Part 2

The author still claims discovery of a distinct physiological function which he first named "Nature's Food Filter." Van Someren preferred the name of a "New Reflex of Deglutition." It is, in fact, the "Natural Swallowing Impulse," _invited only_ by food mechanically and chemically _prepared_ for passing on to the interior, call it by whatever name you like or may.

At the time this little book was first published, the only note in favour of giving special attention to "buccal digestion," that had been sounded, was the advice of Mr. Gladstone to his children, "Chew your food thirty-two times to each mouthful," or words to that effect. The "Masticate well" prescription of the physician when given at all, had meant little or nothing, to either the patient or to the prescriber, except that one must not swallow hard food whole.

For two years after its publication little heed was given to the suggestion because the author happened not to be a medical man, but, finally, the reserve of indifference was broken, first by Dr. Joseph Blumfeld, in a review of the book in the London _Lancet_, and soon after by Dr. Ernest Van Someren of Venice, Italy, an English physician residing and practising in Venice. Dr. Van Someren's interest and experience are best stated in his _own words_, as follows:

THE PERSONAL "CASE" AND "ENDORSEMENT" OF DR. ERNEST VAN SOMEREN AN ENGLISH PHYSICIAN AND SURGEON, PRACTISING IN VENICE, ITALY

"MY DEAR MR. FLETCHER:

"It would be almost _àpropos_ to send you, as an endorsement of your principles, the dictum of the ragged and dirty tramp in the advertisement of Pear's soap. I would have to amend it slightly and say: 'I used your {principles} three years {soap} ago; since when I have used no other.' I say '_almost àpropos_' advisedly, for, while the soap claims to keep the outer man clean, the practice of your principles justly claims to keep the inner man sweet and clean, so lessening the need to cleanse the outer man!

"A well-known English surgeon (I think Sir Wm. Mitchell Banks) recommends physicians and surgeons to take a leaf from the book of patent-medicine vendors, and make their patients testify to their successful treatment. I will take the hint and give you, as my 'doctor,' a testimonial of how personally I am benefited by your advice.

"Three years ago, when I first met you, though under thirty years of age, and myself a practising physician and surgeon, I was suffering from gout, and had been under the _régime_ of a London specialist for the treatment of that malady. Though vigorously adhering to the prescribed diet, I suffered from time to time. My symptoms were typical--paroxysmal pain in my right great toe and in the last joints of both little fingers, the right one being tumefied with the well-known 'node.' From time to time, generally once a month, I suffered from incapacitating headaches. Frequent colds, boils on the neck and face, chronic eczema of the toes, and frequent acid dyspepsia were other and painful signs that the life I was leading was not a healthy one. Yet I was accounted a healthy person by my friends, and was, withal, athletic. I fenced an hour daily, took calisthenic exercises every morning, forcing myself to do them, and I rowed when I obtained leisure to do so. In spite of this exercise and an inherent love of fresh air, which kept all the windows of my house open throughout the year, I suffered as above. Worse still, I was losing interest in life and in my work.

"In one or two conversations you laid down your simple principles of economic nutrition. You told me that my food ought to be masticated thoroughly, until taste was eliminated, and that (my) liquid nourishment, if taken, ought to be similarly treated. You also told me that, taking food in this way, I might, without fear of consequences, give free rein to my appetite. To shorten my story, I'll say that in three months after the practice of these principles my symptoms had disappeared. Not only had my interest in my life and work returned, but my whole point of view had changed, and I found a pleasure in both living and working that was a constant surprise to me. For this, my dear Mr. Fletcher, I can never repay you. My only desire has been and is, to try and do for others in my practice what you did for me.

"Now I have since that time had occasional colds, headaches, and gouty pains; but, whereas formerly I could not explain their causes, I can now invariably trace them to carelessness in the buccal digestion of my food, and can soon shake them off. So much for my testimonial. Now for other matters.

"I do not know what may be the extent of the claims you are advancing in regard to the benefits accruing from the practice of your principles. If you, as you in justice may, claim even the widest benefits as surely following the practice of these principles, many will relegate these claims to the limbo where all such 'panaceas' are soon forgotten. They will err greatly if they do so. The seemingly simple procedure of insalivating one's food most carefully is not calculated to impress people with the fact that great permanent benefit follows. The subtlety of the changes that occur is due to the greatly increased action of a vital process, _i. e._, of the admixture with the food-stuffs of saliva, in such quantities as to alter the chemical reaction of the initial stage of digestion. This initial change causes a consequent change of all the processes following it, and a change also in the final products of the entire process of digestion; the greatest change being, perhaps, the elimination of last-resort digestion by the intestinal flora (digestion by decomposition caused by bacteria), and consequent elimination from the body, of the toxins they produce. The life of an organism has been defined as 'the sum of all those inter-actions which take place between the various cells constituting the organism and their several environments.' (Harry Campbell.) The final products of digestion are absorbed into the blood stream, and go to form part of the 'several environments' of the cells. The individual cell, the various groups of specialised cells, such as the brain, nerves, muscles, bones, etc., in short, the whole organism is beneficially influenced and made more resistent to disease by the purity of a blood stream that no longer contains the toxins of bacterially digested food.

"The further investigation of your discovery by those competent will, I am confident, result in such a simplification of the rules for a healthy life that the medical profession, at present forced by a lack of knowledge of the vital processes of nutrition to base their treatment on the veriest empiricism, will then be able to teach all and sundry how to live. At present, all we can do is to treat and perchance cure for a time certain symptoms, allowing the patient to return afterwards to a mode of life that is really responsible for his malady. 'Disease is an abnormal mode of life.' (Harry Campbell.) The three factors in its causation are:

"(_a_) Cell structure.

"(_b_) Internal cell environment.

"(_c_) External body environment.

"Heredity determines, to a very large extent, our cell structure, and consequently our body structure.

"Sanitary science regulates our external body environment as much as the artificial and noxious habits of so-called civilisation will allow. The mental and physical external body environments have also their effect on the organism.

"Your discovery of simple rules for an Economic Nutrition will control the internal cell environment. In doing this, the predisposition to disease is materially affected. The internal cell environment being free from toxic material, and the cell itself better nourished, the cell's resistance to disease is increased, the possible source of disease being limited to the external body environment.

"In concluding this endorsement I can promise, to each and all who may intelligently practise the principles of Thorough Buccal-Digestion, a complete knowledge of their body's food requirements, or, as a patient of mine tersely put it, they will learn the way to 'run their own machines.'

"Yours ever, "ERNEST VAN SOMEREN."

* * * * *

Dr. Van Someren and the author, assisted by Dr. Professor Leonardi, of Venice, as Consulting Physiological-Chemist, and several colleagues, pursued some experiments during the winter of 1900-1901; and Dr. Van Someren read a paper on our work, entitled, "Was Luigi Cornaro Right?", before the meeting of the British Medical Association the following August.

The paper is too long to reprint here but it will be found in full in another volume, entitled, "The A.B.-Z. of Our Own Nutrition."

The following "Note" by Dr. Professor, Sir Michael Foster, K.C.B., M.P., F.R.S. etc., is a further link in the chain of development of appreciation of the need of serious attention to the science of human nutrition excited by this initiative. (Dr. Foster is the Permanent Honorary President of the International Congress of Physiologists.)

EXPERIMENTS UPON HUMAN NUTRITION

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

"In 1901 Dr. Ernest Van Someren submitted to the British Medical Association, and afterwards to the Congress of Physiologists at Turin, an account of some experiments initiated by Mr. Horace Fletcher. These experiments went to show that the processes of bodily nutrition are very profoundly affected by the preliminary treatment of the food-stuffs in the mouth and indicated that great advantages follow from the adoption of certain methods in eating. The essentials of these special methods, stated briefly and without regard to certain important theoretical considerations discussed by Dr. Van Someren, consist of a specially prolonged mastication which is necessarily associated with an insalivation of the food-stuffs much more thorough than is obtained with ordinary habits.

"The results brought to light by the preliminary experimental trials went to show that such treatment of the food has a most important effect upon the economy of the body, involving in the first place a very notable reduction in the amount of food--and especially of proteid food--necessary to maintain complete efficiency.

"In the second place this treatment produced, in the experience of its originators, an increase in the subjective and objective well-being of those who practise it, and, as they believe, in their power of resistance to the inroads of disease. These secondary effects may indeed be almost assumed as a corollary of the first mentioned; because there can be little doubt that the ingestion of food--and perhaps especially of proteid food--in excess of what is, under the best conditions, sufficient for maintenance and activity, can only be deleterious to the organism, clogging it with waste products which may at times be of a directly toxic nature.

"In the autumn of 1901 Mr. Fletcher and Dr. Van Someren came to Cambridge with the intention of having the matter more closely inquired into, with the assistance of physiological experts. The matter evoked considerable interest in Cambridge, and observations were made not only upon those more immediately interested, but upon other individuals, some of whom were themselves medical men and trained observers.

"Certain facts were established by these observations, which, however, are to be looked upon as still of a preliminary nature. The adoption of the habit of thorough insalivation of the food was found in a consensus of opinion to have an immediate and very striking effect upon appetite, making this more discriminating, and leading to the choice of a simple dietary and in particular reducing the craving for flesh food. The appetite, too, is beyond all question fully satisfied with a dietary considerably less in amount than with ordinary habits is demanded.

"Numerical data were obtained in several cases, but it is not proposed to deal with these in detail here, as they need the supplementary study which will be shortly referred to.

"In two individuals who pushed the method to its limits it was found that complete bodily efficiency was maintained for some weeks upon a dietary which had a total energy value of less than one-half of that usually taken, and comprised little more than one-third of the proteid consumed by the average man.

"It may be doubted if continued efficiency could be maintained with such low values as these, and very prolonged observations would be necessary to establish the facts. But all subjects of the experiments who applied the principles intelligently agreed in finding a very marked reduction in their needs, and experienced an increase in their sense of well-being and an increase in their working powers.

"One fact fully confirmed by the Cambridge observations consists in the effect of the special habits described upon the waste products of the bowel. These are greatly reduced in amount, as might be expected; but they are also markedly changed in character, becoming odourless and inoffensive, and assuming a condition which suggests that the intestine is in a healthier and more aseptic condition than is the case under ordinary circumstances.

"Although the experiments hitherto made are, as already stated, only preliminary in nature and limited in scope, they establish beyond all question that a full and careful study of the matter is urgently called for.

"For this fuller study the Cambridge laboratories do not possess at present either the necessary equipment or the funds to provide it. For the detailed study of the physical efficiency of a man under varying conditions, elaborate and expensive apparatus is required; and the advantages claimed for the special treatment of the food just discussed can only be fully tested by prolonged and laborious experiments calling for a considerable staff of workers.

"It is of great importance that the mind of the lay public should be disabused of the idea that medical science is possessed of final information concerning questions of nutrition. This is very far indeed from being the case. Human nutrition involves highly complex factors, and the scientific basis for our knowledge of the subject is but small; where questions of diet are concerned, medical teaching, no less than popular practice, is to a great extent based upon empiricism.

"But the scientific and social importance of the question is clearly immense, and it is greatly to be desired that its study should be encouraged.

"M. FOSTER.

"April 26th, 1902."

* * * * *

The interest excited in Professor Foster was coincident with that espoused by Dr. Professor Henry Pickering Bowditch, Professor of Physiology of Harvard Medical School, and Dean of American Physiologists. Under the ægis of such encouragement the later developments are not at all surprising. In order to extend and verify the findings of Dr. F. Gowland Hopkins, of Cambridge University, England, as stated in the preceding note by Professor Foster, Professor Russell H. Chittenden, President of the American Physiological Society, Director of the Sheffield Scientific School of Yale University, and one of the leading chemico-physiological authorities of the world, as measured by accepted research work, volunteered to submit the author to further test. The report of this test is too long for reproduction here. It was first published in the _Popular Science Monthly_ of June 1903, but will be found in full in the "A. B.-Z." just referred to. The special reference to the author's case and the quoted report of Dr. William G. Anderson, Director of the Yale Gymnasium which tells the story of efficiency, was as follows:

Extract from an article by Professor Russell H. Chittenden in _Popular Science Monthly_, June, 1903.

"The writer has had in his laboratory for several months past a gentleman (Horace Fletcher) who has for some five years, in pursuit of a study of the subject of human nutrition, practised a certain degree of abstinence in the taking of food and attained important economy with, as he believes, great gain in bodily and mental vigour and with marked improvement in his general health. Under his new method of living he finds himself possessed of a peculiar fitness for work of all kinds and with freedom from the ordinary fatigue incidental to extra physical exertion. In using the word abstinence possibly a wrong impression is given, for the habits of life now followed have resulted in the disappearance of the ordinary craving for food. In other words, the gentleman in question fully satisfies his appetite, but no longer desires the amount of food consumed by most individuals.

"For a period of thirteen days, in January, he was under observation in the writer's laboratory, his excretions being analysed daily with a view to ascertaining the exact amount of proteid consumed. The results showed that the average daily amount of proteid metabolised was 41.25 grams, the body-weight (165 pounds) remaining practically constant. Especially noteworthy also was the very complete utilisation of the proteid food during this period of observation. It will be observed here that the daily amount of proteid food taken was less than one half that of the minimum Voit standard, and it should also be mentioned that this apparent deficiency in proteid food was not made good by any large consumption of fats or carbohydrates. Further, there was no restriction in diet. On the contrary, there was perfect freedom of choice, and the instructions given were to follow his usual dietetic habits. Analysis of the excretions showed an output of nitrogen equal to the breaking down of 41.25 grams of proteid per day, as an average, the extremes being 33.06 grams and 47.05 grams of proteid.

"In February, a more thorough series of observations was made, involving a careful analysis of the daily diet, together with analysis of the excreta, so that not alone the proteid consumption might be ascertained, but likewise the total intake of fats and carbohydrates. The diet consumed was quite simple, and consisted merely of a prepared cereal food, milk and maple sugar. This diet was taken twice a day for seven days, and was selected by the subject as giving sufficient variety for his needs and quite in accord with his taste. No attempt was made to conform to any given standard of quantity, but the subject took each day such amounts of the above foods as his appetite craved. Each portion taken, however, was carefully weighed in the laboratory, the chemical composition of the food determined, and the fuel value calculated by the usual methods.

"The following table gives the daily intake of proteids, fats and carbohydrates for six days, together with the calculated fuel value, and also the nitrogen intake, together with the nitrogen output through the excreta. Many other data were obtained showing diminished excretion of uric acid, ethereal sulphates, phosphoric acid, etc., but they need not be discussed here.

+-----+-----------------------------------------+---------------------+ | | | | | | Intake. | Output of Nitrogen. | | | | | | +--------+------+-------+--------+--------+------+-------+------+ | | | | | | | | | | | |Proteids| Fats |Carbohy|Calories|Nitrogen|Urine | Fæces |Total | | | | | | | | | | | +-----+--------+------+-------+--------+--------+------+-------+------+ | | Grams. |Grams.| Grams.| | Grams. |Grams.| Grams.|Grams.| | | | | | | | | | | |Feb 2| 31.3 | 25.3 | 125.4 | 900 | 5.02 | 5.27 | 0.18 | 5.45 | | 3| 46.8 | 40.4 | 266.2 | 1690 | 7.50 | 6.24 | 0.81* | 7.05 | | 4| 48.0 | 38.1 | 283.0 | 1747 | 7.70 | 5.53 | 0.81* | 6.34 | | 5| 50.0 | 40.6 | 269.0 | 1711 | 8.00 | 6.44 | 0.81* | 7.25 | | 6| 47.0 | 41.5 | 267.0 | 1737 | 7.49 | 6.83 | 0.81* | 7.64 | | 7| 46.5 | 39.8 | 307.3 | 1852 | 7.44 | 7.50 | 0.17 | 7.67 | | | | | | | | | | | +-----+--------+------+-------+--------+--------+------+-------+------+ |Daily| | | | | | | | | |Av. | 44.9 | 38.0 | 253.0 | 1606 | 7.19 | 6.30 | 0.60 | 6.90 | +-----+--------+------+-------+--------+--------+------+-------+------+ *Average of the four days.

"The main things to be noted in these results are, first, that the total daily consumption of proteid amounted on an average to only 45 grams, and that the fat and carbohydrate were taken in quantities only sufficient to bring the total fuel value of the daily food up to a little more than 1,600 large calories. If, however, we eliminate the first day, when for some reason the subject took an unusually small amount of food, these figures are increased somewhat, but they are ridiculously low compared with the ordinarily accepted dietary standards. When we recall that the Voit standard demands at least 118 grams of proteid and a total fuel value of 3,000 large calories daily, we appreciate at once the full significance of the above figures. But it may be asked, was this diet at all adequate for the needs of the body--sufficient for a man weighing 165 pounds? In reply, it may be said that the appetite was satisfied and that the subject had full freedom to take more food if he so desired. To give a physiological answer, it may be said that the body-weight remained practically constant throughout the seven days' period, and further, it will be observed by comparing the figures of the table that the nitrogen of the intake and the total nitrogen of the output were not far apart. In other words, there was a close approach to what the physiologist calls nitrogenous equilibrium. In fact, it will be noted that on several days the nitrogen output was slightly less than the nitrogen taken in. We are, therefore, apparently justified in saying that the above diet, simple though it was in variety, and in quantity far below the usually accepted requirement, was quite adequate for the needs of the body. In this connection it may be asked, what were the needs of the body during this seven days' period? This is obviously a very important point. Can a man on such a diet, even though it suffices to keep up body-weight and apparently also physiological equilibrium, do work to any extent? Will there be under such condition a proper degree of fitness for physical work of any kind? In order to ascertain this point, the subject was invited to do physical work at the Yale University Gymnasium and placed under the guidance of the director of the gymnasium, Dr. William G. Anderson. The results of the observations there made, are here given, taken verbatim from Dr. Anderson's report to the writer.

"'On the 4th, 5th, 6th and 7th of February, 1903, I gave to Mr. Horace Fletcher the same kind of exercises we give to the Varsity Crew. They are drastic and fatiguing and cannot be done by beginners without soreness and pain resulting. The exercises he was asked to take were of a character to tax the heart and lungs as well as to try the muscles of the limbs and trunk. I should not give these exercises to Freshmen on account of their severity.