First in the list of foods the writer would place those nitrogenous substances commonly eaten that belong to the class of albumins. That these substances are in reality the most important of all food-stuffs there can be no sort of question, since they, of all things eaten by the human being, are alone absolutely essential for his well being and even his existence. They are the substances that almost exclusively go to make up the muscle and tendons. Along with the lime-salts they enter largely into the composition of the bones and cartilages, brain, spinal cord and nerves. Other foods are incapable of taking the place of the albumins, so that they are absolutely essential for normal life in the human being.
The amount of albumin necessary for the normal adult has been variously estimated, the tendency at the present time being to place the quantity needed somewhat lower than was at one time done. It is probable that about two ounces of pure albumins is somewhere near the amount required in twenty-four hours by a normal adult.
It is well, since we are so dependent on foods of this class, that we have two quite distinct sources from which they may be taken. The great bulk comes to us in the form of meats, including poultry, game, oysters and fish of various kinds, in addition to beef, mutton, and hog-meat in its several forms. Of animal origin also we have eggs, which are among the most valuable of all foods of this class on account of their high digestibility.
From the vegetable world we get albumins known as legumins, which differ somewhat from those obtained from animal sources, though taking their place in the economy in all essential particulars. Unfortunately the legumins are usually so mixed with starches and other vegetable substances less digestible, that it is necessary to take a large bulk of foods of this latter class in order to secure anything like the requisite amount of the former.
Before taking up individually the various albuminous foods, the writer would again direct attention to the chapter on cooking, and would strongly urge upon the reader the proper methods of preparing nitrogenous foods therein stated. Where the albumins are in a nearly pure state, as in milk and eggs, they are slightly more digestible when raw, but all meats should be cooked until only the faintest tinge of red remains if we wish to have them prepared in the most wholesome way for those with delicate digestions. Meats are, as a rule, most wholesome when cooked “very done.”
It has long been the cry of sentimentalists that no living being should die in order that man might exist. Unfortunately for such theories, the stern and unbending edict of nature has negatived views of this kind ages before the altruistic philosopher came on the scene, and we are daily constrained to bow to this mandate of one of the primal laws of existence. However much we might desire it otherwise, it has been written that “only in death is there life;” nor may any animal being disobey and continue to exist. As has been already explained, the human being cannot thrive on vegetable substances alone; from them he may get a certain amount of nitrogen in the form of legumin, but there is not enough to make up for the waste of this substance that constantly goes on in the body.
Theoretically it is of very little importance which of the meats are selected to supply our nitrogenous food, but it is unfortunately true that such foods vary much in digestibility, and it will therefore be necessary to consider them separately.
Beef.—When tender and cooked to a proper degree, beef is considered one of our most wholesome of meats. Like other foods of this kind, it should not be fried, but should be broiled or roasted, and a certain amount of fat may be eaten along with the lean portions without injury, and in many persons unquestionably with benefit.
Mutton.—Of all the coarser meats, mutton is unquestionably the most digestible, and when cooked in the same way as directed for beef is eminently wholesome.
Hog-meats.—On account of the large portion of fat between the muscle-fibers, hog-meat, particularly when fresh, is not usually regarded as being digestible. Some persons eat it with impunity, but for the vast majority it should be taken only in small quantities. It should not be fried. In the form of ham, hog meat is more wholesome than when fresh, but even in this condition many dyspeptics find much difficulty in digesting it. The best method of cooking it is to boil thoroughly. After being cooked in this way and then broiled, it is most appetizing, and is much more wholesome than when broiled without being previously cooked. As bacon, hog-meat enters largely into the dietary of a great portion of the laborers of this country, and there can be no doubt that on the whole it answers the purpose of a staple food admirably. It contains even more fat than nitrogenous substances, and may therefore be looked upon as a mixture of butter and meat. Dyspeptics cannot eat it with impunity in many instances, though it agrees far better with them than does ham or the fresh meat. If it were generally eaten boiled it would provoke less trouble than when fried. At this point the writer would repeat his warning concerning the indigestible character of melted grease, of which the gravy from bacon is a striking example.
When “cured” in a somewhat different way hog-meat as “breakfast-bacon” is very generally used throughout the civilized world, and is one of its most wholesome forms. This when broiled is both appetizing and wholesome, and should form a part of the daily dietary of everyone able to afford it.
Poultry and Game.—Among the more delicate and most wholesome forms in which albumins are taken we find poultry and game well up toward the head of the list. Meats of this character should be very thoroughly cooked by being either baked, smothered or broiled.
Fish.—Fish of almost all kinds are wholesome provided they be fresh and properly cooked. The culinary artist prepares of them most appetizing and nutritious dishes, and they are therefore properly to be recommended as among the best of the albuminous foods.
Oysters and Clams.—Oysters and clams are usually considered somewhat apart from the generality of the foods of this character. When fresh they are wholesome and delicious when eaten raw, and may be cooked in a great variety of ways. The reader should be especially warned that fried oysters are not so wholesome as when they are prepared by other methods, for the reason that they are surrounded by a batter containing quantities of melted grease.
Eggs.—Among the most delicate, digestible, and nutritious of all foods we may place eggs. Though somewhat more digestible when raw, they agree, as a rule, even with the most fastidious stomach, however cooked, even when hard-boiled. Eggs lend themselves readily to the formation of many delicious dishes, such as omelets, soufflés, etc.; but unfortunately they do not contain nutriment in a very concentrated form, and where an adult is living on them alone it requires from one and a half to two dozen daily to furnish the necessary amount of food.
Fats.—Under the term “fats” are included all oily substances, such as butter, lard, olive and cotton-seed oils, and to a great extent the fat contained in meats. These substances are closely related to starches and sugars, and undoubtedly play a more or less similar rôle when taken into the body as food. From the standpoint of heat-producing capacity they more than double, weight for weight, meats and starches, and are, therefore, instinctively highly prized by dwellers in cold countries where much heat is necessary. In warmer countries the necessity for excessive heat-production in the body does not exist.
While oily substances are certainly capable of adding to the cushion of fat commonly found beneath the skin in normal individuals, they are not looked upon as being to any extent tissue-builders, resembling in this particular the starches and sugars.
When fats are to be eaten, care should be taken that they be as fresh as possible, or, if this is not feasible, they should be preserved in such a way as to prevent their becoming rancid—a condition which is the result of the formation of fatty acids, lending a peculiarly unpleasant odor and taste, and producing a decided decrease in food-value. This alteration may be largely prevented by keeping fats in a refrigerator at a low temperature, and may also be greatly retarded by the addition of salt. In this country butter is usually treated with a very considerable amount of salt, but in Europe it is universally served fresh. Within recent years facts have been established that show that Americans use an excessive amount of this substance—possibly causing disease in some cases; and doubtless we would be better off if we were to follow the European practice.
Oily substances when in good condition are certainly of high value as foods, but should be taken more or less with an eye to the climate, and to the season of the year. When placed on cold bread and eaten along with it they are extremely palatable, and may be taken in reasonable amounts with decided benefit to the whole body. In temperate climates it is generally estimated that about three ounces is a desirable amount for the average adult. In this connection it may not be out of place to mention that the various preparations of cod-liver oil, advertised so freely in the lay press, in some instances actually do not contain a single particle of the substance that they are supposed to be principally composed of; and it may be further stated that there is no good reason to believe that bulk for bulk oils of this kind are in any way superior to those fats commonly eaten. The writer often recalls the saying of a very wise old physician of his acquaintance that “cod-liver oil is nearly as good as butter.”
Sugars.—This term includes the large number of different substances of a more or less sweetish taste that belong to the group of carbohydrates. They are closely related to the starches, and it is generally assumed that they play much the same part after being taken into the body. Some of these are of animal and some of vegetable origin—but except the sugar found in milk, the only ones commonly consumed are those derived from cane, beets, and fruits; the sugar from the first two is known as cane sugar or dextrose, and that from the latter as grape sugar or glucose. Like albumins they may be eaten without having been previously cooked, and are unique in that they undergo no chemical change whatever as a result of ordinary degrees of heat.
While the consumption of sugars in all civilized nations is rapidly increasing, there can be no question that, irrespective of fruits, they are, of all foods, the most frequent causes of digestive disturbances. It is only within comparatively recent times that mankind has possessed means of separating sugars in any great bulk from the plants containing them, and as a consequence they have only entered prominently into our every-day diet for a relatively short period of time. Before this, it is true, they were consumed to a greater or less extent in various fruits, but the quantity was insignificant as compared with the amount now universally eaten. As a result of this we are now confronted with a new dietetic problem. For ages the human stomach has been accustomed to deal with only small quantities of these substances, and developed accordingly a capacity to digest them proportionate to the amounts then eaten. Now, however, we constantly call upon our digestive organs to deal with large quantities of such foods, and it is not strange that there has been more or less rebellion on their part.
Experiments have shown that a small amount of sugar assists in the normal chemical changes that go on in the body, and it is, therefore, obvious that nature intends us to take a certain quantity of it. Moreover it is true that sugars while being burned in the body give off much energy—mainly manifested in muscular power; where then we are taking active physical exercise foods of this kind are peculiarly appropriate. It would, therefore, not be wise for us to leave this food entirely out of the dietetic list, but to use it only in small amounts—particularly where we lead sedentary lives. Sugar and alcohol play a more or less similar rôle in the animal economy. It is well known that those who do not use alcohol are peculiarly prone to consume considerable quantities of sugar; and it is equally a matter of common observation that those who habitually take alcohol rarely eat sweets to any extent.
When sugar is properly assimilated, as seems to be done most easily by children, it is an excellent food, but where sweets are over-eaten, and not properly digested, they give rise to a great accumulation of gas in the intestine, and produce in many persons a marked acidity of the stomach, frequently accompanied by severe insomnia. Nothing so quickly relieves such sleeplessness, caused by a “sour stomach,” as allowing ten or fifteen grains of ordinary cooking-soda to slowly dissolve in the mouth and swallowing the saliva rendered alkaline in this way.
Milk.—Milk may be looked upon as an ideal food, it being composed of water carrying in solution the three great natural foods—albumins in the form of casein, carbohydrates as milk-sugar or lactose, and fat. Mixed in the proportion in which they here occur, they are most admirably adapted to the delicate digestive apparatus of the infant—the relative proportion of the different substances even gradually changing as the assimilative powers of the youthful organism increase; it is thus seen that milk itself is not of constant composition, even in the same animal, and that it alters in such a manner as to meet best the needs of the delicate being depending upon it for proper sustenance. It is also the case that the composition of milk varies in different animals—showing again how admirably nature exerts its powers in meeting desired ends.
The lesson of practicable importance that we learn from this is that the milk of one of the lower animals is not in its natural state quite suited to the delicate stomach of the growing infant, and that if it be substituted for the mother's milk it must be more or less altered, depending upon the age of the child. It is particularly important that sweet milk be taken slowly, as otherwise large curds, difficult of digestion, form as soon as it gets into the stomach.
In recent times we hear much of vegetarianism, which has its advocates among many highly intelligent people, and which, as a consequence, has achieved a certain vogue throughout the civilized world. It is rarely the case, however, that those who affect to practice this cult in reality live exclusively on a vegetable diet. As a rule it will be found that they are milk-drinkers, and not infrequently add eggs to their dietary. It is, of course, absurd to regard as vegetarians those who simply avoid meat, since it is true that the nitrogenous substances contained in milk and eggs differ in no essential particular from similar substances found in flesh of all kinds.
Experiments on a somewhat extended scale have shown within recent years that young and vigorous individuals at least may live and thrive on a diet composed largely of vegetables; no one has yet shown that a strict vegetable diet is that best adapted to the average individual, and no competent authority on this subject at the present time advocates a diet purely of this kind. It is true that the vegetables ordinarily eaten contain all of the elements that are essential to the animal system, such as starch, sugar, fat and albumins. Unfortunately, however, the amount of the last-named substance is usually so small in food-plants that the quantity that would have to be eaten by a normal individual taking active exercise would cost considerably more than if a reasonable proportion of animal food were included, and—which is of even greater importance—the digestive powers of the individual who attempted to live only on food of this character would be severely taxed, and, in the long run, probably seriously impaired. Furthermore, vegetables and fruits contain substances, usually in great quantity, that are scarcely acted upon at all by the digestive juices. Chief among the latter is cellulose, which, while forming the great bulk of the food of herbivorous animals, is scarcely suited to the weaker digestive capacity of the human being; practically none of it is converted to the uses of the body. It is thus seen that in the average man or woman a dietary consisting largely of vegetables would result in the presence in the intestines of a greater or less bulk of indigestible materials, which could subserve no good purpose other than that they would by their mechanical presence have a tendency to cause the bowels to act; as is the case with fruits, however, it is unfortunately true that this large residue of undigested food, in one way or another, often gives rise to considerable irritation of the mucous membrane of the intestine, and frequently produces dyspeptic disturbances, among which looseness of the bowels is common.
This brings us to a consideration of the digestibility of vegetables in general, which is always the paramount consideration when dealing with the value of any substance to be used as a food. It has been before remarked that young and vigorous persons seem to thrive on a dietary largely of vegetable character, but the case is certainly quite different with older people, particularly where their digestive powers are impaired. In the latter we often find that severe intestinal disturbances follow even after moderate indulgence in vegetable foods—particularly where they are served with vinegar, or some other fruit acid. Another peculiarity of foods of this kind that makes decidedly against their digestibility lies in the fact that, being soft and containing a large proportion of water, they are scarcely ever properly chewed, and as a consequence they are swallowed in comparatively large masses without having been adequately insalivated.
Vegetables may be roughly classified as legumes, roots and tubers, and green vegetables, and will now be considered briefly in the order named.
Legumes,—Beans, Peas, Lentils, and Peanuts.—With the exception of the cereals, the legumes are the most valuable of all vegetable foods. Their nutritious properties are mainly due to their relatively high percentage of nitrogenous material, though they also contain starch and fat. Hence these vegetables contain the ingredients necessary to supply all the needs of the human economy; unfortunately, however, when eaten alone in sufficient bulk to furnish the nourishment required, they often—even in healthy individuals—give rise after a little time to dyspeptic disturbances.
Of beans, a large number of different varieties are in common use including string-beans (or snap-beans), lima-beans, kidney-beans, red beans, the frijole, and the Soya bean. String-beans are exceedingly palatable, and are very much prized as an article of diet by the peoples of all countries. When gathered young and thoroughly cooked while still fresh they are exceedingly wholesome, and are very well assimilated, when properly chewed, by even those whose digestions are considerably impaired. The other beans named are generally eaten dry after having been removed from the pod in which they grow. When they are soaked in water until they become soft and then thoroughly cooked they make an excellent food, and, when not taken in too great quantities, are fairly digestible. When cooked with onions, parsley, and red pepper in proper proportions they make a very delicious dish. In Japan the Soya bean forms the basis for a kind of vegetable cheese which is eaten with rice, and furnishes the nitrogenous materials in which the latter is deficient. Peas are wholesome when young and fresh and when properly cooked, and as they come on in the early spring when other fresh vegetables cannot be obtained, they furnish a most acceptable addition to the dietary. When old, after their skins become tough, they cease to be digestible, and should not be eaten except in the form of purees, during the preparation of which the hull is removed.
Lentils are scarcely eaten at all in America, but are much prized in some portions of the Old World, as the basis of soups.
Peanuts belong to the group of legumes, though, unlike the others that serve as food, they grow beneath the surface of the ground. They are highly nutritious, but are, unfortunately, indigestible, owing largely to the high percentage of oil that they contain. The latter is extracted, and is sometimes sold as olive-oil; in a somewhat different form it is made into a sort of butter which is quite palatable.
Roots, Tubers, and Yams.—Sweet and Irish potatoes, which constitute the most important members of this group, have already been discussed under the head of breads. Of those that remain, some few, as beets and artichokes, may be regarded as related to those just referred to, while others, such as carrots, turnips, radishes, parsnips, etc., are generally reckoned among the succulent tubers on account of the large proportion of juice that they contain. Irrespective of the beet, which furnishes a considerable portion of the sugar of commerce, none of them may be looked upon as foods of a very important character, as they contain only relatively small proportions of sugars, starches, and nitrogenous materials. Beets, however, do contain a very high percentage of that which makes potatoes so popular,—about eighty-five per cent. of starches and sugars, with only a trifle of nitrogenous material. When young and tender they are often eaten as a salad, either alone or mixed with other vegetables, and are generally regarded as being wholesome and highly nutritious. They should not be eaten by dyspeptics when pickled, on account of the vinegar.
Artichokes are occasionally eaten, but are not nutritious, although they agree well with many persons.
Carrots, when young and fresh, are fairly digestible, but like other vegetables are exceedingly apt, particularly if old, to produce intestinal disturbances in dyspeptics. They are not very commonly eaten in the United States, but where selected with care we would profit by their more frequent use. They contain a small percentage of starches, with an insignificant proportion of vegetable albumin.
Turnips are exceedingly unwholesome, contain very little nourishment, and may be eaten with impunity only by persons in vigorous health. The same remarks apply to radishes, and to parsnips.
Green Vegetables.—Vegetables of this class are of much more value from the standpoint of their agreeable taste, and the consequent stimulating effect upon the appetite, than from the nutritive materials that they contain. Some of them are eaten cooked, while others are usually consumed in a raw state. They are all much less indigestible if eaten when quite young and fresh—drying seemingly having the effect of producing alterations in them that predispose to dyspeptic disturbances in those so inclined.
Spinach is one of the most digestible of the entire group, and is much eaten in all parts of the world.
Turnip-tops differ in no essential particular from spinach. They have a somewhat bitter taste, but when young and fresh are highly palatable, and if thoroughly cooked cause comparatively little intestinal trouble, but like spinach they contain practically no nourishment. The same may be said of the leaves of various other plants commonly served as greens, among them beet-tops, and dandelion-tops.
Cabbages, many different kinds of which are habitually eaten as food in civilized countries, have comparatively little nutritive value, and are, generally speaking, decidedly indigestible, although young and vigorous persons, particularly where they take abundant out-door exercise, find no difficulty in assimilating the inner portions of the fresh cabbage “head.” As in the case with other vegetables, the soil and locality in which the cabbage is grown largely influences its taste, and to some extent its digestibility. It should never be given to infants. Sauerkraut is a preparation of cabbage leaves produced by adding salt, and later crushing them with considerable pressure; after a time alterations occur of a fermentative character, and the product is generally regarded as more wholesome than fresh cabbage.
Cauliflower consists of masses of the somewhat modified flowers of a plant closely related to the cabbage, and is, when properly prepared, palatable, and perhaps somewhat more digestible than cabbage. Cole, and Brussels sprouts, are plants of the cabbage family, and are perhaps even more indigestible.
Salad Plants.—The leaves of the lettuce are usually eaten raw, most commonly being served as a salad in combination with oil and vinegar, or lemon juice. That the leaves possess, when treated in this way, a very palatable taste all will perhaps agree, but they cannot be said to be of any nutritive value, nor are the acids just referred to conducive to their digestibility.
On account of their somewhat pungent taste, watercresses are used in many parts of the world as ingredients of salads, but they are, of all vegetables, the ones that are most liable to transmit disease to man, for in addition to the possibility of contracting in this way typhoid fever, dysentery, cholera, and the ordinary intestinal worms, the human being is apt to receive with them the eggs of the flukes, and the spores of the amœbæ that produce chronic tropical dysentery. As they are probably never grown under such conditions as to preclude the possibility of this danger, it would be the part of wisdom to absolutely refrain from their use.
Onions, Leeks, Shallots, and Garlic.—Vegetables of this group are eaten either raw or cooked, and of all those consumed in the former state are least liable to transmit disease, owing to the fact that they are nearly always thoroughly peeled before being eaten. They have the advantage, furthermore, that they may be preserved for long periods of time in such a way as to be fit for food, and when properly cooked have a delicate flavor, and are quite wholesome although furnishing little food for the body. Garlic is never eaten as a vegetable, but serves as the basis for many of the delicate sauces for which the French cooks are so justly celebrated.
The tomato has been used as a food only within comparatively recent times, it having been formerly thought to be poisonous. Like the onion it may be eaten either raw or cooked, and if taken in moderation does not, as a rule, produce any serious harm. When eaten in greater quantities, both on account of the acid that it contains and its relatively small proportion of assimilable nutriment, the tomato is exceedingly prone to cause intestinal disturbances, and should rather be regarded as a fruit than a vegetable. Growing at some distance from the ground, it is rather less apt to convey diseases than the majority of vegetables eaten in a raw state.
While celery is generally eaten raw, it furnishes a palatable dish when cooked in milk. It should not be eaten by dyspeptics or children, particularly if raw. Similarly the cucumber has a well-merited reputation for producing dyspeptic disturbances. It is only eaten raw, is frequently served as a salad, and should be used only when very young and fresh, and eaten only by persons of sound digestion.
Okra is much prized in the Southern States as the principal ingredient of a very palatable soup, but is not as a rule looked upon with favor by the uninitiated. It is also much eaten boiled and served with a little butter and pepper. When fresh and young it is fairly digestible, and furnishes a very agreeable addition to the dinner.
In addition to those already referred to, there are a number of vegetables that are very popular either alone, or in combination as salads—particularly in the South; among them are green peppers, parsley, mint, capers, endive, and chicory. The remarks already made concerning green vegetables apply equally to these just mentioned, and it should here again be particularly insisted upon that salads containing acids are unwholesome for infants and children, and should be used sparingly even by those in health. None contains much nourishment.
Among easily digestible vegetables asparagus probably takes front rank, and in addition to this has the merit of being exceedingly agreeable to the taste. It possesses little nutritive value, but when young, fresh, and well cooked, it may be taken even by infants without harm.
Rhubarb, or “pie plant,” is eaten stewed, and made into pie. It is said to be somewhat laxative, and is decidedly more wholesome than many others. The squash, when properly cooked is comparatively wholesome, but contains little nourishment, and is of no particular value as a food, and the pumpkin is not much better, although useful during the winter for making pies after the ordinary vegetables and fruits are gone.
Cranberries, when thoroughly cooked and separated from the hulls, form the basis of a delicious jelly that is widely eaten in the winter over all portions of the United States. Like all sweets it is not entirely wholesome for dyspeptics or infants, but as it is usually eaten with meats and not in great quantities, it may be looked upon as being one of the most wholesome of all foods of this class. It does not seem to have such a tendency to produce sour stomach in many dyspeptics as is so frequently done by other foods containing vegetable acids.
It is an error shared almost universally by both medical men and the laity that fruits and raw foods are wholesome. Everyone is familiar with the fact that fruits produce intestinal disturbances in children,—not only when they are very young, but after their digestive apparatus is fully developed. Rather curiously, however, instead of ascribing the disturbances that follow to the real cause, we generally dismiss the matter with the assertion that “early fruits are unhealthy,” or trace the resulting ill effects to some other equally imaginary factor. In reality the reason why diarrhœa and other intestinal troubles so often occur after eating fruits in the early spring is that the boy or girl after a winter's fast greedily devours enormous quantities of them when they first ripen, and disturbances follow in proportion to the amount and character of these substances taken.
There can be no question that fruits, while extremely palatable, usually produce trouble in dyspeptics, and even in those who still possess unimpaired digestive organs ill effects quite constantly follow on the heels of the taking of food of this character. Unfortunately, however, the great majority of dyspeptics have symptoms that in no way outwardly point toward digestive errors; as common examples, we might refer to the blackheads, pimples and small boils, so frequently observed on the faces of young boys and girls, or the rheumatic pains, and, at a later time, the “Bright's disease,” that occur in older people. When you tell such patients that their trouble is indigestion, they are often mildly indignant, and loudly protest that they can eat anything with impunity; that they never have heart-burn, feelings of heaviness after eating, pains in the abdomen, or other symptoms referable to the stomach and intestines. We are rather disposed to be proud of our digestive powers, just as we are of our bodily strength, and nothing is more common than for chronic dyspeptics to maintain that they have never had indigestion in their lives, and to resent any insinuation to the contrary.
Another popular error, almost universally accepted, is that fruits are highly nutritious; as a matter of fact they consist almost wholly of water, and of materials that are utterly indigestible. The latter substances pass through the alimentary tract, therefore, in much the same condition that they enter and serve no better purpose than to promote, somewhat, activity in the bowels. Nevertheless the writer does not wish to be misunderstood as advocating total abstinence from such a palatable class of foods; no harm results in most people if they only take perfectly ripe and fresh fruits in moderation now and then; and these should be always eaten after meals rather than before.
The fruits that contain comparatively little acid are, as a rule, more wholesome than those that are rich in substance of this kind. For example, perfectly fresh and ripe figs or peaches may be taken by most persons with impunity if they be eaten after meals, and at intervals of at least two or three days. Acid fruits, particularly lemons, seem to be peculiarly unwholesome; apples are prone to cause trouble and can rarely be eaten without ill effects, however mellow and palatable they may be. It sometimes happens that persons take grape-fruit with less harm than others.
Closely akin to fruits in their deleterious action on the digestive apparatus are sours in any form whatever. Women, especially, indulge freely and at irregular hours in foods containing much vinegar, lemon-juice, etc.,—usually in the form of pickles or salads. In healthy persons, in moderation, foods of this character perhaps produce no appreciable trouble, but nothing is more thoroughly established than that they act harmfully on the general run of dyspeptics, such as most of us are to a greater or less degree after thirty years of age. This leads to the remark that here, as in everything else, we must regard individual peculiarities—it being true that one person can eat without ill effects what may produce decided disturbances in others, or suffer from excess when moderation would entail no ill-effects.
An immense amount of rubbish has been written during the last few decades concerning the supposed good effect of excessive water-drinking on the human economy. Something like a quarter of a century ago a London physician by the name of Haig brought forward and strenuously advocated the view that a large number of minor ailments were the result of the presence in the body of excessive quantities of uric acid; applying the well known fact that the substance just mentioned requires a large amount of water to dissolve it he conceived the idea that the proper remedy was to flood the body with enormous quantities of liquids, and thus, as it were, wash the offending substance out of the system. So plausible did he make this theory appear that it was accepted very largely by medical men, who in turn taught it to the general public. Within recent times it has been fortunately shown that Haig's theory was wholly chimerical, and that quantities of uric acid greatly in excess of the normal amount could collect in the body, or might be injected into the blood-vessels, without the least harm resulting; thus, at one blow, this widely accepted theory was annihilated, and there now remains no sort of reason for attempting to remove uric acid by excessive water-drinking, or by other means.
It is fortunate that the uric-acid theory has been disproved, for the excessive use of water is not only unnecessary, but highly injurious to the digestive organs, particularly when the fluids are taken at or about meals. Experience has shown that excessive stomach-acidity, which is the most common form of indigestion, is in a large degree dependent on the taking of liquids while eating, and that even in those who are healthy any more than small quantities cannot be looked upon as being wholesome. In dyspeptics liquids seem to act in a hurtful way in several different directions. For example, where persons constantly take liquids while eating the necessity of properly chewing the food is largely done away with; in addition to this the mere presence of water in the stomach seems to tend to the production of increased acidity, for it has often been observed by the writer that even where food was eaten dry indigestion would follow in many dyspeptics if they took water just before or immediately after eating.
The only sensible advice that can be given in this connection is that persons should take no more liquids that they feel a desire for, and they should avoid taking them in any quantity about meal time. What has just been said concerning water applies equally well to milk. When taken alone it very frequently agrees with patients much better than does solid food, but when mixed with the latter is prone to produce indigestion, just as does water. Fermented milk in the form of buttermilk is a very popular beverage in some parts of the world, but it may be well doubted as to whether it deserves the reputation for wholesomeness generally accorded it; being a liquid, and at the same time acid, it is peculiarly prone to increase acidity, and is not tolerated by persons who suffer with sour stomach. It should, however, be said that it, on the other hand, seems to agree particularly well with some people, and has been known when taken alone, at least temporarily, to relieve obstinate forms of indigestion.
Coffee.—The most universal beverage taken at meal time in America is undoubtedly coffee. Each morning countless thousands are cheered and stimulated by its invigorating properties to undertake their daily tasks, but, as is always the case after taking drugs that have such action the system has to pay the penalty in a reaction following later, during which the capacity for work is diminished. It is, however, true that the effect last referred to is not of such importance as to constitute in itself a serious objection to the use of coffee, but other ill results are rather prone to ensue that in many instances change the aspect of the question entirely. In a great many people, particularly after the first vigor of youth has passed, coffee produces anything but pleasant effects, and on some it seems to act as a downright poison. Like all liquids taken at meal time, it predisposes to acid indigestion, particularly when it is sweetened. It is likewise true that when it contains any considerable quantity of cream the liability to dyspeptic disturbances following its use are particularly great—doubtless as a result of the considerable quantity of melted fats that it contains under such circumstances.
From the foregoing it appears then that coffee without either cream or sugar is less unwholesome than when these substances are added to it, but even when it is taken in this way it causes decided symptoms of indigestion in many persons. The writer is not of the opinion that the habitual taking of coffee is to be commended, and would, therefore, not advise its constant use; it, however, must be admitted—as is the case with all other substances that cause indigestion—that in many people, and particularly in those who live out-of-doors and are actively engaged in physical occupations, the use of coffee seems to result in no harm. Like other substances that cause indigestion in a concentrated form, coffee when largely diluted is less apt to produce disturbances of this kind; for example, a beverage consisting of two-thirds of hot skimmed milk and one-third coffee may be taken by many dyspeptics in reasonable amounts without any particular harm. Parents should be warned against allowing growing children to drink coffee; it seriously interferes with the normal chemical changes going on in their bodies, and is almost certain to be followed in later life by nervous dyspepsia.
Tea.—The stimulating principle of tea is chemically so nearly like that of coffee that they are generally considered as being one and the same. That they differ decidedly in their action on the stomach and the body generally there can, however, be no doubt. The stimulating action of tea comes on more slowly than that of coffee, and is correspondingly prolonged. In most persons it is not so apt to produce nervousness, nor is its action in preventing sleep so pronounced. On the stomach it also produces effects that are diametrically opposed to those induced by coffee, since, instead of stimulating, it seems actually to retard the secretion of acids. It is, therefore, probably true that we should look upon tea as a beverage with much less disfavor than we do coffee—though, of course, it should always be remembered that there may be, and unquestionably are, many exceptions to this judgment.
Probably no other daily article of food or drink is so commonly prepared in an improper manner as tea—which is all the more curious when we consider that perhaps none other that requires heat for its preparation is so easily made. It should be brewed by simply pouring boiling water upon the leaves, but the vessel containing the decoction should not be placed over the fire while the tea is being prepared. Of even greater importance is the necessity of allowing the water to remain in contact with the leaves only a few moments—never more than a minute if we wish the tea to be good. The reason for the latter precaution lies in the fact that tea-leaves contain a considerable amount of tannic acid, and, as the longer the water and leaves remain together the more of this substance is extracted from the latter, it is not difficult to see that we should be careful to allow only a brief contact between the two; the presence of this acid is undesirable, not only on account of the fact that it gives to the decoction a bitter and unpleasant taste, but because it has a tendency to cause digestive disturbances. It is seemingly not generally known that there are many varieties of tea, and that some of them are so superior in flavor and bouquet to others that they might well be entirely different substances. The best of all (in the writer's opinion) are those that are composed largely of leaves grown in Ceylon, usually mixed with India tea. If we will demand of our grocer a first-class Ceylon tea we will find that a beverage may be made from it that will appeal quite as much to the palate as a good coffee.
Before dismissing this subject finally, some reference should be made to ice-tea. This beverage is exceedingly palatable when properly prepared, and under such circumstances by no means deserves the disfavor with which it is regarded by many. The latter circumstance is entirely due to two things; first, we find too frequently that it is the habit of house-keepers to pour boiling water on the leaves when the midday meal is cooked and to allow them to soak together until night, and second, the fact that lemon-juice is very commonly added to the tea before being drunk. The ice that the tea contains has little or nothing to do with the dyspeptic disturbances that frequently follow the drinking of cold tea. If we will leave out the lemon and pour off the water after it has been in contact with the tea leaves for something like a minute, it will be discovered that practically all of the ill effects usually ascribed to this palatable beverage have been done away with.
Alcohol.—A discussion of beverages would not be complete without some mention of those containing alcohol. This at once brings us face to face with the bitter controversy on this subject that has been waged so long throughout the United States, and which can only be considered here from the standpoint of the effects of alcohol on the human economy, and to draw corresponding conclusions.
That alcohol, even in very small quantities, reduces the general strength and capacity for work there can be no question, and in addition we find from experiments carefully conducted on the lower animals that the liability to infection by various disease-producing germs is greatly increased by the administration of even minute amounts of the drug. A man then who is a habitual user of alcoholic drinks not only thereby diminishes his capacity to labor effectually, but at the same time renders himself more liable to disease. No more striking example of this could be brought forward than the well established fact that persons who use alcohol are exceedingly prone to consumption—so true is this, indeed, that we might almost look upon the drug as being practically the cause of this disease in most instances. Of course the bacillus of tuberculosis must be present in order for the malady to develop, but we find that the alcohol has prepared a soil for the growth of the germ which would not otherwise exist. This holds with equal force as regards other infectious diseases.
Again, it is true that maladies that result from bad digestion and improper assimilation are frequently produced by the habitual use of alcoholic liquors. Gout and Bright's disease are in the vast majority of cases the indirect off-spring of habitual drinking. It should be noted—and the distinction is of importance—that the affections of a grave character most frequently produced by the alcoholic habit do not ensue as a consequence of what could be rightly called intemperate taking of the drug,—its moderate use more commonly resulting in serious disease than when it is taken in great excess.