Class _ Book GoMiftfi? CUPYKIGIIT DEPOSIT m ! I FOOD IN HEALTH AND DISEASE DAVIS FOOD IN HEALTH AND DISEASE BY NATHAN S. DAVIS, JR., A. M., M. D., PROFESSOR OP THE PRINCIPLES AND PRACTICE OP MEDICINE IN NORTHWESTERN UNI- VERSITY MEDICAL SCHOOL; PHYSICIAN TO ST. LUKE'S HOSPITAL, MERCY HOSPITAL AND WESLEY HOSPITAL, CHICAGO*, MEMBER AMERICAN MEDICAL ASSOCIA- TION, AMERICAN CLIMATOLOGICAL SOCIETY, ETC. SECOND EDITION PHILADELPHIA BLAKISTON'S SON & CO. 1012 WALNUT STREET 1912 Copyright, 1912, by P. Blakiston's Son & Co. THE. MAPLE. PRESS. YORK- PA ©CI.A328345 PREFACE TO SECOND EDITION This book was written originally for "A System of Physiologic Therapeutics" so ably planned and edited by Dr. Solomon Solis Cohen. The title given to this series of treatises devoted to nonmedicinal therapeutics has been generally adopted as the best and most expressive for the methods discussed. At the time of its appearance the information contained in it could not be found in any other one place, and it has aided in calling forth much valuable study and many useful publica- tions. This volume was devoted to a subject which had been written upon frequently but by few American authors with as much fullness. In revising it much of it has been rewritten and additions have been made to almost every subject discussed in it. This was made necessary by additions to our knowledge of physiology and of the management of diseases by diet. More- over, the presentation of this volume to the public independent of its original setting in "A System of Physiologic Thera- peutics" has made some changes necessary. A description of the principles of dietetics has been attempted, as well as a full and practical consideration of the problems of diet and their solution in health and in the most important diseases. It is hoped that by explaining the principles and the limita- tions of dietetic treatment in each disease it will be easy for physicians and nurses to construct appropriate menus for individual patients. N. S. Davis. Chicago, 8 East Huron St. PREFACE TO FIRST EDITION It has been my aim to make as practical a book upon dietetics as possible. For that reason the diet best suited in individual diseases has been described fully under the heading of each ailment, although this has necessitated some repetition. The preservation of health is of as much importance as the treat- ment of the sick, and in order that the food may be adapted to both these purposes the principles underlying its use must be understood. It has therefore seemed best to review the chemical and physiologic data concerning the nutritive and other qualities of various kinds of food; to discuss briefly their relations to the digestive organs and to the organism as a whole; and to trace many of the changes that food must undergo before it can be appropriated to the needs of the human system and prepared for elimination. The first part of this volume treats of these subjects, with such brevity as has seemed compatible with thoroughness. For a similar reason, in the section devoted to the consideration of diet for invalids, attention has been given to the causation of disease, especially as diet, and digestive and nutritional processes are related to it. Symptoms are described whenever it seems best in order to make clear the indications for dietetic and general hygienic treatment. I wish to call special attention to the numerous studies of food and dietetics prosecuted under the auspices of the United States Department of Agriculture, and under the supervision of Professor Atwater. The value of these investigations is not fully appreciated by the medical profession, yet they constitute the most valuable original contributions to this subject that have emanated from America, and rank with the best studies made in other countries. I have, therefore, made numerous quotations from them. Use has been made also of standard works upon dietetics, and of monographs and case reports b}' vii Mil PREFACE TO FIRST EDITION. various writers, to whom I thus make acknowledgment. I have likewise availed myself of the valuable analytic studies to be found in the recently published treatise of Hutchison on "Food and the Principles of Dietetics," which came to hand while I was revising the manuscript of this volume. The recommendations made both as to diet for invalids and as to diet for persons in health under various conditions, are, however, largely based upon my own observation. N. S. Davis, Jr. Chicago. CONTENTS PAPT I— GENERAL PRINCIPLES OF DIET AND DIET IN HEALTH CHAPTER I Page Food in Health, 3 General Pysiologic Considerations. Composition of Human Body and of Foods. Alteration of Foods in Process of Digestion, Absorption, and Utilization. Classification. CHAPTER II The Uses op Water, 7 Uses of Water. Effect of too Little and of too Much Water. Amount of Water Used. Effect of Water in Health and Disease. Impurities in Water. Purification of Water. Kinds of Water. CHAPTER III The Elements of Food, 18 Proteins — Digestion, Assimilation, Elimination; Effects in Health and Disease. Fats and Oils — Uses; Digestion and Assimilation; Effects in Health and Disease; Butter; Cream; Cod-liver Oil. CHAPTER IV The Elements of Food (Continued), 29 Carbohydrates — Composition; Digestion; Abnormal Fer- mentation; Absorption. Action of Liver. Utility in Health and Disease. Interrelationship of Foods. Effect of Changes of Diet. Salts. CHAPTER V Quantity and Kinds of Food Needed in Health, ... 40 Alimentary Equilibrium. Proteins and Calories. Dietary Standards. Army and Navy Dietaries. Prison Dietaries. Diet of Savages. Investigations of Actual Dietaries in the United States. ix X CONTENTS. CHAPTER VI Page Animal Foods, 68 Milk and Milk Products. Composition. Variation. Adulteration. Contamination. Sterilization and Pas- teurization. Digestion. Absorption. Predigestion. Kephyr. Kumiss. Matzoon. Cream. Butter. Buttermilk. Cheese. CHAPTER VII Animal Foods (Continued), 88 Eggs. Meats. Cooking. Meat Products. Digestibility. Food Value. Fish. CHAPTER VIII Vegetable Foods, 107 Digestibility. Sugars. Cereals. Roots and Tubers. Peas and Beans. Green Vegetables. Fruits. Nuts. Fungi and Algae. Spices and Condiments. CHAPTER IX Beverages, 129 Tea. Coffee. Cocoa. Alcoholic Beverages. CHAPTER X Diet in Health, 151 Diet for Athletes in Training. Diet for Brain Workers. Starvation. Diet in Different Periods of Life. CHAPTER XI Infant Feeding, 171 Mother's Milk. Irregularity in Feeding. Rules for Infant Feeding. CHAPTER XII Infant Feeding (Continued), 181 Substitutes for Mother's Milk. Peptonization of Milk. Food for Premature Infants. Mixed Feeding. Weaning. Diet for Children. CONTENTS. CHAPTER XIII Food as a Cause of Disease, Ill Effects of Food. Parasites and Poisoning by Food. Idiosyncrasies. XI Page 200 Micro-organisms . PART II— DIET IN DISEASE CHAPTER I Feeding the Sick, General Considerations of Diet of the Sick. Foods. Fats and Oils. Rectal Feeding. 207 Concentrated CHAPTER II Diet in Infectious Diseases, Typhoid Fever. Typhus Fever. Dysentery. Yellow Fever. Cholera. Dengue. Relapsing Fever. 214 CHAPTER III Diet in Infectious Diseases (Continued), Smallpox. Scarlet Fever. Measles. Erysipelas. Septice- mia and Pyemia. Malaria. Tuberculosis. Influenza. Whooping-cough. Cerebrospinal Meningitis. Diphtheria. Rheumatism. 230 CHAPTER IV Diet in Diseases of the Stomach, Dysphagia and Odynophagia. Vomiting. Dyspepsia. Acute Gastritis. Chronic Gastritis. Dilated Stomach. Gastric Ulcer. Gastric Cancer. 260 CHAPTER V Diet in Diseases of the Intestines, Liver, and Peritoneum, Diarrhea. Diarrhea in Infants. Cholera Infantum. Enterocolitis. Chronic Enterocolitis. Appendicitis. In- testinal Obstruction. Constipation. Catarrhal Jaun- dice. Obstructive Jaundice. Cholelithiasis. Cirrhosis of the Liver. Peritonitis. 2S8 Xll CONTENTS. CHAPTER VI Page Diet in Diseases of the Respiratory Organs, 312 Laryngitis. Laryngismus Stridulus. Bronchitis. Em- physema. Asthma. Croupous Pneumonia. Pleurisy and Empyema. CHAPTER VII Diet in Diseases of the Blood 321 Simple Anemia. Chlorosis. Pernicious Anemia. Leuke- mia. Pseudoleukemia. CHAPTER VIII Diet in Diseases of the Circulatory Organs, ...... 334 Acute Pericarditis and Endocarditis. Acute Dilatation. Weak Heart. Palpitation. Angina Pectoris. Aneurysm of the Aorta. Arteriosclerosis. CHAPTER IX Diet in Diseases of the Kidneys, > . . 345 Nephrolithiasis. Albuminuria. Uremia. Passive Conges- tion of the Kidneys. Acute Nephritis. Chronic Diffuse Nephritis. Interstitial Nephritis. Pyelitis. CHAPTER X Diet in Diseases of the Nervous System, 364 Neuralgias. Migraine. Neurasthenia and Hysteria. In- somnia. Epilepsy. Mental Diseases. CHAPTER XI Diet in Diseases of the Skin, 377 Eczema. Acne Rosacea. Acne. Furunculosis. Urti- caria. CHAPTER XII Diet in Disorders of Nutrition, 382 Emaciation. Obesity. Rachitis. Osteomalacia. Beri- Beri. Diabetes. Rheumatoid Arthritis. Gout and Gouti- ness. Index 427 PART I GENERAL PRINCIPLES OF DIET AND DIET IN HEALTH FOOD IN HEALTH AND DISEASE PART I GENERAL PRINCIPLES OF DIET AND DIET IN HEALTH CHAPTER I FOOD IN HEALTH General Physiologic Considerations. Composition of Human Body and of Foods. Alteration of Foods in Process of Digestion, Absorption, and Utilization. Classification. Dietotherapy is the application of foods to the preservation of strength, flesh, and energy, or to their repair when diminished by disease. Necessarily the value of foods in health must be understood in order to appreciate their relative utility in disease. The human body contains the following chemical elements : Carbon, hydrogen, oxygen, nitrogen, sulphur, phosphorus, chlorin, iodin, potassium, sodium, calcium, magnesium, and iron. A few other elements have been found in the human body, but they are not uniformly present. The first four named occur in much larger proportions than the others. It is self-evident that food that is to make an infant's body grow to man's dimensions and capacity must contain these elements. It is, however, impossible to feed human beings upon chemical elements. To be useful they must be furnished in certain combinations. The following table shows the composition of foods. In the processes of digestion and assimilation many of these com- pounds are transformed into others which are peculiar to the human body. Therefore the chemical composition of the human body is not an adequate guide to the foods which are useful. FOOD IN HEALTH. Food- stuffs Inorganic Water. Salts Organic Carbohy- drates Fat Proteins Nad, KC1. Na 2 C0 3 , MgCOs. NajS04, K2SO4, MgSO<. Na 2 HP04, K2HPO4, MgHP04, CaHPO*. Na, K, Ca, etc., combined with fruit acids — tartaric, citric, malic, etc. Fe combined with animal products (hemoglo- bin) and with vegetable compounds (chloro- phyll). Monosaccharides Hexoses. Pentoses Disaccharides. Trisaccharides. Polysaccharides. f Dextrose. ^ Levulose, etc. Maltose. Lactose. Sucrose, etc. Raffinose. Starches. Gums. Celluloses. Palmatin. Stearin. Olein. Butyrin, etc. Simple proteins. Congugate proteins. Products of protein hydrolysis. f Albumins. \ Globulins, etc. Nucleo-proteins, etc. Proteoses. Peptones, etc. Utilization of Food Although food has been adapted to the needs of the tissues by- digestion, it must undergo still further chemical modification when it is selected by cells for their repair, is stored in them, or by contact with them is decomposed to generate heat or muscular power. Food is not consumed in the stomach as coal in a furnace — to produce heat and energy. It must be prepared by digestion ; it must be absorbed; it must be modified by the liver, by the thyroid gland or its secretions, and by other glands ; it must be selected by such cells as need it ; it must be modified chemically UTILIZATION OF FOOD. 5 and physically each time before it serves its purpose of con- tributing to growth and strength, to the production of heat and muscular and nervous energy, to the formation of secre- tions, and to reproduction. Finally, remnants of food that are not utilized may in part have to undergo additional changes to prepare them for elimination from the body by the skin, the lungs, the liver, the intestines, or the kidneys. As the utilization of food involves such numerous modifica- tions of its form and character before it is finally adapted to the needs of the various tissues of the body, it is evident that very many breaks may take place in the series of changes that it must undergo, destroying its value or even making it harmful. Food must be adapted not only to the needs of the digestive organs, but to the capabilities of other tissues to elaborate it still more, and finally to appropriate it. When the digestive organs are diseased, food must evidently be adapted to the digestive disturbances that have been produced. But even when primary digestion is well performed, some other metabolic failure may call for consideration in the adaptation of a diet. For example, in diabetes food must be adapted to the ability of the liver to retain sugar or of the tissues to utilize it. In this malady diet is not regulated by the ability to digest foods. In pathologic states of the human body various kinds of food, or for the time, all food, may be harmful. For example, when elimination by the kidneys is greatly lessened or suppressed, nitrogenous food, potassium, extractives, etc., may provoke uremic poisoning. When the stomach fails to secrete sufficient gastric juice and performs its normal churning movements infrequently and imperfectly, food will be digested in it slowly and disintegrated imperfectly; decomposition will almost surely take place and give rise to chemical compounds that are unnatural and noxious to the viscus. Even when all the bodily functions are being normally performed, too great a quantity of food of a certain kind may do harm. In certain conditions, as when the stomach is acutely inflamed or when vomiting is persistent, it may be necessary to abstain from food for a time in order to rest the stomach. These statements are made to emphasize a fact often lost sight of in the prescription of diet: that it is not sufficient to 6 FOOD IN HEALTH. adapt food to the power of the stomach and the intestines to digest and absorb it ; the complex processes of utilization after digestion and of elimination of waste must likewise be kept in mind. Classification Foods may be variously classified. For instance, they may be divided into organic and inorganic; those belonging to the former, into animal and vegetable groups. Physiologists find the following chemical classification the most convenient : Water. Proteins. Fats. Carbohydrates . Mineral salts. It is necessary to trace the passage of each of these groups of foods through the system. The therapeutist, however, cannot administer simple chemicals such as these, but is obliged to give them in mixtures of various composition. For illustration, the mineral salts that the human body needs are partly obtained in spring-water and partly in meat, in vege- tables, and in cereals. Although proteins predominate in meat, fats and salts are also found in it. Milk contains water, proteins, fats, carbohydrates, and mineral salts. It is there- fore necessary to consider the complex composition of each article of diet. For convenience, however, we may classify the various kinds of foods by the ingredient that predominates in them, as water, protein, fat, or carbohydrate. The thera- peutist must study not only the chemical composition of foods, but also their palatability, digestibility, assimilability, and capability of elimination; and give attention likewise to the best methods of preparation and administration. All these qualities and conditions affect the dietetic value of individual articles. CHAPTER II THE USES OF WATER Uses of Water. Effect of too Little and of too Much Water. Amount of Water Used. Effect of Water in Health and Disease. Impurities in Water. Purification of Water. Kinds of Water. Water is of the greatest importance for the maintenance of life. It constitutes about 60 per cent, of the human body. S. Solis Cohen has rightly said that "the cells of the body are aquatic in their habit." They not only are composed largely of water, but are bathed by it more or less freely. Even the skin is coated at times with a perceptible, at other times with an imperceptible, film of it. It enters into the chemical composition of the tissues. It constitutes much the largest proportion of all the fluids of the body. By keeping serous and mucus surfaces moist it prevents friction and the distress which their drying would cause. In the blood and lymph it helps to carry food to all parts of the body and to eliminate waste matter. It helps to distribute body heat and to regulate it by the physical pro- cesses of absorption and evaporation. All living things soon die if deprived of water. Man can abstain from eating for weeks, but he cannot live and be deprived entirely of water for more than a very few days, and much distress is caused in a few hours. When abstinence from water is enforced, the first noticeable change is dimin- ished secretion of fluid by various glands; therefore the skin, the mouth, the stomach, and the intestinal canal become abnormally dry. The free action of the kidneys is interfered with. Thirst is felt keenly. Next the tissues lose their water and the body diminishes rapidly in size and may even become emaciated. The muscles lose their power to act. The mind is affected, possibly in part from the drying of nerve tissues; probably chiefly from the failure to eliminate toxins naturally formed by tissues. Delirium develops, and finally coma and death ensue. 8 THE USES OF WATER IN DIETETICS. Deleterious results may also occur from the too free use of water. Physicians see cases of indigestion almost every summer that have gradually been provoked by too copious drinking. Such cases occur almost exclusively among those who are per- forming laborious work in very hot places. After a day or two of excessive water-drinking, appetite for solid food lessens and some gastric distress, usually a sense of fullness and distention, is noticed. Later flatulence, sour stomach, vomiting, and sometimes purging occur; this is due to the fact that gastric juice is so diluted that it can digest but little food, and that but slowly. Although appetite is lessened, more food is eaten than can be digested before putrefaction or abnormal fermentation takes place. The products of these latter changes excite vomiting, or purging and sometimes both. Most frequently these changes are assisted by indiscretion in eating. The quantity of water needed by a man varies greatly under diverse conditions. It may be said, however, that an average of from fifty to sixty ounces of water is required each day; twenty-five ounces more are obtained from the so-called solid food of which water constitutes an average of 50 per cent. If we say that from two to four pints or from four to eight glasses of water are required daily, the quantity may be more readily comprehended. The variations in the needs of individuals are due to: (1) Their varying size; (2) the character of the food they eat; (3) the quantity and kind of labor they perform; (4) the temperature of the air; (5) the dryness of the air. A small woman or a child needs less water than a large man. Some fruits and vegetables contain as much as from 90 to 95 per cent, of water; meats, from 60 to 80 per cent.; and some articles of food, 10 per cent, and less. The amount of water required as fluid will, therefore, necessarily, vary with the character of the food ingested. If the surrounding air is hot, evaporation from the skin and lungs will take place rapidly and must be compensated for by drinking. The rapidity of such elimination is increased greatly if the air is both dry and hot. Physical labor also provokes perspiration, deep and more vigorous breathing, and therefore elimination from the skin and lungs. Oertel has demonstrated that the elimination of fluid by these channels was much greater during mountain ELIMINATION. 9 climbing than when the same distance was traveled upon a level. Therefore the character of work done influences the craving of the system for water. Water is eliminated by the skin, the lungs, the kidneys, and the feces. The variability of action of the skin and lungs has just been illustrated. The kidneys are particularly sensitive to the existence in the stomach and intestines of water in quantities greater than are actually required, and respond by eliminating rapidly a part of that which is in the blood, to permit the absorption of the former. The kidneys act most freely in cold weather, when the skin is least active. If stools of a liquid character are passed frequently, elimination of water by the kidneys is lessened. Because of the varying activity of these organs a statement can be made of only the average elimination by each of them. Approximately, 28 per cent, of the water eliminated escapes from the body through the skin; 20 per cent, through the lungs; 50 per cent, through the kidneys; and 2 per cent, through the feces. Water is absorbed almost exclusively from the intestines. A comparatively small quantity may be absorbed from the stomach, and possibly a trifle from the mouth. It is taken up by the portal veins and the lymphatics. Not only does the quantity of water swallowed and eliminated vary, but also does the ability of the intestines to absorb it. In health this function of the alimentary canal changes little, if at all ; but in pathologic- conditions — as, for instance, in cholera, severe diarrhea, and dysentery — there is often evacuation from the mucous membrane of the intestines rather than absorption by it. Most persons drink too little water rather than too much. Especially is this true of those who lead a sedentary life, and of many others during the winter season. It is necessary, therefore, whenever elimination seems imperfect, to inquire as to the quantity of water and other fluids that is being consumed daily. From four to eight glasses are required by the average person. Under exceptional circumstances this allowance must be increased. The temperature of drinking-water should be governed by the needs of the stomach. Iced water will stimulate a more rapid and more copious secretion of gastric juice. Hot water IO THE USES OF WATER. will soothe an irritated stomach if taken into it before food is swallowed, and will help to cleanse it of mucus, bacteria, and remnants of food. When the stomach is secreting an in- sufficient amount of gastric juice, it is well to give a glass of iced water before or with an albuminous meal. If starches form the chief constituent of the meal, iced water should not be given, because the cold lessens salivary secretion and salivary digestion in the stomach. When an excess of gastric juice is formed a copious draft of hot water taken twenty minutes before a meal is beneficial. Ordinarily, drinking-water may be cooled, but should not be excessively cold. Iced water should not be taken when one is overheated. Many cases of gastro-intestinal derangement in summer are due in part, if not altogether, to the excessive use of cold drinks. If water is drunk during meals, it should be taken only when the mouth is empty, and in moderate quantity. Food which is only half masticated must not be washed into the stomach by drinking fluids. It is often best to drink water freely when digestion is at its height or has passed that point — say three or four hours after meals, especially if the stomach's contents is strongly acid. It will then help to wash the digested and disintegrated food from the stomach, and dilute the acids of the stomach so that they can be more quickly neutralized by the secretions in the duodenum. Mattil and Hawk 1 recently have studied experimentally the effect of drinking water at meal- times, and conclude that, if it is drunk when the mouth does not contain food, it does good. From one to two liters of water taken at meals caused fat, protein, starch and sugar to be absorbed more perfectly than when little water was drunk, doubtless because the gastric and pancreatic juices are increased and peristalsis is made more active. An important cause of constipation is a lack of sufficient fluid to keep the fecal matter soft. A mild grade of consti- pation can frequently be corrected by the drinking of one or two glasses of water, preferably hot, when the patient first leaves his bed in the morning, for it then stimulates peristalsis. Water is essential to the maintenance of good elimination. It is a most important diuretic and diaphoretic. In many 2 Jnl. American Chemical Soc, Vol. XXXIII, No. 12, Dec, 1911. HYPODERMOCL YSIS . 1 1 pathologic states, when the stomach will not retain water and when frequent, copious intestinal movements prevent its retention in the blood in quantities that make it diuretic, water can be advantageously administered hypodermically. This method is called hypodermoclysis. A pint or half-pint of sterile, ''physiologic" salt solution (i.e., 0.5 to i per cent, of sodium chlorid) can be introduced beneath the skin and will be rapidly absorbed and as rapidly eliminated. This is one of the most powerful diuretic measures that can be adopted. Water is also often given by the rectum when it cannot be taken by the stomach. A half-pint or pint of salt solution will be absorbed from the lower intestine. If the latter is irritable, small quantities only should be introduced into it. Unless the rectum be first emptied of its fecal contents, such enemata are of but little use, as they will not long be retained. In many cases, especially of bed-ridden patients, it is well to give a ''high" or ''colon enema" of salt solution by means of a tolerably thick soft-rubber colon tube, of as large caliber as can conveniently be used. Such tubes are less likely than smaller ones to kink or become bent back upon themselves when pushed through the rectum. Water or salt solution can be introduced also into the rectum drop by drop continuously. It is then very perfectly absorbed and its presence does not provoke expulsion. The water should be kept at a temperature of 98 to ioo° F. in a vessel about 18 inches above the patient. The rectal tube attached to it must have in it a stopcock so adjusted that it will deliver a drop in the rectum about once a second. This is the best method of administering large quantities of fluid constantly to those who need them. It is often said that to drink water copiously is fattening. Water does not contribute to the production of fat, but it does produce more rapid and better distribution of nourishment throughout the body than occurs when food is eaten and but little fluid is imbibed. To lessen fat-production it is best to diminish the quantity of food eaten and to modify, if need be, its character, but it is best not to lessen unduly or for many days the quantity of water consumed, because that will diminish the elimination of waste, salivary, gastric, and other 12 THE USES OF WATER. secretions, and tend to promote constipation and other patho- logic states. Through the agency of drinking-water many harmful impurities are introduced into the body. These may be inorganic chemicals, such as lime, magnesia, iron, and other salts, or micro-organisms. Typhoid fever and cholera are chiefly disseminated by drinking-water. Therefore it is of the greatest importance that the water-supply of a community be free from organized and organic impurities. The inorganic ones do serious harm least frequently, but an excess of lime- salts may increase the tendency of certain individuals to develop renal calculi; and sulphates in abundance may produce annoying purgation. It is not only necessary that drinking-water shall be pure, but all that is used for cooking purposes and for washing dishes in which food is stored or cooked must also be pure. Not infrequently epidemics of typhoid fever have been traced to milk contaminated by water that contained typhoid bacilli, and that had been used to cleanse the cans in which the milk was stored. Water is best purified by distillation. Both organic and inorganic impurities can thus be removed. Micro-organisms can be killed by prolonged boiling. When water is boiled, the air is driven out of it and the organic matter in it is often partly decomposed which therefore makes is for the time being at least offensive. This odor is lost by prolonged boiling, for during the process the volatile impurities are driven off. Both distilled and boiled water has a flat, insipid taste, because the air has been expelled from it. It can be made palatable by forcing a current of pure air through it, or by pouring it from pitcher to pitcher or shaking it in a large bottle. In these ways water can be once more aerated. Filters will remove gross impurities from water. The best will eliminate even most of the micro-organisms. In the course of time, however, the filtering material becomes saturated with bacteria, which are finally washed through in very large numbers. Therefore filtered water cannot be so thoroughly depended on as distilled water; consequently when filters are used, great care must be taken to change or cleanse the filtering RAIN-WATER. 1 3 substance frequently. The Pasteur or Chamberlain filter is the best. It will remove micro-organisms almost entirely from water. It is made of porous earthenware through which the water is filtered. The filter-tubes should be boiled frequently, to destroy all organized impurities in their pores. Numerous small stills are upon the market that are adapted to family needs. These are much more reliable purifiers of water than filters and are no more difficult to use. Waters are classified as soft or hard, according as they contain little, or no, or much, mineral matter in solution. Rain-water is soft and more nearly resembles distilled water than any other natural water. When rain first falls it absorbs from the air certain germs and volatile acids that are at times present in it. If rain-water is collected, as it usually is, from roofs, it will contain also dirt that has lodged upon them. For this reason it is best to permit the rain that falls during short showers and during the first few minutes of heavy ones to escape, and to collect only that which falls later. Certain spring-waters contain a minimum of mineral matter. The water of these springs does not pass through many strata of rock. Soft waters are the most wholesome for consumption, but they are not always the most palatable. Hard waters frequently are relished better. Mineral waters have been drunk for their medicinal effect since the savage days of man. Some have a pronounced physiologic action and others little or none. The benefit which invalids derive from a visit to a spa can rarely be obtained by drinking the same water at their homes. The freedom from care and hopefulness which absence from home generally insures, the change of diet, more exercise than usual in the open air are more important factors in influencing some cases than the mineral water. Invalids improve with so much greater certainty at the spa that many think the waters contain some volatile substance such as radium which is lost when the water is transported or stored. It is true that the latter element or some radioactive ingredient is found in many mineral waters. But how active therapeutically this agent in them is, has not been demonstrated. 14 THE USES OF WATER. Artificial mineral waters are certainly not the same in effect as natural ones and probably not in composition. The latter contain traces of mineral matter which may help to make them more efficient. Moreover, they are formed under pressure and contain double salts. The difference in their physiologic effect is typified by the fact that more mineral matter is absorbed from them in a given time than from those artificially mineralized and water artificially charged with carbon dioxid gives off the gas much more rapidly than does that which is charged naturally. In the latter the gas is probably in loose combination which causes its slower escape and its less violent ebullition. Spring waters vary greatly in the degree of concentration of their mineral ingredients and in the relative amounts of them. The analyses of two waters may be alike in their ingredients and not very different in relative proportion of each, but one may contain twice or several times the amount of mineral matter that the other does. Moreover, the analyses of spring-waters vary a little from time to time but chiefly in the degree of concentration of the mineral matter in them. Spring waters are classified by their predominating ingredi- ents for they often contain other ingredients which, if they occurred in large instead of small quantities, would change the position of these waters in the classification usually adopted. The following is the best classification and is based on their chemical composition: Class I. — Alkaline: contains alkaline carbonates chiefly. Class II. — Alkaline- Saline ; contains in approximately equal quantities carbonates and chlorides. Class III. — Saline: contains chlorides in largest quantity. Class IV. — Chalybeate: contains salts of iron. A water in either of these may be described as sulphated or muriated according as sulphates or chlorides are next in degree of concentration to the predominant salt. They may also be either hot or cold and gaseous or plain. The gas in them may be carbon dioxid or sulphureted hydrogen. All of these varia- tions change the therapeutic properties of springs. For instance, much of sulphates in an alkaline water may make it purgative. A hot water is more soothing than a cold one. It often lessens SPRING WATERS. 1 5 peristaltic activity and the rapid formation of gastric secretions. However, these effects are not very marked when water is drunk for it is so quickly reduced to body temperature. But cold water does stimulate the secretion of gastric juice. Carbon dioxide gas makes a table water more agreeable both to the eye and to the taste. It aids digestion by promoting chemical changes and muscular activity. It is also somewhat more rapidly absorbed than plain water. However, it should not be given to persons who are cyanotic or to those whose stomachs are dilated or to those whose hearts are weak and easily influenced in rate and regularity by gastric distention. Sulphureted hydrogen gas is not usually an active therapeutic factor in mineral water. It may be beneficial in catarrhal and in mild suppurative disorders of mucous membranes. Usually salts in solution in these waters are the most active therapeutic agents. The alkaline waters neutralize acids in the stomach, stimulate a more liquid and less mucous secretion from various mucous membranes, makes alkaline the urine and increases its amount. They are useful in catarrhal inflammation of the gastro- intestinal, biliary, respiratory and urinary tracts. The simple alkaline waters are used almost exclusively to neutralize acids in the stomach and to stimulate diuresis. When the chlorides appear in them in considerable quantity they become better solvents and diluents of mucus, and when the sulphates also occur in them in notable amounts they become mildly laxative. The latter are especially useful in gastro-intestinal catarrhs, gastric ulcer, catarrhal jaundice, congestion of the liver, cholelithiasis, gout and renal lithiasis. The following well- known waters may be regarded as types of the groups of acidulous waters or of those containing carbon dioxide : Simple acidulous, Alkaline acidulous Appolinaris. Geyser Spring, California. Manitou Soda, Colorado. Neuenahr, Salvator, Vals, Vichy, California Seltzer, Saritoga Vichy. i6 THE USES OF WATER. Alkaline muriated acidulous Alkaline saline acidulous Ems, Seltzer. Saratoga, Roy at. Carlsbad, Marienbad, Keyser Spa, California. Castle Hot Springs, Arizona. Idaho Hot Springs, Manitou Springs. In saline spring waters chlorides or sulphates predominate sometimes together though often separately. In the chloride group of waters sodium chloride predominates but many other chlorides are commonly present in varying amounts. Bromine and iodin are sometimes present in these waters, usually in amounts so small as to make their therapeutic value doubtful but, when relatively abundant, the waters containing them have been found beneficial for the scrofulous and the syphilitic. The chlorides stimulate gastric, hepatic, intestinal and renal secretions. The waters containing them have been found bene- ficial in chronic gastritis especially of the mild type and often in exacerbation of the alcoholic type. When spring waters contain these ingredients in considerable quantity they are mildly aperient. They are preferred to the bitter waters in the portal congestion of thin people who cannot stand much reduction in weight. They are also often prescribed as an expectorant by those having chronic bronchitis. The bitter waters contain magnesium sulphate or sodium sulphate or both in large quantity. When these waters are concentrated they are vigorous purgatives. They also stimu- late the secretion of bile and urine. Therefore they are bene- ficial in cases of chronic constipation in which there is enlarge- ment of the liver and often a subicteric staining of the conjunc- tiva and skin. The presence of chlorides and alkalies make some of this group of waters more beneficial. Sulphureted hydrogen exists in many of these spring waters. When the mineral matter is at all concentrated in them they are bitter and sometimes nauseous. This necessarily limits their usefulness. The following are among the well-known chlorid saline springs: Eureka Springs, California; Magnetic Mineral Spring, SPRING WATERS. 1 7 Indiana; Blue Lick, Kentucky; Mount Clemans, Michigan; Congress, Saratoga; Glenwood, Colorado; Harrowgate, England; Baden Baden, Hamburg and Wiesbaden, Germany; and among the well-known sulphate saline springs are: Crab Orchard, Kentucky; Bedford Springs; Apenta; Hunyadi Janos and Kissingen. The chalybeate springs contain iron in the form of bicarbon- ate, oxide, sulphate or chlorid. Of these the first, especially if it is combined with other carbonates and contains carbon dioxid, is the best and most agreeable to take. The fact that only small amounts of iron are contained in these waters does not make them less useful in the treatment of anemias. The springs which contain iron in the form of sulphates often also contain alum and arsenic and are particularly useful in diarrheas and in the anemias due to them. Usually these waters must be drunk in small amounts otherwise they will produce indi- gestion. Franzenbad, Richfield, Cresson and Rawley, Vir- ginia, are types of the carbonated chalybeate springs. Sharon chalybeate and Bedford alum are types of the sulphated alum group. As the active ingredients of waters vary in amount in different springs the quantity to be drunk varies at each and also varies with the nature of each patient's disorder. Spring waters to be effective therapeutic agents must be given with the same care and judgment as other medicine. When properly used and especially when drunk at the spring, mineral waters will be found to be most important remedial agents and ought not to be neglected. CHAPTER III THE ELEMENTS OF FOOD Proteins — Digestion, Assimilation, Elimination; Effects in Health and Disease. Fats and Oils — Uses; Digestion and Assimilation; Effects in Health and Disease; Butter; Cream; Cod-liver Oil. PROTEINS Proteins have both an animal and a vegetable origin. They form so large a proportion of animal food, however, and so small a proportion of vegetable food that the former is their chief source. They are composed of carbon, hydrogen, nitrogen, oxygen, and sulphur, which are united to form a very complex molecule. The first step toward the digestion and utilization of proteins is mastication, by which the food is broken and roughly dis- integrated and lubricated with mucus, while some of the salts in it are dissolved. Unless mastication is thoroughly performed when meat — pre-eminently protein food — is eaten, its further disintegration and digestion by the stomach will be slow, and in pathologic states may be painful. Cooking is of importance in preparing meats for easy digestion, for by it the connective tissues are converted into gelatin, which readily dissolves in the gastric juice and permits the rapid separation of cell from cell. Hydrochloric acid is the essential acid of the stomach, and its presence is necessary for the proper digestion of proteins. Meat and bouillon rich in meat extractives are the best stimulants to the formation of hydrochloric acid by the glands of the stomach. Acids taken before a meal of meat will hinder the formation of gastric juice and are to be deprecated at this time. If taken at the end of the meal, they are not harmful. 18 DIGESTION OF PROTEINS. 1 9 The normal churning movements of the stomach are most im- portant in order to facilitate the commingling of food and gastric juice so that digestion may progress as rapidly as possible, and to transfer what has been well disintegrated or digested into the intestines. Many cases of functional derangement of digestion are due primarily to slow and imperfect movements of this organ. Impaired mobility is also an important factor of in- digestion when there is structural disease of the organ. A sedentary life and reduced muscular strength and nervous energy from any cause will lessen the activity of the stomach. Although its churning movements are altogether involuntary, they are much influenced by emotional excitement, especially when great or prolonged. Distress, anxiety, sorrow, and fear will often check digestion for the time being. The first chemical change that proteins undergo in gastric digestion is the conversion of a part of them, by means of the hydrochloric acid that the stomach's juice contains, into acid albumin. Under the influence of pepsin the latter is still further transformed by several changes into a series of proteoses, and finally into the terminal product, peptone. Peptone is absorbed from the stomach in comparatively small quantity. Most of it, together with the proteoses and the pro- teins, as yet undigested, is emptied into the duodenum. Here the acidity of the stomach-contents is neutralized, and protein digestion is completed under the influence of the pancreatic ferment, trypsin. Trypsin is formed in the small intestines from trypsinogen which is excreted by the pancreas in its juice or secretion. A ferment secreted by the glands of the intestines called entero- kinase converts inactive trypsinogen into active trypsin. The intestinal glands also secrete erepsin, a ferment which splits peptones into aminoacids and ammonia. In the intestine, proteins that have not undergone digestion in the stomach are first transformed into alkali albumins, then into proteoses, peptones, polypeptids and amino acids. The proteoses and peptone that come from the stomach are also con- verted into antipeptone and amino acids. The following diagram will make these processes clearer: 20 THE ELEMENTS OF FOOD. Stomach Digestion. Intestinal Digestion. Proteins ► Proteins (by HC1) (by tryspin) 1 I Acid Albumin Proteoses (by Pepsin) 4 1 Proteoses Peptones I I Peptones (by erepsin) 1 J Polypeptides \ Amino acids It is uncertain whether the products of protein digestion are absorbed as polypeptids or amino acids or both. Certainly the latter finds its way to some extent into the portal vessels. It is doubtful if the epithelial cells of the intestine synthesize the products of digestion into the albumens of the blood as was once supposed, certainly they do not do so completely. Syn- thesis takes place probably in every cell of the body, the amino acids brought to them by blood and lymph or possibly formed by their disintegration being utilized for cell production. Moreover, it is known that the products of protein digestion are transformed in part at least into nitrogenous derivatives which may be eliminated as such and into nonnitrogenous derivatives which may be utilized for the production of energy or stored as fat or glycogen. The nitrogenous derivatives are ultimately eliminated by the kidneys as urea, ammonia and purin bodies. Urea the form in which they are mostly eliminated is produced in the liver from ammonia made in the tissues and brought to that organ by the blood as a carbonate. Imperfect functional activity on the part of the liver causes a relatively large amount of ammonia to be eliminated by the kidneys. Pathologic conditions such as fever and diabetes also disturb the relative proportion of these substances in the same way by forming acids during metabolism which produce stable ammonium salts. Normally 2 to 6 per cent, of the total nitrogen elimi- nated by the kidneys is in the form of ammonium salts. The purin bodies including uric acid are formed from nucleoprotein. From 0.3 to 0.4 grams per day is produced by metabolism of the tissues; the remainder from nucleoprotein in food. The On High On Low Protein Protein Diet Diet Grams Grams 16.8 3.6 14.7 2 . 2 O.49 0.42 0.18 0.09 0.58 0. 60 FERMENTATION OF PROTEINS 21 amount of nitrogenous excreta varies with the diet as is shown by this table modified slightly from Sherman. 1 Total nitrogen Urea Ammonia. Purins, etc. Uric acid Creatinin Undetermined 0.85 0.27 The acidity of the contents of the small intestine is due to the acids derived from the stomach and to organic acids formed from fats in the intestine. As these are in part absorbed, and in part neutralized by the secretions normally poured into the intestine, the contents grow less acid and often become alkaline very quickly. In both the stomach and the intestine bacteria cause more or less putrefaction or abnormal fermentation of foods. Among the compounds thus formed from proteins in the intestines, indol and skatol are especially well known. They are produced most abundantly when protein digestion is slow or ceases, and when proteins remain undigested and unabsorbed for a long time in the intestine. Therefore, disturbances of pancreatic secretion and imperfect or very slow peristalsis are conditions that contribute to their formation. The discovery of these substances in the urine in unusually large quantities is indicative of such disturbances of protein digestion. The movements of the intestines, or peristalsis, are quite as essential to rapid digestion of food in them as are the churning movements of the stomach. As the food is moved through the intestine its digestion is completed and it is absorbed. Normally the products of protein digestion are not absorbed from the stomach. Most of them are absorbed from the small intestine ; probably more than 80 per cent, is taken up by its villi. 1 Chemistry of Food Nutrition, by H. C Sherman page 116. 22 THE ELEMENTS OF FOOD. Inflammation of the intestines often hinders or prevents absorption. This will necessarily interfere with the mainte- nance of strength and flesh. Disturbances of circulation, de- struction of epithelium, the obstruction of lymph-spaces with inflammatory exudates, and the formation of a covering of mucus, all take part in the causation of such an interference with absorption. Pathologic processes sometimes give rise to the appearance of peptone in the urine. Often, they prevent, as in fevers, for example, the appropriation of food by tissue cells. When this happens, the cells can no longer develop a normal degree of energy, and may waste, atrophy, or die. Meat is the chief source of proteins. Beefsteak, for example, contains 20 per cent, of it. In foods of vegetable origin a variable amount is found. For instance, bread contains 8 per cent. ; arrow-root, 0.8 per cent. ; potatoes, 2 per cent. ; and dried peas, 22 per cent. Although dried peas are as rich in proteins as is beefsteak, they contain only 2 per cent, of fat and 53 per cent, of carbohydrates, while the flesh contains 3.5 per cent, of fat and no carbohydrates. If meat be the chief food consumed by a man, the quantity of urates, urea, phosphates, and sulphates in his urine will be increased. Animal food requires a considerable quantity of oxygen for its utilization by the tissues. Therefore, a diet composed largely of meat increases the demand for oxygen. Most persons are more energetic and active when they eat meat freely than when they live chiefly upon vegetables. But if digestion is disturbed, or if there is a tendency to gout, this is not the case. Meat better satisfies hunger than will the same bulk of carbohydrate food. It is very agreeable to most persons, and its aroma and flavor stimulate appetite and gastric secretions. For these reasons most persons are tempted to eat too much meat. If, by an abundance of outdoor exercise, sufficient oxygen is not furnished to utilize it and a need for it is not also thereby created, an excess of protein waste will accumulate in the blood and tissues and cause biliousness, gout, and other disorders. Meat is not a necessity of life. Nitrogenous food is a neces- sity, but it can be obtained in sufficient quantities from vege- QUALITY OF PROTEIN NEEDED 23 tables, certainly from vegetables supplimented by milk and eggs. An exclusively vegetable diet will enable a person to do as much, and at times even more work, as a diet containing an excessively large amount of meat, but it will not fit one as well to meet sudden demands for great exertion. A mixed diet is undoubtedly the most desirable : but one that contains a very moderate amount of meat is best. A diet rich in meat and relatively poor in carbohydrates is less fattening than one with these conditions reversed. When carbohydrates and fats are eaten abundantly less protein is required to maintain a protein balance than when less is taken, therefore, they are called protein savers. Exercise or muscular work does not increase the breaking down of tissues in proportion to its increase, on the contrary muscles grow larger by use not smaller, therefore there occurs an appro- priation and storage of nitrogen from protein food. There is, however, enough protein in an ordinary mixed diet always to supply this need. How much protein is required to maintain health when an abundance of fuel in the form of carbodydrates and fat is eaten is a problem which has long vexed dietitians and physiologists. Voit observing the habits of large numbers of individuals con- cluded that 118 grams of protein were needed. Playfair recom- mended 1 19 grams, Gautier 107 and Atwater in our own country 150 for a man at hard work and 90 to 100 when at rest. More recently Chittenden has studied the subject exhaustively. By practical experiments on groups of men following different vocations and doing various grades of work, he found that they remained in good health, were well nourished and strong on a diet which afforded an average of 50 grams of protein and enough of other foods to supply the needed energy. Therefore he concludes that the old standards are much larger than they should be. This is doubtless true at least in adult life. In- fants get in the milk which is their only food an amount of protein which would be equivalent to 140 grams for an adult. But it must be remembered that their cells are multiplying with rapidity and for this a large amount of protein is needed. As a child develops into manhood or womanhood gradually less is needed. 24 THE ELEMENTS OF FOOD. FATS AND OILS Sources of Body Fat Twenty per cent, of the normal weight of the average man is fat. It is, however, only in small part derived from fatty food. Its chief source is carbohydrate food. Proteins also produce a part of it. Uses of Body Fat and Fat Food Most of the fat that is eaten is rapidly oxidized and supplies much of the heat generated by the living body. Because it is so rapidly utilized for heat-production it saves the living tissues in part from waste. It also contributes a little to the formation of tissues. Tissue waste is most rapid under a protein diet. For these reasons a moderate ingestion of fatty foods makes it unnecessary to eat so large a quantity of protein as would otherwise be needed to furnish energy and contribute to the growth and repair of tissues. Fat is, therefore, sometimes said to be a protein saving food. The accumulation of fat in the tissues has little to do with the ingestion of it. It is in them a store of potential energy, and may be drawn upon when the food supply is deficient or de- fective. When present in the subcutaneous tissues it gives rotundity and often beauty of form, both of which are absent when the muscles are unpadded. It also preserves the heat of the body by preventing too rapid cooling. Digestion of Fatty Food When eaten, fat undergoes no digestive change in the mouth but when it is taken in the form of a fine emulsion, as in milk and yolk of egg f a ferment formed in the stomach can split it into its components. When it occurs in cooked meat, it is set free in the stomach in the form of large oil globules, because the gelatinized connective tissue that holds it is then dissolved. In certain forms of indigestion it is decomposed in the stomach and fatty acids are set free. They are irritating to the viscus, and may excite local inflammation. Such decomposition is due to the growth of certain micro-organisms that enter the stomach with the food. It is in the intestines that DIGESTION OF FATS. 25 fats and oils are modified by digestion and are prepared for absorption. The pancreatic ferment steapsin decomposes them into fatty acids and glycerin. The presence of fatty acids in the small intestine gives its contents a faintly acid reaction, although the first effect of the alkaline secretion of the intestine is to neutralize the acids of the chyme from the stomach. Formerly it was taught that the fatty acids help to facilitate the emulsification of the remainder of the oils and fats of the food, and that from the bile, pancreatic juice, and succus enter- icus an abundance of sodium carbonate is obtained. The sodium unites promptly with the fatty acids to form soap, and carbonic acid gas is set free. The soaps thus formed, and the agitation that intestinal peristalsis gives to the contents of the alimentary canal, afford the conditions needed for the making of an emulsion in which form is was believed to be absorbed into the lacteals. Sodium makes, with fatty acids, soluble soaps, but magnesium and calcium also form soaps in the intestines that would be almost insoluble were it not for the bile, which is able to dissolve them. It is now believed that most of the fat in the intestines is split into glycerin and fatty acids and the latter is held in solution by the bile. In pathologic states, when bile is secreted in insufficient quantity or its entrance into the intestines is prevented by a calculus or other obstruction of the common bile-duct, fatty acids are very imperfectly dissolved and most of the fat then eaten appears in the stools saponified or undigested. When the pancreatic juice is deficient or absent, the same disturbance of digestion is observable. Inflammation of the duodenum may also delay fat digestion, but not to the same extent as results from the failure of bile or pancreatic juice to reach the intestine. Fats are not absorbed until they reach the intestine, and are taken up almost exclusively from the small intestine, the wall of the large bowel absorbing an inconsiderable quantity. The epithelial cells covering the villi of the intestine play an im- portant part in the absorption of fat. Fatty acids and glycerin are taken up by these cells and are recombined by them into fat granules, which are excreted in turn into the lacteals. The abdominal lymphatics collect the fat thus properly synthesized 26 THE ELEMENTS OF FOOD. for the use of the human body and finally empty it into the general blood-current. The fat in the blood is oxidized chiefly in the most actively metabolic tissues of the body. Possibly a small amount may be oxidized in the blood itself, and another small amount may be deposited as reserve in fat tissues. It might be supposed that the epithelial cells of the intestines when they recombine fatty acid and glycerin would fashion the fat into that peculiar to the body of which they are a part, but this is not altogether true, for when rapeseed oil and mutton tallow which can be easily de- tected have been fed to animals, they have been recovered again from the fat stored by the animals in their own tissues. The end-products of fat metabolism are carbonic acid and water; these are excreted by lungs, skin, and kidneys. Butter and cream are the most agreeable forms of fatty food. Bacon, when hard fried, is digestible and well relished by many persons. Cod-liver oil is not agreeable, although a fondness for it is sometimes acquired. It is, however, easily digested. Even if one does not become fond of this oil, he soon learns to tolerate it. Of fat meats, fat pork is least digestible and fat mutton is less digestible than fat beef. Artificial emulsifi cation has been resorted to in order to make fats and oils more digestible. It is doubtful if such emulsions accomplish their purpose. Certainly the cruder ones, made by mechanical processes or by simple suspension of an oil in fluids thickened with gum arabic, sugar, and other viscid substances, do not aid digestion. An emulsion made with pancreatic extract may do so. Too much fat in the food leads to abnormal production of fatty acids and consequent indigestion. Of all common articles of food, fat must be used most sparingly and most judiciously. Fats and oils are especially to be limited in amount whenever one has indigestion. They are likely to cover the mucous mem- brane of the stomach and particles of food, and so to hinder secretion by the peptic glands and interfere with the attack of foods by the gastric juice after it is formed. When digestion is good, a limited quantity of fat can be digested and is most wholesome. Satiety is reached more USEFULNESS OF FATS. 27 quickly by its use in increasing amounts than by protein or carbohydrate foods. In general, animal fats are better toler- ated than vegetable oils. Hot fats are usuallly less digestible than cold fats. For this reason many persons find it difficult to eat hot mutton and pork, but digest them when eaten cold. Fried foods are not so digestible as foods cooked in other ways, and should be forbidden absolutely for invalids, and but rarely be employed by persons in good health, as these foods are difficult of digestion, and thus lead to dyspepsia and even to disease of the digestive tract. All fats, except limited quanti- ties of butter and cream, should be forbidden in acute diseases of the stomach, intestines, and liver, and in most of the chronic ones. Their use should be closely limited in the presence of gall-stones and when there is a tendency to acne or urticaria. On the other hand, fatty food must be prescribed for children with rickets and for all who have diabetes. In the latter disease, it partly replaces the carbohydrates, which cannot be used. Fat may be prescribed with benefit in chronic wasting diseases, such as tuberculosis, and during convalescence from severe acute diseases. The most agreeable and digestible forms should be used. At first small portions only should be taken and the quantity be increased as tolerance is acquired. In a general way fats and oils are laxative, and consequently are useful for those who are constipated, and equally harmful for those who have a tendency to diarrhea. Most articles of food contain a varying amount of fat and oil. For instance : Pork (salt) contains 82.8 per cent. Bacon contains 69 . 5 per cent. Beef contains 27.0 per cent. Milk contains 4.0 per cent. Beans contain 2.0 per cent. Potatoes contain o . 1 per cent. Oatmeal contains 7.1 per cent. Cornmeal contains 3.8 per cent. Peas contain 1.7 per cent. Butter contains 85.0 per cent. The animal fats most commonly used, aside from what is con- tained in meats, are butter, cream, eggs, lard, suet, tallow, 28 THE ELEMENTS OF FOOD. oleomargarin, butterin, and cottolene. These may all be used in cooking or as adjuvants to foods, but they must be employed sparingly by most persons. The vegetable fats that are most used are olive oil, cotton-seed oil, linseed oil, cacao-butter, the oils of various nuts, especially cocoanuts, peanuts, and almonds. Cod-liver oil not only is a food, but contains some medicinal properties, probably chiefly due to the iodin and other inorganic elements that it contains; and possibly also to certain organic derivatives of the liver that resemble alkaloids. Cod-liver oil is used whenever it is desirable to administer fats in as large an amount as possible, and when only the most digestible forms can be given. A tolerance of it is soon acquired by children, even by infants. Adults are rarely able to take it in sufficient quan- tities to make its use of much importance. It is given to adults in doses of one or two tablespoonfuls three or four times daily, commencing with much smaller doses. To disguise its taste it is frequently given as an emulsion that is flavored with winter- green and other aromatic oils, or it is mixed with malt extracts. If the taste is disagreeable, it is best given in elastic capsules. The clearest oils are the best and are most easily taken. A pinch of salt taken before and after the oil often makes it palatable. It can also be floated in strong coffee or peppermint water, and so swallowed as scarcely to be tasted. Preferably it should be taken clear and swallowed quickly ; a little salt or a dry cracker may be eaten afterward to remove the taste from the mouth. CHAPTER IV THE ELEMENTS OF FOOD (Continued) Carbohydrates — Composition; Digestion; Abnormal Fermenta- tion; Absorption. Action of Liver. Utility in Health and Dis- ease. Interrelationship of Foods. Effect of Changes of Diet. Salts. CARBOHYDRATES Composition Carbohydrates are composed of carbon, hydrogen, and oxy- gen. The most important are starch, sugar, and cellulose. Chemists recognize three main divisions: (i) Polysaccharides, or starches, cellulose, dextrin, and gums; (2) disaccharides, such as cane-sugar, lactose, and maltose; (3) monosaccharides, which include dextrose, or grape-sugar, and levulose, or fruit-sugar. Carbohydrates are eaten chiefly in the form of starch and cellu- lose, but must be transformed into dextrose, or grape-sugar, before they can enter the blood and contribute to the main- tenance of bodily vigor. Digestion Starch occurs in the form of grains or small particles with a nondigestible envelope of cellulose about them. When, in cook- ing, it is subjected to heat and moisture, it swells, and the envelope ruptures, permitting the starch grains to escape. Therefore, in order that starch may be digested, cooking is essential. If starch, cereals, and vegetables are cooked imperfectly they are indigestible. When, after cooking, starch is taken into the mouth, the granules are, by masti- cation, more completely broken up and are incorporated with saliva so as to form a paste-like mixture. The thorough commingling of saliva with the starch is essential to good sal- ivary digestion. Ptyalin, the digestive ferment of saliva, splits starch first into various dextrins and ultimately into maltose, which is the end-product of its digestion. These changes are only begun in the mouth, as food is rarely retained in it more than a few seconds, or one or two minutes at the longest. A 29 30 THE ELEMENTS OF FOOD. comprehension of the process of salivary digestion makes evi- dent the necessity of perfect and slow mastication. Although salivary digestion progresses best in a slightly alkaline or neu- tral medium, it can take place in a faintly acid mixture also. Therefore it is chiefly continued in the stomach before the contents of the latter become strongly acid. It is supposed to be checked by the end of the first half-hour or three-quarters of an hour of gastric digestion. As starches usually form a large part of our meals, it is impossible to convert much of them into maltose while they are in the stomach. By the end of the period of gastric digestion some starch is undigested in the stomach, much of it is converted into various dextrins, and a little into maltose. The churning movements of the stomach, as well as the process of salivary digestion, help to disintegrate and dissolve the starch clumps that are swallowed, so that they will be emptied into the duodenum in a state of fine division and suspension, if not of solution. Such cane-sugar, milk-sugar, or fruit-sugar as is eaten is also partly digested in the mouth and stomach. When grape-sugar is eaten, it undergoes no digestive change. As already explained, salivary digestion in the stomach is in- fluenced by cooking and by mastication. The body-tempera- ture especially promotes its progress. Ice, iced food, e.g., ice- cream, and iced water will hinder the formation of saliva and lessen the activity of ptyalin digestion. Very cold drinks at the beginning of a meal or with it are therefore not favorable for starch digestion in the stomach. Starch in cold foods, such as potato salads, cold oatmeal mush, and similar articles, is not readily transformed in the stomach and should be eaten only by those whose digestion is good. However, the chief changes that starch-containing foods undergo in the stomach are disintegration and comminution of the masses in which they are swallowed, and a very moderate degree of chemical alteration. Salivary digestion is also delayed by eating, at the beginning of a meal, very acid fruit or food, which will rapidly acidify the contents of the stomach. Oranges and other acid fruits are therefore not so wholesome when eaten at the beginning of a meal as at the end. If fruit is eaten before breakfast, it should preferably be a sweet fruit or a compote. DIGESTION OF CARBOHYDRATES. 3 1 When the digestion of starch in the stomach is imperfectly performed because of an excess of acid gastric juice, it may often be aided, if a glass of hot water is taken twenty or thirty min- utes before eating, in order to lessen the secretory activity of the stomach and to dilute partly its juice. If only carbohy- drates are eaten at one meal and only proteins at another, gastric digestion is often improved. Carbohydrates are chiefly digested in the intestine. Amyl- opsin, a pancreatic ferment, is essential to this process. The changes that it effects in starch are similar to those wrought by ptyalin. Maltose is again its end-product. Several dex- trins are formed in the progress of the final transformation of starch. Dextrins, cane-sugar, milk-sugar, and grape-sugar also find their way into the intestine. The first of these is modified by amylopsin and converted into maltose. Maltose is the final product of all carbohydrate digestion. It does not enter the blood, but is still further transformed into dextrose, either by the invertase of the intestinal juice, or possi- bly by the epithelial cells of the villi. Dextrose is the only carbohydrate found in the portal blood. Abnormal Fermentation When the digestion of carbohydrates is slow or ceases, bacteria and yeasts give rise to abnormal fermentation. Bac- teria are probably always active to some extent in the small intestine, and when carbohydrate food is eaten in quantities so large that it cannot readily be disintegrated by salivary digestion and the muscular activity of the stomach, it is certain to be a nidus for their growth. Potatoes, fried or stewed, and swallowed in chunks, will be slow to disintegrate. Fresh hot breads usually form masses of dough in the stomach that can- not well be broken up. A large meal of pancakes and syrup will be imperfectly prepared by the stomach for digestion, partly for the same reason that hot breads are, and partly because the excess of sugar that is eaten overtaxes the digestive powers of the organs. These articles of food at the tempera- ture of the body, and mingled with the other contents of the stomach, are especially favorable media for the growth of numerous micro-organisms. 32 THE ELEMENTS OF FOOD. The results of bacterial fermentation of starches and sugars are ethyl alcohol, acetic, lactic, butyric, and succinic acids, carbonic acid gas, and hydrogen. Cellulose, when decomposed, forms marsh-gas and carbonic acid gas. The flatulence and meteorism characteristic of many dyspeptic states are due chiefly to the copious generation of these gases. When carbohydrate food rich in cellulose is fermented, it is especially productive of gases. Sugars are more likely to produce an excess of lactic, butyric, and acetic acids and a moderate amount of carbonic acid gas. Bacterial fermentation usually lessens from the beginning of the small intestine to its end. When excessive, it continues in the colon. Gases in the small intestine give rise to rumbling noises — borborygmi. These gases rarely find their way into the stomach. They may be passed from the anus, or may in part be absorbed. An idiosyncrasy present in certain persons is an inability to digest much carbohydrate food. Fever lessens the activity of all digestive processes and increases the tendency to abnormal fermentation. Most chronic diseases that produce great weak- ness have a similar effect. Absorption Carbohydrates are absorbed almost exclusively from the small intestine. A very small amount may be taken up by the walls of the stomach and the large intestine. Cane-sugar and milk-sugar are readily absorbable, but must undergo changes before they can enter the blood. Their conversion into dex- trose may occur in the epithelial cells or be produced by inver- tase in the succus entericus. These processes may be interfered with by extensive inflammation of the small intestine and by those maladies that are characterized by frequent profuse watery stools. Action of Liver The blood in the portal vein may contain as much as 0.3 per cent, of dextrose, but the blood that leaves the liver and enters other tissues of the body does not contain more than 0.1 per cent. It is evident, therefore, that much of the carbohydrate food that is eaten is arrested by the liver before it is distributed UTILITY OF CARBOHYDRATES. 33 to the other tissues. The dextrose of the portal vein does not remain in that form in the liver, but is transformed into com- paratively insoluble glycogen. Glycogen is derivable to a small extent from fat and proteins, but carbohydrates are its chief, almost its exclusive, source. Sugar is retained in the liver as glycogen only temporarily. The organ contains an amylolytic ferment that converts it again into dextrose, in which form it is found in the general circulation. Glycogen is also formed and stored to a limited extent in muscles. Utility Dextrose is utilized by the metabolic tissues for the liberation of energy. Whether this is accomplished in the blood or in the lymph when it is in contact with active cells, or whether it must first be absorbed by, or form part of, the cells, has not yet been established though most physiologists to-day believe that it is accomplished outside the cells by a ferment which is made active by something derived from the pancreas. When metabolized, the waste is eliminated chiefly by the lungs as carbonic acid gas and water. All the dextrose in the general circulation is not used for the creation of energy; a part of it is stored as fat in the connective tissues. It is. put away, as it were, as a reserve of potential energy. Pavy contends that many protein molecules contain a carbo- hydrate element, and that albuminoid matter can be split into protein and carbohydrate matter or, it may be said, better into a nitrogenous and nonnitrogenous portion. This takes place apparently when, in certain diabetics, the ingestion of food has ceased, glycogen has been consumed, and still sugar is excreted. He claims that from 45 to 60 per cent, of the protein molecules is thus transformed into sugar. Not only can albuminoids be decomposed into protein and carbohydrate elements, but also a synthesis can be effected and part of the ingested and absorbed carbohydrate goes to form protein molecules. In diabetes there is a disturbance of dextrose metabolism that permits it to accumulate in the general circulation until it exceeds the normal 0.1 per cent., when it is eliminated by the kidneys. Individuals are peculiar as to the ease with which 3 34 THE ELEMENTS OF FOOD. they store dextrose as fat. There are many who accumulate fat even upon a poor diet, and many who remain thin upon a habitually generous one. These variations become pathologic in cases of obesity and of excessive emaciation. Emaciation does not necessarily mean an inability to form fat from carbohy- drates. The fault lies often in the digestive organs, where food is not properly prepared for absorption or is not retained; or the dextrose that is absorbed is consumed in the production of heat, as in fevers. Interrelationship of Foods The interrelationship of proteins, fats, and carbohydrates is well illustrated by the following diagram. The ability of each to replace measurably one or both of the others is also shown. When proteins are eaten they are in part transformed into tis- sue, in part directly catabolized, and in small part transformed into carbohydrate matter and fat. When fats are eaten they are in small part stored in the tissues as fat ; in large part they undergo combustion directly. A part of the stored fat of the system that may be consumed in case of need is derived from the proteins and carbohydrates. Carbohydrates for the most part undergo direct combustion. Physiologic Interrelationship of Foodstuffs Fats Stored fat Carbohydrates Proteins Eliminated It is evident from this that proteins can very imperfectly replace the functions of fat and carbohydrate. Fat and carbo- hydrate are closely related in function and may in large degree replace each other, but neither can perform the special func- tions of proteins. PECULIAR DUCTS. 35 Vegetarianism Those who live chiefly upon cereals, vegetables, fruits, and nuts are called vegetarians. These foods are with rare excep- tions supplemented by such animal food as milk, cheese, and eggs. A menu made up of these foods can be so planned as to supply both the carbohydrates, fats, and proteins that are needed. A part of the protein is derived from milk and eggs, and a part from the vegetables eaten. The nitrogenous matter obtained from vegetables is less easily digested than that which is of animal origin; a much larger percentage passes from the alimentary tract unutilized. Few persons live entirely upon a vegetable diet. Those who attempt it lose vigor and show languor and disinclination for physical and mental work. They become less able to resist disease. Because a vegetable diet is an economical one, it has sometimes been forced upon bodies of laborers, but uniformly the decrease in the amount of work that they are able to perform more than counterbalances the de- creased expense of their food. In vegetables enough protein can be found to make it possible to substitute them for meat for the purpose of maintaining life and strength. As vegetable protein is very imperfectly digested and absorbed, a sufficient vegetable diet must be a very bulky one. It will maintain strength, and by eating vegetable food only one may be able to lift as much ; but one will not be able to work so fast as on a mixed diet. He will lack energy and alertness. It is quite evident, from man's anatomic structure, physio- logic functions, and habits of eating, handed down from the earliest times, that a mixed diet is best adapted to his needs. At the same time it is unquestionably true that too much meat is ordinarily eaten by many individuals. Effect of Changes of Diet Often a change from a generous mixed diet to a so-called vegetarian regimen improves the health of individuals. It does this chiefly by correcting bad habits, such as eating too much, eating rich foods, drinking little; and by removing such pathologic states as constipation. A radical dietetic change usually diminishes a person's appetite, for fewer things that he 36 THE ELEMENTS OF FOOD. enjoys are placed before him. The vegetables, fruits, and cooked cereals contain a larger amount of water than may otherwise be obtained. The coarser cereals, such as bran bread and fruits, as well as the increased supply of water, help to provoke more regular and copious bowel movements. SALTS The mineral ingredients of the body are essential to the main- tenance of life, to give the body form and stability, and to main- tain numerous special functions. Doubtless they take large part, by so-called catalytic action, in the more recondite chemistry of cells and fluids. They are obtained in abundance, even in excess, in the foods that are ordinarily eaten. In health, sodium chlorid is the only salt that need be added to foods. Sodium chlorid is found in all the tissues and fluids of the body. It is most abundant in the latter. It performs various functions. It gives relish to the food that contains it and im- proves appetite. From it the hydrochloric acid formed by the glands of the stomach, and so essential to digestion, is produced. It promotes the diffusion of fluids through membranes. It keeps globulins in solution in blood and lymph. It stimulates protein metabolism and increases the excretion of urea. Partly by increasing metabolism and the production of waste, and partly of itself, it stimulates the kidneys to increased activity. It is of value as a mild laxative. When taken the first thing in the morning with water, it will often promote free catharsis in those who are constipated. It is an important element in many laxative mineral waters. An adult in health will eat and eliminate 200 grains of sodium chlorid daily. The kidneys are the organs through which it is chiefly excreted. It is used extensively as a food preservative. Beef, pork, and fish are commonly "salted" in order to preserve them. Sodium carbonate and bicarbonate are found in the blood. They are present in the foods consumed, and are also formed in the alimentary tract by the decomposition of salts of the vegetable acids. Their presence in the blood is important because they help the plasma to carry carbonic acid from the tissues to the lungs for elimination. SALTS. 37 Sodium and potassium sulphate occur in small quantities in the body. In part they are eaten as such, and in part are formed in the body by the oxidation of organic substances containing sulphur. Sodium and potassium phosphates also are important mineral constituents of the body, and are distributed widely therein. The alkaline phosphates give to the blood and lymph their alkaline reaction, and the acid sodium phosphate gives the urine its usual acid reaction. Potassium chlorid is widely distributed in the body, but it occurs in comparatively small proportion. It is most abundant in the muscle-cells and the red blood-cells. In general it may be said of potassium that it is most abundant in the cells of tissues, and of sodium that it is most abundant in the fluids. Calcium phosphate and calcium carbonate are associated in the tissues. The former is much the more abundant, forming more than half of bone. It is essential to all cell growth, and is present in all tissues. Magnesium phosphate occurs with the lime-salts, but occurs in much smaller quantity. Sulphur and phosphorus are introduced into the system with the albuminates. They occur in both animal and vegetable foods. Iron is essential to the maintenance of health. It is an im- portant ingredient of hemoglobin, and occurs in appreciable amounts in muscle-fibers, and in minute amounts in various other tissues. Only a small quantity of iron is needed to main- tain its balance in the system. In anemic states it is deficient in the blood; sometimes, however, this deficiency is due to a destruction of hemoglobin or of red corpuscles which cannot be prevented by administering iron. Iron is eliminated by the mucous membrane of the intestines but only in small amounts. Most of what appears in the feces when food which is rich in iron is eaten passes through the intestines not having been absorbed at all. There has been much discussion as to whether inorganic salts of iron are absorbed and if so whether they can make hemo- globin and other compounds in tissues containing iron. It has been proven that it can be absorbed and stored in tissues, but that it cannot contribute to the production of iron compounds in cells. What is needed for their production must be derived 38 THE ELEMENTS OF FOOD. from the organic iron of foods. However, as has been known for very many generations inorganic iron can stimulate blood formation when anemia exists, that is, it can stimulate the appropriation of organic iron by cells needing it. The human body contains relatively the largest amount of iron at birth. As the food of infants in the first months contains very small quantities, this stored iron is drawn upon for the growth of blood during the period of rapid body development. For the maintenance of iron equilibrium in an average man ten to twelve milligrams of food-iron are required daily. It is probably safest to fix the standard for a diet at fifteen milligrams which is close to what is obtained from an ordinary diet. Average American dietaries afford twelve to nineteen milligrams. The iron in meat is chiefly in the blood which it contains. The following table shows the percentage in some common foods : Whole wheat 0052 Spinach 0038 Meat 00375 Raisins 0036 Eggs 003 Prunes 0029 Oatmeal 002 7 Wheat flour 0015 Potatoes 0012 Corn meal 001 Cabbage 0009 Corn 0008 Rice 0007 Apples 0003 Milk 00024 An excess of salts will sometimes irritate the organs of diges- tion. An excess of lime and phosphates often gives rise to the formation of calculi in the urinary channels. Their absence is a cause or concomitant of rachitis. It is probable, however, that in this malady other salts also are deficient. The absence of the salts of vegetable acids is said to be an important element in the causation of scurvy. Most mineral salts undergo no change of form in the system. They are found in the tissues in the form in which they are eaten, and are eliminated in the same condition. Some notable QUANTITY OF FOODS. 39 exceptions to this rule occur; these have already been referred to. Iron, for example, is greatly modified before it is combined with protein in the blood-corpuscles and muscle-cells. Mineral salts are chiefly eliminated by the kidneys and intestines. They are also eliminated to a small extent by the skin. They are contained in various secretions as products having functional utility or as excretions. Sodium chlorid when eliminated in large quantities causes renal casts to form and albuminuria. In much smaller amounts it is an irritant to kidneys already inflamed. Moreover, it has been found to often accumulate in the tissues of those who have disease of the heart or kidneys and then to lead to the produc- tion of dropsy. In these cases it must be almost excluded from the diet in order promptly to effect the absorption and elimina- tion of the dropsical fluid. As a rule, little attention is given to supplying salts to meet the needs of the body when more is required than is found in the meats and vegetables that are eaten. This need should be remembered, however, when but small quantities of food, or foods greatly diluted with water, are taken. Infants who do not digest cow's milk well are often given milk so much diluted with water that it is deficient in both fats and salts. Such children are especially likely to develop rachitis. CHAPTER V QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH Alimentary Equilibrium. Proteins and Calories. Dietary Stand- ards. Army and Navy Dietaries. Prison Dietaries. Diet of Savages. Investigations of Actual Dietaries in the United States. Equilibrium In order to determine the quantity of food that is needed to supply the waste that man's tissues constantly undergo and to supply fuel for the generation of muscular force and bodily heat it is necessary to study carefully the income and the outgo of the body. If the absorbed matter equals in weight the excreted matter, the body will neither gain nor lose: it will be in equi- librium or balance. This condition cannot long be maintained accurately. We habitually eat more than is needed to supply waste. Children must eat much more proportionately than adults, for they must provide for growth as well as for wear and tear. This habit of eating very generously is carried into adult life and excites many of the digestive disturbances that arise at that time. It also helps to produce the obesity that is so common in middle age. In adult life only so much food is needed as is required to supply energy and to repair waste. In old age less is needed, for less force is exerted and there is a gradual waste of tissue and consequent loss of flesh. Nitrogen equilibrium exists when the amount of nitrogen in the food eaten equals the amount of nitrogen in the excreta. This condition can be brought about and even maintained for ' some time by due care. It is attained, however, only as an experiment. By such studies we have learned that the average man excretes approximately twenty grams of nitrogen daily. The amount of nitrogen destroyed by life's processes is greater when the diet is chiefly nitrogenous than when it is mixed and contains a generous proportion of fat and carbohydrate. Therefore, these last are often spoken of as nitrogen savers. Ordinarily they furnish the fuel needed to generate muscular 40 THE CALORIE. 41 power and heat, but if they are insufficiently represented in a diet, the nitrogenous tissues and food must supply this fuel. Carbon equilibrium also can be established, and the experiment teaches that approximately 320 grams of carbon are used daily by the average adult. Catabolism The catabolism or protein is nearly independent of muscular work, for it repairs cellular waste almost exclusively. It has been found, however, that nitrogen equilibrium can be main- tained by a supply of nitrogenous food varying between com- paratively wide limits. This means that nitrogenous food in greater quantities than are strictly needed to maintain nitrogen equilibrium will cause a waste of tissues as well as repair. In other words, all changes are stimulated by proteins. Moreover, when a change is made in the amount of protein eaten it requires a few days to bring about protein balance under the new con- ditions. Under normal conditions muscular work depends mainly, if not exclusively, on the oxidation of nonnitrogenous material. Potential Energy Food eaten represents potential chemical energy, the source of bodily energy. To determine the amount of potential energy in food eaten it is necessary to know how much food is consumed and the potential energy of food-stuffs. The calorie is the unit that has been fixed upon to express the energy stored in food. A calorie is the amount of heat required to raise one gram of water i°C. The most convenient way in which to estimate the value of food-stufls is to determine how many calories a given weight will furnish. It has been established that one gram of dry protein will furnish 4.1 calories, the same quantity of carbo- hydrate 4.1 calories, and the same quantity of fat 9.3 calories. With these facts known, it is easy to determine the calories that any given food-stuff will furnish, provided the percentages of protein, fat, and carbohydrate that it contains are known. These percentages must be multiplied by the figures just given and their results added in order to ascertain the number of calories in 100 grams of the food. As has already been shown, a certain amount of protein is 42 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. necessary to sustain life. It is not sufficient, therefore, to say- that a food to be able to maintain life and strength can furnish a given number of calories. Any number of calories can be obtained from fat, but fat will not maintain life and promote growth of cells. Food must be estimated in terms of protein required and calories required. A large proportion of the latter can be obtained from variable amounts of fats and carbo- hydrates. The number of calories required by an individual man will necessarily depend upon his weight and the amount of energy which he expends in work or muscular exercise. In establishing a standard, the weight fixed upon by various investigations has been approximately 150 pounds. The number of calories required by a man of this size when leading a sedentary life has been determined by four methods : 1. By observing the average amount of food consumed by many men in different countries and under varying conditions. 2 By observing the amount of oxygen consumed. 3. By determining the balance of intake and output. 4. By direct measurement of heat given off by the body. All of these methods have given approximately the same results. A man at rest requires 2000 calories and one leading a sedentary life needs 2300 calories daily. The amount of protein required cannot be so accurately determined. This has been attempted generally by observing the amount used in various places and by different people. Voit in Germany fixed upon 118 grams of protein as the stand- ard. Playfair in England fixed upon 119. Gautier of France fixed upon 107 and Atwater in this country fixed upon 100 grams for a man of sedentary habit, 125 for one at moderate work, 150 for one at hard work and 90 for one completely at rest. Chittenden objects to the deduction of a standard from these facts; for such a standard, he says, is based upon evidences of self indulgence not upon the needs of an individual or the most profitable use of food. To determine the amount of protein needed he experimented on many individuals, gradually reduc- ing the amount of protein in their food to as low a point as was compatible with good health and mental and physical strength but permitting the calories required for the production of energy. In this way he found that approximately 50 grams RATIONS. 43 were needed. This is the minimum which insures health and strength. Therefore Chittenden fixes as a standard 60 grams. He believes that much larger amounts overtax the organs of elimination and lead to disease. It must be remembered, how- ever, that all the organs of the human body are capable of many times the amount of work required of them to maintain life and health. Nevertheless it is to-day generally admitted that more protein is ordinarily consumed than is needed and often more than is good for one. Most recent writers have, therefore, been inclined to compromise between the standard fixed upon by ob- serving habits of eating and that fixed upon by Chittenden by experiment and have named 70 or 75 grams of protein as prob- ably the safest standard. It is interesting to compare these standards of 75 grams of protein and 2300 calories with the dietaries in the tables on pages 62 to 66. Army and Navy Ration The United States Army ration is as follows : Ounces Fresh beef 20 or mutton at same price 20 or pork 12 or bacon 12 or salt pork 22 or dried fish 14 or pickled fish 18 or fresh fish 18 Flour 18 or soft bread 18 or hard bread 16 or corn meal 20 Baking powder when troops are in the field. Beans 2 2/5 or peas .' 2 2/5 or rice 1 3/5 or hominy 1 3/5 Potatoes 16 or potatoes 124/5 an d onions 31/5 16 or potatoes 11 1/5 and canned tomatoes 4 4/5 16 or other fresh vegetables when they can be obtained near the post 16 44 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. Coffee 13/5 or roasted 1 7/25 or tea 8/25 Sugar 2 2/5 or molasses 16/25 or can syrup 16/25 Vinegar 8/25 Salt 16/25 Pepper 1/25 When traveling a much simpler ration is temporarily fur- nished United States soldiers consisting of soft or hard bread, canned beef, baked beans, coffee, sugar and canned tomatoes. An emergency ration is also provided consisting of bacon, hard bread, pea meal, coffee or tea, saccharin, salt, pepper and tobacco. Desiccated fruits have been found almost a necessity, and whenever practicable are added to the ration, to obviate consti- pation and scurvy. When in garrison, a much more generous diet is had, for the regular ration is supplemented by food purchased by the soldiers. Woodruff carefully estimated all that was eaten during ten days by the men in one of our western garrisons, and found that in addition to the regular rations, such articles as oatmeal, apples, canned and dried, tapioca, butter, lard, canned corn, canned tomatoes, macaroni, milk, cheese, prunes, cabbage, apricots, barley, raisins, and chocolate were eaten. The United States Government is the only one which furnishes its soldiers a complete ration. Others provide soldiers with part of their food but expect them to purchase the rest out of their pay or an especial money allowance. For instance, English soldiers, when stationed in England, receive one pound of bread, three-quarters of a pound of meat, and about five pence to purchase vegetables, milk, sugar, and other articles. When in the field, a complete ration is furnished them that varies somewhat with the climate in which they serve and with the work they have to perform. In the United States Navy a larger variety of food is con- stantly used. The following is the legal ration for each person daily. RATIONS. 45 One pound and a quarter salt or smoked meat, with three ounces of dried or six ounces of canned fruit, and three gills of beans or peas, or twelve ounces of flour; or one pound of pre- served meat with the same amounts of dried or canned fruit, and twelve ounces of rice or eight of canned vegetables or four of desiccated vegetables; together with one pound of biscuit, two ounces of butter, four ounces of sugar, two of coffee or cocoa or one-half of tea and one of condensed milk or evaporated cream ; and an allowance weekly of one-half pound of macaroni ; four ounces of cheese, four ounces of tomatoes, one-half pint of vinegar, one-half pint of pickles, one-half pint of molasses, four ounces of salt, one-fourth ounce pepper and one-half ounce dried mustard. Five pounds of lard or a suitable substitute for every hundred pounds of flour and yeast to make bread. The following substitute for the above ration may be made when deemed necessary by the officers in command: For the salt or smoked meat or preserved meat one and three-quarters pounds of fresh meat; instead of the articles usually issued with salt or preserved meat, fresh vegetables of equal value; for biscuits one and one-fourth pounds of soft bread or eighteen ounces of flour; for three gills of beans or peas twelve ounces of flour or rice or eight ounces of canned vegetables or for twelve ounces of flour or rice or eight ounces of canned vegetables, three gills of beans or peas. An extra allowance is also made when men are worked over- time or more than usual. Prison menus are simple, but supply enough in quantity and variety of food to maintain good health. Calculated in terms of protein and calories they correspond well with the standards of At water, Playfair, and Voit. Usually, breakfast consists of a vegetable soup or cereal with bread and butter or milk; dinner of meat or baked beans, vegetables, and bread or fruit; supper of bread and butter or cereal and milk. They should take into consideration the kind and quantity of labor performed by the prisoners and the opportunities or necessities for exercise or work in the open air. Unfortunately, individualization is impracticable, however necessary it may seem from a medical viewpoint. AMERICAN AND EUROPEAN (Quantities per man Dietaries. Tl Gr i ams Proteins. Gms. Fats. AMERICAN (MASSACHUSETTS AND CONNECTICUT). 20 40 60 80 100 120 140 160 180 200 Familv of carpenter in Middletown. Conn. 114 127 Family of glass-blowers in East Cambridge, Mass. 105 132 Boarding house, Lowell, Mass.; boarders, operatives in cotton mills 132 200 Boarding bouse, Middletown, Conn.; / well-paid machinists, etc., at mod- \ Food purchased 127 186 erate work v Blacksmiths, Lowell, at. bard work _ 105 155 Brickmakers, Massachusetts; 237 persons at very severe work ,,. 182 368 Mechanics, etc., in Massachusetts and Connecticut; average of 4 dietaries of mechanics at severe work 218 295 Average of 20 dietaries of wage-workers in Massachu- setts and Connecticut _ 155 227 Average of 5 dietaries of professional . Food purchased 136 164 men and college students in Mid- •[ die-town, Conn * Food eaten 123 155 EUROPEAN (ENGLISH, GERMAN, DANISH, AND SWEDISH). "Well-fed tailors, England, Playfair 132 41 Hard-worked weavers, England, Playf air 155 41 Blacksmiths at active labor, England, Playfair 177 73 Mechanic, Munich, 60 years old, in comfortable circum- stances, light work, Forster . , „ „ 118 68 "Well-paid mechanics, Munich, Voit. ,., _„ 155 55 Carpenters, coopers, locksmiths, Bavaria; average of 11 dietaries, Voit. . 123 36 Miners at severe work, Prussia, Steinheil 136 114 Brickmakers (Italians), Munich, diet mainly maize meal 168 118 114 41 German army ordina.ry ration , war footing- 136 59 German army extraordinary ration, in war. 191 45 University professor, Munich; very little exercise, Ranke. 100 100 Lawyer, Munich, Forster 82 127 Physician, Munich, Forster . 127 91 Physician, Copenhagen, Jurgensen _ 136 141 Average of 7 dietaries of professional men and students, . German, Denmark, and Sweden 114 100 DIETARY STANDARDS. Adults in full health, Playfair. _ _ __ 118 50 Active laborers, Playfair 155 73 Man at moderate work, Moleschott 132 | 41 Man at moderate work, Voit 118 1 55 145 1 100 Man with little physicial exercise, Atwater -2L | 91 Man with light muscular work, Atwater _ 100 100 Man with moderate muscular work, Atwafer 127 127 Man with active muscular work, Atwater 150 150 177 u 250 46 DIETARIES AND DIETARY STANDARD& per da j.) (Numbers from Atwater.) lit? fc> OS'S Nutri- Calories. tive ratio 450 900 1350 1800 2250 2700 3150 3600 4050 4500 4950 5400 5850 S300 5750 7200 7650 3100 8550 9000 (345 3055 5.5 I 482 3590 8.2 550 4650 7.6 427 4010 6.8 1382 6905 7.4 1154 8850 11 750 6705 6.6 627 5275 7.5 509 4140 6.6 491 3925 6.6 527 3055 4.7 623 3570 4.8 668 4115 4.7 345 2525 4.3 482 3085 4 J 582 3150 5.3 J 636 4195 6.7 8 677 4540 5.6 I 482 2800 5 491 3095 4.6 677 3985 4.1 241 2325 4.7 223 2400 6.3 364 2830 4.4 241 2835 4.1 286 2G70 4.7 528 3140 5.5 568 J630 4.7 550 3160 4.9 500 3055 5.3 450 3 J70 4.7 300 2450 5.5 350 2800 | r ■ - 5.7 500 3520 5.8 500 4060 5.6 650 5700 1 6.9 47 48 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. The Diet of Savages It is probable that, in prehistoric times, the food of man con- sisted of fruits, nuts, raw meats, and fish. Such is the diet of some primitive tribes to-day. Cooking in some form is, how- ever, used by most known tribes. The most northern Eskimos live almost exclusively upon meat rich in fat and oil which constitutes an important element of their diet and helps to balance it. Once in a while they ob- tain lichens from the stomach of the reindeer and the flower of the arctic poppy and the so-called scurvy grass are equally rare articles of food with them. They eat at irregular times and when it is possible. Indians and uncivilized people in the temperate and tropic zones have a more varied diet. Fruits, nuts, some wild vege- tables, fish, wild fowl, and other game supply their wants. In the tropics, where fruit is abundant at all seasons, it con- stitutes a large and often the main part of their food. The diet of savages is governed by what is supplied by the country in which they live. The same statement, with a slight modification, can be made of civilized races, for they live chiefly upon what their country can be made to produce. Recently, however, since cold storage transportation has been made cheap and efficient, there has been effected an interchange of fresh commodities between the peoples of different lands and climates, thus no longer leaving them wholly dependent upon the soil on which they live. Relation of Diet to Seasons During hot seasons most persons prefer food that contains an abundance of water; therefore cereals, vegetables, and fruits, are eaten with but small amounts of meats. In cold weather hot soups, hot beverages, and fat meats are enjoyed. These changes most persons make when they can. The poor, who always live upon a diet restricted in character, do not make extensive seasonal changes and yet retain health and strength, The variations serve, therefore, to gratify appetite and taste, and arise for these reasons rather than because they must be made to preserve health. Relation of Diet to Climate. — The number of calories needed DIETARIES. 49 for the production of energy is the same in all climates but at times more may be needed in very cold climates to maintain bodily temperature as well as energy. However, clothing usually preserves bodily temperature and therefore equalizes the dietetic requirements in all lands. Fats are better digested as a rule in cold countries than in the tropics. In the latter regions if fats are eaten in large amounts they are apt to provoke indigestion and ultimately diarrhea. Moreover, one becomes more easily satiated by them than in cold climates. A larger variety of food, particularly of fruits and vegetables, are craved in the tropics. The protein of beans and peas can be easily substituted for most of the meat eaten in temperate climates and this is often done by natives of the tropics. Where cooling drinks are craved as in cold regions hot beverages and hot soups are. The food used in regions climatically so diverse as the tropics and poles or high altitudes depend in part also on the ability of different kinds to keep. Many vegetables and fruits freeze and are thereby spoiled. Meats spoil with equal readiness in the tropics if they are not kept cool or otherwise preserved. These facts govern the dietaries of nations uncivilized and largely even of civilized peoples who have not sufficient wealth to provide luxuries. Dietaries of Inhabitants of the United States The numerous investigations upon nutrition made in various parts of the United States under the auspices of the Depart- ment of Agriculture, make it possible to state with much cer- tainty what articles of food are eaten, and in what quantities, by different classes. It is evident from these statistics that the people eat what their markets provide, except when poverty prevents purchasing. For instance, the family of a sewing woman of New York City averaged for one person a day in animal food, 26 grams of protein, 34 of fat, 15 of carbohydrate — equivalent to 485 calories; in vegetable food, 31 of protein, 7 of fat, 222 of carbohydrate — equivalent to 11 00 calories, or a total of 1585 calories and 57 grams of protein. This is less than a mere subsistence has been estimated to be. The articles of food consumed by this family were beef shank, pork chops, sar- dines, eggs, butter, milk, barley, wheat flour, bread, wheat, 4 50 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. rye, rolls, cakes, crackers, sugar, beans, potatoes, radishes, rhu- barb, and tomatoes. The largest quantities of animal food consumed were in the form of eggs and milk; of carbohydrates, bread, sugar, potatoes, and canned tomatoes. How far short of the possibilities of the market this diet falls, is self-evident. It shows idiosyncrasies, however, or, more probably, the limita- tion that a lack of time or of ability to cook may have placed upon it. Most mechanics in the United States eat food that will afford them from ioo to 150 grams of protein and from 3000 to 5000 calories. Many will average from 90 to 120 grams of protein. Atwater and Wood call especial attention to the fact that "our dietary is out of balance," and state that "the one-sided- ness is greater in the South than in the North." By this is meant that the ratio between protein and calories is greater than it should be. In the South a larger amount of protein of vege- table origin is eaten than in the North. The same comment might be made upon the dietaries of the families of professional men, as the table on page 5 1 will show. The following table of dietaries of student clubs in various col- leges of the country is interesting: WEIGHT OF DIFFERENT CLASSES OF FOOD PURCHASED PER MAN PER DAY Tennessee Missouri Connecticut Maine Beef , veal, mutton ... . 187 160 245 231 Pork 89 113 91 98 Poultry 28 12 6 100 Fish 12 6 24 77 Eggs 32 55 35 53 Butter 39 27 60 52 Cheese 7 7 Milk 97 680 457 910 Buttermilk 108 Cereals, sugar, etc 564 524 361 835 Vegetables 250 266 189 530 Fruits.. 50 51 89 48 The greatest quantities of animal food were consumed in Maine, Missouri, and Connecticut, and the least in Tennessee. Maine leads again in the use of vegetable foods, and Connecticut falls behind. In the schools of the two northern States a much DIETARIES. to © 1 d 3 © o o 5 © O CO CO o eo o 1 s 8 CO © 1 o o j£ « o CO to to o o CM LO CO o o en CM © © eo © CO a CO o co o o co (M o © 1 1 LO LO CO eo 1 o (N o tH n I o § o o o CO o CO s. o CI CO cs eo (M CN © © s © © CM o * g . i i g c cc £ j 3 5 s 5 d a .5 a 1 d 3 "5 6 At I I 5i 52 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. larger proportion of beef is eaten than in the two others. In Missouri a noticeably large amount of pork is consumed. In Maine poultry and fish are conspicuous features of the dietary, while they are comparatively little used in the colleges of the other States. Milk forms a large element of the diet in the States of Maine, Connecticut, and Missouri, and a noticeably small element in Tennessee. The diet of the club at the State College in Maine is much more generous in all respects than the others. The table on p. 53 will make this more evident. In Tennessee 38 per cent, of the food value was contained in animal food, and 62 per cent, in vegetable. In Missouri it was about equally divided between the two. In Connecticut 53 per cent, was furnished by animal and 47 per cent, by vegetable foods. In Maine 40 per cent, was furnished by animals and 60 per cent, by vegetables. The table opposite gives the same facts with reference to the diet of student clubs in colleges for women, and contrasts them with those of similar organizations for men, and with the diet of professional men and mechanics. The dietaries of these college clubs do not portray accurately those of the people of the different sections of the country from which the students are drawn, but represent them fairly. The negroes of the southern states have a particularly un- varied diet. In Alabama, about Tuskegee, where their diet has been most studied, their staple foods are fat salt pork, corn meal, and molasses. Cooking is most primitive; only two families of those investigated had stoves. The following extract from a letter of Mr Hoffman, 1 of the Tuskegee Institute, is of special interest in this connection: "The daily fare is prepared in very simple ways. Corn meal is mixed with water and baked on the flat surface of a hoe or griddle. The salt pork is sliced thin and fried until very brown and much of the grease fried out. Molasses from cane or sorghum is added to the fat, making what is known as 'sap,' which is eaten with the corn bread. Hot water sweetened with molasses is used as a beverage. This is the bill of fare of most of the cabins on the plantations of the 'black belt,' three times a day during the year. It is, however, varied at times: thus collards and turnips are boiled with the bacon, the 1 "Food of the Negro in Alabama," United States Department of Agriculture, Bulletin No. 38. DIETARIES. 2 o 1 3 ? o i o o is CO 1 o o i CO p 5 I- o oi | .2 o 1 'u o 3 CO ■■"3 CM I 1 o 8 a !M s s CO 8 1 OS © SB i 1 8 CO CO CO CO p., 1 CO CO C! 9 CO S 8 o o m rll to — cprt— § CM CO CO CO o CO rH o © 9 rH 5 § SI rH It — a=£= o rH CO CO t- 5q H 1 rH CO CI s 3 | § s -2 r-i o © c- W ^ P § 1 H 0D 5 a CN § o £ 8 a rH to .s I o H 5' o 00 .2 W £ 2 Ah s i— i Q O § 8 fc ^ o O rH a o CM £ g 1 € © 3 3 CM 1 g CM 01 CO Oi 05 CM CO « 2 be 1 p i 1 "d S 1 i 1 1 > 8 J* 1 p d ho tn 3 d CJ d tn § e he 3 S Q a 2 u ^5 1 d 3 rt § 1 fa -d d "3 9 T3 g jjj 1 a 3 | 'm "in 8 a fa (• d d a O rf .0 "2 13 3 | 2 T3 3 o 5 a □ to 'P $ •r-< in 0Cj in r! in in ca c 1 in 8 g a I o a to 1 s, 8, p p m Ps 53 54 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. latter being used with the vegetables to supply fat 'to make it rich'. The corn-meal bread is sometimes made into so-called 'cracklin bread/ and is prepared as follows: A piece of fat bacon is fried until it is brittle; it is then crushed and mixed with corn meal, water, soda, and salt and baked in an oven over the fireplace. Occasionally the negroes may have an opossum. To prepare this for eating it is first put into hot water to help in removing a part of the hair, then covered with hot ashes until the rest of the hair is removed; thereupon it is put in a large pot, surrounded with sweet potatoes, seasoned with red pepper, and baked. One characteristic of the cooking is that all meats are fried or other- wise cooked until they are crisp. Observation among these people reveals the fact that very many of them suffer from indigestion in some form." The following diagram taken from Atwater and Wood, 1 is interesting as it illustrates still more the variation of dietaries actually used, from the standards that have been computed. ACTUAL DAILY DIETARIES OF NEGRO FIELD LABORER AND FARMER COMPARED WITH A WELL-BALANCED STANDARD DIETARY Diet of Laborer Con- sisted of Furn- ished Con- sisted of Bacon 0.75ft). Flour 0.42ft). Corn meal . . .0 95ft) Molasses .. .0.421b. Protein '0.17ft) Calories 524°. Diet op Farmer Bacon 0.05ft). Lard o. 05ft). Flour 0.34ft). Corn meal. .0. 681b. - 1 Furn- ished Protein . Calories . 0.09ft) 2095 A WELL BALANCED DIET pum . f Protein.... o. 2 8tb. ished I Calories. . . .3500 H BSShH '< 1 Bulletin No. 38, United States Department of Agriculture. DIETARIES OF NEGROES AND MEXICANS. 55 No group of people in the United States whose diet has been carefully studied is comparable to the negroes about Tuskegee, except the Mexicans of New Mexico. 1 "Mexicans of the poorer class raise the greater part of their food, which is almost entirely of vegetable origin. Flour and corn are used, the relative amounts depending upon the amount of money available. If it is necessary to reduce the cost of living to the minimum, as is often the case, more corn and less flour is used. "Probably the next article in amount, and a very important one, is the native bean or 'frijole' (Phaseolus sp.), which, together with peas and lentils, is used to supply the protein necessary in the absence of meats and other nitrogenous foods of animal origin. "Another universal article in the Mexican diet is red pepper, or 'chili,' which, while it constitutes comparatively a rather small pro- portion by weight of the total food, is still consumed in enormous quantities as compared with the use of such material by the people of the eastern states. Chili is probably used more for its stimulating effect on the digestive organs than for the actual amount of nutrients which it furnishes. "In point of cost, probably the most important article used by the Mexicans not home produced is coffee. Lard is another very important article which is usually purchased, and which is used in considerable quantities. As the vegetable foods used contain very little fat, it is necessary to increase the amount of this substance by addition from out- side sources, usually either lard compound or beef tallow, which are the cheapest forms of fat in this region. "In the houses of the poorer class the cooking is done in an open fireplace, usually located in one corner of the room. "The 'tortillas,' or cakes made of flour or ground corn, are one of the most generally and extensively used foods. When the tor- tillas are made from corn, the kernels are first boiled with lime, which softens them. The skin is then usually, though not always, removed, and the grain is ground in a crude stone-grinding apparatus or 'metate,' consisting of a concave slab of stone and a smaller convex piece, which is held in the hands and which serves as a pestle. The grinding is not rotary, however, as in an ordinary mortar, but up and down, toward and from the body. The corn used is usually a small blue kind, rather soft, which seems to contain somewhat more than the average amount of fat. After the corn has been ground into a mush on the metate it is patted out in the hands into the tortillas. Corn tortillas are never rolled, as is the case with those made from flour. If flour is used, it is mixed into a dough with water and the cake rolled out from it. The flour used is not ground in the metate, but in the ordinary flouring mills. It is usually of poor quality, coarse, and dark colored. After ^'Dietary Studies in New Mexico," by Arthur Goss, United States Department of Agriculture, Bulletin No. 40. 56 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. being worked into the proper form, the tortilla is baked on a flat piece of iron, supported directly over the fire in the open fireplace, the iron being first greased with lard. As soon as it is done on one side the tortilla is turned by pressing the moistened fingers against the "upper side of it, thus causing it to adhere to the fingers, whereupon it is deftly turned and the opposite side is browned. "The frijoles, or beans, are cooked in small, home-made earthen- ware pots, and are almost invariably combined with a very liberal proportion of chili and also considerable lard. DAILY DIETARY OF NEGRO FARMER AND POOR MEXICAN Negro farmer, animal, . vegetable, Same, animal, . vegetable, Same, animal, . vegetable, Poor Mexican, animal, vegetable, Same, animal, . vegetable, Same, animal, . vegetable, Same, animal, . vegetable, Protein. Grams. 52 40 2 42 26 33 107 93 4 82 29 72 Fat. Grams. Carbo- hydrate. Grams. 119 5 65 360 1585 3270 41 16 372 395 1845 74 26 403 900 1890 56 19 713 520 354o 61 19 644 565 3200 49 23 571 470 2890 60 680 7 572 2705 Calories. "The chili is cooked alone, and also with various other articles of food. It is prepared by first removing the stems and seeds of the pods, which constitute somewhat more than half of the total weight, after which it is sometimes ground in the metate, but is usually soaked in water and the inner or edible portion separated from the outer skin by squeezing in the hands. Owing to the extremely strong irri- tating effect on the hands, this operation cannot be performed by an amateur. The Mexican women, however, become so accustomed to it that it seems to have no effect on them. "Among the poor families the meals are served on the floor in the middle of the room, the family sitting on the ground around the food and eating without knives, forks or plates." CHITTENDEN S MENU. 57 The small amount of animal food used by some of the negro families studied, and its entire absence, except as it was rep- resented by lard, in the diet of some of the Mexicans is shown in the preceding table on page 55. The analyses show a sufficient source of heat units or of fuel, but great deficiency of protein. Most of the latter is derived from vegetables, and in several instances is altogether so. As the experiments of Chittenden which lead him to urge a great reduction in the amounts of protein eaten, have at- tracted attention both of dieticians and of the public the follow- ing dietary recommended by him and devised to put in practice his standards will be instructive and interesting: Articles Breakfast : One shredded wheat biscuit One teacup of cream One German water roll Two one-inch cubes butter Three-fourths cup coffee One lump sugar One-fourth teacup cream Lunch : One teacup home-made chicken soup. 144 One Parker-house roll 38 Two one-inch cubes of butter 38 One slice lean bacon 10 One small baked potato 60 One rice croquette 90 Two ounces maple syrup 60 One cup of tea with one slice lemon . . ... One lump of sugar 10 One teacup cream of corn soup 130 One Parker-house roll 38 One inch cube of butter 19 One small lamb chop 30 One teacup of mashed potato 167 Apple, celery, lettuce salad with mayonnaise dressing 50 Weight Grams Fuel-value Calories Protein Grams 30 106 3-i5 120 206 3.12 57 165 5-C7 38 284 0.38 100 0. 26 10 38 3° 51 0.78 60 5-25 no 3-38 284 0.38 65 2.14 55 i-53 150 3-42 166 38 .... 72 325 1 10 3.38 142 0.19 92 8.51 175 3-34 75 0.62 58 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. Articles Dinner : One Boston cracker One-half teacup of bread-pudding . . One-half inch American cheese One lump of sugar One demi tasse coffee Weight Grams 12 85 12 IO Fuel-value Calories 47 150 38 Protein Grams i-3 2 5.25 3-35 From the food analyses that are given in the next chapter it will be easy to compute the number of calories in any diet of which the quantity of each constituent is known. If one so wishes, he may construct dietaries of standard composition from various foods with the aid of these analyses. The tables on the succeeding pages will give graphically an idea of the variations in eating which the habits and circum- stances of different individuals and groups of individuals in this country have fixed. DIETETIC FADS Fruitarians eat exclusively fruit and nuts or sometimes a little of vegetables and cereals in addition to them. Careful studies of persons living upon such food has not often been made, therefore the work of M. E. Jaffa 1 is of especial interest. The following summary of the elements of nutrition which each person, described by Jaffa, ate is instructive : Age Years Weight Pounds Protein Grams Fat Grams Carbo- hydrate Grams Crude Fiber Grams Calor- ies Woman Woman Girl 33 30 13 9 6 7 63 64 10 8 34 22 25 90 104 75-5 43 30.5 34 124 136 58 37 93. S 170 152 33 25 26 27 24 40 40.3 53- 5 48.4 32.3 42.5 85 68 59 57 52 56 58 72 53-7 76.9 67.7 81.7 81. 1 158.7 103 IIO 72 in 102 97 126 286.3 301.8 246.7 155 156.8 366.3 55o.i 40 27 46 50 37 8 24.6 10 13-4 10.7 9-8 64.7 1.300 1,040 Boy Girl 1,25s Girl 1.385 Woman Boy... 2,043 Girl Woman 1.432 Man 1 Bulletin No. 107 and Bulletin No. 132, U. S. Dept. Agriculture. DIETETIC FADS. 59 The first six of these people lived on apples, dates, figs, peaches, apricots, bananas, grapes, oranges, pears, plums, raisins, olives, almonds, pignolia, pine nuts, brazil nuts, walnuts, sometimes tomatoes, celery and honey. They were all vigorous and healthy. The youngest never had had any other diet after infancy. She was undersized but this may have been from inheritance. During the time that she was studied (a period of ten days) she gained a pound and her brother made a similar gain in a period of twenty-two days while he was under observation. It was found that the coeffi- cient of digestibility (that is completeness of digestion and absorption of food) was quite comparable to that of a person on a mixed diet; even 80 per cent, of the crude fiber was digested. The ninth study and the fourth is of the same person a year later. At this time he took milk and eggs as well as fruit and nuts. One or two of the others ate cereals to a limited extent. The twelfth in this list was not accustomed to a fruitarian diet but tried it for the time of the experiment. All of the people studied were in good health. The small amount of protein and small number of calories which the diet of these fruitarians contained as compared with the average of most people is very striking. However they approach closely to what Chittenden has shown is all that is needed to maintain health and strength. Vegetarians eat not only fruit and nuts but vegetables, cereals, breads and usually milk, butter, cheese and eggs. From these foods a well balanced and generous ration can be prepared. In proportion as individual vegetarians more strictly adhere to a vegetable diet and reject eggs and milk products does their diet approach that of the fruitarians in value. It is interesting to compare the statistics 1 on page 60 of a vegetable diet with those of a fruitarian diet and a mixed one previously given. These vegetarians average a larger number of calories but about the same relative amount of protein as fruitarians. The latter is far below what is used by the average man in a mixed diet but corresponds closely to what Chittenden recommends as an ideal standard. 1 Bulletin No. 132, U. S. Department of Agriculture. 60 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. Age Years Weight Pounds Protein Grams Fat Grams Carbo- hydrate Grams Calories Woman Girl 34 8 42 93-5 37 83 43 32 34 49 54 63 54 74 81 82 36 51 77 66 22 28 167 165 227 324 312 593 573 700 1,430 1,403 1,399 1,998 2,044 3,302 2,775 3,431 Woman 64 48 28 19 136 153 125 138 Man Diet, Japanese. — The diet of the Japanese has been carefully studied by competent men of that country. Beef, mutton, pork and their products are scarcely eaten and were not at all until very recently, but fish is eaten by all who can afford it. The laborers in the country, however, do not average a meal of fish oftener than twice a month. They are vegetarians because they cannot afford meat and fish. They derive the protein which they need from cereals, beans and vegetables. Rice, barley and soy-beans are the staple articles of food of all classes. Wheat, millet, buckwheat and vegetables are also eaten but in smaller quantities. Fish is the staple meat, though poultry and eggs are eaten in small amounts and other meats in insignifi- cant quantities. The quantity of food elements eaten by different classes corresponds closely with the ideal standard advocated by Chittenden. Protein Calories Miscellaneous classes 59 grams 2,190 Rural laborer 59 grams 2,700 Average of 24 studies 62 grams 2,445 These figures do not make plain all the peculiarities of the diet of the Japanese for as compared with our own and that of Europeans it is deficient in fat. The dietary studies show that on the average 20 grams of fat are eaten daily by those on a mixed diet and about 10 grams by those on a vegetable diet, which is from a sixth to a thirteenth of the amount consumed by Americans and Europeans. Moreover, the carbohydrates in DIET OF JAPANESE. 6 1 the diet of the Japanese are derived in very large part from cereals, on the average 87 per cent., and in the diet of Americans only about 55 per cent, have the same origin. A digest of the Japanese Investigations on the nutrition of man by Kintamo Oshima has been published by the United States Department of Agriculture in which the peculiar foods of this people, their composition and nutritive value, are fully described. 62 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. ILLUSTRATIVE DIETARIES (Numbers from At water Dietaries. Proteins. (Quantities NEGROES NEAR TUSKEGEE 20 40 GO 80 100 120 140 160 No. 137, farmer __ 31 No. 132, farmer. 26 No. 141, farmer 33 No. 100, farmer, summer 44 No. 130, farmer, winter 35 No.105, farm manager 49 No. 136, farmer 49 No. 102, sawmill laborer, summer _ . 59 No. 131, sawmill laborer, winter. _ 58 No. 135, farmer. _ _ _ . 54 No. 101, farmer. 71 No. 140, plantation band.. 52 No. 138, farmer. __ _ _ ____. 52 No. 99, farmer 92 No. 98, farmer 97 No. 133, farmer— woman 77 No. 134, farmer 86 No., 139, farmer... .__. 80 No. 104, cotton plantation laborer. . 99 * No. 103, cotton plantation laborer 93 Averaere of all 62 POOR PEOPLE, UNITED STATES. 25 families in poorest part of Philadelphia: 66 Largest dietary, German __ 202 Average. _ _ _ __ 109 26 families in poorest part of Chicago: Smallest dietary 86 Largest dietary 168 Average „ -, . .... . , 119 PEOPLE IN MORE COMFORTABLE CIRCUMSTANCES, UNITED STATES. Farmer, Connecticut 79 Farmer, Connecticut __ — 104 Average 5 dietaries, farmers in Connecticut 92 105 90 Boarding house,well-paid machinists,etc.,Connecticut_ 103 110 Average 9 dietaries of mechanics, etc.... ... | 105 1 DIETARIES. 63 IN ACTUAL USE. and Wood and others.) in Grams. ) Fats. Carbo- b.ydra' Calories 3S. 180 200 450 900 1350 1800 2250 2700 3150 3600 4050 4500 4950 5400 27 304 1625 83 225 1800 99 214 1935 57 372 2240 60 389 2295 138 255 2535 119 362 2790 85 429 2790 118 390 2932 85 458 2890 126 432 3230 182 324 3235 120 467 3245 124 425 3270 148 558 4060 131 649 4195 141 627 4235 269 518 4955 252 666 5400 2S3 649 5400 132 436 3270 68 181 1630 206 608 5235 108 435 3235 100 213 2195 ( 204 626 4950 141 398 3425 117 354 2865 156 494 3900 114 483 3420 136 362 3185 134 408 3285 152 401 3490 210 412 4090 152 420 3570 64 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. ILLUSTRATIVE DIETARIES Dietaries. Proteins. (Quantities PEOPLE JN MORS COMFORTABLE CIRCUMSTANCES, united states — continued. 20 40 60 80 100 120 140 160 Boarding- house, Lowell, Mass., boarders operatives in cotton mills 132 Average 20 dietaries of people at active exercise, mechanics, etc., in Massachusetts and Connecticut 154, PROFESSIONAL MEN. Average of 9 dietaries 104 COLLEGE STUDENTS' BOARDING CLUBS, UNITED STATES. Average of 15 dietaries 108 POOR PEOPLE SCANTILY NOURISHED. EUROPEAN. "Working people, Saxony, average 13 dietaries 69 Mechanics, laborers, beggars, etc.,- Naples, Italy, averae-e 5 dietaries 76 Farm laborer, Saxony, food mainly vegetable 80 Farm laborer, Prussia, food mainly vegetable 83 PEOPLE IN MORE COMFORTABLE CIRCUMSTANCES. AT MODERATE WORK, EUROPEAN. Bavaria, average 11 dietaries of carpenters, coopers, and locksmiths 122 Peasants near Moscow 129 Average 5 dietaries of farm laborers, Bavaria 137 Average G dietaries of mechanics^tc^southem Sweden 134 Peasant farm laborer, Italv 118 PEOPLE AT ACTIVE EXERCISE , EUROPEAN. Average 5 dietaries of machinists,etc.,southern Sweden 189 . Farm laborers, Austria, diet, corn meal and beans 159 Javanese in Java village World's Fair, Chicago 6G United States Army rations 120 DIETARY STANDARDS. European: "Woman at moderate work _ 92 Man at moderate work__ _ _ 118 Man at hard work 145 American: "Woman with light muscular exercise, _ 90 "Woman with moderate muscular work 100 Man without muscular work 100 Man with light, tmassftiilar work .. 112 Man with moderate muscular work 125 Man with hard muscular work- 150 DIETARIES. (Continued). in Grams. ) Fats. Harbo- rydra Calories. 3S. 180 200 450 900 1350 1800 2250 2700 3150 3600 4050 4500 4950 5400 200 594 4650 227 626 5275 122 428 3315 148 460 3700 45 384 2275 38 396 2290 37 504 2740 17 373 2S45 34 570 3130 33 589 3250 55 542 3295 79 523 3435 65 628 3665 110 714 4725 62 977 5235 19 254 1490 161 454 3S50 44 400 2425 56 500 3055 100 450 3370 2400 2700 ^H — | 2700 3000 3500 1 i 4500 66 QUANTITY AND KINDS OF FOOD NEEDED IN HEALTH. Dietaries Proteins "WASHINGTON GOVERNMENT HOSPITAL FOR THE_INSANE 20 40 60 80 100 120 140 160 88 84 90 97 104 92 NEW YORK HOSPITAL FOR INSANE 72 73 Disturbed ...... 95 105 65 95 BOSTON 93 94 79 "W^mPTi 118 94 Harvard students __ — 75 PHILADELPHIA 107 114 Jews, German.Russian, Roumanian 120 130 83 Irish 135 CHICAGO American..... -. 117 German descent — . 109 Trish rip.sf^ftnt 161 125 Irish— — -_ 131 189 Hungarian 146 Bohemian 106 Scotch ... 112 CHINESE AND OTHER ASIATICS IN U.S. Professional man and family 115 Laundry Association 135 Employees on Truck Farm 144 Malay professional man 73 66 DIETARIES 6 7 L Fats. Carbcj hydra ,es Calories 180 200 450 900 1350 1800 2250 2700 3150 3600 4050 4500 4950 5400 105 370 2767 97 350 2599 73 348 2402 106 297 2519 125 347 2917 106 368 2783 65 348 2259 65 346 2255 81 391 •2685 93 415 2908 86 363 2477 146 376 3186 156 349 3156 131 289 27u0 94 259 2183 115 390 3057 127 317 2776 78 312 2243 121 374 3001 116 368 2968 69 496 3086 101 565 3676 71 474 2861 129 537 3836 151 452 3623 119 393 3070 153 910 5647 161 405 3552 154 441 3660 _ 198 454 4335 201 622 4860 89 394 2792 127 325 2878 113 289 2705 76 566 3580 95 640 4100 30 472 2512 '. 19 254 1490 1 1 CHAPTER VI ANIMAL FOODS Milk and Milk Products. Composition. Variation. Adulter- ation. Contamination. Sterilization and Pasteurization. Digestion. Absorption. Predigestion. Kephyr. Kumiss. Matzoon. Cream. Butter. Buttermilk. Cheese. MILK AND MILK PRODUCTS Milk is universally used as an article of food by civilized and by many uncivilized peoples. It is one of the cheapest, most easily digested, and perfect foods that we use. Mother's milk is the natural aliment for infants. Composition Milk contains more than 85 per cent, of water and variable proportions of protein, fat, carbohydrate, and mineral salts. It contains two proteins. Fibrinogen, or casein, is the most important because it constitutes six-sevenths of all the protein in cow's milk. Lactalbumin, the second protein of milk, is similar to serum albumin of blood. The fat of milk consists chiefly of stearin, palmitin, and olein. The proportion of fat varies much in different kinds of milk. The carbohydrate of of milk is lactose, or milk-sugar. It occurs in an almost un- varying amount in each variety of milk. The other constit- uents are subject to variation. The mineral salts in milk are numerous, but slight in quantity. Their relative percentages in the ash of human milk are as follows: Calcium phosphate 23.87 per cent. Calcium silicate 1.27 per cent. Calcium sulphate 2.25 per cent. Calcium carbonate 2.85 per cent. Magnesium carbonate 3-77 P er cent. Potassium carbonate 23.47 per cent. Potassium sulphate & -33 P er cent. Potassium chlorid 12.05 per cent. Sodium chlorid 21.77 per cent. Iron oxid and aluminum ° • 3 7 per cent. 100.00 per cent. 68 MILK. 6 9 The following table gives the comparative composition of milk of different kinds : COMPARATIVE COMPOSITION OF VARIOUS KINDS OF MILK Source of Milk Woman Cow.. . Dog. . . Ewe... Buffalo Cat Goat. . . Llama. Ass Mare. . . Water Total Solids Per cent. Per cent. 87.4 12 .6 87.2 12 8 75-4 24 6 80.8 19 2 81.4 18 6 82.1 17 9 85-7 14 3 86.5 13 5 89.6 10 4 91-5 8 5 Total Solids Protein Fat Albu- Total min Protein Per Per Per Per cent. cent. cent. cent. 1.0 1.3 2.3 3-8 3 5 3-5 3 7 6 1 5 1 11. 2 9 6 5 1 5 6.5 6 9 5 8 3 6.1 7 5 3 1 6 9.1 3 3 3 2 1 1 4-3 4 8 3 9 3-9 3 2 7 1 6 2.3 1 6 1 2 1 J. 3 1 2 Carbo Min- eral (Milk- sugar) Mat- ters (Ash) Per cent. Per cent. 6.2 0.3 4-9 7 3-i 7 4-9 9 4.1 9 4.9 6 4.4 8 5-6 8 6.0 5 5-7 6 3 Fuel Value per Pound Calor- ies 319 313 671 503 506 400 365 312 222 180 Human milk and cow's milk are not very dissimilar in the amount of energy that they might generate, but their food value, as estimated by the ratio of their protein to the calories that they might produce, is very different. Human milk is poor in protein and rich in carbohydrate. The average composition of human milk is: Water 87 to 88 Fats 3 to 4 Sugar 6 to 7 Proteins 1 to 2 Ash o . 1 to 0.2 It is slightly alkaline, and has a specific gravity of from 1028 to 1034. The following analyses, made by Harrington for Rotch, illustrate the variability of human milk: I II III IV V VI VII Fats S.16 4.88 4.84 4.37 4. 11 3.82 3.80 Sugar 5.68 6.20 6.10 6.30 5.90 5.70 6.15 Proteins 4.14 3-7 1 4. 17 3- 2 7 3 7 1 1 -° 8 3-53 Ash 0.17 0.19 0.19 0.16 0.21 0.20 0.20 70 ANIMAL FOODS. VIII IX X XI XII XIII XIV Fats 3-7^ 3.30 3.16 2.96 2.36 2.09 2.02 Sugar 6.95 7.30 7.20 5.78 7.10 6.70 6.55 Proteins 2.04 3.07 1.65 1.91 2.20 1.38 2.12 Ash 0.14 0.12 0.21 0.12 0.16 0.15 0.15 The fats and proteins may vary very much more than these analyses would lead one to think. The following analyses show how greatly a mother's milk may vary from time to time : Standard Case I Case II Fats 4.00 0.72 5.44 5.50 1.62 3.20 3.04 Sugar 7.00 6.75 6.25 6.60 6.10 6.40 6.60 Proteins.... 1.50 2.53 4.61 2.90 3.54 2.52 2.32 Ash - x 5 0.22 0.20 0.14 0.17 0.18 0.12 Case III Case IV Case V Fats 1.62 3.20 3.04 1.37 2.02 2.74 3.05 0.65 3.34 Sugar 6.10 6.40 6.60 6.10 6.55 6.35 6.10 5.25 6.30 Proteins 3-54 2 -S 2 2 -3 2 2.78 2.12 0.98 3.89 3.82 2.61 Ash 0.17 0.18 0.12 0.15 0.15 0.14 0.16 0.18 0.16 Case VI Case VII Case VIII Fats 3.44 2.09 3.98 3.19 5.71 2.67 0.34 3.24 2.79 4.84 Sugar 5.60 6. 70 7.00 5.60 4.00 6.60 5.40 5.45 5.05 6.00 Proteins.... 3.96 1.38 2.22 1.78 4.29 3.18 3.61 3.95 3.66 3.42 Ash 0.20 0.15 0.19 0.16 0.19 0.17 0.18 0.16 0.20 0.17 Cow's milk varies almost or quite as much as human milk. The most constant ingredients in it are milk-sugar and mineral matter. The following is an average analysis of cow's milk: Water 86 to 87 Fats 2.5 to 4.50 Sugar . 4 to 4 . 50 Proteins 3 . 75 to 4 . 00 Ash , 0.70 It is slightly acid in reaction and has a specific gravity of 1029 to 1033. The milk of a cow may vary in composition at different times. It is usually richer in cream for a time after her calf is born than later. Food, excitement, and illness will also cause it to vary. So long as the animal is upon a uniform diet and is healthy, her milk will not vary noticeably in com- position or amount. Different breeds give milk of varying degrees of richness: VARIATIONS IN MILK. 7 1 Durham Devon Ayr- Hol- Swiss shire stein Fats 4.04 4.09 3-89 2.88 4.00 Sugar 4.34 4.32 4.41 4-33 4-3° Proteins 4. 17 4.04 4.01 3-99 4.00 Ash °-73 0.76 0.73 °-74 0.76 Good cow's milk should contain from 3 to 5 per cent, of fat. Variation The proportions of the constituents of milk vary from the filling of the cow's udder after calving to the time when it ceases to be secreted. After the first week it is usually the richest and remains about the same for months, providing the animal's diet is uniform. Ultimately the milk becomes less abundant, but the percentage of solids increases. The flavor of milk is frequently modified by diet; certain plants may make it disagreeable. Milk is more nearly uniform when it is obtained habitually from a herd of cows; that procured from one animal varies much from time to time. Adulteration As it is purchased from dealers, milk is at times modified in composition or adulterated. The addition of water is the commonest mode of adulteration. If the water is pure, its addition is harmless, except as it lessens the nutritive value of a given quantity of the milk. Coloring-matter is added to make milk look richer. Milk is sometimes slightly thickened by the addition of starch. Preservatives, such as salicylic and boric acids and formaldehyd, are mixed or dissolved in it. They prevent its souring rapidly. Although these agents are used in very small percentages, and, if taken occasionally, would probably be harmless, they must be regarded as deleter- ious when administered habitually, as they may be in milk. Contamination Milk is often unwholesome because it is obtained from cows that are not healthy. The commonest cause of its contamina- tion is disease of the udders, but even disease in distant organs 72 ANIMAL FOODS. makes it undesirable. Milk taken from a sick cow should not be used for food. Unfortunately, chronic maladies like tuber- culosis may exist in an animal for a considerable time without causing sufficient change to attract the keeper's attention. Tuberculosis of the udder or slight inflammation due to pyogenic microbes may easily be overlooked. Of 186 samples of milk, Dr. Eastes 1 found tubercle bacilli in n and pus organisms in 47. Milk is often contaminated by dirt, which comes from the cows when they are not properly cleansed before milking, from the hands or clothes of the milker, or from the dust of the stable, barnyard, and milk room. Besides dirt, micro-organisms of various kinds gain access to it in this way. Some are innocuous, a few produce souring, and others are specifically pathogenic. Of the last, the commonest are the microbes of typhoid fever and diphtheria; and, possibly, of scarlatina and, in certain countries, of cholera. The typhoid and cholera germs are added to the milk with water used in cleansing the vessels in which the milk is gathered or kept, or added as an adulterant. They are also sometimes carried on the feet and proboscis of flies which convey them from sewerage to the home or dairy. They both grow freely in milk when it is kept sufficiently warm. Local epidemics of typhoid fever have frequently been traced to milk thus contaminated. Scarlet fever has been said to be communicated by milk when cows were milked by one who was recovering from the malady and who had not yet com- pletely shed the skin of his hands. In a report upon milk examination made by de Schweinitz, of Washington, to the Department of Agriculture, attention is called to the fact "that in the milk supply of our large cities the number of bacteria per cubic centimeter has been found to vary from 30,000 to 85,000, and has often been found as high as the number of bacteria in the sewage of several towns — namely, between 1,000,000 and 4,000,000 per cubic centimeter." But- ler, a German authority upon the subject, claims that the maximum limit for milk that is fit for food is 50,000 germs in a cubic centimeter. If this rule is applied to samples obtained by de Schweinitz from 32 Washington dealers, the milk supply of only 13 was fit for use. Of the samples from these dealers, 1 " British Medical Journal," November n, 1899. CLEAN MILK. 73 one showed only about 4000 bacteria in a cubic centimeter; one, 2500; five others, from 10,000 to 15,000; six, from 30,000 to 50,000; and the remainder, more than 50,000; in several instances, more than 100,000. De Schweinitz also examined 135 samples of milk obtained from a dairy in which the utmost pains were taken to prevent contamination. In a majority of these samples from 200 to 5000 bacteria in a cubic centimeter were found. Three samples showed more than 50,000, one more than 15,000 and less than 20,000; two more than 10,000 and less than 15,000; two more than 5000 and less than 10,000. These results show what can be accomplished by due care. Legal standards, both chemical and bacteriologic, have been established by certain health boards in the United States and other countries. The milk supply of communities thus safe- guarded has consequently been greatly improved and made more uniform. All this emphasizes the need of the utmost care in the handling of milk to insure its purity. Purity is the more necessary as milk is so largely used uncooked. At the Clover Farm Dairy, which offers a particularly uniform rich and pure milk for use in Chicago, the following precautions are taken : The herd is made up of grade Holsteins, grade Jerseys, and grade Durhams. These crosses are thought to give animals more vitality, better constitutions, and less liability to disease than the registered animals of the various breeds possess. It is also important, in the production of milk for baby and invalid food, to secure milk that retains its cream as well as possible. The cream of Jersey milk rises so rapidly that a thick buttery cream is produced that does not mix so readily with the milk after it has once risen as does that of most of the other breeds and their grades. This characteristic of the Jerseys adds to their value as butter cows, but detracts from their usefulness when a milk is wanted to retain its fat. Milk should be con- stantly agitated during the cooling process, for this prevents the rising of the cream until after it is cooled, and by this treatment cream and milk are much more readily and thor- oughly incorporated when preparing it for feeding. Each cow is tested for tuberculosis at frequents intervals, and 74 ANIMAL FOODS. also to determine her value as a butter producer. A cow not in perfect health cannot reach a high productive standard. These tests insure a healthy herd from which the milk is obtained. The stable has cement floors and cement mangers. It is fur- nished with individual stalls. The stall work is of iron and woven wire. It has a good system of ventilation and has plenty of light. The cement floors can be easily cleaned, and every day they are thoroughly flushed and scrubbed, abundance of water being at hand. A complete system of sewerage is provided. One-half hour before milking, the cows are groomed. The milkers are required to cleanse their hands and put on white milking suits. One man is required to cleanse the udders of the cows just in advance of milking, using a sponge and warm water for this purpose. Each milk pail is furnished with a closely fitting strainer cover, into which is fastened a layer of absorbent cotton, so that all the milk passes through this cotton before entering the milk pail. The milk is poured out through a covered spout, and the strainer is not removed from the pail until the milking is finished, when it is destroyed and a new one is prepared for the next milking. The milk pails, strainers, cans, and all other utensils, also the bottles in which the milk is shipped to the consumer, are thoroughly cleansed and then sterilized by live steam in a sealed room, the temperature of which is held at 2 1 2 F., for thirty minutes. The first milk from each teat is rejected, as experience has shown that germs which may sour the milk invade the milk-ducts and cannot be gotten rid of by washing alone. As soon as the milk is obtained it is run through a centrifugal machine, such as has been in use for some years in creameries, as a means of rapidly and economically separating the cream from the milk. By its use the percentage of fat can be kept constant, and at the same time dirt or other solid matter that may have gotten into the milk in spite of the precautions previously used can be removed from it. Although in this operation the cream and milk are separated from each other, they are again mixed when they come from the separator, and there is left behind in the machine a peculiar mass of mucus, germs, etc., which it is very desirable to have out of the milk. Immediately after STERILIZATION AND PASTEURIZATION. 75 leaving the separator the milk is cooled to a low temperature. The milk is then bottled, each bottle stopped with a wood-pulp stopper, and a metal cap and a seal put over the top in such a manner that the contained milk cannot be reached unless the seal is destroyed. On each seal is stamped the date of the bottling. This seal is a guarantee of genuineness to the con- sumer. Although this process seems complex, it is in reality carried out quite readily by trained workmen. The dairies which supply the Walker-Gordon Milk Labora- tories in various cities are managed in much the same way, and an equally uniform and pure production is the result. In several cities of the United States the whole or a part of the milk-supply has been taken under the voluntary supervision of medical societies cooperating with reputable dairymen. The societies appoint veterinarians, bacteriologists, and chemists. They fix and announce their requirements, and these are specified in contracts. Every month, at times not previously announced, samples of milk are procured and examined, and the veterinarian visits the dairy farm. If the milk examined comes up to the standard, a certificate is given; if not, the certificate is withheld until another examination shows the milk to be right. Inside of the metal cap on every bottle is a small certificate, printed and signed with the printed autograph of the Commission, stating that an examination was made on such and such a date, and that another will be made within the month and new certificates issued, and counseling buyers to watch for the change in dates. Sterilization and Pasteurization Pathogenic organisms in milk can be killed by boiling it. This constitutes sterilization. It is, however, then changed in taste and made distinctly less digestible. If milk is kept at a temperature of 70 C. (158 F.), for twenty or thirty minutes, most of the germs will be killed. Their spores will not be destroyed but their growth will be checked for a time. This process is called Pasteurization. It does not modify the taste of the milk, nor lessen digestibility so much as steri- lization does. Except in the hottest summer weather, 76 ANIMAL FOODS. resort to Pasteurization is not necessary to prevent the souring of milk. Pathogenic organisms should be excluded by- scrupulous care in the collection and distribution of milk. Digestion Milk is easily digested by most persons. It is usually spoken of as a liquid food, but when it reaches the stomach it is con- verted at once into a finely divided solid. Its casein is curdled and precipitated in flocculent particles by rennin, the milk- curdling ferment of the stomach. The gastric acids coagulate it also. When this process goes on with unusual rapidity, instead of flocculent particles of casein there may be formed large masses of cheese-like material that will prove slow of digestion. This often occurs in the stomachs of both infants and adults whose digestion is enfeebled. Cow's milk curdles in larger particles than human milk, and is therefore more difficult of digestion. After milk is curdled in the stomach its compo- nents are digested as are other foods. It is often important to prevent the formation of large curds in the stomach. Adults who feel uncomfortable after drinking milk can frequently be taught to like it and to dispose of it readily. It must be given at first in small doses — one or two tablespoon- fuls every quarter or half hour — and gradually in larger quantities and at longer intervals. Patients should be instructed to drink milk slowly, sipping or 'chewing' it; often hot milk will be found better than cold milk for this purpose, and those who become accustomed to the flavor of heated milk usually prefer it. Giving it in small quantities prevents it from forming large cheese-like masses in the stomach ; and the same purpose is accomplished by slow sipping, and thorough mixing with the saliva. Lime-water is frequently added to milk to prevent it from coagulating into large chunks of casein. Usually two or three tablespoonfuls are added to a glass of milk. Lime-water partly neutralizes the acids in the stomach and prevents them from still further contracting or coagulating the milk curds. Other antacids are useful for this purpose. Sodium citrate is added to milk to prevent coagulation which it does by convert- ing the soluble lime salts into insoluble citrate. For this pur- ABSORPTION OF MILK. 77 pose, add to milk, one-fifth of its bulk of a 25 per cent, solu- tion of sodium citrate. It is scarcely detectable by taste. Aerated waters, such as Vichy and Selters, when added to milk increase its palatability for many persons and combat its dot- ing, in part by diluting it and in part by making the clot friable. Dilution of the milk also insures dilution of the acids in the stomach. Barley-water and flour ball are used to prevent the formation of large, firm clots in the stomach. They do this by mingling with the particles of casein the mucilaginous particles of starch, which prevent the clot from shrinking into a tough mass. Boiled milk does not clot so firmly as raw milk out of the stomach, but in the latter it does. Boiling renders some of the lime-salts less soluble, but when they are introduced into the stomach, they are redissolved by its acid. It is interesting to note the time that milk remains in the stomach after it is taken. This is determined by drinking a measured quantity and by washing the residue out of the stomach at different times. It has been found 1 that — 602 c.c. of raw milk disappeared from the stomach in three and one- half hours. 602 c.c. of skimmed milk disappeared from the stomach in three and one-half hours. 602 c.c. of sour milk (buttermilk) disappeared in three hours. 602 c.c. of boiled milk disappeared in four hours. However, the correctness of these figures is disputed by all good observers and it is still undecided that there is a difference in the digest- abilility of boiled and raw milk. Absorption Milk is not completely absorbed from the intestine. In adults it leaves a considerable residue. In infants and children it is much more completely taken up. In childhood the residue is about 4 per cent., as compared to 10 per cent, in adults, and is still less in infants. If two liters of milk are the only food taken by an adult, the residue will be from 5 to 8 per cent.; if three liters are taken, from 10 to 11. 16 per cent, will remain 1 Hutchison, "Food and the Principles of Dietetics," p. 122, London, 1911. 78 ANIMAL FOODS. unabsorbed. When milk is taken with other food, a similar residue is left; for instance, on an exclusive milk diet 92.1 per cent, of protein and 86.3 per cent, of carbohydrate will be digested and absorbed, and upon a bread and milk diet 97.1 per cent, of protein and 98.7 per cent, of carbohydrate will be digested and absorbed. Utility in Disease Milk is particularly well adapted for use in many diseases because it is easily digested, comparatively unirritating, and, when used exclusively, lessens abnormal fermentation in the intestines. No single food is so valuable to the sick. It occupies a unique position, for it is easily administered and it combines in itself the qualities of a beverage and of a food. It is a bulky food, however, because it contains so much water. When a patient is confined to his bed, three or four pints daily will maintain life and sometimes even increase his weight, but a person in health, engaged in active work, will need twice this amount. The milk cure, or an exclusive milk diet, has been recom- mended for very many diseases. It is carried out systematic- ally at certain health resorts, especially in Switzerland and Germany. Its applicability in pathologic states is discussed in the second part of this volume. When milk forms the only article of diet, it should at first be given in quantities not to exceed from one-third to one-half glass every second hour. After two or three days, two-thirds of a glass can be given at a time, and later a whole glass, or about eight ounces. It should be drunk slowly, or sipped. It should be taken with perfect regularity during the day, and two or three times at night. As many as twelve glasses (three quarts or liters) are usually prescribed for use in twenty-four hours. Constipation is not an unfavorable indication when milk only is taken as food. It means that the milk is well digested and well absorbed, and it can be counteracted by mild laxatives. Vomiting and diarrhea, however, indicate indigestion and malassimilation. At first, patients upon a milk diet lose flesh, but when they take the maximum quantity, they hold their own or gain. They often PREDIGESTED MILK. 79 feel drowsy. The tongue is thickly covered by a white or yellowish-white pasty coat and a disagreeable mawkish taste is often complained of. The urine is increased in quantity. The output of uric acid is lessened. Indican and compounds of similar origin disappear. If milk was the only food a person took, its bulk would be uncomfortably large, providing enough was taken to furnish 2500 or 3000 calories, for 100 grams (three and one- third ounces) furnishes 69.2 calories or units of energy and approximately 3.3 grams of protein. Therefore, as the only food for a person it is only adapted to those who are at rest in bed. For others it can be made a more perfect ration by adding sugar to it or by giving with it a little bread or crackers. The milk cure is persisted in for six or eight weeks ordinarily. It is not suddenly discontinued, but milk is given in gradually lessened amounts, and other easily digested foods are substi- stituted for the quantities withdrawn. It is sometimes necessary to modify the flavor of milk when it is used as an exclusive food or as the chief article of diet, as the taste of it is not agreeable to every one. Warm milk is preferred by many, and is particularly well borne by the stom- achs of most persons. A little salt and pepper are sometimes added to milk to modify its taste. Predigestion When milk is administered to those whose digestive organs are weak and incapable of full work, it is often partly digested beforehand. This is accomplished by adding to milk that has been slightly acidified a good preparation of pepsin. The mixture is kept at body-temperature by immersion in hot water. The proteins of the milk are soon converted into albu- moses. If digestion is allowed to continue, the mixture becomes bitter. It is customary, therefore, to remove the milk from the hot water before it grows bitter and to place it upon ice until it is used. Pancreatin is employed more often than pepsin for the digestion of milk, for it acts in an alkaline medium. A small amount of pancreatic extract and a few grains of sodium bicarbonate are dissolved in water and added to the milk. 80 ANIMAL FOODS. The mixture is kept at body-temperature or slightly higher, usually by placing the containing vessel in water at from ioo° to no° F. for about fifteen or twenty minutes until a slightly bitter taste is developed. The ferment is then destroyed by quickly bringing the milk to a boil and afterward placing it upon ice; or it may be placed upon ice without the preliminary boiling, in which case the activity of the ferment will be checked, but not destroyed. In what is termed the cold pro- cess, the digestive powder is dissolved in water added to the milk, and the whole placed upon ice, or allowed to stand, properly covered, in a cool room and used as wanted. Fair- child's tubes of peptonizing powder are composed of pancreatic extract five grains and sodium bicarbonate fifteen grains. One of these tubes will digest a pint of milk. There are various other good preparations upon the market. To prevent curd- ling of the milk by the digestive powder it is necessary to dis- solve the latter in a sufficient quantity of water — about one- fourth the bulk of the milk to be prepared. This holds good for all methods of preparation. Milk that is predigested in these ways should be taken cold. Its bitter taste may be disguised by the addition of a little coffee or carbonized water. The taste of the digested milk can also be well disguised by mixing together equal parts of milk and of flour gruel before the pan- creatic powder is added. In many cases it will suffice to dis- solve the necessary quantity of peptonizing powder in sufficient cold water, stir this into warm milk, and give to the patient at once, before the bitter taste develops. Milk thus prepared is sometimes termed 'pancreatized milk,' to distinguish it from the peptonized milk that has been allowed to stand. It is rare for a patient to object to the taste. To make milk more digestible for certain persons, and espe- cially for infants, its components are modified in their propor- tions by diluting it with water and by adding, if need be, cream and milk-sugar. Such milk modification or the preparation of percentage milk is described as a part of infant feeding in a sub- sequent chapter. Kumiss is a milk preparation that is agreeable to many pa- tients, very readily digested, and more completely absorbed than ordinary milk. It has been made for many hundred years KEPHYR. 8 1 in Eastern Europe from mare's milk. A substitute for it, made from cow's milk, is called kephyr. 1 All so-called kumiss in this country is kephyr. The presence of more fat in cow's milk than in mare's milk makes it less suitable for the fermentation that must take place to convert it into kephyr; therefore it is diluted or modified before it is fermented. The ferments used effect several changes in the milk. A part of the sugar in it is con- verted into lactic acid; another part into alcohol and carbonic acid gas, and a small amount of the casein is digested. The lactic acid precipitates the casein in fine particles; by constant agitation they are made still finer and gradually undergo partial digestion. The product is a milk that is sour, effervescent, and weakly alcoholic. The following table from Hutchison gives 1 Kephyr, like kumiss, was first made in the Caucasus by fermenting cow's milk with saccharomyces mycoderma, which produces alcohol, and lactic-acid-forming organisms. The kephyr granules used in the Caucasus to start this fermentation contain also bacterium dispora caucasica. It was supposed this played a part in producing the beverage — kephyr — but recent investigations show that it produces little or no effect. It may help to liquefy the precipitated casein. According to C D. Spivak (" N. Y. Medical Journal," Jan. 18, 1896, p. 82): "The Tar- tars prepare the kephyr in the following manner: A leathern bag (burdjuck) is filled with fresh cow's or goat's milk, the kephyr grains are thrown in, and the bag is tightly tied up. In summer the bag is placed in the shade, and in winter where the sun can reach it. From time to time the bag is shaken. The children take the office upon themselves, and usually the bag is used as a ball. It is also considered a duty that every passer-by should kick the bag, and set it rolling. In a few hours, or, at the utmost, two days — according to the season — the kephyr is ready for use. The bag is emptied and refilled, using the same grains over and over again. "The method of preparation now used in civilized countries is that elaborated by Dr. Dmitrieff. The grains are placed in an earthern or darkened glass vessel and are covered with milk, the bulk being three times that of the grains. The mouth of the vessel is covered with gauze or hygroscopic cotton with a view to exclude the ingress of dust only, and not to make it air-tight. The vessel is placed in a cool place at 12 R., and as soon as the fermentation sets in — i.e., as soon as the grains rise to the surface of the milk — the vessel is to be shaken up every two or three hours, with a view to thoroughly mixing up the fluid and liberating the grains from the curds and the bubbles. After twenty-four hours the grains are separated from the fluid by means of a sieve, are placed in a clean vessel, and a new quantity of milk is poured on them. Unlike the Tartar method, this product is not used as a beverage, but as a fermenter,' or, as it is called in Russia, 'zakvaska.' The zakvaska is diluted with double the quantity of milk and poured into bottles, which are corked hermetically. The bottles must not be completely filled, as they may burst. They are kept at the same temperature as the zakvaska, but they do not require the exclusion of light. The shaking is to continue at regular intervals, but not so that it may churn the milk. In twenty-four hours the kephyr is ready for use, and it is called the first day's kephyr, or weak kephyr. It has the following characteristics: the consistence of thin, sour cream, a white color, a pleasant, sour-sweetish taste, slightly acrid. When the bottle is opened it effervesces. The walls of the bottle and the glass which have held kephyr are covered with fine curds. When the bottle is left under the same conditions for another twenty-four hours, the kephyr is called second day's or medium kephyr; in forty-eight hours, third day's or strong kephyr. The terms weak, medium, and strong kephyr refer to the quantity of alcohol and carbonic acid gas contained in it." 6 82 ANIMAL FOODS. the relative composition of kumiss and mare's milk, of kephyr and cow's milk, and compares them with each other: Protein Percent- age Sugar Percent- age Fat Percent- age Salts Percent- age Alcohol Percent- age Lactic Acid Percbnt- AGB Kumiss 2.2 2.6 3-1 3-3 3-8 i.5 5-5 i.6 4.8 3-3 2. I 2-5 2 .O 3-6 1.2 0.9 °.5 o.8 0.7 o.6 i.7 0.9 Kephyr 2. I o.8 0.3 When kumiss or kephyr is fermented for only twelve hours, it is slightly sour and resembles milk in taste and appearance; when fermented for twenty-four hours, some of the casein will be dissolved, and the kumiss will be thinner and sourer. If the process is continued another day, it will be still thinner, sourer, and more thoroughly charged with carbonic acid gas. In Russia there are many places where the kumiss cure is applied. Those who need the cure are placed in sanatoriums, taught to drink large quantities of kumiss, and also fed gener- ously of other foods. The change of climate, the influence of the sun, and the fesh-air life have much to do with the cures that are effected at these resorts. At first, four or five glasses of kumiss are given daily. By degrees more is given, until from fifteen to twenty are taken in a day. It is especially valuable in some chronic catarrhs of the alimentary and respira- tory tracts, the early stage of pulmonary tuberculosis, anemia, scrofula, and rachitis. It is certainly nutritious and distinctly diuretic. If kumiss is too fresh or has not been kept clean, it may cause flatulence, colic, and diarrhea. It is often used as a substitute for milk by those who prefer its taste. Matzoon is a fermented milk. A lactic acid ferment obtained from Syria is used in its manufacture. It is sour, thicker, and is more of the consistency of cream than kumiss. It does not contain alcohol or carbonic acid gas, and is taken in smaller amounts at a time. It is agreeable, very readily digested, and also highly nutritious. CONDENSED MILK. 83 Preservation In countries where fresh milk cannot be had, milk is con- densed to preserve it for use. It is evaporated in vacuo until it becomes thick and paste-like. Two kinds of condensed milk are to be had in the market: one unsweetened, the other con- taining cane-sugar. In the former the proportion of water is reduced from 88 to 60 per cent. The latter contains from 40 to 75 per cent, of sugar. Condensed milk is often used as an infant's food. Some children grow fat upon it, but rarely thrive long. They are prone to rachitis. Their flesh is generally soft, and they do not resist disease well. Cream contains most of the fat of milk. It is obtained either by permitting milk to stand, when the fat will rise to the top and can be skimmed off, or it may be obtained more rapidly and perfectly by means of the centrifugal cream separa- tors now so generally used by dairymen. The proportion of fat in cream varies greatly. Ordinarily it is from 15 to 20 per cent, of the whole. Cream separators will produce a cream containing 65 per cent. fat. It is quite as essential that a legal standard should be fixed for cream as for milk. Cream contains about the same percentage of protein and sugar as milk. The fat in it displaces only some of the water that milk contains. Cream is agreeable to most persons, and is one of the most easily digested fats. Although not quite so digestible as cod- liver oil, it is an excellent substitute for the latter, because it is more willingly taken in sufficient quantities. A pint of cream will furnish 125 more calories (1425 calories) than four quarts of milk. It is a heat producer or energy producer, and should be supplemented by porteins to make a complete diet. Ice-cream, when made simply, is wholesome and agreeable. It may be fed to many invalids with benefit. It is cream flavored with vanilla, sweetened with sugar, and frozen. Ice- cream that contains rich flavoring extracts or much fruit is less easily digested. Skimmed milk is the residue left when cream is removed from milk. It is milk poor in fat. Its composition varies inversely as that of the cream that has been removed from it. 84 ANIMAL FOODS. It is adapted for use when the fat of milk cannot be well digested. Butter is produced from cream by churning. In this process the albuminous envelops of the fat globules of the cream are broken and the fat particles are permitted to commingle and to form a solid mass. The fluid residue contains most of the sugar and protein of the cream. The flavor of butter is derived from the growth of organisms in it while it is ripening. In many creameries pure cultures of certain micro-organisms are now used to ripen butter and thus insure a uniform flavor to their product, or to adapt the flavor to the preference of certain markets. Butter prepared from fresh cream has not what is known as the butter flavor. It is comparatively insipid. Salt is mixed with butter to preserve it and to flavor it. When butter is not salted, it spoils quickly. When it spoils it becomes rancid, bitter, and unwholesome. These changes take place readily if it is kept in too warm a place. Two one-inch cubes of butter weigh approximately an ounce and furnish 284 calories and 0.38 grams of protein. Butter is often adulterated by coloring matters and by admix- tures of other fats. Margarin is prepared from ox fat, and is quite as digestible and wholesome as butter. When mixed with it, an agreeable fat results that is much cheaper than butter. It is known as butterin. If it is well made, it is not harmful. Butter that has become partly rancid may be washed repeatedly with hot water and again 'worked'; it will taste nearly as well and be as cheap as butterin, but it is not equally wholesome. Most persons eat an ounce of butter or more daily. As a rule, it is very easily digested. Although it is less digestible when cooked than when used cold. Butter contains from 12 to 5 per cent, of water, 82 per cent, of fat, and about 2 per cent, of other organic matter. Margarin contains 9.3 per cent, of water, 1.3 per cent, of protein, 82.7 per cent, of fat, and 6.7 per cent, of ash (Atwater). Buttermilk, or the residue after butter is made from milk, contains albumin, salts, sugar, and water. Much of the sugar is converted into lactic acid and gives to buttermilk its sour CHEESE. 85 taste. It is relished by many persons and particularly well digested by those who cannot eat fats. In Turkey, Bulgaria, Servia and the neighboring countries sour milk has been used as a beverage very generally and is preferred to sweet milk. The bacterium caucasicus or Bul- garian bacillus is the most active of the lactic acid ferments. It has been observed that it will, when introduced into the intestinal tract in large numbers, check the growth and thereby greatly lessen the number of other organisms in it. Butter- milk is therefore especially useful to lessen fermentation in the intestines. Of late years it has been largely used because Metchnikoff has praised it as an elixir of long life. He believes that arterio- sclerosis and the lesions caused by it are due to bacterial fer- mentation of food products in the intestines and he urges the drinking of buttermilk or the taking of lactic acid ferments to prevent this. However, there is not sufficient positive experimental evi- dence to show that lasting effects of this kind can be produced by the lactic acid ferments or by the Bulgarian bacillus especially. Moreover there is some evidence to prove that certain micro-organisms are needed in the intestines to com- plete digestion, and therefore to maintain good health. Cheese is a product of milk and is composed of its casein and fat. The casein is precipitated either by permitting the milk to sour or by adding acids or rennet to it. Cheeses vary in composition according as they are made of milk to which cream has been added, of whole milk, or of skimmed milk. In this way the relative quantity of fat that they contain is made to vary. They are modified in consistence according as the curd is pressed into hard cakes or left as a soft mass and shaped by the hand of the maker or by light pressure. The peculiar flavor of cheese is due to special micro-organisms that, by their growth during the period of 'ripening,' develop in it chemical bodies of peculiar flavor. The soft cheeses, such as cream cheese, Brie, Camembert, Neufchatel, and Stilton, must be eaten fresh, as they will not keep long. 86 ANIMAL FOODS. The hard cheeses, such as American dairy, Parmesan, and Edam, will keep for a long time. With few exceptions cheese is made from cow's milk. Par- mesan is made from goat's milk partly skimmed, and Roquefort from the milk of the ewe. The following table, taken from Hutchison, shows the com- position of many of the common cheeses : 1 Nitrogenous Cheese. Water Matter Fat Ash American 26.9 32.9 3 1 >° 4.5 Brie 49.7 18.9 26.8 4.5 Camembert 48.6 21.0 21.7 4.4 Cheddar 31.9 33.4 26.8 3.9 Cheshire 33.2 29.4 30.7 4.3 Cream 32.0 8.6 35. 9 1.5 Dutch 32.9 30.8 17.8 6.3 Gloucester 3 x -9 36.7 24.7 4.4 Gorgonzola 39. 2 25.9 29.9 4.7 Grueyere 34.1 31.5 28.2 4.0 Neufchatel 41.0 *4-3 43-2 1.4 Parmesan 30.0 43.8 16.5 5.9 Roquefort 25.1 34.8 31.5 5.5 Stilton 27.6 23.9 38.9 3.1 In general it may be said that cheese contains approximately one-third water, one-third nitrogenous matter, and one-third fat. It would seem to be a most concentrated and cheap nitrogenous food. A pound of lean meat contains over 70 per cent, of water. Mattieu Williams says that a cheese of twenty pounds contains as much nutriment as a whole sheep weighing sixty pounds. A pound of cheese will produce at least 2000 calories. This is more than three times as much as a pound of lean beef will yield. Although, from its composition, cheese appears to be so perfect a nitrogenous food, it illustrates well the fact that the value of articles of food cannot be estimated by their composi- tion alone. Cheese is not easily digested. The fat that it contains surrounds the particles of casein of which it is chiefly composed and prevents the gastric juice from coming readily 1 For a full description of all of the many kinds of cheese and their composition, see "Varieties of Cheese," Bulletin 146, U. S. Department Agriculture, Bureau of Animal Industry, 1911. TYROTOXICON POISONING. 87 in contact with them. Cheese is most easily digested when it is eaten in a state of fine subdivision or in solution, as recom- mended by Williams. It can be readily dissolved by a small amount of potassium bicarbonate. A savory and nutritious dish can be prepared by adding milk and eggs to this dissolved cheese. Certain cheeses contain fatty acids that are developed in the process of ripening. They are frequently irritating to the stomach. Cheese, like other milk products, may contain tyrotoxicon and cause even fatal poisoning. This ptomain is the product of a specific micro-organism which sometimes infects milk and its products without materially modifying their appearance or taste. CHAPTER VII ANIMAL FOODS (Continued) Eggs. Meats. Cooking. Meat Products. Digestibility. Food Value. Fish. EGGS Hens' eggs are a complete food in the sense that they contain some of all the ingredients that are essential in foods. On account of the small quantity of carbohydrate in them, they are, however, inadequate. An average egg will yield seven grams of protein; it would, therefore, take from ten to twenty of them to supply the amount requisite for one man for one day. They are, however, among the most important articles of food, for they are bland, easily digested, and capable of being prepared in a great variety of appetizing ways. The composition of the edible part of a hen's egg is: Water 73-7 per cent. Protein 14.8 per cent. Fat 10.5 per cent. Salines 1 . o per cent. The average weight of an egg is forty-four grams, and it will generate seventy calories. The white and the yolk differ con- siderably in composition, as the following analysis shows : Shell. ... 10 parts, average weight 6 grams, carbonate of lime. Yolk. . . .30 parts, average weight 15 grams, Protein. . . 16.0 per cent. Fat 30.7 per cent. Salts 1.3 per cent. Water .... 52.0 per cent. 100. o White. . .60 parts, average weight 29 grams, Protein. . . 20.4 percent. Salts 1.6 per cent. Water.... 78.0 percent. ss DIGESTIBILITY OF EGGS. 89 The protein of the white is commonly called egg-albumen, but it is not a simple substance. Eicholz has shown that some of the molecules contain a carbohydrate component. Fat is not found in the white of egg. In the yolk the fat consists of palmitin, stearin, olein, and such bodies as cholesterin and lecithin, which are frequently grouped with the fats because, like them, they are soluble in ether. Nuclein is one of the most important albumins of the yolk. It carries a part of the phos- phorus which eggs contain. The salts in eggs are the most important ones needed by man's tissues. Moreover, they contain an assimilable iron in relatively large quantity. When cooked, the albumin of the egg is more or less coagulated. When cooked completely, it forms a firm, solid, semielastic mass that is not readily attacked by the digestive juices unless it is finely divided. The following table compiled from Penzoldt is interesting, as it throws light upon the gastric digestibility of different culinary preparations: Two eggs soft boiled leave the stomach in 1 3/4 hours. Two eggs raw leave the stomach in 21/4 hours. Two eggs poached and five grams of butter leave the stomach in 2 1/2 hours. Two eggs hard boiled leave the stomach in 3 hours. Two eggs as omelet leave the stomach in 3 hours. Apparently this table does not accord with popular experi- ence, which assigns the greatest digestibility to raw eggs. The observations of Burke explain the discrepancy. Raw eggs are apparently so bland that they do not excite either gastric secretion or motion, and are ultimately passed into the duo- denum almost unchanged. This, of course, will not be so true if they are taken with other foods, as bouillon, or milk. Hard- boiled eggs become comparatively digestible when they are minced finely and mingled with water in the stomach. Such an egg will disappear from the stomach as quickly as a soft- boiled one. Eggs are absorbed very completely from the intestine, leaving a residue of only about 5 per cent. Modes of Administration Raw eggs can be given directly from the shell, or seasoned 90 ANIMAL FOODS. with pepper or salt, or added to bouillon, to coffee, or to milk. A very palatable preparation is made by shaking an egg thoroughly with lemon- juice and sugar, and diluting the mixture with either plain or carbonized water. Egg-nog is made by shaking an egg with milk and flavoring the mixture with wine or distilled liquor. An agreeable, equally nutritious mixture can be made by omitting the alcoholic and flavoring with cinnamon, nutmeg, or other spice. Custards are made with egg and milk, sweetened, flavored, and cooked. These and boiled and poached eggs are the forms in which they are usually served to invalids. Eggs are, however, often used in other dishes and in cakes of various kinds. When digestion is slow, eggs are often modified before they are completely prepared for absorption. Hydrogen sulphid and ammonia are set free from them. The former especially may escape from the stomach with other gases and be readily detected by its characteristic odor. This is always a sign that the eggs are not being perfectly digested. Somewhat similar changes take place when they spoil from long keeping. Eggs that are not fresh should never be served, and especially not to an invalid. There are a few persons who cannot eat eggs because the eructation of sulphureted hydrogen generated by their imper- fect digestion makes them distasteful. There are a few others who are made quickly and violently ill whenever they eat eggs ; an idiosyncrasy that cannot be accounted for, and that has given rise to the popular expression that eggs are 'bilious/ MEATS Meats are among the most important articles of diet. From them man obtains the largest part of his protein food. Meat flavors are especially savory and excite a flow of saliva and gastric juice. Raw meat, if it is finely divided or thoroughly masticated, is readily digested. It is not so palatable as cooked meat, and is therefore rarely eaten by civilized people. Cooking effects several changes in meat: it causes a loss of water, a loss of fat, a loss of extractives, and, by gelatinizing the connective tissue, which then becomes soluble, loosens the COOKING OF MEAT. 9 1 fibers of the flesh so that they fall apart and are readily reached by the digestive juices. The change effected in the color of the meat renders it more agreeable to the eye of the diner, and the modification of its flavor is more agreeable to the taste. It is not necessary here to discuss in detail methods of cook- ing, but the processes should be understood sufficiently to comprehend their purpose. Meat may be boiled by placing it in cold water and subjecting it to moderate heat for a long time. Before the temperature of the water is much elevated the greater part of the salts, of the juice, and of the extractives or flavors of the meat will be dissolved. As the flesh is subsequently cooked through by the greater heat of the water in which it is placed, the fiber becomes gray in color, the connective tissue being gelatinized and partly dissolved so that the meat readily falls to pieces. It is, however, quite tasteless, although not lacking in nutritive properties. The flavoring is in the fluid in which the meat has been cooked. This is the proper way to stew meat when moderate quantities of water are used and the meat is cut into small pieces before being placed in it. The meat and the fluid in which it is cooked are then eaten together. This makes a savory and easily digested dish. But if a large mass of meat is to be cooked in water, the water should be boiling before the meat is put into it. The albumin of the superficial fibers will be at once coagulated and will seal the juices in the meat. The water should then be allowed to cool so that it is at about 180 F. instead of 212 F., and should be kept at this temperature until the mass of flesh is thoroughly cooked. By this process the meat will be stewed in its own juices, which are retained in it. When meat is roasted after the modern fashion, it is placed in a very hot oven. The hot air about it rapidly coagulates the superficial fibers and therefore prevents the escape of the juices. It should then be kept for a considerable time at a somewhat lower temperature. Large pieces, such as joints and large roasts, should be frequently basted by pouring over them the fat and juices that accumulate in the dish. This helps to seal the meat more thoroughly and to retain the largest part of the juice. It also causes chemical changes that modify the flavor. 92 ANIMAL FOODS. The olden English fashion of roasting was to place the meat upon a spit before the grate and turn it continuously so that each portion of the periphery was successively exposed directly to the heat. Broiling or grilling over an open fire is essentially the same process, but the portion of meat is small in size and is cooked through at once. Exposure to very hot air coagu- lates the albumin upon the surface, and the juices within help both to cook the inner fibers and to cause the whole to swell slightly. The inner fibers are juicy and particularly savory. Frying, as it is ordinarily practised, is not properly managed. It is customary to put a small quantity of fat or oil in a shallow dish over a hot fire; just enough is used to prevent the food from sticking to the dish. When it is melted and simmering, the meat is put in the dish, cooked quickly upon one side, turned and cooked upon the other; if it is small, turning is not con- sidered necessary. The surface of the meat is seared in the hot fat, but as it is not immersed in it, this is done unevenly. Some of the fat penetrates and often saturates it. The hot fat is partly decomposed, and fatty acids are liberated that irritate the stomach when the meat is eaten. The fat that permeates the meat prevents the ready access of the gastric juice to the fibers, and therefore makes their digestion slow. The correct method of frying is the following: A deep dish full of oil is heated to boiling, which means that the oil is at a temperature of from 350 to 380 F.; and the meat to be fried is immersed in this boiling oil. The surface is at once completely seared, the superficial albumin coagulated, the mass made impermea- able and doubly so because the particles of water attempting to escape from the meat keeps it surrounded by a layer of steam. Immersion in the extremely hot fat cooks the food with rapidity. If it is removed from the oil as soon as it is cooked and permitted to drip, it is not excessively fat and not nearly so indigestible as what is ordinarily called fried food. Meat is made most savory by roasting or broiling. It is most digestible when properly stewed, and least so when fried. All meats retain their flavor and their juiciness when the surfaces are rapidly coagulated by high temperature and the interior slowly cooked at a much lower temperature. Roasting accom- BOUILLON. 93 plishes this well, although boiling can be made to do so when it is carried out correctly. The flavor of meat varies with the species of animal from which it is derived. It is most distinct and characteristic in mature animals, and especially in those that have led an active life. The food habitually taken by an animal modifies the flavor of its flesh. The difference thus produced is especially noticeable in ducks fed only upon grain, and in ducks fed partly upon fish. The flesh of the latter retains a distinct taste of fish. When animals first are killed, their meat is less savory than when kept for some time in a cool place. By keeping, changes are produced in it. The albumin partly coagulates, lactic acid forms in the muscle and modifies part of the albumin, making it somewhat more soluble, and rendering the whole more ten- der. Except in the tropics, where meat cannot be kept long, it is customary to keep it in cold rooms for some time, both that a richer flavor may develop in it and that it may become tender. Bouillons are made by soaking finely cut meat for a time in water so that the extractives, the salts, and a little gelatin may be dissolved out. It is then slowly heated and cooked and finally brought quickly to a boil. When the liquid is poured off, it is rich in meat flavor, but contains little nutri- ment. If it is allowed to cool, fat will accumulate upon the surface. This should be skimmed off. The remainder will be found to consist of two layers — the upper and thicker of clear fluid, the lower of a turbid fluid. The turbidity of the latter is due to minute particles of coagulated albumin, which is almost the only nutrient material in it. If a clear bouillon or soup is prepared, this is strained off. The liquid that is swal- lowed contains only a minute amount of protein. Although it is not nutritious to an appreciable extent, it is agreeable to the taste, often whets the appetite, and promptly stimulates the secretion of gastric juice. It is, therefore, an excellent intro- duction to a more solid meal. If soup is to constitute the chief dish at a meal, it should be made more nutritious by the addi- tion of vegetables or cereals or by stirring into it an egg. From such a thick soup the particles of coagulated albumin should not be strained off as they are when a clear bouillon is made. 94 ANIMAL FOODS. Beef-tea, mutton broth, chicken broth, and similar prepara- tions so frequently given to invalids are bouillons and especially poor in nutrient ingredients. They should be used only to whet the appetite and to act as feeble stimulants. When sipped as hot drinks, as coffee, tea, and even hot water, they will make the heart beat stronger and faster. The salines that broths contain are sometimes useful. The extractives or flavorings are not nutritious. They are mostly waste-products that are eliminated by the kidneys during the life of animals, and if they are eaten, must similarly be gotten rid of by man. They may thus in some cases act partially as diuretics, but under some conditions of renal failure may become toxic. Beef-extracts, such as Liebig's, are concentrated bouillons, and when eaten, are diluted to the consistence of broth. Their composition and value are the same. Liebig's extract con- tains approximately 30 per cent, of protein and gelatin. When made into beef-tea, a pint of the latter will contain less than thirty grains of these ingredients. The experiment of starving one set of animals and of feeding another upon beef-extract has been made, with the result that both died in the same length of time. So thoroughly are medical men convinced of the in- significant food value of bouillons and beef-extracts that it is hardly necessary to emphasize the fact. They are still, how- ever, household panaceas. Beef -juice is made at home by lightly broiling a thick, juicy steak, cutting it into fine pieces, and squeezing it in a lemon- squeezer or, better, in a meat press. The extractives, the blood, and some of the proteins of the meat are thus extracted. Round steak can be made to yield nearly 7 per cent, of coagulable pro- tein. If finely chopped raw meat is heated in a bottle kept for two or three hours in hot water, from 2 to 3 per cent, of coagu- lable protein can be extracted. Care must be taken not to boil the juice or heat it greatly, or the albumin in it will coagu- late and will be precipitated. The commercial beef-juices, such as Valentine's, Wyeth's, and Armour's, are made by sub- jecting chopped meat to a strong pressure. The juice that is thus obtained is concentrated in vacuo to prevent coagulation of its protein. These preparations contain from about 2 to 30 per cent, of protein; most of them, from 4 to 5 per cent. MEAT EXTRACTS. 95 The following table of commerical extracts will give informa- tion as to the percentage of nutrients and some other important ingredients: 1 SOLID MEAT EXTRACTS Water Total Ash Total Total Nitro- Pro- gen teins % % 7-30 22. 12 9.07 30.50 7.66 27.51 6.02 14.93 6.60 15.38 6.86 15.01 Kreatin AND Kreat- ININ Xan- THIN Am- monia "Rex" brand beef ext Liebig's ext. of meat. . Armour's ext. of beef. Ext. of beef, Premier. Beef extract Beef ext. , Coin Special 26.50 21 . 14 21.66 21.86 20. 16 12.39 24.06 2 1 . 03 20.46 30.92 27.28 31.68 % 1.03 0.08 o. 11 0.30 1.22 1. 41 % 0.24 o.45 0.26 0.52 0.86 0.30 FLUID MEAT EXTRACTS Concentrated fluid beef ext. Beef juice Meat juice Vigoral " Rex "fluid beef ext Fluid ext. of beef Fluid beef jelly 57-75 17.23 2.85 6.76 58.84 16.21 3.15 6.45 57.64 10. 26 3.06 5.63 49.94 15-91 3.87 io.75 55-99 16.99 3-95 7.00 64.63 16. 13 3.18 10.25 68.97 13.85 2.41 8.13 1. 19 0.81 1.09 1.50 2.50 1.56 0.81 0.62 0.71 0.60 0.46 O. II 0.24 0.13 0.24 0.27 0.16 0.24 0.22 o. 16 MISCELLANEOUS PREPARATIONS Bouillon capsules Bovril, seasoned Beef jelly, Mosquera ext. of beef Essence of beef Predigested beef Soluble beef Bo vox essence of beef Johnsons' fluid beef American brand ext. of beef . Bovinine concentrated beef.. Essence of Mutton Liquid food (ext. of beef, mutton, and fruits) Maggi's bouillon Peptonized beef. Rose Beef ext. and vegetable tablets Leube-Rosenthal's beef solu- tion Malted Meat ext. of beef Beef peptonoids 14.75 39-75 5-93 22. 19 43.39 16.09 562 22.06 27.82 I7.3I 7.83 28.63 90.93 1-34 1.28 5.07 91.69 0.18 0.42 1. 19 30.15 14-55 8.41 37.76 65.77 17.29 3v7i 16.57 47.22 9.80 6.57 3L75 27.54 34-73 5.63 26.69 80.40 1.55 2.36 14.14 82.03 2.25 2.61 12.00 86.09 0.65 1.84 10.69 56.56 21.94 2.76 2.13 45-13 3.52 6.98 22.20 22.29 23.66 4. 10 18.87 72.68 3.91 3.13 16. 13 8.61 7.87 2.02 9.82 5.72 5. 63 4.12 23.32 1.44 1. 59 1. 81 o.34 0.06 1. 3i 0.16 0.62 None. 0.53 None. 0.22 0.22 0.47 0.25 Trace. Trace. 0.35 0.43 o. 14 0.03 0.03 0.60 0.03 0.49 0.08 0.08 O. II 0.08 O. II 0.27 0.43 0.03 0.05 O. II o. 19 o. 19 0.35 0.05 O.OI 0.28 0.21 0.30 0.25 O.OI 0.15 0.06 0.67 0.32 0.08 0.15 0.00 0.00 1 Compiled from Bulletin No. 114, Bureau of Chemistry, U. S. Department of Agriculture 96 ANIMAL FOODS. White of egg contains 12 per cent, of egg-albumen. It is, therefore, much more nutritious than most of these juices and much less expensive. Meat juices have, however, both a positive and a negative value. Like bouillon, they often whet the appe- tite of invalids and excite the stomach to greater work. When bread, crackers, or rice are soaked in them, they make an agree- able dish and one that is nutritious. They should, therefore, be regarded as adjuncts to more nutritious food, and not as staple articles of diet. Their negative value in those cases of illness in which food must necessarily be withheld for a time, is that they permit ' nourishment ' to be given that satisfies the family and does not materially harm the patient. Their use as temporary stimulants will be set forth in another connection. Meat powders of various kinds are upon the market and are more or less useful to strengthen or increase the nutritive value of other foods. Beef powder can readily be made by drying boiled beef upon a water-bath and powdering it in a cofle-mill. The powder thus made can best be given in chocolate or milk. It is useful when it is necessary to administer food in a concen- trated condition. Mosquera's beef meal is a powdered beef that has been partly digested by pineapple juice. Somatose consists chiefly of albu- moses. A variety of 'peptone' preparations in powder form, or predigested powdered meat, are upon the market. Some of them are also offered in liquid form with and without alcohol. The following analyses of certain preparations tabulated by Hutchinson make plain the general nutritive value of the class : Preparations Water Koch's peptone 40 . 16 Liebig's peptone 3 1 . 90 Brand's peptone 84 . 60 Denaeyer's peptone 78 .45 Darby's fluid meat 25.71 Armour's wine of peptone .... 83 . 00 Fairchild's panopepton 81 . 00 Carnrick's peptonoids consist chiefly of starch and milk-sugar. Meat jellies are agreeable, especially during convalescence Soluble Pro- teins, Chief- ly Albu- moses Extractives and Nonpro- tein Organic Matter Mineral Matter 33-78 15-93 6.89 33-40 24. 60 9.90 7 .00 1 .40 12.15 4-3 2 2-54 30.60 30.18 I3.50 3.00 12 . 90 1 . 10 3.00 1 5 . 00 (largely 1 . 00 sugar) DIGESTIBILITY OF MEAT. 9 from illness, and are slightly nutritious. Their basis is gelatin. Glue is a crude form of gelatin. Its purest form is isinglass, which is obtained from the swim-bladders of fishes. The con- nective tissue of young animals is especially rich in it. Calves, feet when boiled yield 25 per cent, of gelatin and a little more than 11 per cent, of fat. Gelatin jellies, whether flavored with meat, fruit, or wine, rarely contain more than 2 per cent, of it. Gelatin is very soluble and easy to digest. It is not, as was explained in a former chapter, a builder of tissue as are proteins, but it possesses about the same power to produce energy. It is a protein sparer — that is, it prevents protein waste. It is estimated that it will save half its weight of tissue protein. It has been calculated that not more than twenty-five or thirty grams of gelatin can conveniently be taken in a day, and rarely more than a small fraction of this is eaten. If the former quantity were taken, it would effect a saving of only a little more than an ounce of flesh. Its value in fevers as a protein saver is therefore slight. Fish is an economic kind of protein food. It is for the most part easy of digestion. The fat fishes, such as salmon, are less digestible than those whose flesh is of shorter, smaller fiber and less rich in fat. Fish is highly nutritious, but because it con- tains more water than most other meats it is weight for weight of less nutritive value. Lobster and crab meat are relatively indigestible because they are coarse and tough. The oyster is the most highly prized shell-fish. When raw, it is more digestible than when cooked. It is nutritious and wholesome unless, as in some cases, contaminated with typhoid bacilli. It contains about 6 per cent, of nitrogenous matter, 1.5 per cent, of fat, and 3.3 per cent, of glycogen. A dozen oysters contain only about one ounce of solid matter. They therefore contain nourishment in a very diluted form and are not an economic food. Digestibility The digestibility of meats is estimated sometimes by the relative length of time that it takes artificial gastric juice to digest different kinds; sometimes, and more perfectly, by 7 98 ANIMAL FOODS. experimentally determining how long different kinds remain in a healthy stomach. The table on the opposite page, which has been compiled from various authors, will give an idea of the relative digestibility of different kinds. Penzoldt's figures illustrate well the fact that small quantities of a given substance are digested by the stomach more rapidly than large ones. This emphasizes the need of small meals when digestion is impaired. The comparatively slow digestion of pigeon and young chicken is surprising, as they are usually believed to be easy for the stomach to dispose of. This calls attention to the fact that, when the stomach is weak, there are other factors to be considered in prescribing foods for it, than their relative rapidity of digestion. Pigeon and chicken are bland and, provided they are not eaten in too large quantities, cause little discomfort, because they contain very little fat, and the muscle-fibers are relatively short and small. Sweetbreads are digestible and bland. They are composed of gland cells held together by a loose and delicate connective-tissue frame- work. Nine ounces are completely disposed of by a healthy stomach in two and three-quarter hours. Liver and kidney are compact organs with a relatively small amount of connective tissue. They are slow to digest unless finely minced before they are eaten. Calf's brain is readily disposed of by the stomach, but it is very imperfectly digested and absorbed by the intestines, for more than 40 per cent, appears in the feces. Fish and oysters are bland and easy of digestion. Fish of coarse fiber, and fat, such as salmon, is relatively slow and difficult for the stomach to dispose of. Three and one-third ounces of boiled salmon are modified and delivered into the intestine by the stomach in from three to four hours, while twice this amount of boiled pike or carp are similarly disposed of in from two to three hours. Three oysters of average size are digested by the stomach in one and three-quarters hours, and two and one-half ounces in from two to three hours. Composition It is unnecessary to discuss the physical attributes of different kinds of meat. They are familiar. The composition of the DIGESTIBILITY OF MEAT. 99 Boiled milk, Bouillon, Eggs, raw, Milk, Pigs' feet, Trout, Calf's brains, boiled, . . . Boiled milk, . . ... Eggs, hard boiled or omelet, Beef sausage, raw, .... Brains, boiled, Sweetbread, Oyster, raw, Carp, boiled, Pike, boiled, Sharper, boiled, Beef, raw, chopped fine, . Beef, half cooked, .... Beef, well cooked, .... Beef, thoroughly roasted, . Mutton, raw, Veal, cooked, Pork, cooked, Mutton, roasted, .... Beefsteak, Ham, cooked, Lean beef, broiled, .... Fish, boiled, Bacon, roasted, Poultry, Veal, Codfish, boiled, Chicken, young, boiled, . . Partridge, roasted, .... Pigeon, boiled, Beef, cooked, Calf's foot, boiled, .... Ham, raw, Beefsteak, raw, grated, . . Salmon, boiled, Caviar, Herring, pickled and smoked, Pigeon, roasted, Fillet of beef, roasted, . . Beef tongue, smoked, . . Bacon, Hare, roasted, Partridge, roasted, .... Goose, roasted, Duck, roasted, Penzoldt. I to 2 hrs. ioo to 200 grams tt n 2OO " " " IOO " 2 to 3 hrs. 300 to 500 g " IOO " " IOO it «. 2 £ " " 250 " « 72 u ti 200 " " 200 « " 200 3 to 4 hrs. 100 grams 100 160 2 to 3 hrs. 200 3 to 4 " 230 " 230 " 250 " 250 " 250 " 160 " IOO " IOO " 72 " 200 to 5 hrs. 210 " 250 " 250 " IOO " 250 " 240 " 250 « 280 Jesskn. 2 hrs. 2)4 hrs, 3 4 2 2K 3 RlCHERT 2 tO 3 hrs. 30 to 60 minutes I hour B EAU- MONT. y 2 hrs. 13/ hours IOO ANIMAL FOODS. meat of different animals and of different cuts of the same animal should be known, and it is fully given in the following tables, compiled by Charles D. Wood 1 and C. F. Langworthy. 2 It must be remembered that the composition as given is an average, for different analyses vary greatly. This is due in part to the variable amount of fat contained in meat, in part to the varying amount of work that animals do, and often largely to the relative dryness of meat. The following analyses of beef from New Mexico with table comparing the analyses made in other States of the Union, show how great may be the variations from climatic causes: Refuse Water Protein Fat Pp _ a ,_ p . r Per Per Per F rw fW Cent. Cent. Cent. Cent - Cent - Maine 16.1 50.2 14.4 18.6 0.7 Tennessee 20.4 52.9 *5-3 IO -5 °-8 Texas 20.0 55-2 15.3 8.8 0.7 New Mexcio 30 .7 51.1 16.6 0.7 0.9 Any one desiring a more elaborate presentation of the subject of the analyses of meats than these tables give should consult such a work as that of C. Ainsworth Mitchell on " Flesh Foods." 1 " Meat Composition and Cooking," Farmers' Bulletin No. 34, United States Department of Agriculture. 2 "Fish as Food," Farmers' Bulletin No. 85, United States Department of Agriculture. COMPOSITION OF MEATS. IOI TABLE SHOWING THE CHEMICAL COMPOSITION AND FUEL VALUE PER POUND OF MEATS. Kind and Cut of Meat. Nl TTRIEN TS. Fuel Refuse. Water. Water- free sub- stance. Pro- tein. Fat. Carbo- hy- drates. Ash. Value PER Pound. Per cent. 14-3 Per cent. 47-4 40.6 Per cent. 52.6 45-1 Per cent. 14.6 12.5 Per cent. 37-2 3i-9 Per cent. Per cent. 0.8 0.7 Cal- ories. 1840 1580 17.0 67.8 56.3 32.2 26.7 19.0 15-7 12.3 10.2 0.9 0.8 870 720 i' 3 '.8 57-3 49-3 42.7 36.9 17.4 15.0 24.4 21. 1 0.9 0.8 1355 1 170 6.6 59-3 55-5 40.7 37-9 17.6 :i6. 5 22.2 20.6 0.9 0.8 1260 "75 13-0 60.5 52.6 39-5 34-4 18.3 15-9 20.2 17.6 1.0 0.9 1190 1040 27 '.6 634 45-9 36.6 26.5 19.2 13-9 16.5 II <3 0.9 0.7 1055 760 14.7 52.7 44-9 47-3 40.4 15-4 131 3i-i 26.6 0.8 0.7 1600 1365 20.8 55-4 43-8 44.6 35-4 16.9 13-4 26.8 21.3 0.9 0.7 1445 1150 12.2 43-9 38.6 56.1 49.2 13-7 12.0 41.6 36.5 0.8 0.7 2010 1765 7-7 65.8 60.7 34-2 31-6 19.7 18.1 12.6 1.0 0.9 935 870 32.1 69-5 47.2 30.5 20.7 20.6 14.0 8.6 5-8 1.3 0.9 745 505 21.4 56.7 44-5 43-3 34-1 16.8 13.2 25.6 20.2 0.9 0.7 1395 1095 36.9 67.9 42.9 32.1 20.2 19.6 12.3 11.6 7-3 0.9 0.6 855 535 53-9 67.8 31-3 32.2 14.8 19.8 9-i "•5 5-3 0.9 0.4 855 395 16.4 68.3 56.8 3i-7 26.8 19.3 16. 1 "•3 9.8 I.I 0.9 835 715 19.4 61.4 49-5 38.6 311 17-5 14.1 20.2 16.3 0.9 0.7 1 180 950 15.8 61.0 51-3 39-0 32.9 18.0 15-2 20.1 17.0 0.9 0.7 1 185 1000 BEEF. Brisket : Edible portion, . As purchased, . Chuck, with shoulder Edible portion, . As purchased, . Chuck ribs : Edible portion, . As purchased, . Flank : Edible portion, . As purchased, . Loin : Edible portion, . As purchased, . Neck : Edible portion, . As purchased, . Plate : Edible portion, . As purchased, . Ribs: Edible portion, . As purchased, . Ribs, cross : Edible portion, . As purchased, . Round : Edible portion, . As purchased, . Round, second cut : Edible portion, . As purchased, . Rump: Edible portion, . As purchased, . Shank, fore: Edible portion, . As purchased, . Shank, hind : Edible portion, . As purchased, . Shoulder and clod : l Edible portion, . As purchased, . , Fore quarter : Edible portion, . , As purchased, . , Hind quarter: Edible portion, . . As purchased, . , 1 The clod itself has no bone — i. e, refuse. 102 COMPOSITION OF MEATS. Table Showing the Chemical Composition and Fuel Value per Pound of Meats. — ( Continued. ) Kind and Cut of Meat. Refuse. Nutrients. Water. Water- free sub- stance. Pro- tein. Fat. Carbo- hy- drates. Ash. Per cent. 60.6 49-7 69.8 Per cent. 39-4 32.0 30.2 Per cent. 17.7 14.5 21.6 Per cent. 20.8 16.8 5-4 Per cent. i"8 Per cent. 0.9 0.7 1.4 53-i 46.9 28.5 14.0 4.4 50.9 40.0 49.1 38.6 18.7 14.7 24.7 19.4 5-7 4-5 49-9 43-7 50.1 44.2 14.2 12.4 33-o 29.2 2.6 40.1 34-3 59-9 51.2 13-3 11.4 £3 4-7 4.0 58.1 54-5 41.9 39-5 15-3 14.4 23-3 22.0 3-3 3-i 50.8 49.2 31-8 6.8 0.6 10.0 51-3 78.7 21-5 23.2 4.0 49-9 62.3 50.1 37-7 21.0 12.5 25.1 20.5 4.0 4-7 66.4 527 33-6 26.7 18.8 14.9 13-8 11.0 1.0 0.8 73-3 59-5 68.9 26.7 21.6 3" 19.2 15.6 19.7 6-5 5-2 10.4 1.0 0.8 1.0 70.4 59-4 29.6 25.0 20.1 16.9 8.4 7.2 I.I 0.9 68.3 65.6 31-7 30.4 20.8 20.0 9.9 9-5 1.0 0.9 69.2 57-2 30.8 25-5 19.4 16.0 10.4 8.6 1.0 0.9 72.6 49-9 27.4 18.6 19-5 13-3 4.6 1.0 0.7 72.5 53-0 27.5 20.1 20.2 14.7 6.2 4.6 I.I 0.8 62.6 43-7 374 26.1 20.1 14.0 16.2 "•3 I.I 0.8 74.0 44.1 26.0 15-5 19.8 11.8 52 31 1.0 0.6 74-5 27.8 25.5 9-5 19.9 . 7-4 4.6 i-7 1.0 0.4 71.7 54-2 28.3 21.3 19.4 14.6 8.0 6.0 0.9 0.7 Fuel Value per Pound. beef. Side: Edible portion, As purchased, Liver, as purchased, Cooked, corned, and canned, as purchased, Corned brisket : Edible portion, As purchased, Corned flank : Edible portion, As purchased, Corned plate : Edible portion, As purchased, Corned rump : Edible portion, As purchased, Dried and smoked, as pur- chased, Tongue : Canned, whole, as pur- chased, Canned, ground, as pur- chased, Pickled, as purchased, . . VEAL. Breast : Edible portion, As purchased, Chuck : Edible portion, As purchased, Flank, as purchased, Leg, whole : Edible portion, As purchased, Leg, cutlets : Edible portion, As purchased, Loin : Edible portion, As purchased, Neck : Edible portion, As purchased, Rib: Edible portion, As purchased, Rump : Edible portion, As purchased, Shank, fore : Edible portion, As purchased, Shank, hind : Edible portion, As purchased, Fore auarter : Edible portion, As purchased, Per cent. 18.3 21.4 12. 1 14-5 £0 20.6 18.9 15.6 4.0 17-3 3i-5 26.9 30.2 40.4 627 24-5 Cal- ories. 1205 980 665 1390 1090 1660 1465 2015 1720 1270 "95 845 1380 1450 1 100 740 630 5io 805 730 620 805 775 800 660 655 440 635 470 1055 735 590 35o 565 210 700 525 COMPOSITION OF MEATS. 103 Table Showing the Chemical Composition and Fuel Value per Pound of Meats. — ( Continued. ) Kind and Cut of Meat. Refuse. Water. Nutrients. Water- free sub- stance. Pro- tein. Fat. Carbo- hy- drates. Ash. Percent. 20.7 Per cent. 70.9 56.2 Per cent. 29.1 23.1 Per cent. 19.8 15-7 Per cent. 8-3 6.6 Per cent. Per cent. 1.0 0.8 22"6 71.3 55-2 73-1 28.7 22.2 26.9 19.6 15- 1 20.4 8.1 6.3 5-3 1.0 0.8 1.2 19. 1 56.2 45-5 43-8 35-4 19.2 15-5 23.6 19.1 1.0 0.8 17.4 639 52.9 36.1 29.7 18.5 152 13.6 I.I 0.9 14.8 53-1 45-3 46.9 39-9 17.6 15-0 28.3 24.1 1.0 0.8 17.7 56.7 46.7 43-3 35-6 17.5 14.4 24.8 20.4 1.0 0.8 20.3 51.8 41.3 48.2 38.4 17-5 14.0 29.7 23.6 1.0 0.8 21.3 50.9 39-9 45-8 49.1 38.8 54-2 14.6 11.5 14.8 H- 6 26.7 38.7 0.9 0.6 0.7 18.0 62.8 5i-4 37-2 30.6 18.2 14.9 18.0 14.9 1.0 0.8 15-3 50.1 42.2 49-9 42.5 15-9 132 33-2 28.6 0.8 0.7 28.4 5 H 41.6 41.8 30.0 16.3 11.7 24-5 17.6 1.0 0.7 21.7 61.9 48.5 38.1 29.8 17-3 13-5 19.9 156 0.9 0.7 21. 1 51-7 40.6 48.3 38.3 150 11.9 32.4 25-7 0.9 0.7 16.7 54-8 45-6 45-2 37-7 16.2 13-5 28.2 23-5 0.8 0.7 19.2 53-1 42.9 46.9 37-9 15-4 12.5 307 24.7 0.7 0.7 18" 1 5i.« 41.8 48.9 40.1 16.9 13.8 3ii 25-5 °-2 0.8 n'x.z 59-0 17.0 41.0 EX.8 17.8 5-i 22.2 6.4 1.0 0.3 Fuel Value per Pound. VEAL. Hind quarter : Edible portion, . As purchased, , Side: Edible portion, , As purchased, . Liver, as purchased, LAMB. Breast : Edible portion, , As purchased, . Leg, hind : Edible portion, . As purchased, . Loin: Edible portion, . As purchased, . Neck: Edible portion, . As purchased, . Shoulder : Edible portion, . As purchased, . MUTTON. Chuck : Edible portion, . As purchased, . Flank, as purchased Leg, hind : Edible portion, . As purchased, . Loin: Edible portion, . As purchased, Neck: Edible portion, . As purchased, . Shoulder : Edible portion, . As purchased, Fore quarter : Edible portion, . As purchased, . Hind quarter : Edible portion, . As purchased, . Side, without tallow Edible portion, . As purchased, . PORK. Chuck and shoulder Edible portion, . As purchased, Flank : Edible portion, . As purchased, 1 . Cal- ories. 720 57o 705 545 605 1355 1095 1040 855 1520 1295 1375 1130 1580 1255 1690 1340 1910 1100 905 1695 1450 960 1 160 910 1645 1305 1490 1245 1580 1275 1630 1335 1265 365 VI— 7 1 Refuse includes fat trimmings. io4 COMPOSITION OF MEATS. Table Showing the Chemical Composition and Fuel Value per Pound of Meats. — ( Continued. ) Kind and Cut of Meat. pork. Loin : Edible portion, As purchased, Leg, hind : Edible portion, As purchased, Ham, smoked : Edible portion, As purchased, Ham. boneless, as purchased, Shoulder, fresh : Edible portion, As purchased, Shoulder, smoked : Edible portion, As purchased, Salt, clear fat, as purchased, . Salt, lean ends : Edible portion, As purchased, Bacon, smoked : Edible portion, As purchased, Feet: Edible portion, As purchased, Ham, deviled, canned, as pur- chased, Side: Edible portion, As purchased, SAUSAGE. Bologna : Edible portion, As purchased/ Frankfort, as purchased, . . . Pork, as purchased, Tongue, as purchased, . . . . SOUPS, CANNED. Bouillon, as purchased, . . . . Chicken, as purchased, .... Consomme, as purchased, . . Mock turtle, as purchased, . . Ox tail, as purchased, .... Tomato, as purchased, .... POULTRY Chicken : Edible portion, As purchased, Fowl: Edible portion, As purchased, Goose : Edible portion, As purchased, Turkey : Edible portion, As purchased, Chicken, canned, as purchased Quail, canned, as purchased, Turkey, canned, as purchased Refuse. Water. Nutrients. Water- free sub- stance. Pro- tein. Fat. Carbo- hy- drates. Ash. Per cent. i's's Per cent. 52.0 43-8 Per cent. 48.0 40.4 Per cent. 16.8 14. 1 Per cent. 30.3 25.6 Per cent. Per cent. 0.9 0.7 42.4 62.8 35-7 37-2 21.9 18.5 10.7 17.7 10.6 1.0 0.6 14.4 40.7 34-9 50.1 59-3 50.7 49-9 15-5 13-3 154 39' 1 334 28.5 4-7 4.0 6.0 46.6 57-5 304 42.5 23.0 15-6 8-3 26.1 14-3 0.8 0.4 154 46.8 39-8 7-3 53-2 44.8 92.7 15.5 1.8 33-3 28.1 87.2 44 3-6 3-7 11. 2 19.9 17.6 80.1 71.2 I' 3 6.5 67.1 59-6 5-7 5-i £0 18.2 16.8 81.8 75-2 10.0 9.2 67.2 61.8 4.6 4.2 35-5 68.2 44.6 31.8 19.9 16. 1 10.0 14.8 9-3 0.6 45-3 54-7 18.9 32.9 2.9 11.2 29.4 26.1 70.6 62.7 8.5 7-5 61.7 54-8 0.4 0.4 3-3 59-5 55-2 55-5 38.7 46.4 40.5 4i-5 44-5 61.3 53-6 18.6 18.0 21.7 12.8 17.3 18.2 19.7 18.8 454 33-i O.I 0.4 0.8 3-6 3-8 3-6 2-3 3-2 96-5 93-8 96.0 89.8 88.8 90.0 3-5 6.2 4.0 10.2 11. 2 10.0 2.0 3-6 2-5 5-2 4.0 1.8 0.1 O.I 0.9 1-3 I.i 0.2 i-5 0.4 2.8 5.6 1.2 1.0 I.I 1-3 1.6 i-5 34-8 74.2 48.5 25.8 16.7 22.8 14.8 1.8 I.i 1.2 0.8 30.0 66.3 46.5 33-7 23-5 18.2 12.5 14.4 10.2 2.1 0.8 22.2 42.3 33-i 57-7 44-7 13.0 10.3 43-9 33-8 0.8 0.6 22.7 55-5 42.4 46.9 66.9 474 44-5 34-9 53-1 33-1 52.6 20.6 15-7 20.5 21.8 20.7 22.9 18.4 30.0 8.0 29.2 i-7 1.0 0.8 2.6 1.6 2.7 Fuel Value PER Pound. Calo- ries. 1590 1340 1090 645 1940 1655 1490 1390 760 1695 1430 3715 2965 2635 3020 2780 925 580 1740 2760 2455 n * 5 1 165 1205 2155 1720 45 100 xll 210 185 500 325 945 665 2095 1620 1350 1070 1645 775 1400 1 Refuse, case. COMPOSITION OF FISH. I05 COMPOSITION OF FISH, MOLLUSKS, CRUSTACEANS, ETC. Kind of Food Material. FRESH FISH. Alewife, whole, Bass, large-mouthed black, dressed, Bass, large-mouthed black, whole, Bass, small-mouthed black, dressed, Bass, small-mouthed black, whole, Bass, sea, dressed, Bass, sea, whole, Bass, striped, dressed, . . . Blackfish, dressed, Bluefish, dressed, Butterfish, dressed, Butterfish, whole, Carp ( European analysis) , . Cod, dressed, Cod, steaks, Cusk, dressed, Eel, salt-water, dressed, . . Flounder, common, dressed, Flounder, winter, dressed, . Hake, dressed, Haddock, dressed, Halibut, dressed, Herring, whole, Mackerel, dressed, Mackerel, Spanish, dressed, Mackerel, Spanish, whole, . Mullet, dressed, Mullet, whole, Perch, white, dressed, . . . Perch, white, whole, .... Perch, yellow, dressed, . . . Pickerel, dressed, ..... Pickerel, whole, ...... Pike, dressed Pike, whole, Pollock, dressed, Pompano, dressed, Porgy, dressed, Porgy, whole, Red grouper, dressed, . . . Red snapper, dressed, . . . Salmon, California (sections), Salmon, Maine, dressed, . . Shad, dressed, Shad, whole, Shad, roe, Smelt, whole, Sturgeon, dressed, Tomcod, dressed, Tomcod, whole, Trout, brook, dressed, . . . Trout, brook, whole, .... Trout, lake, dressed, .... Turbot, dressed, Turbot, whole, Weakfish, dressed, Weakfish, whole, Whitefish, dressed, Whitefish, whole, General average of fresh fish as sold, w -o W W (- b. O - Per cent. 49-5 46.7 56.0 46.4 53-6 46.8 56.1 51-2 55-7 48.6 34-6 42.8 37-1 29.9 9.2 40.3 20.2 57.o 56.2 52.5 51.0 17.7 46.0 40.7 24.4 34-6 49.0 57.9 54-6 62.5 35-1 35-9 47-1 30.5 42.7 28.5 45-5 53-7 60.0 55-9 48.9 5-2 23.8 43-9 50.1 41.9 14.4 51-4 59-9 37-9 48.1 35-2 39-5 47-7 41.7 43-6 53-5 42.0 ■J Z s Sg 22 < < < 2 5 a in * ft Oh (Xh < * Per Per Per Per Per Per Per cent. cent. cent. cent. cent. cent. cent. 37-5 9-7 2.5 0.8 130 41.9 10.3 0.5 0.6 11.4 34-6 8-5 0.4 0.5 94 40.1 "•5 i-3 0.7 13-5 34-7 10.0 1.1 0.6 1 1.7 42.2 10. 1 0.2 0.7 11. 34-« 8-3 0.2 0.6 9.1 37-4 8.7 2.2 0.5 11.4 35-0 8-3 0.5 0.5 9-3 40.3 9.8 0.6 0.7 11. 1 45-» 11.7 7.2 0.7 19.6 40.1 10.2 6.3 0.6 17.1 48.4 12.9 0.7 0.9 14-5 58.5 10.6 0.2 0.8 11.6 72.4 16.9 0-5 1.0 18.4 49.0 10. 1 0.1 0.5 10.7 57-2 14.6 7.2 0.8 22.6 35.8 6-3 o.3 0.6 7-2 37-o 6.1 0.2 o-5 6.8 39-5 7.2 0.3 0.5 8.0 40.0 8.2 0.2 0.6 9.0 61.9 15-1 44 0.9 20.4 37-3 10.0 5-9 0.8 16.7 43-7 11.4 3-5 0.7 15.6 51-4 15.8 7.2 1.2 24.2 44-5 13.7 6.2 1.0 20.9 38.2 15 2.4 0.6 12.8 31-5 2.0 0-5 10.6 34-4 8.7 1.8 0.5 11.0 28.4 7.2 1-5 0.4 9-1 50-7 12.6 0.7 0.9 14.2 5i-i "•2 0.2 0.9 13.0 42.2 9.8 0.2 0.7 10.7 55-4 13.0 0.4 0.7 14.1 45-7 10.7 0.3 0.6 11.6 54-3 15-5 0.6 1.1 17.2 39-5 10.2 4-3 0.5 15-0 34-6 8.6 2.4 0.7 11.7 29.9 74 2.1 0.6 IO.I 35-0 8.4 0.2 0.5 9-i 40-3 9.6 0.6 0.6 10.8 60.3 16.5 17.0 1.0 34-5 51.2 14.6 9-5 °o% 25.0 39-6 10.3 54 16.5 35-2 9.2 4.8 0.7 14.7 71.2 23-4 3-8 1.6 28.8 46.1 10.0 Z.6 1.0 12.0 67.4 154 1.6 1.2 18.2 39-6 8.2 0-3 0.5 9.0 32.7 6.8 0.2 O.4 74 48.4 11.7 1-3 O.7 13-7 40.4 9-8 1.1 0.6 II-5 45-o 12.4 6.6 0.8 19.8 43-1 7-9 8.7 0.8 17.4 37-3 6.8 7-5 0.7 15.0 46.1 10.2 1-3 0.7 12.2 38.0 8.4 1.1 0.6 IO.I 39-4 12.5 3-6 0.9 17.0 32-5 10.3 30 0.7 14.0 44.0 10.5 2-5 1.0 14.0 Calories. 285 215 175 270 230 160 255 175 205 520 455 270 205 335 190 575 130 120 145 160 465 435 360 595 515 285 235 235 265 230 3£ 260 210 315 370 260 225 165 205 1025 675 420 375 595 230 135 275 230 5io 515 440 245 200 385 320 300 io6 COMPOSITION OF FISH. Composition of Fish, Mollusks, Crustaceans, etc. — {Continued.) Kind of Food Material. PRESERVED FISH. Mackerel, *' No. i," salted, . Cod, salted and dried, . . . Cod, "boneless codfish," salted and dried, Caviare, Herring, salted, smoked, and dried, Haddock, " Finnan -had- dock," salted, smoked, and dried, Halibut, salted, smoked, and dried, Sardines, canned Salmon, canned, Mackerel, canned, Mackerel, salt, canned, . . . Tunny (horse mackerel), canned, Haddock, smoked, canned, MOLLUSKS. Oysters, solids, Oysters, in shell, Oysters, canned, Scallops Long clams, in shell, .... Long clams, canned, .... Round clams, removed from shell Round clams, in shell, . . . Round clams, canned, . . . Mussels, General average of mollusks (exclusive of canned), . . CRUSTACEANS. Lobster, in shell, . Lobster, canned, . Crawfish, in shell, Crab, in shell, . . Crab, canned, . . Shrimp, canned, . General average of crustace- ans (exclusive of canned), TERRAPIN, TURTLE, ETC. Terrapin, in shell, Green turtle, in shell, .... Average of turtle and terra- pin, Frogs' legs, General average of fish, mol- lusks, crustaceans, etc., . . ^ w -u W g H no" CO H ►J < CO w h < w H O BS V) H < Per Per Per Per Per Per cent. cent. cent. cent. cent. cent. 33-3 7-i 28.1 14.7 i5-i 24.9 17.2 40.3 16.0 0.4 21.5 54-4 22.1 0.3 38,1 30.0 19.7 7.6 444 6-5 19.2 20.2 8.8 32.2 1.4 49.2 16.1 0.1 6.9 12.1 46.0 19.1 14.0 5-o 53-6 24.0 12. 1 3-9 1.0 59-3 68.2 19-3 15-3 1.9 SI 8.7 19.7 8-3 34-8 213 72.7 Hi 4.1 5-6 68.7 2-3 88.3 6.1 1.4 3-3 82.3 15.4 1.1 0.2 0.6 85.3 7-4 2.1 3-9 80.3 14.7 0.2 34 43-6 48.4 4.8 0.6 1.1 84-5 9.0 1-3 2.9 80.8 10.6 i.l 5-2 68.3 27.3 2.1 0.1 i-3 83.0 10.4 0.8 3-o 49-3 42.7 4.4 0-5 2.1 60.2 34-o 3-2 0.4 1-3 62.1 3i-i 5-5 0.7 77.8 18.1 1.1 0.6 87.7 10.0 2.0 0.1 0.1 55-8 34-1 7-3 0.9 0.5 80.0 15.8 i-5 0.8 70.8 25-4 1.0 0.2 737 20.9 4-3 0.4 0.2 79.0 15.6 4-5 0.7 76.0 19. 1 4-5 0.1 77.5 17.4 4.2 0.7 32.0 ... 57-0 10.2 0.1 44.0 ... 42.5 10.0 2.5 O.I Per cent. 1-7 1.2 i-7 14.6 0.9 0.9 0.4 1-3 1.4 1-5 23 2.3 0.9 2.8 1.0 0.9 0.6 2.4 0.1 1.4 1-9 2.6 0.5 0.2 03 0.2 0.7 0.9 Per cent. 3i-5 17.6 24.1 61.9 29.9 17.2 35-o 41.4 35-8 29.9 37-2 27.3 25-7 11.7 23 14.7 19.7 8.0 15.5 19.2 44 17.0 8.0 5-8 6.8 22.2 2-3 10. 1 20.0 29.2 54 54 4-9 5-1 11.0 13-5 PD Calories. 910 315 425 1530 45 305 945 955 1005 735 1 155 575 505 235 40 300 345 135 275 340 285 140 130 395 i 5 185 370 520 "5 90 105 210 295 Including salt. CHAPTER VIII VEGETABLE FOODS Digestibility. Sugars. Cereals. Roots and Tubers. Peas and Beans. Green Vegetables. Fruits. Nuts. Fungi. Spices and Condiments. Vegetable foods differ from animal foods in the large amount of sugar and starch and the relatively small amount of protein and fat that they contain. They also contain a large quantity of water. A cabbage is richer in water than is milk. The great water-content of vegetables makes them bulky foods, and their small nitrogen value necessitates the eating of a large quantity in order to supply the protein that is required. As vegetable albumin is so much less readily absorbed from the intestines than is animal albumin, the total quantity of vege- table matter that must be eaten to supply all the ingredients needed for the maintenance of life is increased still more. It is estimated that of dry lentils, which, for a vegetable food, contain a large amount of nitrogenous matter, 2000 grams will be needed to supply as much protein as is necessary for a day's rations for a man, or as much as will be supplied by 600 grams of cooked meat. Digestibility The sugars and starches of vegetable foods are very perfectly digested and absorbed. Most vegetable oils and fats are rapidly absorbed. The proteins are not. Cellulose, which, except when very young, is indigestible, seems to interfere with the digestion and absorption of the proteins. The protein of vegetables is contained in cells as starch is; but when cooked, starch swells and bursts the envelop of cellulose, while protein, like other albumins when heated, shrinks and remains inside 107 108 VEGETABLE FOODS. its almost indigestible shell. Probably the quickening of intestinal movements that a vegetable diet produces also plays a part in preventing its perfect absorption. Forty per cent, of the protein of beans when they have been simply soaked and boiled until they are soft is lost in the feces. If they are ground to a fine powder and the cellulose shell about the protein is thus broken, it is almost as well digested and absorbed as is animal albumin. Unquestionably a mixed diet provides the necessary constit- uents in the most digestible and absorbable form. The ratio that should exist between animal and vegetable food is vari- ously estimated. It is probable that one part of raw animal food to three parts of raw vegetable food is as nearly accurate a ratio as can be established. In a large number of dietaries collected in the United States 45 per cent, of the food was of animal ori- gin. This is a high percentage, and especially so for those who lead a sedentary life. However, for the latter class a large amount of vegetable food proves indigestible because its bulk is a tax upon the muscular power of the alimentary canal, and because, when not digested rapidly, it is especially liable to fermentation, forming acids that often provoke intestinal inflammation, acute or chronic. A man doing hard muscular work needs an abundance of carbohydrate to furnish him with strength. His work maintains good muscular activity of his alimentary canal. The free action of skin and lungs also pro- duced by it enables him to dispose of the excess of water that a bulky vegetable diet makes unavoidable. If such foods are eaten hastily by those who are weak, dis- tention of the stomach and intestines is likely to be produced, and ultimately, because of slow digestion and fermentation of food, inflammation of these structures. Only those vegetables that are most digestible and least likely to ferment should be eaten under these circumstances, and then in small or moderate portions. The sugar of vegetable foods is in their juices. It is the circu- lating form of carbohydrate in plants. Starch is the form in which it is stored. Sugar is soluble, starch is not. In cold water starch undergoes no change, but in hot water it swells, breaks its envelop of cellulose, and is washed out. Cooking is, SUGARS. IO9 therefore, essential to make food containing starch capable of digestion. Dry heat can convert starch into dextrin, which is soluble. Cellulose is a carbohydrate that is different from starch, being both insoluble and indigestible except when it is very young. It is, however, especially subject to attack by micro-organisms that generate marsh-gas from it. As sustenance for the human body it is of inappreciable importance. It does stimulate the muscular activity of the intestine by its bulkiness, and foods rich in it, such as brown bread, green vegetables, and fruits, are eaten to correct constipation. Vegetable proteins are mostly globulins. Vegetable as com- pared with animal food is poor in nucleo-albumins. Like other proteins, those derived from vegetables coagulate with heat. Chemical constituents resembling the extractives of meat are also found in vegetables. The fats or oils are for the most part digestible. Vegetables contain most of the salts needed for the maintenance of life, but they are comparatively rich in potas- sium salts and poor in sodium. Sugars Sugar is the form of carbohydrate that needs least modifica- tion by digestion before it is absorbed. Dextrose needs more. The changes that must be effected in cane-sugar and other sugars have already been discussed in the chapter devoted to Digestion and Assimilation. Cane-sugar, which in commerce is chiefly derived from sugar- cane and sugar beet, is the form most used. Maple -sugar is cane-sugar, but contains certain ethereal substances that give it its characteristic taste. Maltose, or malt-sugar, lactose, or milk-sugar, glucose, or grape-sugar, levulose, or fruit-sugar, and invertose, or invert sugar, are other forms met with in foods more or less frequently. Molasses and syrup are crude forms of cane-sugar. Honey consists of approximately 20 per cent, of water, 35 per cent, of grape-sugar, 39 per cent, of fruit-sugar, and 5 per cent, of sub- stances other than sugar. It is obtained by bees from flowers and stored in cells of wax. Since both sugar and starch must be transformed into dex- trose before they are utilizable, they may be said to be identical IIO VEGETABLE FOODS, as nourishment. Sugar is agreeable to the taste, which is important, as it creates an appetite or liking for food to which it is added. Starch is almost tasteless. Sugar is a concentrated form of nourishment that especially gives strength to muscles and helps to produce fat. It has long been known to be a strength producer, but its value was not fully appreciated until demonstrated by Morro with the aid of the myograph, an instrument that records the amount of work done by a muscle or group of muscles. He found that sugar in food in not too great quantities and not too concentrated lessens or delays fatigue and increases working power. Vaughan Har- ley and others have confirmed these results by repeated experi- ments. When muscles are wearied by hard work, they can be revived by a meal of sugar with great rapidity and to a notice- able degree. The effect of sugar on muscular work is demon- strated a half hour after meals, but is greatest two hours after. Tests of its value confirming these laboratory experiments of Morro and Harley have been made upon soldiers, athletes, and others who were submitted to hard muscular work. Sugar is more quickly utilizable by the body than is starch. It is adapted for use in infancy when starch cannot be digested and in some dyspeptic states. It produces fat as well as strength, and may be prescribed or forbidden as one desires to put on fat or lose it. If used in too large quantities it will cause indigestion. Harley took nearly a pound daily without injury except to the stomach. Three or four ounces can be taken daily by an adult without harm. If too much is taken, it will not be held by the liver but will enter the blood in abnormally large amounts and be rapidly excreted by the kidneys. This is called a dietetic or alimentary glycosuria and is temporary. If such glycosuria is persistently or frequently provoked, it will cause pathologic conditions. All forms of sugar do not produce glycosuria with equal readiness. Hutchison found that it was provoked by the following kinds, with the amounts given in this table : Lactose 120 grams Cane-sugar 150-200 grams Levulose 200 grams Dextrose 200-250 grams CEREALS. Ill The readiness with which glycosuria is provoked varies also in different persons. Large quantities of sugar or of sweetened food are likely to ferment in the stomach and intestines, producing alcohol and acids that may excite inflammation in those organs. Aitchison Robertson found that different sugars vary in their susceptibil- ity to fermentation. The following undergo lactic acid fermentation with relative ease in the order in which they are named: Levulose, most fer- mentable, lactose, dextrose, invert sugar, cane-sugar, maltose. The following list shows the relative ease with which butyric acid fermentation can be provoked: Levulose, most ferment- able, maltose, dextrose, invert sugar, cane-sugar, lactose. The following shows the relative ease with which alcoholic fermenta- tion is produced: Maltose, invert sugar, cane-sugar, dextrose, levulose, lactose. It is noticeable that lactose is least likely to undergo any of these forms of fermentation, which makes it especially useful when we wish to avert them. Dyspeptics should use sugar sparingly. Many of them cannot use it even in tea and coffee without discomfort. Sugar should be taken well diluted. Nature furnishes it in milk and most fruits in very small proportion — rarely more than from 4 to 6 per cent. Experience teaches us that it is best borne by stomach and bowels when taken in this way. Candies and food upon which a syrup is used, and compotes that are very sweet, are often indigestible because they contain sugar in concentration. There is no evidence substantiating the popular notion that sugar causes the teeth to decay. Un- doubtedly if starch is allowed to cling long to the teeth or to accumulate in the interstices between them it will ferment and produce acids that may be harmful. If the mouth and teeth are kept clean, it will not produce these results. CEREALS Cereals are the grains that are used for food. They contain relatively little cellulose, much starch, and variable amounts of oil, gluten, and mineral matter; the exact chemical composi- tion varying in different species. Cereals are rarely eaten until 112 VEGETABLE FOODS. they have been crushed or ground to a powder. The outer layers form bran, which consists chiefly of cellulose and is extremely difficult to convert into flour. By modern milling processes the germ as well as the bran is removed from the flour. The former contains a relatively large amount of nitrogenous matter and oil. It easily becomes rancid, and flour containing it may spoil. The proteins can convert some of the starch of flour into dextrin and sugar, which will render bread made from it darker in color than is agreeable. The following table, from Hutchison, shows the composition of the different parts of the grain : Bran, Endo- Germ, 1.5 Whole 13.5 Per sperm, 85 Per Cent. Grain, 100 Cent. Per Cent. Per Cent. Water I2 -5 13 .0 I2 -5 I 4-5 Nitrogenous matter 16.4 10.5 35-7 11.0 Fats 3.5 0.8 13. 1 1. a Starch and sugar 43-6 74-3 31.2 69.0 Cellulose 18.0 0.7 1.8 2.6 Mineral matter 6.0 0.7 5.7 1.7 The best grades of wheat flour are to-day made from the endosperm. The compositoin of flour from various cereals is given in the subjoined table, taken from a report of the United States Department of Agriculture. Carbo- Mineral Water Protein Fat hydrate Cellulose MAtter Wheat meal ... . 12.0 12.9 1.9 70.3 1.6 1.2 Fine wheat flour 13.0 9.5 0.8 75.3 0.7 0.7 Oatmeal 7.2 14.2 7.3 65.9 3.5 1.9 Rolled oats 7.2 15. 4 7.2 64.8 3.5 1.9 Barely meal ... . 11. 9 10. o 2.2 71. 5 1.8 2.6 Coarse rye flour 11. 4 15.3 2.1 66.7 2.3 2.2 Finest rye flour 11. 2 6.7 0.9 80.0 0.8 0.4 Cornmeal 11.4 8.5 4.6 72.8 1.4 1.3 Cornmeal, fine. 12.5 6.8 1.3 78.0 0.8 0.6 Buckwheat flour _ 14.0 7.1 1.2 75-9 0.6 0.2 Rizine (flaked rice) 11. 7 7.9 0.5 79.5 0.4 To utilize flour as food it must be cooked. The simplest way PROTEID. 113 is to boil it. However, only the coarser meals are cooked in this way. Usually they are eaten with cream or milk and sugar. Flour can be mixed with water, molded into definite form, and baked. It is in this way that ship biscuits are made. Primitive races cook flour only in this way. The product is hard, difficult to break and to disintegrate with the teeth, and as much of it is likely to be swallowed before it is perfectly masticated, it is not easily digested. Bread is the chief food-product of flour. It is made by mix- ing flour with water and adding a little salt and sometimes sugar. Yeast is added to the mixture, which is then set aside in a warm place. The yeast-cells grow and convert some of the starch into sugar and then into alcohol and carbonic acid gas. This gas fills the dough with bubbles, which make it light and spongy. The fermentation ceases when the bread is baked. The yeast is killed, and most of the alcohol and gas is driven off. In this process a small amount of nutriment is also lost. One and three-tenths per cent, of the proteins, 71.2 per cent, of the fats, and 3.2 per cent, of carbohydrate are lost, or about 5 per cent, of the calories that might be generated from the flour. To avoid this loss two processes are used. In the first, which is rarely resorted to, the dough is 'aerated' by gas pro- duced outside and forced into it. In the second, the more common process, baking-powders are used. They consist of mixtures of powdered chemicals which, when wet or mixed with moist dough, liberate carbonic acid gas. Stale bread is much more digestible than hot or fresh bread, for the latter, when masticated, is made into a tenacious, dough-like mass. The former crumbles into finer particles, which are attacked by digestive fluids with comparative read- iness. Toast is bread that is cooked in slices until it is brown and brittle. Toasting, if it is properly done, makes bread more digestible. Often only the surface of slices of bread is toasted and the interior is left soft. Such toasting does not increase the digestibility of bread. Zwieback is well-toasted bread. Pulled bread is the heart of a loaf that has been baked until it has become thoroughly brittle. The readiness with which cereal foods are digested depends greatly upon the ease with which they are disintegrated, and the fineness of their 8 114 VEGETABLE FOODS. division during mastication and during their stay in the stomach. An average slice of bread remains in the stomach about two and one-half hours. There is little difference in the behavior of whole wheat and fine flour bread in the stomach, but a con- siderable difference in their absorbability from the intestines. The following table, from Hutchinson, shows the relative amount of their constituents in the stools : White Bread Whole Wheat Bread Total solids 4.5 per cent. 14 per cent. Proteins 20.0 per cent. 20 to 30 per cent. Ash 25.0 per cent. 5 1 per cent. Carbohydrates, 3.0 per cent. 6 per cent. The excess of cellulose in whole wheat bread interferes with the absorbability of the latter. The larger percentage of fat and protein makes it more likely to ferment in the intestines and provokes soft and numerous stools. Bread is considered one of the most nutritious forms of food, but owing to the relatively small amount of protein it contains, it is not a perfect food. It should be looked upon as an impor- tant supplement to meat and fat. Meat powder has been added to bread to increase its nutritive properties. Milk, skim milk, and cheese have been used similarly. Oats are chiefly used as porridge. Unless other flour is mixed with oatmeal, good bread cannot be made from it. It is particularly difficult to separate the husks of oats from the kernel. Oatmeal is especially rich in fat. In certain persons it has the peculiarity of provoking skin eruptions. Cornmeal (maize) contains less protein than most others, but relatively a large amount of fat. It is eaten as mush, as bread, and as johnny-cakes. Hominy, cerealine, and samp are special prep- arations of corn that are particularly adapted for making puddings and mush. Barley meal contains little gluten, and therefore good bread can be made from it only when it is mixed with other flour. Bread made in this way is agreeable and nutritious. Barley-water, which is much used as a diluent of milk for children and in the sick-room, contains very little nutriment, for 99 per cent, of it is water. About 1/3 of 1 per ROOTS AND TUBERS. 115 cent, is starch, its next largest ingredient. Next to wheat, rye is the best bread-making flour. Rye bread is not quite so nutritious as that made from wheat. When its flour is fine it is quite as digestible, but when coarse, as is often the case, it is wasteful, for much of it remains in the ieces undigested. Rice contains a small amount of protein and almost no fat. Two and one-half ounces of boiled rice are disposed of by the stomach in three and one-half hours. It is absorbed from the intestines very completely. Its starch is practically all utilized. The amount of protein it contains is so small that it leaves almost no residue in the bowel, although 20 per cent, of it is not ab- sorbed. Rice contains no cellulose. Granose is a partially cooked preparation made of whole wheat in the form of flakes. It is easily digested. Shredded wheat is a preparation of whole wheat in the form of flakes having the consistence of a biscuit. It is also easy to digest. Imperial granum is one of a large number of preparations pre- scribed for invalids and children. It contains more than 75 per cent, of starch. Like most of its class, it is not adapted for an infant's food, as starch cannot be digested during the first months of life. It is useful when children are old enough to receive a farinaceous food. To this same class belong Horlick's food, Mellin's food, malted milk, Nestle's food, farina, and wheatena. ROOTS AND TUBERS Roots and tubers are much used as articles of diet and differ greatly in nutritive value. They are chiefly composed of starch or sugar. The most valuable of them is the potato. It con- tains about 80 per cent, of water, 18 per cent, of starch, approxi- mately 2 per cent, of nitrogenous matter, and 1 per cent, of mineral matter. The amount of fat that it contains is a small fraction of 1 per cent. Less than one-half of the nitrogenous matter in it is protein. Extractives (asparagin, etc.) constitute the remainder. The potassium salts that it contains are impor- tant for the prevention of scurvy. Potatoes can be kept well and carried long distances, especially at sea. A new or young potato contains less starch than an old one and relatively more Il6 VEGETABLE FOODS. nitrogenous matter. Potatoes are often boiled and stewed. Cooked in this way they lose much of their nitrogenous matter and mineral constituents. To retain these they should be baked or roasted in their skins. An old potato that is baked and mealy is the most digestible. Puree or mashed potato is almost or quite as easily digested. Potatoes stewed, boiled, fried, or cooked otherwise in chunks, and swallowed in con- siderable masses, are least digestible. Two boiled potatoes of average size will remain in the stomach about two and one- half hours. More than 90 per cent, of the starch in them is absorbed from the intestine. Potatoes contain a relatively small amount ot cellulose. They must be used in the same manner as bread — that is, to supplement meat and fats. The sweet potato has a similar composition, but a larger proportion of carbohydrate. Carrots are rich in sugar. They contain almost no starch and relatively a large amount of cellulose. Nitrogenous matter and fat occur in them in very small amounts. They are not easy to digest, and much of their constituents is lost in the feces. More than one-fourth of their sugar, which is their chief nutritive ingredient, is lost. A given weight of carrots will stay in the stomach an hour longer than the same quantity of potatoes. Parsnips and beets are similar to carrots in that they are rich in sugar, containing from 10 to 15 per cent, of it. They contain so little nitrogenous matter that it need not be taken into account. Onions are chiefly valuable because of their pungent oil, which is relished as a condiment. They also contain a considerable percentage of carbohydrate. Turnips have a small nutritive value, since they contain about 5 per cent, of a carbohydrate, which is neither starch nor sugar, but belongs to the group of bodies named pentoses. The changes that the latter undergo in digestion are not clearly understood. Tapioca, arrow-root, and sago are almost pure starches. The first two are derived from roots of tropic plants; the third, from the pith of the sago palm. Like rice, they are nutritious, and are probably almost completely absorbed from the intestine. Tapioca, however, is not quickly disposed of by the stomach. If a large plateful of it is eaten, it will not disappear completely from the stomach in less than two and one-half hours. LEGUMES. II 7 PEAS AND BEANS Peas and beans differ from the other vegetable food-products thus far considered, in that they are rich in nitrogenous matter. They are frequently spoken of as good substitutes for meat. Their chief nitrogenous constituent is legumin, a protein, which in many of its chemical reactions resembles casein. They also contain much carbohydrate and little fat. Beans and peas are not quickly digested, and, as ordinarily cooked and eaten, are not very perfectly absorbed from the intestine. If they are simply boiled, a large plateful will not be disposed of by the stomach for from four to five hours. Forty per cent, of their protein will be lost in the intestine. However, if they are eaten after they have been ground to a fine flour, only 8 or 9 per cent, will be lost. They are most digestible when made into mush or prepared as a pur£e. They are highly nutritious, but should be supplemented by fats. String-beans and wax beans are eaten when young, and the pod as well as the bean is eaten. The former consists largely of cellulose. It contains little nourish- ment and is not easy to digest. Beans, especially dried beans, are likely to cause flatulence. This is in large part due to their slow digestion. They also contain sulphur and form sul- phureted hydrogen in the alimentary canal. The following table of analyses, taken from a bulletin of the United States Department of Agriculture, gives the composition of this important group of foods : COMPOSITION OF FRESH AND DRIED LEGUMES COMPARED WITH THAT OF OTHER FOODS Material. Water. Protein. Fat. Carbohy- drates. Ash. Fuel Value Per Pound. Per Per Fresh legumes: Per cent. Per cent. cent. Per cent. cent. Calories. String-beans, . . . 89.2 2-3 0-3 7-4 0.8 195 Whole pods of Doli- chos sesquipedalis, . 79-9 45 0.5 13-9 1.2 365 Sugar peas or string peas, 81.8 3-4 0.4 13-7 O.7 335 Shelled kidney beans, 58.9 9 4 0.6 29.1 2.0 740 Shelled Lima beans, . 68.5 7.1 0.7 22.0 1.7 57o Shelled peas, . . . 74.6 7.0 0.5 16.9 I.O 465 Shelled cowpeas, . . 65-9 9.4 0.6 22.7 1-4 620 n8 VEGETABLE FOODS. Composition of Fresh and Dried Legumes Compared with that of Other Foods. — ( Continued.) Material. Water. Protein. Fat. Carbohy- drates. Ash. Fuel Value per Pound. Per Per Per cent. Per cent. cent. Per cent. cent. Calories. Canned string -beans, . 93-7 I.I O.I 3-8 1-3 95 Canned Lima beans, 79-5 40 03 14.6 1.6 360 Canned kidney beans, . 72.7 7.0 0.2 18.5 1.6 480 Canned peas, . . 853 3-6 0.2 98 1.1 255 Canned baked beans, . 68.9 6.9 2-5 19.6 2.1 600 Peanut butter, .... 2.1 29-3 46.5 17.1 5-0 2825 Dried legumes : Lima beans, .... 10.4 18.I 1-5 65-9 4.1 1625 Navy beans, 12.6 22.5 1.8 59-6 3 5 1605 Frijoles, . . 7.5 21.9 i-3 65.1 4.2 1695 Lentils, . . 8.4 25-7 1.0 59-2 57 1620 Dried peas, 9 5 24.6 1.0 62.0 29 1655 Cowpeas, . 13.0 21.4 1.4 60.8 3-4 1590 Soybeans, . 10.8 34 16.8 33-7 4.7 1970 Chick-pea, . 14.8 12.4 67 63-3 2.8 1690 Peanuts, 9.2 25.8 38.6 24.4 2.0 2560 St. John's bread (ca- rob bean), • • 150 59 i-3 75-3 25 1565 GREEN VEGETABLES This group of vegetables contributes little to the nourishment of man. They are eaten chiefly because of their agreeable flavor and because they add variety to our diet. The amount of protein and fat that they contain is inappreciable, and their carbohydrates are in very small quantities. They possess mineral salts of value and sometimes organic acids. Oxalic acid, which occurs in considerable quantities in some of the green vegetables, makes them harmful to those who are prone to develop oxalic acid calculi. The large amount of cellulose they contain produces bulky feces, but stimulates peristalsis. Many of these vegetables are distinctly laxative. They contain from 80 to 96 per cent, of water, which makes them a bulky form of food. For the most part they must be cooked, a process that softens the cellulose and makes them more digestible. A few are eaten raw. Certain of them cause flatulence; many do not. Cab- bages are especially prone to create a condition of flatulence. Green vegetables are antiscorbutics. Most green vegetables are not sufficiently digestible to be GREEN VEGETABLES. II 9 good for invalids. If the functions of the stomach and in- testines are not greatly impaired , the blandest can be used . With the exception of lettuce, cabbage and tomatoes they should not be eaten raw. Spinach and celery boiled in milk, if finely chopped, are bland and agreeable. These articles do not ferment in the stomach or bowels to an appreciable extent, and can often be prescribed when other vegetables must be avoided. Penzoldt found that it required for from two to three hours for the stomach to dipose of 150 grams of boiled cauliflower or asparagus, three to four hours for the same quantity of carrots, kohlrabi, spinach, cucumber salad, and radish. The following table, taken from Hutchison, will give some idea of the com- position and food value of this class of foods : Water. Nitrogen- ous. Matter. Fat. Carbo- hydrates. Min- eral Mat- ter. Cellu- lose. 89.6 I.80 0.40 5.8 I.30 I. IO 974 O.60 O.IO 0.4 0.13 I.30 90.7 2.20 0.40 4-7 O.80 I.20 93-3 I 40 3-8 O.60 0.90 97-9 O.40 0.07 0.3 O.20 1. 10 90.6 2.50 0.50 3-8 I.70 O.90 94.8 O.06 0.20 2.6 O.50 I.30 99.2 O.09 0.04 0.2 0.05 0.37 93-7 I.50 O.IO 3-4 I.30 91.9 I.30 0.20 5-o 0.70 I.IO 94.0 1. 00 0.20 O.I O.70 1.50 82.9 380 0.90 8.9 350 94.1 I.40 0.40 2.6 1.00 0.50 97.2 O.50 0.16 0.5 0.40 0.90 91.8 I.20 0.50 5-8 0.70 93-4 I.40 O.IO 33 0.90 0.90 970 0.30 0.06 0.8 0.50 1. 00 87.1 2.60 0.20 71 1.50 1.30 94.6 O 70 0.70 2-3 0.60 I.IO 93 1 I.40 45 1. 00 93- 1 0.70 0.50 3-7 1.30 O.IO 959 O.80 10 2.1 0.40 0.50 97-4 0.50 0.02 0.7 0.20 0.90 91.7 2.20 0.20 2.9 90 2.10 87.2 I.20 0.08 9.0 0.30 2.20 94.0 I. OO 30 0.80 0.60 87.0 3 30 0.70 6.0 1.60 1.20 90.0 I.80 0.19 58 0.70 1.20 91.0 I.40 0.70 2.9 1.70 0.90 Fuel Value per Pound, Calories. Cabbage, . . . Cabbage, cooked, Cauliflower, . . Sea-kale, . . . Sea-kale, cooked, Spinach, . . . Vegetable marrow, Vegetable marrow cooked, . . . Brussels sprouts, Tomatoes, . . Tomatoes, cooked, Greens, .... Lettuce, .... Lettuce, cooked, Leeks, .... Celery, .... Celery, cooked, Turnip cabbage, Rhubarb, . . . Macedoine (thinne Water- cress, Cucumber, . . . Cucumber, cooked Asparagus, . . Salsify, cooked, Endive, .... Savoys, .... Red cabbage, Sauer-kraut, . . d) 165 175 X20 95 275 105 150 85 145 105 no 70 120 VEGETABLE FOODS. FRUITS Fruits can conveniently be classified as those that are eaten as a relish or to afford variety, and those that have food value. Their value as food is small, however. They are pre-eminently carbohydrates for their chief nutritive constituents are sugars, mostly levulose, or fruit-sugar, and cane-sugar. Many of them contain varying small amounts of a jelly-producing substance called pentose, the chemical nature and utility of which are not well understood. They contain numerous salts formed of potassium and sometimes of sodium, and magnesium, with the fruit acids, such as citric and malic. The flavors of fruits are due to oils and ethers. Very few fruits contain enough sugar to make them of much value as food. The most nutritious of the raw fruits is the banana. Many others become more so when they are concentrated by drying. For instance, fresh apples contain 12 per cent, of carbohydrate, but when dried, almost 50 per cent. ; dates and figs, more than 60 per cent. ; raisins, 74 per cent., but fresh grapes, only from 10 to 20 per cent. Fruit is eaten, first, because it is appetizing and palatable; second, because it is refreshing, lessening thirst by its large amount of water; third, because of its nutritive properties; fourth, because of its salts and acids which make fruit an im- portant antiscorbutic; fifth, because some kinds possess diuretic properties, and sixth, because most of them possess laxative properties. Unripe fruit contains a relatively large amount of cellulose and of solid matter and a small amount of sugar. It is, there- fore, usually hard, sour, and indigestible. It lacks the flavor of ripe fruit. When fruit ripens it becomes juicier, and the starch in it is converted into soluble sugars. The acids that it contains are more dilute. The cellulose framework of fruit as it fills during the stage of ripening becomes thin, relatively soft, and easily broken by mastication and agitation. Cooking usually makes fruit more digestible, because it softens the cellulose and converts the gums (pectin) into a gelatinous mass. Nevertheless if stewed or cooked with water, fruits lose part of their nutritive ingredients. Apples lose 4 FRUIT PRESERVES. 121 per cent, of carbodydrates, pears about the same, and peaches 7 or 8 per cent. Fruit is often cooked to preserve it, and cane-sugar is added to make it keep better. It is usually stewed, but is also often dried, which concentrates it by raising its percentage of sugar. Partial desiccation prevents its spoiling. Jellies are made from many fruits. They are useful condiments for invalids. Jams and marmalades are fruit sweetened and partly converted into jelly. Occasionally fruits are spiced and preserved in an acidi- fied (vinegar) syrup. In Germany fruit soups are often eaten. In the United States they are almost unknown. Fruit -juices and syrups are sometimes employed to flavor iced drinks, and are often grateful to invalids, and, if not drunk in too large quantities, are wholesome. All these preparations are used because of their agreeable flavors rather than for their nutritive value. From the banana, a meal is made by drying and grind- ing it. In nutritive power it is quite equal to the same quan- tity of rice. It is agreeable, easy to digest, and very thoroughly absorbed. Those who have digestive disorders that make the stomach and bowels intolerant can use it because it is so bland. It is, therefore, a useful addition to the list of bland foods, such as sago and arrow-root. Banana flour contains little or no starch but an abundance of sugar. It is not used so much as it might well be. Ripe fruits, stewed fruits, and jellies are usually very diges- tible. If taken in too large quantities, they often ferment in the alimentary canal and produce colic and gastro-enteric disorders. Unripe or overripe and spoiled fruit is especially prone to cause these disturbances. The time during which fruit remains in the stomach and its absorbability by the in- testine have not been thoroughly studied. A large apple does not pass out of the stomach for more than three hours. Many fruits are marketed before they are ripe, and are allowed to ripen partly afterward. These are much less digestible than they would be if eaten when ripe. The acids of many fruits make them indigestible to those who suffer from acid fermenta- tion in the stomach. Occasionally a person is met with who possesses an idiosyncrasy, and who, after eating certain fruits, 122 VEGETABLE FOODS. will have gastroenteric troubles, hives, or other evidence of poisoning. The seeds of berries often irritate the intestines. Apples, pears, and even more often figs, dates, and prunes, are employed as laxatives. The laxative effect is most noticeable when these fruits are eaten the last thing at night or the first thing in the morning, at a time when the stomach contains little or no food. They are least effective when they are eaten at the end of a meal or with a full meal. The very acid fruits, such as lemons, grape-fruit, and oranges, are least laxative. Most berries must be classed as intermediate between these two groups, so far as laxative properties are concerned. When the 'grape cure* is taken in Germany, from one to eight pounds of grapes are eaten daily, and little or no other food for a time. At first, a small quantity is eaten, but day by day it is increased. Those who take this 'cure' are expected to pick the grapes for themselves, which insures outdoor life and gentle exercise. It is a mode of treatment chiefly adapted to the obese and to those who lead a sedentary life. The acids contained in fruits often have much to do with their digestibility. In health apples and strawberries can usually be eaten with impunity but in some gastric disorders the malic acid in them and other fruits makes them unwholesome. More than one acid is contained in some fruits, though one usually predominates. Apples, blackberries and strawberries contain malic acid; currants and grapes tartaric acid; and oranges, lemons, grape fruit, and gooseberries, citric acid. Of these the citrous fruits are the best tolerated by all persons. SUGAR AND ACID CONTENT OF COMMON FRUITS 1 Sugar Acid Apples : — Greening 10 . 95 .70 as Malic. Winesap 1 1 . 95 .50 as Malic. Northern Spy 1 1 . 80 .70 as Malic. Apricots : — Fresh 11. 01 1.15 as Malic. Dried 2 9-59 2.52 as Malic. Bananas 20.28 .3 as Sulfuric. Blackberries 5-78 .77 as Malic. Cranberries 1.52 2 . 34 as Malic. 1 "Poods and Their Adulterations." Wiley, 1911. OLIVES. 123 Sugar Currants 6 Grapes 7 Lemons Oranges 5 Grape fruit 9 Peaches 7 Pears 9 Pineapples 11 Plums 14 Prunes 16 Raspberries 5 Olives 7 9 37 65 5 88 1 1 5 71 1 1 33 Acid 2 .24 •59 5-39 i-35 2.7 •56 .19 .6 •77 •32 1.48 as Malic, as Tartaric, as Citric, as Citric, as Citric, as Sulfuric, as Malic, as Sulfuric, as Malic, as Malic, as Malic. Two food products of considerable importance are made from olives — namely, olive oil, or salad oil, and pickled olives. A third product, little known in America, is the dried olive, much eaten in Greece and some neighboring countries. All olive oil and pickled olives were formerly imported, most generally from southern Europe. In recent years California has devel- oped olive growing. The ripe olive fruit is not unlike an oval damson plum in form and size. In color it ranges from various shades of purple to almost black. It has a sour and persistent bitter flavor. Both pulp and pit contain oil. The amount of oil in the pulp in different samples ranges from 13 to about 88 per cent.; that in the pit, from 0.36 to 1.52 per cent. Whether used for oil making or pickling, the olive should be carefully gathered. The ripe fruit is used for oil making and for pickling; the exact stage when it is best suited for this purpose must be learned by experience. The green fruit is also used for pickling and should be gathered when full grown and just before it begins to color and soften. The pickled olives usually found in the American market are made from the green fruit. The pickled ripe olives are also met with and may be recognized by their dark color. The best oil is made by crushing the carefully picked fresh olives. To facilitate the extraction of the oil, the olives are often partially dried before crushing. Old-fashioned stone mills are commonly used to crush the fruit, although bronze crushers are sometimes employed. The ground mass is pressed to ex- 124 VEGETABLE FOODS. tract the liquid portion, which contains watery plant juices in addition to the oil and more or less pulpy matter. Various devices are used to separate the oil and to purify it. It is said that the best oil is obtained by allowing the pulp, etc., to settle, and decanting the clear oil. It generally takes about one month for oil to settle the first time. It is usually decanted three times. The oil thus obtained is almost as bright as can be produced by the most effective filtration, and it has, besides, the distinctive olive flavor and lacks the greasiness that is characteristic of all filtered oils. Great cleanliness must be observed in oil making and every precaution taken to avoid rancidity. Essentially the same process is followed in making pickles, whether from ripe or green olives. The unpleasant acid and bitter flavor is removed by soaking the fruit in a solution of potash lye for a short time or by longer soaking in water. The lye also softens the skin, so that the undesirable substances may be more readily extracted by water. Olives treated with lye must be soaked in clear water, which is frequently changed, to remove the potash. They are then placed in a weak brine for a short time and afterward in stronger brines. The details of each step of the process vary considerably, and much de- pends upon skill and experience. An abundant supply of pure water is of the first importance, and great care must be exer- cised to prevent the growth of molds, etc. As in the manufac- ture of oil, cleanliness is a prime requisite. The uses of olive oil and olives as articles of diet are familiar. The former is used chiefly for salad dressing and for frying; the latter as a relish for seasoning sauces, etc., and for garnish- ing various foods. The oil, like all fats, has a high fuel value, and on this its value as a food depends. COMPOSITION OF PICKLED RIPE AND GREEN OLIVES Water Fat (Oil) Carbohy- drates Protein, Ash, etc. Pickled ripe olives, . . Pickled green olives, Per cent. 65.08 78.41 Per cent. 25-52 12 .90 Per cent. 3-75 I.78 Per cent. 5.65 6 .91 COMPOSITION OF FRUITS 125 Green olives are simply a relish and to be used in very lim- ited quantities in the same way as pickled walnuts or cucumbers. A meal of bread and ripe olives is not only palatable, but nutri- tious and sustaining, and the amount eaten is to be limited only by the same considerations as that of any other good, whole- some food. In southern Europe and other regions the ripe olive is used as a staple article of diet. The following table will show the composition of most fruits. From one-half to three-fourths of the carbohydrates in them is sugar. In this table, taken from Hutchison, the cellulose is sometimes included with the other carbohydrates and sometimes estimated separately. Water. Protein. Ether Extract. Carbohy- drates. Ash. Cellu- lose. Acids. Apples, .... 82.5 0.4 05 12-5 0.4 2.7 1.0 Apples, dried, . 36.2 1.4 3.0 49-1 1.8 4-9 3-6 Pears, .... 83-9 0.4 0.6 "5 0.4 3-1 0.1 Apricots, . . . 85.O I.I 12.4 05 1.0 Peaches, . . . 88.8 o-5 0.2 5-8 0.6 3-4 0.7 Green gages, . 80.8 0.4 13-4 0.3 4.1 1.0 Plums, .... 78.4 1.0 14.8 0.5 4-3 1.0 Nectarines, . . 82 9 0.6 15-9 0.6 Cherries, . . . 84.0 08 O.8 100 0.6 3-8 1.0 Gooseberries, . 86.0 0.4 8.9 0.5 2.7 »-5 Currants, . . . 85.2 0.4 7-9 o-5 4.6 1.4 Strawberries, ; 89.1 1.0 OS 6-3 0.7 2.2 1.0 Whortleberries, 76.3 0.7 3° 5-8 0.4 12.2 1.6 Blackberries, 88.9 0.9 2.1 2-3 0.6 5.2 Raspberries, . . 84.4 1.0 5-2 0.6 7-4 1.4 Cranberries, . . 86.5 0.5 0.7 3-9 0.2 6.2 2.2 Mulberries, . . 84.7 0.3 11. 4 0.6 0.9 1.8 Grapes, .... 79.0 1.0 1.0 15-5 o-S 2-5 0.5 Melons, . . . 89.8 0.7 03 7.6 0.6 1.0 Watermelon, 92.9 °-3 O.I 6-5 0.2 Bananas, . . . 74.0 i-5 0.7 22.9 0.9 0.2 Oranges, . . . 86.7 0.9 0.6 8-7 0.6 1.5 1.8 Lemons, . . 89-3 1.0 0.9 8-3 o-S Lemon-juice, 90.0 2.0 0.4 7.0 Pineapples, . . 89.3 0.4 0.3 9-7 o-3 Dates, dried, 20.8 4.4 2.1 657 i-5 5-5 Figs, dried, . . 20.0 5-5 O.9 62.8 2-3 7-3 1.2 Figs, fresh, . . 79 1 i-5 18.8 0.6 Prunes, dried, . 26 4 2.4 O.8 66.2 i-5 2.7 Prunes, fresh, . 80.2 0.8 185 °-5 Currants, dry, . 27.9 1.2 3-0 64.0 2.2 i-7 Raisins, .... 14.0 2-5 4-7 74-7 41 126 VEGETABLE FOODS. NUTS Nuts are eaten almost exclusively for dessert. They are agreeable, but have little value as food. They contain a large amount of oil, a moderate amount of carbohydrate, and rela- tively a large amount of protein. Chestnuts are an exception to this general statement, for they contain only a small percentage of oil and a large percentage of carbohydrate. Nuts are variously estimated by writers upon dietetics. I do not know of any careful study of their digestibility. Owing to their high fuel value and low protein contents they will not make a well- balanced food when eaten by themselves. As they are usually eaten raw and as they contain a large amount of cellulose, they COMPOSITION OF NUTS AND SOME OTHER FOOD MATERIALS. Nuts, etc. Almonds, Brazil nuts, Filberts, Hickory nuts, Pecans, English walnuts, Chestnuts, fresh, Chestnuts, dried, Acorns, Beechnuts, Butternuts, Walnuts, Cocoanut, Cocoanut, shredded, . . . Pistachio, kernels, .... Pine nut or piiion (Pinus edulis), Peanuts, raw, Peanuts, roasted, Litchi nuts, Beefsteak, Wheat flour Potatoes, Refuse, Per cent. 64.8 49.6 52.1 62.2 53-2 58.0 16.0 24.0 35-6 40.8 86.4 74.I 48.8 40.6 24.5 32.6 41.6 12.8 Edible Portion Per cent, 35-2 5o.4 47-9 37-8 46.8 42.0 84.0 76.0 64.4 59-2 13-6 25-9 512 100.0 100.0 59-4 75-5 67.4 58.4 87.2 100.0 80.0 Composition and Fuel Value of the Edible Portions. Water. Per cent. 4.8 5-3 3-7 3-7 3-o 2.8 45-o 5-9 4.1 4.0 4-5 2-5 14. 1 3-5 4.2 3.4 9.2 1.6 17.9 61.9 12.8 78.3 Pro- tein. Per cent. 21. I7.0 15.6 15-4 II. O 16.7 6.2 10.7 8.1 21.9 27.9 27.6 5-7 6-3 22.6 14.6 25.8 3o-5 2.9 18.9 10.8 2.2 Fat. Per cent. 54-9 66.8 65-3 67.4 71.2 64.4 5-4 7-o 37-4 57-4 61.2 56.3 50.6 57.3 54-5 61.9 38.6 49.2 0.2 18.5 1.1 0.1 Carbo hy- drates Per cent. 17.3 7.0 13.O II.4 13-3 I4.8 42.I 742 48.O 13.2 3-4 11.7 27.9 31-6 i S .6 17-3 24.4 16.2 77-5 74.8 18.4 Ash. Per cent. 2.0 3-9 2.4 2.1 1-5 '•3 13 2.2 24 3-5 30 1.9 i-7 i-3 3* 2.8 2.0 2-5 15 1.0 0.5 1.0 Fuel value, per Pound. Per cent. *3°3<> 3329 3432 3495 3633 *33<>5 1125 1875 2718 3263 337i 3105 2986 *3i25 *3oio 3364 *256o 3177 1453 1130 1640 *3*5 * These values were calculated ; unless otherwise indicated the fuel values were determined. FUNGI AND ALGjE. 1 27 are not easily disintegrated or prepared for digestion. The large amount of oil in them quickly causes a feeling of satiety, as do other oils. They are usually eaten after hearty meals, as a part of the dessert. These are conditions that are least favorable to their digestion. They are often chopped and used in salads, as a relish in sandwiches, or as a part of the stuffing of fowl. They are also commonly used in confectionery. From certain pine nuts, and from the cocoanut, flours can be made that are valuable especially for diabetics, as they can be made into bread containing practically no starch or sugar. The preceeding analysis is taken from Bulletin No. 122 of the United States Department of Agriculture. FUNGI AND ALGJE Fungi are sometimes described as "vegetable, steak, and roast beef," and the poor are urged to eat them for economy. This is an exaggerated estimate of their value. It is true that they contain a large amount of nitrogenous matter; a con- siderable percentage of it, however, is not protein. They contain a small amount of carbohydrate, the exact nature of which is not understood, but which is not believed to be nutritious. Their abundant framework of cellulose helps to make them indigestible. When cooked, they contract and become tougher. From 30 to 50 per cent, of the protein in them is not digested or absorbed from the intestine. They must, therefore, be classed with other wasteful foods. They are not adapted to the use of most invalids, but have the valuable quality of adding variety to the limited list of foods that may be eaten by diabetic patients. They are also agree- able additions to the dietary of the healthy. The amount of protein in different varieties of fungi varies from 2 to 5 per cent. The differences between edible and poisonous mushrooms and other fungi will not be described here. Of the many hundreds growing in this country, only a few are commonly eaten. Excellent descriptions of these will be found in Bulletin No. 15 of the United States Department of Agriculture. The only alga commonly employed as a food is Irish moss. 128 VEGETABLE FOODS. Its chief ingredient is a mucilaginous substance that can be dissolved or softened by hot water, and, when cooked, becomes a yellowish jelly. It is not acted upon by any of the digestive ferments and probably has no value as a food. It is bland and soothes an irritable throat, stomach, or intestine. Sugar and cream may be added to it or eaten with it. It is a pleasant addition to the limited dietary of diabetics. Iceland moss is a lichen that is used by cooks, as Irish moss is. It is likewise without value as a food. SPICES AND CONDIMENTS A word must be said of this group of adjuvants to food. They possess no nutritive value, but often aid digestion by stimulating the organs to secrete digestive juices in larger amounts and they make food more palatable. The most im- portant of them are mustard and pepper. Various spices and condiments are employed, chiefly for their flavor or for certain oils, such as vanilla and lemon. Sugar is of great value both as a food and as a condiment for it makes food more palatable. Saccharin and dulcin must be substituted for sugar when the latter is not well digested or assimilated. They are, however, condiments, and not foods. Vinegar is useful both as a flavor- ing agent and because it helps to soften hard muscle-fibers and cellulose. For the latter purpose it is frequently added to preparations of lobster and to raw green vegetables, such as lettuce, celery, sorrel, cucumbers, and tomatoes, when used as salads. CHAPTER IX BEVERAGES Tea. Coffee. Cocoa. Alcoholic Beverages. The necessity for water, and its various uses, have already been discussed. Other beverages are drunk because they are agreeable to the taste or are stimulants or anesthetics. Most uncivilized as well as civilized peoples use beverages that will either stimulate them, and thus relieve a sense of fatigue, or anesthetize them — that is, make them less conscious of it. If the habit of using these beverages be acquired, they are often taken when they are not needed, or in quantities larger than is necessary, and sometimes even to an extent that is harmful. TEA Tea has been used by Europeans for about three hundred years. It is employed in the United States extensively, but not so much as in England, in the British colonies, and in Russia. Many varieties of tea can be purchased. These depend for their peculiarities upon the plant from which they are obtained, upon the season of the year when the leaves are gathered, and upon the age, tenderness, and juiciness of the leaf. Tea-leaves were primarily culled from two species of plants, Thea chinensis and Thea assamica. Now, however, there are numerous hybrids. Teas grown in China, Japan, India, and Ceylon vary somewhat in flavor. The finest tea is made from the small tender leaves at the end of new shoots, each succeeding pair of leaves upon the branch furnishing a different and less valuable grade. Three or four pairs of leaves or grades are gathered. The various kinds and grades of tea are classified as green or black, according to the method adopted for curing them. Black tea is made by 'withering' the freshly picked leaves in 9 129 130 BEVERAGES. the sun. They are then mashed and rolled in order to break the fiber and cells of the leaf and liberate their constituents. After this the leaves are gathered together and fermented, dur- ing which process a part of the tannic acid in them is made less soluble and the essential oils are modified in character. They are again exposed to the sun, and finally * fired ' or dried in an oven. Green teas are withered in pans that are at a tempera- ture of 160 F.; in Japan they are steamed. They are then rolled, withered again, sweated in bags, and finally slowly roasted. These processes of manufacture modify the compo- sition of the product. The following table shows these changes : Black Green Tea Tea Water 8.20 5-96 Caffein 3 . 24 2.33 Albumin 17.90 1 7 . 63 Alcoholic extract 6.79 7 . 05 Dextrin 0.50 Pectin and pectic acid, 2 . 60 3.22 Tannic acid 16.40 27.14 Chlorophyll and resin 4 . 60 4.20 Cellulose 34 . 00 25 . 90 Ash 6.27 6.07 The nutritive ingredients of tea are insignificantly small. Them, chemically the same as caffein, and tannic acid are the ingredients that are physiologically active. The aroma and its variations are produced by volatile oils. In the process of manufacture of green tea the quantity of water and of caffein in it is lessened, and the tannic acid is much increased in amount. In general it may be said that teas contain fron 2 to 4 per cent, of thein or caffein and from 10 to 25 per cent, of tannic acid. Caffein is responsible for the feeling of nervous stimulation that tea-drinkers experience. Tannic acid affects digestion chiefly in a detrimental manner. It is, therefore, important so to prepare tea as a beverage that it will contain a maximum quantity of caffein and a minimum quantity of tannic acid. To accomplish this more depends upon the manner of brewing than upon the variety of tea. Caffein is extracted from the leaves at once when boiling water is poured upon them, but tannic acid is extracted much more slowly. Almost one-third more tannic acid is obtained in the COFFEE. 131 beverage if the leaves stand in hot water thirty minutes than if they are in it only five. The difference in the percentage of caffein in the two infusions is slight. As ordinarily made, a cup of tea contains about one-tenth as much thein or caffein as a cup of coffee. The beverage tea, is made by pouring boiling water upon tea-leaves. The mixture should stand where it can be kept hot, but not boiling, for from three to five minutes. The water should be fresh, not very hard, and just brought to a boil. Stale water, very hard water, and water that has been sub- jected to prolonged boiling and from which, in consequence, all air has been driven does not make so agreeable a beverage. Some inveterate tea-drinkers keep the tea-pot with water and tea-leaves in it upon the stove constantly and frequently drink the beverage that is thus made. It contains a large amount of tannic acid and is most unwholesome. The tannic acid in concentrated solution precipitates the pepsin of the gastric juice and prevents digestion. In weaker solution it often makes digestion slow. When taken upon an empty stomach, it acts as an astringent, lessening the secretions from the mucous membranes. In the intestines it is an astringent and often causes or aggravates constipation. Tea should not be used by dyspeptics or by those who are constipated. When taken in too large amounts, it will produce wakefulness, nervousness, excitability, and even muscular un- steadiness or twitching. The digestive disorders due to its tannic acid are much more pronounced when tea is drunk to excess than its stimulating effects. Flatulence, gastric distress, constipation, often cardiac irregularity, pleurodynia, and sleeplessness are the predominant symptoms of excessive tea-drinking. Tea is not disposed of by the stomach so rapidly as water. It is estimated that a pint of the latter is evacuated into the intestine within an hour. Half as much tea remains in the stomach for from one to two hours. COFFEE Coffee was introduced into Europe a few years later than tea. It is derived from Coffea arabica. The seeds, which are used 132 BEVERAGES. in the manufacture of the beverage, develop in pairs in a fruit that resembles a cherry. Different varieties of these seeds or beans are produced in different countries, each having a char- acteristic flavor. To make the bean brittle, so that it may be ground easily, and to develop its flavor more perfectly, it is roasted. This should be done shortly before it is used, as the flavor is lost by keeping. Roasting causes a loss of from 5 to 20 per cent, of the caffein. The small amount of saccharine matter that coffee contains is also almost completely lost. Mocha in the raw- state contains 9.55 per cent, of this, and when roasted, only 0.43 per cent. The fats or oils in it are increased. The most important of these oils is caffeol, which gives to roasted coffee its aroma. If two ounces of powdered coffee are used to make a pint of the beverage, the latter will contain approximately 3.5 grains of caffein and 6.5 grains of tannic acid. Each cup- ful will contain about one-half as much. Caffein is chemically trimethylxanthin and is closely related to xanthin, uric acid and the other purin bodies. Coffee is frequently adulterated; such substances as peas, beans, acorns, and, more frequently, chicory are used for this purpose. The last is thought by many to modify the flavor of coffee agreeably, and it is not detrimental. Caramel is also occasionally used as an adulterant. The beverage is made in several ways: Sometimes boiling water is filtered through finely ground coffee. By this proc- ess, however, one-half less of the coffee is dissolved than by the other methods. It may be infused, the ground coffee being put into boiling water and allowed to stand in it for some min- utes in a hot place, but without boiling. In Turkey, coffee- beans are powdered and a decoction is made from them by putting the powder in cold water, which is then heated to boil- ing. This beverage is not strained. If coffee is boiled for some time, it loses its aroma, contains a larger percentage of tannic acid, and becomes more indigestible. Both the caffein and the oil in coffee are stimulants. Caf- fein affects especially the central nervous system. Under its influence mental processes are quickened, the mind is made wakeful and restless, and if a sense of weariness exists, it is COCOA. 133 lessened. Respiration grows deeper, the heart beats with more force and rapidity and the pressure of blood in the arteries is increased. Coffee is a mild laxative to some persons. It in- creases tissue waste. In no sense is either tea or coffee a food, but sugar and milk added to them may give them food values. Coffee is variously tolerated by different persons. Those who are nervous are made more so, and they are often made sleep- less by it. Others feel only an agreeable stimulation. Many acquire a tolerance of coffee that makes them unconscious of its ill effects. Dyspeptics generally cannot drink it, especially if cream and much sugar are added to it. It is comparatively seldom that illness caused by coffee-drinking is seen, although it is not uncommonly observed from excessive tea-drinking. Soldiers and other bodies of men subjected to severe physical strain depend upon coffee to lessen their consciousness of fa- tigue. As a rule, they prefer it to tea. Its use improves the feeling of well being in soldiers so quickly that their officers regard it as a necessity. Numerous substitutes for coffee and tea have been devised. The substitutes for the former are usually made from grains. They possess a somewhat similar aroma and flavor, but do not contain caffein or other stimulating properties. They are not, however, better digested than coffee. Mate, or Paraguay tea, is extensively used in South America. It is a native prod- uct, containing a small amount of caffein and considerable tannic acid. It produces the same ill effects that tea does, but it is drunk in a very dilute form and before the tannic acid has been extracted ; therefore large amounts can be taken with comparative safety. COCOA Cocoa was introduced into Europe about one hundred years before tea and coffee were. The cocoa which is made into the beverage of the same name is made from the seeds of Theo- broma cacao. They develop in a pulpy fruit that somewhat resembles a cucumber. They are gathered into heaps in a warm, moist place and permitted to ferment. This process darkens the beans, lessens a bitter taste that they have at 134 BEVERAGES. first, and loosens any pulp adhering to them. Afterward they are roasted in order to make them brittle and to loosen their husks. They break readily into halves called cocoa nibs. The latter contain about 50 per cent, of fat or cacao-butter, some starch and albuminous matter, but very little protein, a little cellulose, and from 1 to 3 per cent, of alkaloids and some oxal- ates. The active principle, theobromin or dimethylxanthin is closely related to caffein. The beverage cocoa differs from tea and coffee in that it is nutritious as well as stimulating. Its food value is due to the fat that it contains. The starch and protein are too inconsid- erable in amount to be of much worth. The beverage usually is made with milk, and sugar is added to it in varying quantities. These additions increase its nutritive properties very much. Ten grams of cocoa, the amount usually used to make a cupful, yields fifty to seventy calories. When made with milk and sugar, the beverage will yield 400 calories. The stimulating effect of theobromin, the chief alkaloid of cocoa, is different from that of caffein, to which it is chemically allied, in that it does not cause sleeplessness or muscular tremors. Under its influence the mind does not become so alert, but it relieves a feeling of muscular fatigue in much the same way. The exces- sive use of cocoa does not produce the nervous symptoms that tea and coffee do, though it is likely to cause indigestion because of the large amount of fat in it and sugar added to it. If the beverage is not made too rich with cocoa and not too sweet, it is digestible, somewhat nutritious, and mildly stimulating. It is much better adapted for use by children than tea or coffee, which should not be given to them at all. Cocoa cannot be used by persons who find it difficult to digest fats. It is an agreeable and useful beverage for convalescents, but can rarely be used by those whose gastric digestion is disturbed or enfeebled. Cocoa nibs are ground, and often a part of the fat is removed from them when they are prepared for the retail market. Chocolate is cocoa to which sugar, starch, and flavoring, usually vanilla, have been added. It contains commonly more than 50 per cent, of sugar. To both cocoa and chocolate an alkali is frequently added to make them more soluble or more easily ALCOHOLIC BEVERAGES. 135 suspended in water, for cocoa goes into solution very imper- fectly. The fat in it and most of the other ingredients are suspended in water or milk, whichever may be used as a vehicle. An alkali converts a little of the fat into soap, which helps to emulsify the remainder. Cocoa is quite as quickly disposed of by the stomach as tea or coffee. Two hundred cubic centimeters, or a cupful of any one of them, disappears from the stomach in a little less than two hours if they are made with water, and in two and a half hours if cocoa is made with milk. The following analyses of a few of the preparations of cocoa and chocolate on the market will give a better idea of their average composition. Moisture Fat Nitrogenous Matter Other In- gredients Ash Cadbury's cocoa essence. Van Houten's pure cocoa. Epp's prepared cocoa. Epp's cocoa Van Houten's choc- 3-9 3-0 4-9 4-7 25.2 28.0 15. 1 33- 2 27.5 21.3 21 .2 20.9 20.5 6.7 18.6 3-9 45-2 39-7 71.8 36.7 4.8 8.8 6.8 1.8 olate. Chocolat Menier . . . 1.4 i-9 Plain chocolate 7-8 ALCOHOLIC BEVERAGES Ethyl alcohol is the active principle of alcoholic beverages. It is produced by fermenting sugars with yeast. The differ- ence in these beverages is due in part to the kind of sugar used, in part to the kind of ferment, and largely to by-products of fermentation that help to give flavor to them. Alcoholic beverages do so much harm that their utility under any circumstances has been denied. It is true that they are unnecessary as beverges and even as medicines, for there are other things that can produce all the good results ascribed to them, I36 BEVERAGES. but they do excite definite physiologic effects that are often forgotten because of their common use as drinks. A man in health does not need to use alcohol; but it is so extensively employed the world over either to produce factitious exhilaration, or, by lessening sensibility, to mitigate fatigue and discomfort, sorrow and suffering, and it has been so largely and often so injudiciously used in disease, that it demands consid- eration. As the physiologic effects of beverages containing alcohol are due practically to this factor alone, it seems well to discuss these effects before describing the various forms of alcoholic beverages. Alcohol is a poison to protoplasm which checks the activities of living matter and may kill it. By a rapid abstraction of water it precipitates albumin. The latter may be quickly redissolved in water if it has not been left too long in the alcohol. After a certain time resolution is impossible. When alcohol is taken into the mouth, it causes a sense of warmth in the mucous membranes, causes them to be unusually congested, and forms upon the surface a pellicle of precipitated albumin that is rapidly washed off by the saliva. The latter is formed in unusually large amounts because of the irritation of the mouth by the alco- hol. In contact with the mucous membranes of the stomach it causes similar changes. It also increases the formation of gastric juice, provokes more vigorous peristalsis of the stomach, induces congestion of its mucous membrane, and thus excites an excessive secretion of mucus. If a large amount of con- centrated alcohol is swallowed, it will produce acute inflammation of the stomach. If moderate amounts are taken frequently, and especially upon an empty stomach, it will gradually cause subacute inflammation. The chemical changes of digestion are not affected by very dilute solutions of alcohol. Five to 10 per cent., however, retards them, and 20 per cent, stops digestion. Strong alco- holic solutions precipitate the pepsin of the gastric juice and coagulate the albumin of foods, making them less soluble. Pancreatic digestion is more easily affected by alcohol than is peptic digestion. From 2 to 3 per cent, will retard it. Two tablespoonfuls of brandy delay the digestion of a meal in the stomach for a half-hour. PHYSIOLOGIC ACTION OF ALCOHOL. I37 Small doses of alcohol may be beneficial, stimulating the secreton of gastric juice and increasing peristalsis. For this reason it has been used when the stomach is weak and is doing its work imperfectly. When the stomach is inflamed, alcoholic beverages aggravate the condition. Certain of them produce acidity, as will be explained later, and are therefore counterin- dicated in many digestive disorders. Intoxicating doses interfere with digestion because of the nervous and vascular depression that they cause. Alcoholic beverages habitually used in generous amounts cause sufficient irritation of the mucous membrane to give rise to the formation of an excess of mucus that, enveloping food particles, prevents the digestive juices from gaining access to them, and, by coating the interior of the stomach, lessens the secretion of gastric juice. Alcohol is readily absorbed from the stomach. It undergoes no change before being taken into the blood. By the portal vessels it is carried to the liver and thence into the general circulation. When alcohol is absorbed from the stomach, it provokes a counterflow of water from the tissues into that organ four times as great as its own weight. After absorption into the blood it forms a compound with hemoglobin, which causes that body to part with its oxygen more slowly than is natural. This in part explains the dis- turbed metabolism that exists after taking alcohol. Imbibed in small amounts, alcohol causes the heart to beat faster and more forcefully. These effects are often noticeable before the beverage has been absorbed; in that case they are caused reflexly by irritation of the mouth, for they are also produced by sipping other pungent or hot fluids. In the arterioles it causes a muscular relaxation or loss of tone. Be- cause of this the blood flows more readily from the arteries into the veins, blood pressure is lowered, and the heart beats faster. The pulse seems bounding, because in the intervals between the beats it is so completely emptied, the blood flowing rapidly into the capillaries and veins. The pulse is typically dicrotic. The habitual use of alcoholic beverages often produces persistent vascular paralysis. This is seen in the full red capillaries of the cheeks and noses of steady drinkers. Alcohol is often used because of its effects upon heart and blood-vessels. It helps to 138 BEVERAGES. make the circulation more uniform and the heart beat faster and more effectively if the drug be given when the skin is blanched, the pulse small and hard, and the heart feeble. These conditions are met with in collapse, and occasionally in acute diseases accompanied by intense congestion of viscera, and sometimes in infections. If alcohol is used under these circumstances, it must be re- membered that frequently repeated doses will cause its ac- cumulation, when its sedative effects upon the nervous system will show themselves. A large dose is also counterindicated for the same reason. The so-called cardiac stimulation of alcohol is of short duration and not well maintained, either in those accustomed to its use or in others to whom it is given repeatedly in full doses. There are other medicaments capable of producing similar results, and that by constant repetition, do not produce sedation. When the effect of alcohol upon the heart has worn off, the latter beats less vigorously and more slowly than at first ; in other words, its stimulation of the heart is followed by a period of depression. The heart has been known to stop suddenly when a pint of whisky or more was drunk at once. This is probably due to strong reflex action produced by irritating the mouth, gullet, and stomach. From the fact that depression follows stimulation it is evident that alcohol does not act as a food to the heart muscle, but as a spur or stimulant. This stimulant effect is obtained only from small doses. Large ones directly depress and paralyze the heart. Very large ones cause it to dilate. The habitual use of alcohol makes the heart actually beat faster than is natural. For instance, according to B. W. Richardson, one ounce of alcohol daily will increase its beats 430, two ounces 1872, four ounces 12,960, six ounces 30,670. This makes the heart do much more work than it does when alcohol is not taken. That a period of unnatural enfeeblement should follow its use is not, therefore, surprising, especially as it does not feed the heart. There is much discussion as to whether or not alcohol is a food. If a food is defined as anything that can be decomposed in the tissues and eliminated in a form different from that in which it enters, alcohol is a food. The inadequacy of this ALCOHOL A FOOD. 139 definition is self-evident. Water is a most valuable food, yet it is not decomposed, but eliminated as ingested. Many- poisons are decomposed, at least in part, in the body, as most foods are. If food is denned as a body that contributes to the growth of cells or their multiplication, and to the generation of heat and energy by them, it is very questionable if alcohol can be classed as a food. When limited amounts, not exceeding one or one and a half ounces a day, are taken in small doses at a time, it seems to be decomposed by the tissues and does not appear in the exhalations from the lungs or skin or in the urine. This would suggest that it has a food value. Its effect upon heat and energy production will be referred to later. Ham- mond found that when he was upon an insufficient diet and was losing weight, the addition of a little alcohol made him gain. This also suggests its having a food value. The calorimetric experiment of Atwater points to its having a limited food value. For three days he measured the number of calories produced by a man on non-alcoholic diet in the calorimeter. For the next three days he made similar observations upon the man but substituted an isodynamic quantity of alcohol for an equivalent amount of carbohydrate and found the resultant in calories in both instances was the same within a small fraction of 1 per cent. But if alcohol is taken generously or in large quantities most of it escapes through the lungs, skin and kidneys without being utilized in the body. It is often, although not uniformly, noticed that habitual drinkers put on flesh. This does not, however, demonstrate that the alcohol has entered into the structure of cells in a beneficial way. It modifies oxidation processes, prevents the complete utilization of foods, and causes a retention of fats and some waste-products in the system. The fact that it can be proven that only a very limited quan- tity is retained and replaces or saves other components of food, is not characteristic of a true food, which if not used at once for the production of energy or cell growth is at least stored and in the process undergoes changes in composition. Moreover, food gives strength but alcoholics lessen it at least if more than small quantities are taken. They also interfere 140 BEVERAGES. with or modify the normal function of organs and lead ulti- mately to destructive changes in many tissues. The fact that it does not appear in the excretions of the body when not more than one ounce is taken in a day hardly demon- strates its utility as food. The most recent researches point to its being a poison to protoplasm, but it is probable that this amount may be taken without noticeable impairment. Hutchison 1 says: ''Alcohol is a protoplasmic poison or anes- thetic, but is itself easily burnt up in the body." Because of this effect, he continues, " If alcohol gets access to the cell and partially paralyzes or anesthetizes it, the cell will lose its power of breaking down those compounds, such as fat, with which it has, even in a condition of full activity, most difficulty in coping. Alcohol then saves fat from combustion; in other words, it is a fat sparer. It also appears, though with greater difficulty, to be able to spare carbohydrate, but it is exceedingly doubtful whether it is ever able so far to paralyze the cell as to destroy its power of dealing with protein." It exerts much the same influence upon cells generally, interfering with or lessening their normal functions, that it does upon the red blood-cor- puscles with whose power to take up and set free oxygen it interferes. It does this by making with hemoglobin a com- pound that is an inefficient oxygen carrier. Is it not probable that it unites similarly with some cell constituents and modifies their functions? We know that when applied directly to cells it coagulates a part of their albumin, as has been explained of its topical action on mucous membranes. One ounce of alcohol should yield as much heat by combus- tion as one ounce of butter — about 200 calories. But prac- tically this is not the result. In 185 1, the late N. S. Davis first demonstrated that alcohol lowers temperature. Two factors help to cause this loss. Even small doses dilate the peripheral arterioles, bringing thereby a large amount of hot blood rapidly to the surface of the body, from which radiation quickly takes place. Therefore more rapid radiation of heat is one factor causing a lowered temperature when alcohols are drunk. Considerable doses also lessen oxidation or heat-production. The fact that bodily temperature is thus lowered has caused 1 "Food and the Principles of Diet," page 344, London, 1911. EFFECTS OF ALCOHOL. 14 I those who send men into cold regions to forbid the use of alcohol, because it increases greatly their liability to freeze. Alcohol has been advised in fevers as an antipyretic. It has, however, the same mode of action and the same faults as other chemical antipyretics and is less efficient than several of them. Nor does alcohol increase muscular energy. Experiments with the ergograph and with the dynamometer, as well as the cruder ones that have been so frequently repeated, of having the same work done by two sets of men, alcohol being given to one set only — all demonstrate that more muscular work can be done without it than with it. After a dose of alcohol a man feels that he can lift a great weight, or in other ways exhibit unusual strength, and is surprised to find that he cannot. The subjective error is due to the same interference with the per- ceptive faculties that permits after-dinner trivialities to pass as weighty utterances. Fatigue is hastened, not delayed, by it. As alcohol does not modify protein metabolism, it will not materially change the output of urea. Experiments upon this point are conflicting. H. C. Wood, however, believes that it lessens the products of tissue waste. In fevers the albuminoids of the body suffer greatly and they are not proportionally, if at all, protected, by alcohol, as fats, and to a limited extent carbohydrates, are said to be. If alcohol is not taken in sufficient quantity to produce intoxication, only a very small percentage will escape from the body unchanged ; but if enough is taken to intoxicate, 10 per cent, or more may do so. Under the influence of full doses of alcohol the vessels of the brain, like those of the skin, become greatly relaxed and filled with blood. When this change is first produced, the mind seems invigorated. It is generally asserted that mental work is for a time more easily accomplished. This is doubtful. All parts of the brain are not affected with equal quickness or by the same doses. The brain-cells are poisoned or partly para- lyzed, the higher ones before the lower. The portion of the brain that is most influenced by external inhibitants or that itself restrains the other portions is first affected. So soon as the normal restraints are lessened, one becomes garrulous, ready to say and to do things that otherwise he would not do or say. The effects thus produced may easily deceive and lead one to 142 BEVERAGES. think that the mind has been stimulated, when it has only been unchecked. It has been shown that continuous mental work of a high grade cannot be done as well with alcohol as without its influence. Activity of neurons may multiply the trains of association and quicken the succession of images, but the weakening of inhibition prevents concentrated choice. Thus judgment is affected early, while imagination may be left untrammeled. The emotions may be more than usually active. The drinker is easily made combative, affectionate, lachrymose. Moral perception is less keen in the habitual user of alcohol than in others. Mental diseases are often due to it. The motor centers are also easily involved, some- times even before judgment is materially affected. Speech is made thick, and later the movements of the extremities are unsteady or uncertain. Walking and other movements show imperfect muscular coordination. It requires very large doses of alcohol to affect the spinal cord. When it is involved, the respiratory center is paralyzed before the heart is. The vasomotor center is, however, early involved. The various portions of the central nervous system are affected in the same order as when ether is administered. They may all be overwhelmed, producing stupor or even death. Quantities of alcohol not sufficient at any one time to produce intoxication or outwardly visible effects will, if their drinking be habitually repeated, seriously injure the tissues by interfering with oxidation. The brain and nervous system are especially likely to feel the effects. Degenerative changes are excited in these structures. In these, as in all tissues, even if alcohol enters them only in small amounts yet is present constantly or with frequency, the chemical energy of the cells is diminished or changed. The disturbed metabolism leads to fibroid and later, to fatty metamorphosis. The disturbed metabolism of proteins increases or creates a tendency to attacks of gout or to the more chronic or obscure lithemic or alloxuremic dis- turbances. Sometimes the disturbing influence of alcohol upon carbodydrate decomposition and appropriation aids in the production of diabetes. Although it is claimed that alcohol when given in small doses, is not eliminated as such, it is well known that all inflamma- EFFECTS OF ALCOHOL. 143 tions of the urinary organs are aggravated by it. Those who have been steady, moderate, or heavy drinkers are especially prone to renal diseases. Two or three glasses daily of a bever- age containing so small an amount of alcohol as is present in beer will cause casts to appear in the urine. The liver is also especially susceptible to disease when alcoholic drinks are used. The stronger beverages are most likely to affect it. Individuals vary greatly in their susceptibility to alcohol. Some show ill effects from small doses, and others are seemingly resistant to large ones. Certain persons are stimulated by it to eat more heartily and to do less, and as oxidation goes on more slowly in these persons, they easily accumulate fat. Although plump, they are not resistant to disease, nor capable of prolonged hard work. Because alcohol is an antiseptic it has been tried as an internal antiseptic in infectious diseases. Experiments have shown, however, that alcohol given to animals lessens their power to resist inoculation with numerous micro-organisms. When given in infectious diseases, no antiseptic influence has been demonstrable. Alcohol is unnecessary in health, and those who have not strong self-control or who inherit a love of liquor or a tendency to inebriety, to gout, to arteriosclerosis, or to other degenerative changes are better off without it. Many individuals can use it in strict moderation without apparent harm. The majority sooner or later find that even with moderation they are not so well when they use it habitually, and they cease to drink it, or they take it more rarely. The abuse of alcoholic beverages is invariably harmful. The wisdom or unwisdom of the use of alcoholic beverages in health is not a question that the physiolo- gist alone can determine. The ease with which the habit of using them grows to an excess and the injury done thereby to society make the desirability of their use a social problem as well as a physiologic one. This is not, however, the place to discuss the sociologic phase of the subject. There are drugs that may be substituted for alcohol which are equally potent with the latter for the treatment of the sick. Its use is, therefore, not necessary either in health or in sickness. When prescribed in disease, it must be regarded as a medicine 144 BEVERAGES. and not as something to be used at will by the patient. As the percentage in all beverages varies greatly, it would seem best, as urged especially by B. W. Richardson and by the late N. S. Davis, to prescribe pure alcohol diluted to the desired strength. Doses can then be regulated with the certainty deemed nec- essary when other medicines are given. It must be rem- embered, when in the following pages percentages of alcohol in various beverages are mentioned, that they are averages, the variation in different samples often being considerable. Alcoholic Beverages Alcoholic beverages are generally classified as fermented or distilled. The former include wines and beers; the latter, spirits and liqueurs. Spirits are made by fermenting various saccharine substances until as much alcohol as possible has been generated in them. From the mixture of sugar, ferments, water, and alcohol the latter is distilled. When separated in this way alcohol can be made of various grades of strength and purity. The saccharine matters that are subjected to fermentation are derived com- monly from barley, corn, rice, potato, sugar, and molasses. The odor and flavor of each kind of spirit depend upon its source and upon different volatile ethers and by-products of fermentation that also pass through the still. Their medicinal action is that of alcohol. Whisky is defined by the United States Pharmacopeia as "an alcoholic liquid obtained by the distillation of the mash of fermented grain (usually mixtures of corn, wheat, and rye) and at least four years old." It has an alcoholic strength of from 44 to 55 per cent, by volume. It should be free from disagree- able odors. Its specific gravity should be between 0.945 and 0.924. When spirits of any kind are kept, the volatile ethers and aldehydes that give flavor and character to them change and become more agreeable. For this reason distilled liquors are always ripened for a variable period of time. Brandy of the standard of the United States Pharmacopeia is "obtained by distillation of the fermented, unmodified juice of fresh grapes, and should be at least four years old." Its specific ALCOHOLIC BEVERAGES. 145 gravity varies from 0.941 to 0.925. It contains from 46 to 55 per cent, by volume of alcohol. Brandy is kept for many years to ripen. Rum is distilled from fermented molasses. It is often made by adding molasses caramel and various essences or flavorings to a solution of rectified spirit. It contains about the same percentage of alcohol that whisky and brandy do. Gin is distilled from a rye mash. It is flavored by juniper berries, which are put in the mash during distillation. It con- tains from 15 to 20 per cent, of alcohol, but is often strengthened by the addition of proof spirit, so that it contains from 30 to 35 per cent. Gin undergoes a double distillation and contains, therefore, less solid matter than the other forms of spirit. No gin contains so much as 1 per cent. There is no sugar in it and little acid. Liqueurs and bitters are made from pure alcohol and various spirits and wines by the addition of sugar, aromatic herbs, and essences. The following table, compiled by Hutchison, will afford some idea of the composition of a few of those most commonly used: A.COHO, EXTRACT £»» bSES- Absinthe 58.93 0.18 0.32 Benedictine 52.00 36.00 32.57 3-43 Creme de Menthe 48.00 28.28 27.63 0.65 Anisette '. 42.00 34-82 34-44 0.38 Chartreuse 43.18 36. n 34-37 1.76 Beer or ale and stout or porter are made by fermenting malt and hops. Malt is made by germinating moistened barley at a uniformly moderate temperature. During germination the starch of the grain is converted into dextrin and sugar. Malt after it is dried and ground, is mixed with water to make a 'mash,' which in turn is heated to different degrees by different brewers. In this way the starch is more completely trans- formed into sugars and the latter are carried into solution. The action of the diastase of malt is arrested by boiling the wort, or filtrate, of the mash. Hops are boiled with it in order to extract some tannin, a bitter principle, and extractives. After the wort has been boiled it is rapidly cooled, and finally 10 146 BEVERAGES. fermented by the addition of yeast. To obtain a uniform prod- uct great care is taken that only a pure culture of yeast is used, and accidental infection of wort by other ferments is guarded against. Most of the yeast gradually rises to the top and can be skimmed off; some settles to the bottom of the tank in which fermentation is carried on. The beer is drawn into casks, where fermentation to a limited extent continues. The yeast is finally completely precipitated, and the clear beer bottled. If it stands long in casks the slight fermentation that goes on gradually increases the percentage of alcohol in it, making a 'heavier' beer. Beer and ales are described as 'mild' or 'bitter,' accordingly as they contain relatively much or little hops. The tempera- ture at which malt is dried and mash is made also modifies the taste and character of the final product. Sugar and dextrins are important constituents of the fermented beverages. Stout or porter is made as beer is, but the malt used in its brewing is first roasted, by which process some caramel is formed in it. This gives to the final product a dark color. All these beverages contain from 3 to 8 per cent, of alcohol, from 1/2 of 1 to nearly 1 per cent, of sugar, from 2 to 5 per cent, of dextrins, and possess a demonstrable acidity. The acidity of beer will check starch digestion in the stomach. Its bitterness, however, increases the flow of saliva and the secretion of gastric juice. Beer delays the chemical process of gastric digestion more than the small amount of alcohol in it will account for. It increases and often creates abnormal acidity of the stomach, and flatulence. Beer and stout are especially likely to produce obesity. Their use predisposes the drinker to gout and lithemic affections. They cannot be used by diabetics because of the carbohydrates which they contain. They also aggravate renal inflammations, cystitis, and urethri- tis. They are frequently drunk in quantities sufficient to dis- tend the stomach even to a pathologic extent. Many persons feel somnolent after drinking beer, wherefore it is frequently taken at night as a mild soporific. Wine is fermented grape- juice. The quality of wine depends upon many conditions. Some of these are : the variety of grape WINE. 147 used, the soil and climate in which it is grown, its culture, and the character of the ferment that is employed in the manufac- ture of the wine. In recent times bacteriology has solved many of the problems with which wine-makers were formerly struggling. Pure cultures of various yeasts are used, and sometimes combinations of them, in order to produce the flavors that are sought for in wines. The sugar in grape- juice is more or less completely decomposed by fermentation, pro- ducing thereby varying amounts of alcohol. Its more or less complete fermentation depends in part on the amount of albuminous matter in the grape-juice. The yeast lives upon the albumin, but during its growth breaks up the sugar. If a given grape-juice is rich in albuminous matter, all the sugar may be fermented, and a 'dry' or sour wine may be the result. If it contains little, the wine will be sweet. The character of wine is often modified by the addition of alcohol or sugar. Natural wine cannot contain more than from 15 to 16 per cent, of alcohol, as yeast-cells are paralyzed by it when this percent- age is reached. 'Fortifying' or adding alcohol to wine is a common practice. It is done both to flavor it and to prevent all further fermentation in it. Sherries are always fortified; so are most champagnes, especially the sweeter ones. The details of wine-making vary greatly and cannot be described here. The character of individual wines depends much upon the methods employed in their manufacture. Some are made from the juice squeezed from the grapes under high pressure; others are made by fermenting the juice with more or less of the skins and seeds in it. To some grapes, lime is added when they are crushed. So much to illustrate the very numerous modifications that are adopted by wine-makers in the production of this beverage. The most important ingredients of wine are water, alcohol, acids, sugar, ethers, extractives, and glycerin. Wine contains several alcohols. Ethyl is the one that occurs in the largest amount; amyl, propyl, butyl, and others are developed in it in smaller quantities. A wine containing more than 15 per cent, of alcohol is fortified. The most important of the vinous acids are tartaric and tannic. A number of others are sometimes present. Acetic 148 BEVERAGES. acid is not uncommon. The total amount of acid varies, but is often considerable. Sugar occurs in wine in too small a quantity to be of much value as a food. The sweet wines contain about 4 per cent, of sugar, and the sour ones 1/2 of 1 per cent., Or thereabouts. If wine were taken in sufficient quantity to obtain from it more than one-half or perhaps one-third of an ounce of sugar, it would produce intoxication. The ethers result from the action of alcohols and acids upon one another. The flavors of special kinds of wine depend largely on the character and relative percentage of the contained ethers. They are very numerous, but each one occurs in very small percentage in any given specimen of wine. The extrac- tives are mostly such carbohydrates as pectins and gums. Glycerin is always present in wine, but in very small proportion. The following table from Dupre's analyses will give some idea of the chemical composition of a few wines that may be regarded as types of larger groups : Wine Absolute Alcohol Total Acid Sugar Dry Residue Ash Total Alcohol in Ethers Hock, Claret, Hungarian, .... Greek, Sherry, ..... Madeira, Port, Marsala, 9-73 9.68 10.16 12.35 17.80 17.82 18. 1 1 16.80 O.506 0.599 0.694 O.611 O.487 O.680 o.434 O.361 0.062 0.243 0.077 0.225 3015 1.850 2.540 3-5O0 I.92 2.12 I.90 2.50 5.06 4.44 5-34 5-36 0.17 0.21 0.18 0.30 0.50 o.37 0.23 0.26 O.042 O.038 0.046 O.048 O.061 O.096 0053 O.049 Cider, which is made from apples and pears, is very similar to wine. It contains from 3 to 8 per cent, of alcohol, from 0.2 to 0.6 per cent, of sugar, and 0.1 to 0.6 per cent, of acid. The chief acid present is malic. Sparkling wines and ciders are bottled before fermentation is checked, and filled with carbonic acid gas by its continuance. When uncorked, the gas escapes in bubbles. This is called 'natural sparkling.' Artificial sparkling is produced by forcing carbonic acid gas into wine, as into soda-water. Effervescence EFFECTS OF WINES. 149 adds to the attractiveness of wine, modifies its taste, and is said to hasten the absorption of alcohol from the stomach. Wines check the chemical processes of digestion more than can be accounted for by the alcohol they contain. One per cent, of sherry will stop salivary, gastric, and pancreatic digestion. It is probable that the acids in wines, and possibly also some of the ethers, increase the inhibiting influence of alcohol over digestion. Sherry and port are more active in delaying digestion than claret, and much more so than cham- pagne. Although they exert this deleterious influence upon the chemical processes of digestion even when they are taken in small quantities, they often improve appetite and stimulate more vigorous gastric peristalsis. Large amounts lessen nervous and muscular excitability. A person leading a sedentary life cannot with safety take as much wine as one who is doing hard muscular work. Accepting as a just estimate the statement upon an earlier page that two ounces of alcohol is the limit permissible in health, one bottle of claret that contains approximately this amount is all that should be taken in a day, and not to exceed half of this amount of the stronger 'fortified' wines, such as sherry. Taking different kinds of alcoholic beverages at a time, or even during one day, interferes with digestion more than the drinking of one kind does. Wines are used in health chiefly because their flavor is agreeable and their milder effects upon the nervous system, such as lessening sensibility to worries and nervous tension, are grateful. Their habitual use often produces sour stomach. Sometimes their excessive use causes gastritis. When those who are dis- posed to lithemia, gout, or rheumatism drink wine habitually, and sometimes even when they drink it only occasionally, they become especially liable to outbreaks of these maladies. It is not probable that the alcohol in the wine is the only or the chief cause of this. The acids and the sugars in it must also be blamed. For although the organic acids form in the blood alkaline salts which theoretically should do good, especially in cases of uric acid calculi, it is probable that the presence of acid wines commingled with food, and especially with sugar and starch, delays digestion, and permits the occurrence in the con- 150 BEVERAGES. tents of the stomach of changes that produce the chief toxic principles. The ill-effects of these beverages are usually not felt by persons of the class under consideration immediately after drinking, but in from twelve to forty-eight hours later. The tannic acid in sour wines gives them a rough, astringent taste. Such beverages may lessen diarrhea and aggravate constipation. CHAPTER X DIET IN HEALTH Diet for Athletes in training. Diet for Brain Workers. Starva- tion. Diet in the Different Periods of Life. It is self-evident that a larger amount of fuel or of calories — that is, units of energy — will be needed by those who are work- ing hard than by those who are doing but little physical work. The tables in Chapter V illustrate the differences in the amount of food consumed by different classes of workers because of the different demands that their systems make and that are expressed by their appetite. However, the appetite is not always a good guide to the amount of food or kind of food that should be eaten. It is often capricious. It is commonly governed by habit, and therefore does not quickly adjust itself to varying modes of life. For example, many men who have worked hard during early manhood and middle age, when they needed a large amount of food, continue to eat as heartily after they give up such work and begin to lead a life of leisure. At the end of the tables on pages 46 and 1 56 is given the estimated amount of food needed by those doing various kinds and degrees of work. Diet for Athletes in Training Much has been written of the diet best adapted to an athlete when training for a contest. The object of training is to prepare a man to do a very large amount of work, and sometimes skilled work, in a very short time. This is a different problem from that which confronts a laborer or an artisan. The latter requires that regimen which will enable him to do a large amount of work daily over long periods of time. During the period of preparation for an athletic contest, muscles must be made to grow, and the waste caused by tests or trials of strength be repaired. Proteins are therefore needed for cell growth and 151 152 DIET IN HEALTH. repair. They are also required, as has already been explained, to furnish nervous energy. The work that muscles do can be accomplished upon carbohy- drate food, as it will economically furnish a large number of calories or units of force. But to set the muscular work free quickly, and to perform it accurately by a correct correlation of movements, much nervous energy is needed, and for its production proteins are required. When large amounts of food must be eaten, proteins should form a conspicuous part ot the diet, because they are digested with comparative ease. Such carbohydrate food as is eaten should be as digestible as possible. In preparing for many kinds of athletic contests it is also an object to lessen the weight of the contestant as well as to increase his strength. This is best accomplished by exercise. A relatively large amount of protein will also help to accomplish it. However, athletes, when in training, always eat enough to grow fat, if it were not for the severe exercise that they take. Increased endurance is acquired by such exercises as gradually strengthen the heart and increase the depth and power of respiration. Diet influences these changes only as it does general strength, by furnishing to the muscles and the nerves to be used, such food as they need to produce energy. Experience has taught athletes and their trainers that a generous mixed diet is the best one for them. At the training tables of the Harvard and Yale crews such foods as the following are eaten: Breakfast cereals, dry toast, vegetables in reason- able variety, and fruits; beef, lamb, mutton, chicken, fish, bacon, and eggs. Desserts of simple puddings or ice-cream are furnished, but no highly seasoned food. The utility of sugar or of carbohydrates as producers of strength has already been dwelt upon. In this connection it is interesting to note the experience of the Holland oarsmen who, while in training, began to show signs of overwork, loss of flesh, a lack of ambition and energy, and disinclination for study. and work. By eating sugar as freely as they wished, sometimes as much as one-third of a pound a day, they were refreshed and enabled to win a race against antagonists who did not believe in its use. Sugar is generally permittedfto DIET FOR ATHLETES. 1 53 those in training, but pie, cake, and other sweet and more or less indigestible dishes are forbidden. Although food must be eaten by those in training in larger amounts than by the same persons at other times, care must be taken not to overeat, and thereby derange digestion; nor must meals be eaten at too long intervals. The table on pages 156 and 157, compiled by At water and Bryant, gives a summary of results of dietary studies of uni- versity boat crews, foot-ball teams, and professional athletes, and compares them with the ordinary diets of men of various occupations and with the generally accepted standard dietaries. It is noticeable that the diets of the university crews compare closely with the American standard for one doing hard work and are somewhat more generous than that of German and English standards. The largest amount of food is eaten by the foot-ball teams. It is also noticeable that the proportion of proteins is greatly increased relatively to other kinds of food. This is also true of Sandow's diet. The excess of proteins in the food of college students training for a contest is particularly striking when their diet is compared with that of their fellows at an ordinary college club. The latter furnishes 3690 calories and contains 107 grams of protein; the average diet of a col- lege crew in training furnishes 4085 calories and contains 155 grams of protein. The difference in fuel value of the two diets is approximately 400 calories. The oarsmen's diet furnished one-ninth more energy than that of their fellows who were not doing athletic work. There was a difference of 48 grams, or an increase of nearly one-half, of protein. The relative propor- tion of protein was therefore unusually large. Tea, coffee, and cocoa are usually permitted to men in train- ing. Occasionally the first two cause so much nervousness as to prevent skilful coordination of muscles and they must be forbidden. Spirits and other strong alcoholic beverages are forbidden. Beer and light wines are sometimes allowed. Violent exercise should not be taken soon after meals. It will hinder and sometimes stop digestion. Light exercise with dumb-bells or pulley weights is not only permissible, but de- sirable before breakfast, but prolonged or violent exercise should not be taken after so long a fast as a night's sleep entails. 154 :DIET in health. If violent exercise is attempted after a hearty meal, it will be observed that weariness is felt more quickly, and that it requires more mental force to compel one's self to do the work, and even under such compulsion it is not done with the quickness, clever- ness, and accuracy that may be shown at other times. Although exercise creates a need of food to restore the strength and energy that has been expended, it is best not to eat immediately after exercise. A short rest of a half-hour or an hour should intervene. The habit of athletes of reclining and being rubbed for some minutes after exercise is useful both as a rest, and as an equalizer of the circulation. Diet for Brain -workers Mental work does not increase bodily waste. In this it differs radically from physical work. But it cannot be well done unless nutrition, and especially the nutrition of nervous tissues, is good. There is no kind of food especially adapted to create nervous energy or to restore worn nervous tissue to a condition of vigor. Agassiz at one time suggested that, as the brain was rich in phosphorus, a food containing it, such as fish, was best adapted to the needs of brain- workers. Exper- ience has demonstrated that this is not true. Intense mental work checks digestion just as all kinds of strong emotions do. It is evident, therefore, that health will not be preserved if the habit is formed of doing hard mental work immediately after eating heartily. It is quite as harmful to accomplish hard mental work immediately after a large meal as it is to do hard physical work. Indigestion and slow digestion always make mental work difficult; therefore the most important dietary regulation for those who must do hard mental work constantly is that the food eaten shall be easy to digest. In other words, the regimen must be determined by the digestibility of food rather than by its composition. Brain-workers need a com- paratively small amount of food. As proteins of animal origin are, as a rule, digested easily, and quickly and readily utilized by the living tissues, they are well adapted to the needs of such persons. There is a dependence of nervous activity upon muscular activity. While one is working hard, exhaustively, with his muscles, he is unable to do much mental work. One OVEREATING. 1 55 who does prolonged and intense mental work will find his mind grow dull and his temper become quick, irritable, and peevish unless he maintains a balance between muscular and nervous work by some gentle exercise. It is probable that under these circumstances, exercise does good chiefly by stimulating a better lymph circulation through the brain as well as other viscera, and therefore a more rapid and perfect elimination of the products of tissue waste. Overeating Overeating is a common fault in adult life and not uncommon in childhood. With children it is usually an acute condition; with adults, a chronic one. Men and women are tempted to overeat by habits acquired early in life and by the pleasures of the table. When in good health, a moderate excess of food can be digested and comfortably utilized and eliminated, but more than this leads to pathologic states. If the excess of food is small and taken habitually, it may not disturb digestion, but will gradually lead to obesity or to a condition that borders upon grossness. The kidneys are particularly prone to be injured by high living, which means not only eating heartily, but also eating rich and highly seasoned foods. Chronic nephritis is the lesion most commonly produced under these conditions. Arteriosclerosis is also likely to develop. The eating of excessively large meals is a common cause of indigestion and of gastric dilatation. The liver is also frequently overtaxed and its functions disturbed. Starvation Abstinence from food can be persisted in for variable periods of time. If the faster is in a room where an equable and com- fortable temperature is maintained, and if he is supplied with all the water that he needs, and is permitted as much rest as he requires, life, and even health, can be maintained for six weeks and more. If, in fasting, much energy is consumed in main- taining body-temperature or in doing work, death will occur in a few days. Under favorable conditions life will be main- tained until even the half of the usual weight of the body is lost. SUMMARY OF RESULTS OF DIETARY STUDIES OF (Nutrients in food actually Proteids. (Quantities DIETARY STUDIES OF UNIVERSITY BOAT CREWS, 20 40 60 80 100 120 140 160 180 200 220 240 Harvard University crew at Cambridge (No. 227). 162 Har vard Freshman, crew at Cambridge (No. 228). 153 Yale University crew at New Haven xNo..229) 145 Harvard University crew at Gales Ferry (No. 230_ 160 Harvard Freshman crew at Gales Ferry (No. 231; 135 Yale University crew at Gales Ferry (No. 232) 171 Captain of Harvard Freshman crew (No. 233). __ 155 * Average . 155 SUMMARIZED RESULTS QF OTHER. DIETARY STUDIES Football team, college students, Connecticut . 181 FootbaH team, college students, California 270 Professional athlete, Sandow . 244 Prize fighter, England 278 Average of 15 coHege clubs 107 Average of 14 mechanics' families 103 Average of 10 farmers' families* 97 Average of 24 mechanics anad farmers 1 families 100 Average of 14 professional men's families 104 DIETARY SBANDARDS Man with moderate muscular wor-k,"Voit 118 Man with moderate muscular work, Playfair 119 Man with moderate muscular work:, Atwater I 125 Man with hard muscular work, Voit 145 Man with hard muscular work, Playfair 156 Man with hard muscular work, Atwater 150 Man with severe muscular work, Playfair 185 Man with severe muscular work, Atwater i 175 156 UNIVERSITY BOAT GREWS AND OTHER DIETARY STUDIES, eaten per man per day 7) in Grams.) Fats Cart hyd y ", Calories. ates 260 280 300 450 900 1350 1800 2250 2700 3150 3600 4050 4500 4950 5400 5850 6300 6750 7200 7650 8100 175 449 4130 223 468 4620 170 375 3705 170 448 4075 152 416 3675 171 434 4070 181 487 4315 177 440 4085 1 292 557 5740 1 416 710 7885 . 151 502 4460 78 83 2205 148 459 3690 150 402 3465 130 467 3515 141 429 3480 125 423 3325 .56 500 3055 51 531 3140 3500 100 450 3370 71 568 3630 4500 71 568 3750 5700 157 158 DIET IN HEALTH. When tood is suddenly withheld, hunger increases until it becomes extreme. This feeling lasts for two or three days, when the desire for food gradually lessens. During the period of hunger there are burning and gnawing in the epigastrium, which are followed by a feeling of weakness and faintness. When food is gradually lessened, the feeling of hunger may not be experienced, or, if experienced, not in an extreme degree. The body loses weight at first because the fat of the adipose tissue is consumed, and later because the muscles waste. The heart grows quick and feeble. The temperature of the body falls so that it is subnormal much, if not all, of the time. Finally, muscular exertion may be impossible. The mind grows dull and listless. Dreams, hallucinations, and insomnia may tor- ment the starving person. The aspect of those who are starv- ing is pitiable in the extreme. We have become familiar with it because of the numerous pictures in illustrated papers of the famine sufferers in India. After prolonged starvation it is not well to administer food in generous quantities, or any food except what is most digestible, as the organs of digestion have become so weakened that they cannot do much work. At first, small quantities of bland, very digestible food, such as milk, gruel, or albumin water, should be given every half-hour until some improvement is evident. The amount of food may then be gradually increased and a larger variety given. Diet in the Different Periods of Life Aged persons bear want better than do young ones. Indeed, after middle life abstemious eating should be practised in order to maintain health. During old age less work is done; tissues cease to grow, and repair takes place slowly. The need for food is therefore greatly lessened. It is a common dietetic error at this time to eat too much. Food should be varied, but taken in small portions. When old people are feeble, they should eat four or five times daily. Often because of few and poor teeth old people must live chiefly upon liquid and soft foods. Whenever it is possible their teeth should be repaired or false ones provided that food of all kinds may be eaten. As tissue repair and tissue growth is stopped or reversed, a gradual DIET IN MIDDLE LIFE. 1 59 wasting being the rule in old age, protein foods are not so neces- sary as in early life. Moreover, they are not so desirable, for often elimination of nitrogenous waste by the kidneys is less perfect. Bland, easily digested foods should be preferred. Foods which are not easily digested will ferment in the gastro- intestinal canal and will form toxic substances which increase arterial tension and thereby the work which the heart has to do. The latter organ under these conditions grows weak and is unable to maintain a perfect circulation, a condition which deranges the functions of various organs. This produces ill health and is often the cause of fatal illness. Such stimulating beverages as tea, coffee, and cocoa are well borne and particu- larly grateful. In middle life, or, to be more exact, after the thirtieth year, it should be remembered that it is no longer necessary to eat to make more tissues or to promote growth, but only to maintain an equilibrium of weight and strength. At this time the habit acquired in childhood of eating largely is strongly estab- lished and the pleasure of eating is most appreciated. Therefore, most men and women are inclined to eat too much and to eat food that is too rich or that, although most palatable, is indiges- tible. It is at this time that indiscretions of diet are with especial frequency a cause of disease. The quantity of food eaten should vary with the amount and character of one's physical work. When a sedentary life is led, only the most digestible foods should be eaten, and these in moderate amounts. At this time the habit of eating only what is needed should be acquired and earlier habits should be broken. The average man should limit himself to small portions and should make it his rule not to take more than one portion of any kind of food at a meal. This general rule is subject to modification for many who are doing hard physical work need a somewhat more generous supply than this general rule implies but they should endeavor to vary their eating as their work varies. It is a common observation of physicians that farmers who eat very heartily during the summer when their hard work enables them to digest and utilize it continue the same habit during the winter when work is comparatively light. This results at first l6o DIET IN HEALTH. in mild forms of indigestion, but ultimately in a chronic gastric disorder. In infancy and childhood food must be eaten to maintain heat, which is radiated with relatively great rapidity, to supply muscular energy, which in childhood is generously expended; and to supply the great demands that rapid growth of tissues makes during the earliest years of life. The most rapid growth takes place in infancy, when there is the smallest expenditure of muscular energy. The composition of mother's milk, which is nature's especial aliment for this period, gives us a key to the kinds of food needed and to the relative quantity of each required to promote a rapid growth of tissues. It contains from i to 2 per cent, of protein, approximately 4 per cent, of fat, 5 or 6 per cent, of digestible carbohydrates, and about^oo per cent, of water. Food of this composition does not make hard, firm flesh or create power to resist disease. These condi- tions are developed later when the diet is richer in proteins and solids. From the following table compiled from the more extensive one made by E. A. Locke, 1 it will be easy to estimate the pro- tein and caloric value of a meal made up of common foods for the values are given for portions ordinarily served. ^ood Values by E. A. Locke, A. M., M. D. Published by D. Appleton & Co., N. Y., 191 1 FOOD VALUES. 161 O H n < •< Q x £ < 2 2 £o J < 2 * « a > n o £0 o fri ^5 o a s o S* o « Oi -t oo o o\ Tt o\ « N M Ci M fO M O O O vo M O -* O t- -* O O c* •* O Oi f} ^- O <0 mmtI-O^^-Omon 00 O O O O vO O 00 O (0 >o O W h w W « ei N N O N \ D a; co a) bo bo bo bo bo > > > <<< 4) 4> > > < < A 6 q go S3 2* 4) T3 m or PQ O 5 S -a _ .O 4> 6 « rt CO CO O q co G O * S W 01 +-> 3 5^6E o o 3 3 SS M -• "- IE CO S cOcooo3c3.5'grt •<-» *• c o a E S co c s § S OT " T) E 1 as . Pi m o O O O co l62 DIET IN HEALTH. 8 a I P > Q O o O o o Pi * < Q r» 00 or, t 00 f~ «o r^ NO VI >o 00 00 ve U-) O N 00 ^O T* 00 O *o O f0 M •O r^ o « "* to M •*r o w >0 o tr, O O o o o o o o M o M n l-l M i-. CO 9 a »o 00 ^ oo c« ■+ o « O SO V) -o o o vO o\ 1- ■<*■ ■*■» t O lO <0 M CO O O <* aooco m * O oooo Tt-O»^«O>00^-Mt^t»MH f0« Tf «*)«*) t*3 <*) *0 « ■>* *0 O O «) (<) m ^ to* »^«>o o» o o o o o iOir>i/>«/iOOmOOOOO H S5 o < 23 £> td o 60 c a S .3 ■£ .£ n - o 'o ' O aaaaaaaaaaa : « o o o 3 3 3 3 3 3 S 3 3 S S-nSSS ooooooooouo'S'Shhh o y. en OT W s •- ^s ^s ^ o "w "S "5b "Si •ti 01 •sl I s . St* C O rt & fi °. « S g a ib § S E S, c .* .3 g 8 » .s .a o s & £ m B 3 J3 j= o " O O P V u < O I 8« tit Ah /« bo a I ^ £ B "2 n »h uj S .P £ <3 ^ C '•3 ^3 •S " s cj^O^^^^^^ w o FOOD VALUES. 163 m W P < > P O o o s c o 2 H 2 w H 3 S2 £0 W5 Ov «/> 00 0\ « r» O* CO to o co o m a 00 H ^ OJ «♦> M »-» M « M *i « O O O O O O M H 6 CO M O) CI O co O 4 a O O M ' 1000 CO w O to 00 O O n >o ifl O O Tf \r> V) i/> O O 00 t» >t •* V3 10 10 00 O *t LT> ei m r~ t^ *0 CO 00 * -* •* in ro ■ H (O ro co f*> « M CI n O O H H H H «0 O O >0 vo O 0» c c o o o o a a co xn (jffltlOJUDIUU 00 00 a a 'a 'a 60 +i 5 w a 5 c c c c 0000 0000 x> x 3 .a *» N N N . w • C • O • O • a • CO ■ JS : 3 J -»-> N a c c c C at • • • « be a 'u i 1 s g e 8 " «J O O 3 3 C O" Q O O 3 nJ C ^1 ci g 164 DIET IN HEALTH. Ov 00 VO WJ N CN O cnoono»omo*<) wi O <3\ O 10 5 * O f> o o IO Ov Oi Q\ *0 o 00 o 00 w Tt O «1 (1 N O o o O O O w o O O M o O O O O to M S C*mOOmOOOOOm tOHOOfOOOOOOOOcOPOtO £0 o a 00 o M ^1 « X X .fj © fl> « *». tw 00 M 00 c C > > < < IS c a a c c 00000 00000 Pi Pi P i O r Pi to to to to to ]) g> OJ O 1) 3 3 3 3 3 bo 00 bo 00 bfl S 5 S 2 H 'a "a 'a 'a "S. MHWHfONHMP) 3 3 *r o o to 3 3 •8 c o o Id <8 2 > o S £ T3 O c8 2 o g CO CO * M o o o o 13 D r» t^ O O ■* 00 O O O 00 & r» O* N e» to C\ M O M • • •; *; g ^ w ti .a .2 .2 : • -^^^n^^^^^co h p X X XI XI rt nj 60 00 bo 60 bo bo bo to bo c c c c a c c c a a a a a a a a a aj 0} si si .a si si si xi x xi V, T? ^CO «*)^-« 6? 3* a « i« *0 ■«* M tooooo M K) M «$- 1 I ■S CO p > Q o £ o o o 83 io * io m no io>o S3 M jj v v o> 4> 'a "a "S 'a 'a « ll FOOD VALUES. 167 2 5 5 3 * as 8 3 60 . S w a? 8,9 CO c« -^ & 60 a I & & o rt rt S _.. a> a> S o '3 s B - ^ g-B a « J 60 "O £ rt ,9 o to H .2S a 60 ■»-> 03 S 8 & .2 o o t( w a g, S" S* « a * 3 3 S «• .§ a S 60 rt d " « 6 3 4) *J *> .2 §, CO O •h *0 « 9* G O M rt i_i H 8 s §8 a a -4-> 0) rt 60 * S "afi 3 1 i68 DIET IN HEALTH. o X mo a M O 6 .§1 » o T3 ,« •s s s M w fo 2 » C w 8. S.2 8 2 u bo «u g a i TG CO el a> 10 10 00 O :G G o o ^ j§o M •G> ^ 2g 8 q. 2 g VI) « ^ G 0) c .2 a & « G \ G O . •£ 60 v-i 00 O 0) FOOD VALUES. 169 to J a is O r- 00 k - ,B (i * ^ 1 0"%*r^0 O tz+» • N H C> M Tf HI CI ,V W CI r»5 CO ■ W O H O < « a < Q O > X 10 0000000000»/50>>© O r»»OON « M 00 M » 5 « 0\ 00 «5 00 to O «) iO>0 *0 NOMCIIOt-COO OOONr-NOOOUt^ 2 » « s «oO O 0 Oi m M co f» tOO«MM>orot* « 2 h m t«.\OONOvr>00^000« M N >iwOw>oiOCO>-'cOfO** Quantity c c c a I i c 1 c p £ c c c 3 a J \ t c c - c I c b c - '2 r c ) - a I s c s C £ C " I i c c g S 1 c t 1 c t- C to (t, Pd H w Q O O £ \ u c c Ingredients: 4 tablespoons olive oil 1 tablespoon vinegar 1/4 teaspoon salt Pepper. Mavonnaise dressing Ingredients: 2 eggs 2 cups olive oil 1 tablespoon vinegar or 1 tablespoon lemon juice Salt, pepper, mustard. Cube sugar t " O C i c q 1- S 1 O d c a 1 S = a 1 1 ) S ■ a c a! s to -a c c E < S c '5 s PQ ■5 5 i •_> H 5 a l a ■ B C V3 CJ fi O : c a c 1 1 a 1 s p V H 5 § I 1 a Ph a s C ■5 170 DIET IN HEALTH. I ••a 8 <3 I W P < > Q o o o o o (0 ►J 2 S3 O O VO "* r- vt 0> M w N CO A w £ H 9 * < > X «/} «<1 O 00 00 W) t<> r» o> « M « 58 ««> ** W U5 vO 00 M M B CO is 00 00 a « to H 1^. VO O « « « >< ■< a C U C c 1 1- 1 n fa fa t> H CO a 03 ^ £& 00 3 O CO 00 5 00 g a a c •- 4> CO ^ C w -^ +* ^ ° 1 .S .5 a w i *a a a. 3 <" w