[With the exception of a brief review of Glutton or Epicure, by Dr. Joseph Blumfield, of London, published in The Lancet, no scientific or professional recognition of the principles of an economic nutrition attained by means of thorough buccal digestion was gained until issue of the following paper by Dr. Ernest Van Someren, of Venice, Italy.
The previous autumn and winter had been devoted to experiments by Dr. Van Someren and the writer, in co-operation with Dr. Professor Leonardi, for twelve years Professor of Chemistry in the University of Pavia, Italy. In the spring and summer of 1901 the field of experiments was changed to Mendel Pass, bei Bozen, Süd Tirol, Austria, and related to endurance work in climbing mountains and bicycle runs among the Dolomites.
Dr. Van Someren’s paper attracted the attention of Sir Michael Foster, Professor of Physiology at the University of Cambridge, England, and Permanent Honorary President of the International Congress of Physiologists.
Professor Foster entered into correspondence with Dr. Van Someren, and this was followed by an invitation to Dr. Van Someren and the writer to attend the Congress which was to convene in Turin, Italy, during the month of September following. At the Congress Dr. Van Someren presented a technical thesis on the probable causes of the economy attained, and gave a demonstration of the movement of his Swallowing Reflex in relation to food in the process of liquefaction and preliminary digestion in the mouth.
Following the Congress we received an invitation to visit Cambridge, England, and submit to tests of nitrogenous measurements in the Physiological Laboratory of the University, under the direction of Dr. F. Gowland Hopkins; and also to an examination of the bacterial flora incident to the nitrogenous estimations, under the direction of Dr. George H. F. Nuttall.
The report of the experiments in the Chemical-Physiological Department is given in the “Note” of Sir Michael Foster, which follows Dr. Van Someren’s paper, but the bacterial examination was not carried far enough to warrant a scientific report, owing to difficulty of obtaining, at the time, sufficient data.—Horace Fletcher.]
A Paper read before the Physiological Section of the British Medical Association, August, 1901, by Ernest Van Someren
Mr. President and Gentlemen:
Being a general practitioner, it is with some trepidation and an apology that I present myself before this section. The reasons for my doing so are: First, that I believe that a hitherto unsuspected reflex in deglutition has come to light which has an important bearing on health, the prevention of disease and on metabolism. Second, that any theory whatever, based on a possible physiological function, claiming to diminish, as this does, the amount of sickness and suffering now existent, should have serious investigation. Third, that I desire to enlist your skilled help in the consideration of the theories I have doubtless crudely erected on my premise.
According to the “Encyclopædia Britannica,” “Luigi Cornaro (1467-1566) was a Venetian nobleman, famous for his treatises on a temperate life. From some dishonesty on the part of his relatives, he was deprived of his rank and induced to retire to Padua, where he acquired the experience in regard to food and regimen which he has detailed in his work. In his youth he lived freely, but after a severe illness at the age of forty, he began under medical advice gradually to reduce his diet. For some time he restricted himself to a daily allowance of 12 ozs. of solid food and 14 ozs. of wine. Later in life he still farther reduced his bill of fare, and he found that he could support his life and strength with no more solid meat than an egg a day. So much habituated did he become to this simple diet that when he was about seventy years of age the addition, by way of experiment, of 2 ozs. a day had nearly proved fatal. At the age of eighty-three he wrote his treatise on the ‘Sure and Certain Method of Attaining a Long and Healthful Life.’ And this work was followed by three others on the same subject, composed at the ages of eighty-six, ninety-one, and ninety-five, respectively. ‘They are written,’ says Addison (‘Spectator,’ No. 195), ‘with such a spirit of cheerfulness, religion, and good sense, as are the natural concomitants of temperance and sobriety.’ He died at the age of ninety-eight. Some say of 103!
Now, was Luigi Cornaro right? Did he make use of a physiological process unknown to us of the value of which he was not cognisant? To live to an advanced age, must we be as temperate as he, reducing the quantity of our food to a minimum required by Nature?
That we all eat more than we can assimilate is unquestionable. How can we determine the right quantity? Instinct should guide us, but an abnormal appetite often leads us astray. Nature’s plans are perfect if her laws are obeyed. Disease follows disobedience. Wherein do we disobey?
We live not upon what we eat, but upon what we digest; then why should undigested food, recognisable as such, be deemed a normal constituent of our solid egesta?
Something like the following must be a common experience to general practitioners, especially to those practising on the Continent. The patient comes to see us and volunteers the information that he or she has the “gout,” “rheumatic gout,” or “dyspepsia.” Symptoms are asked for. The case is gone into carefully for causation. An appropriate diet and an appropriate bottle of medicine prescribed. As the patient leaves the room, we may, or may not, call attention to the fact that both teeth and saliva are meant to be used. The patient returns, better, in statu quo, or worse. If better, he remains so while under treatment, and relapses when he returns to ordinary habits. If unaffected, or worse, we try again and again, until we despair, then take or send him to a consultant. Temporary benefit, possibly owing to renewed hope, results; but finally the unfortunate gets used to his sufferings and, if he can afford it, is sent to join the innumerable hosts that wander from one Bad to another, all Europe over, trying, praising, and damning each in turn. Their manner of living is, of course, at fault. Nature never intended that man should be perpetually on a special diet and hugging a bottle of medicine, nor did she ordain that he should go wandering over the map of Europe drinking purgative and other waters.
Though early yet to speak with certain voice, it would seem that we are provided with a Guard, reliance on which protects us from the results of mal-nutrition. There seems to be placed in the fauces and the back of the mouth a Monitor to warn us what we ought to swallow and when we ought to swallow it. The good offices of this Monitor we have suppressed by habits of too rapid eating, acquired in infancy or youth.
Last November my attention was called by Mr. Horace Fletcher, an American author living in Venice, to the discovery in himself of a curious inability to swallow, and a closing of the throat against food, unless it had been completely masticated. My informant stated that he noticed this peculiarity after he had begun to excessively insalivate his food, both liquid and solid, until all its original taste had been removed from it. Any tasteless residue in the mouth, being refused by the fauces, required a forced muscular effort to swallow. He further told me that since adopting this method of eating he had been cured of two maladies, adjudged chronic, the suffering from which rendered him ineligible for Life Insurance. His weight now became reduced from 205 lbs. to 165 lbs. He had practised no abstemiousness, had indulged his appetite, both as to selection and to quantity, without restraint, and for the last three years had enjoyed perfect health.
After his cure, he was accepted without difficulty for insurance, the last examination finding him an unusually healthy subject for his age. Having leisure, he had spent three years in investigating the cause of his cure, had pursued experiments upon others, and had extended his inquiries, both in America and Europe, until our meeting in Venice. He had also published a statement and inquiry in book form, entitled “Glutton or Epicure,” which had been reviewed by the “Lancet.”
For nearly a year I also had been experimenting on myself and others with various diets, and was ready to believe that in the manner of taking food and not altogether in its varying matter lay perhaps its protean effects on our system. I at once adopted the same method of eating. At the end of six weeks, I noticed that not only did the fauces refuse to allow of the passage of imperfectly prepared food, but that such food was returned from the back to the front of the mouth by an involuntary, though eventually controllable, muscular effort taking place in the reverse direction to that occurring at the inception of deglutition.
What actually happens is this: Food, as it is masticated, slowly passes to the back of the mouth, and collects in the glosso-epiglottidean folds, where it remains in contact with the mucous membrane containing the sensory end-organs of taste. If it be properly reduced by the saliva it is allowed to pass the fauces,—a truly involuntary act of deglutition occurring. Let the food, however, be too rapidly passed back to these folds, i.e., before complete reduction takes place, and the reflex muscular movement above referred to occurs. The process of this reflex is as follows: The tip of the tongue is involuntarily fixed at the backs and bases of the lower central incisor teeth by the anterior fibres of the geniohyoglossi muscles. With this fixed point as fulcrum, the lower and middle fibres of these muscles, aided by those of the stylohyoid and styloglossi muscles raise the hyoid bone, straighten out the glosso-epiglottidean folds, passing their contents forward, by the fauces, the opening of which is closed by approximation of its pillars and contraction of the superior constrictor. The tongue, arched postero-anteriorly by the geniohyoglossi, palato, and styloglossi muscles, laterally, by its own intrinsic muscles, is approximated to the fauces, soft and hard palates in turn, and thus, the late contents of the glosso-epiglottidean folds are returned to the front of the mouth for further reduction by the saliva preparatory to deglutition.
The word reduction is used for the reason that all foods tested, without exception, give an acid reaction to litmus, when served at table. The reflex muscular movement occurs in the writer’s case from five to ten times during the mastication of each mouthful of food, according to its quantity and its degree of sapidity. As often as it recurs, the returned food continues to give an acid reaction, while food allowed to pass the fauces is alkaline.
Saliva, flowing in response to the stimulation of taste, seems more alkaline than that secreted in answer to mechanical tasteless stimulation. It is found that the removal of original taste from any given bolus of food coincides with cessation of salivary flow and complete alkaline reduction. The fibre of meat, gristle, connective tissue, the husk of coarse bread and cellulose of vegetables are carefully separated by the tongue and buccal muscles and rejected by the fauces. To swallow any of these necessitates a forced muscular effort, which is abnormal.
Adult man was not originally intended to take his nourishment in a liquid form, consequently all liquids having taste, such as soup, milk, tea, coffee, cocoa, and the various forms of alcohol, must be treated as sapid solids and insalivated by holding them in the mouth, moving the tongue gently, with straight up and down masticatory movements, until their taste be removed. Water, not having taste, needs no insalivation and is readily accepted by the fauces.
In explanation of the phenomenon described, the following theory is advanced: The fauces, back of the tongue, epiglottis, in short, those mucous surfaces in which are placed the sensory end-organs of taste and “taste-buds” (the distribution of which, by the way, has yet to be explained), that these surfaces, readily becoming accustomed to an alkaline contact by excessive insalivation and consequent complete alkaline reduction of the food, afterwards resent an acid contact and express their resentment by throwing off the cause of offence by the muscles underlying them.
This phenomenon must not be confused with the cases of rumination and regurgitation, which from time to time are recorded. The food in this case is not swallowed, nor does it pass any point from which it can be regurgitated. Eighty-one individuals of different nationalities and from several classes of society whom we have studied are now in conscious possession of their reflexes. These seem readily educated back to normal functions by all who seriously and patiently adopt the habit of what seems only at first to be excessive insalivation.
The dictum “bite your food well” that we so often use, has no meaning to those suffering from the results of mal-assimilation and mal-nutrition, especially should they have few or no teeth of their own. I make so bold as to state that dyspepsia et morbi hujus generis omnis will cease to exist if patients be persuaded to bite their food until its original taste disappears, and it is carried away by involuntary deglutition.
The important point of the whole question seems to be this alkaline reduction of acid food before it passes on to meet subsequent digestive processes elsewhere, which then become alternately acid and alkaline.
In the first few months of infant life, when saliva is not secreted, Nature ordains that mammary secretion be alkaline. With the eruption of teeth come an abundant flow of saliva and a synchronous infantile capacity for managing other foods. This flow of saliva depends on a thorough demand and use to maintain its generous supply. It is just at this time that children learn to bolt their food,—the demand fails, with a consequent detriment to the salivary glands, digestive processes, and the system generally.
A, B, C, and D were placed on an absolute milk diet. A drank his milk in the ordinary way, and at the end of three days begged to discontinue the experiment owing to disgust at the monotony of the diet. B, C, and D continued the experiment for seventeen days, insalivating the milk, but to a varying extent, B the least and D the most. Though D took most milk, he excreted least solid egesta, C excreting less than B. Can one infer that increased insalivation of a non-starchy food insured its better digestion and assimilation? Each subject took as much milk only as his appetite demanded, D taking the most, which never exceeded two litres daily. The weights of the subjects after the usual sudden drop of the first three days remained remarkably even until the end of the experiment. B, C, and D all relished the diet, and it satisfied the requirements of their appetites, but they experienced an increasing monotony.
As long ago as the seventeenth century, before the transformation of matter into energy by the animal organism, known as Metabolism, was understood, the fact was recognised that by the lungs, kidneys, skin, and intestines, substances no longer useful to the organism were eliminated, the retention of which proved harmful. The nature of these substances was unknown, but it was noted that however much the food was increased the weight of the body remained the same. In other words, a state of complete nutritive equilibrium was maintained.
The following table contains the résumé of two experiments in which a state of complete nutritive equilibrium was maintained by individuals of about the same weight, on widely different quantities of food similar in quality. The subjects of the experiments were a laboratory assistant of Dr. Snyder, of the U. S. Department of Agriculture, and the writer. The experiment of the former was made primarily to show the relative digestibility of the several articles of Writer’s Experiment. diet, potatoes, eggs, milk, and cream:
| Dr. Snyder’s Experiment. Published in Bulletin 43 |
Writer’s Experiment. | |
|---|---|---|
| Age of subject | 22 years | 30 years |
| Duration of experiment | 4⅓ days | 5 days |
| Number of meals | 13 | 10 |
| Weight at beginning | 62.5 kilos. | 57.3 kilos. |
| Weight at end | 62.6 kilos. | 57.5 kilos. |
| Potatoes (daily average) | 1587.6 grammes | 159.4 grammes |
| Eggs (daily average) | 411.08 grammes | 124.7 grammes |
| Milk (daily average) | 710 c.c. | 710 c.c. |
| Cream (daily average) | 237 c.c. | 237 c.c. |
| Daily urine | 1108 grammes | 1098 grammes |
| Daily fæces | 204 grammes | 18.9 grammes |
The daily diet of Dr. Snyder’s subject consisted of three and one-half pounds of potatoes, eight eggs, a pint and a half of milk, and half a pint of cream. The writer’s diet of twelve ounces of solid food (like Luigi Cornaro) consisted of three eggs, the remainder of the twelve ounces in potatoes, and an equal quantity of similar liquid food to that taken by Dr. Snyder’s subject. The exercise of the laboratory assistant comprised his daily routine of laboratory work, while that of the writer consisted of six sets of tennis, or an hour and a half on horseback, with an hour to an hour and a half’s walk or climb daily, in addition to much reading and writing.
In each case complete nutritive equilibrium was maintained, although the author subsisted on three-seventeenths of the solid food taken by the other subject.
Again, cannot one infer that better assimilation and less waste resulted from the better preparation of the smaller quantity of food by insalivation? Surely, too, there must be less daily strain on the intestinal canal, and body generally, in getting rid of 18.9 grammes of inoffensive dry waste, than in getting rid of 204 grammes of humid, decomposing, and offensive matter.
“Considerable importance has been attached to the normal action of the bacteria in the intestines; and it has even been supposed that the presence of bacteria is essential to life. Such a view has recently been shown to be erroneous by an elaborate and painstaking research carried out by Nuttall and Thierfelder, who obtained ripe foetal guinea-pigs by means of Caesarean section carried out under strict antiseptic precautions. They introduced the animals immediately into an aseptic chamber through which a current of filtered air was aspirated, and fed them hourly on sterilised milk day and night for over eight days.
“The animals lived, and throve, and increased as much in weight as healthy normal animals subjected to a similar diet for the purpose of controlling the results. Microscopic examination at the end of the experiment showed that the alimentary canal contained no bacteria of any kind, nor could cultures of any kind be obtained from it.
“The same authors, in a subsequent paper, described the extension of their research to vegetable food. This was also digested in the absence of bacteria. Under such conditions cellulose was not attacked. Hence they consider that the chief function of this material is to give bulk and proper consistency to the food so as to suit the conditions of herbivorous digestion.” (Schäfer’s “Text-Book of Physiology,” vol i. p. 465.)
Now, inasmuch as bacterial digestion has no place in the animal economy, surely it can only occur at the expense of the organism?
Can micro-organic action take place in the intestines without the production of toxins and the consequent absorption of these toxins into the blood?
We know that the metabolism of a cell is determined by the general physical environment of the whole organism, by supplies of oxygen and water, on nervous impulses, and, what chiefly concerns this argument, on the nature and amount of the pabulum supplied to it. This pabulum is derived from the alimentary canal.
Are not even those of us who may be enjoying seemingly the best of health supplying to our tissues pabulum containing mild toxins, thus causing an increased katabolic action to occur in each individual cell of our bodies?
Are not the blood elements, floating in a plasma containing such toxins, rendered resistant, weaker, less capable of fulfilling their functions as carriers and combatants of disease?
Are not their and our lives, in consequence, more painful and shorter than they need be?
Would not the elimination of these toxins render us less liable to disease? And is not their presence an important element in predisposition to disease?
When this reflex is restored micro-organisms get no further than the stomach. They are destroyed there by the acid gastric juices, then only stimulated to their full and normal secretion by the presence of a sufficiency of alkaline substance. Undigested matter having been eliminated, micro-organisms, still existing in the intestines, deprived of their means of subsistence, decrease, and, in time, may cease to exist. The body no longer absorbs the toxins these produced. To this fact may be ascribed the increase of mental energy, the general physical betterment, the cessation of morbid cravings for food and drink and of those of a sexual nature, which are noticed and experienced.
What has just been stated is based not entirely on experimental evidence but somewhat upon inference. The inference seems justified because the excreta, more especially of the intestines, but also of the kidneys and skin, become almost odourless and entirely inoffensive. The solid egesta are voided thickly covered with mucus, leaving the end of the bowel dry and clean. The sense of cleanliness can only then be appreciated to the full, for it is internal as well external. Flatus is no longer produced. The urine is inoffensive and seems to be materially changed in quality, as shown by chemical analysis. Uric acid, the chlorides, and, more markedly, aromatic sulphates are reduced in quantity.
Owing to deliberation in eating, necessitated by this new habit, satiety occurs on the ingestion of considerably less food. By carefully studying one’s self I believe it possible to cultivate an instinct which will regulate not only the quantity but the quality of food that the body may need, and that in the normal health of a full-grown body, no more food either in quantity or quality should be supplied than suffices to supply diurnal waste. Any excess must result in pathological processes.
Although there results enhanced pleasure in the taking of all foods, rich and simple, and especially in the appreciation of good wines, the quantities of these foods and beverages that suffice to fully satisfy the appetite are much smaller than before, while there is a marked preference for the simpler kinds of food. The writer now can imagine no more pleasurable meal than one consisting of good brown bread, eggs, butter, cheese, and cream. These, with fresh vegetables and a very little fruit, form his staple diet. This tendency and preference for simple foods is the general experience among those who have recovered their reflexes of deglutition.
Following on the ingestion of a lessened quantity of food and on its better assimilation, there is less waste, the egesta are voided less frequently, sometimes only once in five to eight days.
The lower bowel is not the reservoir it formerly was. So hæmorrhoids cease from troubling and constipation cannot exist. For this same reason the body, at the beginning of the practice, commences to approximate to its normal weight, increasing or decreasing as the individual’s environment demands.
A few more words only need be said. It has been easy to state the results of experiments and observations: but the acquiring of this new reflex, while pursuing daily occupations, is not easy, and needs more than a little patience and much serious thought. The habits of a lifetime cannot be changed in a few days or weeks. The shortest time in which the reflex has been re-established is four weeks, and this only by avoiding conversation at meal-time and concentrating the attention on keeping the food in the mouth until complete alkaline reduction has taken place and sapidity has disappeared.
In closing I wish to maintain as a fact, gentlemen, of the truth of which you will only be convinced by actual experience, that by the restoration of this reflex and in complete dependence on its use, there lies true health, the establishment of a condition of stable nutrition and the possible abrogation of two great predisposing factors of disease, mal-assimilation and mal-nutrition. Unless there be among you, as in the “Cities of the Plain,” a parlous minority who possess this reflex and take your food as you ought, none of you are in the enjoyment of such health as you might have. A like punishment will be meted out to you as was visited on those cities, for you will all be consumed long before your day by the unnecessary combustion in your bodies caused by the circulation in them of toxins, the product of undigested and decomposing food.
The writer, bearing in mind the warning suggested by the Frenchman whose donkey died as soon as he had reduced his food to a single wisp of straw, finds that he is taking less and less food. While his mind is open as to his arriving at the final diet of Luigi Cornaro, yet it is easily conceivable that living a similar life of retirement in a placid environment, it would be quite possible to do as he did. Hence the title of this paper and the queries at the commencement.
The objects in publishing and distributing this paper are twofold: to make the subject as widely known as possible, and to solicit the aid of colleagues in investigating it more fully.
There is ready at the service of the general practitioner an important and potential therapeutic agent in the saliva of his patients and in the use ad finem of their salivary digestions.
By any chance should readers of this paper wish to ask any questions, the writer will be happy to communicate with them.
183, Calle del Capello Nero,
Piazza San Marco,
Venice, Italy.
Editor’s notes. (1) Confirmatory evidence of the correctness of the deductions made in this paper has begun to come in from many professional sources and notably from a famous child specialist who avers that children would follow the natural requirements in eating were it not for artificial food, bad example, and bad teaching.
(2) In a report of a paper read before the Société de Biologie, Paris, France, March 15th, 1902, by M. Max Marckwald, of Kreuznach, “On Digestion of Milk in the Stomach Of Full-grown Dogs,” the following appears: “Hence these experiments confirm those of Horace Fletcher and Ernest H. Van Someren on the importance of prolonged mastication” (translation). Referring, as the latter statement does, to mastication (insalivation) of liquid, it gives an important suggestion relative to some probable causes of uncertain or defective digestion in human nutrition.
[In connection with a report of the Cambridge Examination the writer wishes to acknowledge the interest and assistance of Dr. Francis Gowland Hopkins, head of the Physiological-Chemical Department of the Physiological Laboratory of the University; Dr. George H. F. Nuttall, in charge of the Bacteriological Section of the Pathological Laboratory; Mr. Sidney W. Cole, Mr. Robert Barrett, and Dr. Hubert Higgins, both for practical work in the laboratory and in serving as test-subjects. To Dr. Higgins so much is due that it is difficult to measure. Since our first meeting in Cambridge, Dr. Higgins has been unremitting in his study of the subject and in consideration of its application to human betterment. Having the altruistic temperament inborn and not yet smothered by disappointment, the good doctor has consecrated himself to the service of poorer humanity, and his inspiration in so good a cause is wonderful motive power behind the native desire to do good. The statement of Dr. Higgins’ experiences in pursuit of an Economic Nutrition is given in his own manner in the new edition of Glutton or Epicure, which is being published coincidently with this volume in the A. B. C. Life Series.
At the time we were in Cambridge, Dr. Hopkins and Mr. Cole had just published their paper in the Journal of Physiology (English), describing their isolation of the tryptophane element of the proteid molecule which had eluded chemists from the beginning. In tryptophane they found embodied the odourous indol and skatol which appear so offensively in the putrid decomposition of proteid. In the excreta of the test-subjects in our Economic-Nutrition-Inquiry these malodorous substances did not appear, and hence another question is opened up to investigation relative to the putridity of human excrement under ordinary conditions of carelessness, and the absence of putridity in the case of nutrition accomplished by aid of thorough buccal treatment of food preparatory to digestion.
It is a matter of interest, relative to the patience required in science, to state that Dr. Hopkins and Mr. Cole were fourteen months searching for the fugitive tryptophane element after they received their first clew to its whereabouts. When isolated, tryptophane masses in a substance having the appearance of silver, but not the solidity of that metal.—Horace Fletcher.]
In 1901 Dr. Ernest Van Someren submitted to the British Medical Association, and afterwards to the Congress of Physiologists at Turin, an account of some experiments initiated by Mr. Horace Fletcher. These experiments went to show that the processes of bodily nutrition are very profoundly affected by the preliminary treatment of the food-stuffs in the mouth, and indicated that great advantages follow from the adoption of certain methods in eating. The essentials of these special methods, stated briefly and without regard to certain important theoretical considerations discussed by Dr. Van Someren, consist of a specially prolonged mastication which is necessarily associated with an insalivation of the food-stuffs much more thorough than is obtained with ordinary habits.
The results brought to light by the preliminary experimental trials went to show that such treatment of the food has a most important effect upon the economy of the body, involving, in the first place, a very notable reduction in the amount of food—and especially of proteid food—necessary to maintain complete efficiency.
In the second place this treatment produced, in the experience of its originators, an increase in the subjective and objective well-being of those who practise it, and, as they believe, in their power of resistance to the inroads of disease. These secondary effects may indeed be almost assumed as a corollary of the first mentioned; because there can be little doubt that the ingestion of food—and perhaps especially of proteid food—in excess of what is, under the best conditions, sufficient for maintenance and activity, can only be deleterious to the organism, clogging it with waste products which may at times be of a directly toxic nature.
In the autumn of 1901 Mr. Fletcher and Dr. Van Someren came to Cambridge with the intention of having the matter more closely inquired into, with the assistance of physiological experts. The matter evoked considerable interest in Cambridge, and observations were made not only upon those more immediately interested, but upon other individuals, some of whom were themselves medical men and trained observers.
Certain facts were established by these observations, which, however, are to be looked upon as still of a preliminary nature. The adoption of the habit of thorough insalivation of the food was found in a consensus of opinion to have an immediate and very striking effect upon appetite, making this more discriminating, and leading to the choice of a simple dietary, and in particular reducing the craving for flesh food. The appetite, too, is beyond all question fully satisfied with a dietary considerably less in amount than with ordinary habits is demanded.
Numerical data were obtained in several cases, but it is not proposed to deal with these in detail here, as they need the supplementary study which will be shortly referred to.
In two individuals who pushed the method to its limits it was found that complete bodily efficiency was maintained for some weeks upon a dietary which had a total energy value of less than one-half of that usually taken, and comprised little more than one-third of the proteid consumed by the average man.
It may be doubted if continued efficiency could be maintained with such low values as these, and very prolonged observations would be necessary to establish the facts. But all subjects of the experiments who applied the principles intelligently agreed in finding a very marked reduction in their needs, and experienced an increase in their sense of well-being and an increase in their working powers.
One fact, fully confirmed by the Cambridge observations, consists in the effect of the special habits described upon the waste products of the bowel. These are greatly reduced in amount, as might be expected; but they are also markedly changed in character, becoming odourless and inoffensive, and assuming a condition which suggests that the intestine is in a healthier and more aseptic condition than is the case under ordinary circumstances.
Although the experiments hitherto made are, as already stated, only preliminary in nature and limited in scope, they establish beyond all question that a full and careful study of the matter is urgently called for.
For this fuller study the Cambridge laboratories do not possess at present either the necessary equipment or the funds to provide it. For the detailed study of the physical efficiency of a man under varying conditions, elaborate and expensive apparatus is required; and the advantages claimed for the special treatment of the food just discussed can only be fully tested by prolonged and laborious experiments calling for a considerable staff of workers.
It is of great importance that the mind of the lay public should be disabused of the idea that medical science is possessed of final information concerning questions of nutrition. This is very far indeed from being the case. Human nutrition involves highly complex factors, and the scientific basis for our knowledge of the subject is but small; where questions of diet are concerned, medical teaching, no less than popular practice, is to a great extent based upon empiricism.
But the scientific and social importance of the question is clearly immense, and it is greatly to be desired that its study should be encouraged.
M. Foster.
April 26th, 1902.
[Sir Michael Foster’s “Note” (preceding) and Professor Chittenden’s article in the Popular Science Monthly (following), which form a part of this book, show a common want of exact knowledge relative to human nutrition not at all creditable to human intelligence at the beginning of the twentieth century; but they both offer hope of relief from this discreditable stigma in systematic study of the question. For this purpose an international inquiry was proposed, a plan was drawn up under advice of Sir Michael Foster, and the matter was given to the writer to promote by the best means available.
The Carnegie Institution seemed, at the time, the most likely supporter of such a scheme; but owing to an embarrassment of applications for support of American science needs, it was considered best not to attempt any foreign or even international benefaction, for the present at least, and hence other means of furthering the inquiry were sought.
The invitation of Professor Chittenden to repeat the demonstration of food-economy made by the author and Dr. Van Someren at Cambridge, England, of which Sir Michael Foster’s “Note” treats, at the laboratories of the Sheffield Scientific School of Yale University, led to the discovery that New Haven already possessed an equipment suitable for the inquiry much more complete than the plan Professor Foster had outlined as being desirable.
At Yale were found not only a very well-adapted chemico-physiological laboratory with some of the most active and scientifically respected research talent of the world in charge, but the laboratory stood only three minutes away from one of the best furnished gymnasiums in the world, under a director who is an M. D. of twenty years’ experience, as well as a famous athlete and author of an athletic manual. It so happened that this gymnasium was especially suited for assisting in a research into the very causes of human efficiency, or lack of it, which nutrition is supposed to affect.
Only forty minutes from New Haven by rail,—a distance not greater, as measured by time separation, than from one side of London to the other,—at Middletown, Conn., stood also the recently completed calorimeter of Professors Atwater and Benedict ready for making a calorimetric trial-balance measurement of metabolism attained and chemically estimated in the tests at New Haven.
After the Yale demonstration, of which Professor Chittenden’s article, previously mentioned, treats, the author responded to an invitation from Professor Atwater and submitted himself to a 32-hour confinement in the calorimeter for confirmation of the results obtained at New Haven.
This experience in the calorimeter at Middletown was very significant and instructive. The author was the first test-subject used in the newly completed calorimeter. The oxygen-measuring attachment of Dr. Benedict that completed the apparatus and gave a complete trial balance of the metabolism of the subject under examination was as yet untried, but it proved its integrity within the fraction of one per cent and registered as accurately as necessary for all practical purposes. So much for the machine; but it measured a result which is of the greatest importance to the human race. The author had just demonstrated the possibility of running the human machine on half the heat, on one-third of the fuel, and with only one-tenth of the waste, as represented by the waste, or ashes of digestion. Not only was this done while in pursuit of the ordinary activity of present-day life, but under stress of ’Varsity-Crew exercise, as reported by Professor Chittenden and Dr. Anderson. Had this demonstration been made relative to steam engines or electrical motors, the information would have been revolutionary in establishing new values for things industrial and commercial.
Its significance relative to human profitable possibilities is even more important than if related to steam or electrical power. The possibility of economy in the human machine gives also a hope of immunity from the common diseases which now afflict mankind.
The trial of the calorimeter as a measuring machine and the trial balance of the economic metabolism which the author had attained by five years of careful attention to the natural requirements of nutrition were epoch-making events coincidently related, and for them the author here makes this distinguished claim—not on account of any accomplishment of himself, but as a promise of great possibilities for human betterment.
Here follows a reproduction of the plan just referred to, with fac-simile of the signatures of the distinguished physiologists who approved the plan and consented to serve as “Assessors.” To this list should have been added the name of Professor Ozawa, professor of physiology at the University of Tokio, Japan; but time and distance did not permit gaining the required understanding and assent. Professor Ozawa’s connection with the inquiry would make it not only international but interhemispherical and interracial as well, and this possibility of scientific coördination and coöperation is typical of the harmonising wave that is fast enveloping the earth for the benefit of mankind.
I give a copy of the document entire, with estimates of cost, etc., just as it was originally drawn and intended only as a trial suggestion, to be modified by circumstances.—Horace Fletcher.]
Notwithstanding the enormous development which the study of Experimental Physiology has undergone during the last half-century, and the constant multiplication of physiological laboratories fitted in a manner which enables them to be used as places of research as well as of instruction in the methods of physiological inquiry, it has appeared to many physiologists that a great need remains to be supplied by the establishment of an International Laboratory of Research, devoted primarily, if not exclusively, to the investigation of problems connected with the Nutrition of the Animal, and particularly of Human Organisms,—studies particularly, and in the first instance, from the point of view of the relation of the food consumed by the animal body to its output of energy, either in the form of heat or mechanical work.
The reason for establishing such a laboratory, available for the use of investigations of all nations, is to be found in the fact that the researches which are now called for, in order to place upon a firm foundation our knowledge of food and its relations to the activity of the organism, necessitates an assemblage of apparatus and machinery so specialised and so costly that they are not to be found collected together even in the best equipped of the physiological laboratories of Europe or America, which all subserve in the first instance the purposes of systematic instruction. Undoubtedly, unquestionably, certain of the great and costly appliances of research are to be found in particular laboratories, as, for instance, in those of Berlin, Munich, Paris, and Turin, but there certainly exists no laboratory in which the investigator can find assembled under one roof all the specially fitted chemical, physical, and even bacteriological appliances which he may need to employ in the investigation of the Phenomena of Nutrition.
A more precise conception of the nature of the proposed laboratory may be formed if reference is made to certain groups of appliances which such a laboratory should possess and be able to place at the disposal of the scientific men coming to it for facilities which may be denied them at home. It should possess a complete set of respiration chambers of various types, and especially should be provided with the “Atwater Respiration Apparatus;” the most perfect appliances for the analyses of gases should be available; it should be provided with the most perfect calorimeters of various types, both for the investigation of the calorimetric value of the foods experimented on, and for the determination of the heat produced by man or by the lower animals,—the subjects of observation. The laboratory should possess, besides, the most perfect appliances for the measurement of work done by man and by animals (“ergostat,” “ergograph”), and a set of balances of the highest perfection capable of weighing with accuracy very heavy loads. These characteristic appliances of a laboratory specially designed for placing our knowledge of Animal Nutrition on a thoroughly sound basis must be superadded to the ordinary means for pursuing with success researches in Pure Organic, Physiological, and Physical Chemistry, as well as in Bacteriology.
1. To determine with greater precision than has yet been possible the efficiency of the animal organism considered as a machine in which potential energy of the organic constituents of food is converted into mechanical work. The knowledge that we already possess has shown that in the animal we have an engine infinitely more efficient as a utiliser of the potential energy supplied to it than any appliance yet constructed, or which we can, in the present state of physical science, construct. A still more precise study of the actual efficiency of the animal as a whole, as well as of certain of the vital organs which are mainly concerned in mechanical work, and a more thorough investigation of the processes whereby—for instance, in the muscles—the potential energy of stored-up chemical compounds is, as appears certain, directly converted into mechanical work, is not only desirable in the interest of the ultimate object of the work of the Laboratory, but possesses a high degree of theoretical interest, even from the point of view of Pure Physics. To sum up: One of the first objects of the investigations to be carried out in the projected Laboratory should be “the more precise determination of the minimum transformation of energy which corresponds to mean and accurately determined conditions of the animal body, and of that of man in particular.”
2. We are acquainted with the fact that the potential energy which is utilised by the animal is supplied to it with the least wear and tear to, or strain upon, its mechanism by non-nitrogenous organic constituents of food which must belong to the groups of starches and sugars or fats, but that the continued existence of the organism demands, as an essential condition, the introduction of a certain proportion of albuminous matter. In spite of numerous very fine investigations on this subject, the yet more precise determination of the minimum quantity of the albuminous constituents which are absolutely necessary or desirable, under the most varying conditions, is eminently desirable, especially in the light of recently recorded facts, amongst which are those to be referred to under 3 (following):—
3. Certain very noteworthy observations made by Messrs. Horace Fletcher and Ernest H. Van Someren have shown that an excessively prolonged mastication and insalivation of food leads to remarkable results in respect to the diminution of the total quantity of food necessary to keep the body in a state of health, and to, as is alleged, a remarkable improvement in the digestive functions as well as of the general health of the individual. It appears highly important thoroughly to investigate the remarkable phenomena discovered by Messrs. Fletcher and Van Someren, and to determine how far they may lead to a modification of or improvement in the dietary of healthy individuals and of persons in a state of disease.
4. Indeed, it may truly be said that the average diet of man, that is to say, the absolute and relative amount of certain food-stuffs on which an average man should live, is at present, to a large extent, determined in an empirical manner. It is most necessary that this should be determined in an exact manner, since it is at least possible that a more complete knowledge may reveal that the good results thus obtained empirically are only reached by means of an excess of one element being counterbalanced by excess of another element, and thus open up a way to considerable economy. The changes needed for variations from the average, to meet certain conditions, are also at present, to a very large extent, determined empirically, and these also most certainly ought to be determined in an absolutely exact manner.
5. The researches of Pawlow on the conditions which influence the activity of the secreting glands of the organs of digestion, upon the relation of their activity to the nature of the food ingested, upon the influence exerted by the secretion of the glands situated in one part of the alimentary canal, upon the activity of glands situated lower down, indicate lines of research only recently opened out, but the importance of which in reference to the problems of nutrition is probably great.
6. Similarly, the facts which have in recent times been ascertained in reference to the remarkable influence exerted by the so-called “internal secretion” of certain ductless glands on the general metabolism, the part played by the pancreas in reference to the transformations of sugar in the body indicate yet other lines of research to be carried out in connection with the main inquiry.
In conclusion: The final problem of the work of the proposed Laboratory will be to ascertain the conditions which will “render it possible to obtain from the human machine, under varying conditions, the highest efficiency at the least cost.”
The value of results which may be thus obtained, considered from the point of view of social, political, and administrative economy, is hardly to be exaggerated.
Suggestions as to Staff and Personnel of the Proposed International Laboratory
For the coördination and general direction of the several investigations, the services of an eminent physiological chemist (preferably one having the principal European languages at his command) is essential.
Such a director would need at least two efficient permanent technical assistants, as for instance, one to deal with the problems of Organic Chemistry, and another competent to deal with the problems of Physical Chemistry. Other assistants might be necessary, but it would probably be desirable that the Institute should have the power of subsidising, for a longer or shorter period, men who would undertake special investigations in coördination with the general work, and who would thus be, as it were, temporary assistants. This would be quite apart from the general hospitality of the Laboratory offered by the Institute to other investigators.
| INITIAL OUTLAY | ||
|---|---|---|
| Director | $5,000 | $5,000 |
| Permanent and Temporary Assistants | 7,500 | to 10,000 |
| Other General Maintenance | 5,000 | to 7,500 |
| $17,500 | $22,500 | |
With regard to the second item, the permanent assistants would be required at the outset, but the temporary assistants would be taken on as opportunity offered. Less than even the lower estimate might suffice at first.
Regarding the third item, also, the maximum might not be required in the beginning.
The place fitted for the establishment of an International Institute should be one which can be reached with comparative facility by investigators of the different nationalities. It must be one free from the objections due to national susceptibilities. It should also be, if possible, a place agreeable to live in; a place where work can be carried on through the year; and a place where expenses, both the personal expenses of the investigators, and the general expenses of the Institute, are not excessive. Venice has been suggested as a place fulfilling the above requirements. It can be reached readily from all parts of Europe, and is as accessible to Americans as any other European city. Living is very cheap, and, indeed, all expenses are very moderate.
On sea level itself, Venice is within near distance of very high altitude, and hence offers facilities for the study of the effects of climatic influence on nutrition. It is also sufficiently near the Regina Margherita Laboratory, on Monte Rosa, to enable the observations made at the two places to be coördinated. Venice is, moreover, a cosmopolitan centre; and persons of many different nations and races might readily be obtained as subjects for observation and experiment.
On the other hand, it may be regarded as essential to the complete success of the proposed Institute that both the director and those engaged in investigation should have ample opportunities of ready and frequent intercourse with eminent men engaged in investigation in Physics, Chemistry, and the allied sciences. The help which is thus gained by intercourse with men at the very head of various scientific inquiry cannot be supplied in any other way. There is also an urgent reason for ready access to a most thoroughly equipped scientific library. It is also essential that the Institute should have facility of obtaining, or of getting constructed, with the least possible delay such apparatus as it might need. These essentials cannot be supplied otherwhere than in great centres of scientific activity. A small university cannot supply them. If they are insisted on, the Institute must be located in a place which has metropolitan distinction and holds not only a large but an active university. The choice of a situation, from this point of view, in Europe, is thus almost limited to such places as Paris, Berlin, Vienna, or London. Of these London probably best recommends itself for international purposes.
But, on the other hand, London is distinctly an expensive place to live in. Indeed, all expenses there are great, and the same may be said of any great metropolitan centre. Moreover, London cannot be reached from the countries of Europe without sea transit.
The choice between such a place as London and such a place as Venice must depend upon the relative weight attached, on the one hand, to the scientific advantages dwelt on above, and, on the other hand, to the advantages other than scientific.
It is proposed that: First, there should be a small body of trustees who should undertake the financial responsibility; and, Second, a board of scientific assessors, representing several nations, who, in conjunction with the director, should exercise general supervision of the work of the Institute. Such a board need meet only at rare intervals, much being done by way of correspondence. The expenses which the members incur in the exercise of their functions ought to be met out of the funds of the Institute.
The following have expressed willingness to act as scientific assessors:—