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MANUAL OP DIET.



BY THE SAME AUTHOR.



THE INDIGESTIONS,

OR DISEASES OF THE DIGESTIVE ORGANS FUNCTIONALLY TREATED. By THOMAS
KING CHAMBERS, M.D. OXON., F.R.C.P., LOND. Third American Edition revised. In one
handsome octavo volume of 287 pages, cloth, $3.00.



RESTORATIVE MEDICINE.

AN HARVEIAN ANNUAL ORATION, delivered at the Royal College of Physicians, London,
on June 24th, 1871. In one handsome volume, small 12mo. ; cloth, $1.00.

In this little book, the reader will recognize the same independence and vigor of thought
and clearness of diction which characterize the works of the distinguished author. This
small book comprises within its pages a collection of subjects, medical and social, which will
occupy men's thoughts, and awaken discussion for many years to come. Brit, and For. Medico-
Chimrg. Review, January, 1872.



r



A MANUAL



OF



DIET IN HEALTH AND DISEASE,



BY



THOMAS KING CHAMBERS,

M.D. OXON., F.R.C.P., LOND.,

HONORARY PHYSICIAN TO H.R.H. THE PRINCE OP WALES, CONSULTING PHYSICIAN

TO ST. MARY'S AND THE LOCK HOSPITALS, LECTURER ON MEDICINE

AT ST. MARY'S SCHOOL, CORRESPONDING FELLOW OP THE

ACADEMY OF MEDICINE, NEW YORK, ETC.




PHILADELPHIA:

HENRY C. LEA.

1875.




SHERMAN A CO., PRINTERS,
PHILADELPHIA.



PREFACE.



THE aims of this Handbook are purely practical, and there-
fore it has not been thought right to increase its size by the
addition of the chemical, botanical, and industrial learning which
rapidly collects round the nucleus of every article interesting as
an eatable. Space has been thus gained for a full discussion of
many matters connecting food and drink with the daily current
of social life, which the position of the Author as a practicing
physician has led him to believe highly important to the present
and future of our race.

THOS. K. CHAMBERS.

24 MOUNT STREET, GROSVENOR SQUARE,
January 1, 1876.



y



CONTENTS.



PART I.



CHAPTER PAGE

I. THEORIES OF DIETETICS, ........ 17

II. ON THE CHOICE OF FOOD, ....... 29

III. ON THE PREPARATION or FOOD, 87

IV. ON DIGESTION, . . . 101

Y. NUTRITION, .......... 122



PART II.

SPECIAL DIETETICS OF HEALTH.

I. EEQIMEN OF INFANCY AND MOTHERHOOD, .... 125

II. KEGIMEN OF CHILDHOOD AND YOUTH, 134

III. COMMERCIAL LIFE, 140

IV. LITERARY AND PROFESSIONAL LIFE, 144

V. Noxious TRADES, 152

VI. ATHLETIC TRAINING, 155

VII. HINTS FOR HEALTHY TRAVELLERS, 169

VIII. EFFECTS OF CLIMATE, 175

IX. STARVATION, POVERTY, AND FASTING, 184

X. THE DECLINE OF LIFE, . 197

XI. ALCOHOL, 200






Vlll CONTENTS.



PAKT III.

DIETETICS IN SICKNESS.

CHAPTER PACK

I. DIETETICS AND REGIMEN OF ACUTE FEVERS, . . . 231
II. THE DIET AND EEGIMEN OF CERTAIN OTHER INFLAMMATORY

STATES, 245

III. THE DIET AND REGIMEN OF WEAK DIGESTION, . . . 252

IV. GOUT AND RHEUMATISM, 261

V. GRAVEL, STONE, ALBUMINURIA, AND DIABETES, . . . 270

VI. DEFICIENT EVACUATION 278

VII. NERVE DISORDERS, 282

VIII. SCROFULA, RICKETS, AND CONSUMPTION 294

IX. DISEASE OF HEART AND ARTERIES, 301



ALPHABETICAL INDEX, 307



DIET AND REGIMEN.



I.

GENERAL DIETETICS.



CHAPTER I.

THEORIES OF DIETETICS.

WHAT is the natural food of man ?

Each animal in a state of nature finds substances suited for its
nutrition ready to hand, and within the grasp of the instruments
he possesses for their acquisition. And these substances seem,
generally, the most proper to sustain the health and strength. So
that it has been not irrationally argued, that it would be a useful
act of scientific reasoning to infer from the structure of the human
organs what kind of food they are most fitted to appropriate, for
this would probably prove most conducive to physical well-being.

When, in pursuit of this reasoning, we come to compare man's
form with that of other mammalia, his prehensile organs his
teeth, his jaws, and his feet and his nails do not seem to fit him
for grappling with any of the difficulties which the adoption of
special kinds of food prepared by nature entails. He can neither
tear his prey conveniently, nor crack many nuts, nor grub roots,
nor graze. His digestive viscera, in middle life, are too bulky
and heavy to qualify him for the rapid movements of the car-
nivora; and they are not long enough to extract nourishment from
raw vegetables. To judge by form and structure, alone, the natu-
ral food of an adult man must be pronounced to be nothing.

On the other hand, if we read the laws of man's nature by the

2



18 GENERAL DIETETICS.

light of the general consent of the individuals of his race, which
is the wisest course, 1 we shall arrive at the opposite conclusion,
that his food is everything which any other warm-blooded animal
can use as nourishment. If we try to construct a universal diet-
ary from the records which each new traveller brings home of
what he has beheld habitually eaten, we shall find very few forms
of organic matter, capable of supporting mammalian life, which
are not appropriated by man also to his own use. By selection
and preparation he contrives to remove such parts and such quali-
ties of the substances presented by nature as are noxious to him,
and to improve such as suit his purpose ; so that as finally swal-
lowed, they are more wholesome to him than to the beasts who eat
nothing else. These lists of possible eatables are most interesting
to the student of human nature; they lead to inferences as to the
action of laws, religions, customs, and associations, in making that
abominable to one race which is most highly appreciated by
another, and they are an important part of the arguments of those
who trace political events and national character to physical causes;
but they are not suited to the present volume, which will concern
itself with the action on individual health of food generally acces-
sible in the British market. Reference may be occasionally made
to a more extended materia alimentarla, but it can contribute little
to the main arguments proposed.

The power by virtue of which man becomes so truly omnivor-
ous is habit. He can gradually, in time, accustom himself to live
on anything containing nourishment, provided he be not limited
in quantity, nor restricted in facilities for preparation. The in-
ferior animals could do the sante if they only knew how to set
about it ; for when we bring our reason to bear on their lives, we
can effect what at first sight seem most radical changes in their
nature, in respect of food ; and we can even induce and perpetu-
ate hereditary forms of body suited to the altered circumstances
we have brought about. Spallanzani found that pigeons may be
fed on flesh, and eagles on bread, by accustoming them to it ; the
domestic dog grows strong on biscuit, and often suffers in health
on being brought back to his native food ; our poultry is more



1 " Consensus omnium nationum lex naturae putancla est." Cicero de Legi-
biea, i, 8.



THEORIES OF DIETETICS. 19

robust, more fertile, and apparently happier, for being supplied
with meat, fat, or soup, and our cats have accommodated them-
selves to a mixed diet, assimilating their form to that of herbivora,
by a considerable increase in the length of their bowels over those
owned by their cousins of the mountains. The speechless creatures
have not the wits to acquire unaided these new powers; compulsory
education is necessary ; even for such a simple process as learning
to eat turnips, the lamb requires a shepherd to stand over him
and forcibly make him chew. Man's chief bodily strength de-
pends on his willingness to submit to the pain of acquiring habits,
and on his forcing his domestic stock to submit to it, for the sake
of a future advantage.

The solvent actions of the juices of the intestinal canal on food
seem to be the same in quality in all classes of animals, and to
admit of modification in the proportions of their ingredients ac-
cording to the diet adopted. Under vegetable food the saliva
becomes more copious, under meat there is more gastric juice.
The bile of a grazing ox is more watery than that of a man ; the
bile of a growing boy (who can digest any amount of meat) was
found by Gorup-Besanez 1 to contain nearly double the amount of
solid contained in that of an old woman (whose age would dispose
her to be very little carnivorous).

This shows the importance of what may be called the prepara-
tory or mechanical parts of digestion. The digestive solvents can
evidently grow equal to all emergencies of the chemical acts re-
quired of them, and the differences in the results of those acts must
mainly hang on the mechanical condition of the substances pre-
sented to them. Fortunate indeed is it that such is the case, for
the mechanical condition of the food is certainly more fully in our
power, and more easily influenced by our reason, than the chemi-
cal solvency of the secretions. We can choose, according to its
hardness, softness, and other external qualities, the sort of victual
we put in our mouths ; we can prepare it with art, can regulate
its bulk and the period of taking it; while the muscles which
chew it and swallow it are almost entirely under our direction.
But it is only very indirectly that we can influence the saliva, the
gastric and pancreatic juices, and the bile.

1 Untersuchungen iiber d. Galle, Erlangen, 1846. The relative proportions
of solid matter were 17.19 per cent, as against 9.13 per cent.



20 GENERAL DIETETICS.

Assuming, then, that man can easily accommodate himself to a
varied and mixed diet that he has, as a matter of fact, accom-
modated himself to it and that, therefore, it will in future, as in
the past, best suit his requirements the next point of interest is
the proportion which its several ingredients should bear to one
another.

Physiologists have pointed out that in the preparation made
for the infant at its entrance into life, and which is a striking in-
stance to the faithful mind of a controlling design in creation, we
have a typical instance of what the All-wise considered a suitable
dietary. Looking to its qualitative composition, we find milk
contains alimentary principles capable of separating themselves,
and, in fact, habitually separated for economical purposes, some-
what in the following proportions :

Water, 88 per cent.

Oleaginous matter (cream, butter), 3 "

Nitrogenous matter (cheese and albumen), . 4 "
Hydrocarbon (sugar), . . . . 4J "

Saline matter (phosphate of lime, chloride of

sodium, iron, etc.), "

This rough average is the best way of stating the facts for phys-
iological purposes; since, as every mother, physician, and far-
mer knows, the proportions vary considerably in different speci-
mens of even the same species of animal, and are influenced by
differences in the mode of living. The argument is, that there
or thereabouts, may be found the ratio which there should be in
our dietary, in the amounts of the alimentary substances of which
the above may be taken as representatives. That is to say, that,
supposing a man to consume 200 ounces of victual daily, the con-
tents should be about

6 quarts of water,

J a Ib. of animal matter, such as cheese, or lean meat, or eggs,

6 ozs. of fat, oil, or butter,

9 ozs. of sugar or starch,

1 oz. of salt, and some small quantity of bone or iron.

A serious flaw in this argument is that while the dietary is pre-
pared for, and truly suits very well, the newly born, we have no
evidence that either it is intended for, or would suit better than



THEORIES OF DIETETICS.



21



another, the adult. The milk of our domestic animals so closely
resembles that which supported us in infancy, that if we carried
the reasoning out to its logical consequences, we should all be
feeding together now at the same manger. If the milk represents
what the adult ought to make his diet, our bull would require
only a little more butter, and our horse only a little less than we
do; our goat would want one-third more meaty or nitrogenous
matter to be contained in the food than ourselves; and the dog
would require five times the proportion of flesh that is laid on his
master's table to be afforded him. 1 In point of fact, the life led
by the young of all animals is much the same, whereas in adult
age they differ widely in their occupations, and in the demand for
the sort of viands best adapted to those occupations.

There is greater promise of profit to the dietician in a calcula-
tion of the outgoings of matters resulting from the wear and tear
of the body, reducing these to ultimate elementary substances, and
thus ascertaining in what proportion to one another new supplies
of ultimate elementary substances are required, merely to replace
those consumed. It is obvious that the food which supplies the
demand most accurately will be the most economical in the highest
sense. "We can measure, for example, the carbon and the nitro-
gen daily thrown off in the excretions, and then lay down a rule
for the minimum quantity of those elements which the daily food
must contain to keep up the standard weight. If the diet is such
as to make it necessary to eat too much carbon in order to secure
a due amount of nitrogen, there is an obvious waste, and the di-

1 The computation of the ingredients of milk is a deduction from the fol-
lowing table of M. Boussingault's analysis:



Milk of


Water,
per cent.


Casein and
Albumen.


Butter.


Sugar of
Milk.


Salts.


Woman, . . .
Cow,


88.9
86.6


3.9
4.0


2.6
4.0


4.3

4.8


0.1
6


Ass, ....


90.3


1.9


1.0


6.4


4


Mare, ....
Goat,


90.9
84 9


3.3
6.0


1.2
4.2


4.3
4.4


0.5
5


Sheep, ....

Dos, .


86.5
77.9


4.5

15.8


4.2
5.1


6.0
4.1


0.7
1.0















22 GENERAL DIETETICS.

gestive viscera are burdened with a useless load. The same reck-
oning can be applied to the lime, sulphur, phosphorus, oxygen,
and hydrogen, which go towards building up and renewing the
tissues of the body. The dietary must contain these, or the body
must waste away by the unstayed drain of destructive assimila-
tion; and if it contains any notable excess, not only is it uneco-
nomical, but may be pernicious to the health.

Suppose, for instance, a gang of a hundred average prisoners to
excrete in the shape of breathed air, urine, and fseces, daily 71 J Ibs.
of carbon and 4J Ibs. of nitrogen, which is pretty nearly the
actual amount of those elements contained in the dried solids of
the secretions, as estimated in current physiological works. Ni-
trogen and carbon to that extent, at least, must be both supplied.
Now, if you fed them on bread and water alone, it would require
at least 380 Ibs. of bread daily to keep them alive for long; for it
takes that weight to yield the 4J Ibs. of nitrogen daily excreted.
But in 380 J Ibs. of bread there are 128| Ibs. of carbon, which is
57 Ibs. above the needful quantity of that substance. 1

If, on the other hand, you replaced the bread by a purely ani-
mal diet, you would have to find 354 Ibs. of lean meat in order
to give them the needful 71 J Ibs. of carbon ; and thus there would
be wasted 105 Ibs. of nitrogen which is contained in the meat,
over and above the 4^ Ibs. really required to prevent loss of
weight. 2

In the former case, each man would be eating about 4 Ibs. of
bread, in the latter, 3J Ibs. of meat per diem. If he ate less, he
would lose his strength. In the former case, there would be a
quantity of starch, and in the latter, a quantity of albuminous
matter, which would not be wanted for nutrition, and would
burden the system with a useless mass very liable to decompose
and become noxious.



1 Dr. Letheby's Analysis gives 8.1 per cent, of nitrogenous matter to bread
(Lectures on Food, p. 6). Of this } is nitrogen; Boussingault's analysis of
gluten giving 14.60 per cent. (Ann. de Chim. et Phys., Ixiii, 2*29). M. Payen
makes the proportion of carbon to nitrogen in bread as 30 to 1.

2 The proportion of nitrogen to carbon in albumen is as 1 to 3 (15.5 to
53.5 by Mulder's analysis, quoted in Lehrnann's Phys. Chemie, i, 343). In
red meat there is 74 per cent, of water (ditto, iii, 96).



THEORIES OF DIETETICS. 23

Now, if a mixed dietary be adopted, 200 Ibs. of bread with
56 Ibs. of meat would supply all that is required. Besides water,

200 Ibs. of bread contains . . 60 of carbon . . 2 of nitrogen.
60 " meat (including 12J
Ibs. of fat upon it), .... 12 " . . 2 "

72 4\

Judged by the above standard, it will be clearly seen that milk
does not represent a typical diet for an adult population, the ni-
trogenous matter being in considerable excess in proportion to
the carbonaceous. This is suitable to the young animal, whose
main duty consists in growing, that is in appropriating an excess
of nitrogenous matter to form an addition to the body daily, but
not to the full-grown, who has to develop force, or its equiva-
lent, heat, by the combustion of carbon, and had rather not go on
growing.

Calculations such as these, applied to the other numerous,
though less bulky constituents of the body, are invaluable. They
afford a basis for the administration of food-supply to armies, na-
vies, prisons, and other bodies of men dependent upon us ; they
enable us to detect the causes of wasteful expenditure, and to
distribute limited means in an economical fashion. They tell us
why nations which, voluntarily or involuntarily, become depen-
dent on one kind of food for subsistence can never be wealthy,
for they devour and waste their substance ; and they teach states-
men how to avoid those ruinous revolutions, which, as has been
well observed, arise more often from want of food than from want
of liberty.

But the calculations must always be open to the correction of
continuous observation and experiment. Chemical analysis is
much too young an art to be infallible, and hitherto undetected
substances and conditions are, year by year, turning up, which
modify our conclusions. And a very wide margin must be left
for unforeseen contingencies, and a discretionary power be placed
in the hands of individuals, or there is a risk lest the adminis-
trator should have to regret making too precise a reckoning. He
whose income is only just equal to his expenditure, is always on
the brink of insolvency.

The most important modification required to be made arises



24 GENERAL DIETETICS.

out of the differences of work demanded. Men may languish in
solitary prisons, invalids may lie bedridden, paupers may wait for
better times, nations may idle away existence, on a scale of food-
supply which is followed by death from starvation when work is
demanded. How shall the effect of physical exertion be reckoned ?
Here the engineers have helped us with their precise and irrefrag-
able science. Joule of Manchester analyzed, about thirty years
ago, the relation which the heat used in machinery, as a source of
power, bore to the force of motion thus made active. He found
means of proving, that raising the temperature of a pound of
\vater one degree Fahrenheit was exactly equivalent to raising
772 Ibs. to the height of a foot. And, conversely, that the fall of
772 Ibs. might be so applied as to heat a pound of Avater one de-
gree Fahrenheit. Thus, the mechanical work represented in the
lifting 772 Ibs. a foot high, or one pound 772 feet high, forms the
" dyna'mic equivalent," the measure of the possible strength, of
one degree of temperature as marked by the thermometer. Phys-
iologists seized eagerly on the opportunity which Joule's demon-
stration seemed to afford them of estimating, in actual numerals,
the relation of living bodies to the work they have to do. So
much earth, raised on an embankment, represents so much heat
developed in the machinery, living or dead, muscle or steel, gang
of laborers or steam-engine, which raised it. Both muscle and
steel come equally under the great physical laws of the universe
which the far-sighted mechanician has expounded. Now, in the
animal frame, the supply of heat, and therefore the supply of ca-
pacity ibr work, is that which is developed from latency into
energy by the chemical actions, the ceaseless round of unending
change,, which is an inseparable part of life. The amount of fully
digested food, converted through several stages into gaseous,
liquid, and solid excretory matters, produces by its chemical
changes a definite amount of heat, of which a definite amount es-
capes, and a definite amount is employed in working the involun-
tary machinery of the body, and the rest is available for conver-
sion at will into voluntary muscular action. As the mechanician
allows for the effect of friction, etc., in making his calculations, so
the physiologist allows for the action of diffusion, conduction, im-
perfect secretion, and so on, in reckoning the quantity of heat
available, and allows also for the waste of mechanical power in-



THEORIES OF DIETETICS. 25

volved in the form and structure of the limbs. To make all
these allowances necessitates courses of experiments and calcula-
tions which have taken more than a generation, and will probably
take more than another generation to complete. But the road
seems clear, and already we have gained fruitful information as
to the sort of food by which we can expect to get most work out
of men and beasts; we have found the cause of many of our
failures in distributing victuals ; and we have learned how to avoid
much cruelty and injustice that our fathers unknowingly perpe-
trated.

It may be reckoned from experimental calculations, too long to
be inserted here, that the expenditure of force in working the
machinery of the body in raising the diaphragm about fifteen
times, and contracting the heart about sixty times a minute ; in
continuously rolling the wave of the intestinal canal ; and in
various other involuntary and voluntary movements which can-
not be avoided even by a mere cumberer of the ground, without
doing anything that can be called work it may be reckoned that
the expenditure of force in doing this is equal to that which
would raise a man of ten stone 10,000 feet. But a man cannot
even pick oakum without expending more force and requiring
more to support it. A prisoner on penal diet has half as much
again.

There are several reasons for believing that in assigning their
physiological functions to the several sorts of food, we should as-
cribe nearly all the business of giving birth to force to the solid
hydrocarbons, starch and fat, by their conversion into carbonic
acid, just as we have good grounds for thinking that it is the con-
version of the solid hydrocarbon, coal, into carbonic acid, which
drives our locomotives. It is not necessary to be acquainted with
every step of the process, which, in the body, we confessedly are
not, to appreciate the argument. To the nitrogenous aliments
seems allotted the task of continuously replacing the wear and
tear of the nitrogenous tissues. Flesh food, or that which comes
near it in nitrogenous contents, after a few changes replaces the
lost flesh which has passed away in excretions ; and thus the en-
gineer takes iron ore, makes it into wrought plates or steel, and
renews the corroded boiler-plate or worn piston-rod. One of the
most cogent of these reasons is that the chief nitrogen-holding



26 GENERAL DIETETICS.

excretion, the urea, is little, if at all, increased in quantity by an
increase in the work done : whereas the excretion of carbonic
acid, in a decided manner, follows the amount of muscular exer-
tion. Now it is very clear that if the supply of power to do
work depended on the renewal by food of the nitrogenous tissues,
and on their decomposition, the urea would have no escape from
being largely augmented in quantity by muscular efforts, and di-
minished by rest. This is not the case. At first, exercise dimin-
ishes the amount of urea (Parkes), and, even when continued,
very little increases it (E. Smith, Haughton and several others
quoted in Parkes's " Hygiene," p. 383). The very small increase
which takes place during the following rest may be attributed
fairly to the extra wear of the muscles from extra motion, just as
a steam-engine is expected to require more repair than usual when
in hard use. But that amount of repair demanded is as nothing,
compared with the increase in the tonnage of coal consumed.

To give an example of the mode of working out a problem by
this theory : Dr. Frankland ascertains with the calorimeter, which
calculates the amount of heat evolved as a thermometer does its
degree, the quantity of energy or force, under the form of heat,
evolved during the complete oxidation in the laboratory of a given



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