SECTION I. From _London Lancet_, July 11, 1903

Transcriber’s Notes

Obvious typographical errors have been silently corrected. Variations

in hyphenation and accents have been standardised but all other

spelling and punctuation remains unchanged.

Italics are represented thus _italic_ and bold thus =bold=.

THE A. B.-Z.

OF

OUR OWN NUTRITION

HORACE FLETCHER’S WORKS

THE A. B.-Z. OF OUR OWN NUTRITION. 462 pp. Just issued.

THE NEW MENTICULTURE; OR, THE A-B-C OF TRUE LIVING. Fortieth thousand.

310 pp.

THE NEW GLUTTON OR EPICURE; OR, ECONOMIC NUTRITION. 324 pp. Just

issued.

HAPPINESS AS FOUND IN FORETHOUGHT MINUS FEARTHOUGHT. Tenth thousand.

251 pp.

THAT LAST WAIF; OR, SOCIAL QUARANTINE. 270 pp.

_The_ A. B.-Z.

_of_ OUR OWN

NUTRITION

_By_ HORACE FLETCHER

_Author of “Menticulture,” “Happiness,” “That

Last Waif,” “Glutton or Epicure,” Etc., Etc._

EXPERIMENTALLY ASSISTED BY

DR. ERNEST VAN SOMEREN,

M. R. C. S., L. R. C. P., _of Venice, Italy_

& DR. HUBERT HIGGINS, M.A.,

M. R. C. S., L. R. C. P., _of Cambridge, England_

_NEW YORK_ ‧ FREDERICK A.

STOKES COMPANY ‧ _PUBLISHERS_

COPYRIGHT, 1903

BY HORACE FLETCHER

Published November, 1903

Reprinted February, 1904, August, 1904

February, 1905, August, 1905

THE UNIVERSITY PRESS

CAMBRIDGE U. S. A.

CONTENTS

Page

INTRODUCTION ix

POSTINTRODUCTORY xxvii

THE A.B.-Z. PRIMER

Explanation 3

Some Pertinent Questions 4

A.—The Psychology of Nutrition 6

B.—The Mechanical and Chemical Physiology of

Nutrition 8

Method 9

Z.— The True Chemical End-Point of Digestion 10

A.B.-Z. Figure 12

Preface to 1906 Edition 13

HISTORY OF DEVELOPMENT AND SUPPORTING

EVIDENCE

Summary of the Foregoing Pages by an Experimenter

of One Month’s Experience 19

First Scientific Recognition of the Principles of

Economic Nutrition Outlined in “Glutton or Epicure.” H.F. 26

Was Luigi Cornaro Right? by Ernest Van Someren 27

The Cambridge Tests.H.F. 47

Experiments upon Human Nutrition, by Sir Michael

Foster, K.C.B., M.P., F.R.S. 48

Report of a Plan for the Institution of an International

Inquiry into the Subject of Human

Nutrition.H.F. 53

Proposal to Found an International Laboratory of

Research for the Study of Nutrition in all Its

Aspects. Recommended by the following 55

Professors of Physiology, etc.:

Sir Michael Foster, Cambridge, England.

Angelo Mosso, Turin, Italy.

Hugo Kronecker, Bern, Switzerland.

N. Zuntz, Berlin, Germany.

Paul Heger, Brussels, Belgium.

A. Dastre, Paris, France.

Henry P. Bowditch, Harvard Medical School.

Russell H. Chittenden, Yale University.

William H. Welch, Johns Hopkins University.

J.P. Pawlow, Saint Petersburg, Russia.

Nationality and Scientific Titles of the above Board

of Scientific Assessors 68

Persistent Scientific Doubts.H.F. 69

Physiological Economy in Nutrition, by Professor

Russell H. Chittenden 72

Introduction to Dr. Harry Campbell’s Contribution

on the Importance of Mastication.H.F. 92

Observations on Mastication, by Harry Campbell,

M.D., F.R.C.P. 96

Introduction to Professor Pawlow’s Demonstrations

of Psychic Influence in Digestion.H.F. 180

Selected Lectures by Professor J.P. Pawlow (Dr.

W.H. Thompson’s translation) 182

Lecture IV.: General Scheme of an Innervation

Mechanism--The Work of the Nervous Apparatus

of the Salivary Glands--Appetite, the First

and Most Potent Exciter of the Gastric Secretion 182

Lecture V.: Period of Occurrence and Importance

of the Psychic or Appetite Juice in the Secretory

Work of the Stomach--The Inefficiency of

Mechanical Stimulation of the Nervous Apparatus

of the Gastric Glands 212

Lecture VIII.: Physiological Action and the Teaching

of Instinct: Experiences of the Physician 247

Introduction to Dr. Cannon’s Papers on Movements

in the Alimentary Canal studied by Means

of the Röntgen Rays.H.F. 284

Swallowing and Movements of the Stomach and

Intestines, by W.B. Cannon, M.D. 285

The Movements of the Food in the Œsophagus,

by W.B. Cannon and A. Moser 285

The Movements of the Stomach, by W.B. Cannon 301

The Movements of the Intestines, by W.B. Cannon 342

The Battle Creek Laboratories.H.F. 389

Experimental Investigation of the Influence of

Mastication and Cooking of Food, etc., in the

Laboratories of the Battle Creek, Michigan, Sanitarium,

under the direction of Dr.J.H. Kellogg 391

Dr. Edward Hooker Dewey and the “No Breakfast

Plan.” H.F. 396

Professor Jaffa and the Fruitarians.H.F. 397

Dr.H.P. Armsby.H.F. 397

Explanation of the A.B.C. Series.H.F. 399

INDEX 409

INTRODUCTION

_DO WE EAT TOO MUCH?_

CAN WE LEARN TO EAT RIGHT?

WITHOUT LOSS OF ENJOYMENT?

WITHOUT CARE BEING A NUISANCE?

WITHOUT SOCIAL INTERFERENCE?

WITH ASSURANCE OF HEALTH?

WITH INCREASE OF ENERGY?

WITH INCREASE OF ENDURANCE?

* * * * *

TO ALL THESE VITAL QUESTIONS,

THIS BOOK ANSWERS ONLY “YES.”

* * * * *

VERIFY THIS BY PERSONAL EXPERIMENT.

IRRESISTIBLE DESIRE FOR PHYSICAL EXERCISE

WILL FOLLOW, AS A MATTER OF COURSE,

PROBABLY FRUITING IN USEFUL ACCOMPLISHMENT

BY THE SAME INVITATION OF HEALTHY IMPULSE

WHICH CAUSES CHILDREN TO PLAY TIRELESSLY.

DO RIGHT YOUR FEEDING OF THE BODY.

NATURE WILL DO ALL THE REST FOR YOU ARIGHT.

Introduction

DO WE EAT TOO MUCH?

(_A propos of the Scientific-Military Experiments at Yale University_)

Do we eat too much?

Nine out of every ten physicians tell us “Yes,” and tell us true!

How much too much?

* * * * *

Luigi Cornaro suggested that all persons in his time ate more than was

necessary; most persons ate twice as much as was good for them; and

some, who were extravagantly gluttonous, ate ten times as much as was

their most economic need; and Cornaro, who was a dissipated wreck at

forty, reformed his manner of eating and lived to be a hundred to prove

his declaration.

Experiments carried on in this country and in Europe during the

past five years confirm this estimate of habitual excess; but

fortunately they have also revealed a natural protection, heretofore

unappreciated, available to all, which can regulate the appetite to

suit the real needs of nutrition and thus avoid the dangerous excess

which predisposes to discomfort and disease.

* * * * *

Luigi Cornaro lived more than three hundred years ago. His charmingly

frank and interesting autobiography has been published in English

upwards of forty times in different new editions, and no one has

disproved the possibility or probability of his claim. We all know that

Cornaro was right. We know, in a general way, that the great Italian

dietitian and philosopher was wise and uttered wisdom, and we are told

that most, if not all, of the diseases which pain, worry, and afflict

us are caused by indigestion or mal-assimilation of food, the result

of some indiscretions of eating. The questions then are “What are our

indiscretions?” “How can we avoid them?” and “What is the new discovery

that will protect us and, at the same time, add to the pleasures of the

palate and of living?”

The answers to all these queries will be found herein, as will also

an explanation of the very active interest which is being taken just

now in the problem of human nutrition by scientific and military

authorities, as evidenced by the Yale investigation.

The author has, in collaboration with several others, found a way how

_not to eat too much_ while eating _all that the appetite desires_, and

in a way that leads to a _maximum of good taste_ and at a _minimum of

cost and waste_, but it is necessary to test many persons of different

physiques and varying temperaments, and also to test other methods of

attainment of economy, to learn what is best for general application,

and that is what is being done at Yale.

* * * * *

The cost to the pocket that is saved by economic nutrition is of little

matter as compared with the saving of the waste of energy and the

menace of disease.

* * * * *

Nature certainly never intended that we should weaken, depress, and

distress ourselves in the way that is common to present-day living, as

is made evident by the prevalence of discomfort and disease relative

to our daily food. Nature’s plan of evolution does not work that way

in general, does not retrograde in the progress of the improvement

of plants and dumb animals, and certainly does not intend that Man,

the First Assistant of Nature in the cultivation of things and in the

domestication of the powerful natural forces, should suffer and become

degenerate contrary to her general law.

If we are agreed upon the foregoing, let us ask ourselves a few

questions.

Without any undue egotism, may it not be possible for a generation of

human beings, who have progressed so far in intelligence as to be able

to move things by steam, to communicate across the ocean even without

wires to guide our messages, and to see clearly through objects that

are as dark as night to the unassisted human eye with the aid of an

artificial light, to learn the secret of right self-nutrition and

practise it in a manner that will not deprive us of the maximum of

pleasure which Nature invariably gives as a reward for conformity with

her beneficent requirements? May we not assume that beings who have

learned to breed and train horses to race with human intelligence, and

to run, trot, or pace a mile in less than two minutes, may also train

themselves to have the proportional relative speed, endurance, and

longevity that has been attained by race horses through man’s care,

and to enjoy the pleasure of living that is evident in these favoured

animals, mere servitors of man though they be?

If this disparity of man is due to ignorance arising in self-neglect,

which is the usual accompaniment of genius, may we not now, at the

beginning of the pregnant twentieth century, rest for a moment from

discovering, developing, and improving the world outside our personal

selves and concentrate our attention for a while on learning to know

and care for ourselves? May we not, at least, give “horse sense”

attention to such a vital interest?

* * * * *

In the midst of the present confusion which exists among opinions as to

the right conduct of life and activity, and the best manner and system

of diet to be used to secure health and efficiency, it seems almost a

vain appeal to call for concert of action in a matter of common and

persistent neglect. Each person, as his own keeper, is careless, and

in matters of bodily management no one feels called upon to be his

brother’s keeper; but this is merely the lethargy of oversight and

consequent ignorance, and this book is published to call attention to

the oversight and to attempt to dispel the ignorance.

* * * * *

At the present moment of writing (October, 1903) there are quartered

at New Haven, Connecticut, twenty privates of the Hospital Corps of

the United States Army and three non-commissioned officers, under the

command of Assistant Surgeon, Lieutenant Wallace DeWitt. These men

and officers, while they are under regular army discipline and are

performing duty in conformity with their oath of enlistment, are yet

volunteers. They are from the same corps, if they are not the same

men, which furnished volunteers to investigate the causes of yellow

fever in Cuba, whose heroism resulted in stamping the fever out of the

islands and in that more effectually protecting our coast states from

its yearly incursions. These are the same men who generously refused to

accept the offered bounty. This latter expression of exalted manhood is

evidence of what humanity is whenever there is real need for heroes to

serve the general good. They refused to _sell_ themselves as risks for

money, but they freely _offered_ themselves as subjects of scientific

investigation for the benefit of their fellows and of mankind at large.

* * * * *

The duty that the soldiers are engaged in at Yale has no element of

risk, and need not have any feature of monotony or tediousness in

it, much less has it the romance of sacrifice, for it deals with an

attempt to restore normality and does not consort with disease. But the

service being rendered by these guardians of our health, these soldiers

of hygiene, is even more important than was the service rendered in

stamping out yellow fever, for it deals with an enemy much more

subtle, treacherous, common, and deadly than Yellow Jack. Yellow fever

calls for a halt and an immediate attempt at cure, and further, for

stringent defence to extermination; but indigestion and the American

plague, _dyspepsia_, work their evils slowly but surely to cut off our

best men and loveliest women in their prime and to rob us of their

richest product and of their maturest wisdom.

* * * * *

The investigation at Yale is a link in a chain of effort that has

developed in logical sequence and has been planned to effect a cure of

the common ignorance and practice relative to right human nutrition in

its relation to profitable thinking and doing; and to discourage the

personal neglect which has been responsible for the existing ignorance,

this book is issued to show what may easily be done and what has been

done, so far, in this direction. It is a compilation of important

knowledge which has been born of recent scientific research but which

is hidden away from common comprehension in scientific publications;

and it relates the story of the development of which this book is an

exponent. Herein are given the reasons why the government and the

most eminent scientists in the line of researches in nutrition are

coöperating so earnestly and so unusually in a commonweal inquiry.

* * * * *

About ten years ago, at the critical age of forty-four, the author was

fast becoming a physical wreck in the midst of a business, club, and

social tempest. Although he was trained as an athlete in his youth

and had lived an active and most agreeable life, he had contracted a

degree of physical disorder that made him ineligible as an insurance

risk. This unexpected disability, with such unmistakable warning, was

so much a shock to his hopes of a long life that it led to his making

a strong personal effort to save himself. The study was taken up in

systematic manner, account of which is too long to relate here; but the

eager auto-reformer soon learned that his troubles came from _too much_

of many things, among them too much food and too much needless worry;

and realising the danger ahead, he sought a way to cure himself of

his disabilities by the help of an economic food supply, as did Luigi

Cornaro; but what is even more important, he found a way to enjoy the

smaller quantity of food much more than any plethoric luxury can give,

and arrived at the method by a route that showed a means of conserving

a healthy economy and an increased pleasure of eating, at the same

time, in quite a simple and scientific manner, that any one may learn

and practise without any ascetic deprivation whatever. Cornaro buried

the real clew to his economic and pleasurable success with his body,

owing to his vague generality of description of his method. The author

is determined not to make the same mistake, and thereby bury _his_ key

to a happy and easy life.

* * * * *

The secret of the method is all told in this book and is confirmed

herein by both theoretically scientific and scientifically practical

authority; but the experiments which are being conducted at Yale by

Professor Chittenden, in coöperation with Surgeon-General O’Reilly of

the army, of which the _Daily Press_ has given notice, together with

experiments which are in progress in many university laboratories in

this country and in Europe, are for the purpose of explaining the

“reasons for things” by complete scientific reasoning, so that none may

doubt the disadvantage and sin of dietic ignorance and carelessness.

The acceptance of the theory and method of the author at the great

Battle Creek Sanitarium, after more than a year’s trial, and elsewhere

among curative agencies, and their adoption and use as the first

requisite of treatment, of which the public have not so generally

heard, are indorsements coming from practical, intelligent, and expert

sources of experience and judgment, and hence they are of the utmost

value and significance.

* * * * *

This introductory chapter is being written after the “clippings” of

newspaper comment relative to the presence of the soldiers at Yale have

begun to come in. The majority of comments are generous in spirit, but

indicate a lack of complete understanding which this “Introduction” is

intended to correct.

* * * * *

Some of the comments are couched in ridicule, and express pity for the

poor soldiers who are being “misused” as subjects of starvation in an

investigation which promises to make starvation a rule in the army. To

the writers of such trifling and unfair paragraphs let me, one of the

fraternity in an amateurish way, beg consideration of the following.

The campaign that has been started is against a common enemy of

mankind, and of the American and English nations in particular. In our

successes in agriculture, manufacture, and commerce we have cultivated

insidious, luxurious temptations which bring all of us some ill and

many of us, or our loved ones, fatal disease and premature death. The

advance agent of these enemies of ours is Eating-and-drinking-too-much.

* * * * *

The officers and men of the army and the eminent scientists of our

country and those of all nationalities who have entered into the

campaign with us, and the great power of the sanitaria joining as

practical nurses, demonstrators, and exponents of the reform, are all

working for you and for everybody. It is voluntary service and has

already cost some of the volunteers much time and patience and also a

considerable sum in money.

* * * * *

You, gentlemen of the Press, wielders of the helpful or careless pen,

have a conspicuous pulpit and a far-reaching influence. No one can

escape you. In the search for the news of the day you are encountered

at every turn in your editorials or your paragraphs. In this campaign

we need your assistance to make the coöperation between the army and

science easy and effective. They are too busy working for you and your

best interest to stop to argue to correct your misunderstanding, but

the cause will feel the benefit of your assistance.

Encouragement has powerful influence in stimulating effort and also in

creating and conserving conditions in which men may “do their best.”

What we are trying to learn is, what man _may_ do, under favourable

conditions of knowledge and confidence, to relieve his body of the

_strain of energy-taxing labour_ in disposing of the waste _which any

excess of food imposes_. It is a constructive experiment and not a mere

statistical measurement. Appreciation and applause assist; doubt and

ridicule obstruct.

The soldiers and physiologists are too busy studying indigestion and

possible proteid poisoning and what-not-other causes of intemperance,

disease, and suffering to ask you to assist in spreading only serious

report and right suggestion relative to the importance and purport of

the investigation, but it is my privilege to ask it for the general

good.

* * * * *

Just another word of introduction and then will follow some

_postintroductory_ coincidences relative to the work in hand, and then

an attempt to lay out a ten-page chart of the personal responsibility

in the care of the body and the nourishment of the mind by aid of an

economic and most satisfactory nutrition, so as to make conservation

of energy as easy as possible and life well worth the living. The

scientific support from the pens of professional observers is, however,

the real meat of the book, for which compiler and reader alike are and

should be grateful.

* * * * *

In serving in the humanitarian ranks in a commonweal campaign one

should not need to use the concealment of modesty, nor should he fail

to speak with all frankness. What are the motives behind all this

energy to reform the eating habits of the people? The question has been

so often asked that it is better thus publicly answered.

No one concerned in the campaign has any personal monetary interest

in any kind of food, prepared or otherwise. The movement began in a

suggestion carried by an accidental word given to the author by a

friend, an old-time friend in Japan, and a friendship never to be

forgotten, as related in the author’s book “Menticulture.” Pursuit of

menticulture led further to the discovery that the best mental results

could not be accomplished in a body weakened by any indigestion, any

mal-assimilation of nutriment, any excess of the waste of indigestion.

Then came the quest for the causes of mal-nutrition, which were soon

found, by study of the natural sequences and by going behind the

hypotheses of text-book authority, to arise in the careless ingestion

of food, its neglect in the mouth, and the consequent glut of

unassimilable excess within the body, necessitating enormous expense

of brain and body energy to get rid of the excess.

When the secret of the potency for good of a rationally economic

alimentation was revealed to the author, was confirmed by several

colleagues of different ages and both sexes, and was tested by work

and endurance measurement, and also by the test time, it became

necessary to have given to it the indorsement of highest authority

in order to have the information credited. The new rediscovery was

a simple matter, something everybody thought they knew all about

because it had been under their nose all their life and was one of the

commonplaces of every-day living, but for that very reason it failed

to receive credence, and the backbone of the doubt was habit--lifelong

habit--and this was hard to break even in those who accepted the theory

of economic nutrition as a logical conviction. It was also necessary

to prove that it was not personal idiosyncrasy that favoured us, its

advocates.

It is in pursuit of the latter desideratum that the officers of the

army, the scientists, and the great humanitarian health-restoring

institutions have entered upon conclusive investigations, each in

their own way, to chart out a law of economy that will be generally

applicable and which, it is hoped, can be understood by kindergartners

and mothers for the benefit of the present and of coming generations.

* * * * *

It was just stated that no one concerned in the inquiry was interested

in any food product or in any personally profitable business concern,

and mention of the Battle Creek Sanitarium, so widely known as the

pioneer in fostering the pure food and prepared-cereal manufacture,

may cast a doubt upon the matter in the minds of those who do not

know that the Sanitarium organisation, in its every department, is a

philanthropic, humanitarian institution. It is the parent and feeder of

the American Medical Missionary Cause, which already has established

branches in something over sixty localities situated in or near large

cities in different parts of the world, chiefly America. By perpetual

charter all the profits revert to the spread of the work and the

employees serve for a mere pittance, deriving their major compensation

from enjoyment of the altruistic work.

* * * * *

The old prejudice against the human race which declared that “everybody

had an axe to grind,” that there was “a nigger in every woodpile,” and

such like slanders, must be modified in the light of recent altruistic

development. Altruism has always been existent and had a great new

birth with the beginning of our era, but it was never before so frankly

put upon a business basis as it is now, and this is fast being applied

to every department of business activity. It is now done, not in the

name of any particular creed or cult, or for future reward, but because

_it pays_--first, last, and all the time.

* * * * *

In the study and pursuit of menticulture the author has found that

working for the common good is as necessary to happiness as working for

self, and that the retroactivity and reciprocity of the idea multiplies

the profits indefinitely.

The sequence of profitable, altruistic interrelation is stated in the

“Explanation” of the chain of the A. B. C. Life Series, of which this

book is one of the links.

* * * * *

Aside from those actively engaged in the several investigations to whom

reference is often made, the author wishes to express special gratitude

to Sir Michael Foster and to Professor Henry Pickering Bowditch of

the Board of Scientific Assessors. Unselfish and unremitting in their

assistance and encouragement, the author’s work has been made easy

since their interest was enlisted.

Sir Michael, as Member of Parliament in England, and as a physiological

savant, knows that economic nutrition is the key to England’s welfare,

as well as the basic necessity of temperance, morality, health, and

efficiency, as is expressed in the two documents from him reproduced

in the “Report of a Plan for an International Investigation into

the Subject of Human Nutrition” and in his “Note” on the Cambridge

examination of the author and Dr. Van Someren at Cambridge University

laboratories, given herein.

Professor Bowditch, as a distinguished physiologist, publicist, and

especially as the President of the Children’s Aid Society, of Boston,

Massachusetts, often mentioned as the model institution of its kind

in the world, realises that the effort of the author to secure basic

knowledge relative to right nutrition, adaptable to kindergarten

teaching and home training during the impressionable period of youth,

is of the greatest importance in social reform.

A trial suggestion relative to ways and means of _beginning right_ with

_all the children_ and thus insuring a regeneration of the classes most

in need of reform, in not longer than two decades, is outlined in the

author’s appeal for the waifs of society, entitled “That Last Waif; or

Social Quarantine.”

Whenever there is any disposition to slack up in patience or enthusiasm

to accomplish the ultimate end aimed at, the picture of the waif

in that story is flashed back by memory, and there can be neither

forgetfulness, indifference, nor repose until “that last waif” has been

given _at least a chance of choosing_ between the right and the wrong,

the good and the bad.

POSTINTRODUCTORY

[Just before “going to press” the author has received a letter from

his esteemed colleague, Dr. Hubert Higgins, giving the gist of

interviews with an eminent European physiologist and with a famous

American chemist and dietitian, which so well describes the attitude

of the scientific mind towards the problem of human nutrition that the

scientific mentor of the writer advises its addition to the book.

By the same post there arrived a letter from Dr. J. H. Kellogg, the

life and director of the Battle Creek Sanitarium, expressing practical

appreciation, the result of demonstration, of what is being done to

solve the problem.

Eliminating the personal element and keeping the ultimate object in

view, these communications are coincidentally _a propos_ and intimate

to our “Introduction”; hence their reproduction here.

Numerous other letters and extracts from communications received by the

writer, bearing upon this subject, from the above and other sympathetic

friends are reproduced in “The New Glutton or Epicure,” a free and

easy companion of this book, intended to appeal to a variety of readers.

When it is known that the proceeds of all the publications of the

author are dedicated to the promotion of the objects they advocate,

reference to them or advertisement of them cannot be considered

inappropriate.—HORACE FLETCHER.]

EXTRACTS FROM DR. HIGGINS' LETTER

PALAZZINA TASSO,

CAMPO S. POLO,

VENEZIA.

October 3, 1903.

DEAR MR. FLETCHER,--A. appears to me to have an exceedingly broad and

philosophic grasp of the problem of nutrition.

He recognises that all present data are subject to criticism, and that

there are no scientifically accurate data available because

(_a_) Observations are taken over too short a period.

(_b_) They have mainly dealt with one side of the problem,--the output

of muscular work.

(_c_) The observations are not sufficiently complete.

He acknowledges that cleavage products from food broken down in the

intestines by bacteria are the cause of

(_a_) Inefficiency

(_b_) Diseases

(_c_) Mental derangements.

(See Mott’s work.)

He recognises that the majority of people eat far too much. He puts

this in the following way. If a “mediæval devil” had wished to discover

the most subtle and most effective way to destroy mankind mentally,

morally, and physically, he would have arranged for them to be supplied

with tasty, well-cooked foods, wines, etc.; in short, he would have

used every means to tempt, confuse, and pervert their appetite. He

would also have arranged every possible means to prevent their being in

the fresh air and taking exercise. He thinks one has here the picture

of modern civilisation.

He talked in a very interesting and instructive manner about the

necessity and value of exercise and a muscular body for the maintenance

of good health. He has evidently worked at and thought a good deal

about this side of the subject.

He regrets that there are not more people who realise the huge

importance of understanding the nutrition problem for the sake of

the progress of humanity. He would like to join all those who are

interested in forming an international society, as far as I understood

him.

He is most keen on getting subjects, such as myself, for study over

a very long period of time,--two to three years,--as he very justly

observed “Muscular output is a very small part of the measure of a

man’s efficiency. Mental efficiency, manual dexterity, and other

psychological tests are necessary.” He seemed very much interested in

my idea of making a large number of curves of daily observations. He

said that it appeared to him to offer the best means of ultimately

measuring the degree of deviation from the subject’s optimum state of

health.

He argues the necessity of getting some scientific definition of health.

* * * * *

The phrase that reduces all these people to contemplative silence is

this.

“You acknowledge that the state of knowledge is insufficient to

prescribe a diet for any individual that he should take daily; or

in other words, that there is very little accurate knowledge of the

nutrition problem.”

Reply. “Yes. I do not feel I could prescribe a diet for any one with

any degree of confidence.”

“Very well, then. Why should not the body have or acquire the quality

that all animals have, in a free, natural state, of knowing what their

body wants by appetite and taste?”

This is more or less how you put it to me when I first met you at

Cambridge. Its full significance did not dawn on me till much later;

till, in short, I commenced the study of my desires at Cambridge.

Now this point of view is the rock on which we stand, and is the cause

of H.'s and A.'s interest, and as H. said, is the “most fascinating

idea” he ever heard.

It had very much the same effect on A. He was reduced to silence. The

more you think of it the more you see there is no answer that could

contradict it.

_He then admits that_

(_a_) The food should be finely divided.

(_b_) That it should be thoroughly insalivated.

(_c_) That in all probability most diseases are caused by dietetic

error.

(_d_) That we have still to find the optimum health and the optimum

diet.

He only kicks at the low proteid. Now I don’t care a “kuss” for the low

proteid, as such, or high proteid. Proteid like everything else will

be demanded by the appetite when it is wanted.

Our great danger, to my mind, is the tendency so strongly exemplified

by some of prescribing diets and quantities and the length of time food

should be chewed.[1] Now the very errors we are fighting against are

the prescription of methods on insufficient information or knowledge.

_You have gone straight back to Nature._ _There is your strength_ in

convincing the scientific world, and we must study the problem from

that point of view if we are to get any great degree of success.

A. had nothing to say when I told him that I did not hold by either

high or low proteid but only by my appetite and taste, developed by

ample mouth opportunity to discriminate, which I hoped, in time, to

understand more thoroughly than I do now. He told me that he feared

that there would be great physical deterioration after a long period

of low proteid. I said that I did not believe it would be the case by

your method. For instance, right in the midst of a long period of most

satisfactory low-proteid supply, I once ate nearly a whole chicken

with some ham at Penegal. I could not get saliva for anything else.[2]

In short, then, I insisted only on thorough mastication to protect

taste and appetite, and had no other theories. I was only concerned

in observing the factors determining my taste and appetite. I would

be more than contented to leave the question of minimum and maximum

quantity of proteid to be settled in the future after normality had

been established by practical demonstration.

Yours faithfully,

HUBERT HIGGINS.

EXTRACTS FROM DR. KELLOGG’S LETTER

BATTLE CREEK, MICH.

October 7, 1903.

MR. HORACE FLETCHER.

DEAR FRIEND,--Yours of September 30th just reached my hands and I

hasten to reply.

I saw a newspaper note in reference to the soldiers which the

government has selected for the dietetic experiments, and also read

an interesting article in the _Popular Science Monthly_. You have

accomplished a great good thing in enlisting these scientific and

military men and interesting them in the investigation of this

wonderful reform. The marvellous thing about it is that these busy men

of science should have so readily undertaken an investigation which

involves so much surrender and self-denial, at least, at the start. I

know you are absolutely right. My personal experiences and observations

confirm me. In the experiments you mention, which I made in reference

to the daily ration for ordinary persons, I simply sought to ascertain,

as have others, how much and what kinds of food people are in the habit

of using, taking no account of the possible excess or the careless

manner in which they eat. The figures I got were sixteen ounces of

starch; 1.2 ounces fat, and three ounces proteids,--approximately 2,500

calories. In observation of patients I have seldom found one able to

eat this amount. Personally, I habitually eat scarcely half as much. My

breakfast to-day was the yolks of two eggs, two or three tablespoonfuls

of corn flakes, a moderate-sized potato, and a couple of peaches. At

dinner I shall take a little more.

I have been so busy with my patients and the new building, getting

things organised, that I have not done as much as I ought to in the

way of promoting your splendid reform; but I am going at it now in

good earnest. I feel it is one of the greatest things in sight, and it

fits right in to all the other things I am trying to do. I feel that

I owe you continually a great debt for the efforts you have made and

the splendid work you are doing, which will accomplish more for the

uplifting of humanity than all that Carnegie and Rockefeller are doing

with their millions. What they are doing is mainly to perpetuate old

errors, while you are bringing out new truth of basic importance, and a

kind Providence has certainly inspired you to do this grand work.

I thank you for all your good thoughts towards us, and assure you

the loving encouragement your letters always contain is very much

appreciated, and sometimes it gives us a mental uplift just when we

need it. The road we are travelling over is not altogether free from

thorns. All your suggestions are gratefully received. I remain,

Faithfully yours,

J. H. KELLOGG.

A. B.-Z. PRIMER

EXPLANATION

This is a condensed presentment of a subject of basic importance to

everyone, supported by numerous appendices of great scientific weight.

The special object of such brevity and elementary treatment of the

subject is:

=1.= To accentuate the facts showing how little we really have to know

and do in connection with our sustenance in order to have the NATURAL

AUTOMATIC PROCESSES done rightly and healthfully.

=2.= To permit busy persons who will take our dictum as gospel and our

advice as sound to learn their necessary share in their own nutrition

in the least possible time, leaving the less credulous and more curious

to study the appendices at leisure and at will.

=3.= For some ten years it has been the ambition and the aim of the

older and non-professional author to embody the fundamental essentials

of human responsibility in self-understanding and self-management in

not more than ten pages of coarse print that a child could understand

and that mothers and teachers might commit to memory and never forget.

This is only a first trial-attempt to fulfil the ambition and the aim;

but the appendices show the assembling and concentration of scientific

and militant forces which will not allow this subject of primal

human interest to remain longer the most neglected of educational

departments.

SOME PERTINENT QUESTIONS

Will the reader not ask himself the following questions?

=1.= How much do I know about my own nutrition?

=2.= Do I know the particular need and purpose of my last meal and what

it is likely to accomplish?

=3.= Considering my body as an engine, would I accept myself as a

competent engineer on my own examination and confession?

=4.= Were I an iron and steel automobile, instead of a flesh and blood

automobile, which I really am, could I get a license for myself, as a

_chauffeur_, to run myself with safety, based upon my knowledge of my

own mechanism and the theory and development of my power?

=5.= Were I an owner of valuable live-stock, would I employ a farm-hand

or a stable man, even at so low a wage as fifteen dollars a month, who

knew as little about the proper feeding of my animals as I know about

the proper feeding of myself and my children?

=6.= Should I employ such an ignorant attendant for my live-stock, and

catch him worrying them during their feeding, and hurrying them away

from their fodder to hitch them up for work, would I not have the man

arrested for cruelty to animals? And yet this is what is habitually

done to children!

=7.= Do I appreciate how important it is to learn sufficient of the

requirements of economic and healthy nutrition to enable me to escape

the depressing and debilitating effects of a faulty nutrition.

=8.= How can I religiously “ask a blessing” upon food and then

immediately sin by treating it in a manner abhorrent to the natural

requirements?

=9.= If “cleanliness is next to godliness” is it respectable for me to

slight my proper feeding in a manner that I know may induce putridity

of excreta through indigestion and that _may_ produce fatal disease?

=10.= With All Eternity ahead of me, cannot I afford at least 1∕48[3]

of my time for careful feeding of my body in a manner known to favour

physical health; mental keenness; firmness of character; enjoyable

temperance; sexual vigour without morbidity. In fact, general

respectability and efficiency?

Having duly reasoned out logical answers to the questions, may they not

seem sufficiently important to be remembered and respected as a DIETARY

TEN COMMANDMENTS?

A

The Psychology of Nutrition

APPETITE ATTENTION APPRECIATION

APPETITE is the most important factor in digestion (vide Pawlow).

NORMAL APPETITE is indicated by a desire for _some particular_ simple

food accompanied by a “watering of the mouth.”

FALSE APPETITE is a general discontent of the body, indefinite of

description. It is often expressed by “all gone-ness,” or stomach

craving, and calls for _something_, ANYTHING! to smother the discomfort

of present or recent indigestion. It is like the thirst which follows a

debauch.

IGNORE FALSE APPETITE, and WAIT for a RETURN of NORMAL APPETITE.

It will come as soon as body repairs have been effected by natural

agencies and more material is required. No one was ever injured by

intelligently and calmly waiting for an appetite. No one ever starved

to death for lack of appetite. Most human ills come from forcing

appetite, anticipating appetite, abuse of appetite in some form.

APPETITE is the most important factor in nutrition. This estimation is

based upon evidence given more fully in the various appendices, but the

measure of its importance may be briefly stated, as follows:—

_First_

In its normal state, Appetite is a perfect indicator of the bodily need

of nutriment and moisture, both as to quantity and as to the chemical

elements required at the moment.

_Second_

APPETITE is a creature of the mind and does not attach to a tissue.

It can be as easily changed, from abnormal to normal, by suggestion,

as can the mind itself, and is not like a solid, the form or habit

of which has been set in a mould. Whoever has once experienced a bad

oyster and has abhorred oysters ever after will substantiate this claim

regarding the caprices of appetite.

_Third_

APPETITE can be easily comprehended and read and the degrees of its

satisfaction understood by simple attention and study for a brief

period (vide Van Someren).

_Fourth_

ATTENTION is necessary to create APPRECIATION, and appreciation is

absolutely necessary to stimulate the secretion and flow of gastric and

other digestive juices (vide Pawlow).

_Fifth_

ANGER, or shock of any kind, and WORRY, or any of the pessimistic

depressants, stop digestive activity and cause indigestion (vide

Cannon).

_Sixth_

MENTICULTURE should begin with its application to selection (through

a normalised appetite) of nutriment for the body, and continue to aid

digestion by right thinking.

It is very easy to cultivate calm and fortify against surprise, shock,

and anger if the nutrition of the body is carefully attended to. The

physical and the mental equipments are beautifully reciprocal and

necessary to each other in promoting MENTICULTURE.

B

The Mechanical and Chemical Physiology of Nutrition

BUCCAL DIGESTION

THROUGH

MOUTH THOROUGHNESS

Mouth treatment of food, which permits, aids, and includes insalivation

(mixing with saliva), and which is both actively digestive in its

functions and preparatory to final digestion, is the only _actual

mechanical responsibility_ we have in our nutrition; and, in connection

with favourable A conditions, insures perfect digestion. It has been

so fully and clearly explained in some recent articles, “Observations

on Mastication,” by Dr. Harry Campbell, F.R.C.P., physician to the

Northwest London Hospital, printed in the “Lancet” of July 11th, 18th,

25th, and August 8th, 1903, that reference to the articles, reprinted

herewith, is all that is necessary here.

In giving attention to careful mouth-treatment of soft or liquid foods

until they are absorbed by the Swallowing Impulse the best health and

economic results are obtained. It should, at least, be tried.

This will not be found to be a tedious operation after a little

practice, when the habit of attention and care has been formed. On the

contrary, a new appreciation and enjoyment of taste will be acquired,

the delight of which has to be experienced to be understood.

Some hints on learning how to _read_ the appetite, _command_ the

attention, and _masticate_ and _swallow_ food material _properly_

follow.

METHOD

_First; Last; and All the Time_

Be sure that you are really hungry and are not pampering False

Appetite. If true appetite that will relish plain bread alone is

not present, wait for it. Especially beware of the early-morning

habit-craving. Wait for an _earned_ appetite, if you have to wait till

noon. Then: “Chew,” “Masticate,” “Munch,” “Bite,” “Taste” everything

you take in your mouth (except water, _which has no taste_), until

it is not only thoroughly liquefied and made neutral or alkaline

by saliva, but until the reduced substance all settles back in the

(glosso-epiglottidean) folds at the back of the mouth and excites

the Swallowing Impulse into a strong inclination to swallow. Then

swallow what has collected and has excited the impulse, and continue

to chew _at_ the remainder, liquid though it be, until the last morsel

disappears in response to the Swallowing Impulse. Never forcibly

swallow anything that the instincts connected with the mouth show any

disposition to reject. It is safer to get rid of it beforehand than to

risk putting it into the stomach.

Sip and taste milk and all liquids that have taste as the wine-tasters

do. They never drink wine and yet they get all the enjoyment there is

in it and waste none. In a very short time sipping and tasting liquids

and masticating and tasting solid food for “all they are worth” will

become an agreeable and profitable fixed habit.

WHETHER WE “EAT TO LIVE OR LIVE TO EAT,” WHY NOT DO AS ABOVE?

Z

The True Chemical End-Point of Digestion

THE DIGESTION-ASH WHAT IT SHOULD BE LIKE WHEN IT IS NORMAL

_First_

In adults; or, in children after the eruption of teeth and the

ingestion of solid food: The non-liquid and non-gaseous waste of the

human body, which, in its normal state, is not offensive, should be

very small, in quantity, should be pillular in form, either separate or

massed together; should have no odour when released, should take on no

odour on standing, should be entirely aseptic (non-poisonous); should

drop freely from the exit, leaving nothing behind to wash or wipe away.

It _may_ not be collected in the intestines of full-grown and elderly

persons, when normal, as above, in sufficient quantity to require or

necessitate emptying oftener than from twice a week to once in two

weeks; according to age, activity, etc.; and should neither invite nor

justify the description “it is not that which goeth into a man that

defileth him but that which cometh out.”

_Second_

Economic Digestion-Ash (solid _excreta_), as a daily average for an

adult of 140 lbs. (10 stone; 63.5 kilos), including moisture, when

released, should not weigh more than two ounces (56.70 grams). An

average of less than one half this amount of waste has been secured in

test experiments.

_Third_

The true test of healthy Z is absence of odour and completeness, ease

and cleanliness of delivery. Frequency or otherwise, does not so much

matter. Quantity too, is not so important; but with foul odour there is

disturbance, strain and danger.

The normal man is a cleanly being with all excreta inoffensive; and by

these tokens he may be his own private judge.

Why is it that barn-yards are tolerable to the human senses while open

_dépôts_ of human excreta are fever-breeding nuisances and intolerable

to beasts and humans alike?

This curse of putrid excreta caused more deaths from enteric fever

during the Boer War in South Africa than all other causes. It is

equally a menace to health and even to life while being formed and

carried in the body.

_Fourth_

Offensive excreta are quite certain evidence of neglect of the

self-controllable parts of our own nutrition. They are the tell-tale

condemnation of ignorance or carelessness. Each person should learn to

read the true bulletins of his health conditions in his waste-products

of digestion.

Z

is the form the body _must_ assume to render emptying of the

digestion-ash natural and easy. Man was built to squat on his heels in

defecating, and sitting erect on a modern seat is like trying to force

a semi-solid through a kinked hose. HEALTHY HUMAN EXCRETA ARE NO MORE

OFFENSIVE THAN MOIST CLAY AND HAVE NO MORE ODOUR THAN A HOT BISCUIT.

A. B.-Z. FIGURE

TO ILLUSTRATE THE “DIVISION OF LABOUR”

_First._ A

Psychic Environment } This

Mental State } involves:

APPETITE (to select for) }

ATTENTION (to prepare for) } DIGESTION

APPRECIATION (to assist in) }

(Absolutely necessary to secure secretion and flow of the digestive

juices: Vide Pawlow and Cannon.)

_Second._ B

BUCCAL-DIGESTION } This

MOUTH-TREATMENT } involves:

MECHANICAL (teeth) } THOROUGHNESS

CHEMICAL (salival) }

(Absolutely necessary to secure complete digestion and avoid the

putridity incident to bacterial decomposition: Vide Campbell and Van

Someren.)

INTERMEDIATE

The twenty-three letters between “=B=” and “=Z=” represent but an

inadequate proportion for the spelling of the enormous share Nature

assumes in our welfare, marvellously performing her forty-seven

forty-eighths share in the secret laboratory of the alimentary canal.

_Third._ Z

The true chemical end-point of digestion, by which each self-respecter

may know how well he has respected his “A” and his “B,” and how

faithfully he has performed his one forty-eighth share in the promotion

of his own most fundamental interest.

PREFACE TO 1906 EDITIONS

Since the former introductions were written much success has been

attained in further advancing the reforms advocated in the _A. B. C.

Life Series_. Professor Chittenden has published his report on the

Yale experiments in book form in both America[4] and England,[5] and

his results have been accepted in scientific circles the world over as

authoritatively conclusive.

At the present writing the most important Health Boards of Europe[6]

are planning to put the new standards of dietary economy into practical

use among public charges in a manner that can only result in benefit

to the wards of the nations as well as make an important saving to

the tax-payers. In the most important of these foreign public health

departments the Health Officer of the Board has himself practised the

newly established economy for two years, and his plans are formulated

on personal experience which fully confirms Professor Chittenden’s

report and that of the author as herein related.

At a missionary agricultural college, situated near Nashville, Tenn.,

where the students earn their tuition and their board while pursuing

their studies, a six months' test of what is termed “Fletcherism”

resulted in a saving of about one half of the drafts on the commissary,

immunity from illness, increased energy, strength and endurance, and

general adoption of the suggestions published in the several books of

the author included in the _A. B. C. Life Series_.

In the various departments and branches of the Battle Creek Sanitarium

in America, and widely scattered over the world, some eight hundred

employees and thousands of patients have been accumulating evidence of

the efficacy of “Fletcherism” for more than three years, and scarce a

month passes without a letter from Dr. Kellogg to the author containing

new testimony confirming the _A. B. C._ selections and suggestions.

The author has received within the past two years more than a thousand

letters bearing the approval of the writers with report of benefits

received which seem almost miraculous, and these include the leaders in

many branches of human occupation--physiologists, surgeons, medical

practitioners, artists, business men, literary workers, athletes,

working men and women, and almost every degree of mental and physical

activity.

One of the medical advisers of King Edward, of whom the King once said:

“He is a splendid doctor but a poor courtier,” follows the suggestions

of these books in prescribing to his sumptuous clients.

HISTORY OF DEVELOPMENT

AND

SUPPORTING EVIDENCE

SUMMARY OF THE FOREGOING PAGES BY AN EXPERIMENTER OF ONE MONTH’S

EXPERIENCE

(_Requested and given as a test of effectiveness_)

The entire principle of economic nutrition is simple and practical. It

does not prescribe that we shall follow any special diet nor do away

with any of our meals. It simply requires you to throw present habits

and conventions to the winds, and for a little time try the experiment

of giving the matter of your every-day living honest, intelligent

thought.

Eat all you crave, but do not eat more than this simply because you

have been in the habit of doing so. See to it that each morsel put into

your mouth is thoroughly masticated and mixed with the saliva before

going down into the stomach, which is not equipped to perform the work

which the teeth and salivary glands were given you for. The stomach

will struggle bravely to overcome the abuse which you heap upon it, but

in spite of all it can do to manage hastily chewed food, undigested

portions remain which clog the intestines and interfere with the

healthy conditions which Nature intended.

The appetite is given as an indicator of what the body requires. If

you crave potato, the system needs starch, which the saliva makes

digestible, but which the acids of the stomach cannot dissolve. Other

needs of the system are similarly indicated. Take the trouble of asking

your appetite the question, instead of accepting the conventional

number of courses simply because they are set before you. The appetite

will close the valve when you have eaten enough, if you will give it a

chance.

Suppose your time for eating is limited; in twenty minutes you could

not eat slowly the luncheon which you usually select. Then eat that

much less. The amount of food which you can eat and thoroughly

masticate in twenty minutes will give you more nourishment and will

sustain you better than twice the amount thrown into the stomach in the

same manner in which a man usually packs a trunk.

Why is it that so many men require a “bracer” at eleven o’clock?

Because they have loaded their stomachs with a heavy breakfast, and

instead of gaining nourishment from it, the smothered organ is doing

its best to tear the undigested morsels to pieces, that they may pass

into the intestines and prevent sickness, or even death. The time

finally arrives when it finds itself unable to do this, and then comes

acute indigestion, or something worse, and the system becomes run down,

ready to receive typhoid, or any other germs which happen to come along.

Do you know why griddle-cakes hurt you? Because the syrup, which is

cane-sugar,--and as such is indigestible,--is allowed to pass through

the mouth and down into the stomach, without being properly mixed with

the saliva, which makes it digestible. As soon as it enters the stomach

it becomes acid and interferes with everything it meets. Had the cakes

been properly masticated and mixed with the saliva, the cane-sugar

would have become grape-sugar, and in this form it is easily digested.

Why is it that stout people are advised to avoid starchy foods?

Economic nutrition does not advise this. Potatoes, eaten too

hastily, when not craved by the appetite, supply the system with a

superabundance of starch, and this is fat-inducing. Potatoes are

supposed to produce fat; but if your appetite craves potato, and you

properly masticate it, eating only as much of it as satisfies your

appetite, the system absorbs it all, leaving nothing to produce fat.

On this same principle economic nutrition assures that the same food,

taken in accordance with its requirements, will add to one man’s

weight and decrease another’s, simply because proper care of the

stomach supplies the vital organs with the necessary materials to form

each individual person after the model which Nature intended for him.

If Nature intended him to be slight, economic nutrition will not make

him heavy; if Nature intended him to be muscularly strong and heavy,

economic nutrition will not reduce his weight. In each case he will

enjoy that perfect condition which Nature intended him to possess

without fat encumbrance.

Did you ever try to reason out why it is necessary for athletes to go

into training? Simply because, in order to get the best use of their

strength, they are obliged to spend some number of weeks or months in

overcoming false conditions which they have brought upon themselves.

Any person who lives in accordance with the simple requirements of

economic nutrition has nothing of this kind to overcome, but is in

perfect condition all the time.

The requirements of economic nutrition are not hardships but pleasures.

Proper mastication and insalivation (mixing with saliva), give your

sense of taste far greater gastronomic enjoyment than you have ever

before had. If you are a wine drinker, try insalivating a little port

wine; but it must be good wine, for this is a severe test. A sip will

quench your immediate desire and give you more pleasure than a whole

glass gulped down. The professional tea-taster does this in tasting

tea; he never allows himself to drink any tea at all, for drinking

anything that has taste destroys the delicacy of the sense of taste.

But he will tell you that he gets more real enjoyment out of the little

he takes than he previously gained from drinking a larger amount. The

same thing applies to the professional wine-tasters; they never drink

any wine, and yet they enjoy the taste of wine as drinkers never can

do. These men adopt this method as a business; is their commercial

advantage of greater importance than your health and happiness, and

even life itself?

Is it not ridiculous that the average man is so ignorant of the engine

which supplies him with all his activity and upon which depends every

action of his life? Could you tell, were you asked, the particular need

and purpose of your last meal and what it is likely to accomplish?

Consider your body as an engine: would you accept yourself as a

competent engineer on your own examination and confession? Would you

employ a chauffeur to run your automobile who knew as little about its

mechanism and requirements as you do about your own stomach? Yet which

is of greater importance? Were you the owner of valuable live-stock,

would you dare entrust their care to a farm-hand or stableman who knew

as little about their proper feeding as you know about your own proper

feeding or that of your children?

Have you ever stopped to think why the excrements are foul and odorous?

Simply because undigested food, which should have been so masticated

as to give the body nourishment, is thrown off by the stomach into the

intestines, there to decay and produce this unclean condition. If the

dead carcass of a cow is lying in the road, it is removed before it has

an opportunity to decay and thus become filthy and dangerous. Yet how

much more safe it would be for the carcass to lie where it was than

for you to take portions of it into your intestines and allow it to

decay there instead of in the road? In other words, food is intended

to be eaten that nourishment may be gained from it, and when you only

gain a part of the nourishment, you prostitute your stomach and take

tremendous risks of germ diseases in your body.

These facts are set forward thus simply in the hope that they may

impress the reader as they have impressed the writer. Economic

nutrition is not a joke, is not a fad; it is solely an appeal to

self-examination and self-instruction in the most vital question of

all the world, since upon perfect nutrition depends not only health,

but strength, mental acuteness, moral tendencies, attractability to

others, happiness, and, in fact, life itself.

FIRST SCIENTIFIC RECOGNITION OF THE PRINCIPLES OF ECONOMIC NUTRITION

OUTLINED IN “GLUTTON OR EPICURE”

[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.]

WAS LUIGI CORNARO RIGHT?

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 diet, potatoes,

eggs, milk, and cream:

═════════════════════════╤══════════════════════════╤═══════════════

│ Dr. Snyder’s │

│ Experiment. │ Writer’s

│ Published in │ Experiment.

│ Bulletin 43 │

—————————————————————————┼————─—─—─—─—─—────—─—─—─—─┼─—─—─—───—─—─—─

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.

THE CAMBRIDGE TESTS

[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.]

EXPERIMENTS UPON HUMAN NUTRITION

NOTE BY SIR MICHAEL FOSTER, K.C.B., M.P., F.R.S.

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.

REPORT OF A PLAN FOR THE INSTITUTION OF AN INTERNATIONAL INQUIRY INTO

THE SUBJECT OF HUMAN NUTRITION

[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.]

PROPOSAL TO FOUND AN INTERNATIONAL LABORATORY OF RESEARCH FOR THE

STUDY OF NUTRITION IN ALL ITS ASPECTS

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.

OUTLINE OF THE PROPOSED SUBJECTS OF RESEARCH TO BE UNDERTAKEN IN THE

PROPOSED INTERNATIONAL LABORATORY

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.

ESTIMATES FOR THE PROPOSED LABORATORY

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.

SUGGESTIONS AS TO DESIRABILITY OF LOCATION

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.

SUGGESTIONS AS TO MANAGEMENT OF THE PROPOSED INTERNATIONAL INSTITUTE

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:—

[Illustration: Signatures]

NATIONALITY AND SCIENTIFIC TITLES OF OUR BOARD OF SCIENTIFIC ASSESSORS

SIR MICHAEL FOSTER, M.D., K.C.B., F.R.S., M.P., etc. Late Professor of

Physiology, University of Cambridge, England; Secretary of the Royal

Society; Permanent Honorary President of the International Congress of

Physiologists, etc.

DR. PROFESSOR ANGELO MOSSO. Professor of Physiology, University of

Turin, Italy; Director of the Regina Margherita Biological Station on

the summit of Monte Rosa, etc.

DR. PROFESSOR HUGO KRONECKER. Professor of Physiology, University of

Berne, Berne, Switzerland, etc.

DR. PROFESSOR N. ZUNTZ. Professor of Physiology, Berlin, Germany, etc.

DR. PROFESSOR PAUL HEGER. Professor of Physiology, Brussels, Belgium;

Director of the Solvay Sociological Institute, Brussels.

DR. PROFESSOR A. DASTRE. Professor of Physiology, Universitie de la

Sorbonne, Paris, France, etc.

DR. PROFESSOR HENRY PICKERING BOWDITCH, Professor of Physiology,

Harvard Medical School; Second President American Physiological

Society; President of the Children’s Aid Society, Boston, Mass., etc.

PROFESSOR RUSSELL H. CHITTENDEN. Director Sheffield Scientific School

of Yale University; Professor of Physiological Chemistry in Yale;

Present President of the American Physiological Society, etc.

DR. PROFESSOR WILLIAM H. WELCH. Professor of Pathology in Johns

Hopkins University, Baltimore, Maryland; President of the Rockefeller

Institute of Preventive Medicine, etc.

DR. PROFESSOR J. P. PAWLOW. Director of the Department of Experimental

Physiology in the Russian Imperial Military School of Medicine, etc.

PERSISTENT SCIENTIFIC DOUBTS

[Notwithstanding the report of the Cambridge examination of the

claims for an economic nutrition advanced by the authors, American

physiologists were still doubtful if a nitrogenous economy like that

reported could be maintained, and the writer was invited to submit

to further tests at the Physiological Laboratory of Yale University,

under direction of Professor Russell H. Chittenden, Director of

the Sheffield Scientific School, and President of the American

Physiological Society, and Dr. Lafayette B. Mendel.

The following article, first published in the _Popular Science

Monthly_, June, 1903, is a report of that test, and indicates a

desire to carry the investigation further to include a variety of

test-subjects.

In response to Professor Chittenden’s request, the Trustees of the

Bache Fund of the National Academy of Sciences appropriated $1000

towards a more extended inquiry; and other means having been assured,

a project of experiments was taken under consideration.

One of the difficulties encountered was the control of test-subjects

for a sufficiently long time to make conclusive estimates relative

to the minimum needs of nitrogenous food in relation to the common

occupations of life. Few if any volunteers, with the leisure and

interest fortunately possessed by the writer, were available outside

the laboratory force itself, and there were serious objections to

using for test-subjects the same persons who did the chemical analyses

and estimated the results.

In this dilemma the good fortune of a meeting with Surgeon-General

O’Reilly of the United States Army and with General Leonard Wood--the

former on his way to Madrid to attend a medical congress, and the

latter _en route_ to the Philippines to take command there--happened

to the writer on the S. S. _Commonwealth_, on a voyage to Italy in

April, 1903.

Both these officers are medical men and research enthusiasts. They had

fought yellow fever together, in coöperation with martyr Dr. Major

Walter Reed, in Cuba, and the fame of their success was being talked

of as one of the great triumphs of pathologic, or hygienic, science at

the time of the meeting.

There was ample time on the steamer to discuss a subject of such

mutual and general interest, and both officers had had, in service,

experiences that led them to believe that the results obtained by the

writer and his colleagues were the common possibilities of all persons

under right conditions of alimentation.

General O’Reilly was of the opinion that the corps he commanded

could furnish intelligent and earnest test-subjects for nutrition

investigation, as it did in the yellow fever case. In the yellow fever

investigation privates and officers alike had volunteered to act as

test-subjects, even though their lives were at stake and many had

already been sacrificed. It is to their great honour, also, that they

refused to receive the bounty that was offered for test-subjects,

preferring to serve science and humanity freely as volunteers rather

than sell themselves as experimental risks. From such material General

O’Reilly was sure that capable assistants could be secured to test the

not at all dangerous or disagreeable economies of nutrition that the

projected inquiry wished to solve.

Armed with letters of recommendation to the President and to

the Secretary of War from General Wood, and an invitation from

Surgeon-General O’Reilly to call on him if coöperation on his part

were desired, the writer returned to the United States and consulted

with Professors Chittenden and Bowditch relative to the desirability

of army coöperation. It was believed to be just the thing wanted to

facilitate the inquiry, and the writer proceeded to Washington to

effect the combination.

General O’Reilly had already had the matter under consideration and

was quite ready to draw up a project for presentation to the Secretary

of War when Mr. Root should return to Washington from his summer

vacation.

Twenty privates and three non-commissioned officers of the Hospital

Corps of the United States Army under command of Dr. Lieutenant

Wallace DeWitt are now quartered at New Haven in coöperation with

the staff of the Sheffield Scientific School. It is the intention

to learn, if possible, how little nitrogen is necessary to secure

the best human efficiency; and also, if possible, to ascertain some

measure of the evil effects of an excess of nitrogenous food as well

as excess of food in general upon human efficiency.

The writer is grateful for the good fortune of being able to be of

service in a development of interest in a subject which is of vital

importance to the human race. He has enjoyed the benefits of an

economic nutrition and knows its value.

The practical proof of a subject of personal application must come

from such personal application. Each person must be his own doctor and

his own scientist in the matter of his alimentation or he runs the

risk of running amuck in his health economy. There is not so much to

learn, neither is there very much to do to insure right alimentation,

perfect digestion, and continuous good health; but the little required

of us must be attended to with no lapses of attention.—HORACE

FLETCHER.]

PHYSIOLOGICAL ECONOMY IN NUTRITION

BY RUSSELL H. CHITTENDEN

_Director of the Sheffield Scientific School of Yale University_

Among the many problems awaiting solution, none is of greater

importance for the welfare of the individual and of the race than

that which relates to the proper nutrition of the body. Man eats to

live and to gain strength for his daily work, and without sufficient

nutriment the machinery of the body cannot be run smoothly or with

proper efficiency. The taking of an excess of food, on the other hand,

is just as harmful as insufficient nourishment, involving, as it does,

not only wasteful expenditure but, what is even of greater moment, an

expenditure of energy on the part of the body, which may in the long

run prove disastrous. While it is the function of food to supply the

material from which the body can derive the necessary energy for its

varied activities, any excess of food over and above what is needed to

make good the loss incidental to life and daily activity is just so

much of an incubus, which is bound to detract from the smooth running

of the machinery and to diminish the fitness of the body for performing

its normal functions.

A proper physiological condition begets a moral, mental, and physical

fitness which cannot be attained in any other way. Further, it must be

remembered that lack of a proper physiological condition of the body

is more broadly responsible for moral, social, mental, and physical

ills than any other factor that can be named. Poverty and vice on

ultimate analysis may often be traced to a perversion of nutrition.

A healthy state of the body is a necessary concomitant of mental and

moral vigour, as well as of physical strength. Abnormal methods of

living are often the accompaniment or forerunner of vicious tastes

that might never have been developed under more strictly physiological

conditions. Health, strength (mental and physical), and moral tone

alike depend upon the proper fulfilment of the laws of nature, and it

is the manifest duty of a people hoping for the fullest development

of physical, mental, and moral strength to ascertain the character of

these laws with a view to their proper observance. Poverty, crime,

physical ills, and a blunted or perverted moral sense are the penalties

we may be called upon to pay for the disobedience to Nature’s laws;

penalties which not only _we_ may have to pay, but which may be passed

down to succeeding generations, thereby influencing the lives of those

yet unborn.

There is to-day great need for a thorough physiological study of those

laws of nutrition which constitute the foundation of good living.

It is a subject full of interest and promise for the sociologist

and economist, as well as for the physiologist. We need a far more

complete knowledge than we possess at present of the laws governing

nutrition; we need fuller knowledge of the methods by which the most

complete, satisfactory, and economical utilisation of the diet can be

obtained; we need to know more concerning the minimum diet and the

minimum amount of proteid or albuminous foods on which health, mental

and physical vigour can be permanently maintained; we need to know

more fully concerning the influence of various forms of food on growth

and recuperative power; we need more complete knowledge regarding the

rôle of various dietetic and digestive habits, fixed or acquired; the

effects of thorough mastication, insalivation, and the influence of

two versus three meals a day upon the utilisation of food and hence

upon the bodily health. Further, we need more concise information as

to the effect of the mental state upon digestion and nutrition. These

and many other problems of a like nature confront us when we attempt

to trace the influence of a proper nutrition upon the condition of the

body. These problems, however, all admit of solution, and in their

solution undoubtedly lies the remedy for many of the personal ills of

mankind.

The foregoing thoughts have been suggested by observations recently

made in the writer’s laboratory on the amount and character of the

food actually required by a healthy man in the maintenance of bodily

equilibrium in periods of rest and physical work. Our ideas at present

are based primarily upon observations as to what civilised peoples are

accustomed to do, and not upon what they need to do in order to meet

the demands made upon the body. Sir William Roberts has well said that

the palate is the dietetic conscience, but he adds that there are many

misfit palates, and we may well query whether our dietetic consciences

have not become generally perverted through a false mode of living. The

well-nigh universal habit of catering to our appetite on all occasions,

of bowing to the fancied dictates of our palates even to the extent of

satiety, and without regard to the physiological needs of the body,

may quite naturally have resulted in a false standard of living, in

which we have departed widely from the proper laws of nutrition.

Statistical studies carried out on large groups of individuals by

various physiologists have led to the general acceptance of dietary

standards, such as those proposed by Voit, of Munich, and Atwater in

this country. Thus the Voit diet for a man doing moderate work is 118

grams of proteid or albuminous food, 56 grams of fat, and 500 grams

of carbohydrates, such as sugar and starch, with a total fuel value

of 3,055 large calories or heat units per day. With hard work, Voit

increases the daily requirement to 145 grams of proteid, 160 grams of

fat, and 450 grams of carbohydrates, with a total fuel value of 3,370

large calories. Atwater, on the other hand, from his large number of

observations, is inclined to place the daily proteid requirement at

125 grams, with sufficient fat and carbohydrate to equal a total fuel

value of 3,500 large calories for a man doing a moderate amount of

work; while for a man at hard work the daily diet is increased to 150

grams of proteid, and with fats and carbohydrates to yield a total

fuel value of 4,500 large calories. These standards are very generally

accepted as being the requirement for the average individual under the

given conditions of work, and it may be that these figures actually

represent the daily needs of the body. Suppose, on the other hand, that

we have in these figures false standards, or, in other words, that the

quantities of food-stuffs called for are altogether larger than the

actual demands of the body require. In this case there is a positive

waste of valuable food material which we may calculate in dollars

and cents; a loss of income incurred daily which might be expended

more profitably in other directions. To the wage-earner with a large

family, who must of necessity husband his resources, there is in our

hypothesis a suggestion of material gain not to be disregarded. The

money thus saved might be expended for the education of the children,

for the purchase of household treasures tending to elevate the moral

and mental state of the occupants, or in many other ways that the

imagination can easily supply. This kind of saving, however, is purely

a question of economy, and in some strata of society would be objected

to as indicative of a condition of sordidness. It has come to be a

part of our personal pride to have a well-supplied table, and to eat

largely and freely of the good things provided. The poorer man takes

pride in furnishing his family with a diet rich in expensive articles

of food, and imagines that by so doing he is inciting them to heartier

consumption and to increased health and strength. He would be ashamed

to save in this way, under the honest belief that by so doing he

might endanger the health of his dear ones. But let us suppose that

this hypothetical waste of food is not merely uneconomical, that it is

undesirable for other and weightier reasons. Indeed, let us suppose

that this unnecessary consumption of food is distinctly harmful to the

body, that it is physiologically uneconomical, and that in our efforts

to maintain a high degree of efficiency we are in reality putting upon

the machinery of the body a heavy and entirely uncalled-for strain,

which is bound to prove more or less detrimental. If there is truth in

this assumption, our hypothesis takes on a deeper significance, and we

may well inquire whether there are any reasonable grounds for doubting

the accuracy of our present dietary standards.

In this connection it is to be remembered that the food of mankind may

be classified under three heads, viz., _proteid or albuminous_, such

as meat, eggs, casein of milk, gluten of bread, and various vegetable

proteids; _carbohydrates_, as sugar and the starches of our cereals,

and _fats_, including those of both animal and vegetable origin. The

proteids are characterised by containing nitrogen (about 16 per cent),

while the fats and carbohydrates contain only carbon, hydrogen, and

oxygen. The two latter classes of food-stuffs are burned up in the

body, when completely utilised, to carbonic acid (a gas) and water,

while the proteid foods, beside yielding carbonic acid and water,

give off practically all of their nitrogen in the form of crystalline

nitrogenous products in the excreta of the body. Proteid foods have a

particular function to perform, viz., to supply the waste of proteid

matter from the active tissues of the body, and this function can be

performed only by the proteid foods; hence the latter are essential

food-stuffs without which the body cannot long survive. Fats and

carbohydrates, on the other hand, are mainly of value for the energy

they yield on oxidation, and in this connection it is to be remembered

that the fuel value of fats per gram is much larger than that of

carbohydrates, viz., 9.3: 4.1, or more than twice as great. Further,

it is to be noted that the various food-stuffs cannot be utilised

directly by the body, but they must first be digested, then absorbed

and assimilated, after which they gradually, in their changed form,

undergo decomposition with liberation of their contained energy, which

may manifest itself in the form of heat or of mechanical work. The

thoroughness with which foods are digested and utilised in the body

must therefore count for a great deal in determining their dietetic or

nutritive value. Moreover, it is easy to see how an excess of proteid

food will give rise to a large proportion of nitrogenous waste matter,

which, floating through the system prior to excretion, may, by acting

on the nervous system and other parts of the body, produce disagreeable

results. A mere excess of food, even of the non-nitrogenous variety,

must entail a large amount of unnecessary work, thereby using up

a proportional amount of energy for its own disposal, since once

introduced into the body it must be digested and absorbed, otherwise it

undergoes fermentation and putrefaction in the stomach and intestines,

causing countless troubles. When absorbed in quantities beyond the real

needs of the body, it may be temporarily deposited as fat; but why

load up the system with unnecessary material, thereby interfering with

the free running of the machinery? In other words, it is very evident

that the taking in of food in quantities beyond the physiological

requirements is undesirable, and may prove exceedingly injurious. It

is truly uneconomical, and defeats the very ends we aim to attain.

Instead of adding to the bodily vigour and increasing the fitness of

the organism to do its daily work, we are really hampering the delicate

mechanism, upon the smooth running of which so much depends.

Why, now, should we assume that a daily diet of over 100 grams of

proteid, with fats and carbohydrates sufficient to make up a fuel

value of over 3,000 large calories, is a necessary requisite for

bodily vigour and physical and mental fitness? Mainly because of the

supposition that true dietary standards may be learned by observing

the relative amounts of nutrients actually consumed by a large number

of individuals so situated that the choice of food is unrestricted.

But this does not constitute very sound evidence. It certainly is not

above criticism. We may well ask ourselves whether man has yet learned

wisdom with regard to himself, and whether his instincts or appetites

are to be entirely trusted as safe guides to follow in the matter

of his own nutrition. The experiments of Kumagawa, Sivén, and other

physiologists, have certainly shown that men may live and thrive, for

a time at least, on amounts of proteid per day equal to only one-half

and one-quarter the amount called for in the Voit standard. Sivén’s

experiments, in particular, certainly indicate that the human organism

can maintain itself in nitrogenous equilibrium with far smaller amounts

of proteid in the diet than is ordinarily taught, and, further, that

this condition can be attained without unduly increasing the total

calories of the food intake. Such investigations, however, have always

called forth critical comment from writers on nutrition, indicating

a reluctance to depart from the current doctrines of the Voit or

Munich school; and, indeed, it may justly be claimed that the ordinary

nutrition experiments, extending over short periods of time, are not

entirely adequate to prove the effect of a given set of conditions when

the latter are continued for months or years. Thus, Schäfer writes:

“It may be doubted whether a diet which includes considerably less

proteid than 100 grams for the twenty-four hours could maintain a man

of average size and weight for an indefinite time. It has frequently

been asserted that many Asiatics consume a very much smaller proportion

of proteid than is the case with Europeans. The inhabitants of India,

Japan, and China chiefly consume rice as the normal constituent of

their diet, which contains relatively little proteid; and this has

been advanced as an argument in favour of the view that the minimal

amount of proteid is much less than that ordinarily given as essential

to the maintenance of nutritive equilibrium. It must, however, be

stated that we have no definite statistics to show that, in proportion

to their body-weight, Asiatics doing the same amount of work as

Europeans require a less amount of proteids; indeed such evidence as is

forthcoming is rather in favor of the opposite view.” This statement is

typical of the attitude of physiologists in general on this important

subject. Why not candidly admit that the matter is in doubt, and,

with a due recognition of the importance of the subject, attempt to

ascertain the real truth of the matter?

The writer has had in his laboratory for several months past a

gentleman (H. F.) who has for some five years, in pursuit of a study

of the subject of human nutrition, practised a certain degree of

abstinence in the taking of food and attained important economy with,

as he believes, great gain in bodily and mental vigour, and with marked

improvement in his general health. Under his new method of living he

finds himself possessed of a peculiar fitness for work of all kinds,

and with freedom from the ordinary fatigue incidental to extra physical

exertion. In using the word abstinence possibly a wrong impression

is given, for the habits of life now followed have resulted in the

disappearance of the ordinary craving for food. In other words, the

gentleman in question fully satisfies his appetite, but no longer

desires the amount of food consumed by most individuals.

For a period of thirteen days, in January, he was under observation in

the writer’s laboratory, his excretions being analysed daily with a

view to ascertaining the exact amount of proteid consumed. The results

showed that the average daily amount of proteid metabolised was 41.25

grams, the body-weight (165 pounds) remaining practically constant.

Especially noteworthy, also, was the very complete utilisation of the

proteid food during this period of observation. It will be observed

here that the daily amount of proteid food taken was less than one half

that of the minimum Voit standard, and it should also be mentioned that

this apparent deficiency in proteid food was not made good by any large

consumption of fats or carbohydrates. Further, there was no restriction

in diet. On the contrary, there was perfect freedom of choice, and the

instructions given were to follow his usual dietetic habits. Analysis

of the excretions showed an output of nitrogen equal to the breaking

down of 41.25 grams of proteid per day as an average, the extremes

being 33.06 grams and 47.05 grams of proteid.

In February a more thorough series of observations was made, involving

a careful analysis of the daily diet, together with analysis of

the excreta, so that not alone the proteid consumption might be

ascertained, but likewise the total intake of fats and carbohydrates.

The diet consumed was quite simple, and consisted merely of a prepared

cereal food, milk, and maple sugar. This diet was taken twice a day

for seven days, and was selected by the subject as giving sufficient

variety for his needs and quite in accord with his taste. No attempt

was made to conform to any given standard of quantity, but the subject

took each day such amounts of the above foods as his appetite craved.

Each portion taken, however, was carefully weighed in the laboratory,

the chemical composition of the food determined, and the fuel value

calculated by the usual methods.

The following table gives the daily intake of proteids, fats, and

carbohydrates for six days, together with the calculated fuel value,

and also the nitrogen intake, together with the nitrogen output through

the excreta. Many other data were obtained showing diminished excretion

of uric acid, ethereal sulphates, phosphoric acid, etc., but they need

not be discussed here.

═════════╤════════════════════════════════════════╤═══════════════════

│ Intake │ Output of Nitrogen

├————————┬————-┬——————-┬————————┬————————┼—————┼——————-┼—————

│Proteids│Fats │Carbohy│Calories│Nitrogen│Urine│ Fæces │Total

————————-┼————————┼—————┼——————-┼————————┼————————┼————-┼——————-┼————-

│ Grams │Grams│ Grams │ │ Grams │Grams│ Grams │Grams

Feb. 2 │ 31.3 │25.3 │ 125.4 │ 900 │ 5.02 │5.27 │0.18 │5.45

3 │ 46.8 │40.4 │ 266.2 │ 1690 │ 7.50 │6.24 │0.81* │7.05

4 │ 48.0 │38.1 │ 283.0 │ 1747 │ 7.70 │5.53 │0.81* │6.34

5 │ 50.0 │40.6 │ 269.0 │ 1711 │ 8.00 │6.44 │0.81* │7.25

6 │ 47.0 │41.5 │ 267.0 │ 1737 │ 7.49 │6.83 │0.81* │7.64

7 │ 46.5 │39.8 │ 307.3 │ 1852 │ 7.44 │7.50 │0.17 │7.67

————————-┼————————┼—————┼——————-┼————————┼————————┼————-┼——————-┼—————

Daily Av.│ 44.9 │38.0 │ 253.0 │ 1606 │ 7.19 │6.30 │0.60 │6.90

═════════╧════════╧═════╧═══════╧════════╧════════╧═════╧═══════╧═════

*Average of the four days.

The main things to be noted in these results are, first, that the

total daily consumption of proteid amounted on an average to only 45

grams, and that the fat and carbohydrate were taken in quantities

only sufficient to bring the total fuel value of the daily food up to

a little more than 1,600 large calories. If, however, we eliminate

the first day, when for some reason the subject took an unusually

small amount of food, these figures are increased somewhat, but they

are ridiculously low compared with the ordinarily accepted dietary

standards. When we recall that the Voit standard demands at least 118

grams of proteid and a total fuel value of 3,000 large calories daily,

we appreciate at once the full significance of the above figures. But

it may be asked, was this diet at all adequate for the needs of the

body--sufficient for a man weighing 165 pounds? In reply, it may be

said that the appetite was satisfied, and that the subject had full

freedom to take more food if he so desired. To give a physiological

answer, it may be said that the body-weight remained practically

constant throughout the seven days' period, and further, it will be

observed by comparing the figures of the table that the nitrogen of

the intake and the total nitrogen of the output were not far apart.

In other words, there was a close approach to what the physiologist

calls nitrogenous equilibrium. In fact, it will be noted that on

several days the nitrogen output was slightly less than the nitrogen

taken in. We are, therefore, apparently justified in saying that the

above diet, simple though it was in variety, and in quantity far below

the usually accepted requirement, was quite adequate for the needs

of the body. In this connection it may be asked, what were the needs

of the body during this seven days' period? This is obviously a very

important point. Can a man on such a diet, even though it suffices to

keep up body-weight and apparently also physiological equilibrium,

do work to any extent? Will there be under such condition a proper

degree of fitness for physical work of any kind? In order to ascertain

this point, the subject was invited to do physical work at the Yale

University Gymnasium, and placed under the guidance of the director of

the gymnasium, Dr. William G. Anderson. The results of the observations

there made are here given, taken verbatim from Dr. Anderson’s report to

the writer.

On the 4th, 5th, 6th, and 7th of February, 1903, I gave to Mr. Horace

Fletcher the same kind of exercises we give to the Varsity Crew. They

are drastic and fatiguing and cannot be done by beginners without

soreness and pain resulting. The exercises he was asked to take were

of a character to tax the heart and lungs, as well as to try the

muscles of the limbs and trunk. I should not give these exercises to

Freshmen on account of their severity.

Mr. Fletcher has taken these movements with an ease that is unlooked

for. He gives evidence of no soreness or lameness, and the large

groups of muscles respond the second day without evidence of being

poisoned by Carbon dioxide. There is no evidence of distress after or

during the endurance test, _i. e._, the long run. The heart is fast

but regular. It comes back to its normal beat quicker than does the

heart of other men of his weight and age.

The case is unusual, and I am surprised that Mr. Fletcher can do

the work of trained athletes and not give marked evidences of

over-exertion. As I am in almost constant training I have gone over

the same exercises, and in about the same way, and have given the

results for a standard of comparison. [The figures are not given here.]

My conclusion, given in condensed form, is this: Mr. Fletcher performs

this work with greater ease and with fewer noticeable bad results than

any man of his age and condition I have ever worked with.

To appreciate the full significance of this report, it must be

remembered that Mr. Fletcher had for several months past taken

practically no exercise other than that involved in daily walks about

town.

In view of the strenuous work imposed during the above four days, it is

quite evident that the body had need of a certain amount of nutritive

material. Yet the work was done without apparently drawing upon any

reserve the body may have possessed. The diet, small though it was, and

with only half the accepted requirement in fuel value, still sufficed

to furnish the requisite energy. The work was accomplished with perfect

ease, without strain, without the usual resultant lameness, without

taxing the heart or lungs, and without loss of body-weight. In other

words, in Mr. Fletcher’s case at least, the body machinery was kept in

perfect fitness without the consumption of any such quantities of fuel

as has generally been considered necessary.

Just here it may be instructive to observe that the food consumed

by Mr. Fletcher during this seven days' period--and which has been

shown to be entirely adequate for his bodily needs during strenuous

activity--cost eleven cents daily, thus making the total cost for

the seven days seventy-seven cents! If we contrast this figure with

the amounts generally paid for average nourishment for a like period

of time, there is certainly food for serious thought. Mr. Fletcher

avers that he has followed his present plan of living for nearly five

years; he usually takes two meals a day; has been led to a strong

liking for sugar and carbohydrates in general and away from a meat

diet; is always in perfect health, and is constantly in a condition of

fitness for work. He practises thorough mastication, with more complete

insalivation of the food (liquid as well as solid) than is usual,

thereby insuring more complete and ready digestion and a more thorough

utilisation of the nutritive portions of the food.

In view of these results, are we not justified in asking ourselves

whether we have yet attained a clear comprehension of the real

requirements of the body in the matter of daily nutriment? Whether we

fully comprehend the best and most economical method of maintaining the

body in a state of physiological fitness? The case of Mr. Fletcher,

just described; the results noted in connection with certain Asiatic

peoples; the fruitarians and _nut_arians in our own country recently

studied by Professor Jaffa, of the University of California; all

suggest the possibility of much greater physiological economy than we

as a race are wont to practise. If these are merely exceptional cases,

we need to know it; but if, on the other hand, it is possible for

mankind in general to maintain proper nutritive conditions on dietary

standards far below those now accepted as necessary, it is time for us

to ascertain that fact. For, if our standards are now unnecessarily

high, then surely we are not only practising an uneconomical method

of sustaining life, but we are subjecting ourselves to conditions the

reverse of physiological, and which must of necessity be inimical to

our well-being. The possibility of more scientific knowledge of the

natural requirements of a healthy nutrition is made brighter by the

fact that the economic results noted in connection with our metabolism

examination of Mr. Fletcher is confirmatory of similar results

obtained under the direction and scrutiny of Sir Michael Foster at the

University of Cambridge, England, during the autumn and winter of last

year; and by Dr. Ernest Van Someren, Mr. Fletcher’s _collaborateur_,

in Venice, on subjects of various ages and of both sexes, some account

of which has already been presented to the British Medical Association

and to the International Congress of Physiologists at its last meeting

at Turin, Italy. At the same time emphasis must be laid upon the fact

that no definite and positive conclusions can be arrived at, except as

the result of careful experiments and observations on many individuals

covering long periods of time. This, however, the writer hopes to do

in the very near future, with the coöperation of a corps of interested

observers.

The problem is far-reaching. It involves not alone the individual, but

society as a whole, for beyond the individual lies the broader field

of the community, and what proves helpful for the one will eventually

react for the betterment of society, and for the improvement of mankind

in general.

INTRODUCTION TO DR. HARRY CAMPBELL’S CONTRIBUTION ON THE IMPORTANCE

OF MASTICATION

[Since the publication of Van Someren’s paper, “Was Luigi Cornaro

Right?”, read before the British Medical Association, and reprinted

elsewhere in this volume, much more attention has been given to

the study of mastication than had been previously reported. Mr.

Gladstone’s advice to his children, which was commonly current and was

repeated whenever mastication was mentioned, was usually accompanied

and met by an amused smile that showed that the full importance of

better mouth-treatment of food was not appreciated. _Glutton or

Epicure_, a little book by the present writer, published in 1898,

insisted on thorough use of the functions of the mouth in alimentation

but did not go into the anatomical, physiological and dental details.

Dr. Harry Campbell of Northwest London Hospital has performed this

latter service to science and humanity, with splendid carefulness, and

must have devoted much time and study to the collection of evidence

and suggestion which is given here following in full, reprinted from

the _London Lancet_.

The authors acknowledge with much gratitude, the courteous permission

of both Dr. Campbell and of the editor of the _Lancet_, to reprint all

four articles which composed the series.

In our own study of the subject of mouth-treatment of food we have

been led to give more credit to the chemical feature of preparation

than Dr. Campbell yet attributes to the chemical side of the problem.

Comminution of hard food is of first importance, undoubtedly, but

insalivation and neutralisation or alkalinisation are, seemingly,

much more easily and quickly accomplished in the mouth than farther

on in the alimentary canal. The intestines _can_ do all in the way

of digestion, even if the mouth and stomach are passed and their

assistance in the digestive process is entirely neglected, but it is

done at tremendous disadvantage in the supplementary digestive tract

of the intestines. We have proven the economy of letting the mouth

do _all it can_, by the insalivation (sipping and tasting) of liquids

that have taste up to the point of compulsory swallowing (a sucking-up

by the Swallowing Impulse which naturally occurs in the course of

treatment in the mouth if not fought against too strongly). If Dr.

Campbell will extend his observations to liquids, say milk, and for

a sufficiently long time to measure results by continued economy of

assimilation and saving of solid excreta, he will find that it pays

to let the mouth do all it can do, and that while it _cannot do too

much_ it _may do too little_. The natural instincts of the mouth, or

those that attach to the mouth, become much more discriminating also

if exercised on liquids as well as on solids. This they do not learn

to do so well if sapid liquids are habitually rushed past their field

of discrimination.

Taste enjoyed in the mouth is good, and a good part of the pleasure of

living comes from taste gratification, but taste that returns from the

stomach and is belched by eructation or is lingeringly reminiscent in

the mouth or nose is indicative of indigestion.

Hence it is better to dissipate taste in the mouth, which is the sole

region of taste. Spirits tasted into absorption in this way leave

no odour upon the breath, and asparagus munched and tasted to the

limit in the mouth, carries no odour to the urine. Even the stale and

disagreeable odour of onion or garlic can be neutralised by saliva and

killed in the mouth.

It is extremely difficult to get observers to practise tasting taste

out of liquids as the wine tasters do, and as the tea tasters _have to

do or die_; or, at least, become useless in their profession. Once the

efficacy of the liquid-tasting precaution in digestion is understood,

however, to swallow anything but pure water without tasting it into

absorption produces a shock. This care becomes instinctive quite

easily and regulates itself automatically. It is also a distinct gain

to the gustatory possibilities, which are very limited at best.

When the body will tolerate spirits tasted into it--not poured into

it--at all, which is not often when the nutrition is normal (only in

damp or cold weather, as a general thing, and then in the case of

the writer only at rare intervals, say two or three times a year),

the spirit will mix quickly with the saliva and become neutralised

sufficiently to excite the Swallowing Impulse. Continue sipping the

spirit for a time and you will note that there comes a point where the

saliva and the spirit do not mix, do not neutralise; the mouth becomes

unduly full of liquid without any relaxation or invitation of the

Swallowing Impulse; and the really instinctive inclination will be to

_spit it out_. It is a clear indication that the body-_toleration_ has

been fully taxed; there is no longer any bodily need for alcohol--in

fact, there is no longer natural toleration--and the secretion sent

down into the mouth is evidently mucous for a washing-out process, and

is not alkaline saliva for assisting in a utilisation function.

It is quite uncanny to observe the nicety of mouth-discrimination and

the consistency of it as related to similar substances under similar

conditions, if one learn to read it with precision and intelligence.

With increased ease of digestion, which comes with more thorough

attention to solid foods alone, the ordinary observer will think

that he has accomplished the whole of the possible benefit. It is

only when he gives sufficient time to liquids also, to get the added

delight and relief that salivary respect of them brings, that the

whole of the beneficence of mouth-service is realised. Follow this

discrimination and care to a comparative measurement of the waste of

digestion, the solid excreta, and note the increased proportionate

gain in assimilation and the value of the economy will be appreciated.

Try the different treatments on milk for a month; fifteen days with

drinking and fifteen days insalivating (sipping and tasting) the milk

to the limit, and keep account of quantity of intake required to

satisfy appetite and maintain body-weight; and also note carefully the

condition and quantity of the fæces. In the one case you will find

the waste to be _fæces_ indeed, and unmistakably worthy of the name;

but in the case of sipping, tasting and insalivating the milk to the

full satisfaction of the appetite, the _digestion-ash_ will assume

quite a different amount and character and deserve a change of name.

The proportions of the saving in our own experiments have approximated

the difference between three and ten; that is, on a reduction of only

one-third the quantity of food commonly ingested, but fully satisfying

the sipping and tasting appetite, the quantity of solid excreta was

only one-tenth of the other and of quite a different character,

æsthetically considered.

While these suggestions do not discredit or affect the value of the

purely mechanical side of the treatment as given by Dr. Campbell,

and are not intended to be controversial, they are ventured as an

amendment to be worked out in regard to liquids, which are, in fact,

only an extreme of the pultaceous foods against which Dr. Campbell

warns us as being subtly dangerous.

There is another point in our experiences and observations of the

largest importance that may appropriately be introduced here: The

treatment of all liquids in the manner suggested prevents intemperance

of drinking as effectively as it does intemperance of eating.

When food is filtered into the body after having become liquified

and made alkaline, or, at least neutral, by saliva, the appetite is

given a chance to measure the needs of the body and to discriminate

against excess. As soon as the point of complete saturation of any one

deficiency is reached, the appetite is cut off, as short as possible

to imagine, with no indication of stomach fullness. It will welcome

a little of proteid in beans, cheese, eggs, or in some other of its

richer forms, and then turn to sugar or fat in some of their numerous

forms. Thirst for water will assert itself for a moment, sometimes

asking but for a drop and again for a full glass, and afterwards, when

near the point of complete saturation, appetite will hesitate for a

moment, as if searching around for some rare substance, and may find

its final satisfaction in a single spoonful of a sweet or a sip of

something in sight.

The appetite satisfied by the infiltering process is a sweetly

appeased appetite, calm, rested, contented, normal. There is no danger

from the flooding of intemperance, for there is not even toleration

of excess either of more food or of more drink, and this contented

appetite will remain in the condition of contentment until another

need has really been earned by evaporation or destructive katabolism.

In the teaching of this physiology and psychology of alimentation to

the children of England, lies the only true solution of the drink

question, which is now the curse of the nation.

Dr. Campbell has made such a splendid case for the mechanical side

of mouth work, that it is the hope of the writer that he will give

equally careful consideration to the chemical and psychological

sides, and in a completeness of observation render inestimable service

to his country, to science, and humanity. A decade of trial on the

inmates of an infant orphan asylum will show the possibilities for the

nation in a single generation, if broadly applied. It might lead to

an effective intemperance, inhibition, or quarantine, and that is all

any nation needs of advantage to make it independent of the world and

truly great.—HORACE FLETCHER.]

OBSERVATIONS ON MASTICATION

BY HARRY CAMPBELL, M.D., F.R.C.P. (Lond.)

_Physician to the Northwest London Hospital_

[London _Lancet_, July 11, 18, 25, and August 8, 1903]

SECTION I. From _London Lancet_, July 11, 1903

THE EFFECTS OF MASTICATION

The primary object of mastication is to break up the food so as (1)

to facilitate the swallowing of it, and (2), still more important,

to insure its intimate admixture with the digestive juices, not

only within the mouth, but throughout the entire digestive tract.

Mastication has, however, other important and far-reaching effects.

Thus it promotes the flow of saliva and, when properly performed,

secures a due insalivation of the food; it increases the quantity of

alkaline saliva passing into the stomach; it stimulates the heart and

circulation; and it finally influences the nutrition of the jaws and

their appendages by stimulating the local blood and lymph circulation.

Now to consider these various objects and effects of mastication.

_Mastication facilitates swallowing._--Many foods cannot be swallowed

without first going through some preparation in the mouth. Soft, moist,

pultaceous foods, such as milk pudding and porridge, can be and often,

indeed, are swallowed with little or no preliminary chewing. On the

other hand, it is a mechanical impossibility to swallow large lumps

of tough food, or very dry food, even though, like flour, it be in a

finely divided state. Dry food needs first to be well moistened; and

it is not surprising that it promotes a more abundant flow of saliva

than moist food, though the secretion thus excited may be poor in

ferment. Hence it follows that if we desire to give foods which compel

mastication, they should be tough or dry. On the whole, vegetable foods

necessitate more thorough mastication than animal. The carnivora can

scarcely be said to masticate at all the flesh which they consume; they

simply tear off portions, and forthwith swallow them whole. Cooked

flesh, however, does require mastication, owing to the coagulation of

its proteids. The herbivora, on the other hand, unlike the carnivora,

have to subject their food to considerable mastication before it can be

swallowed; but they generally masticate it far more than is needful to

render swallowing mechanically possible, as is exemplified in the act

of rumination, the object here being to facilitate the admixture of the

digestive juices with the food.

According to Van Someren, if the habit of masticating efficiently

is once acquired, the food is not swallowed before it is converted

into the liquid state, the swallowing of unmasticated lumps being

effectually prevented by a pharyngeal reflex.

_Mastication, by breaking the food up into small particles, enables it

to be brought into intimate contact with the digestive juices._--Such

comminution is especially needful in the case of raw vegetable foods

of the tougher kind, in order to break up their cellulose framework,

and to set free the contained starch, proteids, and fats. Foods of

this kind, unless masticated, yield practically no nutriment to the

organism. I cannot too strongly emphasise the fact that before man

learned to break up the cellulose framework of his vegetable food by

cooking he was compelled to subject it to laborious mastication. But,

while thorough comminution is especially needed for vegetable food

when raw, it is also needed for many cooked forms of it also,--as, for

example, solid batter pudding and new underbaked bread, heavy lumps

of which, passing into the stomach, may seriously hamper the work of

that organ. Such substances are indigestible essentially by virtue

of their impermeability to the digestive juices, and they gain in

digestibility in proportion as they are comminuted. The indigestibility

of new bread would appear to be wholly due, not to any peculiarity

of chemical composition, but to its tendency to elude the teeth and

form a sodden mass impermeable to the digestive juices, while the more

powdery stale bread is more easily broken up both in the mouth and

within the stomach. Cabbage, again, owes its indigestibility to the

fact that it is allowed to pass into the stomach in large masses, while

the well-known digestibility of cauliflower and minced spinach is due

to the fineness of their division; were cabbage as finely minced as

spinach usually is it would be equally digestible.

Turning now to animal food it has to be remarked that while in the

raw state it may be readily digestible with little or no previous

mastication, since massive pieces of it are readily attacked by the

digestive juices, the like is much less true of animal food the

proteids of which have been coagulated and rendered less permeable by

cooking. Large lumps of hard-boiled egg or overdone meat, for instance,

may obstinately resist gastric digestion; indeed, as with vegetable

so with animal foods, their relative digestibility depends more upon

physical consistence than chemical composition; beef is generally more

indigestible than mutton and pork or veal than either, not so much

by virtue of chemical composition as of physical consistence; the

indigestibility of cheese illustrates the same truth; the individual

nutritive ingredients of this substance--the proteids and fats--are not

in themselves indigestible; casein in the form of protein or plasmon is

known to be easy of digestion, and butter is one of the most digestible

of fats; but in cheese the two are welded together into a comparatively

impermeable mass, which is apt to escape comminution by the teeth and

to pass down into the stomach in the form of solid lumps. A plain,

wholesome cheese well masticated or intimately mixed with other foods,

as in macaroni cheese, is quite easily digested by the majority.

I do not, of course, deny the influence of the chemical factor.

Undoubtedly food may disturb digestion by virtue of its chemical

composition, apart altogether from its physical characters; thus, while

cooked goose-fat sets up violent irritation in some, others cannot

tolerate eggs in any shape or form, and innumerable idiosyncrasies in

respect of special articles of diet are met with which are essentially

referable to chemical composition; but making due allowance for

this chemical influence there can, I think, be little doubt that the

digestibility of the more common articles of diet, both animal and

vegetable, depends in the main upon their physical constitution, _all

of them tending to be equally digestible when reduced to the same

degree of comminution_. This, if true, is, I need scarcely say, a fact

of the greatest practical importance, for it amounts to this: that we

may often allow to those with very weak digestions foods which are

generally considered indigestible, provided that they be thoroughly

comminuted, whether by mastication or artificial means.

_Mastication promotes the flow of saliva and the insalivation of the

food._--The more efficiently food is masticated the greater is the

salivary flow, and the more intimately is it mixed with the saliva,

or, as we say, insalivated. The saliva has apparently no effect on

fats; whether it acts on proteids seems more doubtful, though by some

authorities the penetration of these by the alkali of this fluid is

said to aid in their subsequent digestion; on starch, however, the

saliva acts very potently, and hence mastication plays a special

part in promoting the digestion of starchy foods. Indeed, if only

mastication be persisted in long enough, starch may be wholly converted

into maltose within the mouth, and it need scarcely be said that it is

better for the individual himself to manufacture his maltose in this

way than that he should take it ready made for him in the form of one

of the many “malt extracts” on the market. Patients are often forbidden

starchy food, while they are allowed the maltose which they can quite

well manufacture in their own mouths. Provided they be sufficiently

insalivated, there are few starchy foods which are indigestible, not

even excepting the proverbially indigestible new potato. These remarks

are especially applicable to children, as will be more particularly

insisted on later.

_Mastication increases the amount of alkaline saliva passing into the

stomach_, and this not only prolongs the period of starch digestion

within this organ but, by its influence upon the reaction of the

gastric contents, influences all the digestive processes taking place

there. I shall have occasion to point out later that a deficient supply

of alkaline saliva in the stomach predisposes to certain forms of

indigestion.

_Mastication acts reflexly upon the stomach._--It is now known that

the act of mastication influences the stomach reflexly, promoting the

flow of gastric juice and thus preparing the stomach for the entrance

of food into it. If the œsophagus of a dog is cut so as to allow the

swallowed food to escape instead of passing into the stomach, it is

found that the mastication of food causes a considerable flow of

gastric juice. Food introduced into the stomach unaccompanied by

mastication is less effective in promoting the gastric flow. It is

probable that the influence of mastication on the flow of gastric juice

is largely produced through the medium of psychic influences, for the

more efficient the mastication the more is the sense of taste affected.

_Mastication stimulates the heart and so promotes the general

circulation._--This stimulating action may be partly due to its local

action on the flow of blood and lymph in the jaws and accessory parts,

and partly to a reflex influence, but whatever the explanation there

can be no doubt of the fact. Hence the mere chewing of a non-nutritive

substance, such as gum arabic, is stimulating, and, doubtless, the

stimulating effects induced by the chewing of such articles as tobacco

and betel are largely to be explained in this way.

THE INFLUENCE OF MASTICATION ON THE JAWS AND ADJACENT STRUCTURES

This subject is of such importance that it needs to be dealt with in

some detail. By “adjacent structures” I mean the masticatory muscles,

tongue, teeth, salivary glands, the nasal passages and sinuses

pertaining thereto, the naso-pharynx, soft palate, and tonsils.

_The muscles of mastication._--Let me at the outset draw attention

to certain anatomical points, in connection with the muscles of

mastication. These are (_a_) their massiveness; (_b_) the very close

relation of the pterygoids to the naso-pharynx; and (_c_) the outward

direction of the pterygoids.

(_a_) It is not until one studies the muscles of mastication closely

that one comes to realise their massiveness. Their large size, in

relation to the bony structures in connection with them, is well shown

in a vertical transverse section of the head carried through the

ascending ramus of the mandible[7] (see Fig. 1). It is evident that

the functional activity of so large a mass of muscle tissue cannot but

exercise considerable influence on the nutrition of the neighbouring

parts.

[Illustration:

FIGURE 1.--Vertical transverse (slightly oblique) section through the

head on a level with the epiglottis. The massiveness of the system of

masticatory muscles is apparent.]

(_b_) The pterygoid muscles, springing as they do from the internal

pterygoid plates, must necessarily be in close relation with the

naso-pharynx, especially the internal pair, which take their origin

from the internal aspect of the internal plates. I would further

point out that the external pair, although they diverge from the

naso-pharynx on their way to the mandibular condyles, yet remain on a

level with that cavity. This close relation of the pterygoids to the

naso-pharynx is, if I mistake not, of great importance in relation to

the etiology of “adenoids.”

(_c_) Of the two pairs of pterygoids the external pair pass in the more

outward direction, forming with the sagittal plane of the head an angle

of 45° (see Figs. 1 and 2). In consequence of this direction they tend

by their contraction to pull the pterygoid plates and posterior parts

of the maxilla away from the sagittal plane of the head, and thus to

secure the normal width of the posterior nares. It is these muscles

which bring about the lateral movements of the mandible, causing the

lower teeth to move laterally and sagittally across the upper, the food

being in this way far more effectually ground than by a mere vertical

pressure of the teeth against one another. These lateral movements are,

as we shall see, less pronounced among the moderns than among primitive

peoples.

[Illustration:

FIGURE 2.--Portion of horizontal section of head about an inch below

the condyles of the lower jaw. The outward direction of the external

pterygoids is well shown; also the close relation of the levatores and

tensores palati with the internal pterygoids.]

_The influence of the contraction of the masticatory muscles on the

local circulation of blood and lymph._--When a muscle is at rest the

blood flows sluggishly through it, while there is a complete, or

all but complete, stagnation of the lymph current; if a lymphatic

trunk of a limb at rest be cut no lymph escapes from it. Rhythmic

muscle contractions, however, stimulate the flow both of blood and

lymph (_a_), in the contracting muscles themselves and (_b_) in the

neighbouring parts. (_a_) Not only are the muscle arteries dilated

during rhythmic contractions, but the blood is vigorously squirted out

of the muscle veins, so that much more blood flows through a muscle

during its rhythmic contraction than during rest. The flow of lymph is

even more markedly stimulated,--this fluid, which, while the muscle is

at rest, is stagnant or all but so, being during contraction driven

actively along the lymphatic trunks. (_b_) How greatly rhythmic muscle

contractions influence the circulation of fluids in the neighbouring

parts is shown by the flushing of the skin and the swelling of the soft

parts generally of a limb which is being exercised. We thus see how

profoundly the exercise of the masticatory muscles--and among these we

must not forget to include the tongue--influences not only their own

nutrition but that of the important structures adjacent to them--that

is to say, of the jaw-bones, salivary glands, buccal mucous membrane,

soft palate, faucial tonsils, pharynx, and naso-pharynx, as well as

of the nasal cavities and their accessory sinuses. All these parts

are during mastication copiously flushed with blood and lymph, from

which it is evident that efficient mastication must stimulate their

nutrition and favour their proper development. Hence, in one who has

from childhood upwards been accustomed to masticate efficiently, we

generally find these parts well developed, the jaws large and shapely,

the teeth regular and straight, the tongue and salivary glands large,

the nasal and naso-pharyngeal passages spacious, and the mucous

membrane of the buccal and adjoining cavities healthy.

_Influence of mastication on the jaw-bones._--It is well known that the

size of a bone is largely determined by the degree to which the muscles

attached to it are exercised. That the jaws do not grow to their normal

size, if not adequately exercised during their period of growth, is

strikingly shown by the overcrowding of the teeth, which takes place

in those brought up on soft foods, and this even though there be no

contraction of the jaws resulting from mouth-breathing. The dependence

of the size of the jaws upon the degree to which they are exercised is

also shown by the smallness of the modern jaw, as compared with that

of primitive peoples, a difference which, as we shall see, is in part

congenital and in part due to the comparative disuse of the former.

Mastication influences not only the size but also the shape of the

jaws (_a_), through its influence on the size of the tongue, which by

pressing against the teeth tends, as Sim Wallace has shown, to expand

the jaws; (_b_) by the pressure of opposing teeth against one another,

which has a similar effect; and (_c_) by the outward pull of the

pterygoids, which tends to widen the maxilla posteriorly and to broaden

the posterior nares.

_Influence of mastication on the teeth._--The teeth being developed

within the jaw-bones and remaining, even after eruption, in close

anatomical and physiological association with them, must necessarily

share in their nutritive tendencies. If these bones are efficiently

exercised during the formation of the teeth--and my remarks apply

especially to the permanent set--the tooth-germs will be abundantly

flushed with blood, while the ample growth of the jaws themselves

will provide the germs with plenty of room in which to grow and to

develop, and the more perfect their growth and development the more

resistant should we expect them to be to the ravages of caries. Who can

contemplate the jaw-bones of a six-years-old child, dissected so as to

display all the imbedded teeth, without being assured of the effect of

mastication upon dental development? Fifty-two teeth meet the view:

the whole region from the orbital rims to the inferior border of the

mandible is literally paved with them, and I can hardly doubt that

they collectively weigh more than the bone in which they are imbedded.

Surely no one can examine such a dissection without being convinced of

the urgent necessity, if the teeth are to grow and to develop normally,

of giving the child’s jaws from infancy onwards plenty of work to do.

The ample development of the jaws, which efficient mastication brings

about, has a further beneficial effect as regards the teeth, in that

it enables them to take up their proper places in the alveolar ridges,

thus securing all the advantages of a good “bite.” These I now proceed

to consider. The teeth during mastication, and especially when the bite

is good and the food of a kind necessitating vigorous and sustained

mastication, are made to move in their sockets both vertically and

horizontally; the effect of this is to stimulate the circulation in the

tooth-pulp, the alveolar periosteum (and hence also in the cementum and

alveolar walls which are supplied by it), and the circumjacent mucous

membrane of the gum. All this makes for the health of the teeth; not

only does it promote the nutrition of the tooth itself and of its bony

socket, thus maintaining a firm dental setting, but it also tends to

secure a healthy environment for the exposed part of the tooth--that

part, namely, wherein caries begins--by maintaining a healthy state of

the surrounding and, indeed, of the entire buccal mucous membrane, as

well as of the various secretions which bathe the mouth. Wherefore it

is not surprising to find that those who masticate efficiently suffer

much less from dental caries and its complications (such as abscess at

the root) and disease of the periodontal membrane (_e.g._, pyorrhœa

alveolaris and loosening of the teeth) than those who are accustomed to

bolt their food.

A few words as to the influence of mastication in wearing down the

teeth. In those races which masticate vigorously the teeth in quite

early adult life show signs of wearing away, while in later life it is

quite common for the biting surfaces to be worn flat; sometimes the

crown of the molars is worn away so that its surface shelves downwards

and inwards and not infrequently it is concave, having a scooped-out

appearance; often the dentine is exposed in this way; and yet among

many hundreds of skulls examined I do not remember to have seen one

single case where caries has started on the biting surface thus worn

down.

I had always attributed this wearing down of the teeth to the friction

of coarse food against them. Primitive races eat coarse vegetable

food, which frequently contains grit, and this doubtless helps to grind

the teeth down, but they may be markedly ground down even in those

living on soft food, and in such cases the grinding away can obviously

only be due to the friction of opposing teeth against one another.

I, indeed, believe this to be the essential cause of the phenomenon,

both in civilised races living on soft food and in primitive races

whose coarse food necessitates prolonged and vigorous mastication and

a corresponding amount of attrition between the biting surfaces of

opposing teeth. In order that this attrition may occur two things are

requisite: the upper and lower teeth must be well opposed--there must

be a good bite--and mastication must be vigorous and of the right kind.

Mere vertical pressure of the teeth against one another will not wear

away the opposing surfaces; there must be friction of these surfaces

against one another--a transverse and sagittal movement of the lower

teeth against the upper by means of the pterygoids. Mainly to this do

I attribute the marked wearing down of the teeth observed in primitive

peoples, and I am gratified to know that so competent an authority on

dental pathology as Sim Wallace is a convert to this view.

That all the teeth may be worn down just as we observe in primitive

people, even in those who have lived all their lives on the ordinary

fare of the moderns, is proved by a case I have under observation. It

is that of a man in his fiftieth year, who was brought up in Belgium

but who has resided in London for the last thirty years. When he came

to my out-patient room I was not a little surprised to find that

all his teeth were sound--a very unusual occurrence, I need hardly

say, among the London poor at his age. In seeking for an explanation

I elicited the fact that he was unable to swallow his food without

chewing it very thoroughly, and on giving him a moderate-sized piece

of bread, with the request that he should chew it in the ordinary way,

I found that he subjected it to one hundred and twenty separate bites

before swallowing it, and in the steady, deliberate way he went to work

and in his extensive lateral movements of the mandible he reminded one

for all the world of a cow chewing its cud. The temporals and masseters

of this man are enormous, and the like is no doubt true of the

pterygoids; he has well-developed nasal passages, has never suffered

from nasal obstruction, while his buccal mucous membrane is unusually

healthy for one of his years and circumstances. May we not attribute

this healthy state of the mouth, teeth, and nose to the good effects

upon them of efficient chewing? Here is a man who has lived for thirty

years in London on the same kind of food as the average poor Londoner,

but instead of finding his mouth full of carious, tartar-coated teeth,

and spongy, receding, pus-exuding gums, we find thirty-two sound teeth

firmly set in healthy gums and all but devoid of tartar.

A word as to the wearing down of the teeth in the anthropoid apes.

In this respect the gorilla differs markedly from the orang and the

chimpanzee. In all the skulls of these latter which I have examined the

teeth show signs of wearing away, while I have found the teeth of the

gorilla, with the exception of the tusk-like canines, but little worn.

From this we should expect the latter animal to be mainly carnivorous,

and the orang and chimpanzee to be largely herbivorous.