The researches of Dr. Hall show that the purins of food are metabolised or broken down by gouty patients, almost as well as by normal individuals, any slight retention being due to increased capillary pressure. A portion of the purins remain undigested, the quant.i.ty depending upon the particular purin and the vigour of the digestive organs. Two rabbits had the purin hypoxanthin given to them daily, in quant.i.ties which if given to a man in proportion to his weight, would have been 17 and 3 grains respectively. These rabbits showed malnutrition, and after death degenerative changes were visible in their liver and kidneys. Dr. Hall has made a large number of personal experiments, and says that when he has taken large doses of purin bodies--such as 7 grains of hypoxanthin, 15 to 77 grains of guanin or 7 to 15 grains of uric acid, apparently a.s.sociated symptoms of general malaise and irritability have frequently appeared. In gouty subjects such moderate or small quant.i.ties of purins which are without effect on the healthy subject, may prove a source of irritation to the already weakened liver and kidneys.

Professor Carl von Noorden says of gout, "with regard to treatment we are all agreed that food containing an excess of purin bodies should be avoided, and those words embody almost all there is to be said as to dietetics. Alcohol is very injurious in gout. Salicylic acid is a dangerous remedy. Alkalies in every form are utterly useless." Dr. J.

Woods-Hutchinson says, "the one element which has been found to be of the most overwhelming importance and value in the treatment of gout and lithmia, water, would act most admirably upon a toxic condition from any source; first, by sweeping out both the alimentary ca.n.a.l primarily, and the liver, kidneys and skin secondarily; and secondly, by supplying to the body cells that abundant salt-water bath in which alone they can live and discharge their functions." Dr. Woods-Hutchinson proceeds to state, that the one active agent in all the much vaunted mineral waters is nothing more or less than the water. "Their alleged solvent effects are now known to be pure moonshine." The value consists in "plain water, plus suggestion--not to say humbug--aided, of course, by the pure air of the springs and the excellent hygienic rules."

It is a common experience amongst rheumatic patients, that they cannot take lentils, haricots and some other foods; sometimes, even eggs and milk are inadmissible. This is not for the alleged reason that they contain purins, or as some misname it, uric acid; but because the digestive organs are unequal to the task. It will be seen, that although Dr. Haig's hypothesis of uric acid as a cause of gout and some other diseases is disputed by many eminent physicians, his treatment by excluding flesh and other foods which contain purins, and also pulse, which is difficult of digestion by the weakly, is a wise one. It has proved of the greatest value in very many cases.

Digestion and nutrition is a complex process, and it may be faulty at various stages and in several ways; there may be either deficient or excessive secretions or inaction. Thus there are exceptions, where gouty symptoms, including an excessive quant.i.ty of urates in the urine, have only been relieved by the giving up of milk foods or starch foods (see _Lancet_, 1900, I., p. 1, and 1903, I., p. 1059).

Those particularly interested in the subject of the purins and gout are referred to the lecture on "The meaning of uric acid and the urates," by Dr. Woods-Hutchinson, in the _Lancet_, 1903, I., p. 288, and the discussion on "The Chemical Pathology of Gout" before the British Medical a.s.sociation at Oxford (see _British Medical Journal_, 1904, II., p. 740).

Dr. George S. Keith, in "Fads of an Old Physician," has a chapter on rheumatic fever; he says that the disease is much more common than it was fifty years ago. He has never met with it in the young or old except when the diet had consisted largely of beef and mutton, and this although he has been on the outlook for at least forty years for a case of the disease in a child or youth who had not been fed on red meat. He speaks of it as being exceedingly common in Buenos Ayres and Rosario in the Argentine Republic, amongst the young; and that it leads to most of the heart disease there. The amount of meat, especially of beef, consumed by old and young is enormous. The main evils there, were anaemia in children and neuralgia both in old and young. Dr. Haig relates how he suffered from migraine all his life, until the time of his discontinuing butchers' meat.

As meat contains a comparatively large quant.i.ty of purins and other bodies called extractives, it is probable that such quant.i.ties have an injurious effect, quite apart from the question of uric acid production. That an excessive meat diet lessens the vitality of the body and pre-disposes to disease is undoubted, but opinions differ as to how the injury is brought about.

On thorough Mastication.--We have written at some length on the quant.i.ty and const.i.tuents of food required per day and have criticised the usually accepted standards. We have since read a valuable contribution to the subject by Mr. Horace Fletcher in his book, "The A.B.-Z. of our own nutrition" (F.A. Stokes & Co., New York). Ten years previous to the writing of the book, when of the age of 4, he was fast becoming a physical wreck, although he was trained as an athlete in his youth and had lived an active and most agreeable life. He had contracted a degree of physical disorder that made him ineligible as an insurance risk. This unexpected disability and warning was so much a shock, that it led to his making a strong personal effort to save himself. He concluded that he took too much food and too much needless worry. His practice and advice is, be sure that you are really hungry and are not pampering false appet.i.te. If true appet.i.te that will relish plain bread alone is not present, wait for it, if you have to wait till noon. Then chew, masticate, munch, bite, taste everything you take in your mouth; until it is not only thoroughly liquefied and made neutral or alkaline by saliva, but until the reduced substance all settles back in the folds at the back of the mouth and excites the swallowing impulse into a strong inclination to swallow. Then swallow what has collected and has excited the impulse, and continue to chew at the remainder, liquid though it be, until the last morsel disappears in response to the swallowing impulse. In a very short time this will become an agreeable and profitable fixed habit. Mr. Fletcher has been under the observation of several eminent scientific men. Professor R.H. Chittenden, of Yale University, in his report refers to the experiments of k.u.magawa, Siven, and other physiologists; who have shown that men may live and thrive, for a time at least, on amounts of proteid per day equal to only one-half and one-quarter the amount called for in the Voit standard (see p. 32), even without unduly increasing the total calories of the food intake. Such investigations, however, have always called forth critical comment from writers reluctant to depart from the current standards, as extending over too short periods of time.

Dr. Chittenden writes that he has had in his laboratory, for several months past, a gentleman (H.F.) who for some five years, practised a certain degree of abstinence in the taking of food and attained important economy with, as he believes, great gain, in bodily and mental vigour and with marked improvement in his general health. The gentleman in question fully satisfies his appet.i.te, but no longer desires the amount of food consumed by most individuals. For a period of thirteen days, in January, he was under observation in Professor Chittenden's laboratory. The daily amount of proteid metabolised was 41.25 grammes, the body-weight (165 pounds) remaining practically constant. a.n.a.lysis of the excretions showed an output of an equivalent quant.i.ty of nitrogen. In February a more thorough series of observations was made. The diet was quite simple, and consisted merely of a prepared cereal food, milk and maple sugar. This diet was taken twice a day for seven days, and was selected by the subject as giving sufficient variety for his needs and quite in accord with his taste. No attempt was made to conform to any given standard of quant.i.ty, but the subject took each day such amounts of the above foods as his appet.i.te craved. The daily average in grammes was, proteid 44.9 (1.58 ounces), fats 38.0, carbohydrates 253.0, calories 1,606. The total intake of nitrogen per day was 7.19, while the output was 6.90. It may be asked, says Professor Chittenden, was this diet at all adequate for the needs of the body--sufficient for a man weighing 165 pounds? In reply, it may be said that the appet.i.te was satisfied and that the subject had full freedom to take more food if he so desired. The body-weight remained practically constant and the nitrogen of the intake and output were not far apart. An important point is, can a man on such food be fit for physical work? Mr.

Fletcher was placed under the guidance of Dr. W.G. Anderson, the director of the gymnasium of Yale University. Dr. Anderson reports that on the four last days of the experiment, in February, 1903, Mr. Fletcher was given the same kind of exercises as are given to the 'Varsity crew. They are drastic and fatiguing and cannot be done by beginners without soreness and pain resulting. They are of a character to tax the heart and lungs as well as to try the muscles of the limbs and trunk. "My conclusion, given in condensed form, is this: Mr. Fletcher performs this work with greater ease and with fewer noticeable bad results than any man of his age and condition I have ever worked with." "To appreciate the full significance of this report, it must be remembered," writes Professor Chittenden, "that Mr. Fletcher had for several months past taken practically no exercise other than that involved in daily walks about town." Sir Michael Forster had Mr. Fletcher and others under observation in his Cambridge laboratories, and in his report he remarks on the waste products of the bowel being not only greatly reduced in amount, as might be expected; but that they are also markedly changed in character, becoming odourless and inoffensive, and a.s.suming a condition which suggests that the intestine is in a healthier and more aseptic condition than is the case under ordinary circ.u.mstances. If we can obtain sufficient nourishment, as Mr. Fletcher does, on half the usual quant.i.ty of food, we diminish by half the expenditure of energy required for digestion. By thorough mastication the succeeding digestive processes are more easily and completely performed.

What is also of great importance is that there is not the danger of the blocking up of the lower intestines with a ma.s.s of incompletely digested and decomposing residue, to poison the whole body. Even where there is daily defaecation, there is often still this slowly shifting ma.s.s; the end portion only, being expelled at a time, one or more days after its proper period. All this improved condition of the digestive tract, leaves more vitality for use in other directions, a greater capacity for work and clearness of brain.

Professor R.H. Chittenden, in "Physiological Economy in Nutrition,"

writes:--"Our results, obtained with a great variety of subjects, justify the conviction that the minimum proteid requirements of the healthy man, under ordinary conditions of life, are far below the generally accepted dietary standards, and far below the amounts called for by the acquired taste of the generality of mankind. Body weight, health, strength, mental and physical vigour and endurance can be maintained with at least one-half of the proteid food ordinarily consumed."

From these and other considerations, we see that it is not only unnecessary, but inadvisable to diet ourselves according to any of the old standards, such as that of Voit, or even to any other standard, until they have been very thoroughly revised. We shall probably find that as the body becomes accustomed to simpler food, a smaller quant.i.ty of the food is necessary. The proportion of proteids to other const.i.tuents in all the ordinary, not over manfactured vegetable foods, such as are generally eaten, may be taken as sufficient. Several cookery books have been compiled in conformity with certain proteid standards and also with some more or less fanciful requirements; these give the quant.i.ties and kinds of food which it is imagined should be eaten each day. Theoretically, this should be calculated to accord with the weight, temperament, age and s.e.x of the eater and the work he or she has to perform. The dietaries that we have seen have their proteid ratio placed unnecessarily high. This high proteid ratio can be got by the use of the pulses, but except in small quant.i.ties they are not generally admissible, and in some of the dietaries they are ruled out. The difficulty is got over by the liberal use of eggs, cheese and milk. To admit a necessity for these animal products is to show a weakness and want of confidence in the sufficiency of vegetable foods.

Some of these cookery books are of use in sickness, especially as replacing those of the beef-tea, chicken-broth, jelly and arrowroot order.

They provide a half-way stage between flesh and vegetable food, such as is palatable to those who have not quite overcome a yearning for flesh and stimulating foods. The liberal use of animal products is less likely to excite the prejudice of the ordinary medical pract.i.tioner or nurse.

Possibly, also, a higher quant.i.ty of proteid may be required on first giving up flesh foods.

The Use of Salt.--One of the most remarkable habits of these times is the extensive use of common salt or sodium chloride. It is in all ordinary shop bread, in large quant.i.ty in a special and much advertised cereal food, even in a largely sold wheat flour, and often in pastry. It is added to nearly all savoury vegetable food, and many persons, not content, add still more at the time of eating. No dinner table is considered complete without one or more salt-cellars. Some take even threequarters of an ounce, or an ounce per day. The question is not, of course, whether salt is necessary or not, but whether there is a sufficient quant.i.ty already existing in our foods. Some allege that there is an essential difference between added salt and that natural to raw foods. That the former is inorganic, non-a.s.similable and even poisonous; whilst the latter is organised or in organic combination and nutritive. The writer is far from being convinced that there is a difference in food value. Some herbivorous animals are attracted by salt, but not the carnivora. This has been explained by the fact that pota.s.sium salts are characteristic of plants, whilst sodium chloride is the princ.i.p.al saline const.i.tuents of blood and of flesh. In their food, the herbivora take three or four times as much potash salts as the carnivora. Of course, the sodium chloride in the flesh of the herbivora and frugivora is obtained from the vegetable matter forming their food, and very few of them have the opportunity of obtaining it from salt-licks and mineral sources. They must have the power of storing up the sodium chloride from plants in sufficient quant.i.ty, whilst the potash salts pa.s.s away. There is no justification for saying that they are worse off by being deprived of salt. If the ape tribe can thrive without added salt why should not man? Bunge considers that a restriction to vegetable food causes a great desire for salt. Opposed to this, is the fact that certain tribes of negroes who cannot obtain salt, add to their vegetable food wood ashes or a preparation of wood ashes; this is chiefly potash. One preparation used in British Central Africa was found to contain about 21 per cent. of pota.s.sium chloride to only 0.5 per cent. of sodium chloride. It has been said that vegetarians consume more salt than those who take flesh food. We doubt this; we know of many vegetarians who have a strong objection to added salt, and have abstained from it for years. Some find that it predisposes to colds, causes skin irritation and other symptoms. At many vegetarian restaurants the food is exceedingly salty; the writer on this account cannot partake of their savoury dishes, except with displeasure. Nearly all who patronise these restaurants are accustomed to flesh foods, and it is their taste which has to be catered for. Flesh, and particularly blood, which of course, is in flesh, contains a considerable quant.i.ty of sodium chloride; and most flesh eaters are also in the habit of using the salt cellar. These people are accustomed to a stimulating diet, and have not a proper appreciation of the mildly flavoured unseasoned vegetable foods. Only those who have, for a time, discontinued the use of added salt, and lost any craving for it, can know how pleasant vegetables can be; even those vegetables which before were thought to be nearly tasteless, unless seasoned, are found to have very distinct flavours. It is then perceived, that there is a much greater variety in such foods than was previously imagined. It is commonly urged that salt and other condiments are necessary to make food palatable and to stimulate the digestive functions. We, on the contrary, say that condiments are the cause of much over-eating; and that if food cannot be eaten without them, it is a sign of disorganisation of the digestive system, and it is better to abstain from food until the appearance of a natural and healthy appet.i.te. An excess of salt creates thirst and means more work for the kidneys in separating it from the blood prior to its expulsion. Even should it be admitted, that certain vegetables contain too little sodium salts, a very little salt added to such food would be sufficient; there is no excuse for the general use of it, and in such a great variety of foods. It is thought that some cases of inflammation of the kidneys originate in excessive salt eating; certain it is that patients suffering from the disease very soon improve, on being placed on a dietary free from added salt and also poor in naturally contained sodium and pota.s.sium salts. It is also possible to cause the swelling of the legs (oedema), to which such invalids are subject, to disappear and reappear at will, by withdrawing and afterwards resuming salt-containing foods. The quant.i.ty of one-third of an ounce, added to the usual diet, has after a continuation of several days, produced oedema. In one patient, on a diet of nearly two pounds of potatoes, with flesh, but without added salt, the oedemia disappeared and the alb.u.min in the urine diminished. As potatoes are particularly rich in potash salts, this case is significant, as showing contrary to expectations, that such quant.i.ty as they contained had not the irritating effect of added common salt. Salt and other chlorides have been shown by several observers, to be injurious, not only in diseases of the kidneys, but also of the liver and heart. In these diseases the excess of salt is retained in the tissues, it causes a flow of fluid into them, and so produces oedema and favours the increase of dropsy. The good effect of milk in such diseases has long been known; it is probably due to its relative poverty in sodium and pota.s.sium chlorides.

Even in the case of three healthy men, by an abrupt change from a diet extremely rich in chlorides to one deficient, they were able to reduce the body-weight by as much as two kilos. (4 lbs. 6 oz.); this was by the loss of an excess of water from their connective tissues. Sodium chloride diminishes the solvent action of water on uric acid and the urates; but pota.s.sium salts, on the contrary, do not, they may even increase the action. Although nearly all the medical experience recorded has to do with diseased persons, such cases are instructive; it is only reasonable to suppose, that more than a very small quant.i.ty of salt in excess of that natural to the food, is a source of irritation in the body, even of the ordinarily healthy individual.

Summary.--Enjoyment of food is dependent upon appet.i.te quite as much as upon the nature of the food. Better a simple repast with good appet.i.te than sumptuous fare with bad digestion. There is indeed a causal relationship between simplicity and health. The savage likes the noise of the tom-tom or the clatter of wooden instruments: what a contrast this is to the trained ear of the musician. Uncivilised man has little enjoyment of scenery or of animal life, except as in respect to their power of providing him with food, clothing or other physical gratification. What an enormous advance has taken place. In the case of the painter, his eye and mind can appreciate a wide range and delicacy of colour. Man has improved on the crab-apple and the wild strawberry. From a wild gra.s.s he has produced the large-grained nutritious wheat. Vegetables of all kinds have been greatly improved by long continued cultivation. In tropical and sub-tropical climates, where wild fruits are more plentiful, high cultivation is of less importance than in temperate regions. In spa.r.s.ely inhabited or wild, temperate and cold regions, in times past, when deer and other animals were plentiful, and edible fruits few, flesh could be obtained at less labour; or such intelligence and industry as is required for the cultivation of fruits, cereals, and other foods scarcely existed.

Flesh almost requires to be cooked to be palatable, certainly this much improves its flavour. The eating of flesh tends to produce a distaste for mild vegetable foods, especially if uncooked. In process of time, not only flesh but vegetable foods, were more and more subjected to cooking and seasoning, or mixed with the flesh, blood or viscera of the animals killed. Next, food was manufactured to produce a still greater variety, to increase the flavour, or less frequently to produce an imagined greater digestibility or nutritiveness. Man has taken that which seemed most agreeable, rarely has he been intentionally guided by scientific principles, by that which is really best. Only of late years can it be said that there is such a thing as a science of dietetics; although cookery books innumerable have abounded. Of recent years many diseases have enormously increased, some even seem to be new. Digestive disturbances, dental caries, appendicitis, gout, rheumatism, diabetes, nervous complaints, heart disease, baldness and a host of other diseases are due, in a great measure, to abuse of food. One of the most learned and original of scientific men, Professor Elie Metchnikoff, in his remarkable book on "The Nature of Man," referring to the variety of food and its complexity of preparation says that it "militates against physiological old age and that the simpler food of the uncivilised races is better....

Most of the complicated dishes provided in the homes, hotels and restaurants of the rich, stimulate the organs of digestion and secretion in a harmful way. It would be true progress to abandon modern cuisine and to go back to the simpler dishes of our ancestors." A few have lived to a hundred years, and physiologists, including Metchnikoff, see no inherent reason why all men, apart from accident, should not do so. Most men are old at 70, some even at 60; if we could add 20 or 30 years to our lives, what an immense gain it would be. Instead of a man being in his prime, a useful member of the community, from about 25 to 60 or perhaps to 70; he would have the same physical and mental vigour to 80 or 90 or even longer.

This later period would be the most valuable part of his life, as he would be using and adding to the acc.u.mulated experience and knowledge of the earlier period.

Some, perceiving the mischief wrought by luxurious habits, urge us to go back to nature, to eat natural food. This is ambiguous. To speak of animals as being in a state of nature, conveys the distinct idea of their living according to their own instinct and reason, uninterfered with, in any way, by man. The phrase, applied to man, is either meaningless, or has a meaning varying with the views of each speaker. If it has any definite meaning, it must surely be the giving way to the animal impulses and instincts; to cast off all the artifices of civilisation, to give up all that the arts and sciences have done for man, all that he has acquired with enormous labour, through countless failures and successes, during hundreds of thousands of years, and to fall back to the lowest savagery--even the savages known to us use art in fashioning their arms, clothing and shelter, to the time when man was a mere animal. Civilised man is not only an animal, but an intellectual and spiritual being, and it is as natural for him to clothe himself as for a cow to eat gra.s.s. Our intellect has been made to wait on our animal nature, whilst our spiritual has lagged far behind. Animal food and all else of a stimulating character, stimulates the lower nature of man, his selfish propensities; whilst mild food makes it easier to lead a pure life. In the treatment of habitual drunkards in retreats, it has been found that a permanent cure is rare upon the usual abundant flesh dietary. Only by the use of vegetable food, particularly farinaceous, can a permanent cure be a.s.sured. The editor of the Clarion, Mr. R. Blatchford, or "Nunquam," has lately adopted a vegetarian diet. He remarks with surprise, that although he has been a heavy smoker for more than 30 years, using not less than eight ounces of tobacco a week, often two ounces in a day, he has found his pa.s.sion for tobacco nearly gone. He has had to get milder tobacco, and is now not smoking half-an-ounce a day. He says "it does not taste the same; I am not nearly so fond of it." He finds, with regard to wine, that he now cannot drink it, "it tastes like physic." He writes: "These things have come upon me as a revelation. I begin to see that the great cure for the evil of national intemperance is not teetotal propaganda, but vegetarianism."

We have given reasons of a scientific character, for abstaining from flesh as food, but higher than these are those relating to ethics. Everything relating to the slaughter-house is revolting to a refined and humane person. In the great slaughter-houses of Chicago; in those huge hideous box-shaped buildings, five or six storeys high, about ten millions of animals are killed every year. They are treated as if they were bales of merchandise and as dest.i.tute of feeling. Bullocks are struck on the head with a mallet and let fall into the bas.e.m.e.nt of the building. They are whilst stunned or half-stunned, at once strung up by their hind legs to some machinery, which moves them along, their heads hanging downwards.

Regardless of their agony, men run after them to cut their throats, followed by others with great pails to catch the blood. Much of the warm blood is spilt over the men or on the floors; but this is of no consequence, if but a small fraction of a minute is economised. In a short time, whether the animal has bled long enough or not, it reaches the lowest and darkest and worst ventilated portion of the gloomy building, where it is disembowelled. The walls and floors are caked with blood, the place is filthy, there is no proper lavatory accommodation, everything both to eyes and nose is detestable. Even if the windows were kept clean, light could not penetrate into the centre of the buildings. Consequently a large part of the work is done by artificial light. Tuberculosis is prevalent amongst the workpeople living under such unsanitary conditions.

Serious crime is much more common amongst them than amongst any other cla.s.s.

We English-speaking people, who pride ourselves on our civilisation and religion; who call ourselves the followers of the gentle Jesus, the Prince of Peace; yet hunt, shoot, trap and torture animals for food sport and science. Our main reason for eating flesh is that of personal gratification. We are loath to admit that the lower animals have any rights. Those Eastern peoples who are adherents to the teachings of the gentle Buddha hold life sacred. Mr. H. Fielding, who lived many years amongst the simple-minded Burmese, says that though there is now no law against the sale of beef, yet no respectable Burman will even now, kill cattle or sell beef. No life at all may be taken by him who keeps to Buddhistic teaching, and this is a commandment wonderfully well kept. "He believes that all that is beautiful in life is founded on compa.s.sion and kindness and sympathy--that nothing of great value can exist without them.

Do you think that a Burmese boy would be allowed to birds'-nest or worry rats with a terrier, or go ferreting? Not so. These would be crimes. That this kindess and compa.s.sion for animals has very far-reaching results, no one can doubt. If you are kind to animals, you will be kind, too, to your fellow-men."

By partic.i.p.ating in any form of cruelty or injustice, not only to our fellow-men, but also to the lower animals, we r.e.t.a.r.d our progress towards the higher life, the subtler forces in man cannot find their full expression and we are less responsive to spiritual influences.