acteristics to their own children, that the very evils they seek to remedy are fostered by their own offspring." "Cocoa is a preparation made from the bean or seeds of the cacao tree." "What is its composition?" "It contains a very large per cent, of oil, theobromine, which is very similar to the caffeine in coffee, and theine in tea. The cocoa also contains a little albumen, starch, fiber and mineral matter." "Where does cocoa come from?" "Principally from the West Indies, Brazil and the north- ern countries of South America." "How is cocoa prepared?" "The seeds grow in a pod and are removed, dried, fer- mented and then ground. Each manufacturer of cocoa, of course, having peculiar ways of preparing his product." "How are the ordinary preparations made?" "After the seeds have. been treated as described, they are made into a paste, to which starch and sugar is added," "Do you consider it a good drink?" "It is less injurious than tea or coffee, and owing to the amount of oil it contains, it is much richer than either of those. People who do not tolerate fats or oils, should not drink cocoa. It is slightly stimulating, and contains some insoluble matter. Some people do not like cocoa, 218 CHOCOLATE CEREAL COFFEE because it presMits ian unsightly appearance, on account of a scum of oil appearing on top of the cup. If this is not relished, it may be skimmed off, either with bread or in some other way. Cocoa butter is said to be a very agreeable and useful oil." "For what purpose?" "Many people prefer cocoa butter to any other fat or oil for table use. It melts at a very low temperature, and is very easily dissolved. It is also used to a very consid- erable extent for the administration of drugs in capsules or suppositories, and for anointing the skin in eruptive fevers; also- useful as inunction while massaging." "Chocolate is made from the same material as cocoa, but is deprived of part of the oil (it is supposed that chocolate contains some of the husks, as well as the seeds). It is not quite so rich, ordinarily, as cocoa, and some people prefer it. Chocolate is also used extensively in confectionery. It might very well be used to flavor foods to make them more palatable. It is also a nutri- tious food when -taken alone." "Doctor, you don't seem to favor chocolate for general use; you say that tea and cofifee are both very harmful, and that many who use them are really tea and coffee inebriates; now, recognizing the universal desire for some drink, what can they drink that will not harm them?" "Cereal coffee. The Sanitarium Food Cu. make what they call Caramel Cereal. It is a pleasant and harmless drink, and will greatly benefit the nervous, anaemic and dyspeptic. It has no particular, food value, and its manu- facturers claim none. The benefits of any cereal coffee are purely . negative, and in that lies their Value; they do not poison; coffee does. Claims for great nourishment from cereal coffees cannot be sustained." "Doctor, you stated awhile ago that tea arid coffee were ALCOHOL 219 abused to such an extent that their effects were almost as far-reaching as alochol." "Yes; but I did not mean by that that the effects were as violent." "What is ordinarily understood by the term alcohol?" "Used in a general way, alcohol includes all alcoholic liquors, such as whisky, beer, wine, ale, gin, as well as chemically pure alcohol." "Is there not much disagreement as to the value of al- cohol when moderately used, as to whether it is really a food or not?" "It has been demonstrated that the system will absorb a small amount of alcohol because it is not exnaled in the breath and cannot be found in the excretions. It is, there- fore, fair to conclude that it is burned up in the system, just the same as fats and starches are." "Then it would seem from this. Doctor, that if a small amount of alcohol is absorbed as food, it would not be injurious?^' "But you forget that I hare already explained that a healthy person has no need for stimulants, but that they are an injury instead of a benefit. This is especially true of alcohol." "Why is it more true of alcohol than any other stimu- lant?" "Because it causes the tissues of the body to be changed, although it is claimed that some persons c^n use a small amount of alcohol without any discoverable change in the tissues of the system." "Then, if that be true, it must explain the constant ten- dency of' those who use alcohol to increase the quantity?" "Yes; the stimulating efiEect is what is always sought, and as the change takes place in the tissues, it takes more 220 EFFECTS OF ALCOHOL and more to have the same effect that the small amount originally had."' "If this be true, it is a dangerous thing to use, purely upon physiological grounds?" "Yes, it is dangerous to make a practice of using any kind of alcohofic liquors, for the reasons explained." "What is the character of the changes usually made by the continued use of alcoholic liquors?" "It changes the texture of the liver, blood vessels,, kidneys and the digestive organs generally. It makes the individual much more susceptible to infectious dis- eases, especially typhoid fever and pneumonia." "Are there any other ill effects resulting from the use of alcoholic liquors?" "Yes; all those cases described under arthritic tenden- cies resulting from uric acid in the blood, are unfavorably affected by all alcoholic liquors, or, more especially, malt liquors, that contain adds, as nearly all the malt liquors and wines do, so that persons having sick headache, rheu- matism or kindred ailments, must not use liquors at all." "Doctor, doesn't the use of alcohol lessen the desire for food?" "Yes, if a certain amount of alcoholic liquors is used up by the system, it corresponds or equals a considerable amount of heat-producing food; and as it contains no waste material, it would naturally have a tendency to pro- duce constipation, which is a well-known fact." "Are these all the objections to the use of alcohol?" "Not all of them. There is still another. That is, that alcoholic liquors lower the temperature of the system." "I thought it produced heat and people ■ drink liquor in the winter time to warm them?" "In cold cKmates they know better. No alcoholic USES OF ALCOHOL 221 liquors dare be permitted in a northern lumber camp." "But it makes a person feel warm." "That is true. It brings the blood to the surface, and for that reason assists in the radiation of heat; or, in other words, it causes the blood to flow out in increased quantities, so that it can cool faster, and it has been dem- onstrated, hundreds of times, that one can stand much more cold without the use of liquor than with it." "Then, if that be true, the use of liquor ought to re- duce fevers." "It is often given for that purpose vvith good results." "Then, from your point of view, alcohol is a medicine, and has no place as a food ?" "That is true ; the habit of using liquors for the purpose of making one feel better results in untold harm. People ought to learn how to live so that they do not need liquor or coffee or any other stimulant to give them energy suffi- cient for their work." "What is the principal effect of alcohol as a medicine?" "It stimulates the nerves, the action of the heart, and increases the circulation. It is sometimes useful in dis- eases of the stomach as a stimulant and to prevent decay, but should never be used except by the advice of a com- petent physician." "Then, according to your view, alcohol does not give increased strength, as many people suppose?" "No ; it merely acts as a spur or as a whip would on a tired horse, and only draws on reserve force; and the more that is drawn on, the sooner .it results in total inca- pacity for work. "Probably the most important of all the uses of alco- ht)lit liquors is iii fevers. When, after prolonged illness, th-ere may be dfingier of the heart's failure, liquors arc 222 WHEN MOST HARMFUL useful in such conditions to stimulate the action of the heart." "Doctor, it is a common belief that the use of beer de- creases the consumption of other liquors?" "That is very doubtful. In the first place, it is difificult to get reliable statistics, because it is almost impossible to determine the number of people who drink liquor. It is a well-known fact that the total abstainers have in- creased more rapidly in recent years than ever before; and if this be taken into consideration it is more than prob- able that the liquor drinkers still drink as much or more distilled Uquors than ever before, notwithstanding the enormous consumption of beer, at least the general use .of malt liquors has increased, rather than decreased, drunkenness." "Doctor, you have said nothing about the moral as- pect of liquor drinking." "Well, we are not dealing with moral questions, but we have already said that most people have neither the instinct of brutes nor sufficient reason to guide them, and are, therefore, very imperfectly organized." "When can liquors be drank with the least injury?" "At meal time; for some people, a small amount of liquor at meal time is less harmful than tea or coflfee; but the man who drinks quantities of liquor of any kind whatsoever,, on an empty stomach, so violently outrages his system that he needs something added to or taken from his brains." "Doctor, what kind of a drink is soda water?" "Soda water is made by simply aerating water with common carbonic acid gas." 'How is the gas made?" "By saturating marble dust with sulphuric acid, and the gas is collected in a tin-lined tank, and is drawn off, mixed SODA WATER 223 with the water as drawn. The flavoring matter is sup- posed to be fruit syrups; but for the most part, they are made of essential oils." "Is the drink beneficial or injurious?" "There is not enough of any very active substance to have much effect, and it is usually considered an occa- sional glass of soda water does no harm, although if tanks are not properly lined, the soda water would be poison- ous. It should not be drunk except on an empty stom- ach." "Ginger ale is quite similar to soda water, only has con- siderable quantity of ginger. It is sometimes beneficial, but not a good drink for continual use." "Root beers are usually fermented drinks; and while some people think them wholesome, it is difficult to un- derstand how any fermented drink can be of any use to the system, although they have probably not sufficient amount of ferment to be of any particular injury, and certainly no benefit. CHAPTER XX. INFANT FEEDING. "Doctor, you have discussed the processes, of diges- tion and the properties of foods, cannot the people adapt their diet to tlieir needs from the information you have given?" "Well, the advice ought to be- of great help, yet there is more to learn; for we have not said a word about the quantities of food needed for diiTerent conditions." "A good many people think that appetite ought to govern, both in the selection and amount of food that each person should eat."' "What else has been governing them since the dawn of creation? As the people now live, ninety-nine out of every hundred are partly or wholly disabled a considera- ble portion of the time, which is a poor reason for doing things as they have in the past. Those who say that appe- tite should absolutely govern, are not very thoughtful, to say the least." "Why so? Do you think present conditions show such grievous effects?'' "Not the effects alone, however bad, tut the principle of being governed by appetite is not in harmony with common practice; for is it not the cook who decides what food we shall eat?" "I guess you are right, Doctor; the cook may not pre- pare one meal a week to suit the appetite or needs of a single member of the family." "That's the point; most people have little or no choice in the selection of their diet; they must eat what is fur- nished, and that is often incompatible; hence, the system 23S 22& HUMAN BEINGS NO INSTINCT is not nourished, and an excessive amount of food must be consumed to supply some necessary ingredients. It is foolish to talk about instinct guiding a human being. If such were possible, it would be the least perverted, and therefore a safe guide in the care of infants. Now, a child will go into the fire, or off of a precipice, or swallow pins, coins, buttons, and ®ften kill themselves eating pop- corn, raisins and other foods ; while an animal, governed by instinct, will not do such things. Here is another very striking illustration of both ignorance and lack of instinct. Young infants often have indigestion from nurs- ing too frequently. This gives them the colic, so-called, and their discomfort makes them fretful." "Well, what of that?" "The baby cries, and the mother hastens to nurse it. Now, it is already sufTering because it has nursed too often, but the child has no instinct and the mother no knowledge to prevent the repetition of the injury." "Your statement seems reasonable. Doctor; for almost every one knows that a grown person cannot stand con- tinual feeding, and it does not seem rational to conclude that a young babe could do it." "No; the injurious effects of continual feeding have been so often proven by every good physician, it must be accepted as a fact." "Doctor, how often should a baby nurse?" "During the first three days after birth, four or five times a day. One or two teaspoonfuls of water may be given occasionaly, but no other food. After the first few days the child may be allowed to nurse every two or three hours, between 5 a. m. and 11 p. m., and once during the night, until five or six months old." "Should the child be fed at regular intervals?" "Yes; it is of greatest importance. The hours for feed- INFANT FEEDING 227 ing should even be more regular than that of a grown per- son." "Doctor, would it not be a good idea to give a table, showing how children should be fed at diflferent ages?" "Perhaps so; the best authorities give the following as a guide to hours and quantity of food required for a child up to one year of age: Age of Child. 1 week 1 weeks 1 month 2 3 4 5 6 9 12 How often fed or nnrsed. 2 hours 2 " 2J " 2J " 2i " 3 " 3 " 3 " 3 " 3 " Number of times fed during night. 2 2 1 1 1 Amount of each feeding. 1 OZ. Hto3 2ito3 4 OZ. 4 OZ. 5 OZ. 3J OZ. 6 OZ. 7^ OZ. 8 OZ. Daily total. 10 OZ. IS to 16 20 to 24 28 OZ. 28 OZ. 30 OZ. 33 OZ. 36 OZ. 37i OZ. 40 OZ. Daily number of feedings. 10 8 to 10 9 to 10 7 7 6 6 6 5 5 Of course the size and vigor of the child make it neces- sary to vary the quantity accordingly." "Will there not be a tendency to fretfulness between the periods of nursing?" "There should not be, although babies frequently get dry and cry for water. If a child is fretful and there is no reason why it should be hungry, it should be given water with a teaspoon." "How soon can the night nursing be discontinued?" "After a child is six months old it may be nursed at bed time, say ten o'clock, and early in the morning, be- fore seven. After it is a year old, it need not be fed later 228 ARTIFICIAL FEEDING than seven or eight in the evening and at its usual hour of awaking in the morning." "Will babies readily accept this arrangement?" "Not always. They may want to nurse every fifteen minutes; but the mother should be guided by reason in feeding, just as she would in keeping her babe out of the fire if it should have an impulse to go into it." "Suppose the child doesn't thrive, what then?" "Of course no arrangement of feeding can supply the place of wholesome milk, ana it often happens that tlie mother is incapable of doing this. In such cases the next best thing is cow's milk." "That would seem to be very poor, considering the number of deaths' attributed to it." "Artificial feeding has always been the greatest source of infant mortality, and great care should always be exer- cised in the preparation of milk for infants. Cow's milk diiifers greatly from human milk." "Yes; I remember that you said it contained much more casein, or curd, and much less milk sug^r." "So I did; and it is therefore much more difficult to digest, and should be modified for infant feeding." "What do you mean by modified?" "It must be diluted to make the curd smaller, and en- ^riched by cream and sugar." "What is the best method of doing this?" "It should receive about twice as much water as the quantity of milk, so that one pint of milk makes three after being diluted. This may be done in several ways. If the child's digestion Be good, pure water may be all that is required ; but if not, and the child is sick or cross, some other method must be resorted to. The most com- mon diluent is barley water. For this, take pearl barley (or rice) and pound or grind to a fine flour; add two ta- MODIFYING MILK 229 blespoonfuls of the flovir to each quart of cold water and boil for an hour, and then strain through clean, fine linen or a colander. Keep in cool place. In case of diarrhoea, lime water will be most useful. Take a lump of unslaked lime, half the size of an eg'g, and pour two quarts of hot water on it, and let it stand until clear; then pour oflf the clear liquid for use. Do not use any part of the sediment. For ordinary use 10 grains of bicarbonate of soda (com- mon baking soda) to each pint of water, will make a bet- ter alkaline water than the lime. This should be used in constipation. If neither of these methods should prove satisfactory, refined gelatine, such as the Keystone (made by the Michigan Carbon Co.) may be soaked in twice its bulk of cold water until soft, and then boiled and strained. As gelatine is a good and easily digested food, a considerable quantity may be added to the water, to be used for diluting the milk." . "Which of these diluents is preferable?" "The barley water or gelatine, the bicarbonate of soda for sour stomach, and the lime water in case of diar- rhoea; but neither lime water nor soda should be used continuously." "These diluents are for breaking up the curds. How do you make the milk richer?" "That is done by adding cream and sugar. Some- times half cream and half milk are used, but it is better to take the top milk; that is, after the milk has stood Some six hours the cream and milk of the upper half of the can or jar isi skimmed ofif for use. To each half-pint of top milk twot and a half to three heaping teaspoonfuls of or- dinary sugar should b^ added." "How would you, mix the ingredients for a child two months old?" 230 MILK INFECTION "A child tw<5 months old would require, say, twenty- four ounces each day, prepared as follows : Top milk 8 ounces. Barley water .... 16 ounces. Sugar 4 heaping teaspoonfuls. If gelatine water, lime water or soda water be used instead of barley water, it will require the same amount." "Will children thrive better on this mixture than pure milk?" "Very much. Milk, without dilution, is too rich for many babes. They cannot digest it, and are not nour- ished, but get diarrhoea and die. Many a young babe has been carried to the grave, because its mother did not know of this way of modifying milk.'' "What is the next most important thing to know?" "That the milk has not been poisoned by disease-breed- ing germs." "I don't see how we are to know this." "If people do not keep their own cows, so that they know that they are clean and healthy, and do not know that the water used in washing the milk vessels is not con- taminated by barnyards or privies, or if so, that it has been boiled before using on milk vessels, it is not safe to use milk unless pasteurized or sterilized." "How about cellars with decaying vegetables?" "Well, milk must be kept in an atmosphere that is sweet; if this cannot be done, it must be put in sealed or air-tight jars." "I have often heard that milk is a great absorbent of poisons from the atmosphere." "That is true; for there is no other animal food which so quickly decays as milk, or which so readily absorbs poison from the atmosphere, so that the greatest care is needed to prevent its contamination. Milk is an ideal food for infants and children, but if not kept from infec- QUANTITY AT EACH FEEDING 231 tion, it becomes a source of virulent sickness and death. This fact makes it incumbent upon us to vise the utmost care to protect milk from all unclean or contaminating influences, and it must never be allowed to stand in open vessels, where there is foul air, and especially in the sick chamber. It is even objectionable to have milk stand in open vessels in sitting rooms, kitchens or pantries." "Suppose there is doubt about the quality of the milk?" "There may be doubt if you keep your own cow, and there certainly will be if milk is purchased from dairymen. In such cases, it will be much better to buy pasteurized milk in botdes, which should be kept tightly corked. If this cannot be done, the milk should be strained and pas- teurized in bottles or fruit jars that are fitted with air- tight lids; the latter are preferable, because easier cleaned. (For method, see 'Miik.')" "Doctor, I have heard that it is better to feed a child with milk from only one cow." "Yes, many writers have advocated this; but it is more reasonable to suppose that the milk from a herd of cows would have a more uniform daily average than that of any one cow." "Should the milk be warmed before giving to the child?" "Certainly. Enough should be poured out of the sup- ply jar for one feeding and the bottle set in warm water (not hot enough to scald the hand), and left until the milk is as warm as fresh milk.' "How much should be given at each feeding?" "That depends on the age of the child; you will see from the table I gave you that at first a baby takes only an ounce of milk at a feeding, but when a year old, eight or nine ounces at a time. One thing is of greatest im- portance, and that is, not to put more milk into the nurs- 232 FEEDING BABIES ing bottle than the child should have at one feeditig, ac- cording to age and amount given in the table." "Why is this?" "It prevents over-feeding, and you know exactly what the child is getting. If there be indigestion, the amount should be at least temporarily reduced; and if extra hearty, slightly increased. There must be uniformity, both in amount and as to time." "This can't be done when the mother nurses her babe?" "Yes, it can ; the child should not be permitted to nurse longer than fifteen of twenty minutes. Some foolish mothers are disposed to give their babies everything they want, as though their opinions were worth more than the most learned men, who have cared for thousands of chil- dren, both in hospitals and private practice. The safe side is on that of short allowance; this will not likely do any harm — extra allowance probably will." "If one lived in a city and found it difficult to get any milk except what is partly skimmed, what should be done?" "Some sweet cream should be purchased and mixed with the milk — say one part cream to two parts of milk. This should then be diluted with barley or gelatine water, freshly made, put in a bottle or fruit jar, then pasteurized and set in a cool place. The amount necessary for each day should be prepared in this way." "What is the best way to feed babies with milk?" "The nursing bottle is generally used, and it is one of the most objectionable things connected with hand-feed- ing." "For what reason?" "From the fact that bottks are hard to clean, and be- cause people persist ih using rubber tubifig. This can NURSING BOTTLES 233 hardly be cleaned, and is, therefore, a breeding-house for bacteria.'' "Then it is better not to use any tubing at all?" "Well, no mother can afford to have disease-breeding tubing attached to the nursing bottle if she wants her babe to live. The bottle should hold about a haii-pint, should have a sloping neck and oval bottom, that it may be easily cleaned with a brush or sterilized cotton. The nipple should be attached direct to the neck of the bottle and be so constructed that it can be turned inside out and thor- oughly cleaned. The bottles should be washed in borax water and then boiled." "Some people will say that all these precautions are a good deal of trouble." "That is true; but not half as much as a sick baby. Those who would rather have their babies in the ceme- tery need not take the trouble." "Will the method of feeding you have outlined insure healthy children?" "As a general rule it will, but not always, and when milk disagrees, other methods are resorted to. It some- times happens that the prepared foods will agree with a child when milk will not." "Are the prepared infant foods made of milk?" "Well, there are milk preparations, such as Horlick's malted milk, but most of the prepared foods are made of starch, dextrinized, or partly digested, by diastase, or other methods. They sometimes serve a good purpose, but even though they make a child fat, they are seldom healthy." "In the event that milk disagrees, what is to be done?" "That may happen because the child gets too much or too rich milk. In such cases, a less quantity should be given, or the milk may be reduced by adxiing a little more 234 BROTHS CEREAL FOODS water, and not so much sugar. If the child is not sick, but does not thrive, the milk may not be rich enough. It must be remembered that infants do not all require foods of equal richness or th€ same ingredients, and that milk varies much, depending on the breed and the feed of the cows. In the Summer, milk is richer in dry weather than in wet, because the grass is drier and richer." "Is it advisable to give meat broths or other foods to young children?" "Yes; broths made of lean beef, chicken or veal, may be used instead of milk, for short periods, when there is indigestion or diarrhoea. They should be made by macer- ating chopped lean meat in cold water and then pressed. The juice should be warmed, but not boiled. Cold water absorbs much more of the nutritious part of meat than hot. Broths made with hot water are not nourishing. Some children thrive on cream gruel." "How is it made?" "Take rolled oats and add three and a half times its bulk of cold water. Boil an hour and a half, or until it is dissolved to a pulp. Strain through a fine colander (sieve) while hot (the strained portion should be about the consistency of jelly when cold). "To the strained oatmeal add an equal part of sweet cream and one or two teaspoonfuls of sugar; then add three to four times the bulk of both oatmeal and cream of boiling water. This should be an admirable food for children eight or ten months old, although children five months old have done as well as they could possibly have done on any food." "Why is it objectionable for children under eight months?" "It is claimed that young babies do not digest starch, and some eminent authorities say they should not have WEANING 235 Starch before they are ten months old; others equally good, say that the ability to digest starch commences to develop "when the child commences to grow and increases so that it is permissible to give starchy food at six or eight months of age. For very young infants the cream gruel should have malt, or diastase to digest the starch before feeding." "About what age should children be weaned?" "It is always advisable for them to nurse through the second summer, if the mother's health permits it, although it is sometimes necessary to wean children very young. At any rate, the weaning should not be begun during the hot season, if it can be avoided, nor under a year, or over eighteen months old." "Should the nursing be suddenly stopped?" "No; they shotdd be fed cow's milk, modified as di- rected. It would be better to try two parts water to one of top milk in the beginning of the weaning period. As the child grows, the water may be reduced to one part, in- stead of two. The milk-feeding should take the place of the mother's nursing at same regular intervals, and the nursings should be dropped gradually, and the weaning cover a period of two months." "Should children ever be bottle-fed and nursed during the same period?" "Wheneve? a child does not thrive, bottle-feeding should be tried for some of the feedings instead of nurs- ing." "When may a child be given foods other than milk or gruel?" "Strained meat broths may b^ given at almost any age, and next to it is soft-boiled eggs, or eggs stirred into hot, but not boiling, gelatine water. A child cannot mas- ticate soUd food until it has teeth, and milk, with sugar, 236 AFTER WEANING beef or chicken broths, soft eggs, bread and milk, and cereal or starch gruels must form the essential part of every child's diet, until it has teeth. The practice of giv- ing young children solid foods like meats, raw vegetables, raisins and like substances, has been the instrument of death for thousands." "Are fruits not permissible?" "Sour fruit juices are not permissible with milk; but fruits, like apples or peaches, when cooked and free from solid substances, may be given children over a year old." "How many meals a day should a child receive when it commences to eat such foods as you have named?" "From four to five meals a day during a child's second year." "Should children be given tea or cofifee?" "Young children must not be given tea, coffee, beer, liquors, or fermented drinks of any kind." "What foods may be given children over two years old?" "I will first speak of some of the foods not to be given them. The worst abused children are those who are in- dulged by their parents to such an extent as to be al- lowed to eat everything they see. They must be kept out of the pantry; for nothing could be worse than per- mitting them cakes, sugar, pastry, green fruits, or anything else they may happen to want. Besides the objection to such articles, they are frequently allowed to eat them at all hours of the day, and if life were not so exceedingly hard to destroy, the mortality rate of children would de- populate the country. Parents are disposed to be particu- lar about almost everything for their children except their diet, and in this they are less restricted than grown people, although they are in greater need of it." "This is not very definite about what they should eat." PROHIBITED FOODS 237 "But I have only discussed preliminaries, and I am go- ing to strike out their ordinary diet at one blow, by throw- ing out the frying-pan and all fried food ; nor will I stop here; pickles for children are instruments of death, but are not worse than sourkraut, and not much worse than griddle or pan-cakes, salads and raw vegetables." "Which of the fried foods are the worst?" "Fried eggs and fried salt pork, ham or snoulder." "Doctor, your attack on the ordinary way of feeding children is rather sharp, and your list of prohibited foods rather sweeping." "That may be, but there are still more; pepper, mustard and all condiments, except a small amount of salt, must go; together with cheese, bananas, cherries, grapes (unless skins and seeds are removed), blackberries and raspber- ries, except the juice, gooseberries, cranberries, currants, stringy vegetables, unless chopped fine, canned fish, hot, doughy biscuits or bread, cakes, pies, doughnuts, nuts, unless ground, popcorn, raisins for children under eight years old, the skin of fowls, green or over-ripe fruits, to- matoes, mufifins, fritters, salt fish, peas and beans, unless ground or thoroughly cooked and passed tin ough a sieve, green, dried, or canned corn, new potatoes, ice water and ice cream, except in small quantity, when slow eating can be enforced." "Doctor, your lists are as sweeping as a cyclone. Are there any foods except milk you haven't condemned?" "Plenty of them. There is bread, cracked wheat and wheat foods, corn preparations Other thati green, dried, and canned corn, rice, oatmeal, barley, rye, meats in small quantities, boiled or roasted, eggs, raw or slightly cooked, fruits, except as prohibited in the list given, fresh fish, cooked vegetables, when strings are cut very short, baked or masked potatoes, arrow root, tapioca, sago, and gela- 238 DIET FOR CHILDREN tine. Wheat, oat and corn mushes should be strained for children under five years old." "What ought to be the staple diet for children?" "Milk, entire wheat bread, oatmeal, wheat gluten, grits, or germ meal, fruits, rice, meat, fresh fish, and soft-cooked eggs. In all food preparations or mixtures, it must be kept constantly in mind that all the starchy foods require much cooking, while meats and eggs but little; also an excess of fat and sweets must be avoided. As an exam- ple, if eggs are used in rice pudding, they must be added after the rice is cooked, for there will be enough heat in the rice to cook the eggs." "Should the diet of growing children differ materially from that of older persons?" "It should contain more tissue-forming food and more mineral matter. These elements are found principally in milk, wheat, oats, meats and eggs. The first three in some fornl or other should compose the main part of their diet. Growing children who do not have foods con- taining lime, will do better on hard water than on soft, as the former furnishes lime necessary for the bones." "Doctor, can you give a model diet for different ages of children?" "It is easy to indicate suitable food, but very difficult to be definite as to quantities, because there are so many modifying circumstances. One child may be as large and active at three years of age as another at five; then tem- perature, clothing, exercise and growth are all elements of food requirements. Probably as near an estimate as to quantity of food needed for an adult is about one ounce of food as ordinarily eaten, or half an ounce of dry food, to each three pounds of weight of the individual, but for fat people, or the sedentary, this would be much too high for a daily average. Now, as I have already stated, chil- INFANT FEEDING, FIRST PERIOD 239 dren require a higher per cent, of nitrogen, because, in addition to the ordinary waste of tissue, they must have something for growth; but as the average growth does not exceed one-third of an ounce per day, which is seventy per cent, water, it will be seen that the need for growth has been gready exaggerated by many writers. A child a year old will consume forty ounces of milk, con- taining five ounces of solid food, while the average growth of a child per day will not exceed a tenth of an ounce of soUd matter." "How would that compare with the standard diet ot grown people?" "The diet for grown people, weighing seven or eight times as much as a child one year old, would contain about four times as much protein as the diet of an infant one year old." "Doctor, how would you divide the dififerent periods of a child's life, for the purpose of arranging dietaries?" "The first period is from birth up to eight or ten months of age. During this period modified milk is next best to that of the mother's. When these fail, pre-digested starch preparations, sold as prepared foods, such as Imperial Granum, should be tried. Some children do better on them than milk, and some give them with milk to great advantage. Part of a beaten egg may be given for tem- porary use." "Then when a child is eight or ten monJ;hs old,, it may be fed some starch?" "Yes; white bread, crackers, arrow. root and sag® may be added to the milk given the child. If bread be used, it must be good bread, well baked and dissolved in milk or hot water, and given in small quantities. Wheat, oats, and rice pl'eparationSj'when boiled to a pulp and strained 240 FEEDING, SECOND PERIOD through a very fine sieve, are very useful additions to milk." "When may other foods be given?" "It must be kept in mind that a, child must not. have solid food until it has teeth, although other soft food, such as mashed potatoes, baked or stewed, sweet or. sub-acid apples, free from peel, seeds and core, may be given." "May other fruits be used?" "They must be used with great care; all very sour and astringent fruits must be avoided. In constipation, slightly acid fruit juices, when strained, may be griveni two or three hours after meals, and one hour before." "When may other animal foods be added?" "Soft-boiled or poached eggs may be given children in their second year, and in some cases the first. It would be well to give only one or two teaspoonfuls at first, and never more than one egg at a meal until a child is four years old. The practice of permitting children to eat two or three hard-fried eggs is most reprehensible and danger- ous to the child." "When may solid food be allowed?" "A child should have a good number of teeth at two and a half years of age, and this may be said to be about the beginning of the third period." "Are no meats to be allowed before a. ekild is two and a half years old?" "Meats are given after eighteen months of age, but they must be- scraped, ground or in some way reduced to a pulp or powder." die'tt'*^'" ^ ''^^^^^ ^^^^^ I suppose it may be given a dry "Only to a limited extent. The diet should still con- tmue much the. same, except thiat the bread need not be" soaked, nor the meat powderedj Cooked gaai^icn vegeta- CAUSES OF INFANT MORTALITY 241 bles (one variety at a time), cliopped crosswise of die fibre, may be added to some of the meals." "When would you change this diet?" "Well, there should be no radical change made from this diet, except an increase in quantity,- and some relax- ation as to straining foods, when a child reaches five or six years of age." "When would you allow such prohibited foods as to- matoes and bananas?" "They might be tried in a limited way, at six or seven years of age; baked bananas at two or three." "Would you allow the use of fried foods at this age?" "No; I would bar the frying-pan for all ages." "Doctor, you seem to be severe. You must consider the effects of bad feeding and training very far-reaching in their effect." "The fearful infant mortality only faintly indicates the direful results of ignorance on this subject. Who can measure the sorrow, anxiety and care expended on sick children, that could easily be avoided? Nor is this all; they are allowed to grow worse than maimed, a burden to themselves and often a care on their friends or society. Why is there not some anxiety on the part of parents, to give their children freedom from pain and disease, as well as riches? Is not a sound body more conducive to hap- piness than wealth?" "Then you think if children were properly ushered into manhood and womanhood, and taught how to live, most of our troubles would be averted?" "Undoubtedly; even a weak child, if properly fed and trained, may be developed into good, healthy manhood or womanhood, and their growing period is the time to cor- rect their defects/' 242 CHILDREN'S DIETARIES From 12 to 18 Months Old. "Doctor, will you arrange dietaries for children from the age of one year to maturity?" "I have already done so, and will read it to you:" "A child 12 months old should be fed at about 7 and 10:30 a. m.; 2:30, 6 and 10 p. m. If the child is not weaned, it will probably be advisable to allow it to nurse the first, third and last meal, and fed the second and fourth. When the nursing is reduced to twice a day, it will be best to nurse the second and last meals, and finally feed- ing may be substituted for these, as weaning progresses. A child a year old, will require forty ounces of modified milk, one-third of which is milk and cream — 'top milk.' A child a year and a half old will require a pint, to a pint and a quarter of top milk, and two or three ounces, when strained, of well-cooked starch, either rice, barley, flour, arrowroot, sago or oatmeal, four or five teaspoonfuls of sugar, and a pint and a half of water, for the five daily feedings. Meat broths, egg or prepared fcods, rhay be • substituted if they agree with the child better than milk and starch." "In following this outline for feeding, what would be the most probable error?" "Giving an excessive quantity of food and too little fat — ^the result of poor milk " Dietaries— 1^ to 2i Years of Age. Milk, cereal gruels and mushes, sago, arrowroot, tapi- oca, eggs, bread and milk or broths, scraped meat in small quantities, meat broths, rice, milk or gelatine or starch pudding, stewed fruits that do not require sugar, such as apples and prunes, without skins. 2| to 6 Years. _ To above add: -Meat, powdered or scraped, bread, en- tire wheat, fish, fruits, according to directions, cooked CHILDPEN'S DIETARIES 243 garden vegetables — except tomatoes, cucumbers and pep- pers — wheat gluten, mashed potatoes, baked potatoes. 6 to 10 or 11 Years. Additional foods: Tomatoes, bananas (occasionally), raisins, oysters. Straining will not be necessary for cereals, but for legumes, peas, beans and lentils, ground or cooked until they are of consistency of puree, powdered nuts." CHAPTER XXI. DIET IN PUBERTY. "Doctor, why do you make a division at 10 or 11 years of age?" "The dietary from 6 to 11 was intended to reach to the age of puberty." "Then you regard puberty as a critical period?" ^ "For girls it is extremely so, because mistakes at this time not only seriously affect girlhood and womanhood, but it also curses unborn generations." "How is that?" "The young girl of to-day will soon be the mothers of another generation, and what affects their health will likely affect their progeny." "What connection has food with such dreadful results?" "There can be no growth without suitable food; for nourishment is a vital element of all life. Now, when a girl reaches puberty, there is an increased physical, de- mand, for two reasons: (1) It is a period, of more rapid growth, or at least it shouM he so. (2) , The functional development of the sexual-organs causes an increased drain on the system, which, if net met by suitable nour- ishment, results in injury well-nigh immeasurable." "Is that the reason why young girls are so often anae- mic ?" "It is the principal reason. A girl cannot grow into healthy womanhood without good blood, and if she has it not, the effect is as obvious as a long drouth on the summer harvest." "Do you. mean to say, that the disorders peculiaf to 246 CAUSE OF WOMAN'S ILLS women, with the agony they have to endure, are mainly due to lack of care during puberty?" "They are largely due to lack of intelligent care between the ages of 11 and 17. Many girls receive a kind of well- meant care, that is worse than total neglect. , They are the children who are fed dainties, over-dressed, restrained, and in winter kept in rooms ten or fifteen degrees too hot; but in summer are dressed in the thinest fabrics, no matter how cool the weather. Woman's physical woes can be described in short terms: Idioti^jeeding, and maniacal folly in dress." "That is strong language." "But not too strong. An idiot is a person without rea- son. When we do things without reason, things, too, that dumb animals will not do, are they not idiotic? Now, as the conventional dress of women is responsible for a large per cent, of their ills, what less can we call it than mania?" "But how is dress related to feeding?" "In this way: A well-nourished body, to a great ex- tent, protects itself; but if the organs of the body are dis- placed* or the circulation interfered with by tight clothing, ^it.carinot dosb" . - "Be a little more specifiG, doctor. .Name the. habits .that seem to you the most injurious." :. ■ . . "Eating at all hours of the day. Eating improper .food, such as pop-corn, cake, candy, pickles, green and over-ripe fruit, fried foods and doughy bread, saturated with butter or gravy. During puberty, girls' appetites seem to crave all sorts of things, because they see others eat them; whereas, the demands of the body require food rich in tissue-forming substances, and not very difficult to digest. Eating between meals is one of the most pernicious habits of school girls, and it can't be cut too short. Pampering ichildren with all Sorts of pastry ^nd "highlyvseasoned , PAMPERING CHILDREN , 247 dishes, destroys the taste for natural food, and curses them for life. They should be fed on plainly, but well cooked cereals, well-baked bread, from entire grain, milk, meat, eggs, cooked without fat, and sound, ripe fruits. A lim- ited amount of sugar, syrup or candy, may occasionally be eaten at meal time. Pop-corn and nuts are wholesome when finely ground, but must be prohibited as ordinarily eaten." "Young people should have good digestion, why so particular?" "Because the newly-developed functions of sex interfere with digestion for about five days before and after stated periods, so that nearly a half a month is taken up with the excretion of waste and repair, which makes them ex- tremely sensitive to cold and liable to constipation, both of which must be shunned as deadly enemies." "Why should they shun constipation more than other people?" "Well, besides the importance of good digestion at this period, accumulation of fecal matter in the bowels, dis- turbs the circulation in the delicate organs of generation, and may cause a life of suffering." "Doctor, you seem to favor both freedom and restraint." "Yes, a girl should be dressed so as to allow the great- est personal activity, and mothers should remember that a daughter's health is far more important than lady-like deportment. As an example of anaemic women, there are none so bad as the French of the upper classes. Re- straint, convent life, and folly in dress, make the French women the poorest, physically, that exist in any enlight- ened, country." "How would you overcome the disregard for warmth, nourishing food, regular eating, and lack of exercise?" "By teaching girls before they rich puberty, that they 248 PROPER TRAINING, PRE NATAL INFLUENCE are to become women, and that it would be far less injuri- ous for them to cut off an arm or a foot, and less painful, too, than to be badly developed women and have to suffer all their lives." "How about diet for boys?" "If fried foods, green and over-ripe fruits, and an ex- cess of food, be kept 'from boys, they will not be sick." "How can over-eafing be prevented?" "By taking all the food necessary for one meal on the plate or dishes at one time. Boys should not be allowed to repeatedly help themselves, for no attention is paid to the great quantities of food eaten in this way." "Doctor, you have indicated from your remarks that you were a strong believer in pre-natal influences, and I suppose that diet and the mental conditions of prospective mothers are very important factors in shaping the char- acter of unborn children?" "Undoubtedly; the unborn child is mainly dependent upon its mother for its physical life, and to a great extent its mentality, and these, in turn, must have proper nour- ishment or be undeveloped." "Are there not other influences which affect the pre- natal life of the child?" "Yes; this is especially true of dress. A well-known author, when asked when a prospective mother should discard the corset, very pithily answered, 'Two hundred years before her child is to be b-orn;" but this does not be- long to foods." "No, I am sorry; but in the companion volume you can sing the undying dirge of the waist-constrictor and pain-producer of female apparel. But what are the faults of the mother's diet that make her children so imperfect?" "The unborn child receives its nourishment direct from its mother's blood, necessitating good health on her part." PRE NATAL EFFECT OF FRUIT 249 "Is there any particular kind of food required?" "There is a theory advocated in Tokology, and other books, that child-birth is made easy by a fruit aiid starch diet. It is argued that acids dissolve mineral matter and prevent the bones of the unborn child becoming solid, and that when fruits are used in connection with foods con- taining but little lime and other mineral substances, the bones of the child at birth will be extremely flexible, and birth, therefore, very easy." "You don't endorse the theory?'' "No; because the bones of all children at birth are soft, and when they are deficient in lime, the child will be in a diseased condition called rickets. In health, nature al- ways preserves its own balance, and when it cannot do this we have disease.'' "Probably the good efTect is due to the fruit diet?" "That is it. A wrong theory did not spoil the good effects of the diet when it happened to be particularly adapted to the person using it." "Then you endorse the fruit and starch diet, but not the reason given for it?" "Not entirely — it is a good thing carried too far. As already explained, fruit is an internal cleanser, which gives life and elasticity to the tissues of the body and prevents constipation and uric acid concretions, and it is these effects which have given such satisfactory results to pros- pective mothers." "What is it that you condemn?" "It has several faults, chief of which is the indiscrim- inate use of fruit acids and starches. To give you an example of the effect of acids and starch, L recently emp- tied a man's stomach eighteen hours after eating tapioca. Now, tapioca is practically pure starch and easily digested , but in this particular case there was an excessive secretion 250 ACIDS AND STARCHES of acid, and the tapioca was not digested in eighteen hours, but the particles were much larger than when swal- lowed. In another case, I found undigested and un- changed grains of rice five hours after the lady had eaten rice and two oranges.'' "Might that not have occurred with meat?" "No ; I have emptied stomachs where there was exces- sive acid secretion and found meat digested within one hour from the time when eaten." "Then you favor a meat diet?" "Only to a limited extent. I favor a fruit diet, but not such incompatible foods at the same meal as rice and oranges and rhubarb and toast." "You must know of some ill effects to unborn chil- dren?" "Yes; excessive or imprudent use of fruits derange di- gestion and bring dyspeptic and crying babies into the world." "Some people think they cannot have too much of a good thing." "I am not one of them. It has been my constant study to find out the use of foods from a practical standpoint, rather than follow the speculative theories of either scien- tists or 'faddists,' and my original investigation makes me an enthusia.st in the use of fruit." "What diet would you advise for the pre-natal develop- ment of the child and the health and comfort of the mother?"' "The welfare of the unborn child and its mother are in- separable. Her largest meal should be breakfast and her lightest one supper. The daily diet should consist largely of fruits and cereals — wheat, oats, and rice, with entire wheat bread for the staple part of the diet. Broiled or stewed chicken, baked fish, broiled, boiled or roast beef PRE NATAL DIETAHIES 251 or lamb may be eaten for one meal, breakfast or dinner, on alternate dap. The meat must be powdered by grind- ing or great care taken in its mastication. Fried or tough meat must be wholly excluded. One or two soft-cooked eggs for breakfast or dinner may be eaten on alternate days, when meat is not allowed. The general rules laid down for the use of fruit apply to all conditions. A model dietary would be something like the following:" Pre-natal Dietaries. Breakfast — For tissue-forming foods use one or two of the following, according to taste and convenience: Eggs soft-cooked at low temperature. Fresh beef, mutton, chicken, venison, quail, pheasants, stewed or roasted — no canned or salt meats — fresh fish, boiled or baked, oysters (fish and shell-fish are so often contaminated that they are more or less dangerous), peas and beans ground and thoroughly cooked, or boiled and passed through a colander, powdered nuts or nut foods, wheat gluten, milk when not used with sour fruits, so as to form. large curds. For Starches. Dry toast, dried and then browned by hot coals or very hot oven. Roast grains that have been well boiled before roasting. Vegetables to Suit. Stewed celery, boiled onions, stewed asparagus, spin- ach, well cooked, tomatoes (occasionally), squash, lettuce, string beans, green peas, radishes (only in small amolmt when in good health), rhubarb (occasionally, in small amount). Fruits. Sour fruits should be used with the meal containing the least starch; for that reason we class them with the meat or egg meal. Baked or stewed apples, such varieties as 252 PRE NATAL DIETARIES Ben Davis, Wine Sap, Northern Spy, and Bellflower. Oranges may be eaten at breakfast or an hour before, with small cup of hot water. Grapes, without skins and seeds, strawberries, plums of the large varieties, but not the as- tringent kinds, peadies, pineapple juice, but no fibre. Fats. Cream, butter, nut butter, powdered nuts or nut foods, breakfast bacon — ^broiled. Butter is often more or less rancid, and is worse in this respect than cream. Good cream and nut butter are the best of all tats. Drinks. Not more than four ounces of fluid is allowable of one of the following: Hot water, hot water and milk mixed, caramel cereal, cocoa and chocolate in small quantities are permissible where there is active exercise. Breakfast should contain from one and a half to two and a half ounces of protein — tissue-forming food — and should give from one thousand to fourteen hundred calories. (See tables giving compo- sition of foods.) Dinner. Dinner should not, under any circumstances, be less than five nor more than seven hours after breakfast, and should be regular. Six hours is the best, and may include one or two articles from the following list, for each meal: Corn bread, whole wheat bread, Ralston Health Club Breakfast Pood, wheat germ grits, Granola, Crystal Wheat, rolled oats, rice, beans, hominy and other cereal foods. All may be served with milk. Vegetables. Potatoes — ^baked, boiled, stewed, roasted or mashed — though mashed potatoes are objectionable, because they do not get sufficient saliva in eating, and become too PRE NATAL DIETARFES 253 easily swallowed. Boiled cabbage, without fat, celery, raw or stewed, greens, spinach, cauliflower, pumpkins, squash, green peas, string beans, green corn, tomatoes. Fruits. Apples — sweet or sub-acid, baked or stewed and eaten without sugar; peaches that are not rich in acid, sweet grapes, figs, stewed, dates, stewed with skins removed, pears (with exceptions of those that are puckery — they are astringent and not allowable), prunes with skins removed. Fats. Same as breakfast. Dinner should furnish one or two ounces of protein and about twelve hundred calories of heat. This is not arbi- trary, but a guide to diet properly balanced. Supper. Stale, dry bread, dry or milk toast, boiled rice — prefer- ably boiled and roasted — wheat foods, tapioca or sago, baked potatoes, honey and molasses (sparingly), baked or stewed apples, sweet grapes, watermelons. Dessert. Fruit pudding, custard, corn-starch, rice pudding, gela- tine pudding, ice cream, in small quantities, slowly eaten. Fats. Same as breakfast, only in less quantity. Drinks. Milk, if it agrees, otherwise same as breakfast. The breakfast meal may sometimes be made the dinner (noon) meal, and the dinner meal the breakfast. Sugar should be avoided so as to allow the largest use of fruits and starches. The astringent fruits, such as blackberries, raspberries, dew-berries, cranberries, pomegranates, wild cherries and quinces are to be avoided, except when there is a tendency to diarrhoea. If bowe's are too free, leave off the coarse vegetables, the cereals containing bran, and 254 TO PROSPECTIVE MOTHERS the sour fruits. The general rules heretofore explained should govern. The amount of food must be adapted to the needs as governed by size, exercise or labor, weather and peculiarities. Prevent constipation without drugs. CAUTION. Never eat many different foods at one meal.. Three different foods at one meal are better than a large num- ber., Craving vjery unusual or unseasonable foods is unnatural. Keep the thought of food, and for that matter all thoughts of self out of mind. It is of greatest import- ance that the will be exercised to keep well and pleasant and not be disturbed by the disagreeable things of life. The mind should be occupied, in a useful way. If there be great desire for something unusual it should be grati- fied in such a moderate way as not to do harm." DIET IN CO'NFINEMENT AND FOR NURSING MOTHERS. "The bringing of a new life into the world is a great responsibility, and as the health and character of the child is dependent upon its parents, the time must be near when they will see that it is far more important to have children that are fit to live, than it is to leave them wealth. In ordinary cases, no food will be needed during labor, but in protracted cases it is better to sustain the strength by a cup of hot meat broth or hot milk. It was formerly thought that puerperal women should be fed for several days on broths and gruels, under the belief that it kept down puerperal fever, which was much more common, before the danger of bacteria was known, than it is now under modern aseptic surgery. After her delivery, the mother should drink water freely, and after a few hours' rest she may then be given a cup of hot bouillon or other meat broths, but they must not contain a. large amount of fat. If the patient is disposed to eat an)'thing. DRUGS DURING NURSING 255 she may again be fed a small amount of milk toast, in four or five hours, if made according to directions. Some physi- cians allow meat and solid foods, but it would seem to be better to confine the diet to soft and easily digested foods until the bowels have moved two or three times. Among the foods allowable for the first two or three days, are: broths, milk if it agrees with the patient ordinarily; one egg at a meal, if cooked but little, without fat, or an egg may be stirred in iny of the broths, only moderately hot, but not boiling. Wheat, breakfast foods thoroughly cooTced, boiled rice, cooked four hours, baked sweet apples, cream, a little butter or nut butter, and any of the drinks allowed before childbirth. On the second or third day, she may resume her ordinary diet, unless there is some particular reason for not doing so. After a child is born, a mother has two lives to feed from one set of digestive organs. Her own health must be considered and also that of her child. And in this connection it will be useful to consider what aflfects the mother's milk. The medical profession believe that acids ingested by the mother, cause colic in her babe and sometimes griping and purging, and therefore forbid the use of ordinary fruits, 'but the sweet fruits are not only allowable, but beneficial. Potash salts, eaten by a nursing mother act as a diuretic in the nursing child. Large quantities of potatoes eaten by the mother would likely act as a diuretic in the child, but no experiment of this kind has ever been reported, and no apparent injury has ever been observed. The greatest danger is from the indigestion of the mother. The human system being a sort of laboratory, if it be thrown out of balance, it may poison itself, and some of the poison must necessarily appear in the mother's milk. Violent exercise or great emotion or mental strain on the part of the mother endangers her nursing child. This is 256 DIET AT WEANING not all the danger to which the child is subject, for an overdose of laudanum taken by a mother has been known to kill her nursing child. Antimony and iodide of potas- sium are said to pass most readily into milk, while senna, rhubarb, sulphur, castor-oil, turpentine, copaiba and anise; the salts of mercurj', lead, arsenic and zinc are excreted in the milk. Nursing mothers must be careful about taking drugs. Diet must be adapted to secure good digestion, and constipation must be avoided by proper regulation of diet, which should be done according to the rules heretofore laid down. Menstruation during nursing is likely to change the mother's milk, and make it neces- sary to feed the child in some other way. At weaning, the mother should eat a dry diet, and drink as little as pos- sible, to keep in health." CHAPTER XXir. DIETETIC ERRORS AND DIETARIES. "Doctor in discussing digestion and foods you have frequently spoken of dietetic errors. Would it not be a good idea to enumerate them?" "Perhaps so, but one scarcely knows what to give the greatest prominence. For convenience, I will begin with one of the most general faults, and enumerate them, as follows: 1 — Overeating. 2 — Eating fried foods. 3 — Drinking an excess of fluids during meals. 4 — Drinking cold drinks at meals or during digestion. 5 — Drinking an excess of liquids, especially beer, or ice water. 6 — Excessive use of strong tea or strong cofifee. 7 — Haste in eating, resulting in imperfect mastication, and the insufficient admixture of saliva with the food. 8 — Excessive meat eating, including wild game. 9 — Excessive sugar eating. 10 — ^Eating doughy bread, pancakes and pastry. ll^Eating vegetables hastily, without chopping the fibres. 12 — Eating tough, raw vegetables. 13 — Irritating foods, pungent vegetables, pepper, salt, mustard, and other irritating substances. 14 — Taking foods and drinks excessively hot. 15 — Pickles and vinegar. 16 — The admixture of starches and acids. 17 — Incompatible foods such as strong tea, and eggs, acids or vinegar and milk, tea, cheese and acids. 258 DIETETIC ERRORS 18 — Eating fruits with seeds or skins, especially black- berries, raspberries, grapes, currants, gooseberries, rlisins and cranberries. 19 — Eating green and overripe fruits. 20 — ^Excessive cooking of meat. 21 — Insufificient cooking of starches. 22 — Excessive consumption of fats. 23 — Eating too little food. 24 — Eating food containing too little waste such as: milk, eggs, white bread, potatoes, butter, sugar, meat. 25 — Eating food containing too coarse waste, such as green, dried or canned corn, and the tough skins of peas and beans. 26 — Excessive consumption of starch, such as a diet of white bread and potatoes. 27 — Diet deficient in mineral matter. 28 — Eating an excessive quantity of sour fruits. 29 — Foods containing Ptomaines from^ decay. 30 — Eating too many kinds of food at the same meal. 31 — Eating too frequently, and not allowing the stomach time to empty itself. 32 — Irregularity of eating. 33— Going too long without eating. "Most of these have been discussed, and those that have not, will be treated at greater length under causes of in- digestion." "Doctor, who requires the most food?" "Growing boys sixteen or seventeen years old, who do the hard physical labor of mature men." • "What do you call hard labor?" "Harvesting, clearing land, chopping cord wood, dig- gmg ditches, brick and stone masonry, plastering, hand- ling freight and heavy material in foundries, factories and FOOD REQUIRED 259 mills, and other labor requiring great activity and use of strength." "How are the needs of the different classes estimated?" "You will remember that focds are divided into two general classes: Tissue-forming and heat-producing. The variation of amount of food needed is mainly of the latter class, and is estimated by units of heat called calories or rather by kilogram degree calories." "What do you mean by calories?" "Foods have been tested for their heat or force-pro- ducing power, by scientific methods, and the term calorie is the unit measure of heat produced. Now one thousand calories make one kilogram degree calorie, which is ordinarily understood when the term calorie is used." "Then the heat and force producing value of food is estimated according to the amount of work or exertion it sustains measured in calories." "Yes that is it. Fats are the greatest heat producers, and butter produces 220 calories to the ounce, and toma- toes only five. Next to fats sugar and starch produce the highest calories — flour producing 103, and sugar 113 calories to the ounce." "What should the diet contain?" "Our daily diet should contain three to six ounces of protein, and heat7produciog material to make from two thousand five hundred to 5,000 calories (exceptional cases may require more than 5000 or less than 2500), mineral matter, and some waste — a large amount for the sedentary and constipated." ''I see the value of this. One could not eat enough cab- bage or tomatoes to produce one-fourth enough calories for a hard day's labor." "That is true, and here is where the vegetarian diet has failed, when relied on for hard labor, because it made 260 DIET FOR THE AGED too much bulk to produce the calories necessary. But- ter, ground nuts or meats, must be added to a vegetable diet to raise the calories without making too great bulk. "Old age is almost synonymous with physical discom- fort and disease, as if it were not enough to see the light of life fading away, nature is inclined to inflict all the over- due penalties for the transgressions on her for the entire life. But the aged are not without hope, for such illus- trious examples as Gladstone and others clearly show human possibilities. Those who are too thin to cast a shadow, can scout the idea that they will "dry up and blow away," likewise the fat rheumatic and gouty, can dis- prove that excessive fat is but another name for folly. The digestive organs are often the first to weaken, and with poor blood, the system is well-nigh defenseless against di^ase. IThose who have bjeeo large eaters, usually continue so, notwithstanding the lessened de- mands of the system. This may overcrowd the blood vessels, which their weakening walls will not stand, and apoplexy is the result. The most common fault in the dietetic habits of the aged, is eating an excess of sugar and meat. This clogs the system with nitrogenous waste, and causes rheumatism, which is well nigh universal among- the aged well-to-do. Those who would be free from -disease, must bear in mind the lessened needs of the system that follow from a less active life, common to old age, and that it becomes less and less able to dispose of any excess of food. They must also bear in mind that besides the weakness, incident to advancing years, diges- tion is also weakened by general inactivity of the body. WHAT NOT TO EAT. Fried meat, nor fried ioods of any kind. Fresh bread, as ordinarily made, hot bread, saturated with butter or gravy, hot biscuit, cakes of every kind, pies with short- DIET FOR THE AGED 261 ened pie crust, pickles, vinegar, sauer kraut, salt meats, sausages, salt fish, dried meats, raw onions, raw vegetables, strong tea and coffee. Foods that may be sparingly (occasionally) used: Sugar, molasses, syrup, honey, boiled ham, breakfast bacon, sweet potatoes, cabbage boiled without fat, rhu- barb, if no rheumatism or disease of digestive organs, astringent fruits, such as cranberries and raspberries. SUITABLE DIET. Stale or dry light bread, wheat foods according to taste and condition, but particularly gluten biscuit, or gluten meal, rolled oats, pearl barley, rice, hominy of all kinds, eggs, milk, cream, butter, fresh fish, fresh beef, mutton and fowl, but not oftener than once a day; puree made of peas, beans or potatoes, stewed celery, string beans, cauliflower, asparagus, cooked onions, beets with- out vinegar; all fruits, except astringent ones, such as rasp- berries, blackberries and some varieties of pears ; quinces. If old people want to avoid rheumatism, they must avoid eating much meat. They must also be careful a*iout eating fatty foods and sugar, as such a diet will be too fattening, and throw the diet out of balance. For these not engaged in hard labor, two meals a day is all that is permissible. These should be at eight or nine in the morning', and three or four in the afternoon, but should be regular. Nothing must be eaten between meals. If food be needed at night before bed time, a cup of hot milk or a baked apple may be eaten, and will often cure sleeplessness. Tea and coffee are bad for all ages, but particularly so for the aged. DIET FOR BICYCLISTS AND ATHLETES. ■'Athletes desire the greatest strength and endurance, with activity developed in the highest degree. To this end mucles are developed, fat and water reduced." 262 DIET FOR ATHLETES "How is this pccomplished?" "By a diet rich in nitrogen and poor in fat and starch, aided by systematic exercise, massage and baths." "As I understand it, the bulk of an athlete's diet in train- ing, is meat?'' "Yes, and if you will notice contests, you will observe that it frequently happens that some one breaks down." "In the haste to reduce fat, so little water is given, with a diet so rich in nitrogen, as meat is, the kidneys are over- burdened, and there is auto-intoxication." "Then the meat diet is carried to far?" "Yes, soft cooked eggs and milk are better than all meat, and dry gluten biscuit, without sugar is still better. If good, fresh gluten biscuit are not easily obtained, bread made of wheat flour, or middlings may be washed in cold water until the starch i§ dissolved, and the remaining gluten may then be baked or cooked as desired." "What is the advantage of wheat gluten?" "It serves about all the purposes of meat, without the danger from uric acid, which meat produces." "Would you allow bread?" "Yes. Entire wheat bread, because it contains more gluten, or, what is still better, dry crackers made of entire wheat flour without sugar. These are an aid towards maintaining a dry diet and are better than toast. Coarse vegetables must not be used, as there will not be constipa- tion with the necessary exercise, massage and baths in- cident to training. An orange or half lemon may be occasionally eaten a half hour before meals." "Then athletes must not eat vegetables?" "In very limited quantities, if at all. If there be a ten- dency to constipation, there should be an increased allow- ance of such foods as granose or cereals with fine bran. Amateurs who have no such aid as massage and baths DIET FOR ATHLETES 263 need more coarse food, and should eat any of the cereals prepared by boihng and roasting." "You haven't given a complete diet list?" Stale bread — small quantity; dry toast; beaten wheait crackers; biscuit without sugar or shortening; granose, dry; bromose; beef steak Vvfithout fat or butter, or roast beef when cooked by basting in dough; eggs soft, without fat; must not be fried; fresh fish; beans and peas; nut meal; cream; butter; nut butter. HEAT OR FORCE PRODUCING FOOD. QUANTITY RFOUIRID FOR ONE DAY. Light Work. Moderate Work. Hard Labor. Wheat Flour 28 oz. 36 oz. 45 oz. White bread 38 oz. 48 oz. 60 oz. Coi-n meal 28 oz. 36 oz. 45 oz. Oatmeal 24 oz. 30 oz. 38 oz. Lard 10 oz. 13 oz. 17 oz. Rice 28 oz. 36 oz. 45 oz. Rye 28 oz. 36 oz. 45 oz. Sugar 28 oz. 36 oz. 45 oz. Barley 28 oz. 36 oz. 45 oz. Buckwheat 30 oz. 38 oz. 48 oz. Beans 28 oz. 36 oz. 45 oz. Peas 28 oz. 36 oz. 45 oz. Butter 12 oz. 16 oz. 17 oz. Eggs 56 oz. 76 oz. 96 oz. Beef 64 oz. 88 oz. 7 pounds, Potatoes 7 pounds 9 pounds 12 " Sweet potatoes 4-5 " 6 '• 8 " Cabbage 15 " 20 " 27 " Cauliflower 14 " 19 " 26 '• Beets 12 " 16 " 21 " Carrots IS " 16 " 21 •' 264 FORCE VALUE OF FOOD Turnips 18 pounds 2 1 pounds 32 pounds Tomatoes 25 ' 34 45 Celery 30 ' 40 52 Onions 12 ' 16 21 Radishes 23 ' 32 42 Cucumbers 40 ' 55 75 Asparagus 23 ' 32 42 Milii 8 * 11 14 Skim milk 12 ' 16 21 Apples 7 ' 10 13 As all the nutriment, shown by chemical analysis, can never be extracted, this table does not accurately indicate the amount of food required. Eggs and milk contain the least indigestible matter, while in such foods as cucumbers or pickles it is doubtful if more than half or three-fourths of the nutriment as shown by -chemical analysis, is really available for the system. The preceding table is intended to point out the deficiencies of foods as heal or force-producers, and the succeeding one the defects of foods as tissue builders. Table showing the amount of heat per ounce of the principal foods, and number of ounces of each foud from which one ounce of protein can be extracted, NUTRIMENT IN FOODS FOODS. MEATS. Chuck Ribs, lean Ribs, fat Round steak Canned beef Dried beef Veal Calories per oz. 47 54 96 58 88 60 50 Quantity of food from which one oz of protein can be extracted. OZ. 2 oz. .7 .1 .1 2.5 02 5 oz. oz. oz. oz. NUTRIMENT OF FOODS Z65 Lamb 95 5.7 oz. Pork, shoulders 118 7.6 oz. Ham 121 6.2 oz. Salt pork, fat 250 12.2 oz. Pigs' feet 56 6.2 oz. Chicken 31 4.4 oz. Turkey 84 4.8 oz. Fish 2& 4.9 oz. Salmon 58 4.8 oz. Oysters 1=) 16 oz. Eggs, white 8.5 oz. " yolk 6.6 oz. " average 45 7 oz. Milk 20 30 oz. Milk skimmed 11 30 oz. Condensed milk 89 12.1 oz Cream 57 40 oz. Cheese (whole) 123 3.9 oz. Skim milk 82 3.2 oz. Gelatine 96 1.2 oz. Lard 264 all fat Butter 217 all fat Oleomargarine 220 78 oz. Entire wheat 104 7 oz. Common flour 104 9oz. Macaroni 102 8.5 oz. Barley (pearl) 104 11 oz. Buck wheat flour 99 13 oz. Corn meal bolted 103 11 oz. Hominy 103 13 oz. Pop corn 117 11 oz. Rolled oats 116 6 oz. Rice 102 13 oz. 266 NUTRIMENT OF FOODS Boiled rice 56 20 oz. Rye flour 102 14 oz. White bread, dry 75 11 oz. Soda crackers 119 10 oz. Gluten 24 1.2 oz. Apple pie 78 30 oz. Tapioca pudding 49 28 oz. Beans 99 4.5 oz. Beans, string 12 45 oz. Asparagus 7 55 oz. Beets 13 90 oz. Cabbage 10 48 oz. Cauliflower 11 60 oz. Celery 5 71 oz. Green corn 22 36 oz. Greens 17 27 oz. Lettuce 7 75 oz. Onions 15 60 oz. Peas 102 4.1 oz. Green peas 25 22 oz. Cucumbers 4 125 oz. Potato, boiled 30 37 oz. Sour Krout 9 67 oz. Tomatoes 12 71 oz. Sugar 116 FROTTS. Apples 21 200 oz. Bananas 30 83 oz. Grapes 20 100 oz. Oranges 14 125 oz. Strawberries 11 100 oz. Rasins 102 40 oz. Figs, dried 87 19.5 oz, NUTRIMENT OF FOODS 267 Dates, dried 97 45 oz Chestauts 71 15 oz Peanuts 160 4 oz 4 oz. bread equals: 4 oz. fat beef equals 4 oz. boiled rice 1 4 02. boiled rice, l-2oz. Eugar and 2 oz. milk : APPROXIMATE FOOD EQUIVALENTS. '4 oz. boiled rice and IJ oz. round steak, or 1 oz. chicken, 4 oz. potatoes, IJ oz. butter, or 3 oz. corn bread, 9 oz. cabbage, or 6 oz. boiled potatoes. 6 oz. milk, or 6 oz. " " 1 oz. steak and 1 oz-. sugar, or 4J oz, cooked rolled oats, or 4 oz. boiled hominy and 4 oz. milk, or 2 oz. egg, 4 oz. potato, 2 qz. tapioca pudding, or 4 oz. potato, 4 oz, green corn, 4 oz. lettuce, or 4 oz. boiled onion and 4 oz. cucumber, or 1 oz. ham, 3 oz. rice, 2 oz. skimmed milk, or 10 oz. milk and 2 oz. cream, or 2 oz. eggs, 10 oz. apples, or 2 oz. bread and 12 oz. skimmed milk, 22 oz. skimmed milk, or 2 oz. beans raw or 4 oz. cooked, J oz. gluten, or IJ oz. peanuts and 5 oz. skimmed milk. 3 oz. peanuts. ' 7 oz. boiled potato, or 4 oz. green peas and 6 oz. apples, or 8 oz. cabbage, J oz. bacou, or 3J oz. cooked rolled oats, or IJ oz. egg, f oz. butter, or 1 oz. steak, % oz. butter, [bacon, or 6 oz. onions, 6 oz. sour krout, i oz. lard or 2 oz. egg and 1 oz. butter, or 1 oz. pork Shoulder and 7 oz. potato. 268 NUTRIMENT OF FOODS 2 OZ. milk. 4 OZ. rolled oats, (8 OZ. cooked ) 4 oz. peanuts 4 OZ. beans. 4 OZ. eggs. 1 oz.glnten, 1 OZ. butter 4 OZ. chicken 4 OZ. potato. 4 OZ. ham, or 3 OZ. lean beef, 4 oz. potato,3-S oz. butter, or 23 oz. whole milk, or 4 oz. cooked beans, 7 oz. potatoes, or 20 oz. skimmed milk, 1 oz. bacon, or 3 oz egg, 3 oz. bread, J oz. butter, or 2f peanuts and 1 oz. potatoes. ' 5 oz. round steak and IJ oz, fat bacon, or 28 oz. whole milk, or 4 oz. chicken, 6 oz. potato, 2 oz. bacon, ^ or S oz, fish and 2 oz, fat pork, or 7 oz.,eggs, 1 oz. butter and 3 oz. cabbage, or 4 oz. beans, 4 oz. boiled rice. '4 oz. beef, 3 oz. pototoes, i oz. butter, or S oz. fat beef, or 3 oz. chicken, 3 oz. potatoes, 1 oz. butter, or 6 oz. eggs, 2 oz. cream, or 4 oz, bread, 2 oz. fish and 1 oz. cream. ( 17 oz. skimmed miik, or 2 oz. lean beef and 2 oz. potatoes-, or 2 oz. fish and 4 oz. potatoes, or 3-5 oz, gluten and 1 oz. oat mearl. 5 oz, medium fat beef steak. li oz. gluten, or IJ oz. gelatine, -or 4J oz. fish, 4 oz. banana, or IJ oz. raisins, or 4 oz. apples and 2 oz. skimmed milk, or 1 oz. green peas and 5 oz. grapes. GENERAL DIETARIES 269 Those foods that are rich in protein, but have but little starch or fat have but few equivalents. Th& principal foods of this class are chicken, fish, gelatine and gluten. It will be well to remember that no foods- have perfect equivalents; that each food contains more or less mineral matter peculiar to itself; also that protein, starch, fat- and sugar are not perfect substitutes for each other. The same foods vary in their composition, so that the propor- tions that would ordinarily be equivalents, are not always the same. It must not be assumed that knowledge of the com- parative value of foods is of no benefit, for the needs of the human system", come within certain limits, and it is of greatest importance that all persons select their foods to meet their particular needs, and we should be well enough informed to do this, without any special effort, just as a person should be able to speak grammatically, without stopping to consider all the rules of syntax. Appetite is seldom, if ever, a reliable guidfe, though iS may have been so several thousand years ago. The cheapest food on which one can live, in most por- tions of the United States, is corn. It does not furnish a perfect food, but one can live on it for months, perhaps many years. Ten to 16 oz. of corn makes the cheapest meal and the best cheap meal in the world. The cost would be from one half to three-fourths- of a cent, and if perfectly cooked it is quite palatable. Ordinarily it is not half cooked, and to prepare it properly, it should be boiled until the grains will scarcely hold together (com will re- quire from three to five hours), then dried and roasted until quite brown and dry. It may then be ground or eaten whole, but great care should be taken to masticate 270 CHEAPEST DIET it thoroughly, ahhough the boiling makes it dissolve very readily as .compared with parched or pop corn. A little butter and salt improves its palatability. Wheat, oats rye, rice, and barley may be treated in the- same manner; After parching they may be softened by a few moments' cooking, but it is best to eat them dry. There are no foods. so wholesome and nutritious as well boiled and roasted cereals. ROASTED CEREALS. If the cereals were treated as described, and then re- duced to fine flour, all the phosphates and gluten would be saved without any objectionable bran, as the cooking and roasting makes it possible to reduce the tough bran to a palatable flour. Starch indigestion would almost be unknown, if dry parched flours were used, for the reason that dry foods cannot be swallowed without mastication and saliva. If people could be taught to use their saliva in their food, instead of trying to float cuspidors and cars, fewer people would be dyspeptic. The simplest and cheapest diet may be made of cereals or cereals and btitter, or cereals and cream, cereals and nuts. A meal would require eight to twelve ounces of dry cereals, one ounce of fat and six or eight ounces of milk. The diet of the Americans is mainly bread, meat, potatoes. An average meal would probably contain about Oz. Protein. Calories 4 OZ. bread give 4 " nieat " 4 oz. potatoes 1 oz. lard 1 oz. butter 1 oz. sugar 2 oz. milk 10 oz, coffee Total .36 300 .73 240 .13 120 164 217 116 .10 40 1.39 1197 DIETARIES 271 People who eat fried meat and gravies are likely to ex- ceed the above allowance of fat, so that the ordinary meal shows an excess of fat and sugar, but too little waste and too much fluid. The coarse garden vegetable and fruits are not impor- tant factors, in force or tissue production, but they are im- portalnt for other (purposes — ^filling, cleansing. The main part of our diet must consist of cereal foods, legumes, meats, fish, nuts, fats, starch, potato, sugar, milk and cream. A meat diet for three meals, moderate work, should be about as follows: BREAKrAST. Protein. Calories 4 oz. entire wheat bread, stale .45 300 2 oz. lean meat .29 120 4 oz. cooked oatmeal .33 232 4 oz. whole milk .13 80 2 oz. cream 114 i oz. butter 109 i oz. sugar 59 /I r\'J /"tit*Qol /'/\TTO/a t Ui. Ccical LUllcc •^~ Total, L.20 1014 DINNER. Protein. Caloriee. 6 oz. entire wheat bread .67 450 6 oz. potatoes .20 180 2 oz. fat meat, beef .37 180 4 oz. beans (cooked) .SO 240 4 oz. coarse vegetables .10 60 1 oz. butter 217 ' 4 oz. milk and hot water .07 28. Total, 1.91 1347 SUPPKK. . Protein. Calories. 4 oz. entire wheat bread .45 300 6 oz. cooked rice .47 330 272 DIETARIES Protein. Calories. 6 oz. whole milk .20 120 2 oz. ham, boiled .33 242 i oz. sugar 58 i oz. butter 109 Total, 1,45 1159 For those who do no physical work, and take but little exercise, the quantities should be reduced from fifteen to t!wenty-fiye per cent, while tiiose doing hard labor will require from twenty to thirty per cent, more in heat-pro- ducing foods. The cereals should be slightly increased, but the main addition for hard labor must be in fat and sugar. The dietary for the three meals is not an ideal one, btit made to bring ordinary usage into better harmony with physical needs. It would be 'better to make breakfast a larger meal than supper, but it is not the usual practice, so the diet list given is arranged accordingly. We would be doing less than our duty if we did not say that, ordinarily, for those who do no labor, meat should not be eaten but once a day, and by many people not at all. We submit the following as the. best dietary for light labor, with meat once a day: BREAKFAST. Protein. Calories. 5 oz. Granose .71 500 3 oz. milk .13 80 3 oz. powdered nuts, .75 4:80 6 oz. baked apples .03 126 4 oz. hot water or ceiteal coffee. Total, 1.62 , 1206 DINNEB. Ka»tein. Calories. 4 oz. entire wheat bread, dry .45 300 DIETARIES Protein. Calories, 3 oz. roast chickon, .70 93 4 oz. potato .20 80 4 oz. string beans .09 48 3 oz. hominy with 2 oz cream .25 165 4 oz. rice or tapioca pudding .18 310 1 oz. butter 217 4 oz. hot drink Total, 1.87 1223 SUPPER. Protein. Calories. 5 oz. dry toast .55 450 8 oz. milk .26 160 4 oz., cauliflower .05 44 ^ oz. butter 4 oz. peaches 109 i oz. sugar 58 4 oz. :hot drink. Total, .87 821 273 For those who eat light lunches at or near noon, tTie morning and evening meals will be larger, lunch taking the place of supper. It will be observed that the dietary here given, is con- siderably below what other writers allow for liglit work, but to those who are not traveling in ruts already made, it may be learned that the difference between light work and hard la!bor is much greater than usually allowed. The fault is that the allowance for light labor is too high, and that for hard labor too low. A laborer's fheals may be patterned after the following: Protein. Calories. 5 oz. dry bread .55 375 6 Qz. cooked rolled oats .50 360 274 DIETARIES Protein. Calories. 3 oz. potatoes .10 90 2oz. lean meat .40 116 2oz. bacon .10 276 6 oz. milk .20 120 loz. butter 217 i oz. sugar 58 4 oz. cabbage Total, .10 52 1.95 1654 One of the common errors for those who do hard work, is to eat too much coarse, watery foods and to drink too much fluid with their meals. This causes the stomach to be unduly distended, and it is frequently unable to Rrop- erly hai. .He tlr.. great bulk. A moment's reflection will convince anyone that the stomach cannot have the same contractile power when its walls are stretched beyond what they should be, so that when there is large demand for force-producing foods, as in extremely hard labor, it is necessary to eat mostly dry food, and to increase the proportion of fat over that of ordinary diet. Each person's diet should be adapted to his or her par- ticular needs, and as many people thrive better without meat, it would be well for those to pattern their dietaries after the following: 4 to 6 ozs. whole wheat bread, corn bread or dry bis- cuits. 3 to 5 ozs. powdered nuts. 6 to 8 ozs. milk. 1/2 dz. butter. 6 ozs. baked apples or other sweet fruit. Milk, eggs, wheat gluten, peas, beans and nifts, must be relied on to furnish tissue food. For fats, nut meal, nut butter, cream and butter are to be preferred to meat fats. DIETARIES 275 The cost of butter and cream is against their exclusive use for many people, but it is probable that peanuts will be as cheap as any other food. It is mainly a question of grinding or preparing them. The addition of fruits and green vegetables makes no great difference in the amotint of other foods required. In eating green vegetables that contain a large amount of fiber, regard must be had for its effect on the digestion of other food. If not very thoroughly cooked without fat, then chopped fine and well rtiasticated, such food may remain in the stomach for several hours, until decay sets in. In concluding the subject of dietaries, the authors would have their readers bear in mind that it is not a subject that can be dealt with exactly as a question of arithmetic. Each person must study his or her require- ments in connection with the general properties of foods. Overeating can be prevented -by taking what food is needed at one meal on the dishes, and then quit when it is eaten. Do not make a fad of diet, for a large per cent, of the common ailments exist only in the mind. Keep dyspepsia, and all thought of it out of mind, and use some common sense to regulate your diet and habits, and all will be well. CHAPTER XXIII. FOOD ANALYSES. The tables of food analysis here given are made up from many analyses, from many sources, but mainly from the Agricultural Department of the United States : The percentages given are exclusive of waste and refuse. BEEF. Water. Protein. Fat. Car- A«h. Calories bohytrate per oz. Brisket (mad. fat) 47.4 14.6 37.2 .08 115 Chuck (lean) 71.2 19.9 7.8 1.1 47 (med. fat) 67.8 19 12.3 .09 44 Chuck Ribs (lean) 66.2 18 14.8 1 60 (med. fat) S7.3 17.4 24.4 .09 85 Flank (lean) 66.3 17.7 13 .01 55- (med. fat) 59.8 17.9 21.5 .08 77 Loin (lean) 67 19 12.7 1 56 (med. fat) 60.5 18.3 20.2 1 74 Sirloin (lean) 68.5 19.8 10.7 1 51 (med. fat) 62.1 19.7 17.2 1 68 Neck (lean) 50.4 14.2 5.7 .07 31 (med. fat) 45.9 13.9 11.9 .07 47 Ribs (lean) 67.9 19.1 12 1 54 (med. fat) 55.4 16.9 26.8 .09 96 Round (lean) 70.3 20.9 7.7 1.1 45 (med. fat) 65.8 19.7 13.5 1 58 ShaEhk (lean) 71.5 21.4 6.1 1 41 (med.. fat) 67.9 19.6 11.6 .09 53 Heart 62.6 16 20.4 13 1 72 Kidney 76.7 16.9 4.8 4 1.2 33 Liver 66.9 23.1 5.7; ?.5 1.5 42 Marrow 3u3 2,6 877 92.8 1.3 248 278 COMPOSITION OF FOODS Sweetbreads 70.9 15.4 12.1 1.6 SO Tallow IS 4.8 79.9 .03 216 CANNED BEEF. Boiled 51.8 24.4 22.5 1.1 88 Corned, cooked 51.2 25.9 18.9 4 80 Dried 45.3 40.1 6.1 12.6 60 Tongue 51.3 21.5 23.2 4 86 It will be well to bear in mind, the fuel value of meat depends mainly on the amount of fat it contains, but that the lean meat contains some fat not ordinarily visible, and that fat meat contains in addition to its visible layers of fat, a great deal more invisible fat than lean meat. The per cent, of waste in the various cuts of meat is not given, because no one has made any record of how much can ordinarily be gotten out of what may be termed waste. The fore shank is forty per cent, bone and the hind shank fifty-five, while rib has about twenty-five per cent bone, loin thirteen per cent., and round steak about six per cent, bone. Fat meat is l!kely to be more tender than lean, but less economical, because beef fat is less desirable than many other fats. \ -VEAI,. Water. Protein. Fat. Car- Asli;Calories bohydrate peroz. Breast (lean) 70.3 20.7 8 1 45 (med. fat) 66.4 18.8 13.8 1 58 Flank (med. fat) 68.9 19:7 10.4 1 50 Leg (average 72.4 20.6 5.9 1.1 40 Loin (average) 69.2 19.5 10.2 1,1 50 Rump 62.6 20.1 16.2 1.1 66 LAMB , Breast 56.2 19.2 23:6 1 85 Loin \ 53.1 17.6 ,28.3 1 95 Shoulder 51.8 17.5 29.7 1 99 COMPOSITION OF FOODS 279 MUTTON Chuck (med. fat) 50.9 14.6 33.6 .9 106 Flanlj (med. fat) 45.8 14.8 38.7 .7 119 Leg (med. fat) 62.8 18.2 18 1 69 Loin (med. fat) 50.1 15.9 33.2 .8 106 POEK Chuck ribs and shoulder 51.1 16.9 31.2 .9 102 Head 45.3 12.7 41.3 .7 124 Loin (average) 50.5 16.1 33.5 .9 104 Shoulder 47.4 13.2 38.7 .7 118 Tenderloin 65.1 19.5 14.4 1 61 Ham, fresh 62.8 18.5 17.7 1 74 Ham, smoked (av. )40.3 16.5 38.8 4.7 121 Shoulder, fresh 54.3 15.5 29.4 .8 94 (California Ham .) Shoulder 45 15.8 35.2 6.7 104 Dry salt backs 17.3 7.2 72.7 2.8 200 " " beliy 17.7 6.7 72.2 3.4 196 Salt pork clear fat 12.2 4.5 78.8 4.5 250 Tongue 58.6 18 19.8 3.6 73 Feet 68.2 16.1 14.8 .9 58 Bacon, lean 32.7 16.4 45.2 5.7 136 Bacon, fat 18.2 10 67.2 4.8 189 SAUSAGE. Pork sausage 38.7 12.8 46.6 1.8 136 Bologna " 59.5 18.6 18.2 2.6 70 Frankfort 55.5 21.7 18.8 3.6 71 POULTRY. Chicken 74.2 22.8 1.8 1.2 31 Goose 42.3 13 43.9 .8 131 Turkey 55.5 20.6 22.9 1 84 FISH. Black bass 76.7 20.4 1.7 • 1.2 28 Buffalo 78.6 17.9 2.3 1.2 27 250 COMPOSITION OF FOODS. Perch 75.7 19.1 4 1.2 IZ Wall eyed pike 79.7 18.4 .5 1.4 23 Pickerel 79.8 18.6 .5 1.1 V Red snapper 78.S 19.2 1 1.3 25 Salmon 65.2 20.6 12.8 1.4 58 Shad 70.6 18.6 9.5 1.3 43 Sheepshead, 75.6 19.5 3.7 1.2 32 Trout 77.8 18.9 2.1 1.2 27 Whitefish 69.8 22.1 6.5 1.6 43 Cod 82.6 15.8 .4 1.2 19 Eels, salt water 71.6 18.3 9.1 1 45 Flounder 84.2 13.9 .6 1.3 18 Herrirtg 72.5 18.9 7-1 1.5 41 Mackerel 73.4 18.2 7-1 1.3 40 SHELL FISH. Clams 85.8 8.6 1 2.6 15 Crabs, hard 77.1 16.6 2 3.1 26 Lobster 79.2- 16.4 1.8 2.2 22 Oyster, as sold 88.3 6.1 1.4 1 15 Terrapin 74.5 21 3.5 1 34 Turtle 79.8 18.5 .5 .3 25 Shrimps, canned 70.8 25.4 1 2.6 ZZ The viscera of animals does not greatly vary in compd- sition from that of the animal from which it is taken. Canned or preserved meats only vary as water and salt are added or extracted. The canned soups sold in the market contain from eighty-five to ninety-five per cent, water, and from two to five per cent, protein, and are not> desirable from any dietetic standpoint. SGOS. Water. Protein. rat. Calories. White 84.8 12 2 Yolk ■ 51.5 15 30 Average 73.5 14.9 10.6 45 COMPOSITION OF FOODS 281 The shells of eggs average about ten per cent, of total weight. MILE. Water. Pi-otein Fat. Cairbo- Ash. Calories 1 liydrate. Milk, Average 87 3.3 4 5 .7 20 Skimmed, average 90.5 3.4 .3 5.1 .7 11 Buttermilk 91 3 .5 4.8 .7 10 Condensed milk 30.5 8.2 7.1 52.3 1.9 89 Cream 74 2.5 18.5 4.5 .5 57 Butter 14.6 1 82.4 217 CHEESE. Cheese, whole milk 33.7 26 34.2 2.3 3.8 123 " skim milk 45.7 31.5 16.4 2.2 4.2 82 Pineapple cheese 23 29.9 38.9 2.6 5.6 140 Limburger " 42.1 24 29.4 .4 4.1 105 Gelatine 13.6 84.2 .1 2.1 98 Isinglass, Sturgeon 19 77.4 1.6 2 94 Tallow 100 264 Lard, refined 100 264 Cottolene 100 264 Oleomargarine 9.3 1.3 82.7 6.7 2:0 CEEKALS. Water. Protein Fat. Carbo- Ash. ( Calories hydrate. Flour, fine 13.8 7.9 1.4 76.4 .5 102 Entire wheat flour 12.1 14.2 1.9 7O.6 1.2 104 Graham 11.8 13.7 2.2 7O.I 2 104 Low grade flour 11.4 13.9 2.6 7O.8 1.3 105 Spring wheat 11.6 11.8 1.1 75 .5 104 Winter wheat 12.5 10.4 1 75 .5 104 Crushed wheat 10.5 11.9 1.7 74 1.4 105 Macaroni Vermicelli 10.8 11.7 1.7 72.9 3 102 Barley meal 11.9 10.5 2.2 72.8 2.6 102 Pearl barley 10.8 9.3 1 77.6 1.3 104 Buckwheat flour 14.3 6.1 1 77.2 1.4 99 Corn meal, bolted 15 9.2' 3.8 7O.6 1 103 .6 78.9 .4 103 5.6 71.4 1.4 109 .5 70.7 1.3 117 7.3 68 1.9 116 7.2 66.8 1.9 116 .4 79 .4 102 .1 49.1 .3 55 .9 78.5 .8 102 282 COMPOSITION OF FOODS Hominy 11.9 8.2 Pop corn 10.8 12.3 Pop corn, popped 4.3 10.7 Oat meal 7.2 15.6 Rolled oats 11.2 16.7 Rice 12.4 7.8 Boiled rice 52.7 5 Rye flour 12.7 7.1 Reported analysis of Southern corn shows a very high per cent, of protein— so high in fact, and so different from the authors, that we refrain from publishing any analysis until we have more convincing data. We regret that we have not more accurate knowledge as to the per cent, of cellulose or indigestible part of the various cereal foods. It appears that fine white flour has less than one per cent, of cellulose; rice about three per cent.; oat meal four per cent.; and corn meal five per cent. ; and that the entire grain of wheat, rye and corn contains a still larger per cent, of cellulose. GEBEALS. Water. Protein 1. Fat. Carbo- hydrate Ash. ( Jaloriei White bread 35.4 9.5 1.2 52.8 1.1 75 Graham 32.3 8.5 1.8 55.9 1.5 80 Rye 31.8 10.1 .7 55.9 1.5 76 Biscuit 22.9 9.3 13.7 1.5 108 Coffee Cake 30.1 8.6 6.6 58.9 .8 90 Drop " 16.6 7.6 14.7 60.3 .8 117 Sponge " 11.6 . 6.5 9.6 70.3 2 114 Butter crackers 6.9 9.2 13.6 69.4 .9 127 Graham " 5 9.8 13.6 69.7 1.9 128 Oatmeal " 4.9 10.4 13.7 69.6 1.4 129 Oyster " 4.3 11. 8.8 74.2 1.7 122 Soda 8. 10.3 9.4 70.5 1.8 119 Doughnuts 17.9 6.6 21.9 52.6 1. 126 COMPOSITION OF FOODS 283 Apple pie 43.2 3.3 9.8 41.7 2. 78 Custard 62.4 4.2 6.3 26.1 1. 52 Tapioca pudding 61.8 3.6 3.7 ,30. .9 49 It will be well to remember that the composition of bread, crackers and pastry vary greatly, according to the amount of butter, lard, sugar, eggs, milk and other in- gredients that may be added. VEGETABLES. Artichokes 79.5 2.6 .2 16.7 1. 23 Asparagus 94. 1.8 .2 3.3 .7 7 Beans, dried 13.2 22.3 1.8 59.1 3.6 99 " Lima 11.1 15.9 1.8 67. 4.1 101 " string 87.3 2.2 .4 9.4 .7 13 Beets 87.6 1.1 .1 9.6 1.1 13 Cabbage 90.3 2.1 .4 5.8 1.4 10 Carrots 88.2 1.1 .4 9.2 1.1 13 Cauliflower 90.8 1.6 .8 6. .8 11 Celery 94.4 1.4 .1 3. 1.1 5 Green corn 81.3 2.8 1.1 14.1 .7 22 Cucumber 96. .8 .2 2.5 .5 4 Egg plant 92.9 1.2 .3 5. .5 8 Greens 82.9 3.8 .9 8.9 3.5 17 Kohlrabi 91.1 2. .1 5.5 1.3 9 Leeks 91.8 1.2 .5 5.8 .7 9 Lentiles 10.7 26. 1.5 58.6 3.2 102 Lettuce 94. 1.3 .4 3.3 1. 7 Okra 87.4 2. .4 9.5 .7 14 Onions 87.3 1.7 .4 9.9 .7 15 Parsnips 79.9 1.7 .6 16.1 1.7 22 Peas 10.8 24.1 1.1 61.5 2.2 102 Peas, green 78.1 4.4 .5 16.1 .9 25 Pickles 89. .5 .5 5.4 4.6 8 Potatoes, boiled 73.7 2.7 .2 22.3 1.4 30 78.9 2.1 .1 18. .9 24 69.3 1.8 .7 27.1 1.1 35 93.1 1. .1 5.2 .6 7 90,8 1.4 .1 6.6 1.1 10 94.4 .6 .7 3.6 .7 7 88.7 1,3 .2 8.5 1.1 12 86.3 1.5 .8 4.4 7. 9 92.4 2.1 .5 3.1 1.9 7 86.5 1.6 .6 10.4 .9 IS 94.4 .8 .4 3.9 .5 7 88.9 1.4 .2 8.7 .8 12 284 COMPOSITION OF FRUIT Potatoes, raw " sweet Pumpkins Radishes Rhubarb Ruta-bagas Sour krout Spinach Squash Tomatoes Turnips Beets, potatoes, cucumbers lose from 15 to 20^ in peel- ing. Turnips, radishes, ruta-bagas lose 30^ in peeling. Rhubarb, 40;^. In peas and beans 50^ loss in pods. These tables do not clearly indicate the food value of the various vegetables. It would appear that pickles have one-fifth the food valuei of potatoes, while , in fact the nutriment in them is not readily available, and they have practically no food value at all, as they are not sufficiently soluble to be of use for waste. Nearly all the green vegetables, with the exception of potatoes, have a large amount of ittdigestible fiber, but experiments have not been sufficiently extensive to give reliable percentages as to how much indigestible waste the various vegetables contain, but it may be assumed that celery contains from two to three per cent; turnips and onions, exclusive of peel, two per cent; cabbage and beets, three per cent; carrots and artichokes, four per cent.; green and strii^ be^is, four to five per cent. The husk or bran (not pods) of peas and beans amount to about five per cent, and correspond to the bran envelope of wheat, but as the legumes are from ten to twenty times COMPOSITION OF FRUIT 285 as rich as most of the green vegetables, the indigestible part is relatively small, FKUIT. Water. Protein, Fat, Carbo- Acid Asli. Calories hydrate. Apples 82. .5 .5 16.6 1.2 .4 21 Apricots 83. 1.1 13.4 1.2 .5 17 Bananas (yel.) 71.1 1.2 .8 22.9 1, 30 Black berries 88.9 .9 2.1 7.5 1.2 .6 16 Cherries 86.1 1.1 .8 11.4 .9 .6 17 Cranberries 89. .5 .7 10.1 .2 14 Currant 84.7 .5 11. 2.15 .7 17 Figs 79.1 1.5 17.4 1.4 .6 24 Grapes 78.8 1.3 1.7 16.2 1. .5 27 Gooseberries 86. .4 4.6 1.5 Lemons 89.3 1. .9 8.3 .5 13 Muskmelons 89.5 .6 4.6 .6 49 Nectarines 82.9 .9 .6 15.9 .6 19 Oranges 88.3 .8 .6 7. 2.44 .6 14 Peaches 84.5 .5 14.2 .9 .8 19 Pears 83.9 .6 .8 14.2 .2 .5 19 Pine apples 89.3 .4 .3 9.7 .3 12 Plums 79. .5 18.5 1.50 .5 24 Prunes 80.2 .8 18.5 .5 22 Raspberries 85.8 1. 12.6 1.38 .6 16 Strawberries 90.9 1. « 1 6.8 1.5 .6 11 Watermelons 92.9 .3 .1 6.5 .2 8 Whortleberries 82.4 .7 3. 13.5 .4 24 DRIED FEUITS. Apples 36.2 1.4 3.0 57.6 1.8 78 Apricots 32.4 2.9 63.3 1.4 78 Currants,Zante27.^ 1.2 3. 65.7 2.2 86 Dates 20.8 2.2 5.1 70.4 1.5 97 Figs 22.5 5.1 70. 2.4 87 Grapes 34.8 2.9 .6 60.5 1.2 79 286 COMPOSITION OF FRUIT Prunes 26.4 2.4 .8 68.9 1.5 85 Raisins 14. 2.5 4.7 74.7 4.1 102 NUTS. Chestnuts,fresh38.5 6.9 8. 44.9 1.7 71 Peanuts 9.2 25.8 38.6 24.4 2. 160 Cocoanuts 46.6 5.5 35.7 11. 1. 115 Filberts, fresh 48. 8.4 28.5 13.6 1.5 Walnuts 45.5 12.5 31.6 9.9 1.7 The amount of sugar and acid varies greatly even in the same variety of fruit. The food value of fruits is mainly dependent upon the gum called pectose, and fruit sugar it contains. It is to be regretted that our present method of analyzing fruits, does not give satisfactory results as to the acids they contain. The very sour fruits, like the lemon and lime, have practically no food value for either fuel or tissue, but very great value for their acids. They must be regarded as cleansing agents. Most all fruits are more or less so. PART II. CHAPTER XXIV. IDIOSYNCRASIES. Idiosyncrasy is a peculiarity, in which one person is in some way affected in a different manner, under the same conditions, from ordinary people. It is applied to foods when there is a great dislike to some particular food, or where some particular food exerts an effect entirely for- eign to what it usually produces. Idiosyncrasia is the term applied to peculiarities of smell. Both are closely related 'in their effects, and have not been given sufficient attention in their relation to health and disease. We are led to do so, because many people believe that individual peculiarities are so great that knowledge of food is of little or no use. If any of our readers take such a view, we have a troublesome question to ask: What makes the peculiarities? At first thought most people will say that they are "born that way;" but suppose we go farther and ask why people are born with idiosyncrasies? Do they come from some unknown realm , or are they transmitted characteristics? Here is the real key. Transmitted pe- culiarities were at some time acquired, and every one knows that acquired peculiarities are mainly due to habits or education. Who can doubt that if an American child a few months old, was taken to the heart of China, and reared as a Chinaman, but what it would eat substantially the same foods as the Chinese? This fact has so often been illustrated by taking children from civilization to as? 288 IDIOSYNCRASIES barbarism, and barbarism to civilization, that it strongly tends to disprove the belief that people are "born that way." Take an illustration from the lower animals. A Texas cow or Texas pony that never saw corn will not eat it when first ofifered, but can easily be trained to do so. Idiosyncrasies are either mainly accpiired by habit or are the heritage of ancestral habits. A small per cent, are doubtless due to some strong mental impressions made upon the individual or upon the mother while carrying her unborn child. A careful study of the subject leads us to believe that idiosyncrasies toward food might properly be divided into three classes: 1. Those that are physiological. 2. Those that are due to habit. 3. Those that are due to mental impressions. It must not be understood that individuals always mani- fest either oi these independent of the others ; for doubtless many have peculiarities about what they eat, which may be due to either or all the causes mentioned. The physio- logical idiosyncrasies are due to inability to digest certain foods, so that, as a matter of fact, most idiosyncrasies of which we take notice, are not idiosyncrasies at all, but irregular physiological action. Upon this we predicate the declaration, that one food will agree with one person as well as with another person under the same conditions. This sweeps away the notion that people's peculiarities make it useless to study food. It really does more; it proves the great importance of such study, because when we know why foods disagree, and the properties of foods, we will know why they agree at one time and disagree at another. The stomach that secretes but little acid, will poorly tolerate large quantities of lean meat, and such a diet will produce a. feeling of weight in the stomach en- tirely independent of any gaseous fermentation. Those IDIOSYNCRASIES 289 who have an excess of acid- will be distressed when they eat starchy foods, especially bread, potatoes, beans, etc. Such persons say they cannot live without meat, and when they do not have it they always feel hungry, for the rea- son that they cannot digest starch, This is the most seri- ous indigestion. Some physicians confound acid secretion with acid fermentation. Sour stomachs and heartburn are most common where tihe gastric secretions are weak and do not call for a meat diet, as many suppose, but an asep- tic (not readily fermentable) one. Laek of ability to digest certain foods, indicates physical abnormality. Examples might be multiplied wherein various foods agree or disa- gree, depending upon the needs of the system, the activity of the stomach, and the condition of the intestines, pan- creas and liver. It may also depend upon the blood at the time the food was eaten. If the blood be laden with elifete matter and poor in quality, because of a previous unsuitable diet, the general tone of the digestive organs will be impaired. All of these are factors which make it difficult to determine what agrees and what disagrees. And people are often mistaken about their supposed peculiari- ties, but as the incompatibilities of foods and weakness of digestion have been previously discussed, the idiosyncra- sies due to habit will be most interesting. Nothing more jtrongly illustrates the efifect of habit than the unlvetsal fondness for foods "like mother used to make." This is one of the strongest traits in human character and empha- sizes the extraordinary importance of proper home train- ing. The habits of early life seem to be interwoven with every fiber of our existence, and while there is no one in this world so revered as she wHb gave us birth; no name so dear as that of mother; yet it is distressing to realize that disease and death-producing habits are not less de- structive because made familiar to us by her hands. When 290 IDIOSYNCRASIES mothers realize their obligations to their children, they ■will not cultivate appetites and tastes for foods that are in effect the same as murder. Most idiosyncrasies of habit are due to ignorance about foods. Could anything better illustrate this than some of the ridiculous notions people have about what they eat? Let us consider a few of them: Oatmeal. Some people say that oatmeal sticks to the stomach; others, that it is too heavy and unfit for food in hot weather; while still others declare that long cooking makes it "slimy" and not fit to eat. Bread. Most Americans think that no bread is fit to eat, except fresh, doughy bread, loaf or biscuit. Tea and Coffee. . That only excessive whisky drinkers are inebriates, and that tea and coffee are good nerve tonics and strengthen the system. Celery. That it is a brain and nerve food. Soup. That it is particularly wholesome and nourishing. Pickles. That they are eaten by people when in love and are good for young girls and "old girls." Prunes. That they are very laxative or cause diarrhoea. Tomatoes. That they cause cancer and are good food for children. Popcorn. That it is wholesome as ordinarily eaten. Fried Meats. That they are fit to eat. IDIOSYNCRASIES 291 Radishes. That they aid digestion and act on the Hvei. Ice Drinks at Meals. That they cool the system and aid digestion. Contdiments. That they are beneficial. Green Corn. That it is healthful for human beings and bad for swine. Alcohol and Beer. That it increases strength and adds to the general well- being of the imbiber. What can be expected of people who are governed by such expansive ignorance? By way of parenthesis and confidential advice to dys- peptics, we might add, that if their attacks do not come often enough they should eat lobster salad, ice cream and rich cake between 10 p. m. and 1 a. m. If you expect the arrival of your family physician, a good meal of cucum- bers, vinegar, milk and ice water, will very likely make you glad to see him. If habits were not so pernicious and far-reaching in their eflfects, idiosyncrasies would not be worth considering; but as many people's lives are spent running from or running after their idiosyncrasies, it is time that attention should be given to the causes which wreck so many lives. Parents should first purge them- selves of their suicidal habits and then start their children right. A generation or two ago, when disease-breeding luxuries were not so easily obtained, children were reared with a view of becoming strong, able-'bodied men and wo- men, who coulid assist in building homes; now, children to a great extent command the obedience of their parents in all their whims and follies. Parents are the guardians of posterity, and no language is strong enough to portray the misery which results from improper feeding. A diet 29:! IDIOSYNCRASIES mainly composed of sweet-meats and highly-spiced foods so perveris the nerves of taste, that plain, wholesome food is too tasteless or disagreeable. The result is that sooner or later the effects of such habits bring disease, and then they bewail their misfortune as a curse from God or Satan, whereas, it is the curse of personal and parental folly. The first step towards reform is sensible cooking; and then parents must see that their children eat a suitable variety of foods. We have often seen children make a meal on canned tomatoes, also on fried eggs and fried meat, corned beef, bananas, green corn, raspberries, pick- les and cake. Children are often allowed to pepper their food until black and then cover with strong mustard. The effects of allowing cTiildren to have what they wished, as mentioned, varied from "unwell' to death. The great- est obstacles to health is pampered appetites. People will not eat what they do not like, no matter what the conse- quences. Some people urge this as an objection to the study of foods ; but it really only emphasizes its importance. When will j)eople like what will keep them healthy and strong? The answer is simple: It will be when they are taught to eat vvholesome foods in their childhood. Here is the strong point we make: People cannot form correct habits as to what and how to eat until they know the prop- erties of foods and how to prepare them. Disease' and death have been accepted as the inevitable, with barely a, thought about individual responsibility. Children are sent to school that they may be trained for the duties of life, but the most important thing is neglected, or taught in a way to be of very little practical benefit. What is the use to train the mind while the body is being killed? The proper use of food must in time hold the highest place in education, both in the home and at school. ITie value of moral and religious training is partly realized, but IDIOSYNCRASIES 2 cle^n apparel, and the best china in the house. Sick peo- ple are often much more observing than whaj weli, and great care must be taken not to present the same appear- ance when offering food as when doing chainher work, otherwise the patient may associate the two and be nause- ated at the sight of food. Hot food should be served quite hot, and cold ones sufficiently cold to be pleasant to the taste. It must be remembered that the sjek are more or less sensitive and whimsical, and great bulk is particularly repugnant to a weak appetite. The practice of leaving medicine bottles and remnants of a meal on' a chair or table, where the patient can constantly see thenii is very careless, to say the least, and calculated to mak^ the patient loathe the sight of food, and instead of a con- FEEDING THE SICK 309 stant vision of nauseating medicine bottles, brig'ht, fra- grant flowers will exert a beneficial influence. The frequency and quantity of food to be given, de- pends largely on the condition of the patient. The diges- tive secretions will usually be the weakest during high fever. Patients are seldom fed at closer intervals than two hours, or farther apart than four or five hours. If food causes nausea and disgust, it only does harm to offer it, no matter who advises it; but it does not follow that all foods will do so; and when one disagrees, some- thing else must be substituted for a time, even if less suit- able, until the patient can tolerate a better food. As a general rule, food should be given at regular intervals and in small quantities. Always carry small quantities of food to the bedside, and when the patient has little or no appe- tite, it is not advisable to ask what would be agreeable. If the patient be nervous and suffer greatly from pain, and therefore unable to sleep, he should not ordinarily be aroused for feeding; but if he sleeps much and is easily aroused, he may be fed at the regular periods. If he should insist on having some food, of doubtful use, pre- pare it without fat of any kind. If it be a solid, grind to a powder, as fine as flour, if pgssible; but it is usually bet- ter to give only liquid food, and if vegetables, they should be stewed and only the broth given; and if fruits, only the juice. In such cases, give teaspoonfuls and watch re- sults. In giving meat broths, the oil floating on the cup should always be skimmed off with a piece of bread, before offering it. The care of the patient's mouth is hardly less important than the feeding, because a bad mouth may indirectly be the cause of death. The mouth is affected by fever, medicine, and foul secretions, which are likely to make it very unc^omfortable and sometimes very sore; and in either case, it may destroy the patient's appetite: Now, many patients die of exhaustion, that would proba- 310 FEEDING UNCONSCIOUS PATIENTS bly not have done so, had they been properly nourished; and this, in turn, may have been because of the condition of the patient's mouth. There are only two things to be' done, and that is to cleanse and disinfect after each feed- ing. Use warm water, to which a little of some mild disinfectant, such as boracic acid, has been added, and then rinse with plain water. Soft brushes or swabs should be used where possible. Of course, in washing the mouth nothing should be swallowed. Chewing a slice of lemon has a remarkable effect in cleansing a foul tongue, and for this purpose probably there is nothing as serviceable. The lips should be moistened with salt water, or vaseline, or nut oils may be applied. Unconscious patients must not be fed anything but liquid food, and that through a catheter. This is necessary, because it is difficult to get food to the stomach in any other way, for the patient will not swallow. If the mouth cannot be opened and there are no teeth missing, through which the tube can be passed, then the tube must always be passed through the nostril. In the absence of any indications to the con- trary, patients may be allowed all the cold water they wis^h. This is especially true in fever. During a chill, or where it is necessary to reduce the volume of blood, as in some disease of the heart, or puerperal etlampsia (spasms after child-birth), "specific directions as to amount of liquid to be allowed, must be given by the attending physician. The matter of ventilation and sanitation do hot belong to this book; except as an incident affecting the patient's appetite. Many people in ordinary health are almost as afraid of "drafts" as of small-pox. It is, therefore, not surprising that sick chambers are often kept without pure air. The sick room must be kept sweet. . No sick person can. have an appetite or relish foods when kept in a foul, stifling IN ACUTE DISEASES 311 atmosphere. Warmth and fresh air are the first of all considerations, and air exerts the greatest influence in diseases of the lungs. All vessels used in the sick-room must be disinfected and cleaned with boiling water every time they are used. Diet in Acute Diseases. Many suppose that feeding in acute diseases is unim- portant, because tiiey are usually of short duration. This is a great error; for who knows the duration of any at- tack of illness? The patient should be kept in as good a condition as possible to resist disease, and to be able to more quickly resume the duties of life. A few years ago, a large per cent, of typhoid patients died of exhaustion after three or four weeks' illness. Now it is possible to carry them the same length of time with very little loss of weight. Fever destroys tissue at a high rate. This calls for diet rich in proteids. There are some general principles which apply in nearly all acute dis- eases. Briefly enumerated, they are as follows: (1) Foods must be well cooked and easy to digest. (2) They should be given in fluid, puree, semi-soHd or powdered form. (3) It is generally necessary to give small quantities with greater frequency than in health. (4) Foods should be given when the body tempera- ture is the lowest. (5) All foods must be bland and unirratating. (6) No iced drinks' should be given except by advice of attending physician. The foods most commonly used in acute diseases, ex- cept water, are as follows : Milk holds first place, and can probably be used in some form in all cases. Plain milk may first be tried, either cold or hot, then pasteurized, sterilized or peptonized. 312 HOW TO PREPARE FOOD If these do not agree, try milk and barley water, or niilk and gelatine, or milk and "slippery elm" water. In diarrh- oea use milk and lime water, and in constipation milk and soda water (see "Milk," for methods). When desirable to use the largest quantity of food, the milk should be thickened with well-cooked starch, either rice, barley flour, aitowroot, sago or com starch. The fine flour starches should be put to cook in cold water and gradually brought to a boil and kept boiling for an an hour or two. Coarse meals should be kept boiling from three to five hours and then strained. Meat broths are used extensively, but as ordinarily made they contain but little nutriment. Meat may be used in powdered form to better advantage. The most practical way to prawder meat is to grind it at least six times, and each time it is run through the grinder, the solid or stringy part should be removed. This will reduce the' btilk about one-half, but the refuse may be used for broths. The powder may be macerated in cold water and then gently warmed. If the patient is very feeble, it should be strained. Eggs may be used with either broths, milk or alcohol, where the latter is prescribed it will usually be desirable to use it as a vehicle for food. They can best be used with- out cooking, when beaten or stirred into hot broths or milk. Skill in flavoring may save life, because recovery may depend on the strength of the patient, and that in turn on the amount of food that can be taken. Lemon, pineapple, vanilla, nutmeg, cinnamon and fruit flavors gen- erally, may be employed. Some .of the prepared infant and invalid foods may be used to great advantage. The use of fruits gives most concern, because of their sugar and acid, which may quickly ferment. Sometimes they seem to exert a restorative power that is marvelous. The sweet fruits seem to ferment too quickly, and the sotlr FRUITS AND MILK 313 ones .are incompatible with milk, and sometimes with' the medicines administered. If attending physician fails to give any directions about fruits, it would be well to ask whether acids would be incompatible with any of the drugs administered. The sour fruits should be given with the egg or meat broths, and not with milk, and always free from seeds and skins. The juices of stewed fruits should be used for their flavor, rather than the nutriment they contain. Great care must be exercised not' to give fruits that are tainted with decay, or that contain any solid or tough substance. Nothing but the juice should be given, with the possible exception of mellow peaches, baked apples and banana meal. It is certainly advisable to give daily all the food that can be digested, whether that be a pint or three quarts. We doubt the propriety of giving more than three pints or two quarts of milk per day in typhoid cases. More nourishment will be needed, but meat-powder or beaten eggs, with an increased supply of water, will bring best results. It is best to add barley water, well-cooked starch or gelatine to milk to prevent the formation of large curds. There are no inflexible rules — feeding must be adapted to the patient. Drinks. Not many generations ago, the sick died of thirst, be- cause the people -vere so ignorant as to believe that water was a strong ally to fever. Now water is administered inside and outside, and fever is controlled by it when all other remedies are impotent. Patients who are rational will ask for water; but those who are unconscious, should be given water at r-egular intervals. If milk be used ex- tensively, the need for water will be much less than if smaller quantities of fluid be ingested. Sour lemonade is one of the favorite drinks in fever. If there is any 314 DRINKS tendency to sour stomach, no sugar should be used. It must not be given with milk or starch gruel, nor with incompatible drugs. Both tea and coffee should be re- fused, but cereal coffee may be allowed, and very useful by way of variety. Coffee may be used for flavoring milk or other foods. It must not be allowed to boil, and should be steeped only a short time. If the patient likes chocolate, a little may be added to cereal coffee, but should be strained before using. Grape juice, unfermented fruit juices, and natural mineral waters are usually allowable, and sometimes very beneficial. Cold drinks must be slowly sipped, otherwise they may greatly interfere with digestion. CHAPTER XXVII. CAUSES OF INDIGESTION. The diseases of the stomach and other digestive organs are so nearly universal in this country, and so closely re- lated to each other, it may not be amiss to call attention to a few general facts as a prelude to a more specific dis- cussion of the causes which produce them, and the mala- dies incident thereto. Primitive man lived much more in harmony with his storrach than our modem, so-called highly educated being. Civilization, with its inventions, has done much to elevate man and produce external com- forts, most of which react on his physical nature; .and this is especially true of his digestive organs. The stom- ach might aptly be called the boiler of the body; and when we think of what its owners compel it to endure, the ques- tion naturally arises, "Had man's stomach been constructed of aluminum, would he still have found some way to destroy it in the gratification of his perverted tastes?" As man now lives, his stomach is totally inade- quate for the uses which he makes of it. Had it been con- structed of some material that would not corrode, that would stretch to unlimited proportions and then set on springs, it might have met the requirements of modern usage. Modern man is a creature of boastful progress; but his very progress has brought him habits of self-de- struction. Nature demands activity; whereas, the con- stant efifort of man is to contrive some way to avoid work, and increase his luxuries — the highway robbers of health. Our savage ancestors were giants in strength and stature, and we, their dwarfed descendants, resemble them only 315 316 SOURCE OF DISEASE as a shadow resembles its substance, and the best that can be said of us is, that we are a badly executed miniature, painted by the cramped, nerve-racked hand of modern civilization. There are several ways of using a candle. In olden times they lighted many candles, at one end, which made a bright light and butned long. Modem man is nothing if rfet ingenious, and seemingly ecofiom- ical. He lights both ends oi his candle, saves candies and candelabra; but alas^ ho"w quickly burned out! We for- get that pain and disease is the base alloy that makes our lives a counterfeit of Nature. If we wxjuld be free from physical infirmities or ciire them, we must study their causes. Causes ot Disease. The source of disease is sometimes obscure,, but gener- ally speaking, its causes may be divided into two general classes: (l) Those that come from extraneous sources, which are called contagious or infectious diseases. (2) Those that come from within, from poisonous products generated in the body, or some form of mal-ntttrition. It '"! a great mistake to suppose that most of our ailments are unavoidable. A few of the more virulent diseasesj such as diphtheria, are probably not dependent on the ill health of those whom it attacks for a starting point; but most genms have little or iio eflfect on those who are in perfect health, while those who are already diseased, are easy victims. Some physicians say that nine-tenths of the ordinary diesases are catlsed by auto-intoxication-^ self-poisoning. This estimate may be too -high, but all physicians of high attainments agree that a very large per cent, are so produced. To put it another way: we allow efffete matter to accumulate in the system, of take sub- stances into the body which form poisonovis compounds, and disease, or at least weakness, results. Now, as good DISEASE SELF INFLICTF.D 317 health is the armor of Nature, the system is defenseless without it. It is our purpose to show how disease origin- ates by pointing out the most common errors in our hab- its of living, and the characteristics of the diseases pro- duced. The immediate sources of contagious diseases are beyond the scope of this book, for they are all de- pendent upon bacteria or other organisms. We there- fore pass them by. Modern investigation has thrown much light upon self-inflicted diseases, and how they originate. This has come from a better knowledge of chemistry and the use of the microscope. Our bodies are real laboratories. We eat food and it is converted into heat, muscle, nerve, fat and bone. The processes are many, and none can be safely omitted. This fact seems to be generally overlooked. We eat to live, but most people exist (not to live) to eat. There is no teamster so dull but that he knows there is a limit to the capacity of his vehicle; no miller that does not know that he cannot put two barrels of flour in one; but how many people have ever given any thought as to the capacity of their diges- tive organs or the needs of the system? In this respect they -have far less regard for themselves than they have for any piece of machinery they possess. To do good work a machine must not be fed beyond its capacity, and it must be kept clean. Just so with the human body. If properly fed, and kept clean, free from effete matter, there will be no disease. A good many attribute their illness to overwork, or the weather^ — sometimes to la grippe or malaria. Old people who are rheumatic, gouty and stiff, are certain that it was the hard work done in early life that makes them so. Is it any wonder that the rising generation is not on good terms with work? There is an occasional person who gets sick from overwork ; but the overwork that causes most sickness is that done at the ta- 318 OVERWORK UNCOMMON ble. Very few people injure themselves by physical labor; but a small number do from mental work. Overwork is usually a nice-sounding name for over-stimulation from tobacco, alcoholic liquors, tea or coffee, which disturb digestion and prevent the relaxation and rest that is es- sential to good health. Injudicious diet, lack of exercise, and stimulants, "overwork" thousands of. people. Any well-nourished person can work nine to twelve hours a day without injury, but the people want to be told that it was overwork, rather than bad habits, that causes their illness. Work is not a curse, but a blessing — though most people don't want to be blessed that way. Some "overworked" people so seldom use their feet and legs to move themselves, if it were not for uncomfortable foot- ware they would forget they had such useless appendages. "Nervous exhaustion" might often appropriately be named pedal inanimation. The other supposedly great cause of disease — the weather — is also only a small factor. And then only in connection with one of the real causes — ^the imperfect elimination of waste. Waste of the Body. The waste of the body is eliminated through the lungs, skin, kidneys and bowels ; and whenever it is not promptly removed from the system, disease results. The waste is made up of three elements : 1. The dead tissue of the body. 2. Indigestible particles of food. 3. Excess of food taken into the system over and above its needs. If the mere smell of decaying tissue-foods, such as meat and eggs, makes one sick, does it not follow that it would have a worse effect when in the system? The effete tissue and excess of food, especially meat and eggs, are really poisonous. People know something about the necessity WATER 319 of food, but seem totally unconcerned whether the waste is removed or not, although it is of vital importance. Every one knows that human- life cannot exist without air, but they do not realize that it could not long exist if every pore in the skin were closed. A large' amount of impurities is thrown out through the lungs, and foul breath (except it come from mouth or nose) is one of the best evidences of how the system tries to cleanse itself. A wet sponge will not absorb as much water as a dry one; nor will air, laden with impurities, carry away as much waste from the system as pure air. An active skin is almost as essential as pure air, and if generally recog- nized, disease would be far less common. All intelligent people understand the necessity for keeping the skin clean, but lose sight of the fact that it must be kept warm. This explains why the changes of the weather make people sick. A chilly or damp day may close the pores of the skin ; and if the other outlets be inactive, a cold is the result. This is especially noticeable in those who eat more than their system needs. An excess or too little clothing (especially on the extremities), overheated rooms that dry the skin, are causes of cold and indigestion. The nitrogenous waste of the body is removed throug'h the kidneys ; but as they are mainly affected by errors in diet, nothing need be said about their action. Non-elimination of waste, on account of constipation, is so common that it demands separate treatment under diseases of intestines. No mat- ter how we live, there will always be a certain amount of tissue that is being removed and entering the circulation. If the excretory outlets are insufficient, the poisonous matter is kept in the system, with results that vary from discomfort to death. Lack of Exercise. The necessity of labor for most people, gives sufficient 31) EXERCISE DIET OVEREATING exerdse; but many women and business men take too little. Those who do heavy work need a great deal of food, because food is burned up in force-production. Besides this, great muscular activity shakes the dormant digestive organs into activity, and assists in the elimination of waste. The m.ain difi&culty is to provide the proper amount of food for a certain amount of exercise. People who lead an active life will eat as much or more on Sun- day, when they do nothing, as when they are at hard la- bor. This brings us to the principal source of disease: Lack of Adaptation in Diet. Under ordinary conditions every organ in the body is more than able to perform the functions for which it was intended, and there should be no disease; but so long as people utterly disregard the law of supply and demand, in the matter of feeding themselves, so long will the hu- man family be cursed with it. The various organs of the body are dependent upon each other, and all are depend- ent upon good blood, which can only come from food adapted to the needs of each individual. It should be constantly borne in mind, that the ordinary diseases re- sult either Irom poison or starvation; poison from dead tissue or decay of foods; starvation, because the foods did not furnish the essential elements of life, could not be digested, or was too small in quantity. It sounds para- doxical to say that one lacks nourishment, when already consuming twice as much food as needed, but such is fre- quently the case. It is not what we eat, but what we digest and assimilate that sustains life; and there is no fault that interferes with digestion more than an excess of food. Overeating. Too much food unduly distends the stomach and weak- ens its contractile power, thus destroying, in a great mea.s- OVEI^EATING COOKING 321 tire, its *Gliiwity— churning movements. This might be illustrated by trying the strength of your arm when stretched as far as you can reach. Besides this, there is a limit to the amount of digestive secretions, and if these be only sufficient to digest twenty ounces of food, it is manifest that twice that quantity could not be digested. Now, what results? The food will most likely remain in the stomach too long and decay, which cannot be cor- rected after the food passes out of the stomach. The blood thus becomes filled with crude and often poison- ous substances. This is what produces the languor, head- ache and general discomfort so frequently felt after eating a large meal, when there was no demand in the system for it. An overloaded stomach acts like a horse with a heavy load on a bad road — very slow. There is a chance that it won*t get through; and if it does, it will be in a bad condition. The most common result of overeating is to throw a great bulk of gaseous, fermenting food into the intestines, unduly distending them and prevent- ing their action, which is a common cause of constipation. Under such conditions, digestion will be very imperfect, and the system poorly nourished and burdened or poi- soned by the waste. Bad Cooking. Next to overeating, it is somewhat difficult to determine whether bad cooking, folly in drinking, or haste in eating, causes most disease. All are well-nigh universally prac- ticed in this country. If our people had to do without foods until they were properly cooked, most of them would starve to death. Some modern cooks try to please the taste, regardless of the stomach, while a large number make no effort to do either. This class simply bring heat, water, food and fat together, and trust to patent medi- cines aad the doctor to keep alive those who. eat their 322 COOKS SLAY MILLIONS products. The modern cook has been energetic in one direction, at least; and that is to get as far away from ra- tional processes as possible. The object of cooking is to disintegrate the food and make it most palatable, but the cook often does everything possible to serve the food in such a way that neither end is attained. Heat coagulates or solidifies albumen — ^the principal element of meat and eggs — so, in order to make them as nearly insoluble as possible, the cook keeps them subject to a hot fire for a long time, and, as if this were not bad enough, they are often saturated with butter or lard. Fats are not digested in the stomach, and when meat or eggs are saturated with it, the food is sheathed with material not acted upon by the secretions of the stomach. Could any process be worse than to first render the food insoluble and then smuggle it through the stomach under a cover of fat? This is not all ; for the process of cooking starch is equally bad. All starch-yielding foods are comj)osed_of layers of starch cells, from one-eight-hundredth, to one-five thou- sandth of an inch in diameter. These cells are enclosed in indigestible envelopes, which must be ruptured by cooking. Rolled oats is often served within five min- utes after it commences to cook, while two hours' cooking would be nearer right. The method of cooking coarse, fibrous vegetables, such as cabbage, is almost as bad. The stomach is the disintegrating vessel of the body, and half-cooked, woody or stringy vegetables, saturated with fat, cannot be dissolved in weak stomachs. The or- dinary cook spoils the meat by over-cooking; the starchy foods by almost no cooking; and caps the' climax of cui- sine folly by serving doughy bread. Verily, the cook slays not only thousands, tens of thousands, but millions. Uselessness of Teeth. The Creator either made a mistake in giving man teeth. EATING AND DRINKING 323 or man makes a mistake in not using tHem. The teeth were evidently intended to crush all solid substances be- fore they were swallowed. It was also intended that saliva be mixed with the food to an extent of thorough saturation; but most people swallow their food without much crushing or saliva, and to make their folly complete, they wash it down with quantities of both hot and cold drinks." Drinking Folly. "If he could run like he can drink, I would like to hunt hares with him," can still be applied to many people. Folly in drink seems to have begun with human life, and we fear it will only end there. The use of alcoholic liquors has long been an important factor in producing disease. Strong liquors paralyze the nerves, deaden sen- sibility and irritate the mucous membranes of the stomach. Mak liquors, in quantities, derange the stomach, because of their icy coldness, their bulk and the amount of acetic acid they contain. Alcoholic inebriety is a great curse both physically and morally, but is not the only harmful drinking. The reformers are not free from folly of a serious char- acter; for many of them are tea and coiifee inebriates, which, if not so bad as alcohol, they make up in the num- bers they injure for what they lack in the intensity of ef- fects. The habit of- stimulating the nervous system with tea and cofifee and tobacco, through its direct and hereditary influences, is one of the principal sources of alcoholic ine- briety. Any considerable drinking during meals is per- nicious, because it dilutes the digestive secretions too much, and makes too great a bulk in the stomach; but warm drinks are not quite as bad as very cold drinks, which lower the temperature of the stomach and paralyze its nerves. Ice water with meals is one of the most stu- 324 INSUFFICIENT DIET pid pieces of folly practiced by Americans (mostly men), but a few (mostly female) have a still worse habit. They drink liquids scalding hot. This practice leads to very serious results, as the excessive heat irritates -the mucous membranes and relaxes the stomach and causes its dila- tation. Foul Mouths. Some people keep their mouths about as foul as garb- age boxes. The food adhwes to the teeth and decays; this destroys them, makes an offensive breath, and poi- sons the food to a greater or less extent, and causes it to decay in the stomach. Deficient Diet. To maintain health, our food must supply the chemical elements found in the body, in proper proportions, and as most people must select their foods from a very limited number set before them, it often happens that the appe- tite causes thern to eat those things that contain an ex- cess of some elements, but deficient in others. Many eat an excess of sugar, syrup, preserves, candy and sweet- ened foods. Many dyspeptics are cured by leaving off all sweetened or sweet food. A large number eat too much fat in the way of fat meat, butter, cream, gravy and pastry rich from shortening. Free fats in the stomach envelop the food and resist the action of the gastric jaice, and delay digestion. If fats remain in the stomach too long, they are partly converted into but3Tic acid, which irritates the stomach. A common instance of a badly- chosen diet is excessive meat eating. If meat be eaten as the principal part of the diet, it must be used for tissue- repair and heat^produotion, or it will poison the body if not promptly eliminated. Some go to. the otner extreme, and eat very little but starch, white bread and potatoes. Such a diet is deficient in protein and mineral matter. INSUFFICIENT DIET 32S Too Little Waste.. One of the most common faults or mistakes jn our diet, is th« use of foods that contain too little waste material. This comes from, the practice of removing all the cellu- lose (bran) from our breadstufifs, so that they may appear white. Finely powdered bran acts as a stimulant of the bowels, and is the best of all known remedies for consti- pation. The practice of eating coarse bran, as advised by some physicians, is a great mistake. It is too irritating, and likely to remain in the stomach too long, and may also obstruct the bowels. Incompatibility of Foods. Foods may be good and wholesome enough, but in- compatible when taken together. As an example, acids arrest the digestion of starch, and acids and milk will often cause vomiting. Strong tea makes eggs insoluble in the S-tomach, and both strong tea and cofifee arrest digestion. Another common fault is that of eating too many kinds of food at the same meal. Some chemical elements unite ; others will only mix like oil and water. Foods contain various chemical elements, and the fewer that are mixed at one time the better for digestion. Another thing, foods that are easily digested, and sour quickly, like sweet fruits and sweetened starch puddings, should not be eaten with hearty meals, or with foods that require a long period for digestion. If this be done, they are likely tp sour the whole meal. Eating too Little Food. Many people, who are somewhat dyspeptic, eat too lit- tle food. LTpon finding that many foods disagree with them, they restrict their diet until it barely sustains life. This increases their constipation, weakens the system and aggravates their dyspeptic troubles. (See Dietaries, for quantity required.) 326 IRRdATING SUBSTANCES Foods may irritate the Stomach: (1) Because of their chemical composition. Such foods as raw onions and strong radishes are examples. Also such condiments as pepper, sage, curry, horse radish, mustard, and other pungent substances. But few people would care to blister the outside of their bodies; yet they have no hesitation about blistering the inside. (2) Foods may irritate, because insoluble. Examples: Green fruits, raw, tough vegetables, pieces of nut kernels, lumps of meat or any other coarse, hard substance. (3) Probably the most irritating of all foods, are those that contain poisonous ptomaines. The most common foods of this class are decaying fruits, decomposing milk products and poorly-prepared canned goods. Both fresh and canned fish are frequent sources of violent gastric attacks, because they are often tainted. (4) Foods frequently contain mineral poisons from the vessels in which they have been kept. Irritating Drugs. The abuse of drugs is one of the most common and potent causes of disease; especially constipation and dys- pepsia. It is putting it mildly to say that not a few have drug mania. Cathartics act by irritating the mucous mem- bran of the digestive tract, and every time it is irritated, it is likely to become less sensitive, until finally the ordinary contents of the intestines do not stimulate it to action, which necessitates a constant repetition of irritating cathartics. Irregular Eating. Nature has method in everything, and we are naturally inclined to sleep and eat at regular periods. If we eat irregularly we break the rhythm of nature, and it is just as bad for the stomach to delay eating as it is for the quality of the dinner to delay after it is prepared. The IRREGULAR HABITS 327 Stomach cannot keep an adequate amount of digestive fluids to be drawn on at any or all times. But this is not all. Going an extra long period without meals causes acute hunger and an overloading of the stomach; and an extra short period does not give time for the stomach to empty. Many people eat regularly during the week, but on Sunday they disturb the regularity of the system by eating a hearty breakfast from one to three hours later than usual, and then an extra large dinner within four or five hours. It is this pernicious practice that makes people so uncomfortable and dull on Sunday and unre- freshed to begin a week's work on Alonday. Evacuation of the Bowels. A frequent cause of disease in the cities is neglect to evacuate the bowels. Pressure of work and laziness is assigned as a reason. The calls of Nature should always be promptly met. Loss of Sleep. Sleep and rest are both- necessary; without them the nervous system has no tone and there is general languor. Late hours burn the candle of life at both ends, and night revelers sooner or later pay a fearful penalty, for late-hour gaiety. Excesses. All excesses disturb the system. This is especially true of those of a private character. Tobacco. The use of tobacco is both vile and pernicious ; and the physical wrecks, directly or indirectly due to tobacco, would astonish the world if all were bunched together. Dyspeptics should quit tobacco. Dress. A distinguished New York specialist reports that his books show that thirty-four per cent, of the women treated 328 " EFFECTS OF DRESS have displaced stomachs, while only six per cent, of the men were so afflicted. Of the females treated, the prin- cipal factor in the displacement was the corset. Of the males, probably the excessive use of beer and other liquids was responsible for their condition. Figure II shows side-view of female form. The dotted lines show the out- line of a '"neat waist" and "fine form," after the adominal organs have been displaced by the corset. Fig III shows front view. The outside waist lines rep- resent the natural waist; the middle dotted w^st line the waist of the ordinary corset-wearer, who says that she does not "lace;" the inside dotted waist line shows how much the corset can improve Nature. Figure IV shows natural position of abdominal organs. Figure V is a front view of female, showing abdominal organs as displaced by corset-wearing. Heredity. No one can doubt the tendencies of heredity. Where both parents are weak their children will likely be so too ; and if there be many children, some will be stronger and some weaker than their parents. The chief crime of parents against Nature is in transmitting nervous tenden- cies that make the child seek stimulants. How could it be otherv^ise, when parents use stimulants from the time they could talk? Can you blame the child of such parents who cries for strong coffee? By beginning early in life, hereditary weakness can, in the main, be overcome, so that personal responsibility can not be ignored, because of the transgression of our parents. Local and General Diseases. Local and general diseases are often most strongly man- ifested by disorders of the stomach. This is especially true of lung diseases — bronchitis and consumption. In these diseases, repugnance to fats is often one of the first symptoms. Side view — female form, Stiowitig natural outfines. Dotted lines represent the cliange due to lacing. 329 (I- Front view — ^female form. A. Outline of, natural waist. B. Outline of ordinary form, "not laced.' C. Common outline of fashionable waist. 330 Front view — female form, showing natural position of abdominal organs, lungs, etc. Front view of female, showing displacement of ab- dominal and other or-gans, due to corset wearing. DISEASES CAUSE INDIGESTION 333 Heart Disease. Indigestion from diseases of the heart is doubtless due to disturbance in circulation; but it should be borne in mind that the heart is much more likely to be affected from the stomach, than the stomach is from the heart. Diseases of the Liver. The stomach is probably more in sympathy with the liver than any other organ; not so much from the assist- ance it gives in digestion, but because it is the chief organ for removing poison from the blood, which may cause indigestion in two -ways: (1) From imperfect elimina- tion of nitrogenous waste. (2). Reflexly, by constant irritation. Of the latter, painters, workers in lead, people living in newly painted houses, are the ones chiefly af- fected. Formerly, lead water pipes were sources of poi- soning, but are not so as now made; but the same cannot be said of face powders. These arrest digestive secre- tions, and greatly diminish the churning movements of the stomach. Diseases of the Intestines. Diseases of the intestines are almost certain tp aflfect the stomach, probably because excessive activity hurries the food out of the stomach before it is digested, and lack of activity has the opposite effect. It may still have another effect, resulting from imperfect digestion. Intestinal di- gestion being very important, if it fails, the blood will not be supplied with necessary elements, and the stomach may show the ill effect. Malaria. Malaria is likely to affect digestion from several causes. Fever of any kind diminishes digestive secretions of the stomach. In addition to this, if the liver is overworked, it cannot perform its functions perfectly. Diseases of the Throat. These may affect the stomach in two ways : by reflex irri- 334 HEAT COLD LIGHT tation and from pus, or mucus, being carried to the stom- ach. Anythiffg that irritates the fauces may cause vomiting and tickhng the throat has long been practiced for that purpose. Pregnancy and. Female Disorders. Pregnancy is frequently accompanied by stomach dis- turbance ; especially nausea, vomiting and craving for par- ticular, and often peculiar, articles of diet. With female diseases, there is frequently associated some stomach trouble which results from the particular disease and dis- appears with it. Thus the physician, in treating women for stomach trouble, should ascertain whether or not it is simply stomach disease, or secondary to some other fe- male disorder. Heat and Cold. Excessive heat and overexertion cause general colfepse; but the indigestion, common to hot weather, is mainly due to cold drinks and use of decaying fruits. Cold, chills the surface and disturbs the circulation, causes congestion, and partially arrests the elimination of waste. Pressure on the Stomach. This is common in occupations requiring a stooping attitude. It restrains the natural activity of the stomach and interferes with digestion. Light. The importance of light is often overlooked. Man was never inteded to live in a cave or dungeon and work by artificial light, and those who do so pay a severe penalty. Ordinarily, people are not seriously affected by sliglit vio- lations of the principles of good living, if not too long continued, nor too many of them. In most cases of ill- ness it will be found that several causes operate together to produce the disease. CHAPTER XXVril. DISEASES OF THE STOMACH. Diseases of the stomach are classified as follows: Nervous dyspepsia, neurosis, of the stomach, gastric neurasthenia and gastralgia, are names applied to various afifections of the stomach that have their origin in the nervous system. Acute and chronic gastritis designate acute and chronic inflammations of the stomach of a catarrhal character. Hyperchlorhydria and hypersecre- tion, apply to excessive secretion of hydrochloric acid in the stomach. The former is used to designate the exces- sive secretion of acid during meals; the latter to uninter- rupted secretion without any relation to meals. Ulcer is a sore on the lining membrane of the stomach, which, in some cases, may perforate it. A dilated stomach is one that is stretched beyond its natural size and remains so. Cancer is a tumor of the stomach, which grows more or less rapidly, and interferes- with digestion. This classifi- cation is made according to the manner in which the stom- ach is locally affected, rather than the cause of the disease or the symptoms produced. Neither of the diseases named have all symptoms entirely dififerent from other diseases of the stomaclh, but usually each has some dis- tinguishing characteristic. The time is past when phy- sicians can call any disease of the stomach dyspepsia or indigestion, and stop there. The modern doctor must now determine what kind of indigestion his patient nas, and to do this it may be necessary to take out the contents of the stomach and make a chemical examination of it. The fact Miat many physicians have not been able to dif- ferentiate one disease of the stomach from another^ ex- 33S 336 NERVOUS DYSPEPSIA plains why so many dyspeptics have failed to be benefited by medical treatment. Nervous Dyspepsia. This ailment is not really a disease, only a local mani- festation of some nerve derangement. It differs from all other diseases of -tlje stomach in this.: it has no anatomical change and is not directly due to any altera- tion in size or structure of the stomach, but to some shock, strain, nervous exhaustion, or nerve irritation in organs other than the stomach. Some eminent physicians are disposed to charge all but contagious or infectious dis- eases to some functional disturbance of the nervous sys- tem, but it seems that in most cases the theory of nervous origin is, "Putting the cart before the horse" — the effect be- fore the cause. Strictly speaking, the term nervous dyspep- sia should only be applied to diseases or symptoms which result from mental disturbances, such as emotional ex- citement, mental worry, or mental activity, too long con- tinued without rest; but for practical purposes it is bet- ter to class all derangements qi the stomach directly due to the causes mentioned, or that are simply reflex from nerve irritation in other parts of the body, as neuroses of the stomach. Some writers have heretofore classed both insufficient and excessive secretion as of nervous origin, doubtless because they were attended by nervous symp- toms. All agree that it is extremely difficult to determine the dividing line between cause and effect. We have in the preceding pages shown how the system may poison itself, and if the blood contains crude or poisonous matter, it is very likely to affect the nervous system. If the food supply be of such a character that it cannot be digested, .the whole system will be weakened, and fatigue follow very little exertion, and if lack of nourishment affects the muscles ai^d the sensibilities, why not the central nervous NERVOUS DYSPEPSIA 337 system? On the other hand, a debilitated nervous sys- tem, from extraordinary worry or loss of sleep, affects the stomach. As to whether the nervous system or the stom- ach is the primary cause of the nervous symptoms, would seem to depend on the causes in operation likely to produce them. If there were some cause of extraor- dinary worry and loss of sleep, the indigestion should be considered as of nervous origin, but if there were a dispo- sition toward unusual worry about trifles in connection with nervous symptoms, it is most likely due to some form of mal-nutrition, or self-poisoning. But few people would be overworked or over-worried if they were prop- erly nourished; and by this we do not mean that there has necessarily been a lack of nutritious foods. It may be because of the inability- jjiLthe system to assimilate the food as it is supplied. As people mistreat their stomachs much more than their nervous systems, it is safe to con- sider that, primarily, it is not overwork that causes most nervous attacks, but lack of good blood and excess of poisonous waste in the system. This is well illustrated by the general anaemic condition, common to most per- sons suffering from nervous dyspepsia. The disease is much more common to women than men, and more fre- quent under forty years of age than after the middle period of life. Nervous dy^epsia has no uniform syrriptoms, as there may be lack of gastric secretion and muscular activity, an excess of secretion, or extreme irritability of the nerves of the stomach. Symptoms. Where there is lack of secretion, or lack of muscular activity, the symptoms are much less marked than the other conditions. Vomiting only takes place when the food has long remained in the stomach and become de- 338 VOMITING IN PPEGNANCY composed. In the mild form there is not much paiti, but a sinking' sensation, or one of great fullness is felt after eating, which may be accompanied by slight nausea and dizziness. In severe cases the stomach will not tolerate any food at all, and vomiting occurs almost as soon as the food reaches the stomach. Some of the symptoms of nervous dyspepsia are found in other diseases of the stom- ach, but there is usually something about each that indi- cates to which class it belongs. In catarrh of the stomach the- disagreeable sensations do not arise until some time after the meals, usually three or four hours, unless there is an acute attack and great irritation of the stomach. In some cases there is excessive sensitiveness of the mucous membrane of the stomach, and the pain severe and the stomach sensitive to pressure. The pain is more general than in ulcer, and has but little relation to meals or kind of food, while the pain from ulcer is much more intense when coarse vegetables or acids are ingested, than when the stomach is empty or when soft-proteid foods like mUk and eggs are eaten. In the form of nervous dyspepsia known as gastralgia, the pain in the region of the stom- ach seemingly radiates in all directions. It occurs quite independently of meals. In neurasthenia, the symptoms and pain are generally out of proportion to any discover- able disease, and often occur when there has been no previous history of dyspepsia. Another ciiaracteristic of nervous dyspepsia is belching of air or gas, without' re- gard to whether the stomach is full or emprty. In other diseases of the stomach the belching only appears when there is gaseous fermentation of food in the stomach. When more or less food is brought up instead of gas, it is called regurgitation, which often precedes nervous vom- iting; Sometimes the openings of the stom-acn are closed by a nervous spasm, or the pyloric end may, for a time. DIET IN NERVOUS DYSPEPSIA 339 refuse to close and the food at once passes into the in- testines, causing diarrhoea. Vomiting in Pregnancy. Thia is usually called "morning sickness," and appears after rising in the morning, when the patient feels faint, "light-headed" and nauseated. When this occurs, slowly sip a cup of hot milk or meat broth, and eat a dry biscuit (cracker) and remain in bed for two or three hours. If the stomach be foul, drink a cup of hot water instead of milk, without food. Aids to Treatment of Nervous Dyspepsia. If the attack be due to overwork or worry, rest is the first requisite; but if from emotional excitement, change in surroundings and something to divert the mind is of great importance. When there is general neurasthenia or hysteria, the patient should be put to bed and kept free from excitement and away from visitors. Diet. The diet must be easily digested, nutritious, and non- irritating. If the stomach be inactive, so that it does not readily empty itself, the diet must be of such character as will not quickly ferment. The principal foods should be malted milk— -pasteurized or sterilized — cream, soft- cooked or whipped eggs, eggnog, malted gluten, meat broths, in acute cases. Such additional foods as meat- powder, toast bread, nut oils, butter, malted nuts, may be given as the patient progresses. If hot milk should be vomited, try it cold, and vice versa. It may be of great advantage to dilute milk with gelatine. If not convenient to make it, a refined gelatine, like the Keystone, may be used. As the appetite is often capricious, it may be of great advanta-ge to flavor the food with a. little vanilla, lemon, nutmeg, or fruit flavors. In the acute or severe cases, a little food should be given at short -periods. It 340 GASTRITIS may be necessary to begin witH a tablespoonful of milk. The patient must take as much nourishment as possible, but must not be crowded beyond what can be digested. When only milk is fed, it should ordinarily be given every two hours, in quantities of one or two ounces at a feed- ing for the first few feedings. Most patients will tolerate a pint and a half of milk the first day, and twice as much the second, and should be able to take eggs and other food the third or fourth day. All made dishes, tea, coffee, and fried foods, must be avoided. Acute and Chronic Gastritis, Usually Called Catarrh of the Stomach, or Bilious Attacks. These are the most common of all diseases in the United States, except colds.. Very few people escape occasional gastric attacks, although they may not be willing to admit the fact. It is indeed a strange thing that people will insist that almost anything ails them except some form of indigestion or mal-nutrition. Gastritis, or catarrh of the stomach, is the every-day dyspepsia of the world. Jts causes, briefly re-stated, are as follows: Excess of food, incompatible, irritating or decompos- ing food, poison taken in or originating in the body, ex- cessive heat, and disease of other organs, especially the intestines. Symptoms. In the ordinary catarrh of the stomach any of the follow- ing symptoms may be felt: Headache, offensive breath, "bad taste" in the mouth, drowsiness, nausea, loss of appetite, great thirst, vertigo, vomiting, belching some hours after meals, constipation or diarrhoea, lassitude, aching limbs, cramps of the muscles of the leg, pain after eating, flatulence, heartburn, difficult breathing, palpitation of the heart, stomach feels SYMPTOMS OF GASTRITIS 341 like it had a weight in it, tenderness of the stomach, erup- tion on the lips, tongue raw, red or coated, lack of energy, chilly sensations and coldness or numbness of hands and feet. The acute attacks are generally called "bilious attacks," and occur most frequently in the night. The patient will usually be wakened by pain, and in some cases there is a feeling of nausea, followed by vomiting and relief. They may occur from only slight or accidental causes, but when the ailment becomes more or less continuous theyarethen termed chronic. Gastric attacks are often so severe that the patient thinks death imminent, although in no danger whatever. Acute gastritis occurs at all ages, while chronic gastritis usually occurs in middle age or late in life, due to slowly-progressive indigestion. In acute cases there is only congestion ; but when chronic, there are structural changes in the stomach, deficiency in digestive secretions, an excessive secretion of mucus, loss of absorptive power and muscular activity. When this condition exists, foods difificult to dissolve, like salt lean meat, especially when fried, and coarse vegetables, will disagree. This will also be true of foods that ferment quickly, such as custard puddings, tapioca, sweet and sweetened fruits, vinegar with starch of any kind. Milk, without any alteration, will usually disagree, because the stomach is not sufifi- ciently active to break up the curds. Diet. In extremely severe cases it m.ay be necessary for the patient to live on milk, diluted with gelatine, or barley water, or it may be malted and used to great advantage with malted gluten. All fried foods must be eschewed, and except in acute attacks, all soups, mushes and gruels must be sparingly used. The diet must consist mainly of dry foods, thoroughly masticated. Saliva and thorough 342 DIET IN GASTRITIS mastication will do more for a damaged stomach than almost all other remedies. The stomach must be strength- ened, by giving it as much work as it can do and no more. It can never get strong without plenty of nourishing food, and "slops" will not do. The curse of the Ameri- can stomach is slops, water and chunks. This unfavorable mention of water would probably please a Kentucky colonel, but the objection is only in the manner of. using it. Dyspeptics need to eat as great variety of food as pos- sible, but it must be done discreetly. Foods that ferment quickly, must be avoided, or when used, it must be on an empty stomach, or with easily-digested foods. If the digestive secretions are deficient, meat will be poorly tolerated,, and an exclusive diet of meat and eggs for two or three days will determine this. The cereals are the best reliance, although if complicated with severe intesti- nal disorders, only gluten should be used, with such foods as meat, milk and eggs. As an aid to curing constipation, there is nothing equal to the bran of cereals, when finely ground. If not convenient to take foods containing fine bran, it will be advisable to boil it for three hours, then roast until brown. It should then be ground as fine as possible. If- desired, flavoring matter may be added to make it palatable. Graham bread is objectionable, be- cause the bran is too coarse. Where the stomach is greatly inflamed, sour fruits are not allowable, but in chronic cases of mere sluggishness they are of great ben- efit, if eaten at proper time, without sugar. Tt lOO sour, a little bicarbonate of soda (baking sioda) may be added while cooking. Sweet fruits may be eaten when the stom- ach is empty, but if it contains the residue of a meal that has soured, they will quickly produce flatulence. When the stomach is very weak, it will .be necessary to take small quantities of food every two or three hours during EXCESSIVE SECRETION 343 the day; but in chronic cases, where the stomach will do its work, if given plenty of time, two meals a day, eight or nine hours apart, will be far better than three or more. The patient must early learn that a suitable diet will do far more to effect a cure than any drugs. As an artifi- cial aid to digestion, very good results are sometimes ob- tained from malt tea. It may be made as follows : Take three or four large tablespoonfuls of malt and steep it in a half-pint of cold water ten or twelve hours. Decant, bottle, and keep in cold place. One or two table- spoonfuls may be used at meals with a little milk and hot water. Diseases of Excessive Secretion. Hyperchlorhydria, Hy- persecretion and Ulcer. These diseases are closely related and usually repre- sent the first, second and third stages, although it is claimed that hypersecretion may commence suddenly. Causes of Excessive Secretion. Excessive use of alcohol, mustard, pepper and other condiments. The use of ices. Too rapid eating for a number of years. Indigestible food, grief, worry and pres- sure on the stomach. The disease may commence sud- denly or gradually. S}Tnptoms. The principal symptoms in excessive secretion is pain. It may begin with mere uneasiness, one or two hours after meals, or with sharp, stinging pain. The excessive amount of acid irritates the stomach, and as soon as diges- tion in the stomach is completed (usually from two to three, hours) the pain begins. In severe cases there may be an attack after every meal, the one after breakfast will be the lightest, and the one after dinner the most severe. Often a little hot acid liquid will be belched. The pain is often sharp and severe, and is usually tailed cramps. It 344 EXCESSIVE SECRETION may be relieved by taking a drink of water, which dilutes the irritating acid, or by eating a soft egg. Appetite is usually good and the tongxie clean. There is no flatulence; no feeling of fullness. If meat or eggs be given every three hours, and it is well tolerated, it is suggestive of excessive secretion, because meats are slowly digested, when the secretion is deficient. If nothing but starch be taken when there is excessive secretion, it may remain in the stomach a day or two. The symptoms of excessive secretion are dififerent from other diseases in this: In nervous dyspepsia, there is no ti^ic relation to meals. In gastritis there is more nausea and flatulence, a furred tongue, and the pain less sharp, and not relieved by food. This is, ordinarily, only an advanced state of excessive secretion, although some specialists say that it may begin suddenly, but, in such cases, it is more than probable that it is a sudden manifestation of what has long existed. The symptoms are similar to excessive secretion, only more pronounced. Hunger is more acute. Patient may wake up in the night with an "all gone" sensation, and if nothing be eaten, there will be severe pair. Thirst is con- stant, especially at night. The attacks are generally worse in the middle of the night, and last two or three hours, and terminate by vomiting, which relieves the pain. An- other characteristic symptom is diarrhoea in the night, due to the excessive acid condition of the food discharged into the intestines, and to the large quantities of fluid drank. This may be followed by constipation. Notwith- standing the voracious appetite, and large amount of food eaten, the patient usually gets thinner. The tongue is sel- dom furred, and likely to be very red. Probably the easiest way to distinguish hjrpersecretion from other dis- eases, is by the matter vomited. If the vomit shows that DIET IN EXCESSIVE SECRETION 345 the lean meat is practically all dissolved, and the bread-stuff unchanged, it points strongly to hypersecretion. Where the excessive secretion has long' been continued, the stomach is almost certain to be dilated. Diet. A meat diet is usually prescribed in excessive secretion, on the theory that imeats are easily digested in an acid stomach, and starches difficult. This is true. And it is also true that meat furnishes the system more hydro- chloric acid than any other food. Now, in ekcessive se- cretion, the object is to reduce it, and what more rational method can be proposed than to withhold foods that make most hydro<;hloric acid? Diet in this disease must be as bland as possible, and as milk is well tolerated, if diluted as heretofore described, it is the best of all foods. Of meats, fresh fish is the easiest digested, and of most serv- ice in excessive secretion. In catarrh of the stomach it is necessary to have the food finely divided, so that it can be dissolved. In excessive se- cretion, it is necessary to have it as fine as can be pow- dered, so that it will not irritate the stomach, and excite the secretion of more acid. The chief difficulty is in the digestion of starches, and it is not easy to prevent loss of weight without them. Con- tinued loss of weight, means loss of strength, and great care must be taken to maintain it. Bromose (malted nuts), cream, nut oils, and the fat of boiled ham, will be useful in furnishing fuel for the body. If the stomach can be washed out once a day, considerable dry toast may be eaten soon after, if taken without any liquid, and thor- oughly mixed with saliva. Malt will also be serviceable, and malted gluten should be used in preference to meat or meat powder. Sour fruits are not suitable, but such fruits as bananas, sweet grapes and pears can be eaten, unless 346 ULCER there be dilatation of the stomach. In such cases foods that ferment quickly must be avoided. The cereals must be extra well cooked, and then roasted brown and pow- dered, and tlaen eaten dry. If the stomach is not washed, a half pint or pint of cold water or moderately cold alka- line mineral water may be drank a half hour before meals and before retiring at night. Mucilaginous drinks, made by steeping "slippery elm" (ulmus fulva) in cold water, may be drank before or after meals. If there is no dilatation of the stomach, the patient should eat as often as every four hours. The bowels should be kept active by massage. All irritating sub- stances such as pepper, mustard, raw vegetables, vinegar, sage and cheese, must be shunned as enemies. A few grains of salt may be used in the food, but the less the better. Very hot drinks are absolutely prohibited, espec- ially where there is a possibility of uker. Ulcer. The question is sometimes asked, why don't the stom- ach digest itself? If an animal or human being be sud- denly killed during digestion, the stomach will digest itself to a considerable extent. In the living stomach it is supposed that a continuous supply of fresh blood protects it from its own secretion. It would follow that if the cir- culation in some part was partially, or wholly destroyed, that the stomach might dissolve itself. In excessive secre- tion, the strong acid probably erodes the membranes in the stomach, which develop into ulcer, if the causes pro- ducing the erosion are long continued. Probably the principal cause is pressure on the stomach, from a faulty system of dress. Other causes are indi- gestion, irritating foods, and a general neurotic. condition of the system which seems to 'be closely associated with ulcer. It is most commonly found in females between the ages of twenty and forty. DIET IN ULCER 347 The common location of ulcer is near the pyloric end of the stomach or on the anterior wall. It is also found in the intestines. The most characteristic symptom is pain at the exact spot of the ulcer, and immediately op- posite in the back. The stomach is often sensitive to pres- sure from other diseases, but in ulcer it is particularly sen- sitive to pressure at the exact spot where it is located. The pain follows the indigestion of foods, and bread or vegetables give much more than milk or soft eggs. If vomiting takes place, the pain is relieved. One of the symptoms most relied on is hemorrhages, and when blood is vomited, and attended by the other symptoms com- mon to ulcer, it is almost conclusive that ulcer exists. The patient generally grows progressively thinner, unless prop- erly treated, and when fatal dies of starvation or perfor- ation. There is a form of ulcer called peptic ulcer, in which the characteristic symptoms of ulcer are absent. These cases are rare, but extremely difficult to diagnose. A patient with ulcer of the stomach should be put to bed, and no foood given in the regular way, except sips of ice water or cracked ice. The nourishment must be administered through the rectum, until the ulcer heals. The rectum must first be cleansed by an injection of water, and then about three to four ounces of pancreatin- ized meat powder, milk, or milk and eggs pancreatinized, should be administered. Some use a 20^ solution of sugar, beaten with three eggs. Whichever nourished the patient most should be used, but ordinarily eggs and milk, equal parts, with a pinch of salt, will be found mosf useful. Five or six feedings a day will be necessary, and one of them must be water, to be retained for absorp- tion, as water is as necessary as food. When the stomach is healed sufficiently, feeding may be resumed by giving a teaspoonful of cold milk to begin 348 . CANCER with, but it would be advisable to first cleanse the mouth with some antiseptic wash. A few grains of powdered boracic acid with a little water and tooth brush will answer. If a teaspoonful of milk is tolerated, two tea- spoonful's may be given at the second feeding and so on, increasing slowly, until tlie patient can take four or more ounces at a feeding, every two or three hours. As feedf ing by the stomach is resumed, the rectal feeding should be discontinued at a rate of one feeding a day. The principal diet in ulcer is milk and ice cream, which should be plain- ly made. It would be well not to be too hasty in in- creasing the diet in ulcer, for it may be necessary to live on milk and ice cream for some months. The first ad- dition to the milk except milk diluents, that is allowable, is one egg beaten and eaten with the mil-lr. Hot dishes are positively forbidden, as they are likely to cause hemorrhage. During convalescence the diet should be similar to that in excessive secretion. Cancer of the stomach is so uncommon, as to scarcely deserve mention. Various theories as to its origin have been proposed, but they are purely speculative. The origin is unknown, further than that it appears to be a hereditary tendency in a few families. It usually appears in middle Kfe or old age. In the early stages of cancer it is difficult to diagnose as the symptoms resemble other forms of dyspepsia. Cancer has one characteristic different from all other diseases of the stomach. It is steadily progressive, and the end soon reached. There is a gradual loss of weight, tumor in the re'g'Ion of the stomach, frequent vomiting, and there may be either constipation or diarrhoea. Nearly all the diseases of the stomach are more or less intermit- tent, except cancer, and it is Usually fatal in less than a year and a ha:lf. If the disease has been recurrent, or con- ENLARGED STOMACH 349 tinued for a much longer time than stated, it is not a can- cer. The diet should consist of milk, eggs, meat powder, nut meal, baked apples, cream and nut oils. The stomach is an elastic pouch, and when it is filled with large quantities of food, water or gas, it becomes dis- tended. This weakens its walls, and whenever it will not* contract to its natural size, after being distended, it is said to be dilated. Prior to 1885, dilatation of the stomach had received but little or no attention, and the relation it bore to many diseases was unknown. The direct cause is continued over->distention, from either food, water or gas. The injury of over-eating is well kflown, but over-drinking is equally bad, though not so common a cause of dilatation of the stomach. Dis- tention from gas results from the putrefaction of foods due to indigestion or partial closing of the pylorus, called stricture. Whatever prevents the stomach emptying be- tween meals, will cause abnormal- fermentation and dis- tention from gas. These causes have been discussed so thoroughly under causes of disease of the stomach, they need not again be repeated. The symptoms are both local and gfeneral. It often happens that the stomach symptoms are not very pro- nounced, and both patient and physician are misled. Of the local symptoms, flatulency is the most common. When the stomach is most distended,,' the abdominal out- line is greatly enlarged. If this be due to gases, the en- largement begins at the lower end of the sternum, but when due to the use of large quantities of water and beer the enlargement of the abdomen is lower. The different aspects compared with the natural outline (side view of male form) are illustrated in figure VI. Dotted line at A shows prominence of dilated stomach, beginning at end of the sternum, while dotted line at B merely shows dis- Fig VI Side view of male figure. A shows prominence due to dilated stomach , without abdominal distention B shows abdominal distention common in obesity, etc. Both con- ditions frequently «xist in same person. 8S0 a — E- FigJll A Cardiac opening of the stomach. B Normal py- loric end. C Constricted pyloric end. D Gall bladder. E Opening of gall bladder into intestines. F Greater curvature of the stomach. G Lesser curvature. H Out- line of dilated stomach. I Folds of stomach J douodenum. 352 SYMPTOMS IN DILATATION tended abdomen. Where both conditions exist, the en- largement begins at A, and extends with increasing prom- inence to abdomen. We have seen a few cases where the stomach was so greatly dilated, that it would hold over four gallons, A simple way to estimate the size of a patient's stomach is to administer seidlitz powders un- mixed, or by inflating with inserted stomach tube. Have the patient lie flat on the back. This wiH indicate the marginal outlines of the stomach. In most cases of di- latation, there will be but very little pain, but where there is sto'icture of the pylorus, it is usually preceded by ulcer and excessive secretion, which are both painful. Figure VII shows natural stomach, and dotted lines indicate a dilated stomach due to stricture of the pylorus. In these cases the outlet of the stomach is narrowed by ulcers or inflammations, until the stomach is unable to empty. These can only be helped by surgical operation. In ordinary dilatation there is but little pain, but a feeling of fullness and weight at the stomach is almost constantly present. There is also frequent belching of gas, which begins two or three hours after meals. Sour liquid or food will often be brought up with the gas and "heart- burn" will likely be a common symptom. The general symptoms of dilatation can hardly be enumerated. Ap-* petite may be very good, excessive or poor. Tongue usually coated; person may be thin or corpulent; often the latter. Constipation is persistent, but sometimes alter- nated by diarrhoea. The feces are fetid, because of the putrefaction it has undergone. Dull head-ach€ and nerv- ousness are common, and frequently there is great sensi- bility to cold. Exertion quickly exhausts. Persistent insomnia is a strong indication of a dilated stomach, and vertigo, unusual vision, dropsy of the limbs, numbness, cold extremities, flus'hing of the face, night sweats, DIET IN DILATATION ' 353 asthma, neui^algia, eczema, are due to poisonous matter taken into the blood from putrefying food. One of the most alarming and sometimes fatal effects due to dilata- tion is palpitation of the heart. The enlarged stomach presses the diaphragm upward against the neart, causing heart failure. Many cases of sudden death in the night are accompanied with the announcement that the person ate a hearty supper, which probably caused the stomach to be distjended with gas, and that in turn displaced the heart and caused heart failure. Too many people imagine that because tlieir digestive organs do not double them over with pain, that they are all right, whereas if their food supply and digestion were all right, and the vi^aste eKminated there would ordinarily be no distressing syiapt-oms of any kind, except from contagious diseases. Diet. The diet must be free from bacteria, and of a character tiiat does not quickly ferment. As a general rule, the digestive secretions will be deficient in a dilated stomach. This is especially true of chronic cases of long standing. Where the pylorus is partly contracted, so that the outlet of the stomach is 'reduced, there will likely be excessive secretion, and then the stomach has to contend with its own acid, and those due to excessive fermentation. These cases however, are not the ordinary ones. When the -stomach is dilated, plain milk will usually disagree. It should be taken with a teaspoon, and each spoonful kept in the mouth a while (a minute or two). The food should be dry, and no drinks taken with it. All gtarchy fpod should be cooked an extra long time, and cereals should be both boiled and roajsted. Fresh doughy bread must be avoided entirely, and all bread should be thoroughly baked, and should then be sliced, and baked ag^iij. Sugar and sweet fruits, sweetened pastry, syrup, preserves, 354 DIET IN DILATATION jellies, and all sweetened foods, must be kept out of the dietary. Cooked, roasted, ground and crushed cereals, should be substituted as far as possible for bread, so as to avoid the yeast ferment and baking powders. Granose biscuits are as good a food for dilated stomachs as can be found. All cured meats and preserved foods are to be avoided, also all fried foods. Meat and eggs can only be partaken of in small quantities, and must never be fried. Peas and beans will be too solid, unless ground. So will nuts, but finely powdered nut meal with sour fruits will often agree better than any other food. Such stimulating foods as cooked onions without fat may be useful. Fine- ly ground wheat bran will be a great aid, as it stimulates the digestive organs without obstructing or causing an excessive irritation. All stale fruits or other foods, except bread, are likely to ferment quickly, an stopping. The same effect may result from poisonous effects of drugs and from long-continued fevef. The higher the temperatiife the more frequent the beats of the heaJft. Probably more deaths result after fever has left the patient than before. This is usually called exhaustion, but means that thete was no nourishment for the overworked heart, Any weakness of the heart due to disease may cause heart failure. _ There is still another form of heart trouble knowrt as nervous palpitation, common to narrow-chested and flfir- vous people, especially those addicted to the use of tea and coflfee. There is no organic disease in this class of cases, and all that is necessary is to eat a plain diet with care as t6 exercise, and avO.u excitement and anything that prevents sleep. DISEASED OF BLOOt) VESSELS 38S The blood vessels are liable to disease somewhat similar to the heart. In the disease called aneurism, the walls of the vessels become stretched in places, so that rupture is liable to occur at any time. Obstruction to the flow of blood may come from tumors, from pressure resulting from displacement of organs in the body, and from accumulated matter in the bowels, which may cause piles, or other diseases. Obstructions may klso occur from tight clothing, hats, corsets, waist- bands, and shoes. The first and most essential thing is to remove the pro- ducing cause. Qtiit liquor drinking — and all other bad habits. If it is from "scorching," quit it. If from con- tracted blood vessels, eat little or no meat, and wear loose clothes. In heart disease it is necessary to reduce the volume of blood and increase its quality. This will require a dry diet, and a small quantity of fluids. This is especially true in obesity. The diet may be similar to that in catarrh or dilatation of the stomach, with the exception that the quantity of liquids be much less than in either of these diseases. Where it is complicated with obesity or diseases of the kidneys, the diet must meet the conditions in these diseases. Rickets. Rickets is a disease essentially due to improper food, but influenced by unsanitary surroundings, such as filth, bad air and water. It is due mainly to -deficiency in min- eral matter and develops in children who are fed on sugar, condensed milk, sterilized milk, fat, and starch food's, that cOntain-but little or no mineral salts. The disease also oc- curs in children occasionally, whom their mothers nurse — due to some deficiency in the mother's milk. Children who are permitted to eat fried foods, pickles, beer, green 386 DEFICIENT BLOOD and over-ripe fruits, and indigestible foods generally, are subject to rickets. There is frequently vomiting in the earlier symptoms of rickets, which indicates digestive disturbances. Rickety children are listless and peevish when awake, and restless when asleep. The bones become soft, and if the child walks, it becomes deformed, twisted or bow- legged, and the spine may become curved. There may be emaciation, or the child may be fat or flabby. See diet for children. Anaemia and Chlorosis. This disease lias attracted a great deal of attention and besides the medical literature on the subject, short arti- cles have frequently appeared in the newspapers and mag- azines. These have usually been misleading, so that it is looked upon as a disease of the blood, rather than iriipov- erished blood, which it really is. Anaemia is not a curse sent from Mars or Jupiter, but the natural result of plain, every-day ignorance; or at least indiscretion in diet and habits. If the system is not supplied with the necessary elements to make good blood, or the blood be poisoned by effete matter in the system, or drained by profuse dis- charges, anaemia results. It is most common in girls during puberty; also frequently found among young wo- men — especially students — and a little less frequent among women generally. Causes. The chief causes are : insufficient clothing on arms and legs, too little exercise, lack of pure air, and, above all, a diet in which candy, pickles and pastry form the larger part. Secondary causes are profuse discharges (which are also due to errors in living), absorption of pus from suppurating inflammations, drugs, and possibly from eating too little food of any kind. Women may have anae- DIET IN ANAEMIA 387 mia, sick-headache, bilious attacks, female complaints, or other disorders, and persist in saying that nothing they eat "hurts them," which may be literally true, but not true in effect. There is something remarkable about the per- version of young girls' appetites at puberty, because the more anaemic they are, the more they crave injurious substances. Parents should bear in mind that poorly- nourished girls will be imperfectly developed women, who, in turn, will probably become mothers of degenerate chil- dren. Many make a great mistake in supposing that fat is an indication of good blood and vigor. The test of good blood is health,- strength and energy. Many anae- mic children are unjustly called lazy, -while in fact they have no vital force. They merely exist in form, but not in an active one. The discussion of foods and dietaries in part one, thoroughly covers the subject; but attention can- not too often be drawn to some errors, and among them iiS the habit of girls "piecing" between meals, eating fried foods, pickles, pastry and white bread. A plain, well- cooked, cereal diet, with stewed or roasted meat, milk, cream, soft-boiled or poached eggs, ground nuts, without strong tea or coffee, will soon dispel anaemia. The time is coming when it will be odious to be sick. Epilepsy, or Fits. Epileptic fits have inany causes. When due to pressure on the brain from injury to the skull, the remedy is only a surgical one. The chief cause, however, is probably due to uric acid in the blood, and the fits become a habit of the nervous system. In this class of cases it is merely an- other manifestation of the same thing that produces sick- headache, asthma, rheumatism, and kindred diseases, al- though epilepsy is not nearly so common. When one or both parents are troubled with sick-headache, asthma, or rheumatism, and a child has epilepsy, it raises a strong 3§8 ASTHMA presumption that it is of uric acid origin. In all diseases of this class, but little or no meat should be eaten, and care taken not to eat an excess of starch or sugar. There will be more or less indigestion, which must be treated according to the conditions found. Daily baths and exer- cise in the open air will be very beneficial. If the patient be weak, the baths should be tepid unti^l cold ones can be borne. Constipation must be avoided, by using fine ce- real bran. A glass of water should always be drunk an hour before meals, and at bed time. A vegetable diet, fresh air, an active skin and bowels, and alkaline waters, will do much for epileptics. Asthma. Asthma is the spasmodic contraction of the breathing tubes, which prevents the free entrance and exit of. air. The attacks come on more or less irregularly, and may be brought on by a number of causes, such as strong odorSj dust, bad air, and by inflammation in otjier parts of the body. Asthma belongs to the arthritic diseases, and is caused by some defect in the elimination of waste, partic- ularly effete tissue or excess of tissue-forming foods. An- other common term for tendencies to diseases of this class, is uric acid diathesis, which is believed to be caused by im- perfect excretion of uric acid. Whefiever there is an ex- cess of uric acid in the system of those who are predis- posed to asthma, it contracts the blood vessels of the air passages. Just how the results are brought about is more or less a matter of conjecture, but it is probable that when the blood is laden as described, that anything which slightly affects the nerves of the bronchial system, will bring on an attack of asthma. Where the uric acid dia- thesis eScists in a family, one may have asthma, some rheu- matism or gout, some sick-headache, some other diseases of- the same class, suth as some fofm of ef)ilepsy, eCzettia, DIET tN ASTHMA 389 dyspepsia^ throat diseases, etc. Medical treatment of asthma is only palliative. The only substaiitial benefit asthmatics can receive is through their diet, and place of living. This is not always an easy matter to regulate, as there is frequently a dilated stomach, and most asthmatics are obese. Leaving off tea, coffee, ale, wine, beer, meat and sugar, will greatly benefit and probably cure those who have good digestion. If the patient be thin and have poor circulation, it may be necessary to prescribe whisky, btit no other liquor; especially none of a fermented char- acter. The diet should mostly be restricted to wheat, oats, corn and rice, prepared as in diseases of the stomach. Thoroughly cooked cereals, eaten dry and well masticated, furnish the best diet. If more fat is needed, use cream and powdered nuts, but never without grinding as fine as fltVur. Milk is also permissible, but where the stomach is dilated it 'frill need to be modified in some of the ways heretofore explained. Fruits are usually prohibited, ex- cept for flavoring, although neutral fruits, such as sub- acid apples arrd grapes, may be eaten during good health. Water, milk, sassafras tea and cereal coffee are the only drinks permissible to use. Leanness. The doctor's advice to the fat and to the lean, has long beeft a target for the humorous paragrapher. It is just pQssibk, too, that they draw a picture too often true, whert they describe the doctor as advising the fat patient to leave off starch, sugar and fat, and the lean one to eat them. Leanness cannot be cured by any rule of arithmetic, but only by scientific dieting. People may be lean because they eat too much fat and starch, as well as not enough. It is a matter of digestion rather than ingestion. Lean- ness is undoubtedly hereditary; but Nature never intended one to be too lean for vigor and endurance. Capacity 390 LEANNESS for work and general health is the real standard for con- dition. When people fall below their average weight, with a tendency toward weakness, there is cause for apprehen- sion. Causes of Leanness. Besides hereditary tendencies, mental worry, over-ex- ertion, mental or physical, loss of sleep, inabiUty to digest starchy food, insufficient, or too much food. Those who are too thin, or lack strength, but are otherwise well, should reckon just how much food they consume each day, and if the quantity eaten does not produce at least 3,000 calories of heat (see dietaries) for moderate work and average size, the diet is deficient. Food in great ex- cess causes indigestion, which may prevent the formation of fat. Such persons will likely have sour stomachs and heartburn, with gaseous eructation (see gastritis and di- lated stomach). Those who have excessive acid secretions will not have a sour stomach from fermentation, until the stomach becomes dilated. Persons of this tendency are nearly always hungry, and are sometimes charged witlh "eating so much that it makes them poor to carry it." Diet. The first requisite is freedom from worry or mental strain. Then regular habits and plenty of sleep. Ten hours' sleep is a great aid toward the accumulation of fat. There must be no excesses of any character, and- two or three moderately cold baths (in a warm room), should be taken every week. After each bath crash towels or flesh brushes must be used for at least ten minutes, until the skin glows. People who are "run down," should not usually be put on large quantities of starch and fat. The system must be toned up by moderate quantities of food that are easily digested. Malted wheat gluten and beaten eggs, with well-cooked wheat foods, containing fine bran, OBESITY 391 will secure activity of the bowels and put the system in condition. Cream, nut butter, and malted nuts will fatten the quickest of all foods. It is a common notiop that both milk and water are 'fattening. The ingestion of large quantities of water may cause more fat to be stored in the system, but it could not, of itself, make fat; and milk is not ordinarily more than three or four per cent. fat. Starch digestion will greatly be increased by using dry food. Tea and coffee should be dropped in favor of hot water and milk, or cereal coffee. The quantity should not exceed four or five ounces at a meal. Particular care should be taken to dress warmly. If the leanness be due to diarrhoea or female diseases, or, in fact, any disease, they must be treated accordingly. Tobacco users should quit the habit, or at least use the least possible. Obesity— Corpulence. Obesity is the accumulation of an excessive amount of fai in the body. Causes. Its most usual cause is over-eating, although some obese people eat very little. In most cases there is a heredi- tary tendency to corpulency, which readily develops when the diet and habits favor it. The most fattening foods ordinarily used are fat meat, butter, lard, or other fat used in cooking, cream, sugar, bread, potatoes, the cereals and nuts. The yolks of eggs should also be included. Water does not produce fat, but favors its accumulation. Alcoholic liquors, especially beer, produce some fat, and besides being fattening, they cause tissue changes and the deposit of fat that would otherwise be burned up. Muscu- lar inactivity aids ip the accumulation of fat. because fat is consumed by muscular exercise. Those who are anae- mic often become fat because poor blood will not carry enough oxygen to burn up the elements that make fat. 392 EFFCTS OF OBESITY Those who are fat and anaemic suffer intensely from ex- posure to cold. Effects of Fat. An excess of fat affects the system in the following ways: (1) It prevents the radiation of heat; (2) interferes with the action of the muscles and various organs of the body; (3) increases the volume of blood; (4) obstructs the circulation; (5) changes the structure of the heart and liver and weakens their action. The first symptom that plainly indicates injury from an excess of fat is an increased rate in breathing from slight exertion, and later without any exertion at all. This con- dition is due, (1) to the fact that the heart cannot force the blood through the lungs fast enough; (2) to the re- stricted action of the lungs. The accumulation of fat in the abdomen prevents the descent of the diaphragm and the full expansion and contraction of the lungs. An excess of fat is a common cause of heart failure and apoplexy. The increased volume of blood and the in- creased resistance to the flow of blood overwork the heart. This is noticeable when an obese person rapidly climbs a hill, or even a stairway. There will be a throbbing of the heart, a fullness of the head, and a fainting sensation. Dietetic and Hygienic Treatment. Many cures for obesity have, from time to time, beea advocated, but almost all of them at the expense of diges- tion. A good many women resort to vinegar drinking, without much reduction of fat and probably great injury to their digestive organs. The use of cathartics is objec- tionable for the same reason, so that .the treatment for this disease mainly comes to a restriction as to food and drink, and sufficient exercise to burn up the excess of fat. The ordinary- foods that prodqee fat, are starch, all the qiET IN OPESITY 39>S cereals, sugar, syrup qr sweetened foods, cream, butter, fat meat, Ig^rd and nuts. Whether nie^t from which all fat h£!,s been remoyed would produce f^t has not been satisfactorily determined, but it is generally believed that it will r^ot. Single articles of food at each, njieal have often been recommerided. Only one good effect could possibly result from, this, and that is, that the appetite would be quickly satisfied and only a small amount of food eaten. Such a dietary iijay cause disease because there is no certainty that the necessary food elements would be supplied. Obesity is often difficult to treat, be- cause obese persons frequently have idiosyncrasies, and the disease is seldom found without complications. Tlie diseases obesity seems to favor are gout, rheumatism, asthma, heart diseases and dyspepsia. Rheurnatism and gout recjuire plenty of water arid a vegetable diet. In such cases, the diet should consist mainly of such garden vege- tables as string beans, beets, cabbage, cauliflower, celery, stewed onions, lettuce, spinach, turnips, parsnips, and car- rots. All should be well cooked and chopped crasswisB of their fibre. For the tissue-forming foods, fresh water fish, skimmed milk, the whites of eggs, and prepared wheat gluten. Two or three ounces of entire wheat bread, or potatoes may be allowed each day. If this diet does not make the bowels active use plenty of bran and wheat mid- lings, which should be boiled, roasted and re-ground as fine as possible. It may then be made into cakes, but no shortening should be used. If obesity is not complicated with gout, rheumatism, or asthma, lean beef, mutton, veal and chicken may be added to the dietary and milk, except for flavoring, taken from it. Water unites with other substances to form fat, and except where there is some disease such as rheumatism, that requires a large sgxipunt of vy?-ter to carry away e.ffe.te. rnatter, fte dryer the 394 DIET IN OBESITY diet, ttie more rapid the reduction in weight The object is to consume more water than is taken into the system, thus compelling the use of water already in the body and the burning up of accumulated fat. All fried foods are prohibited, because of the fat used in cooking. One ounce of butter a day may be allowed if no cream or shortened foods are eaten. Three or four ounces of weak coffee, water, milk and water, or cereal coffee, at each meal is all the fluid that should be drunk at meals. A small quantity of water between meals is allowable. It is necessary to eat some starch and fat, and to take fluids, but the quan- tity consumed must be much below an ordinary diet. Gluten biscuit, made by the Sanitarium Health Food Company, should be substituted for bread, if circum- stances will permit. Mountain climbing, gymnastics and Turkish baths are advocated for obesityj but, before any vigorous exercise is undertaken, it would be well to ascertain how much the heart will stand. When there is no danger of heart fail- ure, plenty of bodily exercise, with restricted diet, will quickly reduce fat. The fat-reducing value of Turkish baths is greatly over-rated, because the water loss from the sweating process is likely to be soon replaced. The baths are useful to remove effete matter and aid in main- taining a dry diet without injury. Headache. . . - ■ This ailment has so many causes that a complete de- scription of them would fill a volume; but they may be briefly described by saying: that headaches are caused by- poisonous substances in the blood, and by some disturb- ance in circulation and diseases of the nervous system. The blood may contain toxic substances from indiges-' tion, effete matter from incomplete elimination," or from' HEADACHE 395 the various micro-organisms that produce contagious or infectious diseases. The periodical attacks of sick-headache are usually due to excess of uric acid in the system. The only cure known is to live mainly on a cereal diet, take out-door exercise, plenty of water and daily baths. Disturbance in circulation results from disease, mental excitement and pressure from clothing. Headaches so produced can only be cured by removing the causes that produce them. See diseases of the stomach, intestines, liver,' asthma, rheumatism and epilepsy. CHAPTER XXXI. ACUTE DISEASES. Cold. Cold is an elastic term that is applied to a large number of syniptoms, varying much in severity. The most com- mon form is called coryza, but better known as "cold in the head." This form of cold is an acute inflammation of the mucous membranes of the nose and adjacent , pas- sages. The swollen membranes cause an oppressive sense of fullness in the head, and may close the air passage in one or both no.strils, which makes it necessary to breathe through the mouth. At the beginning of the attack there will be a watery discharge from the nose. As the more acute symptoms subside, the discharge becomes thicker, and sometimes quite hard. Tosilitis — Quinsy. This is another manifestation of cold, but instead of the inflammation of the membranes of the nose, it is an in- flammation of the throat and tonsils. Children are. much more subject to the disease than adults. ^Pharyngitis — :Sore Throat. 'Pharyngitis is an inflammation of the membranes of the throat, and is a common form of cold. Acute Bronchitis. This is an inflammation of the lining membranes of the trachea and bronchial tubes — the air passages of the lungs. It may fallow a cold in the head, sore throat, or the cold may 'first affect the bronchial membranes. There will usually be a feeling of constriction in the front of the chest, difficult breathing, and a pronounced cough, .although the cough may be a symptom in other disease, especially 397 398 HOW TO CURE A COLD from the throat. All of the membranous inflammations incident to cold, may become chronic, if the causes pro- ducing them are constant, or even frequent. Causes of Colds. Colds are caused by chilling the surface of the body, especially after being overheated. Cold, damp atmos- phere, insufficient clothing, chilling the skin, overheated and badly-ventilated houses, are all causes of colds. It is likely that over-eating and constipation are more fre- quently the cause of colds, than is supposed. Whatever disturbs the circulation of the blood and prevents the elim- ination of waste may cause a cold. Hygienic Treatment. Colds should be prevented by proper living, but when once contracted, how shall we get rid of them? The an- swer is very simple: remove the cause by restoring the functions of the skin, and other excretory outlets. This can best be done by vigorous exercise sufficient to start profuse perspiration. Turkish, vapor, or other baths, that open the pores of the skin and cause free perspiration, will cure a cold at the beginning of the attack, and shorten one already existing. After a sweat, the skin should be cleansed, and sponged at least three times. The first time with tepid, then cool, and finally with moderately cold water. This must be followed by thorough rubbing of the skin, dry clothing and a temperature moderately warm for several hours, or ■patient may go to bed and keep warm. The bowels must be kept active and houses well ventilated. Cold packs with dry covering, give great relief from cough and dis- comfort in the face. Diet. In an acute attack it will be well to eat but little. The maxim "feed a cold and starve a fever" would be better if MALARIA 399 rendered: "li ytju will feed a cold you will have a fever to starve." The diet in ordinary acute cases should be laxa- tive (see constipation) and reduced one-half for two or three days. In chronic cases, where the patient is weak, a rich diet should be allowed and the patient fed on well-cooked cereals, gluten, eggs, milk, powdered meat and powdered nuts. Malaria. It IS now generally accepted as a fact, that malaria is a germ disease. Where there is rich land and heavy vege- tation, there will likely be malaria about the end of the Summer, and in hot climates all the year. There is also more or less malaria adjacent to streams, and it is believed that it always exists in newly-cultivated land. Symptoms. Languor, headache, aching of body and limbs, chilly sensations, followed by fever. There are many types of malaria manifested as "dumt" ague, daily, alternate, and third day ague. Also many forms of intermittent fever. It is supposed that the germs of dififerent types of malaria require different lengths of time for development. At a certain stage, they produce the acute attacks with chill, high fever, perspiration. When the fever subsides, the symptoms may disappear until more germs are matured. Diet. It is remarkable that so little attention has been paid to the dietetic treatment of this, disease. Good blood and an active liver, resist malaria without any drugs, but this fact seems to have been lost sight of in its treatment. We have seen patients treated for months with constant recur- ring attacks, without any notice being taken of the fact that the patient was living on fried pork, hard-fried eggs, hot biscuits, fried potatoes, and strong coffee. No one can eat such a diet and keep well, much less get;w«ll, when debili- 400 DIET IN MALARIA tated by malaria, which engorges the I'ver, impoverishes the blood and weakens the whole digestive system. After an attack of materia, the- system is a much damaged fort- ressi Tlie blood is the agency of repair, and food the ma- terial-. The stomach and bowels will need to be cleansed and disinfected, and as soon as the fever is down, easily digested, and non-fermentable foods should be given, such as egg punch, beaten egg, in three parts milk and one part cream, that have been sterilized, or pasteurized. Gelatine may be used instead of egg, where more agreeable. These may be flavored to suit In most cases sour fruit, such as orangesi lemons, peaches, baked apples, strawberries, and fresh grape juice will give good results. The diet" in convalescence should be similar to that in catarrh of the" stomach. All coarse, tough, or indigestible substances and fermented foods' must be avoided. The cereats' should be well-cooked and malted. Baths and gesnieral care will greatly aid. Get all foul and effete matter out, and good healthy blood as soon as possible, and malaria will seek weaker victims. Scarlet Fever. Scarlet fever is a contagious and infectious disease, and is an infemmation of both skin and mucous membranes o£i the body. It has three periods: 1st. Invasion, which lasts from 24 to 48 ho-urs. 2nd. Eruption, which lasts from -5 to 7 days. Srd; Desquamation, from the '7th to the 21st day. Etiiption commences second or third day after fever^ and consists of very numerous points about the size of pin heads. ,. Between these the skia is of natural color. As the eruption; develops, the red -poiftts? tmite,' bat fade ii^rom five to eight days. ^ SympiomSi Bam in the backaiKiiiit^^ coldness of sktiir headache^ SCARLET FEVER 401 nausea and- vomiting, followed by sensation of heat and high temperature, often accompanied by delirium. In severe cases, the tongue is swollen and presents a straw- berty appearance. Symptoms increase in severity as erup- tion appears. The urine is scant and of dark red hue. The nervous system and kidneys are most affected by the scarlet fever poison. The disease can be communicated bypersonal contact, by atmosphere, clothing, animals, or food,^ especially milk. The scales are- the most contagi- ous. The darker the color of the eruption the more severe the disease. Measles, or erythema, are liable to be mis- taken for scarlet fever. There is this difference: In scar- let fever the eruption first appears on the neck and chest, while in measles, first on face. Eruption does not always appear,, ahd in such cases it is difficult to distinguish it from diphtheria. The urine of scarlatinous patients should be -carefully examined every day after the eruption has appeared, as it not infrequently happens the kidneys are badly- inflamed, and if not watched may result in Bright's disease and death. Diet. This disease is so frequently a source of kioney disease, that great care should be exercised in feeding, until re- covery is complete. Milk is the best food. It may be diluted with well-cooked gruels, but not with gelatine or other animal food. In serious cases milk should be the principal food for some weeks. Effervescing waters, bar- ley water, orange and fruit juices (except astringent ones — ^raspfeerries, etc.), may be given to moisten the mouth and' quench the thirst. During high fever the patient will take from two to five ounces of fluid every hour. In using animal foods during convalescence, eggs, fish and chicken should be allowed before other meats. 402 DIPHTHERIA Diphtheria is a specific infectious disease caused by a microbe known as Klebs-Loeffler bacillus. It is locally manifested by an intense inflammation of the throat, with constitutional symptoms, due to poison produced by the bacillus. Infection may occur by being near the patient, or may be carried by healthy persons to others. Many cases occur by relaxing rules of precaution after patients seem to be about well. The virus attaches itself to cloth- ing, bedding and the room in which the patient has lived. Symptoms. The period of incubation is from two to seven days. There is slight chilliness, aching pains in the body and limbs, followed by fever. Tesmperature usually rises to 103, and In severe cases 104, the first twenty-four hours. In addition to the danger to life which the diphtheretic throat may cause, the kidneys are liable to be seriously affected, so that the diseases which result indirectly from the poisoned condition of the blood need to be carefully guarded against. The urine should be examined daily for kidney complicadons. Diet Diphtheria is the most malignant of the common dis- eases, and needs especial care in feeding. Plain ice cream without sugar is both nourishing and soothing to the throat. Repugnance to food is a bad diagnostic sign, and every effort possible must be made to overcome it, by offering a variety of flavors. Foods thickened with cream, beaten eggs, or gruels, will somfetimes be more easily swallowed than either milk or water. If there is a feeble pulse and danger of heart failure, alcoholic stimulation may be required. In such cases, egg-nog and milk punch should be g^ven. Haemoptysis — ^Haemorrhage of the Lungs. Haemorrhage of the lungs or blood-spitting, has many causes : HAEMORRHAGE MEASLES 403 1. Rupture from external violence, as from blows or falls. 2. Violent exertion, as an attempt to perform some ex- traordinary feat, and inflammation from any cause, throw- ing an excess of blood to the lungs. 3. Secondary effect of heart disease, pressure of tu- mors, or enlarged glands. 4. The perforation of blood vessels by disease. In hemorrhage of the lungs the blood is coughed up, not vomited. In either case it may be possible for the blood to come from the throat. The patient must lie flat on the back without pillow, and must not move or speak. Food must be administered with a spoon. As the volume of blood must be kept as small as possible, but little fluid should be given. Use cracked ice to quench the thirst; alcohol may do harm. Beaten egg and meat powder, with small quantities of milk, should form the principal part of the diet. All fluids must be given cold, or only lukewarm. The prepared foods may be given with milk. Should there be nausea, rectal feeding must be substituted to prevent retching or vomiting. Measles. Measles is a contagious and infectious disease, manii festing itself by an eruption of red spots accompanied by catarrh of the air passages and more or less fever. The eruption makes its appearance first on the face, then upon the neck, chest, over the body, and lastly upon the back of the hand, which usually requires four days from first appearance on the face. As it disappears it assumes more of. a yellowish red. The spots are crescent-shaped, and from one-eightH to two-fifths of an inch' in diameter, and are usually bright red. Sometimes the eruption is so thick as to entirely cover portions of the skin. In severe cases, where there is hemorrhage, black measles develop. Aver- age period of incubation is eight days. 404 PNEUMONIA Symptoms. The first symptoms, eight to ten days after exposure,' is a languid, chilly feeling, and in young children, convul- sions occasionally occur. There will be pain- in front part of the head and general feeling akin to a severe. cold in the head, and likely a constant watery and irritating dis- charge from the nose, with sneezing and coughing. Fever will be developed the second day and continue two to four days. Diet Similar to that used in fevers. Pneumonia. This disease is an acute inflammation of the general structure of the lungs, which may invade any part of the entire lungs. Causes. It is probably due to a germ, but as it cannot find lodg- ment in a healthy person, it may be satd to be due to ex- psosure, cold and' wet, bad air, over-eating, impoverished' blood, especially where it is an incident to malaria; and neglect of skin. Habits which allow waste to accumulate in the system, make pneumonia possible with but very lit- tle eSeposure. It is now conceded to be an infectious' dis- ease. Symptoms. It is usually preceded by a cold with accompanying aches and pains; these are followed by a chill, and a rapid rise of fever. Diet. Pneumonia is a disease of short duration in acute fofm, but it needs careful dietetic treatment. Vomiting must be guarded against. Milk, meat juice, the white of eg'g beateh, and whisky are mainly relied on. Cereal's cooked as heretofore described may be malted and given in form SKIN DISEASES 405" of graeisi ■vwthout sugar. In convalescence an easily di- gested and nourishing diet will be necessary. Skin Diseases. Skin diseases are caused by parasites (such as itch), con- tagious and infectious diseases, diseases of the heart and blOcyd vessels, nervous di«orders, but most commonly by some form of starch or fat indigestion, or deficient elimin- ation of nitrogenous waste. The principal investigator of uric acid diseases, classes skin eruptions among them. Erythema, or Urticaria (Hives). This is the most common of all skin eruptions. There is also a form known as nettle rash, so well-known it needs no ' description; Causes. They are caused by same article of diet, most usually oysters, lobsters, strawberries, bananas, sausage, rich gravy, mushroorts, cheese, and sometimes sour fruit. Bathe the eruption with soda water — small teaspoonful of soda to pint of water — ^and eat a plain cereal diet. Acne. This is an eruption of red pimples on the face, that do- not readify'disapgean Causes. Excess of fats or starch, dougfenuts, sausage, fried meat, brackwheat cakes, or griddle- cakes, pastry, excess of sugar. AU'ofva^iichr or indigestible foods are bad and should bsr left out of the cKet; also tea, coffee and aleohol in all i&rms. ■ Little liq-uid shosuld' be drunk- at meal time, but a glass of hot water a half hour before, when practicable, especially befare- breakfast, and before retiring at night will' be benefieialy if not long- oontinuedj Eczema. This is^the most common of all skin diseases not of a trfeisiehtfnaturei and begins- with an inflamed patch which 406 ECZEMA YELLOW FEVER often spreads. There are usually red pimples, but the red spots may only be swollen vesicles with watery discharges followed by thickening, scabbing, scaling and intense itch- ing. Cause. Excessive meat eating and other causes enumerated in acne. The same rules apply to diet. Yellow Fever. Yellow fever is an infectious disease of a violent char- acter that is caused by a specific gerni which thrives in animal and vegetable matter. It is essentially a dis- ease of the tropics, and is rarely observed above40 degrees north and 20 degrees south latitude, and is always checked by cold weather. It is usually spread from one part to an- other by ships. The period of incubation is from twelve hours to four days. Symptoms. Commences with a chill, alternating with flushes of heat, gradually settling down into a regular fever. The skin varies from dark or swarthy yellow, to dark orange; bowels usually constipated in the beginning, followed by violent diarrhoea. As the disease progresses, pain in the stomach and bowels become severe, and they are sensitive to pressure. The most pronounced symptom is the black vomit,, due to hemorrhages ffom the violent inflammation of the stomach, intestines, kidneys, spleen and liver. Nothing but predigested food should be given, until the most severe symptoms have subsided. Then the diet must be soft and easily digested. Laryngismus Stridulus — Spasmodic Croup. Spasmodic croup is the ordinary croup, in which the spasm aflfects the muscles of the larynx and makes breath- ing difficult, causing a wheezing sound at each respiration. The disease seldom affects any but children, although CROUP BLOOD POISONING . 407 hysterical persons and grown-up people having a catarrhal inflammation of the mucous membrane, are sometimes subject to it. It is said to be an ailment of the nerves, and is entirely reflex, so that the real trouble is to be found elsewhere, and most likely deranged digestion. Causes. Over-feeding, improper food, constipation, colds and teething. (See infant feeding and dietaries for children.) Septicaemia (Blood Poisoning). This is a constitutional disease due to poisoning from the absorption of pus into the blood. Bacteria are always present and enter the system from some local injury or decomposing tissue in the system, such as typhoid ulcers, sloughing memtrane of throat in diphtheria, abdominal abscesses, decomposing placenta remaining in the womb after child-birth or miscarriage, suppuration in small-pox, and especially wounds made in handling dead bodies which are in an advanced state of putrefaction ; also likely to result where a large part of the skin has been burned, and from inflammations where pus is formed in consid- erable amount. Symptoms. Decided chill and rise in temperature, but often irregu- lar chills, followed by profuse and exhausting night sweats. Skin soon becomes dry and hot; pulse 120 to 140, small and intermittent. Tongue at first coated with a white fur, later becomes glazed, dry, grayish-brown and cracked; skin slightly jaimdiced, and usually diarrhoea. Prevention. Wash wounds with water that has been boiled, and in any disease which pus is formed, care must be taken to have it removed, that it may not be reabsorbed. Diet. Malted milk, malted cereals, pancreatinized meat pow- der, or eggs, and beef blood. 408 WHOOPFNG COUGH SCROFULA Whooping cough is an acute contagious disease and is primarily a catarrhal bronchitis or specific catarrh then be applied to good advantage. Any pure oil is use- ful, as it protects the burn from the air. Burns from acids may be relieved by applying baking, soda or soap; burns from lye may be relieved by vinegar. The effect of prolonged cold is to stop the circulation ot the blood, which is followed by loss of feeling in the in- jured parts. The circulation in the part frozen, should be re-estab- lished gradually, and this is best done by keeping" the patient in a cold room and rubbing vigorously with snow or cold water. In severe cases of freezing, there is dan- ger of gangrene of the part affected. Hysterics. Hysterics may be defined as a nervous explosion. It is probably best treate