Chapter 10
Regarding animal foods, they are often spoilt by over-cooking, and it should be remembered that when lightly done they are easiest to digest. White fish, tender steak, or juicy joint and cutlet are superior to the oily fish, and kidney, liver, and heart. These internal organs should be avoided, as they contain even more than the rest of the animal certain extracts liable to produce URIC ACID (_see_). Milk, cheese, eggs, and butter are not open to these objections. Cheese is a food very rich in proteid. It requires careful chewing, and may with advantage be grated before use. Buttermilk is a valuable and strengthening food. A generation or so ago the Scotch peasants lived almost exclusively on buttermilk and oatmeal, and were a magnificent type of men in every respect. Whey is a pleasant drink, and may be made a substitute for tea where the latter is prohibited. It is also beneficial for the kidneys. Jellies are a pleasant addition to the diet of convalescents, but have little nutritive value.
We would strongly urge upon our readers the advantages of simple diet. We mean by this the avoidance of all those rich and spiced dishes which are made up in so many ways to tempt the appetite, of alcohol in every form, of meat to the extent often consumed by the well-to-do, of pastry and such indigestible food as heavy cakes, of fried food in general; and, on the other hand, the adoption of a diet largely consisting of milk, cheese, eggs, butter, cereals, root and green vegetables, fruits, and nuts. It will not be found an expensive diet; on the contrary, it is remarkably cheap; it will give little trouble, for but little cooking will be needed. It may require some little effort at first, and some breakings with social customs, but far less of both than will be imagined. Seeing that a large part of disease is ultimately traceable to a rich and stimulating diet, and to too much food in general, simplicity is imperative on all who seek for the preservation of health. Eat less, eat better (or more slowly, with perfect mastication), eat simpler foods at your meals, eat at these meals only when you require it, and never between your meals. Such eating will ensure good digestion, good assimilation, good blood, and good health.
Diet and Corpulence.--A tendency to obesity should always be carefully checked by attention to diet and exercise (_see_ Exercise). The fattening foods are those which contain either fat or carbonaceous substances. Carbonaceous substances are found in bread, sugar, arrowroot, puddings in general, pastry, potatoes. The fats, such as butter, cream, and animal fat, should be much restricted in their use. As we have above indicated, however, it is not wise, as many corpulent people do in their efforts to get rid of this superabundance of fat, to make up for their restriction by an increase in the quantity of meat consumed. Cheese, peas, beans, buttermilk, and oatmeal might with advantage be drawn upon instead. At the same time, if the circulation is good it is well with such proteid diet to increase the amount of water drunk during the day, as this helps to eliminate the waste which would otherwise overtax the kidneys. Green vegetables and fruits should form a large part of the diet.
It must be remembered that it is dangerous to strike out at once all fattening foods from the diet; many have injured their health permanently by such injudicious haste, and brought on floating kidneys, etc. Remember, also, that exercise is a much safer reducer of fat than a very great reduction in diet, unless there has been a decided tendency to continually overeat. All alcoholic beverages must be strictly forbidden.
Diet for the Lean.--To a large extent the preceding article will suggest what is suitable here, remembering, however, that regular exercise will be also necessary in order to enable the muscles to increase in size. Green vegetables and fruits should be largely used in addition to the carbonaceous foods, as their FOOD SALTS (_see_) are necessary to keep the blood in a condition to allow of proper assimilation. In the case of nervous and consumptive patients, the more digestible forms of fat, such as cream and butter, are to be recommended. Some thin people do not seem able to assimilate much fat. These cases will do better on a smaller quantity. Remember always that it is not what is eaten, but what is assimilated, that goes to increase the weight, therefore if any particular food is found, after a careful trial, to constantly disagree, it must be accepted that for that one at all events, it is not a suitable article of diet.
Diet for Middle Age and the Aged.--In advancing years when less exercise is, as a rule, taken, a restriction in the amount of food consumed is highly desirable. The increasing corpulence, which often begins to show itself from 30 to 40, is far from being a healthy sign; indeed, is often the premonitory symptom of serious disease. It should be remembered that a lessening quantity of food is required from middle life on. This applies to all the elements of food. It is noticeable that a fat person seldom lives to old age, most octogenarians being thin and wiry, and almost all attribute their long life to increasing watchfulness over their health, and largely over what they eat.
When a person is young and taking active exercise, a good deal of surplus food can be worked off, and if the excess be too great, a bilious attack tends to prevent any more being taken, for a time at least.
But as we get on in life, the surplus food, if much is eaten, is deposited in various parts of the body as fatty or gouty accumulations. The liver becomes deranged, and loss of health and strength are at once apparent.
It is then, as Sir Henry Thompson has well pointed out, that the fond but foolish wife often does her husband incalculable harm by her efforts to "keep up his system." She urges and tempts him to take more food, fetching him, between meals, cups of beef-tea, soup, or cocoa, when he really would be greatly the better of total abstinence from all food for several days. What we have said about appetite being the best guide applies to the old especially, and if they could but realize what a very small quantity of food is necessary, they would not be perturbed to find that their appetite guided them to eat very much less than at a younger age.
Milk, which is the ideal food for the very young, is for that reason often undesirable for the old, and it is a great mistake for such to drink much of it with solid food.
Diet for the very aged becomes mainly a question of invalid diet, and it must be remembered that much should be granted to the individual's choice and liking. All foods for the aged should be light and easily digested, and careful attention paid to proper cooking.
A striking example of lost health recovered and life and activity prolonged to a great age, by strict temperance in food, is Cornaro, a Venetian nobleman of the sixteenth century, who lived over 100 years. He says:--"Our kind mother Nature, in order that old men may live to still greater age, has contrived matters so that they should be able to subsist on little, as I do, for large quantities of food cannot be digested by old and feeble stomachs. By always eating little, the stomach, not being much burdened, need not wait long to have an appetite. It is for this reason that dry bread relishes so well with me.... When one arrives at old age, he ought to divide that food of which he was accustomed to make but two meals into four, and as in his youth he made but two collations in a day, he should in his old age make four, provided he lessen the quantity as his years increase. And this is what I do, agreeably to my own experience; therefore my spirits, not oppressed by much food, but barely kept up, are always brisk, especially after eating, nor do I ever find myself the worse for writing immediately after meals, nor is my understanding ever clearer, or am I apt to be drowsy, the food I take being in too small a quantity to send up fumes to the brain. Oh, how advantageous it is for an old man to eat but little! Accordingly, I, who know it, eat but just enough to keep body and soul together."
Digestion.--Digestion is the process whereby the food we eat is turned into material fit to be assimilated by the blood. It begins in the mouth by the mechanical grinding and crushing of the food, and the chemical conversion of the starchy part into sugar, in which form alone it can be assimilated. This conversion is carried out by the saliva. Hence the necessity for thorough mastication, even of sloppy foods that do not seem to require it, and for attention to the teeth in order that they may thoroughly chew. Alcohol and tobacco, as they spoil the saliva, are very unfavourable to digestion, and should always be avoided. Twenty minutes longer to chew one's dinner is worth a whole box of pills, and no one need expect good digestion who neglects thorough chewing and salivation of the food. This may, with advantage, be increased to an extent which most people would think quite absurd. It has been proved that when all food is chewed until completely reduced to a liquid, its nutritive qualities are so increased that about half as much will suffice. This is of immense importance in all cases of weak digestion, or indeed whenever an absence of vigorous health renders the economy of vital energy important.
In the stomach the food meets with the gastric juice, which has the property of turning proteid (_see_ Diet for the various substances contained in food) into material ready for assimilation. The walls of the stomach are muscular, and their contraction churns the food with the juice. The gastric juice is secreted by glands embedded in the walls of the stomach, and is poured out when food is taken.
The whole food, now in the form of a paste, passes into a pipe about 12 inches long (the Duodenum), into which pours the secretion of the pancreas and that of the liver (bile). The pancreatic juice acts upon the starch which has escaped the action of the saliva, and also continues the work of the stomach. It furthermore emulsifies the fat or divides it into extremely fine drops.
The food passes now into a long coiled pipe--the small intestine. This secretes the intestinal juice which further assists the pancreatic juice. Absorption has been proceeding from the stomach onwards (_see_ Assimilation). The mass of undigested food is pushed along the small intestine by means of muscles in its walls and passes into the large intestine where a similar process to that of the small intestine goes on, the remains of the food ultimately reaching the vent in a semi solid form, consisting of the undigested part and the débris of digestion.
During this complex process much blood and energy is needed for the abdominal region, therefore hard work or exercise should not immediately follow a meal. It will be noticed that each stage of digestion prepares the food for the next stage _e.g._, the mouth prepares the food for the stomach. Now, as the food ceases to be under our control when it leaves the mouth, every effort should, as we have said, there be made to prepare the food for its reception by the stomach. Chew food dry as far as possible, for that excites saliva. It is best not to drink till after the meal. The digestive powers often become weakened in advancing years, but may be greatly preserved, and even restored to health after long debility, by careful attention to the above hints.
Drinks made of lemon juice or orange juice and water are often very good to help an invalid digestion, but nothing is better than sips of hot water for some time before a meal. Distilled water is especially a most valuable drink. Cooling applications to a fevered stomach and warm fomentations to a cold one will often promote digestion marvellously. The feet and legs may be fomented if cold while the cold cloth is pressed over the stomach, especially if the process be long continued. Where heat is necessary it should be gradually and cautiously applied, so that sickening the patient may be avoided. (_See also_ Assimilation, Food in Health, Indigestion).
Diet, Economy in.--Dr. Hutchison, one of our greatest authorities on the subject of Dietetics, has well said--
"The dearest foods are by no means the best. 'Cheap and nasty' is not a phrase which can be applied to things which you eat. A pound of Stilton cheese at 1s. 2d. contains no more nutriment than a pound of American cheese at sixpence. A given weight of bloater will yield more building material than the same quantity of salmon or sole.
"The upper classes in this country eat too much. The labouring classes are insufficiently fed--much worse fed than their brethren in America. One of the chief consequences is an undue craving for alcoholic stimulants; another is that our poor are not properly armed against tuberculosis and epidemic disease.
"How can this be rectified? Anyone who knows anything about the poor man's budget knows that he already spends as much on food as he is able. As it is, 50 per cent. of a workman's wages are absorbed in its purchase, so that half the struggle for life is a struggle for food.
"The only remedy is to buy the things which are the most nourishing and which yield the most energy. Quite a good diet can be obtained for fourpence a day, yet the average working man spends sevenpence.
"I advise the buying of more vegetable foods, particularly peas, beans, and lentils, and the cheaper varieties of fish. The working classes should also be taught how to cook cheese, and thus make it more digestible, as the Italians do. Cheese contains much building material, and is therefore a valuable article of diet.
"I strongly recommend one good meal of oatmeal a day, instead of so much bread, butter, and tea, which is the staple diet of so many poor families, because it is easily prepared, and because of human laziness.
"Skimmed milk is better than no milk at all, for it contains all the original proteids, and has only lost its fat. More dripping and margarine should be eaten, instead of jam; margarine being quite as digestible and nourishing as butter."
Vegetable oils are, however, more digestible than animal fats. Cocoanut butter is a cheap and excellent substitute for margarine or butter. As it contains no water it will go much further.
Another instance of bad economy is the use of cod liver oil. Butter or even cream are quite as fattening and much more digestible.
Malt extract is much dearer than honey, which is superior to it in value as a food.
To supply a healthy man with the amount of proteid required by him daily in beef extracts would cost 7s., in milk (a comparatively expensive food) would only cost about 1s.
Diphtheria.--The most striking symptom of diphtheria is the growth of a substance in the upper part of the windpipe, which threatens to close it entirely. Good medical skill is of first importance here, yet much may be done where that is not available. We have often seen the swallowing of a little hot water and treacle enable the children to throw up the entire obstruction and make the breathing perfectly free. Mark at once whether the feet are cold or warm. If cold, oil them well with olive oil, and pack in a hot blanket fomentation to the knees. When the feet and knees are thoroughly warm in this, put a cold cloth on the back of the neck down between the shoulders. Change this as often as felt comfortable. The throat may be brushed out with a weak solution of Condy's Fluid, but a strong solution of common salt will do very well. Good white vinegar and water (_see_ Acetic Acid) is perhaps best of all. We have never seen this fail in changing the character of such growths, and if the windpipe can be washed out repeatedly with it, we should feel sure of a desirable result. Now, we have seen a humble working man's wife wash out the throat of her son as well as any medical man could do it, using Condy's Fluid for the purpose with full success. When you can, have the help of a medical man, but when you are so placed that such help is impossible, you need not fear to try yourself. If there is much fever, cold cloths may be applied to the head to reduce the heat. As the disease is strongly infectious, care should be taken to isolate the patient, and attendants should avoid his breath. Abundance of fresh air and light should be allowed to enter the room, and one window at least should be open as far as possible.
Douche, Cold.--In its most powerful form this is a _solid_ stream of water directed down on the patient's shoulders and spine. It may be applied either by an apparatus fixed up for the purpose, or by merely pouring from a watering-can _without_ a rose. Its power depends on the great heating in the skin which springs up when it is withdrawn. This heating power again depends on the strong shock given to the system when it is applied. Thus it will be seen that what is called a "Spray" or "Spray Douche" is of little use for the same purpose, as it gives little or no primary shock. It is with this application as with many. The patient's feeling benefit is the great and true evidence of the treatment being right. When the douche issues in bodily comfort and cheering to the mind, all is right. If it issues in discomfort, then some other treatment must be tried.
"Downbearing."--This expression will cover many troubles especially common among women, where the weight of the internal organs becomes distressingly felt. These are usually supported without our being conscious of their weight at all. But in weakness, or after long fatigue and standing, it becomes felt as a severe downward pressure. This is often caused by the pressure of corset and skirts upon the waist. In cases where it is troublesome, much help will be derived by adopting some device for suspending the clothes from the shoulders. This may quite cure the trouble (_see_ Tight Lacing). For more serious cases, take daily a short SITZ-BATH (_see_) in cold water, with the feet in hot water. Internal syringing is often required, which is best done with the "Fountain Enema," and very weak acetic acid and water (_see_ Acetic Acid). A more powerful application is to have cold water poured over the front of the body while sitting in the sitz-bath, from a watering-can with a garden rose on the spout. This must be done gently at first, and afterwards more strongly and with colder water. This also prevents the troublesome "flooding" from the womb, which so often accompanies "down-bearing." The water employed in the douche must be _cold_, but it need not be icy cold. Ordinary cold tap water does very well. In serious cases medical advice should be sought, as the womb may be displaced. A golden rule for the prevention of this distressing ailment is to pass water frequently. If women would always do this before pushing heavy furniture, hanging up pictures, &c., many internal ailments would be prevented, as when the bladder is empty there is little danger of the womb being displaced.
After the system has been weakened by a miscarriage, this flooding often occurs. Apply the above treatment: it checks the flooding, and braces the parts.
Drinks, Refreshing.--This is a matter of great importance to the sick. Nor is anything more important to be said on them than this, that the foundation of all such drinks must be _water_. This water must be _pure_, and is best distilled, or boiled and filtered. Long boiling will spoil water, and half-an-hour is long enough to boil. To add to this pure water, we may take the juice of half a lemon, sweetened to taste. Few patients will fail to relish this. A whole orange may be used instead of half a lemon. A substitute may be made by taking half-a-teaspoonful of good white vinegar instead of the orange or lemon. Also in many cases where the cold drink is not relished, it may be taken warm.
Dropsy.--This trouble is rather a symptom than a disease. It rises from accumulation of watery waste in the body, owing to improper action of the skin, lungs, or kidneys, and sometimes follows scarlet or other fevers and lung affections. By far the greatest danger in such cases arises from fashionable medicines. It is of the last importance that nothing should be given to lessen life by injuring already weakened vital action. It is when this is done by metallic preparations that such cases become very grave and even hopeless. There is a prominent error in connection with all dropsical tendencies, which should be removed. That is the idea that the "water" which collects in such swellings is similar to good drinking water, and that giving the thirsty patient water to drink is increasing his illness. The so-called "water" which swells the face, or the feet, or any other part of the body, in dropsy, is used-up matter such as is, in good health, removed (imperceptibly, in greatest measure) by the organs fitted for that purpose.
Water, especially if given about blood heat, is at once used for most important vital purposes. This hot fresh water mingling with the poisonous "water" of dropsy dilutes it--renders it not only so much less injurious, but tends powerfully to its removal. The thirst of the patient is in perfect harmony with this truth, as all natural symptoms are ever in harmony with nature. If there are convulsive attacks, they are the result of used-up matter returning into the circulation, and reaching even the brain and central parts of the nervous system. The cure is gained when the defective organs are brought to act well. It is shortsighted action to deal with the kidneys alone in this trouble. They often fail because they are overloaded through the failure of lungs and skin to do their part. First, it is well to act on the lungs by gentle rubbing with hot olive oil between the shoulders and over all the back--done best in a warm room by the fire, or in bed. This may be continued for half-an-hour or more twice daily. The skin may be stimulated by a smart sponging with vinegar or weak acetic acid, and a rubbing all over with soap lather, and afterwards with hot olive oil. This lathering and rubbing to be done at another time from the first rubbing for the lungs. Then apply a large warm bran poultice to the lower part of the back behind the kidneys.
We have often found the following simple treatment effectual, where the patient is not very weak. If there are any signs of heart failure, do not use it. But if the patient is fairly strong, it is most beneficial. You have a case, say, of dropsy in the abdomen: put on two folds of soft flannel, wrung out of cold water; put two folds dry over the moist ones. Keep away all oiled silk and everything of the kind. You will very soon have an astonishing outflow of insensible perspiration, but it passes off through the soft porous flannel without any obstruction whatever. You will find that under this the swelling soon comes down, and even disappears entirely. It is necessary, in such treatment, to renew the bandage so as to keep all fresh and healthful, but your work is abundantly rewarded. In such a case as this the matter to be passed off is so great that a cotton or ordinary linen bandage may fail, as being too impervious, when a flannel bandage will succeed. A Kneipp linen bandage is perfectly porous, and will not irritate the skin as flannel often does. Worn-out underwear can be kept for this purpose.
If stronger heat seems to be needed, a soft cloth four-ply thick, large enough to cover the whole lower back, should be dipped in CAYENNE LOTION (_see_), slightly squeezed, and placed on the back. Over this a dry cloth should be placed, and the patient should lie down on a bran poultice or hot-water bag for an hour or two. Afterwards the back should be rubbed with olive oil, and a band of soft new flannel worn round the body.